Treatment sensitivity was classified by statistically significant reductions in symptoms following an evidence-based treatment. Correlation values that exceeded this range were considered fair (0.30–0.49) and poor (>0.50) discriminant validity. Good discriminant validity was represented by correlations of 0.10–0.29 between the rating scale and measures of nonobsessive–compulsive symptoms and severity. Correlation values of 0.30–0.49 and 0.10–0.29 represented fair and poor convergent validity, respectively. For internal consistency, α values ≥0.90 were considered excellent, 0.80–0.89 were considered good, 0.70–0.79 were considered fair, and 0.50 between the rating scale and other measures of obsessive–compulsive symptoms and severity. 3, 4 Psychometric evaluation of reliability was based on internal consistency, interrater reliability, and test–retest reliability. When describing the psychometric properties of the measures included in this review, the following criteria were used to benchmark categorizations of reliability and validity. 1, 2 Accordingly, familiarity with the armamentarium of evidence-based assessment measures for OCD meaningfully enhances a provider’s ability to select the appropriate measure to detect and/or monitor the treatment of this disorder. Within this framework, the clinician is guided by knowledge of what tool may be most useful, feasible, and accurate in a specific situation. Thus, a pragmatic framework is useful to inform measure selection to meet the aforementioned aims. Similarly, when monitoring changes in symptom severity during treatment, reliance on assessment tools with demonstrated treatment sensitivity would be prioritized. Comparatively, when confronted with a differential diagnosis (eg, distinguishing OCD from an anxiety disorder or depression), diagnostic specificity would take precedence. For example, measures with strong diagnostic sensitivity might be prioritized when screening for symptoms. First, one must identify the primary aim of the assessment and prioritize measures in line with this goal. Several factors are important to consider when developing an evidence-based assessment battery. Finally, this paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals and empirical support. Second, the incorporation of additional important factors in an evidence-based OCD assessment is discussed (ie, impairment, family accommodation, and insight). Clinician-rated measures are discussed initially, followed by adult self-report measures, and finally parent/child measures. First, the pragmatics of measure administration and psychometric properties are reviewed. In response to these challenges, this paper reviews commonly used OCD measures that have been examined in research studies to enhance clinicians’ abilities to detect and monitor OCD symptom severity during assessment and treatment. Obsessive–compulsive symptoms can be difficult to assess, given that they are often manifested internally, and individuals with OCD may not be inclined to recognize and report symptoms (ie, limited insight). A comprehensive evidence-based assessment is a critical step in accurately identifying the presence and severity of obsessive–compulsive disorder (OCD) in both clinical and research practice.
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