Synonyms SCARED-R | LOINC 62715-8 | |
The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a self-report screening questionnaire for anxiety disorders. The questionnaire was developed by Boris Birmaher, Suneeta Khetarpal, Marlane Cully, David Brent, and Sandra Mackenzie in 1997. The SCARED is a brief self-report instrument intended for children, adolescents, and their parents to complete in about 10 minutes, and 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 potentially school anxiety problems. Most available self-report instruments that measure anxiety in children look at general aspects of anxiety rather than DSM categorizations. The SCARED was developed as an instrument for both children and their parents that would encompass several DSM-IV categorizations of the anxiety disorders: somatic/panic, generalized anxiety, separation anxiety, social phobia, and school phobia.
Contents
Each question measures the frequency or intensity of a variety of symptoms or behaviors and the questionnaire takes about ten minutes to complete. 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". Through research, this assessment has been found to be both valid and reliable in research settings.
Recently the Screen for Child Related Anxiety Disorders was adapted in order to create the Screen for Adult Anxiety Related Disorders (SCAARED). The SCAARED screens for four factors of anxiety related disorders; somatic/panic/agoraphobia, generalized anxiety, separation anxiety, and social anxiety. The SCAARED has shown excellent psychometrics properties and, because of it similarity to the SCARED, will be helpful in longitudinal studies that follow youth into adulthood, as well as studies that compare child and adult populations.
Versions
The SCARED was developed in order to screen for anxiety disorders in children, therefore there is a parent version as well as a youth self-report version.
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 3 additional items in the social phobia scale. 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 encompassing additional anxiety disorder symptoms. The PhenX Toolkit uses SCARED-R as its child protocol Anxiety Disorders Screener.
Development and history
Prior to the development of the SCARED, three rating scales were used to measure anxiety in children and adolescents: the Revised Children's Manifest Anxiety Scale, the Revised Fear Survey Schedule for Children, and the Somatic State and Trait Anxiety Scale. 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.
Impact
The SCARED has impacted the field of psychology by providing an assessment that is able to successfully detect anxiety disorders in children as well as differentiate between depression and anxiety and specific anxiety and phobia disorders. The assessment should not be used alone in order to diagnose a child with an anxiety disorder, however research suggest it is a reliable and useful tool when used along with clinical interviewing in order to successfully diagnose anxiety disorders. The SCARED's good 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 also proved to be a useful tool in studying the effectiveness of certain treatments of anxiety disorders in children.
Use in other populations
Studies of the SCARED also indicate good psychometric properties for children and adolescents of different cultures, distinguishing itself from other similar questionnaires. 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, Italian, Dutch, Spanish, Chinese, Arabic, and Thai.
Limitations
The main limitation of this study is that it is a self-report measure which means that answers and results may be biased. Another limitation is that one version is filled out by a child and depending on the age and maturity of the child they may have trouble recognizing the frequency or severity of both external and internal symptom presentation. The parent may also be limited in recognizing the internal symptoms of their child's anxiety.