Which is the driver, the obsessions or the compulsions, in OCD?

Abstract

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 suggests that compulsions in OCD are a manifestation of a disruption in the neurobiologically well-defined balance between goal-directed action and automatic habits.