A 29-year-old female presents to the psychiatric clinic at 6 weeks postpartum. She reports persistent sadness, excessive worry about her infant's health, intrusive thoughts about accidental harm coming to the baby, difficulty sleeping even when the baby is sleeping, poor appetite, and feelings of guilt about not being a good enough mother. She tearfully reports that she frequently checks on the baby multiple times an hour to make sure the infant is breathing and has been unable to let anyone else hold the baby. She denies thoughts of intentionally harming the baby or herself. Her Edinburgh Postnatal Depression Scale score is 18. She has a history of generalized anxiety disorder prior to pregnancy. Which assessment finding most accurately characterizes the nature of her intrusive thoughts and informs diagnostic differentiation?