Abstract
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.
Similar content being viewed by others
References
Asbahr FR (2004) Anxiety disorders in childhood and adolescence: clinical and neurobiological aspects. J Pediatr 80:S28–34. doi:10.1590/S0021-75572004000300005
Fisak BJ Jr, Richard D, Mann A (2011) The prevention of child and adolescent anxiety: a meta-analytic review. Prev Sci 12:255–269. doi:10.1007/s11121-011-0210-0
Fleitlich-Bilyk B, Goodman R (2004) Prevalence of child and adolescent psychiatric disorders in southeast Brazil. J Am Acad Child Adolesc Psychiatry 43:727–734. doi:10.1097/01.chi.0000120021.14101.ca
Isolan LR, Zeni CP, Mezzomo K, Blaya C, Kipper L, Heldt E, Manfro GG (2005) Behaviorial inhibition and history of childhood anxiety disorders in Brazilian adult patients with panic disorder and social anxiety disorder. Rev Bras Psiquiatr 27:97–100. doi:10.1590/S1516-44462005000200005
Manfro GG, Isolan L, Blaya C, Maltz S, Heldt E, Pollack MH (2003) Relationship between adult social phobia and childhood anxiety. Rev Bras Psiquiatr 25:96–99. doi:10.1590/S1516-44462003000200009
Manfro GG, Isolan L, Blaya C, Santos L, Silva M (2002) Retrospective study of the association between adulthood panic disorder and childhood anxiety disorders. Rev Bras Psiquiatr 24:26–29. doi:10.1590/S1516-44462002000100008
Bittner A et al (2007) What do childhood anxiety disorders predict? J Child Psychol Psychiatry 48:1174–1183. doi:10.1111/j.1469-7610.2007.01812.x
Pine DS, Cohen P, Gurley D, Brook J, Ma Y (1998) The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Arch Gen Psychiatry 55:56–64. doi:10.1001/archpsyc.55.1.56
Konnopka A et al (2009) Cost-of-illness studies and cost-effectiveness analyses in anxiety disorders: a systematic review. J Affect Disord 114:14–31. doi:10.1016/j.jad.2008.07.014
Bolton JM et al (2008) Anxiety disorders and risk for suicide attempts: findings from the Baltimore epidemiologic catchment area follow-up study. Depress Anxiety 25:477–481. doi:10.1002/da.20314
Birmaher B, Khetarpal S, Brend D, Cully M, Balach L, Kaufman J et al (1997) The screen for child anxiety related emotional disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry 36:545–553. doi:10.1097/00004583-199704000-00018
Birmaher B, Brent DA, Chiappetta L, Bridge J, Monga S, Baugher M (1999) Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): a replication study. J Am Acad Child Adolesc Psychiatry 38:1230–1236. doi:10.1097/00004583-199910000-00011
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. Author, Washington, DC
Boyd RC, Ginsburg GS, Lambert SF, Cooley MR, Campbell KDM (2003) Screen for child anxiety related emotional disorders (SCARED): psychometric properties in an African American Parochial high school sample. J Am Acad Child Adolesc Psychiatry 42:1188–1196. doi:10.1097/00004583-200310000-00009
Essau CA, Muris P, Ederer EM (2002) Reliability and validity of the spence children’s anxiety scale and the screen for child anxiety related emotional disorders in German children. J Behav Ther Exp Psychiatry 33:1–18. doi:10.1016/S0005-7916(02)00005-8
Haley T, Puskar K, Terhorst L (2011) Psychometric properties of the screen for child anxiety related emotional disorders in a rural high school population. J Child Adolesc Psychiatr Nurs 24:23–32. doi:10.1111/j.1744-6171.2010.00264.x
Monga S, Birmaher B, Chiappetta L, Brent D, Kaufman J, Bridge J et al (2000) Screen for child anxiety related emotional disorders (SCARED): convergent and divergent validity. Depress Anxiety 12:85–91. doi:10.1002/1520-6394(2000)12:2<85:AID-DA4>3.0.CO;2-2
Muris P, Merckelbach H, Mayer B, van Brakel A, Thissen S, Moulaert V et al (1998) The screen for child anxiety related emotional disorders (SCARED) and traditional childhood anxiety measures. J Behav Ther Exp Psy 29:327–339. doi:10.1016/S0005-7916(98)00023-8
