Appendix 207

Yale-Brown Obsessive-Compulsive Scale (YBOCS)

Questions 1 through 5 are about your obsessive thoughts.
Obsessions are unwanted ideas, images, or impulses that intrude on thinking against your
wishes and efforts to resist them. They usually involve themes of harm, risk, and danger. Common
obsessions are excessive feats of contamination; recurring doubts about danger; extreme concern
with order, symmetry, or exactness; fear of losing important things.

Please answer each question by writing the appropriate number in the box next to it.

1. Time Occupied by Obsessive Thoughts

Q. How much of your time was occupied by obsessive thoughts?
0 = None - If you checked this answer, also check 0 for questions 2, 3, 4 and 5 and
proceed to question 6.
1 = Less than 1 hour per day, or occasional occurrence.
2 = 1 to 3 hours per day, or frequent occurrence.
3 = More than 3 hours and up to 8 hours per day, or very frequent occurrence.
4 = More than 8 hours per day, or nearly constant occurrence.

2. Interference Due to Obsessive Thoughts

Q. How much do your obsessive thoughts interfere with your work, school, social, or
other important role functioning? Is there anything that you don’t do because of them?
. 0 = None
1 = Slight interference with social or other activities, but overall performance not impaired.
2 = Definitive interference with social or occupational performance, but still manageable.
3 = Causes substantial impairment in social or occupational performance.
4 = Incapacitating.

3. Distress Associated with Obsessive Thoughts

Q. How much distress do your obsessive thoughts cause you?
0 = None
1 = Not too disturbing.
2 = Disturbing, but still manageable.
3 = Very disturbing.
4 = Near constant and disabling distress.

4. Resistance Against Obsessions

Q. How much of an effort do you make to resist the obsessive thoughts? How often do you try to
disregard or turn your attention away from those thoughts as they enter your mind?
0 = Try to resist all the time.
1 = Try to resist most of the time.
2 = Make some effort to resist.
3 = Yield to all obsessions without attempting to control them, but with some reluctance.
4 = Completely and willingly yield to all obsessions.
208 The OCD Workbook

5. Degree of Control Over Obsessive Thoughts

Q. How much control do you have over your obsessive thoughts? How successful are you in
stopping or diverting your obsessive thinking?
0 = Complete control
1 = Usually able to stop or divert obsessions with some effort and concentration.
2 = Sometimes· able to stop or divert obsessions.
3 = Rarely successful in stopping obsessions or dismissing obsessions, can only divert
attention with great difficulty.
4 = Obsessions are completely involuntary, rarely able to even momentarily alter
obsessive thinking.

The next several questions are about your compulsive behaviors.

Compulsions are urges that people have to do something to lessen feelings of anxiety or other
discomfort. Often they do repetitive, purposeful, intentional behaviors called rituals. The behavior itself
may seem appropriate but it becomes a ritual when done to excess. Washing, checking, repeating,
straightening, hoarding, and many other behaviors can be rituals. Some rituals are mental. For
example, thinking or saying things over and over under your breath.

6. Time Spent Performing Compulsive Behaviors

Q. How much time do you spend performing compulsive behaviors? How much longer than most
people does it take to complete routine activities because of your rituals? How frequently do
you do rituals?
0 = None.
1 = Less than 1 hour per day, or occasional performance of compulsive behavior.
2 = 1 to 3 hours per day, or frequent performance of compulsive behavior.
3 = More than 3 hours and up to 8 hours per day, or very frequent performance of
compulsive behaviors.
4 = More than 8 hours per day, or near-constant performance of compulsive
behavior (too numerous to count).

7. Interference Due to Compulsive Behaviors

Q. How much do your compulsive behaviors interfere with your work, school, social, or
functioning? Is there anything you don’t do because of your compulsions?
0 = None.
1 = Slight interference with social or other activities, but overall performance not impaired.
2 = Definite interference with social or occupational performance, but still manageable.
3 = Causes substantial impairment in social or occupational performance.
4 = Incapacitating.

8. Distress Associated with Compulsive Behavior

Q. How would you feel if prevented from performing your compulsion(s)? How anxious
would you become?
0 = Not at all anxious.
1 = Only slightly anxious if compulsions prevented.
2 = Anxiety would mount but remain manageable if compulsions prevented.
3 = Prominent and very disturbing increase in anxiety if compulsions interrupted.
4 = Incapacitating anxiety from any intervention aimed at modifying activity.
 Appendix 209

9. Resistance Against Compulsions

Q. How much of an effort do you make to resist the compulsions?
0 = Always try to resist.
1 = Try to resist most of the time.
2 = Make some effort to resist.
3 = Yield to almost all compulsions without attempting to control them, but with
some reluctance.
4 = Completely and willingly yield to all compulsions.
10. Degree of Control Over Compulsive Behavior
Q. How strong is the drive to perform the compulsive behavior? How much control do
you have over the compulsions?
0 = Complete control.
1 = Pressure to perform the behavior but usually able to exercise voluntary control
over it.
2 = Strong pressure to perform behavior, can control it only with difficulty.
3 = Very strong drive to perform behavior, must be carried to completion, can only
delay with difficulty.
4 = Drive to perform behavior experienced as completely involuntary and overpowering,
rarely able to even momentarily delay activity.

Note: Based upon the author’s experience, scores on the YBOCS can be interpreted as follows:

0-14: non-significant to mild OCD

15-23: mild to moderate OCD
23-29: moderate to severe OCD TOTAL = 0
30-40: severe to disabling OCD

This adaptation of the Y-BOCS is printed with the permission of Wayne Goodman at the University of Florida, College of Medicine.
Gainesville, Florida 32610. The original version was published by: Goodman W.K., Price, L.H., Rasmussen, S.A., et al. “Yale-Brown
Obsessive Compulsive Scale I: Development, Use and Reliability.” Arch Gen Psychiatry 1989. 46:1006-1011.

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