Running head: REVIEW OF YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) 1

Paul L. Calabrese

March 29, 2019

Review of YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS)

1. Title of Instrument

Review of YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS)

2. Publisher and publisher’s URL

https://psychology-tools.com/test/yale-brown-obsessive-compulsive-scale

3. Authors

This assessment was developed by the psychiatrist and researcher “Wayne Goodman” and

his colleagues (Goodman, 2018).

4. Publication Date/History/Revisions/Revisions being considered

The publication date is 1989. This assessment is “used extensively in research and

clinical practice to both determine severity of OCD and to monitor improvement during

treatment (Goodman, 2018).

5. Purpose and Recommended Use

The purpose of this assessment is to “rate the severity and type of symptoms in patients

with obsessive compulsive disorder (OCD)” (Obsessive-Compulsive Test - Yale Brown OCD

Scale). “In general, the items depend on the patient’s report; however, the final rating is based

on the clinical judgement of the interviewer” (YALE-BROWN OBSSEIVE COMPULSIVE

SCALE).

6. Examiner/test administrator Qualifications

Running head: REVIEW OF YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) 2

This assessment must be administered by a clinician or trained interviewer. The

assessment instrument is used for the general adult population with “a very similar version for

children (CY-BOCS)” (Bejerot, 2014) which was introduced in 1997. “The Yale-Brown

Obsessive-Compulsive Scale (Y-BOCS) is regarded as the gold standard (4, 5)” (Bejerot, 2014).

“A second edition of the Y-BOCS (Y-BOCS-II) differed from the origin by including

assessments of obsessive-compulsive free intervals and extent of avoidance (9).” (Bejerot,

2014).

7. Target Population

There is an adult version and a child’s version of this assessment. The child’s version

which is called the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) is designed

to rate the severity of obsessive and compulsive symptoms in children and adolescents, ages 6 to

17 years.

8. Available Forms

The YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) is available for free

online at the International OCD Foundation located at www.iocdf.org.

9. Current Cost Information

My research found no price associated with the acquisition of the YALE-BROWN

OBSESSIVE COMPULSIVE SCALE (Y-BOCS) in all its versions. They can be downloaded

from various internet websites such as www.novopsych.com, etc.

10. Normative Data – demographics and size of norm group

In a study conducted by (Castro-Rodrigues, et.al. 2018), “Eligibility was assessed in 223

participants, recruited either at the Champalimaud Clinical Centre or Centro Hospitalar

Psiquiátrico de Lisboa. Patients with a clinical diagnosis of OCD (n = 60) were referred to the
Running head: REVIEW OF YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) 3

study by attending psychiatrists and psychologists, while control patients with other psychiatric

diagnoses (n = 35) were selected randomly from the institutional databases at each institution. A

convenience sample of 128 healthy community dwelling subjects was also recruited at each of

the two institutions” (Castro-Rodrigues, et.al. 2018).

11. Reliability and Validity Information

In terms of reliability and validity, a study entitled “Reliability and Validity of the Yale-

Brown Obsessive-Compulsive Scale” (Wood, et al. 1994) states that “according to a multi-trait

multi-method approach in a sample of 54 outpatients with obsessive-compulsive disorder (OCD),

… [i]nternal consistency was acceptable but improved by deletion of items concerning resistance

to obsessions and compulsions. Inter-relater reliability was excellent, but test-retest reliability

over an average interval of 48.5 days was lower than desirable.” (Woody, et al., 1994).

12. Scoring options and procedures

In a study using the second edition of the Yale-Brown Obsessive-Compulsive Scale,

the study described the procedure that they used. The study states that “[a]ll participants

provided informed consent as approved by the respective institutional review board at each

institution. All participants completed an initial assessment that included a semi-structured

interview with an experienced psychologist and administration of the Y-BOCS–II by a trained

masters- or doctoral-level clinician.” (Storch, 2010). Regarding the scoring options, this study

provides a detailed description of the data analysis.

13. Administration procedures and requirements

In the study completed in the essay called “Development and Psychometric Evaluation of

the Yale–Brown Obsessive-Compulsive Scale—Second Edition” (Storch, 2010), the procedure

Running head: REVIEW OF YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) 4

demanded that “[a]ll participants provided written informed consent as approved by the

respective institutional review board at each institution.” (Storch, 2010).

