Abstract
The Revised Child Anxiety and Depression Scale, 25-Item Version (RCADS-25) is a well-known, brief self-report measure of anxiety and depression in children and adolescents. As part of an initiative to institute school-based screening for psychopathology, this study conducted a psychometric examination of the Spanish form of this measure in El Salvador in a sample of 1296 3rd- through 12th-graders (mean age = 12.73 (SD = 2.67); 55.2% female; 100% Latinx). Confirmatory factor analysis indicated that the previously established two-factor structure comprising Anxiety and Depression subscales provided a strong fit for the data. Additionally, measurement invariance analyses by gender demonstrated scalar (strong) invariance, indicating that patterns of responses did not differ on the basis of this variable. This finding is particularly useful in making direct comparisons of symptom levels between boys and girls in future studies involving Central American youth. Norms derived from the current sample are presented and the utility of invariance study in cross-cultural research is highlighted. The findings are also contextualized in comparison to the broader literature examining the various forms of the RCADS in global populations, which indicates a robust, broadly useful measure for capturing symptoms of anxiety and depression.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
Data are available by contacting the authors or by accessing supplementary material at the journal’s website.
References
Bentler, P. M. (1990). Comparative fit indices in structural models. Psychological Bulletin, 107(2), 238–246. https://doi.org/10.1037/0033-2909.107.2.238.
Brislin, R. W. (1970). Back-translation for cross-cultural research. Journal of Cross-Cultural Psychology, 1(3), 185–216. https://doi.org/10.1177/135910457000100301.
Brown, T. (2015). Confirmatory factor analysis for applied research (2nd ed.). New York, NY: Guilford Press.
Bryant, F. B., & Yarnold, P. R. (1995). Principal-component analysis and exploratory and confirmatory factor analysis. In L. G. Grimm & P. R. Yarnold (Eds.), Reading and understanding multivariate statistics (pp. 99–136). Washington, DC: American Psychological Association.
Central Intelligence Agency. (2019). El Salvador – World Factbook. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/attachments/summaries /ES-summary.pdf.
Chavez, J. M. (2015). How did the civil war in El Salvador end? American Historical Review, 120(5), 1784–1797.
Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling, 14(3), 464–504. https://doi.org/10.1080/10705510701301834.
Cheung, & Rensvold. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233–255. https://doi.org/10.1207/S15328007SEM0902_5.
Child Outcomes Research Consortium. (2020). About CORC. https://www.corc.uk.net/about-corc/
Chorpita, B. F., Yim, L. M., Moffitt, C. E., Umemoto, L., & Francis, S. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour Research and Therapy, 38(8), 835–855. https://doi.org/10.1016/S0005-7967(99)00130-8.
Chorpita, B. F., Moffitt, C. E., & Gray, J. (2005). Psychometric properties of the revised child anxiety and depression scale in a clinical sample. Behaviour Research and Therapy, 43(3), 309–322. https://doi.org/10.1016/j.brat.2004.02.004.
Collins, P. Y., Patel, V., Joestl, S. S., March, D., Insel, T. R., & Daar, A. S. (2011). Grand challenges in global mental health. Nature, 475, 27–30. https://doi.org/10.1038/475027a.
Copeland, W. E., Angold, A., Shanahan, L., & Costello, J. E. (2013). Longitudinal patterns of anxiety from childhood to adulthood: The Great Smoky Mountains study. Journal of the American Academy of Child and Adolescent Psychiatry, 53(1), 21–33. https://doi.org/10.1016/j.jaac.2013.09.017.
Copeland, W. E., Shanahan, L., Davis, M., Burns, B. J., Angold, A., & Costello, J. E. (2015). Increase in untreated cases of psychiatric disorders during the transition to adulthood. Psychiatric Services, 66(4), 397–403. https://doi.org/10.1176/appi.ps.201300541.
Ebesutani, C., Bernstein, A., Nakamura, B. J., Chorpita, B. F., Weisz, J. R., & the Research Network on Youth Mental Health. (2010). A psychometric analysis of the revised child anxiety and depression scale – Parent version in a clinical sample. Journal of Abnormal Child Psychology, 38, 249–260. https://doi.org/10.1007/s10802-009-9363-8.
