Reliability and validity of the Spence Children's Anxiety Scale and the Screen for Child Anxiety Related Emotional Disorders in German children
Introduction
Anxiety disorders represent one of the most common psychiatric disorders in children and adolescents. Findings from epidemiological studies have shown that as many as 10% of the children and adolescents are affected by these disorders (Essau, Conradt, & Petermann, 2000; Essau & Petermann, 2001; Lewinsohn, Hops, Roberts, Seeley, & Andrews, 1993; McGee et al., 1990). Although some fears and anxieties are part of normal development, for some proportions of the children these problems, if left untreated, may persist through adolescence and adulthood (Cohen et al., 1993; Feehan, McGee, & Williams, 1993; Keller et al., 1992). Anxiety is associated with impairment in various life domains such as in school, leisure-time activities, and peer-interaction (Bowen, Offord, & Boyle, 1990; Essau et al., 2000; Kashani & Orvaschel, 1990; Ginsburg, La Greca, & Silverman, 1998). Studies have also indicated that the presence of anxiety symptoms may act as a risk factor for the development of various types of psychiatric disorders in adulthood, including depression and substance use disorders (Wittchen & Essau, 1994). These findings stress the importance to identify clinically anxious children at an early stage so that appropriate intervention can be provided. The realization of this aim, however, depends on the availability of instruments with sound psychometric properties. Structured diagnostic interviews are not practical as a screening instrument because they are too time consuming to administer, and usually require that the interviewers are well-trained in using the instrument (Essau & Barrett, 2001). By contrast, self-report questionnaires are more convenient, less expensive, and are easy to standardize.
Given these advantages, numerous self-report questionnaires for the assessment of anxiety symptoms in children and adolescents have been developed and examined in the literature. The most commonly used scales are the Fear Survey Schedule for Children-Revised (FSSC-R; Ollendick, 1983), the Revised Children's Manifest Anxiety Scale (RCMAS; Reynolds & Richmond, 1985), and the State-Trait Anxiety Inventory for Children (STAIC; Spielberger, Gorsuch, & Luchene, 1976). Other instruments have been tailored to specific types of anxiety, including social anxiety and fear of negative evaluation (e.g., the Social Anxiety Scale for Children; LaGreca & Stone, 1993), and posttraumatic stress disorder (e.g., the PTSD Reaction Index; Frederick, 1985). While these questionnaires have sound psychometric properties, they cannot be used to measure symptoms of DSM-IV anxiety disorders. Two noteworthy exceptions in this respect are the Spence Children's Anxiety Scale (SCAS; Birmaher et al. (1997), Spence (1998)) and the Screen for Child Anxiety Related Emotional Disorders (SCARED; Birmaher et al. (1999), Birmaher et al. (1997)). Unlike other existing questionnaires (e.g., RCMAS or STAIC), the SCAS and the SCARED tap anxiety symptoms that can be specifically linked to DSM-IV anxiety disorders. The SCARED was developed within the context of samples in clinical settings (Birmaher et al., 1997), however, it has been used in non-referred school children (Muris, Schmidt, & Merckelbach, 2000). Although the development of the SCAS was based on community samples, this scale has also norms for clinically referred children (Birmaher et al. (1997), Spence (1998)). Recent studies have provided strong support for the psychometric properties of the SCAS and the SCARED (Birmaher et al., 1997; Muris, Merckelbach, van Brakel, Mayer, & van Dongen, 1998a; Muris et al., 2000; Birmaher et al. (1997), Spence (1998)). Strong correlations have also been reported between the SCAS and the SCARED with traditional measures of anxiety symptoms such as the RCMAS, STAIC, and the FSSC-R (Muris et al., 1998b; Spence, 1998).
The main purpose of the present study was to examine the reliability and the validity of the German translation of the SCAS and SCARED in primary school children. Such psychometric evaluation would indicate whether these two self-report questionnaires are useful for screening anxiety symptoms in normal population. Another purpose is to examine age and gender patterns of anxiety symptoms, and the relationship of anxiety symptoms with psychosocial functioning.
