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Compulsive Activity Checklist and the Maudsley

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BEHAVIORIIi,~RAPY21, 117-127, 1990

Compulsive Activity Checklist and the

Maudsley Obsessional-Compulsive Inventory:
Psychometric Properties of two Measures of
Obsessive-Compulsive Disorder
LEE G. STERNBERGER

G. LEONARD BURNS
Washington State Umversity

The psychometric properties of two measures of obsessive-compulsivesymptoms

are describedin this study. The CompulsiveActivityChecklist(CAC)and the Maudsley
Obsessional-CompulsiveInventory (MOCI) were administered to a nonclinical Amer-
ican sample of 579 college students. Original American norms are presented for the
CAC and the MOCI. Both measures demonstrated good internal consistencyand test-
retest stabilityover a 6-7 month interval. Principal components analysisextracted three
CAC factors: washing, checking and personal hygiene.Four factors were extracted for
the MOCI: washing, checking, doubting and strictness. Both measures showed good
convergent and divergent validity with the nine subscales of the SCL-90-R, though
the results were slightly stronger for the MOCI. The results also provide additional
evidence that the CAC and MOCI are measuring different aspects of obsessive-
compulsive symptoms.

Obsessive-Compulsive Disorder (OCD), once considered a relatively rare

p r o b l e m , is n o w k n o w n to be more c o m m o n with a 2 - 3 % lifetime prevalence
rate (Rasmussen & Tsuang, 1986). I n order to properly diagnose a n d treat OCD,
m e a s u r e m e n t procedures which accurately q u a n t i f y the s y m p t o m s are neces-
sary. Interview schedules, assessor ratings a n d self-report measures are avail-
able for this p u r p o s e (Mavissakalian & Barlow, 1981). O f the existing self-
report inventories, the Compulsive Activity Checklist (CAC) a n d the Maudsley
Obsessional-Compulsive Inventory ( M O C I ) are the two most widely used ques-
tionnaires, a l t h o u g h a new self-report inventory, the P a d u a Inventory, appears
p r o m i s i n g (Sanavio, 1988).

This report is based on the first author's masters thesis which was supervised by the second
author. Preparation of this study was supported in part by funds provided the second author
by Washington State University.
Correspondence concerning this article should be addressed to Lee G. Sternberger or (3. Leonard
Burns, Ikpartment of Psychology,WashingtonState University,Pullman, Washington99164 4820.

117 0005-7894/90/0117-012751.00/0
Copyright 1990by Associationfor Advancementof BehaviorTherapy
All rights of reproductionin any form ~¢.se~red.
1 18 OBSESSIVE-COMPULSIVE DISORDER

