Clinical Correlates and Treatment Response of the Yale-Brown Obsessive Compulsive Scale Auxiliary Items

Abstract

The current study examined clinical correlates and treatment response as they relate to auxiliary clinical characteristics (i.e., insight; avoidance; indecisiveness; sense of responsibility; pervasive slowness; pathological doubt; duration of obsession-free and compulsion-free intervals) in 172 adults with OCD. A trained evaluator administered the Yale-Brown Obsessive Compulsive Scale and the Anxiety Disorders Interview Schedule for DSM-IV. As well, patients completed the Obsessive Compulsive Inventory-Revised; Beck Depression Inventory-Second Edition; State-Trait Anxiety Inventory; RAND 36-Item Health Survey; and Sheehan Disability Scale. Results indicated numerous associations between auxiliary OCD features and both depressive and anxious symptoms as well as impaired health and functioning. All auxiliary features, excluding insight, were reduced following cognitivebehavioral therapy. In particular, changes in symptom-free intervals; avoidance; and indecisiveness were most reliably associated with reductions in core OCD features. The lack of a relationship with insight did not come as a surprise, as insight is considered a relatively stable construct in those with OCD. Implications of these findings in the assessment and treatment of patients with OCD are highlighted.

Behavioral avoidance predicts treatment outcome with exposure and response prevention for obsessive-compulsive disorder

“…The second used logistic regression to predict posttreatment wellness (a state characterized by remission of OCD symptoms as indicated by YBOCS ≤ 12). Both models controlled for baseline YBOCS severity because the YBOCS avoidance item is positively associated with overall severity (Reid et al, 2011). To test the specificity of the avoidance–outcome relationship to EX/RP we reran these analyses in the risperidone and placebo groups separately.…”

“…However, the original YBOCS does include an assessment of avoidance behavior among its auxiliary items (which are often overlooked in research; Reid, Storch, & Murphy, 2011). For this avoidance assessment, raters ask patients to rate the extent to which they have been avoiding places, situations, or people because of obsessional thoughts or the need to perform compulsions.…”

Development and psychometric evaluation of the Yale–Brown Obsessive-Compulsive Scale—Second Edition.

“…However, we found that the obsession-free interval item allowed for improved assessment of the time burden imposed by obsessions and therefore have included it in the Y-BOCS–II. Empirical evidence for this includes moderate correlations between this item and functional impairment (Reid, Storch, & Murphy, 2009).…”

Patient-reported outcomes in obsessive-compulsive disorder

“… 19 Disability was correlated with insight with regards to OCD, 28 as was the degree of avoidance and pathological doubting. 29 Occupational disability was also associated with poorer social functioning. 30 The Social Adjustment Scale (SAS)-non family score (excludes marital and family functioning score) was significantly associated with hostility expressed by patient's relatives.…”