Abstract
A lack of perceived control over anxiety-related situations is theorized to be characteristic of anxiety disorders in children and adolescents. In the current study we tested several theoretical predictions and developmental variation with the Dutch translation of the Anxiety Control Questionnaire for Children (ACQ-C). The theoretical factor structure of anxiety control was tested using Confirmatory Factor Analysis (CFA) in 548 non-referred children (8–18 years old, M = 12.5 years; 50.7 % girls). The incremental predictive validity of perceived control for anxiety status was assessed using logistic regression in 141 clinically anxious children (age M = 12.6 years; 56.7 % girls) and 298 non-referred non-anxious children (age M = 12.6 years; 52.7 % girls). CFA showed that both a one-factor model and two-factor model (perceived control over internal reactions and external events) fit well. The one-factor model proved invariant across age and gender. Internal consistency was excellent (Cronbach’s α = .93). Two-month test-retest reliability was adequate. The ACQ-C was able to incrementally predict diagnostic status, even after controlling for age, gender and self-reported anxiety symptoms. Finally, both younger children and girls reported less perceived control, independent of anxiety level. Findings advance the understanding of the psychometric properties of the ACQ-C, the role of control in childhood anxiety and point to the potential utility of the ACQ-C in both clinical and community samples. The Dutch translation of the ACQ-C demonstrated sound psychometric properties.
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Notes
Most of these parents were parents of children attending schools offering vocational education or schools situated in low socio-economic suburbs. These factors are known to be associated with ethnic minorities and/or low educational level and income of families. Consequently, the available sample characteristics may not fully reflect the actual sample characteristics. There were no significant differences on the child-report questionnaires between children for whom parent questionnaires were or were not available. However, children for whom parent questionnaires were available were a little younger (M = 12.34 vs. M = 13.19, t(546) = 4.14, p < .001).
Unfortunately, due to time constraints we were not able to determine anxiety diagnostic status of the non-referred children using the ADIS-C and base our non-anxious sample on these results. Therefore we decided to screen for anxiety problems using the STAI(−C) and SDQ, as Dutch norms are not available for the RCADS. However, we repeated the main analyses with a selection of non-anxious non-referred children based on clinical cut off scores on the RCADS using American norms. All results were the same.
We also performed all analyses using a Total RCADS score composed of all six subscales, but results were the same.
As one of the reviewers suggested, we repeated the regression analyses including a third group, namely non-referred anxious children. Multinomial logistic regression with three groups (clinically anxious, non-referred anxious and non-referred non-anxious) produced very similar results. Age, gender, RCADS score, STAI(−C) decile score and ACQ-C total score were entered using forward entry as a stepwise method. Two groups were compared against the reference group (clinically anxious children). The overall model including predictor variables was significant (−2LL 741.32, χ2(6) = 316.15, p < .001). The model explained 51.9 % of the variance (Nagelkerke R2). Younger age (OR 0.79, p < .001), more trait anxiety (OR 1.19, p < .01) and more perceived control (OR 1.04, p < .001) predicted non-referred anxious group status compared to clinically anxious children. Less trait anxiety (OR 0.66, p < .001) and more perceived control (OR 1.06, p < .001) predicted non-referred non-anxious status compared to clinically anxious children. These results were thus highly consistent with the logistic regression with the binary outcome variable.
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The authors would like to thank all participating schools, children, and parents for their help, as well as the students who helped collect the data: T. Koolstra, M. Oudega, and E. Kooij.
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Hogendoorn, S.M., Wolters, L.H., de Haan, E. et al. Advancing an Understanding of the Anxiety Control Questionnaire for Children (ACQ-C) in Clinically Anxious and Non-Anxious Youth: Psychometric Properties, Incremental Prediction and Developmental Differences. J Psychopathol Behav Assess 36, 288–299 (2014). https://doi.org/10.1007/s10862-013-9386-x
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DOI: https://doi.org/10.1007/s10862-013-9386-x