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Psychology, 2019, 10, 2247-2265

https://www.scirp.org/journal/psych

ISSN Online: 2152-7199

ISSN Print: 2152-7180

DOI:

10.4236/psych.2019.1016142 Dec. 30, 2019 2247 Psychology

Psychometric Properties of the Greek

Version of the Obsessive-Compulsive

Inventory-Revised in a Non-Clinical

Young Adult Sample

Gregoris Simos

, Olga Zikopoulou

, Anna Nisyraiou

, Konstantinos Zafiropoulos

Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece

Department of International and European Studies, University of Macedonia, Thessaloniki, Greece

Abstract

Obsessive-Compulsive Inventory-Revised (OCI-R) is a self-report question-

naire that assesses the distress caused by a variety of OCD symptoms; OCI-

comprises of 18 items

that are equally divided into six subscales: Checking,

Washing, Obsessing, Neutralization, Ordering, and Hoarding. Research so far

has shown that OCI-R is a psychometrically sound measure with excellent va-

lidity and reliability. It is also appropriate for clinical and non-clinical popu-

lations and has been translated into several languages and has been validated

in diverse cultural contexts.

The aim of the present study was to validate

OCI-R in the Greek language and to examine its psychometric properties in a

Greek non-clinical sample. Three hundred and seventy one university stu-

dents participated in this study. Measures used were OCI-R, the Padua In-

ventory (PI), the Obsessive Beliefs Questionnaire-44 (OBQ-44), and the De-

pression Anxiety Stress Scale (DASS-

21). Consequent analysis of collected

data examined the factor structure of OCI-

R and tested its convergent and

divergent validity. The con

firmatory factor analysis showed good fit for the

model and replicated the results of other studies, meeting thus the require-

ments for the six-

factor solution of the original scale. The Greek version of

OCI-R maintained the good psychometric properties of

the original English

one. Internal consistency was excellent for the overall scale. Convergent and

divergent validity was good and also confirmed previous similar findings.

Keywords

OCI-R, Greek, Psychometric Properties, Validation, OBQ-44

How to cite this paper:

Simos, G., Ziko-

poulou, O., Nisyraiou, A., & Zafiropoulos,

(2019).

Psychometric Properties of the

Greek Version of the Obses

sive-

Compulsive

Inventory

-Revised in a Non-

Clinical Young

Adult Sample

Psychology, 10,

2247-2265.

https://doi.org/10.4236/psych.2019.1016142

Received:

October 29, 2019

Accepted:

December 27, 2019

Published:

December 30, 2019

19 by author(s) and

Scientific

Research Publishing Inc.

This work

is licensed under the Creative

Commons Attribution International

License (CC BY

4.0).

http://creativecommons.org/licenses/by/4.0/

Open Access

G. Simos et al.

DOI:

10.4236/psych.2019.1016142 2248 Psychology

1. Introduction

Obsessive-Compulsive Disorder (OCD) according to the American Psychiatric

Association’s

Diagnostic

and

Statistical

Manual

Mental

Disorders

Fifth

Edi-

tion

(DSM-5) is characterised by various obsessions and compulsions (APA,

2013). OCD shows a rather great heterogeneity with diverse symptom contents

(Bloch, Landeros-Weisenberger, Rosario, Pittenger & Leckman, 2008). Clini-

cians and researchers suggest that OCD symptoms may be classified in distinc-

tive subtypes, such as contamination and washing/cleaning, harm obsessions

and checking rituals, obsessions without overt compulsions, or hoarding sub-

types (McKay, Abramowitz, Calamari, Kyrios, Radomsky et al., 2004). However,

there is still no consensus whether OCD symptom contents should be parti-

tioned into subtypes or symptom dimensions and how many they are (Olatunji,

Williams, Haslam, Abramowitz, & Tolin, 2008; Gönner, Ecker, & Leonhart,

2009).

Moreover, it has been found that OCD has high comorbidity with other dis-

orders, such as anxiety disorders and depression, and thus differential diagnosis

is often a quite challenging task (Clark, 2004). In addition, there is a tendency of

OCD patients to conceal their symptoms, not seek a timely professional help;

duration of untreated OCD remains one of the highest among serious mental

disorder (Altamura, Buoli, Albano, & Dell’Osso, 2010). Most adults with OCD

get effective treatment on average ten years after the onset of the first symptoms

(García-Soriano, Rufer, Delsignore, & Weidt, 2014). Additionally, Wahl et al.

