Helping Give Away Psychological Science/Measures/SCARED

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The Screen for Child Anxiety Related Disorders, or SCARED[1], is a screening measure developed by Boris Birmaher (MD), Suneeta Khetarpal (MD), Marlane Cully (M.ED), David Brent (MD), and Sandra Mackenzie (PhD). It takes the intended users, clinicians and psychiatrists, 10 minutes on average to administer.[2] It is a 41 question (originally 38 question), self-report, multiple choice questionnaire designed for children ages 8–18 to screen for anxiety disorders such as panic disorder (significant somatic symptoms), generalized anxiety disorder, separation anxiety disorder, social anxiety disorder, and significant school avoidance or refusal.[3][4][5] The purpose of SCARED was to create a screening instrument that assesses general anxiety symptoms as well as screen for DSM-IV childhood anxiety disorders.[1] There is a child and adult self-report version of the scale.

Each question measures the frequency or intensity of a variety of symptoms or behaviors and the questionnaire takes about ten minutes to complete.[4] The participant is asked to answer each question with one of three possible answer choices: "Not true or hardly every true", "Somewhat true or sometimes true", or "Very true or often true".[6] Through research, this assessment has been proven to be both valid and reliable.[3][7][8] It has been

Question breakdown, scoring and interpretation

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The 41 question SCARED tallies points on the assessment by rating answers on a 0-2 scale.

  • 0: Not true or hardly ever true
  • 1: Somewhat true or sometimes true
  • 2: Very true or often true

Question breakdown

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Each question is designed to identify symptoms of specific anxiety related disorders. The breakdown is as follows:

  • Some anxiety disorder: questions 1-41
  • Panic disorder or significant somatic symptoms: questions 1, 6, 9, 12, 15, 18, 19, 22, 24, 27, 30, 34, 38
  • Generalized anxiety disorder: questions 5, 7, 14, 21, 23, 28, 33, 35, 37
  • Separation anxiety: questions 4, 8, 13, 16, 20, 35, 29, 31
  • Social anxiety disorder: questions 3, 10, 26, 32, 39, 40, 41
  • Significant school avoidance: questions 2, 11, 17, 36
# Content Subscale Notes
1 When I feel nervous, it is hard for me to breathe. PA/SO SCAARED
2 I get headaches when I am at school, at work or in public places. PA/SO SCAARED
3 I don’t like to be with people I don’t know well. SOC SCAARED
4 I get nervous if I sleep away from home. SCAARED
5 SCAARED
6 SCAARED
7 SCAARED
8 SCAARED
9 SCAARED
10 SCAARED
11 SCAARED
12 SCAARED
13 SCAARED
14 SCAARED
15 SCAARED
16 SCAARED
17 SCAARED
18 SCAARED
19 SCAARED
20 SCAARED
21 SCAARED
22 SCAARED
23 SCAARED
24 SCAARED
SCAARED
SCAARED
SCAARED
SCAARED
SCAARED

Use in Other Populations

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The SCARED assessment has been translated into Arabic, Chinese, French, German, Italian, Tamil, Thai, Spanish, Czech, and Finnish, and these PDFs can be found here.

A meta-analysis of 25 studies from Belgium, Germany, Italy, the Netherlands, the US, South Africa, and China suggested that

Scoring Instructions and Syntax

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Hand Scoring and General Instructions

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On the questionnaire, an answer of "not true or hardly true" is scored as a 0, "somewhat true or sometimes true" is scored as 1, and "very true or often true" is scored as 2. A total score greater or equal to 25 suggests presence of an anxiety disorder.

Scores for Specific Anxiety Disorders
Panic Disorder or

Significant Somatic Symptoms

Score of 7+ on sum of items 1, 6, 9, 12, 15, 18, 19, 22, 24, 27, 30, 34, 38
Generalized Anxiety Disorder Score of 9+ on sum of items 5, 7, 14, 21, 23, 28, 33, 35, 37
Separation Anxiety Disorder Score of 5+ on sum of items 4, 8, 13, 16, 20, 25, 29, 31
Social Anxiety Disorder Score of 8+ on sum of items 3, 10, 26, 32, 39, 40, 41
Significant School Avoidance Score of 3+ on sum of items 2, 11, 17, 36

