The Youth Anxiety Measure for DSM-5 (YAM-5) is a new self- and parent-report questionnaire to assess anxiety disorder symptoms in children and adolescents in terms of the contemporary classification system. International panels of childhood anxiety researchers and clinicians were used to construct a scale consisting of two parts: part one consists of 28 items and measures the major anxiety disorders including separation anxiety disorder, selective mutism, social anxiety disorder, panic disorder, and generalized anxiety disorder, whereas part two contains 22 items that focus on specific phobias and (given its overlap with situational phobias) agoraphobia. In general, the face validity of the new scale was good; most of its items were successfully linked to the intended anxiety disorders. Notable exceptions were the selective mutism items, which were frequently considered as symptoms of social anxiety disorder, and some specific phobia items especially of the natural environment, situational and other type, that were regularly assigned to an incorrect category. A preliminary investigation of the YAM-5 in non-clinical (N = 132) and clinically referred (N = 64) children and adolescents indicated that the measure was easy to complete by youngsters. In addition, support was found for the psychometric qualities of the measure: that is, the internal consistency was good for both parts, as well as for most of the subscales, the parent–child agreement appeared satisfactory, and there was also evidence for the validity of the scale. The YAM-5 holds promise as a tool for assessing anxiety disorder symptoms in children and adolescents.
Anxiety disorders are highly prevalent and have negative consequences on individual and societal level. This study examined the usefulness of screening for anxiety disorders in primary school children. More specifically, the value of the screening method to discriminate between and to predict anxiety disorders was studied. Children and their parents were selected if the children had self-reported scores on the screening questionnaire Screen for Child Anxiety Related Emotional Disorders-71 (SCARED-71) within the top-15% (High-anxious) or from two points below to two points above the median (Mediananxious). Of the selected children, 183 high-anxious children and their parents, and 80 median-anxious children and their parents took part in a diagnostic interview, the Anxiety Disorder Interview Schedule (ADIS). Of the highanxious children, 60% had an anxiety disorder versus 23% of the median-anxious children, whereas groups did not differ on rates of dysthymia/depression and attention deficit hyperactivity disorder. The diagnoses separation anxiety disorder, social phobia and specific phobia were specifically predicted by the corresponding subscales of the screening questionnaire, while the diagnosis generalised anxiety disorder was not predicted by any of the subscales. The screening method has proven its utility for discriminating between children with and without anxiety disorders when applying the top-15% cut-off. Moreover, separation anxiety disorder, social phobia, and specific phobia, all known to be prevalent and debilitating childhood anxiety disorders, can be predicted by the corresponding subscale of the screening instrument.
Anxiety in children is highly frequent and causes severe dysfunction. Various studies have used screening procedures to identify high-anxious children and offer them indicated prevention, but the cost-effectiveness of these screening procedures in combination with a preventive intervention has never been examined. This study compared four potential strategies in relation to the prevention of child anxiety: (1) a one-time school-based screening which offers a child-focused intervention, (2) the screening and offering of a parent-focused intervention, (3) the screening and differentially offering a child- or parent-focused intervention, depending on whether or not the parents are anxious themselves, and (4) or doing nothing. An economic evaluation from a societal perspective (i.e. including direct healthcare costs, direct non-healthcare costs, indirect costs, and out-of-pocket costs), using a decision-analytic model. The model was based on the real-world 2-year participation rates of screening and intervention, and real-world costs and effects of high- and median-anxious children (aged 8-12) from regular primary schools. Incremental cost-effectiveness ratios were calculated, and several secondary and one-way sensitivity analyses were performed. The strategy of doing nothing and the strategy of screening and differentially offering the child- or parent-focused intervention, depending on parental anxiety levels were both worthwhile, with the latter strategy costing relatively little extra money compared to doing nothing. In conclusion, some evidence for the cost-effectiveness of screening and intervening was found. Screening and offering a parent-focused intervention to children of anxious parents, and a child-focused intervention to children of non-anxious parents, were found to be the most cost-effective approach.
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