| RPT |
.| .| Yale-Brown Obsessive Compulsive Scale - II| | Date Given: <.Date_Given.>| Clinician: <.Staff_Ordered_By.>| Location: <.Location.>| | Veteran:
that their obsessions are "disturbing" or "upsetting" but deny "anxiety." Only rate distress that seems generated by obsessions, not generalized anxiety or anxiety associated with other conditions.]|
| <*Answer_7068*>| | 5. INTERFERENCE FROM OBSESSIONS:| "How much do your obsessive thoughts interfere with your social, school, or work (role) functioning?" [If currently not
working (or attending school), determine how much performance would be affected if patient were employed (or in school).] "Have you been avoiding doing anything, going any place, or being with anyone
because of your obsessions?" [Evaluate impact of avoidance on functioning.]| | <*Answer_7069*>| | 6. TIME SPENT ON COMPULSIONS:| "How much time do you spend performing
compulsive behaviors?" [When rituals involving activities of daily living are chiefly present, ask:] "How much longer than most people does it take to complete routine activities because of your
rituals?" [When compulsions occur as brief, intermittent behaviors, it may be difficult to assess time spent performing them in terms of total hours. In such cases, estimate time by determining how
frequently they are performed. Consider both the number of times compulsions are performed and how much of the day is affected. When estimating frequency, count separate occurrences of compulsive
behaviors, not number of repetitions. In most cases compulsions are observable behaviors (e.g., hand washing or refusing to shake ands), but some compulsions are covert (e.g., silent checking or
praying); these mental rituals should be rated as you would overt compulsions. "Active avoidance" (e.g., rule governed behaviors that ensure a minimum "safe" distance from contaminated areas or
wearing a glove on one hand to keep it clean) like compulsions, can manifest as discrete behavioral acts, measurable in hours or by frequency, so should be rated on this item. "Passive avoidance",
<.Patient_Name_Last_First.>| SSN: <.Patient_SSN.>| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)| Gender: <.Patient_Gender.>| | | YBOCS II|
on the other hand, may be difficult to quantify temporally; however, its relationship to compulsions and resultant impact on distress and functioning can be measured on items 9 and 10 respectively.|
| <*Answer_7070*>| | 7. RESISTANCE TO COMPULSIONS:| "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 the patient resists the compulsions may or may not correlate with his ability to control them. Note that this item does not directly measure the
severity of the compulsions; rather it rates a manifestation of health, i.e., the effort the patient makes to counteract the compulsions. Thus, the more the patient tries to resist, the less impaired
is this aspect of his functioning. If the compulsions are minimal, the patient may not feel the need to resist them. In such cases, a rating of "0" should be given.]| | <*Answer_7071*>|
| 8. CONTROL OVER COMPULSIONS:| "How strong is the drive to perform the compulsions?" [Pause] "How much control do you have over the behaviors?" [In contrast to the preceding item on
resistance, this item directly measures success or failure in controlling compulsions.]| | <*Answer_7072*>| | 9. DISTRESS IF COMPULSIONS PREVENTED:| "How would you feel if
prevented from performing your compulsion(s)?" [Pause] "How distressed would you become?" [Rate degree of distress patient would experience if performance of the ritual were prevented or suddenly
interrupted without reassurance. Like compulsions, avoidance maneuvers can reduce distress; conversely, forced confrontation with avoided objects can engender distress. Ask similar questions about
avoidance:] "How would you feel if you weren't allowed to avoid?" [In most, but not all cases, performing compulsions reduces anxiety. In other cases, the compulsions themselves can be a source of
Obsession: <-Obsession->| Compulsion: <-Compulsion-> (Note: Questions 11-14 are not included in this total) | Total: <-Total-> | | | Questions and
distress when laborious or demanding; they can even be painful as in the case of washing with scalding hot water. In these cases, distress or discomfort produced by the compulsions can be taken into
