Examination of a cutoff score for the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a non-clinical Spanish population

Canals, Josefa; Hernández‐Martínez, Carmen; Cosí, Sandra; Doménech, Edelmira

doi:10.1016/j.janxdis.2012.07.008

Cited by 41 publications

(39 citation statements)

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“…Results of our study, and others, suggest that the SCARED-P can be used effectively across racial and ethnic groups (Canals et al, 2012; Cosi et al, 2010; DeSousa et al, 2013; Gonzalez et al, 2012; Hale et al, 2011; Hariz, 2013). In fact, in our sample, the SCARED-P tended to perform as well or better among non-White youth.…”

Section: Discussionsupporting

confidence: 64%

“…There are both parent and child reports, with a five factor structure that corresponds to the following anxiety domains: panic/somatic, generalized anxiety, separation anxiety, social phobia, and school phobia. Importantly, the SCARED has demonstrated validity as an anxiety screening tool for youth from a variety of cultures and ethnicities (Canals, Hernández-Martínez, Cosi, & Domènech, 2012; Cosi, Canals, Hernández-Martinez, & Vigil-Colet, 2010; DeSousa, Salum, Isolan, & Manfro, 2013; Gonzalez, Weersing, Warnick, Scahill, & Woolston, 2012; Hale, Crocetti, Raaijmakers, & Meeus, 2011; Hariz, 2013). Additionally, the SCARED is both free and relatively brief, increasing its appeal for clinicians who are often constrained by limited time and resources.…”

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confidence: 99%

“…Kid, a structured interview for youth. In a similar epidemiological study of Spanish youth, a score of 15-17 was recommended, corresponding to sensitivity of 63% to 66% and specificity of 61% to 70% for diagnoses made with the M.I.N.I (Canals et al, 2012). In contrast, in a study of Lebanese children at an outpatient mental health clinic, a cut-off score of 24 was recommended with sensitivity of 67% and specificity of 55% (Hariz, 2013), consistent with a study of treatment-seeking American adolescents that found an area under the curve (AUC) of .67 for the SCARED-P against diagnoses made with the K-SADS-P or a symptom checklist (Monga et al, 2000).…”

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confidence: 99%

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Diagnostic Efficiency of Caregiver Report on the SCARED for Identifying Youth Anxiety Disorders in Outpatient Settings

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You

Halverson

et al. 2016

Journal of Clinical Child & Adolescent Psychology

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Objective This study investigated the diagnostic and clinical utility of the parent-rated Screen for Child Anxiety Related Emotional Disorders (SCARED-P) for detecting youth anxiety disorders. Method Youth aged 6 to 12.9 were recruited from 9 outpatient mental health clinics (N=707). Consensus diagnoses were based on semi-structured interviews (KSADS) with youth and caregivers; 31% were diagnosed with at least one anxiety disorder. Caregivers completed the SCARED-P to describe youth anxiety levels. SCARED-P scores were not considered during the consensus diagnoses. Areas under the curve (AUCs) from receiver operating characteristic analyses and diagnostic likelihood ratios (DLRs) quantified performance of the SCARED-P total score and subscale scores (generalized anxiety disorder and separation anxiety disorder). Results SCARED-P total scores had variable efficiency (AUCs=.69-.88) and GAD and separation anxiety subscale scores were excellent (AUCs=.86-.89) for identifying specific anxiety disorders. Optimal subscale cutoff scores were computed to help rule-in (DLRs=2.7-5.4) or rule-out (DLRs<1.0) anxiety disorders among youth. Conclusion Results suggest that the GAD and separation anxiety SCARED-P subscales accurately identify their respective matched diagnoses. DLRs may aid clinicians in screening for youth anxiety disorders and improve accuracy of diagnosis.

