Psychometric evaluation of the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) in Iranian clinical and non-clinical samples

Abstract

IntroductionThe Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) is a widely used clinician-administered instrument developed to overcome the problems with the available instruments for OCD in children. The aim of this study was to assess the psychometric properties of the CY-BOCS in an Iranian sample. MethodsThe psychometric properties of the CY-BOCS were assessed in clinical samples with obsessive-compulsive disorder (OCD, n=70), with anxiety disorders (n=58) and a non-clinical student sample (n=400). Using the Structured Clinical Interview for DSM-5 Axis I Disorders (SICD-5) by a trained psychiatrist, all participants were administered the CY-BOCS; Obsessive Compulsive Inventory-Child Version (OCI-CV); Children's Depression Inventory (CDI); and Multidimensional Anxiety Scale for Children (MASC). Receiver Operating Characteristic (ROC) curves were used to determine the optimal threshold scores for CY-BOCS. ResultsThe confirmatory factor analysis demonstrated that the original two-factor structure was valid in the Iranian sample. The overall and individual subscale scores showed moderate to good internal consistency and convergent validity as well as test-retest reliability. ROC analysis showed the area under the curve to be approximately 92%. For OCD diagnosis in ‘any anxiety disorder’ group, the CY-BOCS demonstrated the best psychometric properties for a cut-off score to be 17, with a sensitivity of 98.5%, specificity of approximately 76%, and positive predictive value (PPV) of about 12%. ConclusionThe Persian version of the CY-BOCS is a valid psychometric indicator for obsessive compulsive disorders with adequate sensitivity and specificity, and high NPV and PPV with an optimum cut-off score of 17 for OCD diagnosis.