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

Abstract

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.

Development of inhibitory control during childhood and its relations to early temperament and later social anxiety: unique insights provided by latent growth modeling and signal detection theory

“…In the present sample, toddler BI significantly predicted parent report of social anxiety symptoms ( r = .264, p = .001), but not child report ( r = .033, p = .665). Taken together with other work suggesting parent reports might reflect a better measure of a child's actual overall levels of anxiety in late childhood (Rappaport, Pagliaccioa, Pine, Klein, & Jarcho, ), the moderating effects of IC on relations between BI and anxiety were only examined for parent report (see for examination of child report).…”

Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder

“…Although a meta-analysis also reported moderate to large agreement [39], the agreement on social anxiety in single studies is modest at best (e.g. [40][41][42].). This implies that treatment success may need to take both child and parent perspectives into account [41].…”

The Screen for Child Anxiety Related Emotional Disorders (SCARED): Informant Discrepancy, Measurement Invariance, and Test–Retest Reliability

“…Issues related to discrepant reporting have begun to be explored for the Screen for Child Anxiety and Related Emotional Disorders -Parent and Child versions, (SCARED-P/C) [3,4] a dual informant, goldstandard measure of pediatric anxiety symptoms. While the SCARED has been established as a valid, reliable, and sensitive measure of anxiety, prior studies have yielded inconsistent findings regarding informant (parent-child) agreement/discrepancy, with estimates of agreement ranging from r ~ .2 -.6 on both the SCARED total score and its subscales [3,5,6]. The present study assesses informant discrepancy on the SCARED in the largest sample to date and probes potential clinical, demographic, and familial correlates of discrepant reporting as well as potential psychometric contributors to informant discrepancy.…”