The Parenting Anxious Kids Ratings Scale-Parent Report (PAKRS-PR): Initial Scale Development and Psychometric Properties


Developmental models of pediatric anxiety posit multiple, maladaptive parenting behaviors as potential risk factors. Despite this, a standardized means of assessing multiple of these practices (i.e., anxiogenic parenting) in a comprehensive and efficient manner are lacking. In Study 1531 parents of children 7–17 years old completed an online survey via Amazon Mechanical Turk. In Study 2, a separate community sample (N = 109; 9–17 years old) was recruited and completed a comprehensive assessment battery as part of a larger study. All parents (Study 1 and 2 samples) completed the Parenting Anxious Kids Ratings Scale-Parent Report (PAKRS-PR), a measurement tool designed to assess anxiogenic parenting. Factor analysis conducted as part of Study 1 revealed a 32-item scale consisting of five factors: conflict, overinvolvement, accommodation/beliefs, modeling, and emotional warmth/support. Four of these factors were significantly correlated with parent-report of anxiety severity. Within Study 2, the parents of children diagnosed with an anxiety or related disorder reported significantly higher levels of anxiogenic parenting practices as compared to the parents of healthy controls. The PAKRS-PR and respective subscales demonstrated acceptable reliability and validity in both the internet (Study 1) and community (Study 2) samples. The PAKRS-PR may be a beneficial multidimensional parenting scale for use among anxious youths.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J (2010) Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 49(10):980–989

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Zohar AH (1999) The epidemiology of obsessive–compulsive disorder in children and adolescents. Child Adolesc Psychiatr Clin N Am 8(3):445–460

    PubMed  Google Scholar 

  3. 3.

    Team PTS (2004) Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive–compulsive disorder: the pediatric OCD treatment study (POTS) randomized controlled trial. J Am Med Assoc 292:1969–1976

    Article  Google Scholar 

  4. 4.

    Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill JT, Ginsburg GS, Rynn MA, McCracken J, Waslick B et al (2008) Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med 359(26):2753–2766

    Article  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Ginsburg GS, Schlossberg MC (2002) Family-based treatment of childhood anxiety disorders. Int Rev Psychiatry 14:143–154

    Article  Google Scholar 

  6. 6.

    McLeod BD, Wood JJ, Weisz JR (2007) Examining the association between parenting and childhood anxiety: a meta-analysis. Clin Psychol Rev 27(2):155–172

    Article  PubMed  Google Scholar 

  7. 7.

    Wood JJ, McLeod BD, Sigman M, Hwang WC, Chu BC (2003) Parenting and childhood anxiety: theory, empirical findings, and future directions. J Child Psychol Psychiatry 44(1):134–151

    Article  PubMed  Google Scholar 

  8. 8.

    Affrunti NW, Ginsberg GS (2012) Maternal overcontrol and child anxiety: the mediating role of perceived competence. Child Psychiatr Human Dev 43(1):102–112

    Article  Google Scholar 

  9. 9.

    Burstein M, Ginsburg GS (2010) The effect of parental modeling of anxious behaviors and cognitions in school-aged children: an experimental pilot study. Behav Res Ther 48(6):506–515

    Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Flessner CA, Sapyta J, Garcia A, Freeman JB, Franklin ME, Foa E, March J (2009) Examining the psychometric properties of the family accommodation scale-parent-report (FAS-PR). J Psychopathol Behav Assess 31(1):38–46

    PubMed  PubMed Central  Google Scholar 

  11. 11.

    Kendler KS, Prescott CA (2006) Genes, environment, and psychopathology: understanding the causes of psychiatric and substance use disorders. Guilford Press, New York

    Google Scholar 

  12. 12.

    Baker LA, Jacobson KC, Raine A, Lozano DI, Bezdjian S (2007) Genetic and environmental bases of childhood antisocial behavior: a multi-informant twin study. J Abnorm Psychol 116(2):219

    Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Bartels M, van Beijsterveldt CT, Derks EM, Stroet TM, Polderman TJ, Hudziak JJ, Boomsma DI (2007) Young Netherlands Twin Register (Y-NTR): a longitudinal multiple informant study of problem behavior. Twin Res Human Genet 10(1):3–11

    Article  Google Scholar 

  14. 14.

