Factor structure of the Dimensional Yale-Brown Obsessive-Compulsive Scale in a large sample of adults with obsessive-compulsive disorder

Objectives: Although the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) is a widely used instrument for assessing different obsessive-compulsive symptom dimensions, its factor structure has never been studied in a Brazilian population. Thus, we aimed to assess the goodness-of-fit indexes and factor loadings of two higher-order models of the DY-BOCS using confirmatory factor analysis (CFA) in a large obsessive-compulsive disorder (OCD) sample. Methods: We tested two CFA models in a sample of 955 adults with OCD who had been assessed with the DY-BOCS in a cross-sectional multi-site study. The first model encompassed the symptom checklist (present or absent), whereas the second focused on items related to severity scores. Results: Both models presented adequate goodness-of-fit indexes. The comparative fit index, Tucker-Lewis index, and omega were > 0.9, while the root mean square error of approximation was ≤ 0.06 for both models. Factor loadings for each item of each dimension are presented and discussed. Conclusion: Higher-order factor models showed adequate goodness-of-fit indexes, indicating that they appropriately measured OCD dimensions in this Brazilian population.

The Impact of Personality Traits on Ratings of Obsessive-Compulsive Symptoms

OBJECTIVE: The goal of this study was to evaluate consistencies and discrepancies between clinician-administered and self-report versions of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and to examine relationships between these scales and personality traits. METHODS: A total of 106 patients with obsessive-compulsive disorder (OCD) participated in this study. All participants were assessed with both clinician-administered and self-report versions of the Y-BOCS. The Structured Clinical Interview for DSM-IV Axis II Disorders Personality Questionnaire (SCID-II-PQ) was used to evaluate relationships between personality traits and scores on the Y-BOCS. RESULTS: Scores on the clinician-administered Y-BOCS and its obsession subscale were significantly higher than were those on the self-report version. However, we found no significant differences in compulsion subscale scores. We also found that the discrepancies in the scores on the two versions of the Y-BOCS and its compulsion subscale were significantly positively correlated with scores for narcissistic personality traits on the SCID-II-PQ. Additionally, narcissistic personality traits had a significant effect on the discrepancy in the scores on the two versions of the Y-BOCS and its compulsion subscale in the multiple linear regression analysis. CONCLUSION: This is the first study to elucidate relationships between personality traits and discrepancies between scores on the two versions of the Y-BOCS. Although clinicians tend to rate obsessive symptoms as being more severe than do patients, clinicians may underestimate the degree to which individuals with narcissistic personality traits suffer more from subjective discomfort due to compulsive symptoms. Therefore, the effect of personality traits on symptom severity should be considered in the treatment of OCD.

Korean Self-Report Version of the Yale-Brown Obsessive-Compulsive Scale: Factor Structure, Reliability, and Validity

OBJECTIVE: Although several self-report versions of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) have been developed and used widely, few psychometric studies have established the construct validity of this measure. Therefore, we developed Korean self-report version of the Y-BOCS and evaluated its factor structure, reliability, and validity. METHODS: A non-clinical student sample (n=206) and a clinical OCD sample (n=199) completed the Korean self-report version and other measures of obsessive-compulsive disorder (OCD), depression, and anxiety. RESULTS: Consistent with the originally proposed structure, confirmatory factor analyses supported a factor structure comprised of Obsessions and Compulsions factors in the Korean self-report version. Two subscale scores and the total score of the Korean self-report version showed good internal consistency and convergent validity, but relatively poor discriminant validity. Applying a cutoff score of 16, 84% of OCD patients and 93% of the non-clinical sample were classified correctly. CONCLUSION: Korean self-report version of the Y-BOCS is a psychometrically sound and valid measure for assessing OCD symptoms as compared with the clinician-administered version. The originally proposed division of OCD severity into obsessions and compulsions appears accurate in the Korean self-report version. The cutoff score for the Korean self-report version needs adjustment based on further researches.

Analysis of Defense Mechanism in 40 Patients with Obsessive-Compulsive Disorder / 中国康复理论与实践

@#Objective To explore the characteristics of defense mechanism in patients with obsessive-compulsive disorder(OCD).Methods Outpatients diagnosed as OCD were tested by Yale-Brown obsessive Compulsive Scale. Among them, 40 patients with score beyond or equal to 16 were selected as research group. 33 healthy individuals were selected as normal group. They were tested with Defense Style Questionnaire.Results ①The factor score of immature defense mechanisms in the OCD group is much higher than that in the normal group (P<0.01); the factor score of mature defense mechanisms in the OCD group is lower than that in the normal group (P<0.05); the factor score of middle defense mechanisms in the OCD group is much higher than that in the normal group (P<0.01). ②Passive aggression, acting out, splitting, regression, somatization in the immature defense mechanisms and relief, false altruism, isolation in the middle defense mechanisms are much more used by the OCD group than that in the normal group; but suppression and humor in the mature defense mechanisms are less used by the OCD group than that of the normal group(P<0.05 or P<0.01). ③Sublimation, suppression and consuming tendency are much more used in male patients than female ones in OCD group(P<0.05).Conclusion The patients with OCD tend to use the immature defense mechanisms and middle defense mechanisms, and there is some difference between male and female patients in using defense mechanisms.

