Anxiety in Malaysian children and adolescents: validation of the Screen for Child Anxiety Related Emotional Disorders (SCARED)

Abstract

Objective: Use of the Screen for Child Anxiety Related Emotional Disorders (SCARED) has increased significantly since its publication. Although the validity of the SCARED is well established, most of the samples investigated primarily comprised Caucasian children and, where available, people from Asian cultures such as China. Furthermore, the instrument's utility for screening use in community samples has yet to be validated, although it is commonly advocated for this use. The present study addressed the psychometric properties of the SCARED in a community sample of Malaysian children and adolescents. Method: A total of 386 participants from an urban area, aged between 8 and 17, completed the 41-item SCARED. Confirmatory factor analysis and exploratory factor analysis were performed to investigate the factor structure of the SCARED. Results: Internal consistency ratings for the SCARED's total and subscale scores were good, except for School Avoidance. The validity of the SCARED was further demonstrated through a significant correlation with the Internalizing subscale of the Strength and Difficulties Questionnaire (SDQ). In contrast with the five-factor structure proposed for primarily Caucasian samples, factor analysis revealed a four-factor structure for this Malaysian sample. Conclusions: These research findings support the validity of the SCARED and its utility as a screening tool in a community sample of Malaysian children and adolescents.

The state of psychiatric research in the Asia Pacific region

“…Park, Oh, et al, 2019; Zhong et al, 2019), electroconvulsive therapy, validations of translated scales (C.‐S. Ang, 2020; Cheung, Yeo, Chong, Khoo, & Wee, 2019; Din et al, 2019; Khairani, Ahmad, Ismail, & Aman, 2020; N. T. P. Pang, Kamu, et al, 2020), stigma (Ibrahim, Amit, et al, 2019; Sun et al, 2019) and child and adolescent psychiatry (Adib et al, 2019a, 2019b; A. L. Ang, Wahab, Abd Rahman, Hazmi, & Md Yusoff, 2019; Chhoa et al, 2019; Ibrahim, Amit, et al, 2019; Ibrahim, Che Din, et al, 2019; Ramachandram, 2019). These studies reflect the local differences in cultural, language, and resource availability that renders the practice of psychiatry in this region unique when compared with others.…”

Evaluation of an Adapted Version of the Screen for Child Anxiety Related Emotional Disorders for Secondary School Students

“…The SCARED scale (Birmaher et al, 1997) reflects the following five specific anxiety disorders: somatic/panic, generalized anxiety, separation anxiety, social phobia, and school phobia. Both child and the parent scales yielded identical five-factor solutions, but later studies (Ang, 2020;Vigil-Colet et al, 2009) questioned the robustness of the school phobia or school avoidance factor.…”

“…The Screen for Child Anxiety Related Emotional Disorders -SCARED (Birmaher et al, 1997) is considered a valuable instrument for practitioners despite some identified limitations (Behrens, Swetlitz, Pine, & Pagliaccio, 2019;Pereira et al, 2015). Since the perception of anxiety is likely influenced by cultural factors (Muris et al, 2002;Ang, 2020), applying a new instrument in a country always requires validating such instruments for the national population.…”

“…The SCARED scale has been used widely in several countries and cultures other than where it was first normed. These include Brazil (Desousa, Salum, Isolan, & Manfro, 2013;Isolan, Salum, Osowski, Amaro, & Manfro, 2011), Canada (Martin & Gosselin, 2012), Cyprus (Essau et al, 2013), Finland (Kaajalaakso et al, 2020), Iceland (Olason, Sighvatsson, & Smári, 2004), Iran (Dehghani, Amiri, Molavi, & Neshat-Doost, 2013), Italy (Crocetti, Hale III, Fermani, Raaijmakers, & Meeus, 2009), Malaysia (Ang, 2020), Saudi Arabia/Lebanon (Arab, El Keshky, & Hadwin, 2016;Hariz et al, 2013), South Africa and the Netherlands (Muris et al, 2002), Spain (Hale et al, 2013), and Sweden (Ivarsson, Skarphedinsson, Andersson, & Jarbin, 2018) among others.…”

‘Dirty foreigners’ are to blame for COVID-19: impacts of COVID stress syndrome on quality of life and gratitude among Singaporean adults

“…Other stressors include bereavement, fear of infection, travel bans, and orders to work from home (Ren et al, 2020 ; Wu et al, 2021 ). While the fear response is an important adaptive mechanism that humans have evolved to use in response to environmental threats, it may only be useful for those who believe they can cope with the threats they face (Ang, 2020 ). For those who believe they are unable to cope with such risks, fear can be a critical condition associated with mental disorders.…”