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

Abstract

The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; Goodman, Price, Rasmussen, Mazure, Delgado, et al., 1989) is acknowledged as the gold standard measure of obsessive-compulsive disorder (OCD) symptom severity. A number of areas where the Y-BOCS may benefit from revision have emerged in past psychometric studies of the Severity Scale and Symptom Checklist. Therefore, we created the Yale-Brown Obsessive-Compulsive Scale-Second Edition (Y-BOCS-II) by revising 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. One hundred thirty treatment-seeking adults with OCD completed a battery of measures assessing OCD symptom severity and typology and depressive and anxious symptomology. Interrater and test-retest reliability were assessed on a subsample of participants. The Y-BOCS-II showed strong internal consistency for the Symptom Checklist (Kuder-Richardson-20 = .91) and Severity Scale (alpha = .89). Test-retest and interrater reliabilities were both high (intraclass correlations > .85). Confirmatory factor analyses did not show adequate fit with previous models of the Y-BOCS. Exploratory factor analysis revealed a two-factor solution generally consistent with the Obsession and Compulsion Severity subscales. Construct validity was supported by strong correlations with clinician-rated measures of OCD symptom severity and moderate correlations with measures of worry and depressive symptoms. 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.

Validation of the Italian version of the Yale–Brown Obsessive Compulsive Scale–Second Edition (Y-BOCS-II) in a clinical sample

“…In other patients, rituals may be motivated by disgust rather than fear [13,14]. Accordingly, the Y-BOCS-II-SC has been modified to allow for empirical research aimed at understanding the clinical significance of these distinctions [6].…”

“…Third, the Likert type response format was expanded from a 5-point (0-4) to a 6-point (0-5) scale so that the upper limit on the total Y-BOCS-II-SS is 50 instead of 40. This review is based on the lack of sensitivity to change of the scale at high levels of symptom severity [6]. Finally, in the Y-BOCS-II, modifications have been made in the content and format of the Symptom Checklist.…”

“…For example, (1) The "resistance against obsessions" item is only weakly associated with the Y-BOCS Severity Scale; (2) the Y-BOCS is potentially insensitive to slight treatment changes, (3) the Y-BOCS lacks an avoidance rating scale, and (4) some of the items on the Symptom Checklist are ambiguous. To address these issues, the Y-BOCS was revised, resulting in a second version of the scale (i.e., Y-BOCS-II) [6].…”

Mindfulness-based exposure and response prevention for obsessive compulsive disorder: Findings from a pilot randomised controlled trial

“…The YBOCS-II is a measure of OCD symptom severity and has excellent indices of reliability and validity (Storch et al, 2010). The overall score for YBOCS-II varies between 0 and 50 with ten items, each rated on a 0-5 scale, with higher scores indicating greater OCD symptom severity.…”

Trauma, Symptomology, and Meaning in Life: A Comparison Between Clinical Samples and Healthy Controls

“…Severity of obsessions and compulsions are rated separately (5 items for each scale which measure distress, frequency, interference, symptom control, and resistance; Storch et al, 2005). After its development in 1989, the YBOCS-SR has been considered the gold standard for measurement of OCD symptoms (Storch et al, 2010). Scores for obsessions and compulsions range from 0 to 20 (maximum total score is 40).…”