Table of Contents
Abstract
The Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) is a specialized psychometric instrument designed for the assessment of symptoms related to Obsessive-Compulsive Disorder (OCD) in young people, typically ranging in age from 4 to 18 years. It is an adaptation of the original Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), tailored to capture the unique presentation of symptoms in pediatric populations.
The CY-BOCS serves as a clinically useful tool, incorporating both a comprehensive symptom checklist and a severity rating component. It can be administered as a clinician-rated scale or completed by the child/adolescent themselves, often in collaboration with their parents or guardians, ensuring the collection of the most accurate and comprehensive information regarding the presence and severity of both obsessions and compulsions.
Keywords
Children’s Yale-Brown Obsessive Compulsive Scale, CY-BOCS, OCD, pediatric psychometrics, clinical assessment, compulsions, obsessions, psychological measurement, symptom severity.
Authors
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., Charney, D. S., Heninger, G. R.
Purpose
The primary purpose of the CY-BOCS is the standardized measurement of the presence and severity of obsessive and compulsive symptoms in children and adolescents who have been diagnosed with, or are suspected of having, Obsessive-Compulsive Disorder. Unlike diagnostic interviews, the CY-BOCS is primarily used to track changes in symptom intensity over time, making it an essential instrument for monitoring treatment efficacy, whether pharmacological or behavioral.
The scale aids clinicians in identifying specific target symptoms—both obsessions and compulsions—which are crucial for tailoring effective treatment plans, such as exposure and response prevention (ERP) therapy. The comprehensive checklist ensures that a wide array of potential symptoms, common in the pediatric presentation of OCD, are systematically reviewed.
Construct
The CY-BOCS measures the core psychological construct of Obsessive-Compulsive Disorder (OCD), defined by the presence of obsessions (intrusive, recurrent, and distressing thoughts, sensations, urges, or images) and/or compulsions (repetitive behaviors or mental acts performed to neutralize anxiety associated with the obsessions). The scale is structured to capture these two distinct but interrelated dimensions of the disorder.
The instrument is typically divided into two main components: a symptom checklist (which, in the provided source, contains 70 items detailing various symptom subtypes) and a severity scale (which uses 10 items, rated 0-4, to measure the time spent, interference, distress, resistance, and control over obsessions and compulsions). The construct therefore assesses both the qualitative presence of symptoms and the quantitative degree of associated functional impairment and distress.
Validity
The CY-BOCS demonstrates strong psychometric properties, particularly in its ability to accurately measure the intended construct. The scale exhibits good convergent validity, meaning that its scores correlate highly with measures of global psychological impairment and other established measures of OCD severity. This confirms that the scale is measuring the severity of obsessive-compulsive symptomatology.
Furthermore, the scale shows reasonable divergent validity, indicating that while it correlates with related constructs like anxiety and depression, it remains distinct enough to specifically measure OCD severity rather than generalized distress. This differentiation is critical for clinical utility, allowing clinicians to focus specifically on OCD-related distress and impairment in child and adolescent patients.
Reliability
Reliability of the CY-BOCS is generally considered high across multiple studies. The scale typically demonstrates excellent internal consistency, particularly for the severity subscales, confirming that the items within the scale measure a unified construct. Test-retest reliability has also been established as strong, ensuring that the scores are stable over short periods when the patient’s clinical condition has not changed significantly.
Inter-rater reliability is crucial for clinician-administered scales, and the CY-BOCS generally achieves high levels of agreement between different clinical evaluators, provided they have received adequate training. This makes the CY-BOCS a dependable instrument for consistent and reliable monitoring of symptom fluctuation in clinical trials and treatment settings.
Factor Analysis
Factor analysis of the CY-BOCS symptom checklist often reveals distinct symptom dimensions rather than a single global factor. While the severity scale yields a robust total score (0-40 in the standard version), the symptom checklist is typically examined through exploratory and confirmatory factor analysis (EFA/CFA) to identify underlying symptom clusters.
Commonly identified factors or symptom clusters include, but are not limited to, Contamination/Washing, Checking, Hoarding, Symmetry/Ordering, and Aggressive/Sexual/Religious obsessions. Identifying these factors helps researchers and clinicians understand the heterogeneous nature of pediatric OCD and may inform the selection of targeted therapeutic interventions.
