Screen for Childhood Anxiety Related Emotional Disorders (SCARED)
Description / Purpose:
The SCARED is a child and parent self-report instrument used to screen for childhood anxiety disorders including general anxiety disorder, separation anxiety disorder, panic disorder, and social phobia. In addition, it assesses symptoms related to school phobias.
The SCARED consists of 41 items and 5 factors that parallel the DSM-IV classification of anxiety disorders. The child and parent versions of the SCARED have moderate parent-child agreement and good internal consistency, test-retest reliability, and discriminant validity, and it is sensitive to treatment response.
Target Population: Children ages 8-18 years
Time to Administer: 10 minutes
Completed By: Parent version - Parents about their children; Child version - children about themselves
Modalities Available: Handwritten, computer, online
Scoring Information: It can be scored by hand or automatically (see www.pediatricbipolar.pitt.edu for hand scored and automatically scored forms).
Languages Available: Arabic, Chinese, English, French, German, Italian, Portuguese, Spanish, Thai
Training Requirements for Intended Users: Administered by Clinicians and Psychiatrists. No training is necessary; however, it is important to understand the meaning of the scores.
Availability: There is no cost; the form can be found at www.pediatricbipolar.pitt.edu
- Company: Western Psychiatric Institute & Clinic, Department of Child Psychology
- Website: www.psychiatry.pitt.edu/research/tools-research/assessment-instruments
- Email: firstname.lastname@example.org
- Phone: (412) 246-5788
Summary of Relevant Psychometric Research
This tool has received the Measurement Tools Rating of "A – Psychometrics Well-Demonstrated" based on the published, peer-reviewed research available. The tool must have 2 or more published, peer-reviewed studies that have established the measure’s psychometrics (e.g., reliability and validity, sensitivity and specificity, etc.). Please see the Measurement Tools Rating Scale for more information.
Show relevant research...
When more than 10 research articles have been published in ed journals, the CEBC selects 10 for inclusion, with a preference for s (RCTs) and controlled studies. The 10 articles chosen for the SCARED are listed below:
Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & McKenzie Neer, S. (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.
Participants — 341 outpatient children and adolescents and 300 parents
Race/Ethnicity — 82% Caucasian, 18% African American
An 85-item questionnaire was administered to 341 outpatient children and adolescents and 300 parents. Utilizing item analyses and factor analyses, the original scale was reduced to 38 items. A subsample of children (n = 88) and parents (n = 86) was retested an average of 5 weeks (4 days to 15 weeks) after the initial screening. The child and parent Screen for Child Anxiety Related Emotional Disorders (SCARED) both yielded five factors: somatic/panic, general anxiety, separation anxiety, social phobia, and school phobia. For the total score and each of the five factors, both the child and parent SCARED demonstrated good internal consistency, test-retest reliability, discriminative validity (both between anxiety and other disorders and within anxiety disorders), and moderate parent-child agreement. The SCARED shows promise as a screening instrument for anxiety disorders.
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 Psychiatry, 38, 1230-1236.
Participants — 190 outpatient children and adolescents and 166 parents
Race/Ethnicity — White (n=135), African-American (n=43), and Hispanic (n=11)
The 41-item version of the SCARED was administered to a new sample of 190 outpatient children and adolescents and 166 parents. The internal consistency, discriminant, and convergent validity were assessed. In addition, using discriminant function analysis, a briefer version of the SCARED was developed. Using item analyses and factor analyses on the 41-item version, 5 factors were obtained: panic/somatic, generalized anxiety, separation anxiety, social phobia, and school phobia. In general, the total score and each of the 5 factors for both the child and parent SCARED demonstrated good internal consistency and discriminant validity (both between anxiety and depressive and disruptive disorders and within anxiety disorders). A reduced version of the SCARED yielded 5 items and showed similar psychometrics to the full SCARED. In a new sample, the authors replicated their initial psychometric findings that the SCARED is a reliable and valid instrument to screen for childhood anxiety disorders in clinical settings.
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.
Participants — 295 children and adolescents and their parents
Race/Ethnicity — 85% Caucasian and 14% African American
The SCARED, the Child Behavior Checklist for Ages 4-18 (CBCL/4-18), and the State-Trait Anxiety Inventory for Children (STAIC) were administered to children, adolescents (n = 295), and their parents attending an outpatient mood and anxiety disorders clinic. DSM-IIIR/IV diagnoses were made using a semistructured interview (n = 130) or a symptom checklist (n = 165). The Multi-Trait Multi-Method Matrix was used to assess construct validity, and Receiver Operating Curve analysis was used to assess the sensitivity and specificity of the SCARED, CBCL, and STAIC. The SCARED correlated significantly better with the CBCL’s internalizing factors than with the externalizing factors. In addition, parent and child forms of the SCARED correlated significantly with the trait and state subscales of the STAIC. Children with an anxiety disorder scored significantly higher on the SCARED than children with depression only or disruptive disorders only, thus demonstrating the discriminant validity of the SCARED. The SCARED is a reliable and valid screening tool for clinically referred children and adolescents with anxiety disorders.
Hale, W. W. III, C, E., Raaijmakers, A. W., & Meeus, W. H. J. (2011). 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, 80-90.
Participants — Not Specified
Race/Ethnicity — Not Specified
Studies were collected from the PsycINFO, PubMed, SSCI, SCI-Expanded, ERIC, and A&HCI databases from the year of the SCARED's first publication (1997) to the present. The inclusion criteria focused on all studies that examined the psychometric properties of the SCARED. Twenty-one articles were retained, reporting a total of 25 studies from predominantly Europe (Belgium, Germany, Italy, the Netherlands) and the USA, as well as South Africa and China, which matched the authors' inclusion criteria. It was found that the psychometric properties were robust for the SCARED scales related to the symptoms of DSM-IV-TR anxiety disorders, that females scored significantly higher than males, and that age had a moderating effect on male and female score differences. This meta-analysis suggests that the SCARED can be utilized as a screening instrument for DSM-IV-TR anxiety disorder symptom dimensions for children and adolescents from various countries.
