Core OCD symptoms: Exploration of specificity and relations with psychopathology

Obsessive–compulsive disorder (OCD) is a heterogeneous condition, comprised of multiple symptom domains. This study used aggregate composite scales representing three core OCD dimensions (Checking, Cleaning, and Rituals), as well as Hoarding, to examine the discriminant validity, diagnostic specificity, and predictive ability of OCD symptom scales. The core OCD scales demonstrated strong patterns of convergent and discriminant validity – suggesting that these dimensions are distinct from other self-reported symptoms – whereas hoarding symptoms correlated just as strongly with OCD and non-OCD symptoms in most analyses. Across analyses, our results indicated that Checking is a particularly strong, specific marker of OCD diagnosis, whereas the specificity of Cleaning and Hoarding to OCD was less strong. Finally, the OCD Checking scale was the only significant predictor of OCD diagnosis in logistic regression analyses. Results are discussed with regard to the importance of assessing OCD symptom dimensions separately and implications for classification.

► We examined differential properties of OCD symptom scales relative to SCID diagnoses.
► Checking, Cleaning and Rituals showed good convergent and discriminant validity.
► Checking was a particularly strong, specific marker of OCD diagnosis.
► Specificity of Cleaning and Hoarding to OCD was weak relative to non-OCD symptoms.
► Checking was the only significant predictor of OCD in logistic regression analyses.