See Also

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Screeners

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Parent report

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Child/youth report

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References

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  1. 1.0 1.1 BIRMAHER, BORIS; KHETARPAL, SUNEETA; BRENT, DAVID; CULLY, MARLANE; BALACH, LISA; KAUFMAN, JOAN; NEER, SANDRA MCKENZIE. "The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale Construction and Psychometric Characteristics". Journal of the American Academy of Child & Adolescent Psychiatry 36 (4): 545–553. doi:10.1097/00004583-199704000-00018. https://doi.org/10.1097/00004583-199704000-00018. 
  2. 2.0 2.1 "Instruments | CABS | University of Pittsburgh". pediatricbipolar.pitt.edu. Retrieved 2018-04-10.
  3. 3.0 3.1 Birmaher, B; Khetarpal, S; Brent, D; Cully, M; Balach, L; Kaufman, J; Neer, SM (April 1997). "The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics.". Journal of the American Academy of Child and Adolescent Psychiatry36 (4): 545–53. doi:10.1097/00004583-199704000-00018PMID 9100430.
  4. 4.0 4.1 Osborn, J., & Gately, B. (2014, January 13). SCARED-child – Screen for child anxiety related disorders – Child version. Retrieved from https://valant.atlassian.net/wiki/display/KB/SCARED-Child++Screen+for+Child+Anxiety+Related+Disorders+-+Child+Version[dead link]
  5. The California Evidence-Based Clearinghouse for Child Welfare (2011, August). Screen for childhood anxiety related emotional disorders (SCARED). Retrieved fromhttp://www.cebc4cw.org/assessment-tool/screen-for-childhood-anxiety-related-emotional-disorders-scared
  6. http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/SCARED%20Child.pdf
  7. Birmaher B.; Brent D. A.; Chiappetta L.; Bridge J.; Monga S.; Baugher M. (1999). "Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A replication study". Journal of the American Academy of Child & Adolescent Psychiatry38: 1230–1236.doi:10.1097/00004583-199910000-00011.
  8. Monga, S., Birmaher, B., Chiappetta, L., Brent, D., Kaufman, J., Bridge, J., & Cully, M. (2000). Screen for Child Anxiety-Related Emotional Disorders (SCARED): Convergent and divergent validity. Depression and Anxiety, 12, 85-91.

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From Wikiversity OToPS

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The Screen for Adult Anxiety Related disorders (SCAARED) is a self-report survey that assesses four types of anxiety in adults. The four types include panic disorder, generalized anxiety disorder, separation anxiety, and social phobias.

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From Wikipedia

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Template:More medical citations needed Template:Update Template:Infobox diagnostic The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a screening questionnaire for anxiety disorders developed in 1997.[1] The SCARED is intended for youth, 9–18 years old,[1] and their parents to complete in about 10 minutes.[2] It can discriminate between depression and anxiety, as well as among distinct anxiety disorders. The SCARED is useful for generalized anxiety disorder, social anxiety disorder, phobic disorders, and school anxiety problems.[3] Most available self-report instruments that measure anxiety in children look at general aspects of anxiety rather than Diagnostic and Statistical Manual of Mental Disorders (DSM) categorizations.[4] The SCARED was developed as an instrument for both children and their parents that would encompass several w:DSM-IV and w:DSM-5 categorizations of the anxiety disorders: somatic/panic, generalized anxiety, separation anxiety, social phobia, and school phobia.[4]

Each question measures the frequency or intensity of symptoms or behaviors.[5] This assessment has been found to be both valid and reliable in research settings.[6][2][4]

In 2017 SCARED was adapted to create the Screen for Adult Anxiety Related Disorders (SCAARED).[7] The SCAARED screens for four factors of anxiety related disorders; somatic/panic/agoraphobia, generalized anxiety, separation anxiety, and social anxiety. The SCAARED will be used in longitudinal studies that follow youth into adulthood, as well as studies that compare child and adult populations.[7]

Versions

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Template:Psychology sidebar

The SCARED was developed to screen for anxiety disorders in children; there is a parent version as well as a youth self-report version.[6]

The original version developed in 1997 was available in 38 items. The SCARED is most commonly used in the 41-item version published in 1999 which was updated with three additional items in the social phobia scale.[3] There is also a 66-item SCARED-Revised (SCARED-R) that includes the panic disorder, generalized anxiety disorder, social phobia, and separation anxiety disorder scales.[3]

