Childhood Anxiety in a Diverse Primary Care Population

Wren, Frances J.; Berg, Eric A.; Heiden, Lynda A.; Kinnamon, Carolyn; Ohlson, Lirio A.; Bridge, Jeffrey A.; Birmaher, Boris; Bernal, María

doi:10.1097/chi.0b013e31802f1267

Cited by 77 publications

(31 citation statements)

References 31 publications

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“…This may have been driven by the low level of agreement among the HC’s, as modest correlations were observed across all patients, and within each diagnostic group. Indeed, previous studies of non-diagnosed community samples have also found that children report higher scores than their parents (Cosi et al, 2010; Muris et al, 1999; Su et al, 2008; Wren et al, 2007; Wren, Bridge, & Birmaher, 2004), further suggesting a difference in how children and parents generally report on the child’s symptoms of anxiety. While the data does not necessarily support the proposition that children are responding more accurately than their parents (as indicated by the ROC analyses), it is possible that children are, in certain cases, more knowledgeable about their own feelings and symptoms of anxiety as opposed to the symptoms externally observable to their parents.…”

Section: Discussionmentioning

confidence: 87%

Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatment-seeking youth

Rappaport

Pagliaccio

Pine

et al. 2017

Journal of Anxiety Disorders

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The Screen for Child Anxiety and Related Emotional Disorder (SCARED) may be differentially sensitive to detecting specific or comorbid anxiety diagnoses in treatment-seeking and non-treatment-seeking youth. We assessed the SCARED’s discriminant validity, diagnostic utility, and informant agreement using parent- and self-report from healthy and treatment-seeking anxious youth (Study 1, N=585) or from non-treatment-seeking anxious youth (Study 2, N=331) diagnosed with generalized anxiety disorder (GAD), social anxiety disorder (SAD), or comorbid GAD+SAD. Among treatment-seeking youth, the SCARED showed good diagnostic utility and specificity, differentiating healthy, comorbid, and non-comorbid anxious youth. Child-parent agreement was modest: healthy child self-reports were higher than parent-reports whereas anxious child self-reports were similar or lower than parent-reports. Less consistent results emerged for diagnostic utility, specificity, and informant agreement among non-treatment-seeking youth. Given the number of non-treatment seeking anxious youth (N=33), generalizability of these findings may be limited. Together, results suggest informants may provide distinct information about children’s anxiety symptoms.

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Section: Discussionmentioning

confidence: 87%

Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatment-seeking youth

Rappaport

Pagliaccio

Pine

et al. 2017

Journal of Anxiety Disorders

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“…However, these interviews require extensive training and are time consuming, and as a consequence are mainly used for research purposes (Antony and Rowa, 2005; Lawyer and Smitherman, 2004). Also there are self-reports that measure anxiety symptoms(Derogatis and Unger, 2010; Lowe and Reynolds, 2004; Monga et al, 2000; Muris et al, 1998a; Muris et al, 1998b; Reynolds, 2003; Reynolds and Richmond, 1978; Spitzer et al, 1999; Zimmerman and Mattia, 2001) or symptoms of specific anxiety disorders (e.g., generalized anxiety and social anxiety disorders) (Boyd et al, 2003; Crocetti et al, 2009; Hale et al, 2011; Plummer et al, 2016; Spitzer et al, 2006; Su et al, 2008; Wren et al, 2007). However, to our knowledge, with the exception of the Adult Manifest Anxiety Scale Adult Version (AMAS-A) (Lowe and Reynolds, 2004; Reynolds, 2003), an adaptation from the Revised Children’s Manifest Anxiety Scale (Reynolds and Richmond, 1978), there are no other rating scales that evaluate anxiety in youth and adults using a similar scale.…”

Section: Introductionmentioning

confidence: 99%

“…The SCARED was developed based on the DSM-IV (American Psychiatric Association, 1994); however, the symptoms also correspond to those in DSM-5 (American Psychiatric Association, 2013). Scale construction and psychometric characteristics have been described elsewhere (Birmaher et al, 1999; Birmaher et al, 1997; Boyd et al, 2003; Canals et al, 2012; Cosi et al, 2010; Crocetti et al, 2009; Hale et al, 2011; Monga et al, 2000; Muris et al, 1998a; Muris et al, 1998b; Su et al, 2008; Vigil-Colet et al, 2009; Wren et al, 2007). The SCARED has excellent psychometric properties and screens for Generalized Anxiety Disorder (GAD), Social Anxiety, Panic Disorder (PD) and Separation Anxiety Disorder (SAD).…”