The CAC, first developed by Hallam and published by Philpott (1975), was
originally a 62-item symptom inventory describing specific daily activities which
are rated by the indivdual or an assessor on a 4-point scale of severity (i.e.,
the respondent/assessor rates the degree to which the obsessive-compulsive
behaviors interfere in carrying out these activities). The original version as
well as a shortened version of the CAC is sensitive to both drug and behavioral
treatments for OCD (Foa, Steketee, Grayson, Turner, & Latimer, 1984; Insel
et al., 1983; Marks, Hallam, Connolly, & Philpott, 1977; Marks, Stern, Mawson,
Cobb, & McDonald, 1980).
Freund, Steketee, and Foa (1987) recently examined the psychometric prop-
erties of a 38-item version of the CAC with OCD patients. They found the
CAC to have moderate test-retest reliability (r = .68, p < .001) over an average
o f 36 days and high internal consistency (alpha = .91). Their factor analysis
revealed 2 subscales, washing/cleanliness and checking/repetitive acts, with
internal consistency o f .93 and .89, respectively. Freund et al. (1987) also found
that the CAC discriminated between washers and checkers and was sensitive
to treatment effects.
Subsequent to the Freund et al. (1987) study, a French version of the CAC
was validated using four groups o f i n d i v i d u a l s - O C D patients (N = 45),
agoraphobics with panic attacks (N = 46), social phobics (AT = 34) and con-
trols (N = 55) (Cottraux, Bouvard, Defayolle, & Messy, 1988). These investi-
gators also found good concurrent validity, internal consistency (alpha = .94),
sensitivity to treatment and moderate test-retest reliability over a 1-month period
(r = .62). Further, in contrast to Freund et al. (1987), Cottraux et al. (1988)
suggested a unidimensional factor structure for the CAC.
The second most widely used self-report measure o f OCD is the Maudsley
Obsessional-Compulsive Inventory (MOCI). The MOCI is a 30-item true-false
questionnaire designed to measure the total frequency of OCD symptoms
(Hodgson & Rachman, 1977). Based on the responses of 100 OCD patients,
Hodgson and Rachman (1977) reported two strong factors (checking and
washing) and two minor factors (slowness and doubting) with all four factors
accounting for 43o7o of the scale's variance. The MOCI also appears sensitive
to treatment effects (Perse, Greist, Jefferson, Rosenfield, & Dar, 1987).
Both the CAC and MOCI are widely employed in clinical settings to mea-
sure OCD symptoms. However, neither has been normed on a nonclinical
American sample. The only nonclinical norms for the MOCI are on a small
British sample (N = 243) as well as on two large Italian samples (N = 868
and N = 720) and for the CAC on a small French sample (N = 55) (Cottraux
et al., 1988; Dent & Salkovskis, 1986; Sanavio, 1988; Sanavio & Vidotto, 1985).
Such normative information is crucial to the evaluation o f the clinical
significance o f treatment programs for OCD (Jacobson & Revenstorf, 1988;
Kendall & Grove, 1988). Normative data thus allow the researcher to deter-
mine if the effects of the treatment are strong enough to move the behavior
into the normal range.
The purpose of this study was to provide this information as well as to ex-
amine each measure's factor structure, internal consistency, stability over time
and covergent/divergent validity in a large, nonclinical American sample. The
 STERNBERGER A N D BURNS 119

Symptom Checklist-90 Revised (SCL-90-R) (Derogatis, 1983) was selected to

examine the CAC and MOCI's convergent and divergent validity. It was ex-
pected that the CAC and MOCI would show significantly stronger correla-
tions with the SCL-90-R obsessive-compulsive subscale than with the other
eight symptom subscales (e.g., somatization, interpersonal sensitivity, depres-
sion, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism).
While the obsessive-compulsive subscale of the SCL-90-R cannot be consid-
ered an absolute criterion measure of obsessive-compulsive symptoms by which
to validate differentially the CAC and MOCI (i.e., to determine which is the
better measure), the pattern of correlations across the nine subscales nonetheless
provides useful information on the convergent/divergent validity of the CAC
and MOCI.

METHOD
Subjects
The subjects were 609 Washington State University undergraduates enrolled
in introductory psychology courses. Non-native English speakers were not in-
cluded in the analyses. This left a total of 579 subjects with a mean age of
19.01 (SD = 2.44). The sample contained 355 females and 224 males with
86.7°7o of the sample being Caucasian.
Measures
Compulsive Activity Checklist. The present study used the 38-item version
of the CAC (Freund et al., 1987). Items include washing hands and face,
touching door handles, using public bathrooms, checking electrical appliances
and so on. Each item is rated on a 0 to 3 scale of severity. The total score
is the sum of the 38 items with the maximum score being 114. TWo subscale
scores, washing (24 items) and checking (14 items) may also be calculated
(Freund et al., 1987). The CAC, as noted, is considered to measure the degree
to which obsessive-compulsive symptoms interfere with daily activities.
Maudsley Obsessional-Compulsive Inventory. The MOCI (Hodgson &
Rachman, 1977) is a 30-item true-false self-report scale which measures OCD
symptoms. A total score as well as washing (11 items), checking (9 items), slow-
ness (7 items) and doubting (7 items) subscale scores may be determined for
this questionnaire.
Symptoms Checklist-90-Revised. The SCL-90-R (Derogatis, 1983) is a 90-
item self-report symptom inventory. Each item is rated on a five-point scale
of distress from "not-at-all" to "extremely." The measure provides three total
scores as well as scores on nine symptom dimensions (obsessive compulsive,
depression, paranoid ideation, interpersonal sensitivity, psychoticism, anxiety,
somatization, hostility and phobic anxiety).

