Children's Yale-Brown Obsessive Compulsive Scale in Autism Spectrum Disorder: Component Structure and Correlates of Symptom Checklist

• Type of Material: Article
• Authors: Lawrence Scahill, Emory University; Anastacia Dimitropoulos, Case Western Reserve University; Christopher J. McDougle, Harvard University; Michael G. Aman, Ohio State University; Irene D. Feurer, Vanderbilt University; James T. McCracken, University of California, Los Angeles; Elaine Tierney, Johns Hopkins University; Jie Pu, University of Arizona; Susan White, Virginia Polytechnic University; Luc Lecavalier, Ohio State University; Victoria Hallett, Kings College London; Karen Bearss, Emory University; Bryan King, University of Washington; L. Eugene Arnold, Ohio State University; Benedetto Vitiello, National Institute of Mental Health
• Language: English
• Date: 2014-01-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jaac.2013.09.018
• Title of Journal or Parent Work: Journal of the American Academy of Child and Adolescent Psychiatry
• ISSN: 0890-8567
• Volume: 53
• Issue: 1
• Start Page: 97
• End Page: 107
• Grant/Funding Information: This work was funded by NIMH by the following Research Units on Pediatric Psychopharmacology (RUPP) grants: Yale, U10MH66764; Indiana University, U10MH66766; and Ohio State University, U10MH66768.; This publication was also supported by the Yale CTSA; UL1 RR024139; IU CTSA UL1 RR025761; OSU CTSA UL1 RR025755 from the National Center for Research Resources (NCRR).
• Keywords: RELIABILITY; Pediatrics; Psychology; clinical trials; REPETITIVE BEHAVIOR; Social Sciences; Psychology, Developmental; Psychiatry; SELF; Life Sciences & Biomedicine; INTERVIEW; repetitive behavior; QUESTIONNAIRE; autism spectrum disorder; Science & Technology; outcome measures; PERVASIVE DEVELOPMENTAL DISORDERS; VALIDATION; RISPERIDONE; TRIAL; SERIOUS BEHAVIORAL-PROBLEMS
• Research Categories: Health Sciences, Mental Health; Psychology, Developmental

Abstract

Objective: Repetitive behaviors in autism spectrum disorders (ASD) range from motor stereotypy to immersion in restricted interests. The modified Children's Yale-Brown Obsessive Compulsive Scale for children with autism spectrum disorder (CYBOCS-ASD) includes a Symptom Checklist (behavior present or absent) and 5 severity scales (Time Spent, Interference, Distress, Resistance and Control). Method: We assembled CYBOCS-ASD data from 3 Research Units on Pediatric Psychopharmacology Autism Network trials to explore the component structure of repetitive behaviors in children with ASD. Raters trained to reliability conducted the CYBOCS-ASD in 272 medication-free subjects. Fifteen Symptom Checklist items were endorsed for less than 5% of the sample and were dropped. Principal component analysis was used to explore the clustering of 23 checklist items. Component scores computed for each subject were correlated with other measures. We also examined the distribution of severity scales. Results: The subjects (229 boys and 43 girls; mean age = 7.8 ± 2.6 years) met criteria for an ASD; half were intellectually disabled. The PCA resulted in a 5-component solution to classify repetitive behaviors (34.4% of the variance): hoarding and ritualistic behavior; sensory and arranging behavior; sameness and self-injurious behavior; stereotypy; restricted interests. Sensory and arranging and stereotypy components were associated with lower adaptive functioning (Pearson r = 0.2-0.3; p <.003). The resistance scale showed little variation, with more than 60% of the sample with the highest score. Conclusions: Rarely endorsed items can be dropped from the Checklist. The resistance item does not appear to be relevant for children with ASD.