Over the past six months, Emily has been excessively washing her hands, often for 20–30 minutes at a time, up to 20 times a day. She becomes visibly anxious if unable to wash her hands after touching common objects, such as doorknobs, desks, or shared school supplies.

Emily reports that she constantly worries about germs and contamination, even though she understands that her fears may be excessive. These intrusive thoughts are distressing and lead her to perform rituals, such as repeated handwashing, to reduce her anxiety.

Emily’s parents initially thought she was simply being cautious but became concerned when her behaviors became more extreme and she started missing school due to distress. Teachers noticed she was frequently leaving class to wash her hands and had difficulty finishing assignments on time.

Emily was started on Cognitive Behavioral Therapy (CBT) with a focus on Exposure and Response Prevention (ERP). She and her therapist worked together to gradually expose her to feared situations (e.g., touching a doorknob) without engaging in the compulsive response (handwashing). Her parents were involved in the therapy to help reinforce progress at home. Medication (SSRI – fluoxetine) was also introduced at a low dose after psychiatric evaluation.

Questions:

1. Which of the following is an example of a compulsion Emily exhibited?

A. Fear of germs 

B. Avoiding schoolwork 

C. Feeling sad 

D. Handwashing rituals

2. Which of the following best describes an obsession?
A. Repetitive physical action
B. Unwanted, intrusive thought
C. Avoidance behavior
D. Mood swings

3. Why did Emily’s OCD interfere with her school performance?
A. She was bullied
B. She lacked motivation
C. Her compulsions consumed a lot of time
D. She disliked her teachers

Correct Answers:

1. D

2. B

3. C