Procedure
Subjects completed the CAC, MOCI and the SCL-90-R in groups of 30
to 50 with the administration time being approximately one hour. The sub-
120 SI/~RNBERGER AND BURNS

jects were told that the purpose of the study was to find out how c o m m o n
the experiences listed on the questionnaires were for college students.

RESUDS AND DISCUSSION

Internal Consistency and Factor Structure
Compulsive Activity Checklist. The average item score on the CAC was .28
with a range from .03 to .72. The internal consistency o f the CAC (coefficient
alpha) was .86, similar to the coefficient alpha o f .91 reported by Freund et
al. (1987) in a sample o f O C D patients. The average item-total correlation
for the CAC was .34 with the range being from .10 ( p < .02) to .64 ( p < .001).
The mean inter-item correlation was .14 (range = -.04 to .59).
The factor structure was investigated using a Principal Components (PC)
analysis followed by varimax rotation. 1 Items were included in a factor if the
item loading was .35 or higher. Based on Cattell's scree test and the pattern
of factor loadings, a three factor solution seemed most appropriate. These
three factors explained 29o70 o f the variance. Factor 1 (18.3°70 o f the variance),
the washing factor, included 9 items. All but one item on our washing factor
loaded on Freund et al. (1987) washing factor as well. Factor 2 (5.7o70 o f the
variance), the checking factor, consisted of 8 items. All but two items on our
checking factor also loaded on Freund et al.'s (1987) checking factor. Finally,
factor 3 (4.6°7o o f the variance), which we labeled personal hygiene, consisted
o f 7 items. In Freund et al. (1987) these seven items loaded on their washing
factor.
The main difference between the results of our analysis and that o f Freund
et al. (1987) is that in our sample their washing factor appears as two separate
factors, which constitute our factors 1 and 3. Also, in their sample all 38 items
loaded on either their washing or checking factor .35 or greater, while only
24 items in our analysis loaded .35 or more on one o f our three factors. A
two factor solution o f our data resulted in an even poorer comparison be-
tween the two studies. In a two factor model the items on our factor 1 (washing)
and 2 (checking) combined into a single factor with the items on our third
factor then emerging as the second factor. In a nonclinical sample the first
component to emerge from a PC analysis o f the CAC may thus represent a
general obsessive-compulsive dimension involving both checking and washing
behaviors. The PC analysis on the CAC with a French sample (Cottraux et
al., 1988) provides some support for this possibility.
Maudsley Obsessive Compulsive Inventory. The average item mean on the
M O C I was .25 with the range being from .03 to .59. In this sample 53070 indi-
cated an excessive concern with cleanliness and 48 070reported checking things
more than once. The internal consistency o f the M O C I (coefficient alpha) was
.75 which was similar to the coefficient alpha o f .77 found in a nonclinical
Italian sample (Sanavio & Vidotto, 1985). The average item-total correlation

' The complete results from the principal components analysisas wellas the item means, stan-
dard deviations and part-whole correlations are available from the authors.
 OBSI~S$1VE-.COMPUI~IVE DISORDER 121

