Obsessive-compulsive scale of the child behavior checklist: specificity, sensitivity, and predictive power

Area of Science:

• Child and Adolescent Psychiatry
• Psychometric Validation
• Behavioral Assessment

Background:

• Obsessive-compulsive disorder (OCD) is a significant mental health condition in children and adolescents.
• Accurate and efficient screening tools are crucial for early identification and intervention.
• The Child Behavior Checklist (CBCL) is a widely used measure for child psychopathology.

Purpose of the Study:

• To develop and validate an Obsessive-Compulsive Disorder subscale (OCS) for the Child Behavior Checklist (CBCL).
• To assess the internal consistency, sensitivity, specificity, and predictive power of the CBCL OCS for identifying pediatric OCD.
• To compare the performance of the CBCL OCS with existing screening instruments.

Main Methods:

• Factor analysis was used to create the OCS from 11 CBCL items.
• Three matched samples (N=73 each) were analyzed: clinically ascertained OCD, psychiatrically treated non-OCD, and general population controls.
• Internal consistency, sensitivity, specificity, and positive/negative predictive values were calculated.

Main Results:

• Eight items were retained for the OCS, demonstrating excellent internal consistency (Cronbach's alpha = 0.84).
• OCD participants exhibited significantly higher OCS scores compared to control groups.
• The CBCL OCS achieved high sensitivity (75.3%-84.9%) and specificity (82.2%-92.5%), with strong predictive values.

Conclusions:

• The CBCL OCS is a valid and reliable screening tool for identifying obsessive-compulsive disorder in children and adolescents.
• Its performance favorably compares to the Leyton Obsessional Inventory-Child Version.
• The CBCL OCS offers a practical advantage due to the CBCL's widespread use in assessing various psychopathological conditions.