Have you experienced unpleasant thoughts or mental images that repeatedly reached your mind, regarding the following matters? See below...

1 - The fear of being contaminated (filth, germs, radiations) or getting AIDS?
Yes   |   No

2 - The concern for perfect order of things (clothes, tools, food, etc.)?
Yes   |   No

3 - Images of death or terrible events?
Yes   |   No

4 - Unacceptable and immoral thoughts?
Yes   |   No

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Have you been worried or afraid for some events, such as...

5 - Fires, floodings or thefts?
Yes   |   No

6 - Running down a person with our car?
Yes   |   No

7 - Spreading a disease (for example AIDS)?
Yes   |   No

8 - Losing something valuable?
Yes   |   No

9 - Causing pain to another person because of your neglectful behaviour?
Yes   |   No

10 - Ceding to a sudden impulse, such as the impulse to hurt a beloved person, to push someone on the bus, to perform a dangerous act with your car, to do something sexually inappropriate or to poison your guests?
Yes   |   No

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Have you experienced the need to repeat some behaviours, such as...

11 - The ritual cleaning of your clothes, of your house or of your body?
Yes   |   No

12 - Checking switches, taps, dishware, door locks, safety devices?
Yes   |   No

13 - Counting and/or re-arrange objects, waking up at night to repeat activities already performed during the day?
Yes   |   No

14 - Keeping useless objects or inspecting the garbage before throwing it away?
Yes   |   No

15 - Repeating routine actions (sitting down and standing up, passing through doors, lighting up the cigarette again) more than one time until it's enough?
Yes   |   No

16 - Touching objects or people?
Yes   |   No

17 - Reading and writing the same things over and over, opening and closing envelopes?
Yes   |   No

18 - Examining your body for illnesses?
Yes   |   No

19 - Avoiding specific colors ("red" symbolizes blood), numbers ("13" is unlucky), or names (those that start with D of "Death") that are associated with unpleasant memories or experiences?
Yes   |   No

20 - Feeling a strong need to "confess" something or to be reassured that your thoughts and ideas are right?
Yes   |   No


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Referring to behaviours described above:


21 - Averagely, how much time do these behaviours and thoughts occupy in your life, daily?
None   |   0 - 1 hours   |   1 - 3 hours   |   3 - 8 hours   |   More than 8 hours

22 - How much distress do they cause you?
None   |   Little   |   Moderate   |   Much   |   Very much

23 - How much do they negatively influence your work, your tasks, your relationships with other people?
Not at all   |   Little   |   Enough   |   Much   |   Very much

24 - How much control do you have on them?
Complete control   |   High control   |   Moderate control   |   Modest control   |  No control

25 - Do they cause you to avoid tasks, appointments, meetings, parties?
Never   |   Rarely   |   Sometimes   |   Frequently   |   Always