Ebesutani, C., Bernstein, A., Chorpita, B. F., & Weisz, J. R. (2012a). A transportable assessment protocol for prescribing youth psychosocial treatments in real-world settings: Reducing assessment burden via self-report scales. Psychological Assessment, 24(1), 141–155. https://doi.org/10.1037/a0025176.
Ebesutani, C., Reise, S. P., Chorpita, B. F., Ale, C., Regan, J., Young, J., Higa-McMillan, C., & Weisz, J. R. (2012b). The revised child anxiety and depression scale-short version: Scale reduction via exploratory bifactor modeling of the broad anxiety factor. Psychological Assessment, 24(4), 833–845. https://doi.org/10.1037/a0027283.
Ebesutani, C., Tottenham, N., & Chorpita, B. F. (2015). The revised child anxiety and depression scale – Parent version: Extended applicability and validity for use with younger youth and children with histories of early-life caregiver neglect. Journal of Psychopathology and Behavioral Assessment, 37, 705–718. https://doi.org/10.1007/s10862-015-9494-x.
El Salvador Ministry of Education. (2019). Indicador: Matrícula por nivel educativo. Retrieved from https://www.mined.gob.sv/EstadisticaWeb/indicadores/3.%20COBERTURA%20MATRICULAR/3.1%20Matr%C3%ADcula%20por%20nivel.pdf.
Flora, D., & Curran, P. (2004). An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychological Methods, 9(4), 466–491. https://doi.org/10.1037/1082-989X.9.4.466.
Flores, A. (2017). Facts on U.S. Latinos, 2015. Pew Research Center. Retrieved from http://www.pewhispanic.org/2017/09/18/facts-on-u-s-latinos/
Foa, E. B., Johnson, K. M., Feeny, N. C., & Treadwell, K. R. (2001). The child PTSD symptom scale: A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology, 30(3), 376–384. https://doi.org/10.1207/S15374424JCCP3003_9.
Foa, E. B., Asnaani, A., Zang, Y., Capaldi, S., & Yeh, R. (2018). Psychometrics of the child PTSD symptom scale for DSM-5 for trauma-exposed children and adolescents. Journal of Clinical Child and Adolescent Psychology, 47(1), 38–46. https://doi.org/10.1080/15374416.2017.1350962.
Fontana, F., da Silva, M. P., Mazzardo, O., Choi, S. I., Lumi, P., de Campos, W., & Chorpita, B. F. (2019). Cross-cultural adaptation and psychometric assessment of the revised child anxiety and depression scale in Brazilian youth. Journal of Asia Pacific Counseling, 9(2), 1–16. https://doi.org/10.18401/2019.9.2.1.
Gormez, V., Kilincaslan, A., Ebesutani, C., Orengul, A. C., Kaya, I., & Ceri V…& Chorpita B. F. (2017). Psychometric properties of the parent version of the revised child anxiety and depression scale in a clinical sample of Turkish children and adolescents. Child Psychiatry & Human Development, 48, 922–933. https://doi.org/10.1007/s10578-017-0716-1.
Holgado-Tello, F., Chacón-Moscoso, S., Barbero-García, I., & Vila-Abad, E. (2010). Polychoric versus Pearson correlations in exploratory and confirmatory factor analysis of ordinal variables. Quality & Quantity, 44(1), 153–166. https://doi.org/10.1007/s11135-008-9190-y
Hollon, S. D., Cohen, Z. D., Singla, D. R., & Andrews, P. W. (2019). Recent developments in the treatment of depression. Behavior Therapy, 50(2), 257–269. https://doi.org/10.1016/j.beth.2019.01.002.
Holly, L. E., Little, M., Pina, A. A., & Caterino, L. C. (2015). Assessment of anxiety symptoms in school children: A cross-sex and ethnic examination. Journal of Abnormal Child Psychology, 43(2), 297–309. https://doi.org/10.1007/s10802-014-9907-4.
Hu, L. T., & 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.
Kataoka, S. H., Stein, B. D., Jaycox, L. H., Wong, M., Escudero, P., Tu, W., et al. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(3), 311–318.
