Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS)

The CY-BOCS operationalizes OCD in children as intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that cause distress or consume time. Unlike adult OCD where insight is variable, children often lack full awareness that their OCD is irrational; the CY-BOCS captures this developmental difference by assessing both resistance to compulsions and insight separately. The measure focuses on time, interference, and distress—the functional impact of OCD—rather than specific content (which varies enormously across children: some fear contamination, others fear harm, still others have purely mental compulsions). The CY-BOCS guides treatment selection (ERP for compulsions, acceptance for obsessions) and monitors efficacy of SSRIs and cognitive-behavioral therapy.