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Child & Youth Mental Health Algorithm - GPSC

Child & Youth Mental Health Algorithm - GPSC

CY-BOCS Symptom

CY-BOCS Symptom ChecklistChildren’s Yale-Brown Obsessive Compulsive ScaleCY-BOCS Compulsions ChecklistCheck all symptoms that apply (Items marked “*” may or may not be OCD Phenomena)Current PastWashing / Cleaning CompulsionsExcessive or ritualized hand washingExcessive or ritualized showering, bathing,tooth brushing, grooming, toilet routineExcessive cleaning of items, such as personalclothes or important objectsOther measures to prevent or remove contactwith contaminantsOther (describe) _____________________Checking CompulsionsChecking locks, toys, school books / items,etc.Checking associated with getting washed,dressed, or undressedChecking that did not / will not harm othersChecking that did not / will not harm selfChecking that nothing terrible did / will happenChecking that did not make mistakeChecking tied to somatic obsessionsOther (describe) _____________________Repeating RitualsRereading, erasing, or rewritingNeed to repeat activities (e.g. in / out ofdoorway, up / down from chair)Other (describe) _____________________Counting CompulsionsObjects, certain numbers, words, etc.Other (describe) _____________________Ordering / ArrangingNeed for symmetry / evening up (e.g. liningitems up a certain way or arranging personalitems in specific patterns)Other (describe) _____________________Current PastHoarding / Saving CompulsionsDistinguish from hobbies and concern withobjects of monetary or sentimental value.Difficulty throwing things away, saving bits ofpaper, string, etc.Other (describe) _____________________Excessive Games / SuperstitiousBehaviorsDistinguish from age appropriate magicalgames (e.g. array of behavior, such assleeping over certain spots on a floor,touching an object / self certain number oftimes as a routine game to avoid somethingbad from happeningOther (describe) _____________________Rituals Involving Other PersonsThe need to involve another person (usually aparent) in ritual (e.g. asking a parent torepeatedly answer the same question, makingmother perform certain mealtime ritualsinvolving specific utensils) *Other (describe) _____________________Miscellaneous CompulsionsMental rituals other than checking / countingNeed to tell, ask or confessMeasures (not checking) to prevent :harm to selfharm to othersterrible consequencesRitualized eating behaviors *Excessive list making *Need to touch, tap, rub *Need to do things (e.g. touch or arrange until itfeels just right) *Rituals involving blinking or staring *Trichotillomania (hair-pulling)Other self-damaging or self-mutilatingbehaviors *Other (describe) _____________________Page 3 of 4

CY-BOCS Symptom ChecklistChildren’s Yale-Brown Obsessive Compulsive ScaleTarget Symptom List for CompulsionsCOMPULSIONS (describe, listing by order of severity, with #1 being the most sever, #2 second most severe,etc):1. _____________________________________________________________________________________2. _____________________________________________________________________________________3. _____________________________________________________________________________________4. _____________________________________________________________________________________Page 4 of 4

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