Kessler, R., Avenevoli, S., McLaughlin, K., Green, G. J., Lakoma, Petukhova, M., et al. (2012a). Lifetime co-morbidity of DSM-IV disorders in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A). Psychological Medicine, 42(9), 1997–2010. https://doi.org/10.1017/s0033291712000025.
Kessler, R. C., Avenevoli, S., Costello, J. E., Georgiades, K., Green, J., Gruber, M. J., et al. (2012b). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372–380. https://doi.org/10.1001/archgenpsychiatry.2011.160.
Kohrt, B. A., Asher, L., Bhardwaj, A., Fazel, M., Jordans, M. J. D., Mutamba, B. B., et al. (2018). The role of communities in mental health care in low- and middle-income countries: A meta-review of components and competencies. International Journal of Environmental Research and Public Health, 15, 1279. https://doi.org/10.3390/ijerph15061279.
March, J. S., & Albano, A. M. (1996). Assessment of anxiety in children and adolescents. American Psychiatric Press Review of Psychiatry, 15, 405–427.
Mathyssek, C. M., Olino, T. M., Hartman, C. A., Ormel, J., Verhulst, F. C., & Oort, F. (2013). Does the revised child anxiety and depression scale (RCADS) measure anxiety symptoms consistently across adolescence? The TRAILS study. International Journal of Methods in Psychiatric Research, 22(1), 27–35. https://doi.org/10.1002/mpr.1380.
Meade, A. W., Johnson, E. C., & Braddy, P. W. (2008). Power and sensitivity of alternative fit indices in tests of measurement invariance. Journal of Applied Psychology, 93, 568–592. https://doi.org/10.1037/0021-9010.93.3.568.
Medsker, G. J., Williams, L. J., & Holahan, P. J. (1994). A review of current practices for evaluating causal models in organizational behavior and human resources management research. Journal of Management, 20(2), 439–464. https://doi.org/10.1177/014920639402000207.
Muris, P., Meesters, C., & Schouten, E. (2002). A brief questionnaire of DSM-IV-defined anxiety and depression symptoms among children. Clinical Psychology and Psychotherapy, 9(6), 430–442. https://doi.org/10.1002/cpp.347.
Muthen, B., du Toit, S. H. C., & Spisic, D. (1997). Robust inference weighted least squares and quadratic estimating equations in latent variable modeling with categorical and continuous outcomes. Unpublished manuscript. https://www.statmodel.com/download/ Article_075.pdf.
Neuman, S. (2020). Troops occupy El Salvador’s legislature to back president’s crime package. NPR. https://www.npr.org/2020/02/10/804407503/troops-occupy-el-salvadors-legislature-to-back-president-s-crime-package
Orengo-Aguayo, R., Stewart, R.W., Villalobos, B.T., Rodriguez, J.H., Dueweke, A.R., de Arellano, M.A., & Young, J. (in press). Listen, don’t tell: Partnership and adaptation to implement trauma focused cognitive behavioral therapy in low resourced settings. American Psychologist.
Park, A. L., Ebesutani, C. K., Bose, D., & Chorpita, B. F. (2016). Psychometric properties of a Spanish translation of the revised child anxiety and depression scale – Parent version. Journal of Psychopathology and Behavioral Assessment, 38(2), 307–319. https://doi.org/10.1007/s10862-015-9517-7.
Patel, V., & Saxena, S. (2014). Transforming lives, enhancing communities – Innovations in global mental health. New England Journal of Medicine, 370(6), 498–501. https://doi.org/10.1056/NEJMp1315214.
Patel, V., Kieling, C., Maulik, P. K., & Divan, G. (2013). Improving access to care for children with mental disorders: A global perspective. Archives of Disease in Childhood, 98(5), 323–327. https://doi.org/10.1136/archdischild-2012-302079.
Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., et al. (2018). The lancet commission on global mental health and sustainable development. The Lancet, 392, 1553–1598. https://doi.org/10.1016/S0140-6736(18)31612-X.
Peters, G. J. Y. (2014). The alpha and the omega of scale reliability and validity: Why and how to abandon Cronbach’s alpha and the route towards more comprehensive assessment of scale quality. European Health Psychologist, 16(2), 56–69. https://doi.org/10.31234/osf.io/h47fv.
