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1, Obsession - recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress 2, Obsession - the thoughts, impulses, or images are simply excessive worries about real-life problems 3, Obsession - the person attempts to ignore or suppress such thoughts, impulses or images, or to neutralize them with some other thought or action 4, Obsession - the person recognizes that the obsessional thoughts, impulses, or images are the product of his or her own mind (not imposed from without as in thought insertion) 5, Compulsion - repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly 6, Compulsion - the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive 7, At some point during the course of the disorder, the person has recognized that the obsession or compulsion are excessive or unreasonable 8, The obsessions or compulsions cause marked distress, are time-consuming (take more than one hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships 9, If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of Eating Disorder, hair pulling in the presence of Trichotillomania; concern about appearance in the presence of Body Dismorphic Disorder; preoccupation of drugs in the presence of Substance Use Disorder, preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder) 10, The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.