The Screen for Child Anxiety Related Emotional Disorders (SCARED) and traditional childhood anxiety measures

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a self-report questionnaire that measures symptoms of DSM-IV linked anxiety disorders in children. This article presents two studies that investigated the relationship between the SCARED, on the one hand, and two other widely used anxiety measures for children, namely the Revised Children's Manifest Anxiety Scale (RCMAS) and the Fear Survey Schedule for Children-Revised (FSSC-R), on the other hand. Results indicate that SCARED scores are positively and in a theoretically meaningful way related to RCMAS and FSSC-R scores, and thus provide evidence for the concurrent validity of the SCARED.     

Reliability and validity of the Arabic Screen for Child Anxiety Related Emotional Disorders (SCARED) in a clinical sample

This study aimed at investigating the reliability and validity of the Arabic Screen for Child Anxiety Related Emotional Disorders (SCARED) as a first child and adolescent anxiety screening tool in the Arab World. The English parent (SCARED-P) and child (SCARED-C) versions were translated into Arabic and administered along with the Arabic Strengths and Difficulties Questionnaire (SDQ) to 77 parents and 67 children attending a Psychiatry clinic. DSM-IV-TR diagnoses were made by a psychiatrist without knowledge of the scale scores. Internal consistency was confirmed by Cronbach's α=0.92 for SCARED-P and 0.91 for SCARED-C. Their subscales had internal consistencies between 0.65 and 0.89. Parent–child agreement was r=0.67, p<0.001. SCARED-P demonstrated good discriminant validity between participants with anxiety disorders and those with other psychiatric disorders (t(72)=3.13, p=0.003). For SCARED-C, this difference was significant when participants with depressive disorders were excluded (t(43)=2.58, p=0.01). Convergent validity was evident through a significant correlation between SCARED-P and the parent SDQ emotional subscale (r=0.70, p<0.001), and SCARED-C and the child SDQ emotional subscale (r=0.70, p<0.001). Divergent validity with the SDQ hyperactivity subscale was observed as no significant correlation was found. Overall, the Arabic SCARED demonstrated satisfactory psychometric properties in a clinical sample in Lebanon.     

Sensitivity and Specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A Community-Based Study

The aim of this cross-sectional community-based study was to examine the sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED) to the diagnosis of anxiety disorders (AD). Participants were 119 students aged 9–18. Psychiatric diagnoses were assessed by a psychiatrist throughout a structural clinical interview (K-SADS-PL). Forty-four participants had positive diagnosis for at least one AD. The total score of the SCARED significantly differentiated anxious from non-anxious children with an optimal cutoff point of 22 (sensitivity = 81.8 %; specificity = 52.0 %). SCARED subscales of social phobia and separation anxiety disorder, but not generalized anxiety disorder, revealed better discrimination proprieties than total scores to screen for that specific disorder (p < .05). Both total and specific SCARED scores presented moderate sensitivity and specificity for detecting AD in a community sample. Investigators interested in screening for specific AD, rather than the group of AD, may benefit from using the specific subscales.     

Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study.

OBJECTIVE: To replicate and extend work on the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED), a child and parent self-report instrument used to screen for children with anxiety disorders. METHOD: The 41-item version of the SCARED was administered to a new sample of 190 outpatient children and adolescents and 166 parents. The internal consistency, discriminant, and convergent validity were assessed. In addition, using discriminant function analysis, a briefer version of the SCARED was developed. RESULTS: Using item analyses and factor analyses on the 41-item version, 5 factors were obtained: panic/somatic, generalized anxiety, separation anxiety, social phobia, and school phobia. In general, the total score and each of the 5 factors for both the child and parent SCARED demonstrated good internal consistency and discriminant validity (both between anxiety and depressive and disruptive disorders and within anxiety disorders). A reduced version of the SCARED yielded 5 items and showed similar psychometrics to the full SCARED. CONCLUSIONS: In a new sample, the authors replicated their initial psychometric findings that the SCARED is a reliable and valid instrument to screen for childhood anxiety disorders in clinical settings. Furthermore, pending future research, the 5-item SCARED appears to be a promising brief screening inventory for anxiety disorders in epidemiological studies.     

Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in Brazilian children and adolescents

The aim of this study was to evaluate the psychometric properties of the Brazilian-Portuguese version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a large community sample of Brazilian children and adolescents. A total of 2410 students completed the 41-item Brazilian-Portuguese version of the SCARED. The one-factor and the five-factor structure of the SCARED fit this sample well. However, the five-factor model had a significantly better fit than the one-factor model and an adequate fit for age and gender subgroups. Anxiety symptoms in Brazilian youth were reported at a moderate-high level as compared to other studies. Females were found to score significantly higher on the total score and on all of the subscales as compared to the males. The total score and each of the five factors for both children and adolescents showed good internal consistency, test-retest and construct validity. According to our findings the Brazilian-Portuguese version of the SCARED is a reliable and valid instrument to assess anxiety in Brazilian children and adolescents.     