Section: Introductionmentioning

confidence: 99%

Psychometrics of the screen for adult anxiety related disorders (SCAARED)- A new scale for the assessment of DSM-5 anxiety disorders

Angulo

Rooks

Gill

et al. 2017

Psychiatry Research

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Objective To examine the psychometrics of the Screen for Adult Anxiety Related Disorders (SCAARED). Methods The SCAARED was adapted from the Screen for Child Anxiety Related Emotional Disorders. Participants (N=336) ages 18–27 years old were evaluated using the Structured Clinical Interview for DSM-IV Disorders (SCID). The SCAARED was completed at or within two-weeks before the SCID. The psychometrics of the SCAARED were analyzed using standard statistical analyses including principal components, and Receiver Operant Curve analyses. A replication was performed in an age/sex matched independent sample (N=158). Results The SCAARED showed four factors: somatic/panic/agoraphobia, generalized anxiety, separation anxiety, and social anxiety. The total and each factor scores demonstrated good internal consistency (α= 0.86 – 0.97) and good discriminant validity between anxiety and other disorders and within anxiety disorders for generalized and social anxiety. Area Under the Curve for the total and each of the factor scores ranged between 0.72 and 0.84 (p< 0.0001). These results were replicated in the independent sample. Conclusions The SCAARED showed excellent psychometric properties supporting its use to screen adults for anxiety disorders, longitudinal studies following youth into adulthood and studies comparing child and adult populations. Further replication studies in larger community and clinical samples are indicated.

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“…20,50–54 However, our findings is supported by work done by others 55,56 who suggest that, among Latino families, examination of functional impairment from disruptive behaviors, rather than symptomatology alone, is an important part of a larger cultural appropriate assessment. 57 Moreover, when Hispanic youth screen positive for anxiety, it is usually a result of more somatic symptoms 51,58–60 and higher anxiety symptom sensitivity. 61,62 Authors have hypothesized that this may be due to greater cultural acknowledgement of somatic symptoms as opposed to mental health problems.…”

Section: Discussionmentioning

confidence: 99%

“…Discordance between parent and child report of internalizing symptoms is typical. 24,60 We acknowledge further that we focused on “potential anxiety” rather than internalizing disorders in general, which would include depression. However, a study examining the clinical utility of the VADRS comorbidity screening subscales by Becker et al 29 using the same cut off values that was used in the current study found only one child met Diagnostic Interview Schedule for Children Version IV (DISC-IV) 67 criteria for depression without simultaneously meeting criteria for an anxiety disorder.…”

Section: Discussionmentioning

confidence: 99%

Racial/Ethnic Differences in the Prevalence of Anxiety Using the Vanderbilt ADHD Scale in a Diverse Community Outpatient Setting

Bauer

Yoder

Carroll

et al. 2016

J Dev Behav Pediatr

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Objective Pediatric anxiety is prevalent but frequently under-diagnosed compared to other behavioral conditions in primary care practice. Pediatricians routinely screen for attention deficit hyperactivity disorder using the Vanderbilt Rating Scale, which includes a short screen for anxiety. We sought to examine the prevalence of potential anxiety among patients whose parents originally had concerns of disruptive behavior in a diverse setting and examine differences in anxiety across ethnic groups using the Vanderbilt ADHD Diagnostic Rating Scale (VADRS). Methods This was a cross-sectional analysis of medical records data of children between the ages of 5–12 years whose parents had concerns of disruptive behavior and received primary care from May 25, 2010 to January 31, 2014 at 2 pediatric community health clinics in Indianapolis. Results 16% of children whose parents had concerns for disruptive behavior screened positive for anxiety based on the VADRS screen. Hispanic parents were less likely to report symptoms of anxiety (Spanish-speaking: AOR 0.4, 95% CI 0.2 – 0.8; English-speaking: AOR 0.3, 95% CI 0.1 – 0.9) compared to white and black families. Conclusion Anxiety is detected at a lower rate among Hispanic pediatric patients using the VADRS. This may suggest differences in the performance of the VADRS among Spanish speaking families.

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Childhood Anxiety in a Diverse Primary Care Population

Cited by 77 publications

References 31 publications

Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatment-seeking youth

Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatment-seeking youth

Psychometrics of the screen for adult anxiety related disorders (SCAARED)- A new scale for the assessment of DSM-5 anxiety disorders

Racial/Ethnic Differences in the Prevalence of Anxiety Using the Vanderbilt ADHD Scale in a Diverse Community Outpatient Setting

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