The Toronto Obsessive-Compulsive Scale: Psychometrics of a Dimensional Measure of Obsessive-Compulsive Traits

J Am Acad Child Adolesc Psychiatry. 2016 Apr;55(4):310-318.e4. doi: 10.1016/j.jaac.2016.01.008. Epub 2016 Feb 4.


Objective: To describe the Toronto Obsessive-Compulsive Scale (TOCS), a novel 21-item parent- or self-report questionnaire that covers wide variation in obsessive-compulsive (OC) traits, and to evaluate its psychometric properties in a community-based pediatric sample.

Method: The TOCS was completed for 16,718 children and adolescents between the ages of 6 and 17 years in a community setting. Internal consistency, convergent validity with the Obsessive-Compulsive Scale of the Child Behaviour Checklist (CBCL-OCS), divergent validity with the Strengths and Weaknesses of ADHD (Attention-Deficit/Hyperactivity Disorder) Symptoms and Normal Behaviour Rating Scale (SWAN), interrater reliability, as well as sensitivity and specificity of the TOCS were assessed.

Results: The internal consistency of the 21 TOCS items was excellent (Cronbach's α = 0.94). TOCS was moderately correlated with the CBCL-OCS (Spearman correlation = 0.51) and poorly correlated with the SWAN (Pearson correlation = 0.02). Sensitivity and specificity analyses indicated that a TOCS total score of greater than 0 successfully discriminated community-reported obsessive-compulsive disorder (OCD) cases from noncases. OC traits were continuously distributed both at the total score and dimensional level in our pediatric community sample.

Conclusion: TOCS is a multidimensional measure of OC traits in children and adolescents with sound psychometric properties. TOCS reveals that OC traits are common and continuously distributed in a community sample. TOCS may be a useful measure for studies of the characteristics and etiology of OC traits.

Keywords: Toronto Obsessive-Compulsive Scale (TOCS); general pediatric population; obsessive-compulsive disorder; obsessive-compulsive traits; psychometrics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Community-Based Participatory Research
  • Female
  • Humans
  • Male
  • Obsessive-Compulsive Disorder / diagnosis*
  • Parents
  • Psychiatric Status Rating Scales
  • Psychometrics / methods*
  • Psychometrics / standards
  • Reproducibility of Results
  • Self Report
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Surveys and Questionnaires