Outcome Measure
Obsessive-Compulsive Inventory – Revised
What it measures?
- Symptom severity of Obsessive-Compulsive Disorder (OCD).The OCI-R contains 6 factors representing the following symptom domains: checking, ordering, neutralizing, washing, obsessing, and hoarding.
Who is it for?
Adults and adolescents aged 16 years +
Instrument Quality
- The OCI-R is a widely-used and psychometrically robust instrument for assessing the severity of OCD symptoms, and is sensitive to change over time (Abramowitz, Tolin & Diefenbach, 2005). However, authors have highlighted several limitations must be considered when using this outcome measure. First, OCD symptoms are often idiosyncratic and heterogenous—and may not be reflected in the 18 items included in the OCI-R. Second, the OCI-R may confound the assessment of severity with the types of symptom an individual experiences. Abramowitz et al (2020) argue that patients with more severe OCD symptoms should be assessed with with the DOCs, whose assessment of severity is not influencewd by the type of number of obsessions or compulsions present. Third, an individual may have severe symptoms that are restricted to one or a small number of domains. As a consequence, they may receive a lower OCI-R total score that does not accurately reflect the severity of their difficulties. Finally, some authors have argued that the Hoarding subscale should be removed from the OCI-R, given that it targets a non-OCD symptom domain (Abramowitz et al., 2020)—however others have found the subscale to be useful in identifying the presence of Hoarding Disorder (Wooton et al., 2015).
Structure
- 18 items
- 5-point Likert scale
- Respondents indicate how frequently (0 = "Not at all"; 4 = "Extremely") they have been distressed or bothered by the problems listed in each item (e.g. "I check things more often than necessary")
Scoring instructions
- Sum item responses for the full-scale and for each subscale to derive full-scale and subscale scores.
| Subscale | Item number |
|---|---|
Neutralizing |
4,10,16 |
Full-scale (OCI-R) |
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18 |
Hoarding |
1,7,13 |
Checking |
2,8,14 |
Obsessing |
6,12,18 |
Washing |
5,11,17 |
Ordering |
3,9,15 |
Score Interpretation
What higher scores mean?
- Greater severity of OCD symptoms and/or Hoarding Disorder symptoms (Hoarding disorder subscale only).
How to assess symptom severity & change?
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 1.78 | |
| 1 SD above normative mean | 3.98 | |
| 2 SD above normative mean | 6.18 | |
| Maximum | 12 |
| Description | Score Range | |
|---|---|---|
| Mild | 0 | |
| Moderate | 16 | |
| Obsessive Compulsive Disorder (OCD) | >=12 | Provisional Diagnosis |
| Severe | 28 | |
| Maximum | 72 |
Severity ranges
Values for non-clinical mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004).
Provisional diagnosis
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 25.11 | Based on a sample of 1339 American participants with obsessive-compulsive disorder (OCD; Abramovitch, Abramowitz, Riemann & McKay, 2020). Participants displayed a diverse range of symptoms presenting at various outpatient, partial hospitalization, and residential treatment facilities, and had been diagnosed with OCD based on DSM criteria. |
| Normative | 14.23 | Based on research by Abramowitz et al (2005) who averaged three large normative samples. Two of these samples derive from Hajcak et al (2004; N = 395 & N = 221) and the third sample derives from Tolin, Woods & Abramovitch (2003; N = 562) |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 12.72 | Based on a sample of 1339 American participants with obsessive-compulsive disorder (OCD; Abramovitch, Abramowitz, Riemann & McKay, 2020). Participants displayed a diverse range of symptoms presenting at various outpatient, partial hospitalization, and residential treatment facilities, and had been diagnosed with OCD based on DSM criteria. |
| Normative | 10.16 | Based on research by Abramowitz et al (2005) who averaged three large normative samples. Two of these samples derive from Hajcak et al (2004; N = 395 & N = 221) and the third sample derives from Tolin, Woods & Abramovitch (2003; N = 562) |
Reliability
| Value | Comments |
|---|---|
| 0.82 | Foa et al (2002) assessed test-retest reliability using a sample of patients with OCD. The test-retest period was approximately 2 weeks. Pearson correlation was employed. |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 4.44 | |
| Hoarding Disorder | >=6 | Provisional Diagnosis |
| 1 SD above normative mean | 7.16 | |
| 2 SD above normative mean | 9.88 | |
| Maximum | 12 |
Severity ranges
Values for non-clinical mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004).