Screen for Child Anxiety Related Emotional Disorders (SCARED): psychometric properties in an African-American parochial high school sample

OBJECTIVE: To examine the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) for a community sample of African-American high school students. METHOD: The 41-item SCARED was administered to 111 adolescents (57 girls; mean age 15.75) in an urban parochial school. Item frequency, internal consistency, test-retest reliability, and construct validity were assessed. RESULTS: Approximately 30% of the sample had scores high enough to warrant further assessment for anxiety disorders, and girls reported significantly higher anxiety symptoms than boys. Internal consistency (alpha =.89) and test-retest reliability (r = 0.47) over 6 months for the SCARED's total score were good. The SCARED's total score was positively correlated with other measures of anxiety symptoms and inattention and was negatively correlated with perceived self-worth. Unlike the five-factor structure reported for primarily white samples, only three factors emerged for this African-American sample. CONCLUSIONS: The SCARED shows utility as a self-report anxiety screening instrument in a community sample of African-American youths.     

Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the general adolescent population

OBJECTIVE: This study examined the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a large sample of adolescents from the general population. METHOD: In 2001, 1,340 junior high and high school adolescents in the Netherlands completed the SCARED. The SCARED is a questionnaire that purports to measure five child and adolescent anxiety symptom dimensions. The factor structure of the SCARED was investigated by means of confirmatory factor analyses that were conducted for males and females, early (10-13 years) and middle (14-18 years) adolescent groups, and for Dutch and ethnic minorities. Analyses of variance were carried out to compare mean scores for the various groups. RESULTS: The five-factor structure of the SCARED not only had the best fit for the general adolescent population but also for the age, gender, and ethnic groups. It was also found that the SCARED scores of the adolescent subgroups differed from one another in agreement with previous studies on adolescent anxiety disorder symptoms. CONCLUSIONS: The findings of this study support the claim that the SCARED has a five-factor structure. The usefulness of the SCARED was also demonstrated.     

German Screen for Child Anxiety Related Emotional Disorders (SCARED): Reliability,Validity, and Cross-Informant Agreement in a Clinical Sample

Background  

The psychometric properties and cross-informant agreement of a German translation of the Screen for Child Anxiety Related Emotional Disorders (SCARED) were assessed in a clinical sample     

Examination of a cutoff score for the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a non-clinical Spanish population

We aimed to find a valid cutoff score for the Screen for Child Anxiety Related Emotional Disorders, child (SCARED-C) and parent (SCARED-P) Spanish versions for detecting Anxiety Disorders (AD) in a non-clinical population. The predictive accuracy of the SCARED-C and SCARED-P was assessed using the Area Under the Curve (AUC) of ROC curves. In general, the predictive accuracy of the SCARED-C (full version, short version, and four factors) was good and better than that of the SCARED-P. To differentiate between children who meet the diagnostic criteria for any AD and children who do not, we propose cutoff scores of 25 and 17 for the SCARED-C and SCARED-P, respectively. The sensitivities are 75.9% and 62.8%, and the specificities are 68.5% and 69.5%. The SCARED-C factor that had the best predictive accuracy was Somatic panic followed by Separation Anxiety, Generalized Anxiety and Social Phobia. The SCARED-P factor with the best predictive accuracy was Separation Anxiety. The results support the use of SCARED-C as a screening test for Anxiety disorders while SCARED-P should only be used as complementary information.     

The German version of the "Screen for Child Anxiety Related Emotional Disorders" (SCARED): parent- and self report in a clinical sample

The psychometric properties and cross-informant agreement of the German version of the "Screen for Child Anxiety Related Emotional Disorders" (SCARED) were assessed in a clinical sample. 77 children and adolescents aged 11 to 18 years in outpatient psychotherapy and 66 parents filled out the SCARED and Youth Self Report (YSR) or Child Behavior Checklist (CBCL), respectively. In n = 57 cases both parent and self-report was available. The German SCARED is shown to have good convergent and divergent validity compared with YSR/CBCL scales. The total score discriminated between children with an anxiety disorder and children with another psychiatric disorder. Cross-informant agreement was moderate with children reporting more and more severe anxiety symptoms than their parents. In conclusion, both the parent and the child version of the German SCARED proved valid. In clinical settings the integration of data from both perspectives seems important.     

Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Non-Clinical Sample of Children and Adolescents in Saudi Arabia

This paper examined the reliability, convergent validity and factor structure of the self-report Screen for Child Anxiety Disorders (SCARED; Birmaher et al. in J Am Acad Child Adolesc Psychiatry 36:545–553, 1997) in a large community sample of children and adolescents in Saudi Arabia. The questionnaire showed moderate to high internal consistency and satisfactory test–retest reliability over a 2 week period. In addition, there were significant positive correlations between reported anxiety symptoms with parent report behavioural difficulties. The five factor structure model of the SCARED also had a good model fit in this population. The results showed that self-report anxiety symptoms decreased with age (for boys and not girls) and were higher in adolescent girls. The results suggest that the SCARED could be useful in this population to identify individuals who are at risk of developing anxiety disorders in childhood with a view to implementing prevention and intervention methods to ensure positive developmental outcome over time.     