(Wahl, Kordon, Kuelz, Voderholzer, Hohagen, & Zurowski, 2010) found that in

outpatient clinics over 70% of OCD patients remain unrecognised and thus un-

treated by consultants. OCD symptoms seem to be important factors that under-

lie the need for early detection and treatment intervention (Belloch, del Valle,

Morillo, Carrió, & Cabedo, 2008).

A variety of questionnaires and scales have been designed to facilitate an early

and accurate assessment of OCD symptoms—e.g. the Maudsley Obsessional

Compulsive Inventory-MOCI (Hodgson & Rachman, 1977), the Padua Inven-

tory-PI (Sanavio, 1988), the Yale-Brown Obsessive-Compulsive Scale-YBOCS

(Goodman, Price, Rasmussen, Mazure, Fleischmann et al., 1989), the Padua In-

ventory-Washington State University Revision-PI-WSUR (Burns, Keortge, For-

mea, & Sternberg, 1996), the Obsessive-Compulsive Inventory-OCI (OCI, Foa,

Kozak, Salkovskis, Coles, & Amir, 1998), the Vancouver Obsessional Compul-

sive Inventory-VOCI (Thordarson, Radomsky, Rachman, Shafran, Sawchuk et

al., 2004), the Clark-Beck Obsessive-Compulsive Inventory-C-BOCI (Clark,

Antony, Beck, Swinson, & Steer 2005), the Dimensional Obsessive-Compulsive

Scale-DOCS (Abramowitz, Deacon, Olatunji, Wheaton, Berman et al., 2010).

The OCI is a self-report questionnaire that assesses on a 5-point (0-4) Likert

scale OCD symptom frequency and associated distress, and it consists of 42

items that are grouped under 7 subscales: Washing, Checking, Doubting, Or-

dering, Obsessing, Hoarding, and Mental Neutralizing (Foa et al., 1998). There is

evidence that OCI is a sound psychometric tool with high validity and reliability

G. Simos et al.

DOI:

10.4236/psych.2019.1016142 2249 Psychology

for both clinical and non-clinical population (Foa et al., 1998; Simonds, Thorpe,

& Elliott, 2000). However, OCI presented some disadvantages concerning its

length and the time needed for one to respond to it.

Foa et al. (Foa, Huppert, Leiberg, Langner, Kichic et al., 2002) developed a

shorter version containing 18items, the Obsessive-Compulsive Inventory-Revised

(OCI-R). The OCI-R consists of six factors and its factor structure has been rep-

licated in several studies. OCI-R has demonstrated good psychometric proper-

ties in clinical samples (Abramowitz, Tolin, & Diefenbach, 2005; Abramowitz &

Deacon, 2006) and non-clinical samples (Gönner, Ecker, & Leonhart, 2009; Ha-

jcak, Huppert, Simons, & Foa, 2004; Smári, Ólason, EyÞórsdóttir, & Frölunde,

2007). Consequently it is not surprising that OCI-R is one of the most com-

monly used self-report measures of OCD symptoms. Research on OCI-R indi-

cated good sensitivity and specificity for cut-off scores pointing out its diagnos-

tic sensitivity. The OCI-R subscales are valid measures of six symptom subtypes

of OCD; subscales are reliable and valid measures that adequately differentiate

between DSM-5 diagnostic groups. OCI-R is, therefore, psychometrically sound

and, most importantly, a brief tool that is appropriate for clinical and

non-clinical populations, and for clinical and research purposes (Abramowitz, et

al., 2005; Abramowitz & Deacon, 2006; Gönner et al., 2009; Hajcak et al., 2004;

Smári et al., 2007).

In their recent review on evidence-based assessment of Obsessive–Compulsive

Disorder, Rapp et al. (Rapp, Bergman, Piacentini, & McGuire, 2016) conclude

that the OCI-R is a brief self-report measure that possesses reliability, validity,

and diagnostic sensitivity (with a total score of 21 corresponding to an OCD di-

agnosis), shows good to fair convergence with clinician-rated measures of OCD

severity, but fair to poor discriminant validity from depression, anxiety, and

worry.