for the MOCI was .27 with the range being from .08 (p < .05) to .44 (p <
.001). The mean inter-item correlation was .10 (range = -.05 to .52).
The MOCI factor structure was also investigated by PC analysis with var-
imax rotation. Items with loadings greater than .30 were included in a factor
since this was the value used in the earlier studies on the MOCI. Factor anal-
ysis extracted a factor structure similar to that reported by Hodgson and
Rachman (1977), consisting of two larger checking and washing factors, fol-
lowed by two smaller factors. Hodgson and Rachman (1977) labeled the two
smaller factors doubting and slowness. Because of slightly different items
loading on our fourth factor, our fourth factor is better labeled strictness.
These 4 factors explained 29o70 of the variance.
Factor 1, the checking factor (13.6070 of variance), consisted of 8 items. The
items on our checking factor are similar to the items on the checking factor
of the British clinical sample (Hodgson & Rachman, 1977) and the nonclin-
ical Italian sample (Sanavio & Vidotto, 1985). Factor 2 (5.9% of the variance)
represents a washing and contamination dimension. This washing/contami-
nation factor consisted of 10 items. All but one of these items also loaded
on the cleaning factor from the Hodgson and Rachman (1977) study. The items
on our cleaning factor are also very similar to the cleaning factor in the Sanavio
and Vidotto (1985) nonclinical sample of Italian students. Factor 3 (4.7o70 of
the variance), the doubting factor, included 5 items. The items in our doubting
factor are very similar to items composing the doubting and rumination factor
reported by Sanavio and Vidotto (1985) and overlap some with items in the
slowness factor found by Hodgson and Rachman (1977). Factor 4 (4.6% of
the variance), our strictness factor, involved 5 items. All of these items except
one are the same items which loaded on the doubting factor from the Hodgson
and Rachman study (1977). The items making up our four factors from the
MOCI are thus similar to the British clinical sample and the Italian nonclin-
icai sample.
Convergent and Divergent Validity
The CAC and MOCI total scores were correlated with the SCL-90-R sub-
scales as a test of convergent and divergent validity. Table 1 shows these corre-
lations. While the MOCI and CAC total scores both correlated significantly
with thee obsessive compulsive subscale from the SCL-90-R, the MOCI and
Obsessive Compulsive subscale (OBC) correlation was significantly stronger
than the CAC and OBC correlation, t (576) = 3.15, p = .002. Further, the
MOCI and'OBC correlation was significantly stronger than the correlation
of the MOCI with all the other SCL-90-R subscales (p's < .0001). The CAC
did not show as strong a pattern of convergent and divergent validity. Not
only was its correlation with the SCL-90-R OBC subscale weaker than the
MOCI correlation with the OBC subscale, but this correlation was not
significantly different than the CAC and SCL-90-R Hostility subscale correla-
tion. In addition, the MOCI and CAC correlated .29 (p < .0001) with each
other. This is similar to the .33 correlation reported by Freund et al. (1987),
providing further evidence that the CAC and MOCI are measuring different
aspects of OCD behaviors, a point we will elaborate more on later.
122 STERNBERGER AND BURNS

TABLE 1
CORRELATIONS OF THE COMPULSIVEACTIVITY CI-~CKIItqT (CAC) AND ~m~
MAUDSLEY OBSE~IONAL-CoMPuLSIVEINVENTORY(MOCI) Wtttt THE
SYMPTOU C'~crH~T-90-R (SCL-90-R) SUaSCAL~ S C o ~ s

SCL-90-R Subscale MOC1 CAC

OBC .51 .38

DEP .36 .23
PAR .36 .25
INT .35 .21
PSY .34 .28
ANX .32 .25
SOM .30 .20
HOS .30 .31
PHO .26 .14

Note. OBC = obsessive-compulsive; DEP = depression; PAR = paranoid ideation; INT =

interpersonal sensitivity; PSY = psychoticism; ANX = anxiety; SOM = somatization;
HOS = hostility; P H O = phobic anxiety. N = 579. All correlations are significant
at p < .001.

