(PS2-97) Validation of the Yale-brown Obsessive Compulsive Scale Among Sexual Minority Adults with OCD

Background: Research has identified that the risk for OCD is 9 X higher for sexual minority (SM; e.g., gay, lesbian, bisexual) people compared to their heterosexual peers. Existing research on the mental health disparity between SM and heterosexual adults has emphasized the potential role of minority stress theory; however, an additional explanation for the highlighted disparity in OCD diagnosis may be due to the lack of validated psychological assessments among SM people. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), was developed to measure OCD severity but its intital and follow-up validation studies have not included SM people, calling into question its application to minoritized individuals with OCD. The current project is significant in identifying what unique factors the Y-BOCS severity scale is capturing among this population, expanding the utility of the Y-BOCS to more diverse participants. 

Methods: Participants (N = 112) were SM adults in a partial hospital or residential treatment program for OCD, with an average stay in treatment of 62.6 days (SD = 26.0). Participants identified as asexual (n = 14; 13%), bisexual (n = 43; 38%), demisexual (n = 4; 4%), gay/lesbian (n = 35; 31%), or queer (n = 13; 12%) and primarily identified as non-Latinx White (n = 103; 90%), and cisgender men and women (n = 92; 81%). Participants completed the Y-BOCS self-report at baseline, a 10-item measure of OCD severity, rated on a 5-point Likert scale. An exploratory factor analysis (EFA) was conducted in R to examine the structure of latent variables, and better understand the patterns in which SM people respond to the Y-BOCS items. 

Results: The EFA identified 3 latent variables. Factor 1 was composed of 4 items that explained 19% of the total variance, and based on item content, represents severity of obsessions. Factor 2 was composed of 4 items that explained 34% of the total variance, and based on item content, represents severity of compulsions. Last, factor 3 was composed of 2 items that explained 46% of the total variance, and, based on item content, represents resistance against symptoms.

Conclusions: EFA analysis of the Y-BOCS self-report measure among SM people led to a  3-factor solution, which included severity of obsessions, severity of compulsions, and resistance against symptoms. Our findings align with prior EFA studies of the Y-BOCS among non-SM populations, identifying the same factors with the same items. The current research has limitations; namely, the current sample was not diverse regarding race/ethnicity or gender identity, and several of the items had weak correlations to factors and loaded on several different factors. Future work should compare the Y-BOCS to other clinical tools (e.g., measures for anxiety, depression) to further understand its validity, and utilize confirmatory factor analysis to verify the factor structure and test for measurement invariance.