Trigger Hierarchy

A ranked list of situations, objects, or thoughts that trigger OCD anxiety, ordered from least to most distressing as measured by subjective distress ratings (SUDS). Trigger hierarchies are a foundational tool in Exposure and Response Prevention therapy, guiding the gradual progression of exposure exercises. Research shows that trigger intensity is influenced not just by the type of trigger but by its specific properties (size, proximity, texture, familiarity) and the person's internal state (stress level, fatigue), suggesting that effective hierarchies need more nuanced characterization than traditional clinical checklists provide.