Transcription
CY-BOCS Symptom ChecklistChildren’s Yale-Brown Obsessive Compulsive ScaleAdministering the CY-BOCS Symptom Checklist and CY-BOCS Severity Ratings1. Establish the diagnosis of obsessive compulsive disorder.2. Using the CY-BOCS Symptom Checklist (below), ascertain current and past symptoms.3. Next, administer the 10 item severity ratings (other form) to assess the severity of the OCD during the lastweek.4. Re-administer the CY-BOCS Severity Rating Scale to monitor progress.Patient DatePage 1of 4
CY-BOCS Symptom ChecklistChildren’s Yale-Brown Obsessive Compulsive ScaleCY-BOCS Obsessions ChecklistCheck all symptoms that apply (Items marked “*” may or may not be OCD Phenomena)Current Past Sexual ObsessionsCurrent Past Contamination ObsessionsConcern with dirt, germs, certain illnesses(e.g., AIDS)Forbidden or perverse sexual thoughts,images, impulsesConcerns or disgust with bodily waste orsecretions (e.g. urine, feces, saliva)Content involves homosexualitySexual behavior towards others(aggressive)Excessive concern with environmentalcontaminants (e.g., asbestos, radiation,toxic waste)Other (describe)Excessive concern with household items(e.g., cleaners, solvents)Hoarding / Saving ObsessionsExcessive concern about animals / insectsOther (describe)Excessively bothered by sticky substancesor residuesMagical Thoughts / SuperstitiousObsessionsConcerned will get ill because ofcontaminantLucky / unlucky numbers, colors, wordsFear of losing thingsOther (describe)Concerned will get others ill by spreadingcontaminant (aggressive)Somatic ObsessionsNo concern with consequences ofcontamination other than how it might feel *Excessive concern with illness or disease *Other (describe)Excessive concern with body part or aspectof appearance (e.g. dysmorphophobia) *Aggressive ObsessionsOther (describe)Fear might harm selfReligious ObsessionsFear might harm othersExcessive concern or fear of offendingreligious objectsFear harm will come to selfExcessive concern with right / wrong morallyFear harm will come to others (maybebecause of something child did or did notdo)Other (describe)Miscellaneous ObsessionsViolent or horrific imagesThe need to know or rememberFear of blurting out obscenities or insultsFear of saying certain thingsFear of doing something embarrassing *Fear of not saying just the right thingFear will act on unwanted impulses (e.g., tostab a family member)Intrusive (non-violent) imagesFear will steal thingsIntrusive sounds, words, music or numbersFear will be responsible for something elseterrible happening (e.g. ,fire, burglary, flood)Other (describe)Other (describe)Target Symptom List for ObsessionsOBSESSIONS (describe, listing by order of severity, with #1 being the most sever, #2 second most severe, etc):1.2.3.4.Page 2of 4
CY-BOCS Symptom ChecklistChildren’s Yale-Brown Obsessive Compulsive ScaleCY-BOCS Compulsions ChecklistCheck all symptoms that apply (Items marked “*” may or may not be OCD Phenomena)Current Past Washing / Cleaning CompulsionsCurrent Past Hoarding / Saving CompulsionsExcessive or ritualized hand washingDistinguish from hobbies and concern withobjects of monetary or sentimental value.Excessive or ritualized showering, bathing,tooth brushing, grooming, toilet routineDifficulty throwing things away, saving bits ofpaper, string, etc.Excessive cleaning of items, such as personalclothes or important objectsOther (describe)Other measures to prevent or remove contactwith contaminantsExcessive Games / SuperstitiousBehaviorsOther (describe)Distinguish from age appropriate magicalgames (e.g. array of behavior, such assleeping over certain spots on a floor,touching an object / self certain number oftimes as a routine game to avoid somethingbad from happeningChecking CompulsionsChecking locks, toys, school books / items,etc.Checking associated with getting washed,dressed, or undressedOther (describe)Checking that did not / will not harm othersRituals Involving Other PersonsChecking that did not / will not harm selfThe need to involve another person (usually aparent) in ritual (e.g. asking a parent torepeatedly answer the same question, makingmother perform certain mealtime ritualsinvolving specific utensils) *Checking that nothing terrible did / will happenChecking that did not make mistakeChecking tied to somatic obsessionsOther (describe)Other (describe)Miscellaneous CompulsionsRepeating RitualsMental rituals other than checking / countingRereading, erasing, or rewritingNeed to tell, ask or confessNeed to repeat activities (e.g. in / out ofdoorway, up / down from chair)Measures (not checking) to prevent :Other (describe)harm to selfCounting Compulsionsharm to othersObjects, certain numbers, words, etc.terrible consequencesOther (describe)Ritualized eating behaviors *Ordering / ArrangingExcessive list making *Need for symmetry / evening up (e.g. liningitems up a certain way or arranging personalitems in specific patterns)Need to touch, tap, rub *Need to do things (e.g. touch or arrange until itfeels just right) *Other (describe)Rituals involving blinking or staring *Trichotillomania (hair-pulling)Other self-damaging or self-mutilatingbehaviors *Other (describe)Page 3of 4
CY-BOCS Symptom ChecklistChildren’s Yale-Brown Obsessive Compulsive ScaleTarget Symptom List for CompulsionsCOMPULSIONS (describe, listing by order of severity, with #1 being the most sever, #2 second most severe,etc):1.2.3.4.Page 4of 4
Checking locks, toys, school books / items, etc. Checking associated with getting washed, dressed, or undressed Checking that did not / will not harm others Checking that did not / will not harm self Checking that nothing terrible did / will happen Checking that
