Northcentral University: Child OCD Inventory Comparison

This report provides a comparative analysis of two inventories used to assess obsessive-compulsive disorder (OCD) in children: the Toronto Obsessive-Compulsive Scale (TOCS) and the Obsessive-Compulsive Inventory-Child Version (OCI-CV). The report details the constructs assessed, methods of administration (electronic vs. paper-based), and evidence for reliability (internal consistency and test-retest) and validity (convergent and divergent). It examines the characteristics of the participant populations used to develop each measure and how clinicians utilize them in therapy. The report also outlines recommendations for effective clinical use, the populations studied, and the use of each measure in research, summarizing key findings, and suggesting areas for future research. The TOCS assesses obsessive-compulsive traits across six dimensions, while the OCI-CV focuses on OCD symptoms. Both scales exhibit strong internal consistency, although the TOCS has slightly stronger psychometric properties. The OCI-CV demonstrates a stronger correlation with other anxiety inventories. The report concludes by highlighting the strengths and weaknesses of each measure and suggesting that while both are useful, more research is needed, particularly across diverse cultural contexts.

Running head: CHILD OBSESSIVE COMPULSIVE DISORDER INVENTORIES
CHILD OBSESSIVE COMPULSIVE DISORDER INVENTORIES
Name of the Student
Name of the University
Author note

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Name of measure #1: Toronto Obsessive-Compulsive Scale (TOCS)
Developer(s): Park, Laura S.; Burton, Christie, L.; Dupuis, Annie; Shan, Janet; Storch, Eric A.;
Crosbie, Jennifer; Schachar, Russell, J.; Arnold, Paul, D.
Source reference: Park, Laura S. (2016). The Toronto Obsessive-Compulsive Scale:
Psychometrics of a dimensional measure of obsessive-compulsive traits. Journal of the American
Academy of Child & Adolescent Psychiatry, 55(4), 310-318. Doi: 10.1016/j.jaac.2016.01.008
PsycINFO Record: 2016-16215-014
Name of measure #2: Obsessive Compulsive Inventory—Child Version (OCI-CV)
Developer(s): Foa, Edna B.; Coles, Meredith; Huppert, Jonathan D.; Pasupuleti, Radhika V.;
Franklin, Martin E.; March, John
Source reference: Foa, Edna B. (2010). Development and validation of a child version of the
Obsessive Compulsive Inventory. Behavior Therapy, 41(1), 121-132. Doi:
10.1016/j.beth.2009.02.001
PsycINFO Record: 2010-03660-005
Construct(s) assessed
The Toronto Obsessive-Compulsive Scale assesses obsessive-compulsive traits in
children as well as adolescents. The scale has 21 items that covers major symptoms of obsessive-
compulsive disorder. There are six dimensions in this scale: Cleaning/Contamination,
Rumination, Hoarding, Symmetry/Ordering, Superstition and Counting/Checking. The
Obsessive-Compulsive Inventory – Child Version assesses the obsessive-compulsive disorder

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symptoms. This scale too has 21 items that were selected from the original OCI scale that had 6
domains of Checking, Hoarding, Ordering, Obsessing and Neutralizing.
Methods of administration
The method of administration for the TOCS scale is electronic while the OCI-CV is presented on
a paper.
Reliability evidence
When referring to the internal consistency of the TOCS scale, it has a strong internal
consistency of 0.94 for all the 21 items as indicated by Cronbach’s alpha. Each of the 6
dimensions of the TOCS scale showed high internal consistency with the Cronbach’s alpha
values which are given as follows: Cleaning/Contamination, 0.89; Symmetry/Ordering, 0.93;
Counting/Checking, 0.89; Rumination, 0.86; Superstition, 0.80; and Hoarding, 0.85. The OCI-
CV was found to have strong internal consistency whose alpha values were strong for the total
score as well as the six subscales. The internal consistency of the total score was 0.85. For the six
subscales the internal consistency was as follows: Doubting/Checking- 0.82, Obsessing- 0.83,
Hoarding – 0.88, Washing – 0.83, Ordering – 0.83, Neutralizing- 0.81. The Test- retest reliability
of the inventory, which was given at an interval of 1.5 weeks, was also found to be good. The
reliability for the total score was 0.77, Doubting/Checking – 0.68, Obsessing – 0.85, Hoarding –
0.79, Washing – 0.89, Ordering – 0.70 and Neutralizing – 0.83. Both the scales have high
internal consistency however; the scores of the TOCS scale are much stronger than the OCI-CV
scale.
Validity evidence