    Hewitt JK, Rutter M, Simonoff E, Pickles A, Loeber R, Heath AC, Reynolds CA, Silberg JL, Meyer JM, Maes H et al (1997) Genetics and developmental psychopathology: 1. Phenotypic assessment in the Virginia twin study of adolescent behavioral development. J Child Psychol Psychiatry 39(8):943–963

    Article  Google Scholar 

  15. 15.

    Francis SE, Chorpita BF (2010) Development and evaluation of the parental beliefs about anxiety questionnaire. J Psychopathol Behav Assess 32(1):138–149

    Article  Google Scholar 

  16. 16.

    Peris TS, Benazon N, Langley A, Roblek T, Piacentini J (2008) Parental attitudes, beliefs, and responses to childhood obsessive compulsive disorder: the parental attitudes and behaviors Scale. Child Fam Behav Ther 30(3):199–214

    Article  Google Scholar 

  17. 17.

    Wolk CB, Caporino NE, McQuarrie S, Settipani CA, Podell JL, Crawley S, Beidas RS, Kendall PC (2016) Parental attitudes, beliefs, and understanding of anxiety (PABUA): development and psychometric properties of a measure. J Anxiety Disord 39:71–78

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Benito KG, Caporino NE, Frank HE, Ramanujam K, Garcia A, Freeman J, Kendall PC, Geffken G, Storch EA (2015) Development of the pediatric accommodation scale: reliability and validity of clinician- and parent-report measures. J Anxiety Disord 29:14–24

    Article  PubMed  Google Scholar 

  19. 19.

    Lebowitz ER, Woolston J, Bar-Haim Y, Calvocoressi L, Dauser C, Warnick E, Scahill L, Chakir AR, Shechner T, Hermes H et al (2013) Family accommodation in pediatric anxiety disorders. Depress Anxiety 30(1):47–54

    Article  PubMed  Google Scholar 

  20. 20.

    Mendlowitz SL, Manassis K, Bradley S, Scapillato D, Miezitis S, Shaw BF (1999) Cognitive-behavioral group treatments in childhood anxiety disorders: the role of parental involvement. J Am Acad Child Adolesc Psychiatry 38(10):1223–1229

    Article  PubMed  Google Scholar 

  21. 21.

    Barrett PM, Dadds MR, Rapee RM (1996) Family treatment of childhood anxiety: a controlled trial. J Consult Clin Psychol 64(2):333

    Article  PubMed  Google Scholar 

  22. 22.

    Steinberg L, Silk JS (2002) Parenting adolescents. Handbook Parent 1:103–133

    Google Scholar 

  23. 23.

    Laursen B, Collins W (1994) Interpersonal conflict during adolescence. Psychol Bull 115:197–209

    Article  PubMed  Google Scholar 

  24. 24.

    Lovibond PF, Lovibond SH (1995) The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther 33(3):335–343

    Article  PubMed  Google Scholar 

  25. 25.

    Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP (1998) Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychol Assess 10(2):176–181

    Article  Google Scholar 

  26. 26.

    Henry JD, Crawford JR (2005) The short-form version of the depression anxiety stress scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol 44(Pt 2):227–239

    Article  PubMed  Google Scholar 

  27. 27.

    Hawes DJ, Dadds MR (2006) Assessing parenting practices through parent-report and direct observation during parent-training. J Child Fam Stud 15(5):554–567

    Article  Google Scholar 

  28. 28.

    Shelton KK, Frick PJ, Wootton J (1996) Assessment of parenting practices in families of elementary school-age children. J Clin Child Psychol 25(3):317–329

    Article  Google Scholar 

  29. 29.