Boyd, R. C., Ginsburg, G. S., Lambert, S. F., Cooley, M. R., & Campbell, K. D. (2003). Screen for Child Anxiety Related Emotional Disorders (SCARED): Psychometric properties in an African-American parochial high school sample. Journal of the American Academy of Child & Adolescent Psychiatry, 42(10), 1188-1196.
Participants — 111 adolescents
Race/Ethnicity — 100% African American
This study examined the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) for a community sample of African-American high school students. The results support the SCARED’s utility as a screening tool for anxiety symptoms in this population. However, important differences in the underlying factor structure of the SCARED were found among African-American adolescents compared to primarily white samples, indicating a need for more research in this area. The mean SCARED total and subscale scores found in this study were lower than the mean scores of youths with anxiety disorders in the Birmaher et al. (1999) study. They were similar to mean scores of clinic referred children with nonanxiety, depressive, and disruptive disorders (Birmaher et al., 1999) and predominantly white school samples (Muris et al., 2002). This study supported the reliability of the SCARED total score, although estimates of internal consistency and test-retest reliability for the subscales ranged from good to low. Separation Anxiety and School Phobia subscales performed more poorly than the other subscales. The SCARED’s construct validity within this African-American sample was supported. The total score of the SCARED was positively correlated with other measures of anxiety, such as the RCMAS and MASC. This is consistent with other studies that have used community samples (Muris et al. 1998) and suggests that the SCARED is assessing anxiety, as per its design.
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. Journal of Anxiety Disorders, 22(4), 612-621.
Participants — 1,559
Race/Ethnicity — 100% Chinese
The present study examined the psychometric properties of the screen for child anxiety related emotional disorders (SCARED) in a large community sample of Chinese children. The 41-item version of the SCARED was administered to primary and junior high school students (774 boys and 785 girls) in 12 Chinese cities. Results indicate the SCARED demonstrated moderate to high internal consistency and test–retest reliability, moderate parent–child correlation and good discriminant validity (between anxiety and non-anxiety disorders). The SCARED total score was significantly correlated with the internalizing factor of the child behavior checklist (0.41). Factor analyses revealed the same five-factor structure as the original SCARED.
Crocetti, E., Hale III, W. W., Fermani, A., Raaijmakers, Q., & Meeus, W. (2009). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the general Italian adolescent population: A validation and a comparison between Italy and The Netherlands. Journal of Anxiety Disorders, 23(6), 824-829.
Participants — 3,090 adolescents
Race/Ethnicity — 1,975 Italian; 1,115 Dutch
In this study examination is given to the psychometric properties of the Italian version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a large community sample of adolescents. Additionally, a comparison was made between the anxiety scores of this Italian adolescent cohort (N = 1975) and a comparative Dutch adolescent cohort (N = 1115). Results indicate that a five-factor structure of the SCARED applied not only to the Italian adolescents from the general community, but also to boys and girls, and to early and middle adolescents. Moreover, sex and age differences on anxiety scores within the Italian sample were found to be consistent with previous studies of adolescent anxiety disorders. Finally, Italian adolescents reported higher anxiety scores than their Dutch peers.
Isolan, L., Salum, G.A., Osowski, A.T., Amaro, E., & Manfro, G.G. (2011). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in Brazilian children and adolescents. Journal of Anxiety Disorders,( 25), 741-748.
Participants — 2,410
Race/Ethnicity — 100% Brazilian
The aim of this study was to evaluate the psychometric properties of the Brazilian-Portuguese version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a large community sample of Brazilian children and adolescents. Students completed the 41-item Brazilian-Portuguese version of the SCARED. The one-factor and the five-factor structure of the SCARED fit this sample well. However, the five-factor model had a significantly better fit than the one-factor model and an adequate fit for age and gender subgroups. Results indicate that anxiety symptoms in Brazilian youth were reported at a moderate-high level as compared to other studies. Females were found to score significantly higher on the total score and on all of the subscales as compared to the males. The total score and each of the five factors for both children and adolescents showed good internal consistency, test–retest and construct validity.
Mano, K. E. J., Evans, J. R., Tran, S. T., Khan, K. A., Weisman, S. J., & Hainsworth, K. R. (2012). The psychometric properties of the Screen for Child Anxiety Related Emotional Disorders in pediatric chronic pain. Journal of Pediatric Psychology, 37(9), 999-1011.
Participants — 825
Race/Ethnicity — 79% Caucasian
The aim of this study was to investigate the psychometric properties of the SCARED to begin establishing an evidence base for using the parent- and youth-report versions of the SCARED to measure anxiety symptoms in pediatric chronic pain. Participants completed the SCARED and measures of pain catastrophizing, internalizing problems, and health-related quality of life. Results indicate internal consistency of SCARED Total scores ranged from .92 to .93 across sources of report. All subscales except for School Phobia exhibited good internal consistency. SCARED scores were significantly positively related to internalizing symptoms and pain catastrophizing; and negatively related to health-related quality of life. Confirmatory factor analysis revealed acceptable fit of the SCARED measurement model.
DeSousa, D. A., Salum, G. A., Isolan, L. R., & Manfro, G. G. Sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED): A community-based study. Child Psychiatry & Human Development, 44(3), 391-399.
Participants — 119
Race/Ethnicity — 100% Brazilian
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 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. 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. Both total and specific SCARED scores presented moderate sensitivity and specificity for detecting AD in a community sample.
Date Reviewed: February 2015 (Originally reviewed in August 2011)