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Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder: Factor Structure and Construct Validity

Ivar Snorrason1, Adam C Jaroszewski1, Jennifer L Greenberg1

  • 1Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School.

Journal of Obsessive-Compulsive and Related Disorders
|January 27, 2025
PubMed
Summary

The Body Dysmorphic Disorder-Yale Brown Obsessive Compulsive Scale (BDD-YBOCS) shows two factors: Severity and Resistance/Control. The Severity factor is a stronger measure for assessing Body Dysmorphic Disorder symptoms.

Keywords:
BDD-YBOCSYale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorderassessmentbody dysmorphic disorderpsychometricscalevalidity

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Psychometrics

Background:

  • Body Dysmorphic Disorder (BDD) is a serious mental health condition characterized by obsessive preoccupation with perceived flaws in appearance.
  • The Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) is a key tool for assessing BDD severity.
  • Understanding the psychometric properties of the BDD-YBOCS is crucial for accurate diagnosis and treatment.

Purpose of the Study:

  • To investigate the factor structure of the BDD-YBOCS.
  • To examine the construct validity of the BDD-YBOCS in a sample of adults with BDD.
  • To evaluate the reliability and validity of the BDD-YBOCS for assessing BDD severity.

Main Methods:

  • Exploratory factor analysis was used to determine the underlying structure of the BDD-YBOCS.
  • 366 adults diagnosed with BDD completed the BDD-YBOCS, alongside measures of BDD severity, psychiatric distress (anxiety, depression), and quality of life.
  • Internal consistency (Cronbach's alpha) and construct validity (correlations with other measures) were assessed for each factor.

Main Results:

  • The BDD-YBOCS demonstrated a two-factor structure: Severity (time, distress, interference, avoidance) and Resistance/Control (reduced effort to resist, lack of control).
  • The Severity factor exhibited good internal consistency (α = .82) and strong construct validity across multiple measures.
  • The Resistance/Control factor showed acceptable internal consistency (α = .74) but weaker construct validity, particularly concerning BDD severity and associated distress.

Conclusions:

  • The BDD-YBOCS effectively measures BDD severity through its 'Severity' factor, demonstrating good reliability and validity.
  • The 'Resistance/Control' factor, while internally consistent, has limited construct validity, suggesting it may capture different aspects of the disorder.
  • Findings support the use of the BDD-YBOCS, particularly its Severity subscale, for clinical assessment and research in Body Dysmorphic Disorder.