Which Is the Driver, the Obsessions or the Compulsions, in OCD?

The conventional view is that obsessive–compulsive disorder (OCD) is driven by irrational beliefs, which are a putative basis of obsessions. Compulsions are considered a coping mechanism, which neutralize anxiety or reduce the likelihood that these fears will be realized. Contrary to this view, recent data suggest that compulsions in OCD are a manifestation of a disruption in the neurobiologically well-defined balance between goal-directed action and automatic habits.

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