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OCD Screening Test (Y-BOCS)

OCD screening based on YALE-BROWN OBSESSIVE COMPULSIVE SCALE (Y-BOCS) https://www.sandrarubinmd.com/storage/app/media/ybocs-pdf-yale-brown.pdf

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General Instructions

This rating scale is designed to rate the severity and type of symptoms in patients with obsessive compulsive disorder (OCD). Rate the characteristics of each item during the prior week up until and including the time of the interview. Scores should reflect the average (mean) occurrence of each item for the entire week.
Check all that apply, but clearly mark the principal symptoms with a "P", (Rater must asertain whether reported behviors are bona fide symptoms of OCD, and not symptoms of another disorder such as Simple Phobia or Hypochondriasis. Items maried "*" may or may not be OCD phenomena.)

Questions 1 to 5 are about your obsessive thoughts Obsessions are unwanted ideas, images or impulses that intrude on thinking against your wishes and efforts to resist them. They usually involve themes of harm, risk and danger. Common obsessions are excessive fears of contamination; recurring doubts about danger, extreme concern with order, symmetry, or exactness; fear of losing important things.

The five questions of obsessions remain
Please write down your Obsessional Thoughts
“Obsessional thoughts" refers to unpleasant, unwanted, and intrusive thoughts/images that keeps appearing in your mind. You don't want these thoughts/images, but you can't control it. They always go against your wishes. When you have these thoughts/images, you feel highly anxious.
1. How much of your time is occupied by obsessive thoughts?*
Explain: When obsessions occur as brief, intermittent intrusions, it may be difficult to assess time occupied by them in terms of total hours. In such cases, estimated time by determining how frequently they occur. Consider both the number of times the intrusions occur and how many hours of the day are affected. Ask yourself: How frequently do the obsessive thoughts occur?
- None.
- Mild, less than 1 hr/day or occasional intrusion.
- Moderate, 1 to 3 hrs/day or frequent intrusion
- Severe, greater than 3 and up to 8 hrs/day or very frequent intrusion
- Extreme, greater than 8 hrs/day or near constant intrusion
1b . On the average, what is the longest number of consecutive waking hours per day that you are completely free of obsessive thoughts?*
In other word: What is the longest block of time in which obsessive thoughts are absent?
- No symptoms.
- Long symptom-free interval, more than 8 consecutive hours/day symptom-free.
- Moderately long symptom-free interval, more than 3 and up to 8 consecutive hours/day symptom-free.
- Short symptom-free interval, from I to 3 consecutive hours/day symptom-free.
- Extremely short symptom-free interval, less than I consecutive hour/day symptom-free.
2. How much do your obsessive thoughts interfere with your social or work (or role) functioning? Is there anything that you don't do because of them?*
Explain: If currently not working, try to determine how much performance would be affected if you were employed.
- None.
- Mild, slight interference with social or occupational activities, but overall performance not impaired.
- Moderate, definite interference with social or occupational performance, but still manageable.
- Severe, causes substantial impairment in social or occupational performance.
- Extreme, incapacitating.
3. How much distress do your obsessive thoughts cause you?*
Explain: In most eases, distress is equated with anxiety; however, you may report that your obsessions are "disturbing" but not "anxiety." Only rate anxiety that seems triggered by obsessions, not generalized anxiety or associated with other conditions.
- None.
- Mild, not too disturbing
- Moderate, disturbing, but still manageable
- Severe, very disturbing.
- Extreme, near constant and disabling distress
4. How much of an effort do you make to resist the obsessive thoughts? How often do you try to disregard or turn your attention away from these thoughts as they enter your mind?*
Explain: Only rate effort made to resist, not success or failure in actually controlling the obsessions. How much you resist the obsessions may or may not correlate with your ability to control them.
- Makes an effort to always resist, or symptoms so minimal doesn't need to actively resist
- Tries to resist most of the time
- Makes some effort to resist
- Yields to all obsessions without attempting to control them, but does so with some reluctance
- Completely and willingly yields to all obsessions
5. How much control do you have over your obsessive thoughts? How successful are you in stopping or diverting your obsessive thinking? Can you dismiss them?*
Explain: In contrast to the preceding item on resistance, the ability of the patient to control your obsessions is more closely related to the severity of the intrusive thoughts.
- Complete control.
- Much control, usually able to stop or divert obsessions with some effort and concentration.
- Moderate control, sometimes able to stop or divert obsessions.
- Little control, rarely successful in stopping or dismissing obsessions, can only divert attention with difficulty.
- No control, experienced as completely involuntary, rarely able to even momentarily alter obsessive thinking.