Instrument
Test Type: Clinical Rating Scale and Symptom Checklist
Format: Structured or Semi-structured interview, self-report, or parent/clinician rating.
Language Available: English (Original), widely translated into numerous languages including Spanish, French, German, and others due to its international clinical use.
Population Group: Clinical population diagnosed with or suspected of having Obsessive-Compulsive Disorder (OCD).
Age Group: Children and adolescents (4 to 18 years).
Population Details: Applicable across various demographic backgrounds, primarily used in psychiatric and psychological settings to quantify symptom severity in youth.
Test Methodology: The methodology involves two parts: first, identifying the presence of specific symptoms using a detailed checklist (70 items in the provided version); second, rating the severity (frequency, intensity, distress, and interference) of the identified core obsessions and compulsions on a 0-4 scale. The total score mentioned in the source (0-118) likely refers to a weighted combination or a specific research scoring method, while the standard severity score ranges from 0 (no symptoms) to 40 (extreme severity).
Keywords
Pediatric OCD, symptom inventory, severity scale, psychometric reliability, symptom dimensions, clinical rating, treatment monitoring, anxiety disorders, compulsions.
Authors
Author ORCID Identifier: Not provided in source, requires external search (variable for multiple authors).
Affiliation Email addresses: Not provided in source.
Correspondence Address: Not provided in source.
Permissions & Fee and Test Year
The original Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was published in 1989. The Children’s adaptation (CY-BOCS) was developed subsequently, often referenced from the mid-1990s onward, building upon the original structure. As the scale is widely used in clinical and academic settings, it is often available for non-commercial research use, though formal licensing or permission may be required depending on the specific version utilized and the administering organization. Fees vary based on usage (clinical vs. research) and distribution rights.
Test Year: 1989 (Original Y-BOCS); subsequent adaptations for children.
Reference’s
- Goodman, W. K., Price, L. H., Rasmussen, S. A. et al. (1989). The Yale-Brown Obsessive–Compulsive Scale. Arch Gen Psychiatry, 46, 1006-1011.
- Scahill, L., Riddle, M. A., McSwiggin-Hardin, M., Ort, S. I., King, R. A., Goodman, W. K., Leckman, J. F., & Walkup, J. T. (1997). Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS): Reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36(6), 844-852.
- Storch, E. A., Lewis, M., & Wood, J. J. (2010). The Children’s Yale-Brown Obsessive Compulsive Scale: Review of its use in pediatric OCD. Clinical Psychology Review, 30(3), 295-307.
Items of the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS)
IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.
This questionnaire can be completed by the child/adolescent, parents, or both working together. We are interested in getting the most accurate information possible. There are no right or wrong answers. Please just answer the best you can.
| Current | |
| Please check all COMPULSIVE SYMPTOMS that you have noticed during the past week. COMPULSIONS are things you feel compelled to do even though you may know the behaviour does not make sense. Compulsions are typically done to reduce fear of distress associated with obsessive thoughts. — Washing/Cleaning Compulsions — Excessive or ritualized hand washing (e.g., takes long time to wash, needs to restart if interrupted, needs to wash hands in particular order of steps) | 1 |
| Excessive or ritualized showering, bathing, tooth brushing, grooming, toilet routine | 1 |
| Excessive cleaning of items (e.g., clothes, faucets, floors or important objects) | 1 |
| Other measures to prevent or remove contact with contaminants (e.g., using towel or foot to flush toilet or open door; refusing to shake hands; asking family members to remove insecticides, garbage) | 1 |
| Other washing/cleaning compulsions (Describe) | |
| — Checking Compulsions — Checking locks, toys, schoolbooks/items, and so on | 1 |
| Checking associated with getting washed, dressed, or undressed | 1 |
| Checking that did not/will not harm others (e.g., checking that nobody’s been hurt, asking for reassurance, or telephoning to make sure that everything is alright) | 1 |
| Current | |