account when rating this item. Apart from these latter instances, this item can be viewed as an indirect measure of how dependent the individual is on compulsions or avoidance to keep distress in
check.]| | <*Answer_7073*>| | 10. INTERFERENCE FROM COMPULSIONS:| "How much do your compulsive behaviors interfere with your social, school, or work (or role) functioning?" [If
currently not working (or attending school), determine how much performance would be affected if patient were employed (or in school).] "Have you been avoiding doing anything, going any place, or
being out of concern you will trigger the compulsions?" [Evaluate impact of avoidance on functioning. An example of avoidance relevant to assessment of compulsions is letting soiled clothes pile up
instead of launching into an exhausting and prolonged laundry routine that will defy interruption.]| | <*Answer_7074*>| | 11. INSIGHT:| "Do you think your concerns or behaviors
are reasonable?" [Pause] "What do you think would happen if you did not perform the compulsion(s)? Are you convinced something would really happen?" [Rate patient's insight into the senselessness or
excessiveness of his obsession(s) based on beliefs expressed at the time of the Interview.]| | <*Answer_7075*>| | 12. RELIABILITY:| Rate the overall reliability of the rating
scores obtained. Factors that may affect reliability include the patient's cooperativeness and his/her natural ability to communicate. The type and severity of obsessive-compulsive symptoms present
may interfere with the patient's concentration, attention, or freedom to speak spontaneously (e.g., the content of some obsessions may cause the patient to choose his words very carefully).|
Answers| | 1. TIME SPENT ON OBSESSIONS:| "How much of you time is occupied by obsessive thoughts?" [When obsessions occur as brief,intermittent intrusions, it may be difficult to assess
<*Answer_7310*>| | 13. GLOBAL SEVERITY:| Interviewer's judgment of the overall severity of the patient's illness. Rated from 0 (no illness) to 6 (most severe patient seen). [Consider the
degree of distress reported by the patient, the symptoms observed, and the functional impairment reported. Your judgment is required both in averaging this data as well as weighing the reliability or
accuracy of the data obtained and should be based on information obtained during the interview.]| <*Answer_7311*>| | 14. GLOBAL IMPROVEMENT:| Rate total overall improvement
present SINCE THE INITIAL RATING whether or not, in your judgment, it is due to treatment effects. | <*Answer_7312*>| | Items 13 and 14 are adapted from the Clinical Global Impression
Scale (Guy W: ECDEU Assessment Manual for Psychopharmacology: Publication 76-338. Washington, D.C., U.S. Department of Health, Education, and Welfare (1976)).| | Additional information regarding the
development, use, and psychometric properties of the original YBOCS can be found in Goodman WK, Price LH, Rasmussen SA, et al.: The Yale-Brown Obsessive Compulsive Scale (Y-BOCS): Part I.
Development, use, and reliability. Arch Gen Psychiatry (46:1006-1011, 1989). And Goodman WK, Price LH, Rasmussen SA, et al.: The Yale-Brown Obsessive Compulsive Scale (Y-BOCS): Part II. Validity.
Arch Gen Psychiatry (46:1012-1016, 1989). | | (c) Goodman, Rasmussen, Price, and Storch, 2006| | Information contained in this note is based on a self-report assessment and is not
sufficient to use alone for diagnostic purposes. Assessment results should be verified for accuracy and used in conjunction with other diagnostic activities and procedures.| $~
time occupied by them in terms of total hours. In such cases, posing item #2 first may help identify most appropriate response to item #1. Be sure to exclude ruminations and preoccupations that,
unlike obsessions, are ego-syntonic and rational - albeit excessive.)]| | <*Answer_7065*>| | 2. OBSESSION-FREE INTERVAL:| "On average, what is the longest continuous period
(or block) of time in which you are free of obsessive thoughts?" [Only consider time while awake. You can also ask:] "How frequently do the obsessive thoughts occur?"| | <*Answer_7066*>|
| 3. CONTROL OVER OBSESSIONS:| "How much control do you have over your obsessive thoughts? How successful are you in stopping or ignoring them? Can you dismiss them?"| |
<*Answer_7067*>| | 4. DISTRESS OF OBSESSIONS:| "How much distress do your obsessive thoughts cause you?" [In most cases, distress is equated with anxiety; however, patients may report
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