YOQ-2.0
The Y-OQ® -2.0 (Youth Outcome Questionnaire) is a brief 64 item parent report measure of treatment progress for children and adolescents (ages 4-17) receiving mental health intervention. The Y-OQ®-2.0 is designed to track actual change in functioning as opposed to assigning diagnoses. Through the use of cut-off scores and a reliable change index, the Y-OQ®-2.0 allows the clinician to see the child’s behavioral similarity at each treatment interval to inpatient populations, outpatient populations, and a large untreated community sample.
Noteworthy features of the Y-OQ®-2.0 include:
- Standardized data: Y-OQ®-2.0 has been found to be both reliable and valid, yielding high internal consistency across the 3 samples and correlating favorably with other widely used instruments such as the Child Behavior Checklist. Statistically significant differences are present between the means for the clinical and normative samples.
- Sensitivity to change and robust norms: The Y-OQ®-2.0 is highly sensitive to change in patient’s functioning; interpretive indices tell the clinician if that change is clinically significant.
- Content areas that assess clinically relevant functional domains. The Y-OQ®-2.0 is comprised of six separate subscales of behavioral problems as well as elements of healthy behavior. The subscales include Interpersonal Distress, Somatic, Interpersonal Relations, Critical Items, Social Problems, and Behavioral Dysfunction.
- Applicable to all patient populations. The Y-OQ®-2.0 cuts across treatment models, diagnoses, and disciplines, allowing for use and comparison in a wide variety of settings.
- Ease of administration and scoring. The Y-OQ® -2.0 items are rated by the parent/guardian on a 5 point scale and takes only a few minutes to complete.
- Risk assessment. High scores on the critical items scales indicate those who may need immediate intervention beyond standard outpatient treatment.
Psychometric Properties
The reliability of the YOQ was tested using Chronbach’s alpha with a small student sample drawn from an elementary school (N=41), a community normative sample of 651 subjects and the clinical sample of 490. The total score on the YOQ has an internal consistency estimate of .97 across the three samples. The critical items and somatic subscales had the lowest internal consistency estimates of the six subscales, suggesting greater item heterogeneity. The high reliability estimate of the total YOQ score suggests a strong single factor underlying the 6 subscales.
Preliminary criterion validity was also assessed. The relationshp between the YOQ total and subscales score were examined by comparing parallel subscales from the Child Behavior Checklist (Achenbach, 1991) and the Connors Rating Scale (Connors, 1990). The parents of a sample of 41 elementary children aged 6 to 12 were used. In each case, the highest correlation found between subscales were those expected to converge, indicating adequate convergent validity. Adequate divergent validity was also established as small and nonsignificant coefficients were noted between dissimilar scales. A moderately high correlation was found between the YOQ and CBCL total scores.
A second validity sample of 80 inpatients was used to examine the relationship between the CHCB and relevant YOQ subscales. A strong relationship of .84 was found between the total YOQ score and its counterpart on the CBCL. Overall, the findings from these two samples suggest that the relationships between the YOQ and established criteria are strong.
Support for the construct validity of the YOQ was assessed by comparing the inpatient and outpatient scores on the YOQ and those of the community samples. It was assumed that statistically significant differences would be found between the means of the clinical and normative samples and would be ordered from most pathological to least pathological. The data suggest that the YOQ reflects pathology in line with expectations: inpatients had the highest means (most disturbed), outpatients the next highest, and the community sample the lowest (most healthy).
The sensitivity of the YOQ is 0.81. This means that approximate 81% of true positives of the Normal group were correctly identified as “normal” and 19% were misclassified (put in the abnormal group) using the cutoff score of 46 (see clinical interpretation. The specificity of the YOQ is .79 which means that 79% of true members of the Abnormal group were placed in the abnormal group using the cutoff of 46. Sensitivity and specificity provide an index of the accuracy of the YOQ as a screening tool. It is important to note that the obtained sensitivity/specificity scores may be even higher because the studies considered the children of the community sample to be normal and the children from the patient samples to be abnormal.
Guidelines for Clinical Interpretation
The YOQ®-2.0 total score quantifies overall level of disturbance. A score of 46 or higher is in the clinical or dysfunctional range. A score under 46 is considered to be in the normal or non-clinical range.
The reliable change index for the YOQ®-2.0 is 13 points. This means that a patient must change by at least 13 points for that change to be considered clinically significant.
Spanish Versions of OQ®-45.2 and Y-OQ ®2.0:
Spanish versions of the OQ®-45.2 and Y-OQ®- 2.0 are available for Spanish speakers not fluent in English.