14. Manual availability

The Yale–Brown Obsessive-Compulsive Scale manual is available online at the website

of the International OCD Foundation at the following website: www.iocdf.org. I was able to

find it at the following link: https://iocdf.org/wp-content/uploads/2014/08/Assessment-Tools.pdf

15. Language availability

In terms of the language availability of the Yale-Brown Obsessive-Compulsive Scale, I

found, by doing an internet search, that this assessment is available in many languages including

Italian (Melli, Gabriele et. al., 2015), Portuguese (Castro-Rodrigues et. al., 2018), Spanish, and

French. I was unable to locate downloadable versions of the assessment in these languages, but

only reviews of these different language versions.

16. Time requirements and considerations

Given the brevity of the Yale-Brown Obsessive-Compulsive Scale, the completion time

for this assessment is thirty minutes to an hour.

17. Types of specific activities, questions used, items on the test

The questions on this assessment are basic questions that require a patient to answer

honestly about their obsessive thoughts and compulsive activities. The assessment consists of

ten questions with five responses that change depending on the questions of which the first three

questions are as follows: None (0 points), Mild, less than 1 hour per day (1 point), Moderate, 1-3

hours per day (2 points). Severe, 3-8 hours per day (3 points), and Extreme, more than 8 hours

per day (4 points). Some of the questions on this assessment are as follows:

1. “How much of your time is occupied by obsessive thoughts?”

Running head: REVIEW OF YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) 5

2. “How much do your obsessive thoughts interfere with functioning in your social, work or

other roles?”

3. “How much distress do your obsessive thoughts cause you?”

18. Strengths and limitations

As in many assessment instruments, the Yale-Brown Obsessive-Compulsive

Scale has “demonstrated problematic psychometric properites” (Anholt, 2010). In a study

entitled “The Yale-Brown Obsessive-Compulsive Sale: Factor Structure of a Large Sample”

(Anholt, 2010), the authors explain that the assessment “is a semi-structured interview that

consists of 10 core items, 5 measuring time, interference, distress, resistance and control of

obsessions (items: 1–5), and 5 identical items measuring compulsions (items: 6–10).” .

19. State any controversies or problems associated with this type of assessment.

In the previous question discussing strengths and limitations, the controversy was

discussed about the resistance items used in the Yale-Brown Obsessive-Compulsive Scale that

“demonstrated problematic psychometric properties and lower correlations to the Y-BOCS total

scores” (Anholt, 2010).

20. What is available as supplemental resources for this instrument

In a study entitled “Deep brain stimulation for severe treatment-resistant

obsessive-compulsive disorder: An open-label case series,” (Farrand, Sarah, 2017), the primary

objective of the paper was to describe the outcome of the research that utilized the Yale-Brown

Obsessive Compulsive Scale as a measure of symptom severity to assess the response to deep

brain stimulation treatment. As supplemental resources for this instrument, “[r]ating scales used

[also] included . . . Obsessive Compulsive Inventory, Depression Anxiety Stress Scale and Social

and Occupational Functioning Assessment Scale” (Farrand, Sarah, 2017).

Running head: REVIEW OF YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) 6

21. Expert reviews

In “The Yale-Brown Obsessive Compulsive Scale: A Reliability Generalization Meta-

Analysis” (López-Pina, et. A., 2015), the authors conclude that their research “results pose into

question the general adequacy of the Y-BOCS in terms of its reliability when this instrument is

administered with clinical purposes, especially because the mean coefficient alpha was under

0.90” (López-Pina, et. A., 2015).

22. Your experience with this instrument

I chose this test because I have an older brother who struggles with OCD. Therefore,
I had him take the test, and it matched his current mental state. The test showed that as an
individual’s points become higher, it is a clear that clinical help is necessary with both a trained
therapist and a psychiatrist to provide the proper medicine to help the individual cope with OCD
until his mental state reaches a low level of OCD.

23. Any other information that is relevant and/or interesting

During my research I was able to find online resources available at the International OCD
Foundation are useful for anyone seeking to get more information on this mental

disorder. “From training and educational opportunities to networking, the IOCDF has much to
offer the mental health professional community” (International OCD Foundation).

24. Your personal evaluation of the limitations and advantages

My personal evaluation of the limitations and advantages of this assessment is that the

client needs to be completely honest in their answers for this assessment to be a true

measurement of their mental state. I believe that there are limitations in the Y-BOCS in that
Running head: REVIEW OF YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) 7

there may be clients whose OCD can manifest itself in the activity of taking the assessment

itself.
Running head: REVIEW OF YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) 8

25. References you used to prepare this review (APA format).

References

Anholt, Gideon E., Oppen, Patricia van, Cath, Danielle C., Smit, Johannes H., Boer,

Johan A. den, Verbraak, Marc J. P. M, & Balkom, Anton J. L. M. van. (2010). The

Yale-Brown Obsessive-Cumpulsive Scale: Factor Structure of a Large Sample. Front

Psychiatry. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059660/

Bejerot S, Edman G, Anckars ä ter H, Berglund G, Gillberg C, Hofvander B, Humble MB, M ö

rtberg E, R å stam M, St å hlberg O, Fris é n L. The Brief Obsessive – Compulsive Scale

(BOCS): A self-report scale for OCD and obsessive – compulsive related disorders. Nord

J Psychiatry 2014;68:549 – 559. Retrieved from

https://www.tandfonline.com/doi/pdf/10.3109/08039488.2014.884631.

