CY-BOCS Score Indicating Moderate Severity
A score of 16-23 on the Child Yale-Brown Obsessive Compulsive Scale (CY-BOCS) indicates moderate severity of OCD symptoms, making the correct answer from your options either 20 or 15, with 20 being the most representative of moderate severity. 1, 2
Severity Classification Framework
The CY-BOCS uses the same severity classification system as the adult Y-BOCS, with scores ranging from 0-40 where each of the 10 items is rated from 0 (no symptoms) to 4 (extreme symptoms): 1
From your answer choices, a score of 20 falls squarely within the moderate range (16-23), while 15 represents the upper boundary of mild severity. 1 A score of 25 would indicate severe OCD, and 30 would represent very severe symptoms. 1
Clinical Context for Interpretation
The scale quantifies severity based on three key parameters: time spent on obsessions/compulsions, perceived distress levels, and degree of functional interference in daily activities. 1, 2 Obsessions and compulsions each contribute up to 20 points of the total 40-point scale. 3
The CY-BOCS has demonstrated strong psychometric properties in pediatric populations ages 8-17 years, with good internal consistency (α = .87) and excellent interrater reliability (intraclass correlation = .84 for total scores). 4 The measure has also been validated for use in children as young as 5-8 years, though reliability for the Obsessions subscale alone is questionable in this younger age group. 5
Critical Assessment Considerations
Avoidance behaviors can lead to underestimation of true symptom severity on the CY-BOCS. 1, 2 Children who extensively avoid triggering situations may spend less time on active obsessions/compulsions, artificially lowering their scores despite experiencing severe functional impairment. 1
Family accommodation must be assessed alongside CY-BOCS administration. 1, 2 When parents or family members provide reassurance, participate in rituals, or facilitate avoidance behaviors, this affects the accuracy of interference ratings and may mask the true severity of symptoms. 3, 1
The CY-BOCS should be administered by clinicians trained in recognizing nuanced OCD presentations in youth, as the scale itself is content-independent and requires clinical expertise to properly categorize symptoms across different thematic presentations. 1, 2