| Checking that did not/will not harm self (e.g., looking for injuries or bleeding after handling sharp or breakable objects, asking for reassurance that everything is alright) | 1 |
| Checking that nothing terrible did/will happen (e.g., searching the newspaper or television for news about catastrophes) | 1 |
| Checking that did not make a mistake (e.g., while reading, writing, doing simple calculations, homework) | 1 |
| Checking tied to health worries (e.g., seeking reassurance about having an illness, repeatedly measuring pulse, checking for body odors or ugly features) | 1 |
| Other checking compulsions (Describe) | |
| — Repeating Compulsions — Rereading, erasing, or rewriting (e.g., taking hours to read a few pages or write a few sentences because of concern over not understanding or needing letters to be perfect) | 1 |
| Needing to repeat routine activities (e.g., getting up and down from a chair or going in and out of a doorway, turning the light switch or TV on and off a specific number of times) | 1 |
| Other repeating compulsions (Describe) | |
| — Counting Compulsions — Counts objects (e.g., floor tiles, CDs or books on a shelf, his/her own steps, or words read or spoken) | 1 |
| — Arranging/Symmetry — Arranging/ordering (e.g., spends hours straightening paper and pens on a desktop or books in a bookcase, becomes very upset if order is disturbed) | 1 |
| Current | |
| Symmetry/evening up (e.g., arranges things or own self so that two or more sides are “even” or symmetrical) | 1 |
| Other arranging compulsions (Describe) | |
| — Hoarding/Saving Compulsion — Difficulty throwing things away; saving bits of paper, string, old newspapers, notes, cans, paper towels, wrappers and empty bottles; may pick up useless objects from street or garbage | 1 |
| Other hoarding/saving compulsions (Describe) | |
| — Excessive Games/Superstitious Behaviours — Behaviours such as not stepping on cracks or lines on floor/sidewalk, touching an object/self a certain number to times to avoid something bad happening, not leaving home on the 13th of the month) | 1 |
| — Rituals Involving Other Persons — Needing to involve another person (usually a parent) in rituals (e.g., excessive asking for reassurance, repeatedly asking parent to answer the same question, making parent wash excessively) | 1 |
| — Miscellaneous Compulsions — Excessive telling, asking, or confessing (e.g., confessing repeatedly for minor or imagined transgressions, asking for reassurance) | 1 |
| Measures (not checking) to prevent harm to self or others or some other terrible consequences (e.g., avoids sharp or breakable objects, knives, or scissors) | 1 |
| Ritualized eating behaviours (e.g., arranging food, knife, fork in a particular order before eating; eating according to a strict ritual) | 1 |
| Excessive touching, tapping, rubbing (e.g., repeatedly touching particular surfaces, objects, or other people, perhaps to prevent a bad occurrence) | 1 |
| Current | |
| Excessive list making | 1 |
| Needing to do things (e.g., touch or arrange) until it feels “just right” | 1 |
| Avoiding saying certain words (e.g., goodnight or goodbye, person’s name, bad event) | 1 |
| Other compulsions (Describe) | |
| Please check all OBSESSIVE SYMPTOMS that you have noticed during the past week. OBSESSIONS are intrusive, recurrent, and distressing thoughts, sensations, urges, or images that you may experience. They are typically frightening and may be either realistic or unrealistic in nature. — Contamination Obsessions — Excessive concern with dirt, germs, certain illnesses (e.g., from door handles, other people) | 1 |
| Excessive concern/disgust with bodily waste or secretions (e.g., urine, feces, semen, sweat) | 1 |
| Excessive concern with environmental contaminants (e.g., asbestos or radioactive substances) | 1 |
| Excessive concern with contamination from household items (e.g., cleaners, solvents) | 1 |
| Excessive concern about contamination from touching animals/insects | 1 |
| Excessively bothered by sticky substances or residues (e.g., adhesive tape, syrup) | 1 |
| Current | |
| Concerned will get ill as a result of being contaminated by something (e.g., germs, animals, cleaners) | 1 |
| Concerned will get others ill by spreading contaminant | 1 |
| Other washing/cleaning obsessions (Describe) | |
| — Aggressive Obsessions — Fear might harm self (e.g., using knives or other sharp objects) | 1 |
| Fear might harm others (e.g., fear of pushing someone in front of a train, hurting someone’s feelings, causing harm by giving wrong advice) | 1 |
