BRIEF REPORT: Functional Impairment in Childhood OCD: Development and Psychometrics Properties of the Child Obsessive-Compulsive Impact Scale-Revised (COIS-R)

Abstract

This article documents the development, factor structure, and psychometric properties of the parent- and youth-report forms of the Child Obsessive Compulsive Impact Scale-Revised (COIS-R), a measure of obsessive-compulsive disorder (OCD)-specific functional impairment. Using a sample of 250 youth (M age = 11.7, 54% male, 80% Caucasian) diagnosed with OCD in a university hospital-based child anxiety clinic, exploratory factor analysis was employed to develop a 4-factor structure for the parent-report measure (Daily Living Skills, School, Social, Family/Activities) and a 3-factor structure for the youth-report form (School, Social, Activities). Both measures demonstrated good internal consistency, concurrent validity, and test-retest reliability. Moreover, partial correlations demonstrated significant associations between COIS-R scales and clinician global assessment of functioning scores controlling for both symptom severity and comorbid internalizing and externalizing symptomatology. These findings suggest that the COIS-R may hold utility for assessing the specific impact of OCD symptoms on youth functioning.

Understudied Clinical Dimensions in Pediatric Obsessive Compulsive Disorder

“…However, avoidance maintains a child's anxiety over time [30] and disrupts the development of constructive strategies for mitigating fear [31]. Further, high levels of avoidance may be associated with severe functional impairment (e.g., school and peer avoidance) [32,33] and consequently marked accommodation [34,35] and disability. Although behavioral avoidance tasks [36,37] and other observation-based assays of avoidance may be ideal, there has been little application of such tasks to pediatric OCD; thus, the CY-BOCS (item 12) offers an efficient alternative.…”

“…The COIS-R-C/P [33] are child and parent report measures of the extent to which obsessive-compulsive symptoms cause impairment across the domains of school activities, social activities, home/family activities, and daily living skills. Respondents rate the extent to which OCD interferes with the child's functioning in each area using a 4-point scale ranging from ''not at all'' to ''very much.''…”

Obsessive–Compulsive Disorder

“…The COIS has demonstrated good internal consistency and construct validity (Piacentini et al, 2003), and be treatment sensitive (e.g., Piacentini et al, 2002). Piacentini, Peris, Bergman, Chang & Jaffer (2008) recently published a revised version of the instrument, the COIS-R. They found a fourfactor structure for the parent report version (Daily Living Skills, School, Social, Family/ Activities) and a three-factor structure for the youth-report form (School, Social, Activities).…”

Treatment of Perfectionism in Childhood Obsessive-Compulsive Disorder

“…Sensitivity to mistake as measured by the AMPS was related to decreased happiness, increased emotional difficulties, and decreased popularity in a nonclinical sample of children (Rice et al 2004). Children with OCD frequently experience problems with peer relationships, academic difficulties, and diminished quality of life (Lack et al 2009;Piacentini et al 2007). Difficulties associated with perfectionism, such as concern over mistake, may intensify these already challenging impairments.…”