A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale.

TLDR

The authors created the 12‑item BDD‑YBOCS, a clinician‑rated tool to assess body dysmorphic disorder severity. The scale was tested in 125 BDD patients, with inter‑rater and test‑retest reliability assessed, and its validity and sensitivity to change examined using additional scales and a fluvoxamine trial. The BDD‑YBOCS showed strong reliability, convergent validity with global severity, modest association with depression, a three‑factor structure explaining 59.6 % of variance, and sensitivity to change, confirming it as a reliable and valid outcome measure.

Abstract

The authors developed the Yale Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS), a 12-item semistructured clinician-rated instrument designed to rate severity of body dysmorphic disorder (BDD). The scale was administered to 125 subjects with BDD, and interviews with 15 subjects were rated by 3 other raters. Test-retest reliability was assessed in 30 subjects. Other scales were administered to assess convergent and discriminant validity, and sensitivity to change was evaluated in a study of fluvoxamine. Each item was frequently endorsed across a range of severity. Good interrater reliability, test-retest reliability, and internal consistency were obtained. BDD-YBOCS scores correlated with global severity scores but not with a measure of general psychopathology; they were modestly positively correlated with depression severity scores. Three factors accounted for 59.6 percent of the variance. The scale was sensitive to change in BDD severity. The BDD-YBOCS appears to be a reliable and valid measure of BDD severity and is a suitable outcome measure in treatment studies of BDD.