    Frick PJ, Christian RE, Wootton JM (1999) Age trends in the association between parenting practices and conduct problems. Behav Modif 23(1):106–128

    Article  Google Scholar 

  30. 30.

    Dadds MR, Maujean A, Fraser JA (2003) Parenting and conduct problems in children: Australian data and psychometric properties of the alabama parenting questionnaire. Aus Psychol 38(3):238–241

    Article  Google Scholar 

  31. 31.

    Spence SH (1998) A measure of anxiety symptoms among children. Behav Res Ther 36(5):545–566

    Article  PubMed  Google Scholar 

  32. 32.

    Spence SH, Barrett PM, Turner CM (2003) Psychometric properties of the spence children’s anxiety scale with young adolescents. J Anxiety Disord 17(6):605–625

    Article  PubMed  Google Scholar 

  33. 33.

    Horn JL (1965) A rationale and test for the number of factors in a factor analysis. Psychometrika 30:179–185

    Article  PubMed  Google Scholar 

  34. 34.

    Bryant FB, Yarnold PR (1995) Principal-components analysis and exploratory and confirmatory factor analysis. In Grimm LG, Yarnold PR (eds) Reading and understanding multivariate statistics. American Psychological Association, Washington, DC, pp 99–138

  35. 35.

    Reise SP, Waller NG, Comrey AL (2000) Factor analysis and scale revision. Psychol Assess 12(3):287

    Article  PubMed  Google Scholar 

  36. 36.

    Stevens JP (2002) Applied multivariate statistics for the social sciences, 4 edn. Erlbaum, Hillsdale

    Google Scholar 

  37. 37.

    Tabachnick BG, Fidell LS (2001) Using multivariate statistics. Allyn and Bacon, Boston, MA

  38. 38.

    Nauta MH, Scholing A, Rapee RM, Abbott M, Spence SH, Waters A (2004) A parent-report measure of children’s anxiety: psychometric properties and comparison with child-report in a clinic and normal sample. Behav Res Ther 42(7):813–839

    Article  PubMed  Google Scholar 

  39. 39.

    MY, Brennan E (2015) An examination of executive functioning in young adults exhibiting body-focused repetitive behaviors. J Nerv Mental Dis 203(7):555–558

    Article  Google Scholar 

  40. 40.

    Brennan E, Francazio S, Gunstad J, Flessner C (2016) Inhibitory control in pediatric trichotillomania (hair pulling disorder): the importance of controlling for age and symptoms of inattention and hyperactivity. Child Psychiatr Human Dev 47(2):173–182

    Article  Google Scholar 

  41. 41.

    Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36(7):980–988

    Article  PubMed  Google Scholar 

  42. 42.

    Ambrosini PJ (2000) Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). J Am Acad Child Adolesc Psychiatry 39(1):49–58

    Article  PubMed  Google Scholar 

  43. 43.

    Silverman WK, Albano AM (1996) The anxiety disorders interview schedule for children (ADIS-C/P). Psychological Corporation, San Antonio

    Google Scholar 

  44. 44.

    Silverman WK, Nelles WB (1988) The anxiety disorders interview schedule for children. J Am Acad Child Adolesc Psychiatry 27(6):772–778

    Article  PubMed  Google Scholar 

  45. 45.

    Silverman WK, Saavedra LM, Pina AA (2001) Test–retest reliability of anxiety symptoms and diagnoses with the anxiety disorders interview schedule for DSM-IV: child and parent versions. J Am Acad Child Adolesc Psychiatry 40(8):937–944

    Article  PubMed  Google Scholar 

  46. 46.

    Wood JJ, Piacentini JC, Bergman RL, McCracken J, Barrios V (2002) Concurrent validity of the anxiety disorders section of the anxiety disorders interview schedule for DSM-IV: child and parent versions. J Clin Child Adolesc Psychol 31(3):335–342

    Article  PubMed  Google Scholar 

  47. 47.

    Achenbach T, Edelbrock C (1991) Manual for the CBCL and 1991 profile. University of Vermont, Burlington

    Google Scholar 

  48. 48.

