compulsivity

Compulsivity is a psychological construct referring to the tendency to perform repetitive, ritual-like behaviors or mental acts in response to an urge, distress, or perceived threat, with the aim of reducing anxiety or preventing a feared event. These actions are often excessive, time-consuming, and disengaged from the individual's long-term goals, and may persist despite awareness of their irrational nature.

In clinical settings, compulsivity is a core feature of obsessive-compulsive disorder, where individuals experience obsessions that provoke anxiety and compulsions that temporarily relieve it, such as cleaning, checking, or ordering. Compulsivity also appears as a dimension across other conditions, including body-focused repetitive behaviors (nail biting, hair pulling), gambling and other behavioral addictions, certain eating disorders, substance-use disorders, and autism spectrum disorders.

Neurobiologically, compulsivity is linked to dysfunction in cortico-striatal-thalamo-cortical circuits, particularly involving the orbitofrontal cortex, anterior cingulate, and striatum. Neurotransmitter systems such as dopamine and serotonin modulate these circuits, and problems with cognitive control and habit formation can bias behavior toward compulsive acts even when they are maladaptive.

Assessment relies on structured interviews and rating scales (for example, the Yale-Brown Obsessive-Compulsive Scale, Obsessive-Compulsive Inventory-Revised), which quantify obsessions and compulsions and their impact on functioning.

Treatment combines cognitive-behavioral therapy, especially exposure and response prevention, with pharmacotherapy (typically selective serotonin reuptake inhibitors). In severe or treatment-resistant cases, neuromodulation and other techniques may be employed; relapse prevention and addressing comorbidities are important.