What is the defining feature of Obsessive-Compulsive Disorder in youth?

• A. Recurrent obsessions and/or compulsions that are time-consuming or cause distress/impairment
• B. Chronic euphoria and grandiosity
• C. Persistent sadness lasting most days
• D. Avoidance of social situations

Answer: (A)

The defining feature is having intrusive, unwanted thoughts, urges, or images (obsessions) and/or repetitive behaviors or mental acts performed to reduce that distress (compulsions) that take up a lot of time or cause clear distress or impairment in daily life. In youth, you might see rituals like excessive washing, repeated checking, or strict routines tied to fears of contamination or harm. The important piece is that these obsessions or compulsions are not simply annoying; they consume time—often many hours a day—or disrupt school, friendships, or family functioning, and the child recognizes them as excessive or distressing.

Other options describe mood or social disorders rather than the specific pattern of intrusive thoughts and ritualized actions seen in OCD. For example, chronic euphoria and grandiosity point to mania, persistent sadness points to depression, and avoiding social situations points to social anxiety.