Section snippets
Participants
The sample consisted of 556 children (275 boys and 281 girls) who were enrolled in grades 3–6. Children's age ranged from 8 to 12 years (mean=10.6, SD=1.2). The participants were recruited from urban and rural primary schools in Niedersachen, Germany. Most of the children came from small families and were firstborn children. The vast majority of them came from intact families; about 80% of the children were living with both parents. The socioeconomic status of subjects varied greatly, ranging
Results
The means and standard deviations for the SCAS and the SCARED,1
Discussion
The main purpose of this article was to examine the reliability and validity of the SCAS and the SCARED in German children. Unlike other instruments that measure anxiety in youths, the SCAS and the SCARED contain items that can be linked to symptoms of DSM-IV anxiety disorders. Before discussing our findings, some limitations should be discussed. First, only 8–12 year olds were included in our study, so it is not clear whether our findings can be generalized to other populations (e.g.,
References (38)
- et al.
Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED)A replication study
Journal of the American Academy of Child and Adolescent Psychiatry
(1999) - et al.
The Screen for Child Anxiety Related Emotional Disorders (SCARED)Scale construction and psychometric characteristics
Journal of the American Academy of Child and Adolescent Psychiatry
(1997) - et al.
The prevalence of overanxious disorder and separation anxiety disorderResults from the Ontario Child Health Study
Journal of the American Academy of Child and Adolescent Psychiatry
(1990) - et al.
Assessment of symptoms of DSM-IV anxiety and depression in childrenA revised child anxiety and depression scale
Behaviour Research and Therapy
(2000) - et al.
Frequency, comorbidity, and psychosocial impairment of anxiety disorders in adolescents
Journal of Anxiety Disorders
(2000) - et al.
Mental health disorders from age 15 to age 18 years
Journal of the American Academy of Child and Adolescent Psychiatry
(1993) - et al.
Chronic course of anxiety disorders in children and adolescents
Journal of the American Academy of Child and Adolescent Psychiatry
(1992) Parent-child agreement in clinical assessment of anxiety and other psychopathologyA review
Journal of Anxiety Disorders
(1991)- et al.
DSM-III disorders in a large sample of adolescents
Journal of the American Academy of Child and Adolescent Psychiatry
(1990) - et al.
The Screen For Child Anxiety Related Emotional Disorders (SCARED)Relationship with anxiety and depression in normal children
Personality and Individual Differences
(1998)
The Screen for Child Anxiety Related Emotional Disorders and its relationship to traditional childhood anxiety
Journal of Behavior Therapy and Experimental Psychiatry
Correlations among two self-report questionnaires for measuring DSM-defined anxiety disorder symptoms in childrenThe Screen For Child Anxiety Related Emotional Disorders and the Spence Children's Anxiety Scale
Personality and Individual Differences
Prevalence of psychiatric disorders in a community population of older adolescents
Journal of the American Academy of Child and Adolescent Psychiatry
A measure of anxiety symptoms among children
Behavior Research and Therapy
Manual for the Youth Self-Report and 1991 profile
Global measures of impairment for epidemiologic and clinical use with children and adolescents
International Journal of Methods in Psychiatric Research
The use of diagnostic instruments and global measures of functioning in child psychiatry epidemiological studies
Back translation for cross-cultural research
Journal of Cross-Cultural Psychology
An epidemiological study of disorders in late childhood and adolescence—IAge- and gender-specific prevalence
Journal Child Psychology and Psychiatry
Cited by (157)
Psychometric properties of the Distress Questionnaire-5 (DQ5) for measuring psychological distress in adolescents
2024, Journal of Psychiatric ResearchThe Transmission of Anxiety from Mothers to Adolescents in Rural China: The Protective Roles of Father-Child Attachment Security and Friend Support
2024, Journal of Child and Family StudiesPosttraumatic stress symptoms in adolescents and young adults with a chronic somatic disease: a mixed-methods study
2023, Child and Adolescent Psychiatry and Mental HealthFactor Structure and Measurement Invariance Across Age, Gender, and Clinical Status of the Screen for Children Anxiety Related Emotional Disorders
2023, European Journal of Psychological Assessment