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 ___________________________________________________________________ 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 ___________________________________________________________________ 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
___________________________________________________________________ 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