Contract grant sponsor: National Institute of Mental Health research grants; Contract grant numbers: 5R01MH071688; 5R01MH071456.
A CLINICIAN-ADMINISTERED SEVERITY RATING SCALE FOR ILLNESS ANXIETY: DEVELOPMENT, RELIABILITY, AND VALIDITY OF THE H-YBOCS-M
Article first published online: 13 APR 2012
© 2012 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 29, Issue 7, pages 652–664, July 2012
How to Cite
Skritskaya, N. A., Carson-Wong, A. R., Moeller, J. R., Shen, S., Barsky, A. J. and Fallon, B. A. (2012), A CLINICIAN-ADMINISTERED SEVERITY RATING SCALE FOR ILLNESS ANXIETY: DEVELOPMENT, RELIABILITY, AND VALIDITY OF THE H-YBOCS-M. Depress. Anxiety, 29: 652–664. doi: 10.1002/da.21949
- Issue published online: 3 JUL 2012
- Article first published online: 13 APR 2012
- Manuscript Accepted: 10 MAR 2012
- Manuscript Revised: 28 FEB 2012
- Manuscript Received: 25 NOV 2011
- National Institute of Mental Health research grants. Grant Numbers: 5R01MH071688, 5R01MH071456
- illness anxiety;
- anxiety disorders;
- obsessive-compulsive disorder (OCD);
- health services
Clinician-administered measures to assess severity of illness anxiety and response to treatment are few. The authors evaluated a modified version of the hypochondriasis-Y-BOCS (H-YBOCS-M), a 19-item, semistructured, clinician-administered instrument designed to rate severity of illness-related thoughts, behaviors, and avoidance.
The scale was administered to 195 treatment-seeking adults with DSM-IV hypochondriasis. Test–retest reliability was assessed in a subsample of 20 patients. Interrater reliability was assessed by 27 interviews independently rated by four raters. Sensitivity to change was evaluated in a subsample of 149 patients. Convergent and discriminant validity was examined by comparing H-YBOCS-M scores to other measures administered. Item clustering was examined with confirmatory and exploratory factor analyses.
The H-YBOCS-M demonstrated good internal consistency, interrater and test–retest reliability, and sensitivity to symptom change with treatment. Construct validity was supported by significant higher correlations with scores on other measures of hypochondriasis than with nonhypochondriacal measures. Improvement over time in response to treatment correlated with improvement both on measures of hypochondriasis and on measures of somatization, depression, anxiety, and functional status. Confirmatory factor analysis did not show adequate fit for a three-factor model. Exploratory factor analysis revealed a five-factor solution with the first two factors consistent with the separation of the H-YBOCS-M items into the subscales of illness-related avoidance and compulsions.
H-YBOCS-M appears to be valid, reliable, and appropriate as an outcome measure for treatment studies of illness anxiety. Study results highlight “avoidance” as a key feature of illness anxiety—with potentially important nosologic and treatment implications. Depression and Anxiety 00:1–13, 2012. © 2012 Wiley Periodicals, Inc.