儿童焦虑障碍自评量表的河南农村常模和信、效度检验

目的将儿童焦虑障碍自评量表用于河南农村儿童的信效度检验,并建立河南农村常模。方法在河南全省6个市的6个乡镇的小学中采样1 903人(男1 039人,女864人),平均年龄(11.62±1.73)岁,由学生填写儿童焦虑障碍自评量表。结果 (1)儿童焦虑障碍自评量表的项目分析中41个项目与总分之间r=-0.442～0.695,P=0.00;(2)Cronbachα系数总量表为0.909,分量表为0.705～0.798;(3)重测信度r为0.592～0.684,P=0.00;(4)内容效度中各项目与其维度分、各维度分与总分间r=0.536～0.756,P=0.00;(5)区分效度,将常模儿童与焦虑儿童的量表分进行比较,学校维度t=1.281,P=0.20,其余为t=6.294～8.903,P=0.00;(6)划界常模分为18分,总分>18分即有焦虑障碍的可能。结论儿童焦虑障碍自评量表可用于河南农村儿童焦虑症状的评估,并可用于筛查儿童焦虑障碍。     

The hospital anxiety and depression scale

A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.     

Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the general Italian adolescent population: A validation and a comparison between Italy and The Netherlands

In this study examination is given to the psychometric properties of the Italian version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a large community sample of adolescents. Additionally, a comparison was made between the anxiety scores of this Italian adolescent cohort (N = 1975) and a comparative Dutch adolescent cohort (N = 1115).Findings revealed that a five-factor structure of the SCARED applied not only to the Italian adolescents from the general community, but also to boys and girls, and to early and middle adolescents. Moreover, sex and age differences on anxiety scores within the Italian sample were found to be consistent with previous studies of adolescent anxiety disorders. Finally, Italian adolescents reported higher anxiety scores than their Dutch peers.Findings of this study highlight that the SCARED is a valid screening instrument to rate anxiety symptoms of Italian adolescents.     

Reliability and validity of the Spence Children's Anxiety Scale and the Screen for Child Anxiety Related Emotional Disorders in German children

The reliability and validity of the Spence Children's Anxiety Scale (SCAS) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) were evaluated in a sample of 556 German primary school children. Both the SCAS (alpha = 0.92) and the SCARED (alpha = 0.91) were demonstrated to have high internal consistency. The validity of the SCAS and the SCARED was supported by a number of findings. First, in agreement with previous studies, girls displayed significantly higher levels of anxiety symptoms than boys. Furthermore, SCAS and SCARED scores were substantially interrelated. Finally, significant correlations were found between these two measures of anxiety symptoms and the Youth Self-Report and the Columbia Impairment Scale. The utility of the SCAS and the SCARED as screening instruments for anxiety symptoms in children is briefly discussed.     

One-Year Follow-up of Family versus Child CBT for Anxiety Disorders: Exploring the Rolesof Child Age and Parental Intrusiveness

Objective To compare the relative long-term benefit of family-focused cognitive behavioral therapy (FCBT) and child-focused cognitive behavioral therapy (CCBT) for child anxiety disorders at a 1-year follow-up. Method Thirty-five children (6–3 years old) randomly assigned to 12–16 sessions of family-focused CBT (FCBT) or child-focused CBT (CCBT) participated in a 1-year follow-up assessment. Independent evaluators, parents, and children rated anxiety and parental intrusiveness. All were blind to treatment condition and study hypotheses. Results Children assigned to FCBT had lower anxiety scores than children assigned to CCBT on follow-up diagnostician- and parent-report scores, but not child-report scores. Exploratory analyses suggested the advantage of FCBT over CCBT may have been evident more for early adolescents than for younger children and that reductions in parental intrusiveness may have mediated the treatment effect. Conclusion FCBT may yield a stronger treatment effect than CCBT that lasts for at least 1 year, although the lack of consistency across informants necessitates a circumspect view of the findings. The potential moderating and mediating effects considered in this study offer interesting avenues for further study.     

Convergent and divergent validity of the Beck Anxiety Inventory for patients with panic disorder and agoraphobia

Psychometric properties of the Beck Anxiety Inventory (BAI) (Beck and Steer, 1990) were investigated in a sample of 82 patients suffering from panic disorder with agoraphobia. Before and after brief treatment, patients completed a battery of questionnaires and, for 2-week periods, kept a daily panic diary in which they recorded panic attacks, fear of panic, and average anxiety. The BAI demonstrated excellent internal consistency and good test–retest reliability over a 5-week interval. A partial multitrait, multimethod correlation matrix provided evidence of convergent validity with other measures of anxiety and of divergent validity vis á vis measures of depression. Factor analyses of pretest scores and residual gain scores used to address criticism that the BAI is excessively panic-centric yielded mixed results. In one analysis, the BAI was loaded with multimethod measures of panic and anxiety and, in the other, with questionnaire methods of assessing anxiety and depression. However, the BAI was clearly distinguished from measures of fear of fear, a central construct in panic disorder, and agoraphobic avoidance. Finally, the BAI proved sensitive to change with treatment, yielding effect sizes for improvement comparable to those of other anxiety measures. Depression and Anxiety 6:140–146, 1997. © 1997 Wiley-Liss, Inc.