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) and 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.

Keywords: Adolescents; Anxiety; Children; Psychometrics; Screen for Child Anxiety Related Emotional Disorders (SCARED).

Figure 1 & 2

Child- and parent-report Total (A), GA (B), and SA (C) scores for HCs and Patient groups with between- and within-group differences amongst the treatment-seeking NIMH (Figure 1) and non-treatment-seeking SBU (Figure 2) samples *** p < .001, ** p < .01, * p < .05. Left/Right gray brackets and asterisks reflect between-group Bonferroni post-hoc tests. Asterisks above each line reflect significant within-group differences in pairwise comparisons for child- and parent-report. Circles at the end of the lines reflect significant differences (i.e. greater than or less than) from the clinical cutoff. In Figure 2C, left brackets indicate significant differences between the HC/Matched HC group and the SAD group.