Castro-Rodrigues, Pedro, Camacho, Marta, Almeida, Silvia, Marinho, Soares, Mónica Marinho

Catarina, Barahona-Corrê, J. Bernardo, & Oliveira-Maia, Albino J. (2018). Criterion

Validy of the Yale-Brown Obsessive-Compulsive Scale Second Edition for Diagnosis of

Obsessive-Compulsive Disorder in Adults. Retrived from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141833/pdf/fpsyt-09-00431.pdf.

Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). (2007). Retrieved from

https://iocdf.org/wp-content/uploads/2016/04/05-CYBOCS-complete.pdf .

Farrand, Sarah; Evans, Andrew H; Mangelsdorf, Simone; Loi, Samantha M; Mocellin, Ramon;

Borham, Adam; Bevilacqua, JoAnne; Blair-West, Scott; Walterfang, Mark A; Bittar,

Richard G; Velakoulis, Dennis (2017). Deep brain stimulation for severe treatment-

resistant obsessive-compulsive disorder: An open-label case series. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/28965430
Running head: REVIEW OF YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) 9

Goodman, Wayne. What Causes Obsessive-Compulsive Disorder (OCD). (2018). Retrieved

from https://psychcentral.com/disorders/ocd/what-causes-obsessive-compulsive-disorder-

ocd/.

Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., et al., The Yale-Brown Obsessive

Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. (1989).

46(11): p. 1006-11.

International OCD Foundation. (n.d.). Retrieved from https://iocdf.org/

López-Pina, José Antonio, Sánchez-Meca, Julio, López- López, José Antonio, Marín-Martínez,

Fulgencio, Núñez-Núñez, Rosa Maria, Rosa-Alcázar, Ana I., Gómez-Conesa, Antonia, &

Ferrer-Requena, Josefa. (2015). The Yale Brown Obsessive Compulsive Scale: A

Reliability Generalization Meta-Analysis. Retreived from

https://pdfs.semanticscholar.org/b4fb/5ca5acfb0073507f11753621b7e4976bc7e9.pdf.

Melli, Gabriele, Moulding, Richard, Micheli, Elena, Avallone, Emiliano, Pinto, Antonio, &

Carraresi, Claudia. (2015). Validation of the Italian version of the Yale-Brown

Obsessive Compulsive Scale – Second Edition (Y-BOCS-II) in a clinical sample.

Comprehensive Psychiatry. Retrieved from

https://www.researchgate.net/publication/274251142_Validation_of_the_Italian_version_

of_the_Yale-Brown_Obsessive_Compulsive_Scale_-_Second_Edition_Y-BOCS-

II_in_a_clinical_sample.

Obsessive-Compulsive Test - Yale Brown OCD Scale. (1989). Retrieved from

https://psychology-tools.com/test/yale-brown-obsessive-compulsive-scale.

Rapp, A. M., Bergman, R. L., Piacentini, J., & McGuire, J. F. (2016), Evidence-Based
Running head: REVIEW OF YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) 10

Assessment of Obsessive-Compulsive Disorder. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/27594793.

Storch, Eric A. Measuring Obsessive-Compulsive Symptoms: Common Tools and

Techniques. (n.d.). Retrieved from https://iocdf.org/expert-opinions/expert-opinion-

measuring-oc-symptoms/.

Storch, Eric A., Rasmussen, Steven A., Price, Lawrence H., Larson, Michael J., Murphy, Tanya

K. & Goodman, Wayne K. (2010). Development and Psychometric Evaluation of the

Yale–Brown Obsessive-Compulsive Scale—Second Edition. Retrieved from

https://pdfs.semanticscholar.org/03c3/fe1c676eb4dabf429a65e342ed26db91cd8f.pdf.

Yale-Brown Obsessive Compulsive Scale. In Wikipedia. Retrieved on February 21, 2019, from

https://en.wikipedia.org/wiki/Yale%E2%80%93Brown_Obsessive_Compulsive_Scale