Muris P, Merckelbach H, Ollendick T, King N, Bogie N (2002) Three traditional and three new childhood anxiety questionnaires: their reliability and validity in a normal adolescent sample. Behav Res Ther 40:753–772. doi:10.1016/S0005-7967(01)00056-0
Muris P, Merckelbach H, van Brakel A, Mayer B (1999) The revised version of the screen for child anxiety related emotional disorders (SCARED-R): further evidence for its reliability and validity. Anxiety Stress Coping 12:411–425. doi:10.1080/10615809908249319
Su L, Wang K, Fan F, Su Y, Gao X (2008) Reliability and validity of the screen for child anxiety related emotional disorders (SCARED) in Chinese children. J Anxiety Disord 22:612–621. doi:10.1016/j.janxdis.2007.05.011
Wren FJ, Bridge JA, Birmaher B (2004) Screening for childhood anxiety symptoms in primary care: integrating child and parent reports. J Am Acad Child Adolesc Psychiatry 43:1364–1371
Hale WW, Crocetti E, Raaijmakers QAW, Meeus WHJ (2011) A metaanalysis of the cross-cultural psychometric properties of the screen for child anxiety related emotional disorders (SCARED). J Child Psychol Psychiatry 52:80–90. doi:10.1111/j.1469-7610.2010.02285.x
Isolan L, Salum GA, Osowski AT, Amaro E, Manfro GG (2011) Psychometric properties of the screen for child anxiety related emotional disorders (SCARED) in Brazilian children and adolescents. J Anxiety Disord 25:741–748. doi:10.1016/j.janxdis.2011.03.015
Salum GA et al (2011) The multidimensional evaluation and treatment of anxiety in children and adolescents: rationale, design, methods and preliminary findings. Rev Bras Psiquiatr 33:182–195. doi:10.1590/S1516-44462011000200015
March J, Parker JD, Sullivan K, Stallings P, Conners CK (1997) The multidimensional anxiety scale for children (MASC): factor structure, reliability and validity. J Am Acad Child Adolesc Psychiatry 336:554–565. doi:10.1097/00004583-199704000-00019
Kovacz MA (1992) Children’s depression inventory manual. Multi-Health Systems, North Tonawanda
Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40:1337–1345. doi:10.1097/00004583-200111000-00015
Kaufman J, Birmaher B, Brent DA, Rao U, Flynn C, Moreci P, Williamson D, Ryan N (1997) Schedule for affective disorders and schizophrenia for school-age children - present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988. doi:10.1097/00004583-199707000-00021
Brasil HHA (2003) Development of the Brazilian version of the K-SADS-PL (schedule for affective disorders and schizophrenia for school aged children present and lifetime version): a study of its psychometric properties. Dissertation, Departament of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
Böhning D, Böhning W, Holling H (2008) Revisiting Youden’s index as a useful measure of the misclassification error in meta-analysis of diagnostic studies. Stat Methods Med Res 17:543–554. doi:10.1177/0962280208081867
Shaik SA (2011) Measures derived from a 2 × 2 table for an accuracy of a diagnostic test. J Biomet Biostat 2:128. doi:10.4172/2155-6180.1000128
Acknowledgments
Sources of funding were the National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq), the Coordination for the Improvement of Higher Level Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, CAPES), and the Fundo de Incentivo à Pesquisa do Hospital de Clínicas de Porto Alegre (FIPE-HCPA). We thank all the patients and families involved in this research project.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
DeSousa, D.A., Salum, G.A., Isolan, L.R. et al. Sensitivity and Specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A Community-Based Study. Child Psychiatry Hum Dev 44, 391–399 (2013). https://doi.org/10.1007/s10578-012-0333-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10578-012-0333-y