OBQ-44

What is the Obsessional Beliefs Questionnaire-44 (OBQ-44)?

The Obsessional Beliefs Questionnaire-44 (OBQ-44) is a self-administered psychological assessment tool designed to evaluate dysfunctional beliefs that are commonly associated with obsessive-compulsive disorder (OCD). Developed by the Obsessive-Compulsive Cognitions Working Group (OCCWG), the OBQ-44 serves as a reliable and insightful resource for clinicians to understand the cognitive processes underlying OCD (1997).

This comprehensive questionnaire consists of 44 items, each rated on a Likert scale ranging from 1 (totally disagree) to 7 (totally agree). The scale's nuanced scoring system allows a detailed exploration of an individual's belief systems. These items are grouped into three core belief domains, reflecting key cognitive dimensions related to OCD:

Responsibility and threat estimation

This domain assesses beliefs tied to an exaggerated sense of personal responsibility and the tendency to overestimate potential threats. Individuals scoring high in this area may feel an overwhelming need to prevent perceived harm, even when the likelihood of such harm is minimal.

Importance of control of thoughts

This domain evaluates beliefs about the significance of intrusive thoughts and the perceived necessity to control them. Those with OCD often assign excessive meaning to their thoughts, believing that having certain thoughts is equivalent to acting on them or that failing to control such thoughts might lead to dire consequences.

Perfectionism and certainty

This domain measures beliefs associated with a need for perfection and absolute certainty in one's thoughts and actions. These beliefs often manifest as rigid standards and a fear of making mistakes, which can lead to compulsive behaviors aimed at achieving an unattainable sense of "rightness."

The OBQ-44 has been extensively validated across various languages and cultural settings, demonstrating strong psychometric properties, including high internal consistency and reliability (Moulding et al., 2011; Wang et al., 2015). Its adaptability to diverse populations ensures that it remains a widely accepted tool in both research and clinical practice.

Studies highlight the OBQ-44's ability to distinguish between individuals with OCD and non-clinical populations. Research conducted by Izadi et al. (2014) indicates that individuals with OCD consistently score significantly higher on the OBQ-44 than those without the disorder, underscoring its utility as a diagnostic and evaluative instrument.

How to use our OBQ-44 template

To use our free fillable OBQ-44 template, follow the steps below:

Step 1: Download the template

Begin by downloading the OBQ-44 template by clicking the "Use template" button.  This lets you edit the template before administering it. For a PDF version, choose "Download."

Step 2: Explain the purpose

Provide a brief overview of the purpose of the OBQ-44 to the client. Explain that it is a tool designed to measure beliefs and attitudes related to obsessive-compulsive tendencies and emphasize the importance of honest responses.

Step 3: Administer the questionnaire

Guide the client through the instructions and explain the 1–7 response scale, where 1 represents "strongly disagree" and 7 represents "strongly agree." Encourage them to avoid choosing the neutral option (4) unless it accurately reflects their perspective.

Step 4: Score the responses

After completion, sum the responses for all 44 items. If needed, calculate subscale scores. Use the total and subscale scores to identify the client’s level of agreement with obsessional beliefs. Compare the scores to clinical or normative benchmarks where applicable.

Step 5: Discuss findings

Share the results with the client in a clear and supportive manner. Use these insights to guide therapeutic conversations or plan interventions addressing the client’s needs.

Scoring

To calculate the total score on the OBQ-44, simply add the scores for all 44 items. This cumulative score reflects the individual’s overall endorsement of obsessional beliefs. Higher total scores indicate a stronger endorsement of these beliefs.

The OBQ-44 can be further broken down into three subscales, each representing specific domains of obsessional beliefs. To calculate the score for each subscale, sum the responses for the items associated with each domain:

1. Responsibility/Threat estimation: 5, 6, 8, 15, 16, 17, 22, 23, 29, 34, 36, 39. Higher scores indicate heightened beliefs regarding personal responsibility and an overestimation of threats.
2. Perfectionism and certainty: 2, 3, 4, 9, 10, 11, 12, 14, 26, 37, 40, 43. Higher scores reflect tendencies toward perfectionism and a need for certainty in thoughts and actions.
3. Importance/Control of thoughts: 7, 13, 18, 19, 20, 21, 24, 25, 27, 28, 30, 31, 32, 35, 38, 41, 42, 44. Higher scores suggest stronger beliefs about the importance of controlling thoughts and the perceived consequences of not doing so.

There are no universally accepted cutoff scores for the OBQ-44, as interpretation depends on the context and comparison to normative data. However, high scores on the total or any of the subscales may indicate a stronger endorsement of obsessional beliefs. This could warrant further exploration, particularly if these beliefs align with distress or impairment in daily functioning. High scores may also suggest that cognitive patterns linked to OCD are more pronounced and may require intervention or therapeutic attention.

Next steps after using the OBQ-44

Once the OBQ-44 has been administered and the scores analyzed, the next steps are focused on leveraging the results to enhance treatment planning and monitor progress. Here’s a guide to the next steps following the OBQ-44 assessment:

Develop a treatment plan

Based on the OBQ-44 results, the next step is to create a tailored treatment approach for obsessive-compulsive disorder patients. Cognitive behavioral therapy (CBT) is particularly effective for addressing the dysfunctional beliefs identified in the assessment, such as perfectionism or responsibility overestimation. Exposure and response prevention (ERP) can further help by targeting compulsions linked to specific obsessive beliefs.

Monitor progress

Regular reassessment using the OBQ-44 is crucial to track changes in obsessive beliefs over time. Monitoring progress ensures that treatment remains effective and allows for adjustments if certain beliefs or symptoms persist.

Integrate additional assessments

While the OBQ-44 provides valuable insights into the cognitive patterns associated with OCD, it is beneficial to integrate additional assessments to create a more comprehensive understanding of the individual’s condition. Combining the OBQ-44 results with other OCD symptom measures, such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), can offer a fuller picture of the individual’s symptom severity and overall functioning. This integrated approach can refine the clinician’s diagnostic insights and further optimize therapeutic strategies for managing OCD symptoms.

References

Izadi, R., Asgari, K., Neshatdust, H., & Abedi, M. (2014). Assessment of obsessive beliefs in individuals with obsessive-compulsive disorder in comparison to healthy sample. Global Science Research Journals. https://www.globalscienceresearchjournals.org/articles/assessment-of-obsessive-beliefs-in-individuals-with-obsessivecompulsive-disorder-in-comparison-to-healthy-sample.pdf

Moulding, R., Anglim, J., Nedeljkovic, M., Doron, G., Kyrios, M., & Ayalon, A. (2011, September 1). The Obsessive Beliefs Questionnaire (OBQ): Examination in nonclinical samples and development of a short version. Assessment. https://pubmed.ncbi.nlm.nih.gov/20634421/

Obsessive Compulsive Cognitions Working Group. (1997). Cognitive assessment of obsessive-compulsive disorder. Behaviour Research and Therapy, 35(7), 667–681. https://doi.org/10.1016/s0005-7967(97)00017-x

Wang, J., Wei, Z., Wang, H., Jiang, Z., & Peng, Z. (2015). Psychometric properties of the Chinese version of the Obsessive Beliefs Questionnaire-44 (OBQ-44). BMC Psychiatry, 15(1). https://doi.org/10.1186/s12888-015-0579-6