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Section: Discussionsupporting

confidence: 64%

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confidence: 99%

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confidence: 99%

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Diagnostic Efficiency of Caregiver Report on the SCARED for Identifying Youth Anxiety Disorders in Outpatient Settings

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Halverson

et al. 2016

Journal of Clinical Child & Adolescent Psychology

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“…This is largely due to treatment-seeking individuals having more severe symptoms than the broader population of people who meet criteria for a disorder (Stein & Kean, 2000). In fact, only four studies have tested the validity of clinical cutoffs for the SCARED in community samples that have undergone diagnostic interviews (Canals, Hernandez-Martinez, Cosi, & Domenech, 2012; DeSousa, Salum, Isolan, & Manfro, 2013; Muris et al, 2001; Su, Wang, Fan, Su, & Gao, 2008). Thus, the first goal of this study is to assess the SCARED’s validity in both treatment- and non-treatment-seeking populations.…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, in this study, all participants were interviewed with the K-SADS-PL, as opposed to only those that scored in the top 25% on the SCARED (DeSousa et al, 2013). Moreover, the current study used the original 41-item version of the SCARED and the corresponding clinical cutoff scores (Birmaher et al, 1999), unlike other studies that used the 66-item SCARED-R which excludes the School Avoidance subscale and includes additional subscales (Muris, Merckelbach, Schmidt, & Mayer, 1998b), or those that used non-standard clinical cutoffs (Canals et al, 2012). Finally, the diagnostic accuracy of the GA and SA subscales as well as the Total scale was assessed.…”

Section: Introductionmentioning

confidence: 99%

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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Screening for Anxiety in Children and Adolescents

Viswanathan

Wallace

Middleton

et al. 2022

JAMA

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ImportanceAnxiety in children and adolescents is associated with impaired functioning, educational underachievement, and future mental health conditions.ObjectiveTo review the evidence on screening for anxiety in children and adolescents to inform the US Preventive Services Task Force.Data SourcesPubMed, Cochrane Library, PsycINFO, CINAHL, and trial registries through July 19, 2021; references, experts, and surveillance through June 1, 2022.Study SelectionEnglish-language, randomized clinical trials (RCTs) of screening; diagnostic test accuracy studies; RCTs of cognitive behavioral therapy (CBT) or US Food and Drug Administration–approved pharmacotherapy; RCTs, observational studies, and systematic reviews reporting harms.Data Extraction and SynthesisTwo reviewers assessed titles/abstracts, full-text articles, and study quality and extracted data; when at least 3 similar studies were available, meta-analyses were conducted.Main Outcomes and MeasuresTest accuracy, symptoms, response, remission, loss of diagnosis, all-cause mortality, functioning, suicide-related symptoms or events, adverse events.ResultsThirty-nine studies (N = 6065) were included. No study reported on the direct benefits or harms of screening on health outcomes. Ten studies (n = 3260) reported the sensitivity of screening instruments, ranging from 0.34 to 1.00, with specificity ranging from 0.47 to 0.99. Twenty-nine RCTs (n = 2805) reported on treatment: 22 on CBT, 6 on pharmacotherapy, and 1 on CBT, sertraline, and CBT plus sertraline. CBT was associated with gains on several pooled measures of symptom improvement (magnitude of change varied by outcome measure), response (pooled relative risk [RR], 1.89 [95% CI, 1.17 to 3.05]; n = 606; 6 studies), remission (RR, 2.68 [95% CI, 1.48 to 4.88]; n = 321; 4 studies), and loss of diagnosis (RR range, 3.02-3.09) when compared with usual care or wait-list controls. The evidence on functioning for CBT was mixed. Pharmacotherapy, when compared with placebo, was associated with gains on 2 pooled measures of symptom improvement—mean difference (Pediatric Anxiety Rating Scale mean difference, −4.0 [95% CI, −5.5 to −2.5]; n = 726; 5 studies; and Clinical Global Impression–Severity scale mean difference, −0.84 [95% CI, −1.13 to −0.55]; n = 550; 4 studies) and response (RR, 2.11 [95% CI, 1.58 to 2.98]; n = 370; 5 studies)—but was mixed on measures of functioning. Eleven RCTs (n = 1293) reported harms of anxiety treatments. Suicide-related harms were rare, and the differences were not statistically significantly different.Conclusions and RelevanceIndirect evidence suggested that some screening instruments were reasonably accurate. CBT and pharmacotherapy were associated with benefits; no statistically significant association with harms was reported.

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Examination of a cutoff score for the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a non-clinical Spanish population

Cited by 41 publications

References 36 publications

Diagnostic Efficiency of Caregiver Report on the SCARED for Identifying Youth Anxiety Disorders in Outpatient Settings

Diagnostic Efficiency of Caregiver Report on the SCARED for Identifying Youth Anxiety Disorders in Outpatient Settings

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

Screening for Anxiety in Children and Adolescents

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