Considerable evidence exists to suggest that the need for multilanguage ver-

sions of psychological tools is growing (Hambleton, Merenda, & Spielberger,

2004). Cross-cultural research grows and international exchanges become more

common, therefore the demand for culturally appropriate tools becomes undis-

puted as it establishes fairness in assessment and is time and cost-effective (Er-

cikan, 2002; Hambleton et al., 2004). An increasing number of scales have been

translated into various languages and validated in other cultural contexts (Sousa

& Rojjanasrirat, 2011). This adaptation is important, because replication of re-

search across different cultures requires the use of measures that have been

standardized and validated in these cultures (Arafat, Chowdhury, Qusar, &

Hafez, 2016).

In that context, OCI-R has been the subject of researchers from different cul-

tural contexts and languages. Studies conducted with both clinical and

non-clinical samples provided evidence that OCI-R had good psychometric

properties (Fullana, Tortella-Feliu, Caseras, Andión, Torrubis et al., 2005; Hup-

pert, Walther, Hajcak, Yadin, Foa et al., 2007; Gönner, Leonhard, & Ecker, 2008;

Sica, Ghisi, Altoè, Chiri, Franceschini et al., 2009; Woo, Kwon, Lim, & Shin,

G. Simos et al.

DOI:

10.4236/psych.2019.1016142 2250 Psychology

2010; Souza, Foa, Meyer, Niederauer & Cordioli, 2011; Belloch, Roncero, Gar-

cía-Soriano, Carrió, Cabedo et al., 2013).

More specifically, Fullana et al. (2005) in their study of psychometric proper-

ties of the Spanish version of OCI-R in a non-clinical sample found similar fit

indices in their Confirmatory Factor Analysis for the 6-factor model as Foa et al.

(2002) and Hajcak et al. (2004). They also found good convergent validity and

adequate divergent validity, large to moderate internal consistency, and good

test-retest reliability. Huppert et al. (2007) also studied a clinical sample and

concluded that the OCI-R was a psychometrically sound instrument appropriate

for clinical and non-clinical populations, and for clinical and research purposes.

Gönner and colleagues (2008) conducted a study for the validation of the

German version of OCI-R in a sample of people with OCD, Anxiety disorders,

and Depressive disorders. They found good psychometric properties and excel-

lent fit in their factor analysis for the OCD sample, and good properties in the

anxiety and depressive disorders samples. They also found good internal consis-

tency and good construct validity (convergent/divergent) with a slight overlap in

divergent validity with other tests that are not meant to measure obsessions or

compulsions such as the Beck Depression Inventory (Beck, Rush, Shaw, & Em-

ery, 1979), the Beck Anxiety Inventory (Beck et al., 1979), and the Penn State

Worry Questionnaire (Meyer, Miller, Metzger, & Borkovec, 1990). Overall, they

concluded that OCI-R is a psychometrically sound and valid measure for use in

a German population.

Sica et al. (2009) in their study with both clinical and non-clinical Italian sam-

ples confirmed the six-factor model in the Italian version of OCI-R, and also that

the 6-factor structure of OC symptoms remains invariant across different cul-

tures. OCI-R had good internal consistency and excellent temporal stability in

their community sample and excellent internal consistency in their OCD sam-

ple. OCI-R showed adequate convergent validity and adequate divergent valid-

ity—correlations among OCI-R and measures of anxiety, depression and worry

were small to medium in size (.45, .41 and .43 respectively).

The Woo et al. (2010) study confirms similar findings for the Korean version

of OCI-R. In their research, they examined the psychometric properties and the

effects of gender and cultural differences in both a clinical and a non-clinical

sample. The results of their factor analysis indicated good fit in the six-factor

model. They also found good OCI-R convergent and divergent validity, internal

consistency and test-retest reliability.

Souza et al. (2011), in their study in Brazil, examined the psychometric prop-

erties of the Portuguese version of the OCI-R. For this purpose, they recruited

both a clinical sample including three groups (OCD, Panic Disorder, Social Pho-

bia), and a non-clinical sample. Subjects from the OCD sample received a

12-week Cognitive Behavioural Group Therapy (CBGT) and also completed

OCI-R before and after treatment. In each sample, the overall OCI-R and sub-

scale scores showed moderate to good internal consistency. Nevertheless, al-

though the OCI-R Obsessing subscale had a good internal consistency in the

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