Provisional diagnosis
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 9.29 | Mean and standard deviation for the Hoarding subscale are derived from a sample of patients with a Hoarding Disorder diagnosis (N = 201), diagnosed according to DSM-5 criteria (Wooton et al., 2015). |
| Normative | 4.44 | Mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 2.45 | Mean and standard deviation for the Hoarding subscale are derived from a sample of patients with a Hoarding Disorder diagnosis (N = 201), diagnosed according to DSM-5 criteria (Wooton et al., 2015). |
| Normative | 2.72 | Mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004). |
Reliability
| Value | Comments |
|---|---|
| 0.79 | Foa et al (2002) assessed test-retest reliability using a sample of patients with OCD. The test-retest period was approximately 2 weeks. Pearson correlation was employed. |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 2.95 | |
| 1 SD above normative mean | 5.59 | |
| 2 SD above normative mean | 8.23 | |
| Maximum | 12 |
Severity ranges
Values for non-clinical mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004).
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 4.09 | Based on a sample of 1339 American participants with obsessive-compulsive disorder (OCD; Abramovitch, Ambramowitz, Riemann & McKay). Participants displayed a diverse range of symptoms presenting at various outpatient, partial hospitalization, and residential treatment facilities, and had been diagnosed with OCD based on DSM criteria. |
| Normative | 2.95 | Mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 3.56 | Based on a sample of 1339 American participants with obsessive-compulsive disorder (OCD; Abramovitch, Ambramowitz, Riemann & McKay). Participants displayed a diverse range of symptoms presenting at various outpatient, partial hospitalization, and residential treatment facilities, and had been diagnosed with OCD based on DSM criteria. |
| Normative | 2.64 | Mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004). |
Reliability
| Value | Comments |
|---|---|
| 0.74 | Foa et al (2002) assessed test-retest reliability using a sample of patients with OCD. The test-retest period was approximately 2 weeks. Pearson correlation was employed. |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 2.92 | |
| 1 SD above normative mean | 5.74 | |
| 2 SD above normative mean | 8.56 | |
| Maximum | 12 |
Severity ranges
Values for non-clinical mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004).
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 6.89 | Based on a sample of 1339 American participants with obsessive-compulsive disorder (OCD; Abramovitch, Ambramowitz, Riemann & McKay). Participants displayed a diverse range of symptoms presenting at various outpatient, partial hospitalization, and residential treatment facilities, and had been diagnosed with OCD based on DSM criteria. |
| Normative | 2.92 | Mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 3.76 | Based on a sample of 1339 American participants with obsessive-compulsive disorder (OCD; Abramovitch, Ambramowitz, Riemann & McKay). Participants displayed a diverse range of symptoms presenting at various outpatient, partial hospitalization, and residential treatment facilities, and had been diagnosed with OCD based on DSM criteria. |
| Normative | 2.82 | Mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004). |
Reliability
| Value | Comments |
|---|---|
| 0.84 | Foa et al (2002) assessed test-retest reliability using a sample of patients with OCD. The test-retest period was approximately 2 weeks. Pearson correlation was employed. |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 2.41 | |
| 1 SD above normative mean | 4.96 | |
| 2 SD above normative mean | 7.51 | |
| Maximum | 12 |
Severity ranges
Values for non-clinical mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004).