| Fear something bad will happen to self | 1 |
| Fear something bad will happen to others | 1 |
| Violent or horrific images (e.g., images of murders, dismembered bodies, other disgusting images) | 1 |
| Fear of blurting out obscenities or insults (e.g., in public situations like church, school) | 1 |
| Fear will act on unwanted impulses (e.g., punch or stab a friend, drive a car into a tree) | 1 |
| Current | |
| Fear will steal things against his or her will (e.g., accidentally “cheating” cashier or shoplifting something) | 1 |
| Fear will be responsible for terrible event (e.g., fire or burglary because didn’t check locks) | 1 |
| Other aggressive obsessions (Describe) | |
| — Hoarding/Saving Obsessions — Worries about throwing away unimportant things because he or she might need them in the future, urges to pick up and collect useless things | 1 |
| — Health-Related Obsessions — Excessive concern with illness or disease (e.g., worries that he or she might have an illness like cancer, heart disease, or AIDS despite reassurance from doctors; concerns about vomiting) | 1 |
| Excessive concern with body part or aspect of appearance (e.g., worries that his or her face, ears, nose, arms, legs, or other body part is disgusting or ugly) | 1 |
| Other health-related obsessions (Describe) | |
| — Religious/Moral Obsessions — Overly concerned with offending God or other religious objects (e.g., having blasphemous thoughts, saying blasphemous things, or being punished for these things) | 1 |
| Excessive concern with right/wrong, morality (e.g., worries about always doing “the right thing,” worries about having told a lie or having cheated someone) | 1 |
| Other religious obsessions (Describe) | |
| Current | |
| — Magical Obsessions — Has lucky/unlucky numbers, colors, words, or gives special meaning to certain numbers, colors, or words (e.g., red is a bad color because once had a bad thought while wearing red shirt) | 1 |
| — Sexual Obsessions — Forbidden or upsetting sexual thoughts, images, or impulses (e.g., unwanted images of violent sexual behaviour toward others, or unwanted sexual urges toward family members or friends) | 1 |
| Obsessions about sexual orientation (e.g., that he or she may be gay or may become gay when there is no basis for these thoughts) | 1 |
| Other sexual obsessions (Describe) | |
| — Miscellaneous Compulsions — Fear of doing something embarrassing (e.g., appearing foolish, burping, having “bathroom accident”) | 1 |
| The need to know or remember things (e.g., insignificant things like license plate numbers, bumper stickers, T-shirt slogans) | 1 |
| Fear of saying certain things (e.g., because of superstitious fears, fear of saying “thirteen”) | 1 |
| Fear of not saying the right thing (e.g., fear of having said something wrong or not using “perfect” word) | 1 |
| Intrusive (nonviolent) images (e.g., random, unwanted images that come into his or her mind) | 1 |
| Intrusive sounds, words, music, or numbers (e.g., hearing words, songs, or music in his or her mind that can’t stop; bothered by low sounds like clock ticking or people talking) | 1 |
| Current | |
| Uncomfortable sense of incompleteness or emptiness unless things done “just right” | 1 |
| Other obsessions (Describe) | |
Cite this article
Mohammed looti (2025). Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Psychological Scales & Instruments Database. Retrieved from https://db.arabpsychology.com/scales/childrens-yale-brown-obsessive-compulsive-scale-cy-bocs/
Mohammed looti. "Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS)." Psychological Scales & Instruments Database, 27 Oct. 2025, https://db.arabpsychology.com/scales/childrens-yale-brown-obsessive-compulsive-scale-cy-bocs/.
Mohammed looti. "Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS)." Psychological Scales & Instruments Database, 2025. https://db.arabpsychology.com/scales/childrens-yale-brown-obsessive-compulsive-scale-cy-bocs/.
Mohammed looti (2025) 'Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS)', Psychological Scales & Instruments Database. Available at: https://db.arabpsychology.com/scales/childrens-yale-brown-obsessive-compulsive-scale-cy-bocs/.
[1] Mohammed looti, "Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS)," Psychological Scales & Instruments Database, vol. X, no. Y, ص Z-Z, October, 2025.
Mohammed looti. Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Psychological Scales & Instruments Database. 2025;vol(issue):pages.