472 TREATMENT OF SPECIFIC ANXIETY DISORDERS
nomena using 5-point Likert scales (Sanavio, 1988). Although possessing good psycho-
metric characteristics, a 41-item version of the instrument was developed by van Oppen,
Hoekstra, and Emmelkamp (1995) and a 39-item version was developed by research-
ers at Washington State University (Burns, Keortge, Formea, & Sternberger, 1996) in
order to eliminate items that may have contributed to the high correlation between the
PI and measures of worry (Freeston, Ladouceur et al., 1994). The Padua Inventory—
Washington State University Revision (PI-WSUR) is the most widely used version of the
PI consisting of five rationally determined subscales; (1) obsessional thoughts of harm
to self/others (seven items), (2) obsessional impulses to harm self/others (nine items), (3)
contamination obsessions and washing compulsions (10 items), (4) checking compulsions
(10 items), and (5) dressing/grooming compulsions (three items). The PI-WSUR appears
to have improved psychometric properties over the original PI and so it has gained in
popularity with OCD researchers (see reviews by Antony, 2001b; Grabill et al., 2008;
St. Clare, 2003). However, questions have been raised about the content validity of the
measure with some symptoms of OCD not assessed and other items more ambiguous or
representing phenomena that may not be germane to OCD. The original PI can be found
in Sanavio (1988) whereas the PI-WSUR has been reproduced by Antony (2001b).
The Vancouver Obsessional Compulsive Inventory (VOCI; Thordarson et al., 2004)
is a 55-item questionnaire that is the culmination of extensive item development and
revision of the Maudsley Obsessive Compulsive Inventory originally developed in the
1970s by Hodgson and Rachman (1977). The VOCI consists of six factorially deter-
mined subscales: (1) contamination (12 items), (2) checking (six items), (3) obsessions
(12 items), (4) hoarding (seven items), (5) just right (12 items), and (6) indecisiveness
(six items). The initial psychometric characteristics of the VOCI are strong as indicated
by high convergent validity with other OCD self- report measures, significantly higher
scores of OCD samples than nonobsessional anxious or depressed and nonclinical con-
trols, and moderate discriminant validity. As the most comprehensive OCD symptom
measure with particular relevance to current cognitive- behavioral approaches to OCD,
the VOCI is a promising measure. However, more research is needed on its psychomet-
ric properties and concerns were raised with the lower criterion validity of the Obses-
sions and Hoarding subscales (Thordarson et al, 2004).
Clinician Guideline 11.6
We recommend that the interview version of the YBOCS and the CBOCI be administered
as part of the pretreatment assessment to obtain a clinician-based and a self- report evalua-
tion of OCD symptom content and severity. The VOCI can also be utilized to obtain a more
comprehensive assessment of OC symptom presentation.Case Conceptualization
In order to formulate an individual case conceptualization of OCD ideographic,
process- oriented diaries and ratings forms are needed to determine the individual’s spe-
cific appraisal and neutralization responses to obsessions. A detailed description of a
cognitive case formulation approach to OCD can be found in D. A. Clark (2004) along
with numerous clinical record forms and rating scales. Table 11.3 presents a summary