Yale-Brown Obsessive Compulsive Scale Y-BOCS
Yale-Brown Obsessive Compulsive Scale Y-BOCS overview
Creator and Context
The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the reference standard measure of OCD severity.
It was developed by Wayne Goodman, Lawrence Price, Steven Rasmussen, Carolyn Mazure and colleagues, and published in 1989. It consists of a symptom checklist, a target symptom list and a 10 item severity scale. A children's version, the CY-BOCS, and a second edition, the Y-BOCS-II, are also published.
The Y-BOCS is a trademarked, licensed instrument owned by OCD Scales, LLC. Digital use requires a paid licence.
Presenting Conditions
The severity scale rates obsessions and compulsions separately across five dimensions each:
Time occupied
Interference with functioning
Distress
Resistance
Degree of control
This produces an obsession severity score and a compulsion severity score, each from 0 to 20.
Administration
Clinician administered as a semi structured interview by a trained clinician, rating the past 7 days. Administration including the symptom checklist typically takes around 30 to 45 minutes.
Desired Audience
Adults with OCD. For children and adolescents, the CY-BOCS is the appropriate version.
The Y-BOCS is the instrument on which the entire OCD treatment evidence base is built. Its critical design feature is that severity is rated independently of symptom content, so a person with contamination fears and a person with intrusive harm thoughts can be compared on the same scale and tracked through exposure work.
Considerations
It requires a trained clinician. It is not a self report questionnaire.
The resistance item is difficult to interpret after exposure and response prevention, which is why it was replaced in the Y-BOCS-II.
The Y-BOCS-II uses a 0 to 5 item scale and a maximum score of 50, so scores are not interchangeable with the original.
Licensing is strict. OCD Scales, LLC requires a paid licensing agreement for commercial use, digitalisation, or inclusion in an electronic record or app, and prohibits publication or distribution of the scale in any medium without authorisation.
How to score the Yale-Brown Obsessive Compulsive Scale Y-BOCS
Conducting the assessment
The clinician rates each of the 10 severity items from 0 (none) to 4 (extreme), based on the interview and the identified target symptoms.
Interpretation
Items are summed to give a total from 0 to 40.
The severity bands published by the rights holder are:
0 to 7 subclinical
8 to 15 mild
16 to 23 moderate
24 to 31 severe
32 to 40 extreme
An alternative empirically derived banding, keyed to clinician global impression ratings, has also been published and is used in some research settings.
Clinical Considerations
Use the symptom checklist to identify target symptoms first, then rate severity against those targets. Rating severity without agreed targets produces unreliable scores.
Track change against baseline. Percentage reduction in the total score is the standard measure of treatment response.
Rater training matters. Inter rater reliability depends on it.
Yale-Brown Obsessive Compulsive Scale Y-BOCS use cases
Measuring OCD symptom severity
Tracking response to exposure and response prevention or medication
Establishing baseline severity for treatment planning
Clinical trials and research, where it is the standard outcome measure
Category
Anxiety
Research Summary
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., Heninger, G. R., & Charney, D. S. (1989). The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability. Archives of General Psychiatry, 46(11), 1006 to 1011.
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Heninger, G. R., & Charney, D. S. (1989). The Yale-Brown Obsessive Compulsive Scale: II. Validity. Archives of General Psychiatry, 46(11), 1012 to 1016.
Other Assessment Guides
Clinical Outcomes in Routine Evaluation 10 CORE-10
Explore the Clinical Outcomes in Routine Evaluation 10 (CORE-10), an efficient tool for assessing and monitoring psychological distress. Ideal for clinicians and researchers, this guide covers its use in screening, tracking treatment progress, and evaluating therapy effectiveness.
Depression Anxiety Stress Scales DASS-21
Explore the Depression Anxiety Stress Scales (DASS-21) in our comprehensive guide. Learn about its creation, use in assessing emotional states, practical application, scoring, and clinical guidance. Ideal for professionals seeking a detailed understanding of DASS-21's role in mental health assessment
Generalized Anxiety Disorder 7 Item Scale GAD-7
Explore the Generalized Anxiety Disorder 7 Item Scale (GAD-7), a vital tool for screening and measuring anxiety severity. Our guide covers its use, scoring system, and clinical implications, ideal for healthcare professionals and researchers in mental health.
Note on Assessment licensing
Some assessments are copyright protected and require a licence or the copyright holder's permission for clinical, commercial or digital use. Where that applies, obtaining and maintaining that permission is the responsibility of the practice or organisation using the assessment. Tacklit provides the digital administration, scoring and reporting. We do not grant, transfer or supply rights to the underlying instrument.