Reliability

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Rubric for evaluating norms and reliability for the Screen for Child Anxiety Related Disorders[8]
Criterion Rating Explanation
Norms Good Multiple research studies of large relevant clinical samples.[6]
Internal consistency (Cronbach's alpha, split half, etc.) Good Alphas ranging from .74 to .89[6]
Inter-rater reliability Not published No published studies formally checking inter-rater reliability
Test-retest reliability (stability Adequate r = .86 over a median of 5 weeks[6]
Repeatability Not published No published studies formally checking repeatability

Validity

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Evaluation of validity and utility for the Screen for Child Anxiety Related Disorders[8]
Criterion Rating Explanation
Content validity Excellent Covers DSM diagnostic symptoms for anxiety disorders and specific phobias.[2]
Construct validity (e.g., predictive, concurrent, convergent, and discriminant validity) Excellent Shows convergent validity with other symptom scales. SCARED significantly positively correlated with CBCL.[4]
Discriminative validity Good AUC of .67, able to discriminate between children with anxiety versus non-anxiety disorders in clinical settings, as well as individual types of anxiety disorders.[4]
Validity generalization Good Used in clinical settings for children and adolescents ages 9–18. Reliable across genders and ethnicities. SCARED has been translated into multiple languages with good reliability[6][2]
Treatment responsivity Good Studies show sensitivity to treatment effects when children took the SCARED pre and post treatment suggesting the assessment is effective in both clinical and research settings[9]
Clinical utility Good Free (public domain)

The SCARED provides an assessment that detects anxiety disorders in children and differentiates between depression and anxiety and specific anxiety and phobia disorders.[2] The assessment should not be used alone to diagnose a child with an anxiety disorder, however research suggest it is a reliable and useful tool when used along with clinical interviewing diagnose anxiety disorders. The SCARED's treatment sensitivity means that it is useful in both clinical and research settings to measure symptoms and presence of anxiety longitudinally, specifically over the course of treatment. It has proved useful in studying the effectiveness of certain treatments of anxiety disorders in children.[2]

In other populations

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Studies of the SCARED also indicate good psychometric properties for children and adolescents of different cultures, distinguishing itself from other similar questionnaires.[3] The SCARED has been found to be a reliable assessment tool in several different cultures and translated into many different languages, including, but not limited to, French, German,[10] Italian, Dutch,[11] Spanish, Chinese, Arabic, and Thai.[3]

Limitations

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The assessment tool is limited in that it is a self-report measure, which may introduce bias. Another limitation is that, depending on the age and maturity of the child filling out the questionnaire, they may have difficulty recognizing the frequency or severity of both external and internal symptoms. The parent may also be limited in recognizing the internal symptoms of their child's anxiety.[6]

Development and history

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Prior to the development of the SCARED, three widely used rating scales for anxiety in children and adolescents included the Revised Children's Manifest Anxiety Scale,[citation needed] the Revised Fear Survey Schedule for Children,[12] and the Somatic State and Trait Anxiety Scale.[13] While these methods were useful in assessing general anxiety symptoms, they were unable to discriminate between anxiety disorders. To address this shortcoming, the SCARED was developed based on DSM-IV classification to screen specifically for general anxiety disorder (GAD), separation anxiety disorder (SAD), panic disorder, social phobia, and school phobia.[6]

