Abstract
Anxiety disorders are the most common type of psychiatric conditions in children. Early identification and intervention during preschool years is critical for minimizing their detrimental long-term effects. The Preschool Anxiety Scale (PAS) is a developmentally-sensitive and symptom-specific instrument that has been commonly used and widely validated in the west. The current study tested the psychometric properties of its Traditional Chinese version (PAS-TC) in Hong Kong. The study sample consisted of a total of 1317 Hong Kong parents, recruited from 12 local preschools, with preschool children aged from three to six years old. Results showed that a correlated five-factor model demonstrated a good fit for the data. PAS-TC also demonstrated acceptable reliability and satisfactory validity. Furthermore, gender but not age effects were found in Hong Kong. Additionally, similar to previous studies, items from physical injury fears were the most reported in the top-ten frequently endorsed items. Finally, the anxiety level of our Hong Kong sample was found to be between the Mainland China and western countries. Clinical implications of the above findings concerning PAS-TC are discussed.
Similar content being viewed by others
References
Achenbach, T. M. (1991). Manual for the child behavior checklist 4–18. Burlington: University of Vermont.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed. text revision). Washington, DC: American Psychiatric Association.
Beesdo, K., Knappe, S., & Pine, D. S. (2009). Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V. Psychiatric Clinics of North America, 32(3), 483–524. https://doi.org/10.1016/j.psc.2009.06.002
Bittner, A., Egger, H. L., Erkanli, A., Jane Costello, E., Foley, D. L., & Angold, A. (2007). What do childhood anxiety disorders predict? Journal of Child Psychology and Psychiatry, 48(12), 1174–1183. https://doi.org/10.1111/j.1469-7610.2007.01812.x
Briggs, N. E., & MacCallum, R. C. (2003). Recovery of weak common factors by maximum likelihood and ordinary least squares estimation. Multivariate Behavioral Research, 38(1), 25–56. https://doi.org/10.1207/S15327906MBR3801_2
Briggs-Gowan, M. J., Carter, A. S., Bosson-Heenan, J., Guyer, A. E., & Horwitz, S. M. (2006). Are infant-toddler social-emotional and behavioral problems transient? Journal of the American Academy of Child & Adolescent Psychiatry, 45(7), 849–858. https://doi.org/10.1097/01.chi.0000220849.48650.59
Broeren, S., & Muris, P. (2008). Psychometric evaluation of two new parent-rating scales for measuring anxiety symptoms in young Dutch children. Journal of Anxiety Disorders, 22(6), 949–958. https://doi.org/10.1016/j.janxdis.2007.09.008
Chan, K. W., & Chan, S. M. (2007). Hong Kong teacher education students’ goal orientations and their relationship to perceived parenting styles. Educational Psychology, 27(2), 157–172. https://doi.org/10.1080/01443410601066636
Chan, S. M., Bowes, J., & Wyver, S. (2009). Chinese parenting in Hong Kong: Links among goals, beliefs and styles. Early Child Development and Care, 179(7), 849–862. https://doi.org/10.1080/03004430701536525
Chen, E. S. L., & Rao, N. (2011). Gender socialization in Chinese kindergartens: Teachers’ contributions. Sex Roles, 64(1-2), 103–116. https://doi.org/10.1007/s11199-010-9873-4
Clark, L. A. & Watson, D. (1995). Constructing validity: Basic issues in objective scale development. Psychological Assessment, 7, 309–319, 3, doiSSS: https://doi.org/10.1037/1040-3590.7.3.309.
Dougherty, L. R., Tolep, M. R., Bufferd, S. J., Olino, T. M., Dyson, M., Traditi, J., Rose, S., Carlson, G. A., & Klein, D. N. (2013). Preschool anxiety disorders: Comprehensive assessment of clinical, demographic, temperamental, familial, and life stress correlates. Journal of Clinical Child & Adolescent Psychology, 42(5), 577–589. https://doi.org/10.1080/15374416.2012.759225
Edwards, S. L., Rapee, R. M., Kennedy, S. J., & Spence, S. H. (2010). The assessment of anxiety symptoms in preschool-aged children: The revised preschool anxiety scale. Journal of Clinical Child and Adolescent Psychology, 39(3), 400–409. https://doi.org/10.1080/15374411003691701
Egger, H. L., & Angold, A. (2006). Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology. Journal of Child Psychology and Psychiatry, 47(3-4), 313–337. https://doi.org/10.1111/j.1469-7610.2006.01618.x
Essau, C. A., Leung, P. L., Conradt, J., Cheng, H., & Wong, T. (2008). Anxiety symptoms in Chinese and German adolescents: Their relationship with early learning experiences, perfectionism, and learning motivation. Depression and Anxiety, 25(9), 801–810. https://doi.org/10.1002/da.20334
Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38(5), 581–586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x
Gullone, E. (2000). The development of normal fear: A century of research. Clinical Psychology Review, 20(4), 429–451. https://doi.org/10.1016/S0272-7358(99)00034-3
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
LaFreniere, P. J., & Capuano, F. (1997). Preventive intervention as means of clarifying direction of effects in socialization: Anxious-withdrawn preschoolers case. Development and Psychopathology, 9(3), 551–564.
