Brief Obsessive-Compulsive Scale

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Brief Obsessive-Compulsive Scale

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About Brief Obsessive-Compulsive Scale

Scale Name

Brief Obsessive-Compulsive Scale

Author Details

Susanne Bejerot, Göran Edman

Translation Availability

Not Sure

Background/Description

The Brief Obsessive-Compulsive Scale (BOCS) emerged as a helpful tool to screen for obsessive-compulsive disorder (OCD) in various settings. Its development wasn’t attributed to a single person, but rather a team effort by Swedish researchers.

Building upon the already established Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and its version for children (CY-BOCS), the BOCS offers a concise self-report method for assessing OCD symptoms.

The scale incorporates two parts:

  • Symptom Checklist: This section presents 15 questions that target common obsessions and compulsions. Individuals answer by indicating if they’ve experienced a particular symptom in the past week (current), sometime in the past (past), or never at all (never).
  • Severity Scale: This part delves deeper into the impact of these obsessions and compulsions. It consists of 6 questions that assess aspects like time spent on them, level of distress caused, resistance to engaging in them, and the disruption they cause in daily life. Each question is rated on a 0-4 scale, with higher scores reflecting greater severity.

By combining the scores from both sections, a total score is obtained. While there aren’t specific cut-off points for diagnosis, this score provides valuable information for clinicians. Primarily, the BOCS serves as a screening instrument to identify potential OCD cases and track treatment progress over time. Its advantage lies in its brevity and ease of use, making it suitable for various settings. However, it’s crucial to remember that the BOCS is not a standalone diagnostic tool. A comprehensive clinical evaluation remains necessary for a confirmed OCD diagnosis.

Administration, Scoring and Interpretation

The Brief Obsessive-Compulsive Scale (BOCS) can be administered in two ways, depending on the age of the individual being assessed:

For Adults and Adolescents (over 15 years old):

Self-Report Format: This is the preferred method for adults and adolescents. The BOCS is presented as a questionnaire with clear instructions. The individual reads each item on the Symptom Checklist (15 items) and chooses the answer that best reflects their experience in the past week (current), ever in the past (past), or never (never). They then proceed to the Severity Scale (6 items) and rate each item on a 0-4 scale based on the provided descriptions.

For Children (under 15 years old):

Clinician-Administered Interview: For younger children, a clinician or trained interviewer administers the BOCS. They read each item on the Symptom Checklist and ask the child clarifying questions to understand their experiences. Based on the child’s responses, the interviewer selects the most appropriate answer choice (current, past, never). Similarly, for the Severity Scale, the interviewer asks questions to gauge the impact of the child’s obsessions and compulsions and assigns a rating (0-4) based on the scale’s descriptions.

General Points for Administration:

  • Regardless of the format, it’s important to create a comfortable and private environment for the assessment.
  • The clinician or interviewer should be familiar with OCD symptoms and the BOCS scoring system.
  • Clear and concise instructions should be provided before starting the assessment.
  • The individual or child should be encouraged to ask clarifying questions if needed.
  • The clinician or interviewer should avoid judgment and maintain a neutral stance throughout the process.

Reliability and Validity

The Brief Obsessive-Compulsive Scale (BOCS) shows generally good reliability and validity for assessing OCD symptoms, but with some limitations:

Reliability:

  • Internal Consistency: Studies indicate acceptable internal consistency, meaning the different parts of the BOCS (Symptom Checklist and Severity Scale) measure a related construct (OCD symptoms). However, some research suggests removing items related to “resistance” to obsessions and compulsions might improve this further.
  • Test-Retest Reliability: Research shows satisfactory test-retest reliability, meaning someone’s score tends to stay somewhat stable over time if their OCD symptoms haven’t changed significantly. However, some studies suggest this reliability could be better.
  • Interrater Reliability: When a clinician administers the BOCS through an interview with a child, there’s excellent interrater reliability. This means different clinicians administering the BOCS to the same child tend to get similar scores.

Validity:

  • Convergent Validity: The BOCS scores correlate well with other OCD assessment tools, suggesting it measures similar aspects of OCD.
  • Divergent Validity: The BOCS discriminates well between OCD and other anxiety disorders like generalized anxiety disorder, but may not always effectively distinguish OCD from depression.

Available Versions

15-Items
06-Items

Reference

Bejerot, S., Edman, G., Anckarsäter, H., Berglund, G., Gillberg, C., Hofvander, B., Humble, M. B., Mörtberg, E., Råstam, M., Ståhlberg, O., & Frisén, L. (2014). The Brief Obsessive-Compulsive Scale (BOCS): a self-report scale for OCD and obsessive-compulsive related disorders. Nordic journal of psychiatry68(8), 549–559. https://doi.org/10.3109/08039488.2014.884631

Important Link

Scale File:

Frequently Asked Questions

What is the BOCS?
A short self-report questionnaire to assess OCD symptoms.

Who uses it?
Clinicians and researchers to screen for OCD.

How is it administered?
Self-report format for adults/adolescents, clinician interview for children.

What are the parts of the BOCS?
Symptom Checklist (15 items): Rates presence of obsessions/compulsions.
Severity Scale (6 items): Rates time spent, distress caused, and interference.

How is it scored?
Scores from both parts are summed, no formal cutoffs for diagnosis.

Is the BOCS a diagnostic tool?
No, it’s a screening tool. A full evaluation is needed for diagnosis.

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