See also

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References

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  1. 1.0 1.1 "Screening for childhood anxiety: A meta-analysis of the screen for child anxiety related emotional disorders". J Affect Disord 240: 220–229. November 2018. doi:10.1016/j.jad.2018.07.049. PMID 30081293. 
  2. 2.0 2.1 2.2 2.3 2.4 2.5 Birmaher, Boris; Brent, David A.; Chiappetta, Laurel; Bridge, Jeffrey; Monga, Suneeta; Baugher, Marianne (1999). "Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A Replication Study". Journal of the American Academy of Child & Adolescent Psychiatry 38 (10): 1230–1236. doi:10.1097/00004583-199910000-00011. PMID 10517055. 
  3. 3.0 3.1 3.2 3.3 3.4 Hale, William W., III; Crocetti, Elisabetta; Raaijmakers, Quinten A.W.; Meeus, Wim H.J. (2011-01-01). "A meta-analysis of the cross-cultural psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED)". Journal of Child Psychology and Psychiatry 52 (1): 80–90. doi:10.1111/j.1469-7610.2010.02285.x. ISSN 1469-7610. PMID 20662993. 
  4. 4.0 4.1 4.2 4.3 4.4 Monga, S; Birmaher, B; Chiappetta, L; Brent, D; Kaufman, J; Bridge, J; Cully, M (2000). "Screen for Child Anxiety-Related Emotional Disorders (SCARED): Convergent and divergent validity". Depression and Anxiety 12 (2): 85–91. doi:10.1002/1520-6394(2000)12:2<85::aid-da4>3.0.co;2-2. PMID 11091931. 
  5. BIRMAHER, BORIS; KHETARPAL, SUNEETA; BRENT, DAVID; CULLY, MARLANE; BALACH, LISA; KAUFMAN, JOAN; NEER, SANDRA MCKENZIE (1997). "The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale Construction and Psychometric Characteristics". Journal of the American Academy of Child & Adolescent Psychiatry 36 (4): 545–553. doi:10.1097/00004583-199704000-00018. ISSN 0890-8567. PMID 9100430. https://doi.org/10.1097/00004583-199704000-00018. 
  6. 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 Birmaher, Boris; Khetarpal, Suneeta; Brent, David; Cully, Marlane; Balach, Lisa; Kaufman, Joan; Neer, Sandra McKenzie (1997). "The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale Construction and Psychometric Characteristics". Journal of the American Academy of Child & Adolescent Psychiatry 36 (4): 545–553. doi:10.1097/00004583-199704000-00018. PMID 9100430. 
  7. 7.0 7.1 Angulo, Melina; Rooks, Brian T.; Gill, MaryKay; Goldstein, Tina; Sakolsky, Dara; Goldstein, Benjamin; Monk, Kelly; Hickey, Mary Beth et al. (2017). "Psychometrics of the Screen for Adult Anxiety Related Disorders (SCAARED)- A New Scale for the Assessment of DSM-5 Anxiety Disorders". Psychiatry Research 253: 84–90. doi:10.1016/j.psychres.2017.02.034. PMID 28359032. PMC 5472098. //www.ncbi.nlm.nih.gov/pmc/articles/PMC5472098/. 
  8. 8.0 8.1 Hunsley, J., & Mash, E. J. (2008). Developing criteria for evidence-based assessment: An introduction to assessments that work. In J. Hunsley & E. J. Mash (Eds.), A guide to assessments that work (2nd ed., pp. 3-16). Oxford University Press.
  9. Muris, Peter; Merckelbach, Harald; Gadet, Björn; Moulaert, Véronique; Tierney, Sandy (December 1999). "Sensitivity for Treatment Effects of the Screen for Child Anxiety Related Emotional Disorders". Journal of Psychopathology and Behavioral Assessment 21 (4): 323–335. doi:10.1023/A:1022120832187. ISSN 0882-2689. 
  10. Weitkamp, Katharina; Romer, Georg; Rosenthal, Sandra; Wiegand-Grefe, Silke; Daniels, Judith (2010-01-01). "German Screen for Child Anxiety Related Emotional Disorders (SCARED): Reliability, Validity, and Cross-Informant Agreement in a Clinical Sample". Child and Adolescent Psychiatry and Mental Health 4: 19. doi:10.1186/1753-2000-4-19. ISSN 1753-2000. PMID 20591137. PMC 2912250. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2912250/. 
  11. Hale, William; Raaijmakers, Quinten; Muris, Peter; Meeus, Wim (2005). "Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the General Adolescent Population". Journal of the American Academy of Child & Adolescent Psychiatry 44 (3): 283–290. doi:10.1097/00004583-200503000-00013. PMID 15725973. 
  12. Ollendick (2006). "Appendix III: Fear Survey Schedule for Children-Revised". Fear Survey Schedule for Children- Revised. pp. 322–328. doi:10.1002/9780470713334.app3. ISBN 9780470713334. http://onlinelibrary.wiley.com/store/10.1002/9780470713334.app3/asset/app3.pdf?v=1&t=iwpu1ua2&s=6ab77505c83cd1b141981e8be6ecc0f45057a02d&systemMessage=Wiley+Online+Library+will+be+unavailable+on+Saturday+17th+December+2016+at+09%3A00+GMT%2F+04%3A00+EST%2F+17%3A00+SGT+for+4hrs+due+to+essential+maintenance.Apologies+for+the+inconvenience. 
  13. Grös, Daniel F.; Antony, Martin M.; Simms, Leonard J.; McCabe, Randi E. (2007). "Psychometric properties of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA): Comparison to the State-Trait Anxiety Inventory (STAI).". Psychological Assessment 19 (4): 369–381. doi:10.1037/1040-3590.19.4.369. PMID 18085930. 
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