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The TOCS scale showed both convergent and divergent validity. The scores of the scale
have shown moderate correlations with both Obsessive-Compulsive scale of the Child Behaviour
Checklist total and weighed scores (r = 0.51; p < 0.01). The TOCS scale had low correlation with
the strengths and weaknesses of the ADHD symptoms (attention-deficit/hyperactivity disorder)
as well as with the Normal Behaviour Rating Scale (SWAN). It was not found to be statistically
significant (r = 0.01, p = 0.53). The sensitivity and specificity analyses have indicated that when
the total score of the scale was greater than 0 then it successfully distinguished between the
reported cases of obsessive-compulsive disorder from the non-cases. When referring to
convergent validity, the OCI-CV total score was found to be significantly correlated with the
scores on the Total Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS) as well as with
the Obsessions and Compulsion Scale. The scores were also significantly correlated with the
scores of the NIMH Global Obsessive-Compulsive Scale score that indicated reports of
dysfunction with OCD in both the parent and the child. The scores had a strong correlation with
Multidimensional Anxiety Scale for Children (MASC) and with the Children’s Depression
Inventory (CDI). The scores of OCI-CV had a stronger correlation with the scores on the MASC
scale than the CDI scale and that is expected, as OCD is an anxiety disorder. When comparing
the validity of both the scales, it can be seen that OCI-CV has a stronger validity with the other
anxiety inventories than the TOCS scales as the scores above provide evidences in support of the
point made.
Characteristics of the participants used to develop measure
The participants who were used to develop this scale were from Canada belonging to the
Community Pediatric Sample whose age range was between 6 to 17 years. The sample consisted
of 332 pairs of parent and children, the inventory used both self-reported, and parent reported

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feedback for information. The participants who were used to develop the OCI-VS scale were
children who had OCD and belonged to the age group of 7 to 17 years. The age range of children
used for developing both the scales is similar. While the developers of TOCS used children who
visited the popular science museum and belonged to diverse ethnic backgrounds, the developers
of OCI-CV used actual children who suffered from OCD.
Clinicians have used this measure in therapy
Both the scales have been used by the clinicians to investigate the traits of obsessive-
compulsive disorder in children. Because of the strong reliability and validity of the OCI-CV
inventory, it showed more effective results in diagnosing children with OCD traits. The TOCS
scale has strong psychometric properties that make it liable to be used as by therapists in
diagnosing children.
Recommendations for effective clinical use for each measure
TOCS scale has effective psychometric properties that measure the obsessive-compulsive
traits in children and the adolescents. It is a useful measure that can be used for studying the
characteristics and the etiological traits of OCD. The OCI-CV is a valid and reliable inventory
that measures symptoms of OCD across age groups and has a good clinical utility. Both the
measures can be used effectively in diagnosing children who have obsessive-compulsive
disorder at an early stage.
Population used in the measure
Both the inventories have been used with the population across various ethnicities and
diverse backgrounds. The TOCS was measured on a population at a science museum that
measured the genetic effects as well by using a sample of univariate and multivariate twins

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(Burton et al., 2018). The research was on “Heritability of obsessive–compulsive trait
dimensions in youth from the general population” (Burton et al., 2018). The OCI-CV has been
effective in assessing the OCD symptoms in both the parents and the children from diverse
backgrounds in a research on “Psychometric properties of the Obsessive-Compulsive Inventory-
Child Version (OCI-CV) in Chilean children and adolescents” (Martínez-González et al., 2015).
Use of the measure in studies
A factor analysis was conducted to identify the symptoms of OCD and the trait
dimensions by using the TOCS scale. The OCI-CV has been used in many research studies like
in Chilean community samples. They tested the symptoms across genders and on children and
adolescents who belonged to this community.
Summary of the findings
The findings from the TOCS study revealed that each dimension had a genetic effect.
Every dimension except Hoarding had high correlation with the other dimensions. In conclusion,
every dimension was found to be heritable (Burton et al., 2018). The OCI-CV has been used in
many research studies. The evidence showed high reliability and validity of the test. The results
also showed differences in age and gender. The women and the older participants had higher
symptoms of OCD. The studies showed that it is an excellent measure with high psychometric
properties (Martínez-González et al., 2015).
Future research on the measures
A future research can be done to understand the validity and consistency of the results
across various ethnicities and cultures. Both the measures have not been used to measure the
differences in the trait symptoms that can occur across various cultures.

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Overall impression of measures
The TOCS is a good measure for assessing the symptoms of OCD in children due to its
strong psychometric properties. The OCI-CV is however, a better measure because it is the child
version of the original inventory. Both the measures can be used in therapy to diagnose children
and understand their problems. However, more research has to be done on the validity and
reliability of the inventories across various cultures.

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References
Burton, C., Park, L., Corfield, E., Forget-Dubois, N., Dupuis, A., & Sinopoli, V. et al. (2018).
Heritability of obsessive–compulsive trait dimensions in youth from the general
population. Retrieved 8 April 2020, from https://doi.org/10.1038/s41398-018-0249-9
Foa, Edna B. (2010). Development and validation of a child version of the Obsessive
Compulsive Inventory. Behavior Therapy, 41(1), 121-132. doi:
10.1016/j.beth.2009.02.001
Martínez-González, A. E., Rodríguez-Jiménez, T., Piqueras, J. A., Vera-Villarroel, P., & Godoy,
A. (2015). Psychometric properties of the Obsessive-Compulsive Inventory-Child
Version (OCI-CV) in Chilean children and adolescents. PloS one, 10(8).
Park, Laura S. (2016). The Toronto Obsessive-Compulsive Scale: Psychometrics of a
dimensional measure of obsessive-compulsive traits. Journal of the American Academy
of Child & Adolescent Psychiatry, 55(4), 310-318. doi: 10.1016/j.jaac.2016.01.008