Test-Retest Reliability
The test-retest reliability of the M O C I and CAC was investigated by ran-
domly mailing 300 subjects the two questionnaires 6 to 7 months later. Based
on the 177 questionnaires returned (a 59°70 response rate), the test-retest corre-
lations were .69 and .74 (,o's < .0001) for the M O C I and CAC, respectiveiy,
over the 6 to 7 m o n t h interval. The Time 1 and Time 2 means for the M O C I
were 7.87 (SD = 4.59) and 6.44 (SD = 4.63), respectively, and for the CAC
10.11 (SD = 8.48) and 8.05 (SD = 8.53). While the Time 2 means were
significantly lower than the Time 1 means for both the M O C I and CAC (,o's
< .001), the magnitude o f the decrease was small.
One-way ANOVAs compared the Time 1 scores on the M O C I and CAC
for the individuals who returned the questionnaires to the individuals who
failed to return the questionnaires and to the individuals who were not mailed
the questionnaires. The Fs from the two ANOVAs were both less than one,
indicating that there were no differences between these three groups on their
M O C I and CAC scores at Time 1, suggesting that the test-retest reliability
coefficients for the subsample may apply for the entire sample.
The CAC and the M O C I thus showed adequate stability over a somewhat
lengthy interval (6 to 7 months). The test-retest correlation for the CAC in
our study is also similar to the value of .68 reported by Freund et al. (1987)
over an average interval o f 36.8 days with O C D patients and the value of .62
reported by Cottraux et al. (1988) over an interval o f 30 days in a French non-
clinical sample.

Subscale Analyses
Subscale scores were calculated for the M O C I and CAC based on the recom-
 OBSESSIVE-COMPULSIVE DISORDER 123

mendations from the earlier studies for the creation o f subscale scores (Freund
et al., 1987; Hodgson & Rachman, 1977). The MOCI subscales showed modest
internal reliability (washing subscale alpha = .54 and checking subscale alpha
= .58), lower than the values (.7 and .8) reported by Hodgson and Rachman
(1977) in a British clinical sample though similar to the values (.62 and .57)
reported by Sanavio and Vidotto (1985) in an Italian nonclinical sample. In
contrast, the CAC subscales showed better internal consistency (washing sub-
scale alpha = .78 and checking subscale alpha = .78), although again slightly
lower than the values (.93 and .89) found by Freund et al. (1987).
The MOCI washing and checking subscales showed a modest correlation,
r (577) = .46, p ~ .001, somewhat higher than the .25 correlation reported
by Hodgson and Rachman (1977). The CAC washing and checking subscales
also correlated significantly, r (577) = .64, p ~ .001, which is in contrast to
the nonsignificant correlation (r -- .02) found by Freund et al. (1987). In addi-
tion, the correlations between the MOCI and CAC corresponding subscales
were similar in magnitude to the correlations between the noncorresponding
subscales (i.e., MOCI washing with CAC w a s h i n g - r (577) = .16, p ~ .001;
MOCI washing with CAC checking-- r (577) = .17, p ~ .001; MOCI checking
with CAC checking--r (577) = .29, p ~ .001; and MOCI checking with CAC
washing--r (577) = .26, p ~ .001. This is in contrast to the convergent and
divergent correlations between the CAC and MOCI subscales reported by
Freund et al. (1987).
There was also a lack o f convergent/divergent validity when the CAC and
MOCI checking and washing subscale scores were calculated on the basis of
the factor loadings from the present study. Thus, the subscales from the CAC
and MOCI did not show the pattern of convergent and divergent validity in
a nonclinical sample as was reported in a clinical sample (Freund et al., 1987).
The reason for this was not clear and may partly reside in our failure to find
clear washing and checking factors in the CAC.
Norms
On both scales men in our sample scored significantly higher than women.
On the CAC the mean for men was 12.92 (SD = 9.50) and for women 8.87
(SD = 7.87), t (577) = 5.56, p ~ .0001. On the MOCI the male mean was
8.04 (SD = 4.21) and the female mean 7.28 (SD = 4.30), t (577) = 2.08,
p = .04). The point biserial correlation between gender and the CAC was .23
and between gender and the MOCI .09. Thus, while there was a significant
gender difference on two questionnaires, the amount o f variance accounted
for by the subject's gender was small (i.e., 5070 for the CAC and less than 1070
for the MOCI).
Table 2 shows the mean total scores on the CAC and MOCI for the current
study and other studies with the scales. Our mean score on the MOCI was
similar to the means in three nonclinical British samples as well as a non-
obsessional neurotic British sample, yet significantly different from the mean
MOCI score o f a group o f British OCD patients, t (677) = 21.53, p ~ .0001
(Dent & Salkovskis, 1986; Hodgson & Rachman, 1977). Our mean MOCI score
was also similar to the mean MOCI in a large nonclinical Italian sample which
124 STERNBERGER AND BURNS