The next several questions are about your compulsive behaviors.

Compulsions are urges that people have to do something to lessen feelings of anxiety or other discomfort. Often they do repetitive, purposeful, intentional behaviors called rituals. The behavior itself may seem appropriate but it becomes a ritual when done to excess. Washing, checking, repeating, straightening, hoarding and many other behaviors can be rituals. Some rituals are mental. For example, thinking or saying things over and over under your breath.

The five questions of compulsion remain
6. How much time do you spend performing compulsive behaviors?*
Explain: When rituals involving activities of daily living are chiefly present, ask yourself: How much longer than most people does it take to complete routine activities because of your rituals? If you're unable to figure how long, estimate time by determining how frequently you performed these. Consider both the number of times compulsions are performed and how many hours of the day are affected. Count separate occurrences of compulsive behaviors, not number of repetitions; e.g., a person who goes into the bathroom 20 different times a day to wash his hands 5 times very quickly, performs compulsions 20 times a day, not 5 or 5 x 20 = 100.
- None
- Mild (spends less than I hr/day performing compulsions), or occasional performance of compulsive behaviors.
- Moderate (speeds from I to 3 hrs/day performing compulsions), or frequent performance of compulsive behaviors.
- Severe (spends more than 3 and up to 8 hrs/day performing compulsions), or very frequent performance of compulsive behaviors.
- Extreme (spends more than 8 hrs/day performing compulsions), or near constant performance of compulsive behaviors (too numerous to count).
7. How much do your compulsive behaviors interfere with your social or work (or role) functioning? Is there anything that you don't do because of the compulsions*
Explain: If currently not working, determine how much performance would be affected if you were employed.
- None
- Mild, slight interference with social or occupational activities, but overall performance not impaired
- Moderate, definite interference with social or occupational performance, but still manageable
- Severe, causes substantial impaiment in social or occupational performance
- Extreme, incapacitating. Can't work at all.
8. How would you feel if prevented from performing your compulsion(s)? How anxious would you become?*
Explain: Rate the degree of distress you would experience if performance of the compulsion were suddenly interrupted without reassurance offered. In most, but not all cases, performing compulsions reduces anxiety. If anxiety is actually reduced by preventing compulsions in the manner described above, then asked yourself: How anxious do you get while performing compulsions until you are satisfied they are completed?
- None
- Mild only slightly anxious if compulsions prevented, or only slight anxiety during performance of compulsions
- Severe, prominent and very disturbing increase in anxiety if compulsions interrupted, or Prominent and very disturbing increase in anxiety during performance of compulsions
- Severe, causes substantial impaiment in social or occupational performance
- Extreme, incapacitating anxiety from any intervention aimed at modifying activity, or incapacitating anxiety develops during performance of compulsions
9. How much of an effort do you make to resist the compulsions?*
Only rate effort made to resist, not success or failure in actually controlling the compulsions. How much you resist the compulsions may or may not correlate with your ability to control them.
- Makes an effort to always resist, or symptoms so minimal doesn't need to actively resist
- Tries to resist most of the time
- Makes some effort to resist
- Yields to almost all compulsions without attempting to control them, but does so with some reluetance
- Completely and willingly yields to all compulsions
10. How strong is the drive to perform the compulsive behavior? How much control do you have over the compulsions?*
Explain: In contrast to the preceding item on resistance, your ability to control your compulsions is more closely related to the severity of the compulsions.
- Full Control
- Much control, experiences pressure to perform the behavior but usually able to exercise voluntary control over it.
- Moderate control, strong pressure to perform behavior, can control it only with difficulty
- Little control, very strong drive to perform behavior, must be carried to completion, can only delay with difficulty
- No control. drive to perform behavior experjcoced as completely involuntary and overpowering, rarely able to even momentarily delay activity
11. Do you think your concerns or behaviors are reasonable? What do you think would happen if you did not perform the compulsion(s)? Are you convinced something would really happen?*
Explain: Rate your insight into the senselessness or excessiveness of your obsession(s) based on beliefs expressed at the time of the this quiz.
