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Development and Psychometric Properties of the Dimensional Obsessive-Compulsive Scale (DOCS) Jonathan S. Abramowitz, PhD University of North Carolina at.

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Presentation on theme: "Development and Psychometric Properties of the Dimensional Obsessive-Compulsive Scale (DOCS) Jonathan S. Abramowitz, PhD University of North Carolina at."— Presentation transcript:

1 Development and Psychometric Properties of the Dimensional Obsessive-Compulsive Scale (DOCS) Jonathan S. Abramowitz, PhD University of North Carolina at Chapel Hill

2 Collaborators Brett Deacon Bunmi Olatunji Michael Wheaton Noah Berman Diane Losardo Kiara Timpano Patrick McGrath Bradley Riemann Thomas Adams Throstur Bjorgvinsson Eric Storch Lisa Hale

3 Assessment of OCD OCD is heterogeneous Challenges in assessing OCD symptoms – Measure a wide range of possible symptoms – Do so efficiency (as few items as possible) Approaches – Assess only the quintessential obs. and comps. PI/PI-R, OCI/OCI-R, MOCI – Assess the severity of the patient’s main symptoms YBOCS/D-YBOCS

4 Limitations of Existing OCD Measures Symptom severity is confounded with breadth Severity is confounded with popularity of sx One dimensional assessment of severity Obsessions assessed separately from rituals Avoidance? Hoarding?

5 We Need New OCD Measures Assess the severity of empirically supported symptom dimensions – Contamination, responsibility for harm/mistakes, Unacceptable thoughts, symmetry/incompleteness Multiple severity parameters Assess avoidance Assess severity independent of type or range of symptoms Easy to administer

6 DOCS Four sections (one for each symptom dimension) – Contamination, responsibility, unacceptable thoughts, symmetry/incompleteness Each section contains – Examples of obsessions, compulsions, avoidance – Five severity questions (time, avoidance, distress, interference, control) rated 0 to 4 20 items in all Approximately 5-10 mins. to read and complete

7 Study Aims Factor structure Reliability and Validity Diagnostic accuracy Treatment sensitivity

8 Method Participants (data collected at 8 sites) – 315 adults with OCD – 198 adults with other anxiety disorders (OAD) – 1,044 unselected undergraduate students Measures GroupDOCSOCI-RYBOCSBDIBAIDASSSIAS OCD X X X X X X OAD X X X X X Students X X X X

9 Results: Exploratory Factor Analysis with Half of the Student Sample

10 Results: Confirmatory Factor Analyses Goodness-of-fit parameters indicated that the student and clinical data fit the four-factor structure very well. Goodness-of-fit index GroupRMSEASRMRTLICFI Students OCD + OAD

11 Correlations among factors showing weak to moderate relationships

12 Reliability Cronbach’s alpha and item-total correlation Test-retest

13 Convergent and Discriminant Validity: DOCS Total Score

14 Convergent and Discriminant Validity: DOCS Factors/Subscales

15 Known-Groups Validity

16 Diagnostic Accuracy: ROC Analyses DOCS total score discriminates: – OCD patients from nonclinicals (AUC =.86) – OCD patients from OAD patients (AUC =.77) Cutoff scores – A score of 21 correctly classified 70% of OCD patients and 70% of OAD patients – A score of 18 correctly classified 78% of OCD patients and 78% of students

17 Diagnostic Accuracy: DOCS vs. OCI-R OCD vs. Nonclinical OCD vs. OAD Diff in AUC =.06; Z = 4.68, p <.01 Diff in AUC =.08; Z = 3.57, p <.01

18 Sensitivity to Treatment

19 Conclusions The DOCS is a conceptually & psychometrically sound measure of OC symptoms in patients and nonpatients – Addresses many of the limitations of existing measures Uses – Baseline assessment of symptom dimensions – Treatment response (use “main” symptom dimension) – Measure of psychopathology for research Future work – Test-retest in a clinical (OCD) group – Child version – Translations


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