c o v e r e d t h e a g e r a n g e o f 15 t o 80 ( s e e S a n a v i o , 1988, T a b l e 3). T h e I t a l i a n
d a t a a s well a s t h e E n g l i s h d a t a w i t h o l d e r i n d i v i d u a l s o n t h e M O C I s u g g e s t
that the mean MOCI score for a nonclinical American sample may not greatly
i n c r e a s e w i t h age. T h i s is e n c o u r a g i n g s i n c e o u r s a m p l e o n l y i n v o l v e d c o l l e g e
students.
T a b l e 2 a l s o s h o w s t h e m e a n C A C s c o r e f o r o u r s a m p l e as well a s t h e s a m p l e
f r o m F r a n c e ( C o t t r a u x et al., 1988) a n d t h e c l i n i c a l s a m p l e f r o m t h e U n i t e d
S t a t e s ( F r e u n d et al., 1987). O u r m e a n C A C s c o r e w a s h i g h e r t h a n t h e m e a n
C A C s c o r e f o r t h e n o n c l i n i c a l F r e n c h s a m p l e , t (632) = 7.04, p < .0001. T h e
c a u s e s a n d c l i n i c a l s i g n i f i c a n c e o f t h i s d i f f e r e n c e are o f c o u r s e u n k n o w n at

TABLE 2
MEANS AND STANDARD DEVIATIONS FOR THE COMPULSIVE ACTIVITY
CH~CICII~T (CAC) AND THE MAUDSLEY OBSESSIONAL-CoMPULSIVE INVENTORY
(MOCI) FOR STUDY LOCATION AND SUBJECT TYPE

Age CAC MOCI

Study and Location N M SD M SD M SD

Current Study
(United States)
University students 579 19.0 2.4 10.44 8.76 7.58 4.28
Cottraux et al. (1988)
(France)
Normal controls 55 33.5 9.4 5.10 4.94 - --
Obsessive-compulsives 45 35.0 9.3 33.13 19.33 -- -
Freund et al. 0987)
(United States)
Obsessive-compulsives 51 35.4 ? 40.07 19.77 - -
Hodgson & Rachman
(1977)
(England)
Obsessive-compulsives 100 34.7 11.7 - - 18.86 4.92
Neurotics 50 36.6 13.0 - - 9.27 5.43
Dent & Salkovskis (1986)
(England)
University students 65 20.1 2.6 - - 6.32 3.92
Medical students 142 18.9 1.1 - - 7.26 4.41
Non-students 36 28.6 12.9 - - 5.86 3.51
Sanavio (1988)
(Italy)
Nonclimcal subjects 720 15-25 ? - - 6.0 ?
26-40 ? - - 6.0 ?
41-60 ? - - 6.5 ?
61-80 ? - - 7.8 ?

Note. The means for the Sanavlo (1988) study were estimated from Figure 2 (p. 174) in the
article. Question marks indicate that the data were not available in the particular study.
 OBSESSIVE-COI~PU]LSIVE DISORDER 125

this time. The mean CAC score for the French clinical sample o f obsessive-
compulsive patients and the American clinical sample o f O C D patients was
significantly higher than our nonclinical American norm, t (622) = 7.82,
p < .0001 and t (628) = 10.62, p < .0001, respectively. To summarize, our non-
clinical norm for the M O C I were similar to the British and Italian nonclinical
norms and our norms for both measures were different from the scores for
French, English and American O C D patients.

