The Obsessive-Compulsive Symptom (OCS) scale of the Child Behavior Checklist: A comparison between Swedish children with Obsessive-Compulsive Disorder from a specialized unit, regular outpatients and a school sample

Centre for Child and Adolescent Mental Health, Eastern and Southern Norway Gullhaug Torg 4B, 0484 Oslo, Norway.
Journal of Anxiety Disorders (Impact Factor: 2.96). 02/2008; 22(7):1172-9. DOI: 10.1016/j.janxdis.2007.12.004
Source: PubMed


To evaluate the discriminative power of various items as reported by parents in the OCS-scale extracted from the Child Behavior Checklist (CBCL) problem scale and to compare findings with outcomes of previous validation studies. Children referred to a specialized child psychiatric Obsessive-Compulsive Disorder (OCD) clinic (OCD group) (n=185) receiving a formal OCD diagnosis according to DSM IV criteria based on interviews with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) were compared to a sample recruited from regular child and adolescent psychiatric outpatient clinics (CPO group) (n=177). Both samples were compared to a normative school sample (SS group) and all three groups were matched for age and gender. Thirty seven CBCL items, mostly representing core internalizing symptoms and parts of the thought problem scale as well as physical and sleep problems, were first identified. Ten of these items (including all discriminative items in previous validation studies) could distinguish children with OCD from CPO patients. In a subsequent analysis, the results of a logistic regression showed that four CBCL items, "Obsessions," "Fearful and Anxious," "Compulsions," and "Worries" remained significant predictors. These four OCS items and previously used CBCL OCS-scales were further examined by means of ROC-analysis showing that the "Obsessions" and "Compulsions" CBCL items were the strongest predictors. These two CBCL items performed well as screens for OCS symptoms in children and adolescents and the addition of similar CBCL items did not further increase sensitivity or specificity. It is suggested that parental responses on these two items could preferably be used as screen for OCD in children and adolescents in regular child psychiatric clinics.

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Available from: Tord Ivarsson,
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    • "Although specific items on the CBCL reflect evidence of delusions or hallucinations ( " I hear sounds of voices that other people think aren't there " or " I see things that other people think aren't there " ), these items were very rarely endorsed (6.1%) in this largely at-risk sample, and there were no notable differences across maternal risk groups for these specific items. The two most frequently endorsed items in this sample on the CBCL Thought Problems Scale (42.9% of the sample endorsed " can't get his/her mind off certain thoughts, obsessions " and 14.3% of the sample endorsed " repeats acts over and over " ) may or may not represent problems associated with psychosis (Ivarsson & Larsson, 2008). Furthermore, there is tentative evidence that these two items appear elevated in the at-risk maternal groups (56.3% of O-BD, 45.2% of O-UNI, and 31.7% of O-WELL). "
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    ABSTRACT: There is growing evidence that many offspring of parents with bipolar disorder (BD) will develop moderate to severe forms of psychopathology during childhood and adolescence, including thought problems. The purpose of this study was to evaluate the developmental progression of thought problems within the context of a family risk study. Repeated assessments of thought problems, spanning approximately 15 years, were conducted in offspring (N = 192 from 98 families) of parents diagnosed with BD (O-BD), unipolar depression (O-UNI), or no significant psychiatric or medical problems (O-WELL). Survival analysis showed that the O-BD group had the greatest estimated probability of developing thought problems over time, followed by O-UNI, and then O-WELL and O-BD exhibiting higher levels of persistence than O-WELL. Parent-reported thought problems in childhood and adolescence predicted a range of problems in young adulthood. Disturbances in reality testing and other atypical behaviors are likely to disrupt progression through important developmental periods and to associate with poor outcomes. These findings are likely relevant to preventing the occurrence or progression of problems in offspring of bipolar parents. The study of thought problems across development represents an important area of continued research in children at risk for development of affective disorders.
    Development and Psychopathology 11/2013; 25(4pt1):1079-1091. DOI:10.1017/S0954579413000382 · 4.89 Impact Factor
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    • "It has been shown to be both reliable and valid (Geller et al., 2006; Hudziak et al., 2006; Storch et al., 2006). Although there have been various adaptations of the CBCL-OCS tested, with fewer items including versions with six items (Storch et al., 2006), three items (Geller et al., 2006), and even just two items (Ivarsson and Larsson, 2008), we used the original eight-item scale (Nelson et al., 2001) for the purposes of our research. The CBCL-OCS was the main scale of interest. "
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    ABSTRACT: Diffusion tensor imaging (DTI) has been useful in allowing us to examine the nature and extent of neuronal disruption associated with obsessive-compulsive disorder (OCD). However, little is known about the underlying brain structure in OCD. Diffusion-weighted magnetic resonance imaging was performed in 16 children with OCD and 22 typically developing children. Tract-based spatial statistics (TBSS) was used to compare the microstructure of white-matter tracts of OCD children with those of typically developing children. Correlation/regression analyses were also performed on each diffusion measure in order to detect any correlation of white-matter microstructure with scales of symptom severity. Analysis revealed significantly greater axial diffusivity in both the genu and the splenium of the corpus callosum in the control compared to the OCD group; these regions consecutively connect bilateral medial frontal regions and bilateral parietal regions. Secondly, correlation and voxel-based regression analysis revealed that lower axial diffusion correlated with greater severity of symptoms within the OCD group, as measured by the Child Behaviour Checklist-Obsessive Compulsive Scale (CBCL-OCS). The findings demonstrated a correlation of axial diffusivity with severity of symptoms in children with OCD. DTI may provide novel ways to help reveal the relationships between clinical symptoms and altered brain regions.
    06/2013; 213(2). DOI:10.1016/j.pscychresns.2013.04.003
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    • "Total scores range between 0 and 226. Some CBCL items cover OCD symptoms as well and several different Obsessive-Compulsive sub-scales have been formed and studied (Geller et al., 2006; Ivarsson & Larsson, 2008; Nelson et al., 2001). The sub-scale proposed by Geller (2006) was used to find possible OCD cases in the control group. "
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    ABSTRACT: Objective: Contemporaneous nosological debates include the presence of an Obsessive-Compulsive Spectrum Disorder (OCSD) group incorporating disorders as OCD, Tourette’s syndrome, eating and autism spectrum disorders (ASD). If true, we propose, ASD symptoms should occur in the early childhood of OCD patients, show substantial continuity to later childhood and be present in a large proportion of cases. This study explores whether this is the case or not. Methods: Paediatric patients with OCD (n¼105) according to DSM IV were studied using parent ratings of the Social Communication Questionnaire. A general population group without ASD (n¼108) was used to control for ASD symptoms in the normal population. Results: ASD symptoms were more common in children with OCD than in controls (m¼5.9 versus 3.1; p¼.0001). However, few (one in each group) had scores in the clinical range for ASD. Symptom prevalence was low, except for symptoms that could be confused with OCD or tics. The correlation between preschool and current ASD symptoms was low. Conclusion: ASD symptoms in OCD as reported here do not support claims about OCD as strongly related to ASD. However, a subgroup of paediatric OCD patients has significant subclinical ASD symptom levels.
    Journal of Obsessive-Compulsive and Related Disorders 05/2012; 1(2012):168–174. DOI:10.1016/j.jocrd.2012.04.002 · 1.18 Impact Factor
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