Lai, K., Luk, Y., Leung, C., Wong, E., Law, S., & Ho, L. (2010). Validation of the Chinese version of the strengths and difficulties questionnaire in Hong Kong. Social Psychiatry and Psychiatric Epidemiology, 45(12), 1179–1186. https://doi.org/10.1007/s00127-009-0152-z
Lai, K., Leung, Y., Luk, C., & Wong, P. (2014). Use of the extended strengths and difficulties questionnaire (SDQ) to predict psychiatric caseness in Hong Kong. Child Psychiatry and Human Development, 45(6), 703–711. https://doi.org/10.1007/s10578-014-0439-5
Leung, P. W. L., Kwong, S. L., Tang, C. P., Ho, T. P., Hung, S. F., Lee, C. C., Hung, S. F., Lee, C. C., Hong, S. L., Chiu, C. M., & Liu, W. S. (2006). Test–retest reliability and criterion validity of the Chinese version of CBCL, TRF, and YSR. Journal of Child Psychology and Psychiatry, 47(9), 970–973. https://doi.org/10.1111/j.1469-7610.2005.01570.x
Liu, J., Cheng, H., & Leung, P. W. L. (2011). The application of the preschool child behavior checklist and the caregiver–teacher report form to mainland Chinese children: Syndrome structure, gender differences, country effects, and inter-informant agreement. Journal of Abnormal Child Psychology, 39(2), 251–264. https://doi.org/10.1007/s10802-010-9452-8
Luby, J. L. (2013). Treatment of anxiety and depression in the preschool period. Journal of the American Academy of Child & Adolescent Psychiatry, 52(4), 346–358. https://doi.org/10.1016/j.jaac.2013.01.011
Luo, R., Tamis-Lemonda, C. S., & Song, L. (2013). Chinese parents’ goals and practices in early childhood. Early Childhood Research Quarterly, 28(4), 843–857. https://doi.org/10.1016/j.ecresq.2013.08.001
McLean, C. P., & Anderson, E. R. (2009). Brave men and timid women? A review of the gender differences in fear and anxiety. Clinical Psychology Review, 29(6), 496–505. https://doi.org/10.1016/j.cpr.2009.05.003
Mian, N. D., Godoy, L., Briggs-Gowan, M. J., & Carter, A. S. (2012). Patterns of anxiety symptoms in toddlers and preschool-age children: Evidence of early differentiation. Journal of Anxiety Disorders, 26(1), 102–110. https://doi.org/10.1016/j.janxdis.2011.09.006
Muris, P., Meesters, C., & Knoops, M. (2005). The relation between gender role orientation and fear and anxiety in nonclinic-referred children. Journal of Clinical Child & Adolescent Psychology, 34(2), 326–332. https://doi.org/10.1207/s15374424jccp3402_12
Rapee, R. M., Kennedy, S., Ingram, M., Edwards, S., & Sweeney, L. (2005). Prevention and early intervention of anxiety disorders in inhibited preschool children. Journal of Consulting and Clinical Psychology, 73(3), 488–497. https://doi.org/10.1037/0022-006X.73.3.488
Rapee, R. M., Schniering, C. A., & Hudson, J. L. (2009). Anxiety disorders during childhood and adolescence: Origins and treatment. Annual Review of Clinical Psychology, 5(1), 311–341. https://doi.org/10.1146/annurev.clinpsy.032408.153628
Spence, S. H. (2005). Traditional Chinese version of preschool anxiety scale. Spence Children’s anxiety scale. Retrieved from https://www.scaswebsite.com/index.php?p=1_18.
Spence, S. H., Rapee, R., McDonald, C., & Ingram, M. (2001). The structure of anxiety symptoms among preschoolers. Behaviour Research and Therapy, 39(11), 1293–1316. https://doi.org/10.1016/S0005-7967(00)00098-X
Suveg, C., Zeman, J., Flannery-Schroeder, E., & Cassano, M. (2005). Emotion socialization in families of children with an anxiety disorder. Journal of Abnormal Child Psychology, 33(2), 145–155. https://doi.org/10.1007/s10802-005-1823-1
Ting, T., Ligang, W., Chunlei, F., & Wenbin, G. (2014). Development of self-control in children aged 3 to 9 years: Perspective from a dual-systems model. Scientific Reports, 4(1), 1–5. https://doi.org/10.1038/srep07272
Wang, M., & Zhao, J. (2015). Anxiety disorder symptoms in Chinese preschool children. Child Psychiatry and Human Development, 46(1), 158–166. https://doi.org/10.1007/s10578-014-0461-7
Wu, P., Robinson, C. C., Yang, C., Hart, C. H., Olsen, S. F., Porter, C. L., Jin, S., Wo, J., Wu, X. (2002). Similarities and differences in mothers’ parenting of preschoolers in China and the United States. International Journal of Behavioral Development, 26(6), 481–491. https://doi.org/10.1080/01650250143000436
Zhou, Q., Eisenberg, N., Wang, Y., & Reiser, M. (2004). Chinese children’s effortful control and dispositional anger/frustration: Relations to parenting styles and children’s social functioning. Developmental Psychology, 40(3), 352–366. https://doi.org/10.1037/0012-1649.40.3.352
Acknowledgements
The study was funded by The Church of United Brethren in Christ, The Hong Kong Special Administrative Region.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval
Ethical approval was obtained from the Survey and Behavioural Research Ethics Committee of The Chinese University of Hong Kong
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Leung, G.S.M., Yau, K.C. & Yuen, S.Y. Validation of the Preschool Anxiety Scale-Traditional Chinese (PAS-TC) in Hong Kong. Applied Research Quality Life 14, 359–373 (2019). https://doi.org/10.1007/s11482-018-9596-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11482-018-9596-1