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Related Experiment Video

Updated: Jun 22, 2025

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Rethinking Unacceptable Thoughts: Validation of an Expanded Version of the Dimensional Obsessive-Compulsive Scale.

Eric B Lee1, Chad T Wetterneck2, Elizabeth McIngvale3

  • 1Southern Illinois University.

Behavior Therapy
|June 27, 2024
PubMed
Summary
This summary is machine-generated.

The Dimensional Obsessive-Compulsive Scale (DOCS) can be refined to better capture distinct unacceptable thoughts in obsessive-compulsive disorder (OCD). A seven-factor version shows promise for research, though the original four-factor scale is best for screening.

Keywords:
OCDsymptom dimensionsunacceptable thoughts, assessment

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Psychometrics

Background:

  • The Dimensional Obsessive-Compulsive Scale (DOCS) is a common tool for assessing obsessive-compulsive disorder (OCD) severity.
  • The "unacceptable thoughts" subscale of the DOCS may group distinct thought types, limiting its specificity.

Purpose of the Study:

  • To evaluate the psychometric properties of a new violent/aggressive thoughts subscale for the DOCS.
  • To examine the factor structure and diagnostic sensitivity of a seven-factor DOCS including specific "unacceptable thoughts" subscales.

Main Methods:

  • The study involved 329 outpatients, with 75.2% diagnosed with OCD.
  • Psychometric properties, factor structure, and diagnostic sensitivity of the original and seven-factor DOCS were assessed.
  • New subscales for sexually intrusive, violent/aggressive, and scrupulous/religious thoughts were evaluated.

Main Results:

  • New "unacceptable thoughts" subscales showed convergent and discriminant validity, with unique associations to depression, suicide, and perceived threat from emotions.
  • The seven-factor DOCS had slightly lower diagnostic sensitivity than the original four-factor version for screening.
  • A score of 40+ on the seven-factor DOCS best predicted an OCD diagnosis.

Conclusions:

  • The three additional "unacceptable thoughts" subscales appear to represent distinct factors valuable for research and clinical use.
  • The original four-factor DOCS is recommended for screening purposes due to its higher diagnostic sensitivity.
  • The seven-factor DOCS may offer nuanced insights into specific obsessive-compulsive thought content in clinical and research settings.