Response of symptom dimensions in obsessive-compulsive disorder to treatment with citalopram or placebo

OBJECTIVE: There is increasing evidence that the symptoms of obsessive-compulsive disorder lie on discrete dimensions. Relatively little work has, however, explored the relationship between such factors and response to pharmacotherapy. METHOD: Data from a multi-site randomized placebo-controlled study of citalopram in obsessive-compulsive disorder were analyzed. Factor analysis of individual items and symptom categories of the Yale-Brown Obsessive-Compulsive Scale Checklist were undertaken, and the impact of symptom dimensions on treatment outcomes was analysed. RESULTS: Factor analysis of Yale-Brown Obsessive-Compulsive Scale Checklist individual items yielded 5 factors (contamination/cleaning, harm/checking, aggressive/sexual/religious, hoarding/symmetry, and somatic/hypochondriacal). Hoarding/symmetry was associated with male gender, longer duration of obsessive-compulsive disorder and early onset, whereas contamination/cleaning was associated with female gender. Citalopram was more effective than placebo, but high scores on the symmetry/hoarding and contamination/cleaning subscales predicted worse outcome at the end of study while high scores on the aggressive/religious/sexual subscale predicted better outcome. Factor analysis of Yale-Brown Obsessive-Compulsive Scale Checklist symptom clusters yielded a 4 factor solution, but confirmed that symmetry/ordering was associated with male gender, early onset, and long duration of obsessive-compulsive disorder while high scores on the hoarding subscale predicted worse response to pharmacotherapy. CONCLUSION: Citalopram shows good efficacy across the range of obsessive-compulsive disorder symptom dimensions. The relatively worse response of symmetry/hoarding to a selective serotonin reuptake inhibitor is consistent with other evidence that this symptom dimension is mediated by the dopamine system. There may be associations between symmetry/hoarding, male gender, early onset, tics, and particular...

OBJETIVO: Há crescentes evidências de que os sintomas do transtorno obsessivo-compulsivo residem em dimensões discretas. Alguns estudos têm sugerido que esses fatores possuem suportes neurobiológicos específicos. No entanto, poucos trabalhos têm explorado a relação entre tais fatores e a resposta à farmacoterapia. MÉTODO: Foi realizada a análise fatorial dos itens individuais e categorias de sintomas do checklist da Escala de Obsessão e Compulsão de Yale-Brown e foi analisado o impacto da dimensão dos sintomas no desfecho dos tratamentos. RESULTADOS: A análise fatorial exploratória dos itens individuais da Escala de Obsessão e Compulsão de Yale-Brown produziu cinco fatores (contaminação/limpeza, dano/verificação, agressividade/sexual/religioso, colecionismo/simetria e somático/hipocondríaco). Colecionismo/simetria foi associado ao sexo masculino, longa duração do transtorno obsessivo-compulsivo e início precoce, ao passo que contaminação/limpeza foi associado ao sexo feminino. O citalopram foi mais eficaz do que placebo, mas altos escores nas subescalas de simetria/colecionismo e de contaminação/limpeza predisseram desfecho pior ao final do estudo, ao passo que altos escores na subescala agressividade/sexual/religioso predisseram melhor desfecho. Uma análise fatorial de sintomas do checklist da Escala de Obsessão e Compulsão de Yale-Brown produziu uma solução com quatro fatores, mas confirmou que simetria/ordenação estava associado ao sexo masculino, início precoce e longa duração do transtorno obsessivo-compulsivo, enquanto altos escores na subescala colecionismo predisseram uma resposta pior à farmacoterapia. CONCLUSÃO: O citalopram demonstra boa eficácia ao longo das dimensões do espectro de sintomas do transtorno obsessivo-compulsivo. A resposta relativamente pior de simetria/colecionismo a um inibidor seletivo da recaptação da serotonina é consistente com outras evidências de que essa dimensão de sintomas é mediada pelo sistema...

Dimensional Analyses of the Yale-Brown Obsessive-Compulsive Scale and Yale-Brown Obsessive-Compulsive Scale Checklist / 대한정신약물학회지

OBJECTIVE: Although obsessive-compulsive disorder (OCD) has long been a unitary diagnosis, there is much recent interest in its potential heterogeneity, as manifested by symptom subgroups. Although the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is a widely used instrument to assess obsessive-compulsive symptomatology, the variables reflecting the pathogenesis of OCD and Y-BOCS subscores usually were not significantly associated. The aims of this study are to clarify identification of dimensional structure of the symptoms from YBOCS checklist and to explore the factor structure of the Y-BOCS. METHODS: Ninety five OCD patients participated in this study and performed the Y-BOCS and Y-BOCS checklist. The 13 main symptom categories from Y-BOCS checklist and 10 items from Y-BOCS were factor analyzed by using principal components analysis, respectively. RESULTS: Using principal component analysis, we derived 4 factors from 13 main contents of YBOCS checklist. Four factors-hoarding/repeating, contamination/cleaning, aggressive/sexual, and religious/somatic- accounted for more than 60% of the variance. And we derived 3 factors from 10 items of Y-BOCS and these 3 factors-severity of obsession, severity of compulsion, and resistance to symptoms-accounted for more than 70% of variance. CONCLUSIONS: The four symptom dimensions from Y-BOCS checklist and three symptom dimensions from Y-BOCS were identified as significant factors accounting for the variance. These factors may be of value in future genetic, neurobiological, and treatment response studies.