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Nicki, an adolescent with OCD and chronic emotion dysregulation, was eating pizza with her mother and her mother's friend, Alex. Alex, who was unaware of Nicki's OCD, made a comment during dinner about the pizza's ingredients, a topic that triggers Nicki's OCD obsessions involving unjustified fears of contamination leading to illness/death. In response, Nicki's mother asked Alex to “please stop talking about the ingredients because it is going to upset Nicki.”