SUMMARY
The present study investigated the psychometric properties o f the M O C I
and CAC, two o f the most widely used self-report measures of the symptoms
o f OCD. Prior to this study the only nonclinical norms for the M O C I were
on a small British sample as well as on two large Italian samples and for the
CAC on a small French sample. This study thus provided the first nonclinical
American norms for both measures with a large sample o f individuals. This
information is important because nonclinical norms provide data on the ideal
outcome for clinical trials (Jacobson & Revenstorf, 1988; Kendall & Grove,
1988) as well as the opportunity to study O C D behaviors in nonclinical popu-
lations (Dent & Salkovskis, 1986).
Both measures showed good internal consistency and test-retest reliability
over a 6 to 7 m o n t h interval. These results were similar to those found with
O C D patients (Cottraux et al., 1988; Freund et al., 1987; Hodgson & Rachman,
1977). The factor structure o f the M O C I in our nonclinical sample was also
similar to the factor structure found in O C D patients (Hodgson & Rachman,
1977) and a nonclinical Italian sample (Sanavio & Vidotto, 1985). The factor
structure o f the CAC was somewhat similar to an earlier principal compo-
nents analysis o f the CAC with O C D patients (Freund et al., 1987), though
more differences emerged in the factor structure and item loadings than for
the M O C I .
The mean M O C I score in our American nonclinical sample was very similar
to th~ mean M O C I score for nonclinical British as well as Italian samples.
Given that the British and Italian samples involved older individuals, this pro-
vides tentative support that our mean M O C I score with American university
students may generalize to older individuals in the United States. Also, both
the M O C I and the CAC mean scores in our nonclinical sample were sig-
nificantly lower than the mean M O C I and CAC scores for O C D patients in
France, United States and England.
Both measures also showed convergent and divergent validity with the clin-
ical subscales on the SCL-90-R. However, the M O C I showed a stronger pat-
tern o f convergent and divergent validity. The M O C I correlated more strongly
with the SCL-90-R obsessive-compulsive subscale than with any other SCL-
90-R subscale as well as had a significantly stronger correlation with the
obsessive-compulsive subscale than the CAC did. Nonetheless, this result does
not necessarily imply that the M O C I is a more valid measure o f O C D than
the CAC since the obsessive-compulsive subscale o f the SCL-90-R cannot be
considered an absolute criterion measure o f OCD. A more cautious conclu-
126 STERNBERGER AND BURNS

sion is that both the CAC and MOCI showed good convergent and divergent
validity with the subscales of the SCL-90-R.
The modest correlation (r = .29) between the CAC and MOCI as well as
the failure of the CAC and MOCI washing and checking subscales to con-
verge/diverge in the expected manner suggest that the two measures assess
different aspects o f OCD symptoms. For example, as Freund et al. (1987)
noted, the MOCI measures the presence or absence of OCD symptoms while
the CAC measures the degree to which OCD symptoms interfere with daily
activities. Asking an individual if a symptom is present or absent is probably
different from asking the person the degree to which the symptom interferes
with his or her life (e.g., the person who responds affirmatively to the presence
o f symptoms but who may not report any interference or distress from the
symptoms). This measurement distinction may be more important in non-
clinical than clinical populations. Revisions of the CAC and the MOCI could
make this distinction clearer by asking individuals to indicate the frequency
of occurrence of particular obsessive-compulsive behaviors as well as asking
the degree to which the behaviors interfere with daily routines or constitute
problems. Thus each test item would receive two ratings- a frequency of oc-
currence rating and a severity or interference rating.
We are currently continuing this research by investigating the utility of the
frequency v e r s u s severity distinction in terms of obsessive-compulsive symp-
toms. We are also examining the discriminative validity of the MOCI and CAC
with nonclinical samples. Positive results from discriminative validity studies
will provide further support for these self-report measures of OCD symptoms.
Such results will also suggest the feasibility of studying the phenomenology
of OCD in nonclinical populations as well as theoretical issues related to the
disorder (e.g., Foa & Kozak, 1986).

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RECEIVED: June 12, 1989

FX~ALACCSP'rANcE:September 22, 1989

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