Rapid mental health screening in conflict zones: a translation and cross-cultural adaptation into Arabic of the shortened Revised Child Anxiety and Depression Scale (RCADS-25)
- PMID: 34210326
- PMCID: PMC8247224
- DOI: 10.1186/s13031-021-00386-1
Rapid mental health screening in conflict zones: a translation and cross-cultural adaptation into Arabic of the shortened Revised Child Anxiety and Depression Scale (RCADS-25)
Abstract
Background: During conflict, children and adolescents are at increased risk of mental health problems and in particular, anxiety and depression. However, mental health screening in conflict settings is problematic and carries risk making the need for fast, easy-to-administer, screening instruments paramount. The shortened version of the Revised Child Anxiety and Depression Scale (RCADS-25) is one method of rapidly assessing anxiety and depressive symptoms in youths. This self-report questionnaire demonstrates good internal consistency and diagnostic capacity in clinical and non-clinical populations. Nevertheless, few studies have tested the psychometric properties of translated versions of the RCADS-25 limiting its applicability worldwide.
Objectives: To expand the reach and utility of the RCADS-25, the present study sought to develop an Arabic version of the instrument (RCADS25-Arabic) and to explore its reliability and underlying factor structure. In light of changes to DSM classification, the effects of removing indicator variables for obsessive-compulsive disorder on the psychometrics of the RCADS25-Arabic were also explored.
Method: The scale was back translated into Modern Standard Arabic and administered to 250 Arabic speaking schoolchildren between 8 and 15 years of age in Syria. Mean and standard deviation were used to characterise the sample and summarize scores. The reliability and factor structure of the RCADS25-Arabic was explored using confirmatory factor analysis.
Results: Females were 127 and mean age was 12.11 ± SD 2.35. Males scored lower on anxiety (M 15.05 SD ± 8.0, t(248) = - 3.15, p = .003, d = 0.39) and internalizing factors (M 26.1 SD ± 13.1, t(248) = - 2.36, p = .0160, d = 0.31) with no statistical gender difference recorded for depression (t(248) = - 1.27, p = .202). Fit statistics were good for two- and one-factor solutions (χ2/df = 1.65, RMSEA 0.051, CFI .91, TLI .90 and χ2/df = 1.64 and RMSEA 0.051, CFI .91 and TLI .89 respectively). DIFFTEST showed no significant difference between models (χ2diff (1) = 0.03, p < 0.86) indicating a one-factor (internalizing) solution was preferable. No improvement in scale integrity was found after deleting obsessive-compulsive disorder items.
Conclusion: The RCADS25-Arabic is useful for rapid screening of depression and anxiety but is better used to identify a one-factor internalizing construct. Obsessive-compulsive disorder items should be retained in the RCADS-25.
Keywords: Anxiety; Arabic; Depression; RCADS; Translation.
Conflict of interest statement
No competing interests.
Similar articles
-
Psychometric evaluation of two short versions of the Revised Child Anxiety and Depression Scale.BMC Psychiatry. 2020 Feb 5;20(1):47. doi: 10.1186/s12888-020-2444-5. BMC Psychiatry. 2020. PMID: 32024481 Free PMC article.
-
A multi-group confirmatory factor analysis of the revised children's anxiety and depression scale (RCADS) in Spain, Chile and Sweden.J Affect Disord. 2022 Aug 1;310:228-234. doi: 10.1016/j.jad.2022.05.031. Epub 2022 May 10. J Affect Disord. 2022. PMID: 35561880
-
Psychometric Validation of the Slovenian Version of the Revised Child Anxiety and Depression Scale - Child and Parent Versions (RCADS and RCADS-P).Zdr Varst. 2024 Sep 23;63(4):164-171. doi: 10.2478/sjph-2024-0022. eCollection 2024 Dec. Zdr Varst. 2024. PMID: 39713737 Free PMC article.
-
Psychometric properties of an Arabic translation of the multidimensional assessment of interoceptive awareness (MAIA-2) questionnaire in a non-clinical sample of Arabic-speaking adults.BMC Psychiatry. 2023 Aug 9;23(1):577. doi: 10.1186/s12888-023-05067-2. BMC Psychiatry. 2023. PMID: 37558996 Free PMC article.
-
A systematic review and meta-analysis of diagnostic test accuracy studies of self-report screening instruments for common mental disorders in Arabic-speaking adults.Glob Ment Health (Camb). 2021 Nov 23;8:e43. doi: 10.1017/gmh.2021.39. eCollection 2021. Glob Ment Health (Camb). 2021. PMID: 34966543 Free PMC article. Review.
Cited by
-
Comparative analysis of pulmonary function in school-going adolescents: Examining the impact of depression and anxiety.Indian J Physiol Pharmacol. 2024 Apr-Jun;68(2):149-156. doi: 10.25259/ijpp_572_2023. Epub 2024 Jul 1. Indian J Physiol Pharmacol. 2024. PMID: 39421266 Free PMC article.
-
Post-crisis health reality and wellbeing of children within Syria: a scoping review of research from 2012 to 2024.Confl Health. 2025 Jul 2;19(1):39. doi: 10.1186/s13031-025-00673-1. Confl Health. 2025. PMID: 40604845 Free PMC article. Review.
-
Household food insecurity, family size and their interactions on depression prevalence among teenage pregnant girls in Ghana, a population based cluster survey.BMC Womens Health. 2023 Oct 6;23(1):527. doi: 10.1186/s12905-023-02674-9. BMC Womens Health. 2023. PMID: 37803413 Free PMC article.
References
-
- Abramowitz JS, Jacoby RJ. Obsessive-compulsive disorder in the DSM-5. Clin Psychol Sci Pract. 2014;21(3):221–235. doi: 10.1111/cpsp.12076. - DOI
-
- Alós J. Discourse relation recognition in translation: a relevance-theory perspective. Perspect Stud Transl Theory Pract. 2016;24(2):201–217. doi: 10.1080/0907676X.2015.1042391. - DOI
-
- American Psychiatric Association . Diagnostic and statistical manual of mental disorders. 4. Arlington: American Psychiatric Publishing; 1994.
LinkOut - more resources
Full Text Sources
Miscellaneous