Evaluation of the Yale-Brown Obsessive Compulsive Scale (YBOCS-hd) for heavy drinking with mild to moderately dependent alcohol abusers

Background: Many similarities have been noted between urges and desires to drink heavily and obsessive-compulsive disorders (OCD). Based on such simil arities, Modell et al. (1992) developed the Yale-Brown Obsessive Compulsive Scale for heavy drinking (YBOCS-hd), a modified version of YBOCS, to asses s obsessions and compulsions related to heavy drinking. Evaluation of the Y BOCS-hd has been limited to more severely dependent alcohol abusers. Methods: The present study used a self-administered version of the YBOCS-hd to evaluate (1) the severity of drinking-related obsessive compulsive symp toms with mild to moderately dependent alcohol abusers (problem drinkers), and (2) whether end-of-treatment changes in YBOCS-hd scores would be relate d to within-treatment functioning. Results: Results indicated that problem drinkers have lower alcohol-related Obsessive and Compulsive subscale scores than did more severely dependent drinkers, but higher scores than did non-problem drinkers, supporting the c onstruct validity of the YBOCS-hd. In addition, at the end of treatment, th e YBOCS-hd scores of alcohol abusers who drank at low-risk levels during tr eatment were significantly lower than the scores of those who drank at high -risk levels. Lastly, exploratory factor analysis did not provide support f or the two purported YBOCS-hd subscales (Obsessive, Compulsive). Instead, t he analysis yielded a single general factor and a second factor that contai ned two questions measuring heavy drinking. Conclusions: Despite the fact that total YBOCS-hd scores covaried with drin king, neither the total YBOCS-hd pretreatment score nor the two subscale sc ores predicted functioning at the end of treatment. The present results cal l into question the utility of the YBOCS-hd, because a single item measurin g the heaviness of drinking was as useful as the total YBOCS-hd and its two subscales in relating changes during treatment to end-of-treatment functio ning for problem drinkers. However, although the YBOCS-hd does not predict changes in drinking, it may have value as an indirect measure of drinking i n situations where direct measurement of alcohol consumption is undesirable (i.e., direct measurement might be reactive). Because the present findings are derived from problem drinkers, further research is needed to confirm t he factor structure of the YBOCS-hd with clients who represent a broader ra nge of alcohol problem severity.