- Excellent insight, fully rational
- Good insight. Readily acknowledges absurdity or excessiveness of thoughts or behaviors but does not seem completely convinced that there isn't something besides anxiety to be concerned about (i.e., has lingering doubts).
- Fair insight. Reluctantly admits thoughts or behavior seem unreasonable or excessive, but wavers. May have some unrealistic fears, but no fixed convictions.
- Poor insight. Maintains that thoughts or behaviors are not unreasonable or excessive, but acknowledges validity of contrary evidence (i.e., overvalued ideas present).
- Lacks insight, delusional. Definitely convinced that concerns and behavior are reasonable, unresponsive to contrary evidence.
12. Do you think your concerns or behaviors are reasonable? What do you think would happen if you did not perform the compulsion(s)? Are you convinced something would really happen?*
Explain: Rate your's insight into the senselessness or excessiveness of your obsession(s) based on beliefs expressed at the time of this quiz.
- Excellent insight, fully rational
- Good insight. Readily acknowledges absurdity or excessiveness of thoughts or behaviors but does not seem completely convinced that there isn't something besides anxiety to be concerned about (i. e. , has lingering doubts).
- Fair insight. Reluctantly admits thoughts or behavior seem unreasonable or excessive, but wavers. May have some unrealistic fears, but no fixed convictions.
- Poor insight. Maintains that thoughts or behaviors are not unreasonable or excessive, but acknowledges validity of contrary evidence (i.e., overvalued ideas present).
- Lacks insight, delusional. Definitely convinced that concerns and behavior are reasonable, unresponsive to contrary evidence.
13. Do you have trouble making decisions about little things that other people might not think twice about (e.g., which clothes to put on in the morning; which brand of cereal to buy)?*
Explain: Exclude difficulty making decisions which reflect ruminative thinking. Ambivalence concerning rationally-based difficult choices should also be excluded.
- None
- Mild, some trouble making decisions about minor things.
- Moderate, freely reports significant trouble making decisions that others would not think twice about.
- Severe, continual weighing of pros and cons about nonessentials.
- Extreme, unable to make any decisions. Disabling.
14. Do you feel very responsible for the consequences of your actions? Do you blame yourself for the outcome of events not completely in your control?*
Explain: Distinguish from normal feelings of responsibility, feelings of worthlessness, and pathological guilt. A guilt-ridden person experiences yourself or your actions as bad or evil.]
- None
- Mild, only mentioned on questioning, slight sense of over-responsibility
- Moderate, ideas stated spontaneously, clearly present; patient experiences significant sense of over-responsibility for events outside his/her reasonable control
- Severe, ideas prominent and pervasive; deeply concerned he/she is responsible for events clearly outside his control. Self-blaming farfetched and nearly irrational
- Extreme, delusional sense of responsibility (e.g., if an earthquake occurs 3,000 miles away patient blames herself because she didn't perform her compulsions)
15. Do you feel very responsible for the consequences of your actions? Do you blame yourself for the outcome of events not completely in your control?*
Explain: Distinguish from normal feelings of responsibility, feelings of worthlessness, and pathological guilt. A guilt-ridden person experiences your actions as bad or evil.
- None
- Mild, only mentioned on questioning, slight sense of over-responsibility
- Moderate, ideas stated spontaneously, clearly present; patient experiences significant sense of over-responsibility for events outside his/her reasonable control
- Severe, ideas prominent and pervasive; deeply concerned he/she is responsible for events clearly outside his control. Self-blaming farfetched and nearly irrational
- Extreme, delusional sense of responsibility (e.g., if an earthquake occurs 3,000 miles away patient blames herself because she didn't perform her compulsions)
16. After you complete an activity do you doubt whether you performed it correctly? Do you doubt whether you did it at all? When carrying out routine activities do you find that you don't trust your senses (i.e., what you see, hear, or touch)?*
- None
- Mild, only mentioned on questioning, slight pathological doubt. Examples given may be within normal range.
- Moderate, ideas stated spontaneously, clearly present; patient experiences significant sense of over-responsibility for events outside his/her reasonable control
- Severe, uncertainty about perceptions or ,memory prominent; pathological doubt frequently affects performance.
- Extreme uncertainty about perceptions constantly present; pathological doubt substantially affects almost all activities. Incapacitating (e.g., patient states "my mind doesn't trust what my eyes see").

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