Obsessive-Compulsive and Related Disorders: A Critical Review of the New Diagnostic Class
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The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders includes a new class of obsessive-compulsive and related disorders (OCRDs) that includes obsessive-compulsive disorder (OCD) and a handful of other putatively related conditions. Although this new category promises to raise awareness of underrecognized and understudied problems, its empirical validity and practical utility are questionable. This article reviews the phenomenology of OCD and then presents a critical analysis of the arguments underlying the new OCRD class. This analysis leads to a rejection of the OCRD classification on both scientific and logical grounds. The article closes with a discussion of the treatment implications of the OCRDs approach.
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OCD patients have varying degrees of insight into obsessions and compulsions, with some having good or fair insight, others poor insight, and even absent insight/delusional beliefs.
“The DSM‐5 includes a specifier about the level of insight into obsessions and compulsions (i.e., awareness of their senselessness); it recognizes that OCD patients have varying degrees of insight, with some patients having good or fair insight whereas others poor insight and even absent insight/delusional beliefs (Abramowitz & Jacoby, 2015).”
From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Abramowitz & Jacoby, 2015
The lack of association of acting with awareness with OCD symptoms may reflect that compulsions in OCD are not best understood as automatic, habitual behaviours carried out with little awareness, but rather as functional behaviours aimed at reducing anxiety.
“The lack of association possibly reflects that compulsions in OCD are perhaps not best understood as automatic, habitual behaviours carried out with little awareness, but rather as functional behaviours aimed at reducing anxiety (Abramowitz and Jacoby 2015).”
From The Association of Trait Mindfulness and Self-compassion with Obsessive-Compulsive Disorder Symptoms: Results from a Large Survey with Treatment-Seeking Adults (2020) · cites this paper as Abramowitz and Jacoby 2015
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Şimşek, M. K., & Seçer, İ. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.805035 · Cited by 3 · see citing works
Is ACT-Informed Exposure a Viable Treatment for Excoriation Disorder? A Multiple Baseline Study
Thompson, B. L. (2022) · Behavior Modification · doi:10.1177/01454455221091778 · Cited by 3 · see citing works
Sica, C., Caudek, C., Colpizzi, I., Malerba, A., & Bottesi, G. (2023) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2023.11.002 · Cited by 2 · see citing works
Vera, B. P., Doron, G., İnözü, M., López, F. J. G., & Belloch, A. (2025) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe15070135 · Cited by 2 · see citing works
Choi-Kain, L. W., Rodriguez-Villa, A. M., Ilagan, G. S., & Iliakis, E. A. (2021) · Cambridge University Press eBooks · doi:10.1017/9780511846403.010 · Cited by 2 · see citing works
Obsessive-compulsive disorder: conceptual and clinical aspects
Borges, V. F. (2023) · Concilium · doi:10.53660/clm-901-23b48 · Cited by 2 · see citing works
- Authors
- Abramowitz, J. S., & Jacoby, R. J.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Annual Review of Clinical Psychology
- Publisher
- Annual Reviews
- Published
- 2015-03-28
- Volume
- 11
- Issue
- 1
- Pages
- 165-186
- ISSN
- 1548-5943 (ISSN-L)
- 1548-5951
- OpenAlex
- W2137719365
- Cited by
- 185
- References
- 107
- Citations by year
- 2026: 14 · 2025: 11 · 2024: 12 · 2023: 21 · 2022: 19 · 2021: 34 · 2020: 10 · 2019: 16 · 2018: 11 · 2017: 16 · 2016: 17 · 2015: 4
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annual Review of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- obsessive-compulsive and related disorders, obsessive-compulsive disorder, DSM-5, psychiatric classification, diagnostic validity, therapeutic implications
- MeSH terms
- Hoarding Disorder, Humans, Obsessive-Compulsive Disorder, Trichotillomania, Diagnostic and Statistical Manual of Mental Disorders, Body Dysmorphic Disorders
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