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 4.62 | Based on a sample of 1339 American participants with obsessive-compulsive disorder (OCD; Abramovitch, Ambramowitz, Riemann & McKay). Participants displayed a diverse range of symptoms presenting at various outpatient, partial hospitalization, and residential treatment facilities, and had been diagnosed with OCD based on DSM criteria. |
| Normative | 2.41 | Mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 4.3 | Based on a sample of 1339 American participants with obsessive-compulsive disorder (OCD; Abramovitch, Ambramowitz, Riemann & McKay). Participants displayed a diverse range of symptoms presenting at various outpatient, partial hospitalization, and residential treatment facilities, and had been diagnosed with OCD based on DSM criteria. |
| Normative | 2.55 | Mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004). |
Reliability
| Value | Comments |
|---|---|
| 0.91 | Foa et al (2002) assessed test-retest reliability using a sample of patients with OCD. The test-retest period was approximately 2 weeks. Pearson correlation was employed. |
| Description | Score Range | |
|---|---|---|
| Below normative mean | 0 | |
| Normative mean | 4.48 | |
| 1 SD above normative mean | 7.64 | |
| 2 SD above normative mean | 10.8 | |
| Maximum | 12 |
Severity ranges
Values for non-clinical mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004).
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 4 | Based on a sample of 1339 American participants with obsessive-compulsive disorder (OCD; Abramovitch, Ambramowitz, Riemann & McKay). Participants displayed a diverse range of symptoms presenting at various outpatient, partial hospitalization, and residential treatment facilities, and had been diagnosed with OCD based on DSM criteria. |
| Normative | 4.48 | Mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004). |
Standard Deviation
| Sample | Mean | Comments |
|---|---|---|
| Clinical | 3.68 | Based on a sample of 1339 American participants with obsessive-compulsive disorder (OCD; Abramovitch, Ambramowitz, Riemann & McKay). Participants displayed a diverse range of symptoms presenting at various outpatient, partial hospitalization, and residential treatment facilities, and had been diagnosed with OCD based on DSM criteria. |
| Normative | 3.16 | Mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004). |
Reliability
| Value | Comments |
|---|---|
| 0.84 | Foa et al (2002) assessed test-retest reliability using a sample of patients with OCD. The test-retest period was approximately 2 weeks. Pearson correlation was employed. |
Instrument developers
- Foa, E.B., Huppert, J.D., Leiberg, S., Hajcak, G., Langner, R., et al. (2002). The ObsessiveCompulsive Inventory: Development and validation of a short version. Psychological Assessment, 14, 485-496
Refrences
*Abramovitch, A., Abramowitz, J. S., Riemann, B. C., & McKay, D. (2020). Severity benchmarks and contemporary clinical norms for the Obsessive-Compulsive Inventory-Revised (OCI-R). Journal of Obsessive-Compulsive and Related Disorders, 27, 100557 *Abramowitz, J. S., & Deacon, B. J. (2006). Psychometric properties and construct validity of the Obsessive–Compulsive Inventory—Revised: Replication and extension with a clinical sample. Journal of anxiety disorders, 20(8), 1016-1035. *Abramowitz, J. S., Tolin, D. F., & Diefenbach, G. J. (2005). Measuring change in OCD: sensitivity of the Obsessive-Compulsive Inventory-Revised. Journal of Psychopathology and Behavioral Assessment, 27, 317-324. *Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., & Salkovskis, P. M. (2002). The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological assessment, 14(4), 485. *Hajcak, G., Huppert, J. D., Simons, R. F., & Foa, E. B. (2004). Psychometric properties of the OCI-R in a college sample. Behaviour research and therapy, 42(1), 115-123. *Tolin, D. F., Woods, C. M., & Abramowitz, J. S. (2003). Relationship between obsessive beliefs and obsessive–compulsive symptoms. Cognitive Therapy and Research, 27, 657-669. *Veale, D., Lim, L. F., Nathan, S. L., & Gledhill, L. J. (2016). Sensitivity to change in the Obsessive Compulsive Inventory: Comparing the standard and revised versions in two cohorts of different severity. Journal of Obsessive Compulsive and Related Disorders, 9, 16-23. https://doi.org/10.1016/j.jocrd.2016.02.001 *Wootton, B. M., Diefenbach, G. J., Bragdon, L. B., Steketee, G., Frost, R. O., & Tolin, D. F. (2015). A contemporary psychometric evaluation of the Obsessive Compulsive Inventory—Revised (OCI-R). Psychological assessment, 27(3), 874.
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Severity ranges
Values for non-clinical mean and standard deviation are derived from a sample of 395 undergraduate students (Hajcak, Huppert, Simons & Foa, 2004).
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Mean
Standard Deviation
Reliability