    Ivanova MY, Achenbach TM, Dumenci L, Rescorla LA, ALmqvist F, Weintraub S, Bilenberg N, Bird H, Chen WJ, Dobrean A et al (2007) Testing the 8-syndrome structure of the child behavior checklist in 30 societies. J Clin Child Adolesc Psychol 36(3):405–417

    Article  PubMed  Google Scholar 

  49. 49.

    Dutra L, Campbell L, Westen D (2004) Quantifying clinical judgment in the assessment of adolescent psychopathology: reliability, validity, and factor structure of the child behavior checklist for clinician report. J Clin Psychol 60(1):65–85

    Article  PubMed  Google Scholar 

  50. 50.

    Achenbach TM, Edelbrock CS (1983) Manual for the child behavior checklist and child behavior profile. University of Vermont, Burlington

    Google Scholar 

  51. 51.

    Achenbach T, Rescorla L (2001) Manual for ASEBA school-age forms and profiles. University of Vermont, Research Center for Children, Youth and Families, Burlington

    Google Scholar 

  52. 52.

    Derogatis LR, Melisaratos N (1983) The brief symptom inventory: an introductory report. Psychol Med 13(3):595–605

    Article  PubMed  Google Scholar 

  53. 53.

    Sadeh A (2004) A brief screening questionnaire for infant sleep problems: validation and findings for an Internet sample. Pediatrics 113(6):e570–e577

    Article  PubMed  Google Scholar 

  54. 54.

    Tolin DF, Diefenbach GJ, Flessner CA, Franklin ME, Keuthen NJ, Moore P, Piacentini J, Stein DJ, Woods DW (2008) The trichotillomania scale for children: development and validation. Child Psychiatry Hum Dev 39(3):331–349

    Article  PubMed  Google Scholar 

  55. 55.

    Drake KL, Ginsburg GS (2012) Family factors in the development, treatment, and prevention of childhood anxiety disorders. Clin Child Fam Psychol Rev 15(2):144–162

    Article  PubMed  Google Scholar 

  56. 56.

    Burstein M, Ginsburg GS, Tein J-Y (2010) Parental anxiety and child symptomatology: an examinzation of additive and interactive effects of parent psychopathology. J Abnorm Child Psychol 38(7):897–909

    Article  PubMed  PubMed Central  Google Scholar 

  57. 57.

    Bögels SM, Brechman-Toussaint ML (2006) Family issues in child anxiety: attachment, family functioning, parental rearing and beliefs. Clin Psychol Rev 26(7):834–856

    Article  PubMed  Google Scholar 

  58. 58.

    Crawford AM, Manassis K (2001) Familial predictors of treatment outcome in childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry 40(10):1182–1189

    Article  PubMed  Google Scholar 

  59. 59.

    Brendel KE, Maynard BR (2014) Child–parent interventions for childhood anxiety disorders: a systematic review and meta-analysis. Res Social Work Prac 24(3):287–295

    Article  Google Scholar 

  60. 60.

    Negreiros J, Miller LD (2014) The role of parenting in childhood anxiety: etiological factors and treatment implications. Clin Psychol Sci Pract 21(1):3–17

    Article  Google Scholar 

  61. 61.

    Shapiro DN, Chandler J, Mueller PA (2013) Using mechanical Turk to study clinical populations. Clin Psychol Sci 1(2):213–220

    Article  Google Scholar 

  62. 62.

    Paolacci G, Chandler J, Ipeirotis PG (2010) Running experiments on Amazon mechanical Turk. Judgm Decis Mak 5(5):411–419

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Christopher A. Flessner.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Flessner, C.A., Murphy, Y.E., Brennan, E. et al. The Parenting Anxious Kids Ratings Scale-Parent Report (PAKRS-PR): Initial Scale Development and Psychometric Properties. Child Psychiatry Hum Dev 48, 651–667 (2017).

Download citation


  • Anxiety
  • Parenting
  • Family functioning