Yale–Brown Obsessive Compulsive Scale
The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) is a test to rate the severity of obsessive–compulsive disorder (OCD) symptoms.
The scale, which was designed by Wayne K. Goodman and his colleagues, is used extensively in research and clinical practice to both determine severity of OCD and to monitor improvement during treatment. This scale, which measures obsessions separately from compulsions, specifically measures the severity of symptoms of obsessive–compulsive disorder without being biased towards or against the type of content the obsessions or compulsions might present. Following the original publication the total score is usually computed from the subscales for obsessions (items 1-5) and compulsions (items 6-10) but other algorithms exist.
Accuracy and modifications
Goodman and his colleagues have developed the Yale-Brown Obsessive-Compulsive Scale—Second Edition (Y-BOCS-II) in an effort to modify the original scale which, according to Goodman, "[has become] the gold standard measure of obsessive-compulsive disorder (OCD) symptom severity". In creating the Y-BOCS-II, changes were made "to the Severity Scale item content and scoring framework, integrating avoidance into the scoring of Severity Scale items, and modifying the Symptom Checklist content and format". After reliability tests, Goodman concluded that "Taken together, the Y-BOCS-II has excellent psychometric properties in assessing the presence and severity, of obsessive-compulsive symptoms. Although the Y-BOCS remains a reliable and valid measure, the Y-BOCS-II may provide an alternative method of assessing symptom presence and severity."
Studies have been conducted by members of the Iranian Journal of Psychiatry & Clinical Psychology to determine the accuracy of the Yale–Brown Obsessive Compulsive Scale (specifically as it appears in its Persian format). The members applied the scale to a group of individuals and, after ensuring a normal distribution of data, a series of reliability tests were performed. According to the authors, "[the] results supported satisfactory validity and reliability of translated form of Yale-Brown Obsessive-Compulsive Scale for research and clinical diagnostic applications".
The children's version of the Y-BOCS, or the Children's Yale–Brown Obsessive Compulsive Scales (CY-BOCS), is a clinician-report questionnaire designed to assess symptoms of obsessive compulsive disorder from childhood through early adolescence.
The CY-BOCS contains 70 questions and takes about 15–25 minutes. Each question is designed to ask about symptoms of obsessive compulsive behavior, though the exact breakdown of questions is unknown[how?]. For each question, children rate the degree to which the question applies on a scale of 0-4. Based on research, this assessment has been found to be statistically valid and reliable, but not necessarily helpful.
The CY-BOCS has been adapted into several self- and parent-report versions, designed to be completed by parent and child working together, although most have not been psychometrically validated. However, these versions still ask the child to rate the severity of their obsessive compulsive behaviors and the degree to which each has been impairing. While this measure has been found to be useful in a clinic setting, scores and interpretations are taken with a grain of salt, given the lack of validation.
Another version, which is parent-focused, is similar to the original CY-BOCS and is administered to both parent and child by the clinician. This version was distributed by Solvay Pharmaceuticals in the late 1990s, creating an association between the measure and a number of pharmaceutical groups that has caused it to be avoided by most clinicians. Severity cutoff scores for this version have not been empirically determined.
- Goodman, W.K; Price, L.H; Rasmussen, S.A; et al. (1989). "The Yale–Brown Obsessive–Compulsive Scale. I. Development, use, and reliability". Arch Gen Psychiatry. 46 (11): 1006–1011. doi:10.1001/archpsyc.1989.01810110048007. PMID 2684084.
- Rosario-Campos, MC; Miguel, EC; et al. (May 2006). "The Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS): an instrument for assessing obsessive-compulsive symptom dimensions". Mol Psychiatry. 11 (5): 495–504. doi:10.1038/sj.mp.4001798. PMID 16432526.
- Garnaat, SL; Norton, PJ (2010). "Factor structure and measurement invariance of the Yale-Brown Obsessive Compulsive Scale across four racial/ethnic groups". J Anxiety Disord. 24 (7): 723–8. doi:10.1016/j.janxdis.2010.05.004. PMC 2922480. PMID 20541907.
- Kim, Suck Won; Dysken, Maurice W.; Pheley, Alfred M.; Hoover, Kathleen M. (1994). "The Yale-Brown Obsessive-Compulsive Scale: Measures of internal consistency". Psychiatry Research. 51 (2): 203–211. doi:10.1016/0165-1781(94)90039-6.
- Storch, E. A.; Larson, M. J.; Goodman, W. K.; Rasmussen, S. A.; Price, L. H.; Murphy, T. K. (2010). "Development and Psychometric Evaluation of the Yale-Brown Obsessive-Compulsive Scale—Second Edition". Psychological Assessment. 22 (2): 223–232. doi:10.1037/a0018492. PMID 20528050.
- Esfahani, S.; Motaghipour, Y.; Kamkari, K.; Zahiredin, A.; Janbozorgi, M. (2012). "Reliability and Validity of the Persian Version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). (English)". Iranian Journal of Psychiatry & Clinical Psychology. 17 (4): 297–303.
- Goodman, WK; Price, LH; Rasmussen, SA; Mazure, C; Fleischmann, RL; Hill, CL; Heninger, GR; Charney, DS (November 1989). "The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability". Archives of General Psychiatry. 46 (11): 1006–11. doi:10.1001/archpsyc.1989.01810110048007. PMID 2684084.
- Gallant, J; Storch, EA; Merlo, LJ; Ricketts, ED; Geffken, GR; Goodman, WK; Murphy, TK (December 2008). "Convergent and discriminant validity of the Children's Yale-Brown Obsessive Compulsive Scale-Symptom Checklist". Journal of Anxiety Disorders. 22 (8): 1369–76. doi:10.1016/j.janxdis.2008.01.017. PMID 18329843.
- Piacentini, J; Langley, A; Roblek, T (2007). Cognitive-Behavioral Treatment of Childhood OCD: It's Only a False Alarm Therapist Guide. Oxford University Press. ISBN 9780195310511.
- Piacentini, J; Bergman, RL; Chang, S; Langley, A; Peris, T; Wood, JJ; McCracken, J (November 2011). "Controlled comparison of family cognitive behavioral therapy and psychoeducation/relaxation training for child obsessive-compulsive disorder". Journal of the American Academy of Child and Adolescent Psychiatry. 50 (11): 1149–61. doi:10.1016/j.jaac.2011.08.003. PMC 3205429. PMID 22024003.
- Geller, Daniel A.; March, John; AACAP Committee on Quality Issues (January 2012). "Practice Parameter for the Assessment and Treatment of Children and Adolescents With Obsessive-Compulsive Disorder". Journal of the American Academy of Child & Adolescent Psychiatry. 51 (1): 98–113. doi:10.1016/j.jaac.2011.09.019. PMID 22176943.
- Yale–Brown Obsessive Compulsive Scale - Archived Official Paper Version of Y-BOCS
- Yale OCD Research Clinic - Link to clinic where the Y-BOCS was developed
- Tables of screening tools and rating scales
- Self-report version of the CY-BOCS
- Exposure and Response Prevention for OCD
- Cognitive Behavioral Therapy for OCD
- Acceptance and Commitment Therapy for OCD
- Society of Clinical Child and Adolescent Psychology
- EffectiveChildTherapy.Org information on rule-breaking, defiance, and acting out