Evidence based assessment/Instruments/Yale-Brown Obsessive Compulsive Scale
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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 the type of content of obsessions or compulsions present.
The scale is a clinician-rated, 10-item scale, each item rated from 0 (no symptoms) to 4 (extreme symptoms), yielding a total possible score range from 0 to 40. The scale includes questions about the amount of time the patient spends on obsessions, how much impairment or distress they experience, and how much resistance and control they have over these thoughts. The same types of questions are asked about compulsions (e.g., time spent, interference, etc.) as well. The results can be interpreted based on the total score:
- 0–7 is sub-clinical;
- 8–15 is mild;
- 16–23 is moderate;
- 24–31 is severe;
- 32–40 is extreme.
Patients scoring in the mild range or higher are likely experiencing a significant negative impact on their quality of life and should consider professional help in alleviating obsessive–compulsive symptoms.
A self-rated version of the Yale-Brown Obsessive-Compulsive Scale has been developed. The self-report and clinician-administered versions of the Y-BOCS are correlated to each other.
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 journal, "[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. 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.
Question breakdown, scoring, and interpretation
The 0-4 scale is broken down as follows:
- 0: none
- 1: mild
- 2: moderate
- 3: severe
- 4: extreme
While there is not and exact breakdown of scoring for neither the child report nor the parent report, it can be assumed that the higher the overall score on the test, the more severe the OCD. The following subscores can be used as a tentative reference:
- 0-7: subclinical severity of symptoms
- 8-15: mild symptoms
- 16-23: moderate symptoms
- 24-31: severe symptoms
- 32-40: extreme symptoms
Note that these subscales only suggest these levels of severity.
- Tables of screening tools and rating scales
- Self-report version of the CY-BOCS
- AACAP practice parameter for OCD
- Exposure and Response Prevention for OCD
- Cognitive Behavioral Therapy for OCD
- Acceptance and Commitment Therapy for OCD
- List of diagnostic classification and rating scales used in psychiatry
- Goodman W.K, Price L.H, Rasmussen S.A, et al. The Yale–Brown Obsessive–Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry 1989;46:1006–1011. PMID 2684084
- Rosario-Campos MC, Miguel EC, et.al The Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS): an instrument for assessing obsessive-compulsive symptom dimensions. Mol Psychiatry. 2006 May;11(5):495-504 PMID 16432526
- Garnaat SL, Norton PJ. Factor structure and measurement invariance of the Yale-Brown Obsessive Compulsive Scale across four racial/ethnic groups. J Anxiety Disord. 2010 May 24. PMID 20541907
- Federici A, Summerfeldt LJ, et. al Consistency between self-report and clinician-administered versions of the Yale-Brown Obsessive-Compulsive Scale.J Anxiety Disord. 2010 May 24. PMID 20561767
- 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.
- Yale–Brown Obsessive Compulsive Scale - Official paper version of Y-BOCS
- Yale OCD Research Clinic - Link to clinic where the Y-BOCS was developed
- Society of Clinical Child and Adolescent Psychology
- EffectiveChildTherapy.Org information on rule-breaking, defiance, and acting out