Pina, A. A., & Gonzales, N. A. (2014). The role of theory and culture in child and adolescent prevention science: Introduction to the special section. Journal of Clinical Child & Adolescent Psychology, 43(3), 397–399. https://doi.org/10.1080/15374416.2014.888668.
Pina, A. A., Holly, L. E., Zerr, A. A., & Rivera, D. E. (2014). A personalized and control systems engineering conceptual approach to target childhood anxiety in the contexts of cultural diversity. Journal of Clinical Child & Adolescent Psychology, 43(3), 442–453. https://doi.org/10.1080/15374416.2014.888667.
Pine, D. S., Cohen, P., Gurley, D., Brook, J., & Ma, Y. (1998). The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Archives of General Psychiatry, 55(1), 56. https://doi.org/10.1001/archpsyc.55.1.56.
Piqueras, J. A., Martín-Vivar, M., Sandin, B., Luis, C., & Pineda, D. (2017a). The revised child anxiety and depression scale: A systematic review and reliability generalization meta-analysis. Journal of Affective Disorders, 218, 153–169. https://doi.org/10.1016/j.jad.2017.04.022.
Piqueras, J., Pineda, D., Martin-Vivar, M., & Sandín, B. (2017b). Confirmatory factor analysis and psychometric properties of the revised child anxiety and depression scale−30 (RCADS-30) in clinical and non-clinical samples. Revista de Psicopatología y Psicología Clínica, 22(3), 183–196. https://doi.org/10.5944/rppc.vol.22.num.3.2017.19332.
Putnick, D. L., & Bornstein, M. H. (2016). Measurement invariance conventions and reporting: The state of the art and future directions for psychological research. Developmental Review, 41, 71–90. https://doi.org/10.1016/j.dr.2016.06.004.
Revelle, W., & Zinbarg, R. E. (2009). Coefficients alpha, beta, omega, and the GLB: Comments on Sijtsma. Psychometrika, 74(1), 145–154. https://doi.org/10.1007/s11336-008-9102-z.
Reynolds, C. F., & Patel, V. (2017). Screening for depression: The global mental health context. World Psychiatry, 16(3), 316–317. https://doi.org/10.1002/wps.20459
Sandin, B., Chorot, P., Valiente, R. M., & Chorpita, B. F. (2010). Development of a 30-item version of the revised child anxiety and depression scale. Revista de Psicopatología y Psicología Clínica, 15, 165–178. https://doi.org/10.5944/rppc.vol.15.num.3.2010.4095.
Sattler, A. F., Bentley, J. P., & Young, J. (2019). Validation of a brief screening instrument for adult psychopathology. Professional Psychology: Research and Practice, 50(5), 315–322. https://doi.org/10.1037/pro0000252.
Singla, D. R., Kohrt, B. A., Murray, L. K., Anand, A., Chorpita, B. F., & Patel, V. (2017). Psychological treatments for the world: Lessons from low- and middle-income countries. Annual Review of Clinical Psychology, 13, 149–182. https://doi.org/10.1146/annurev-clinpsy-032816-045217.
Skoczeń, I., Rogoza, R., Rogoza, M., Ebesutani, C., & Chorpita, B. F. (2019). Structure, reliability, measurement stability and construct validity of the polish version of the revised child anxiety and depression scale. Assessment, 26, 1492–1503. https://doi.org/10.1177/1073191117711019.
Southam-Gerow, M., & Chorpita, B. F. (2007). Fears and anxieties. In E. J. Mash & R. A. Barkley (Eds.), Assessment of child disorders (4th ed., pp. 347–397). New York, NY: Guilford Press.
Steiger, J. H. (1990). Structure model evaluation and modification: An interval estimation approach. Multivariate Behavioral Research, 25(2), 173–180. https://doi.org/10.1207/s15327906mbr2502_4.
Stevanovic, D., Bagheri, Z., Atilola, O., Vostanis, P., Stupar, D., Moreira, P., et al. (2017). Cross-cultural measurement invariance of the revised child anxiety and depression scale across 11 world-wide societies. Epidemiology and Psychiatric Sciences, 26(4), 430–440. https://doi.org/10.1017/S204579601600038X.
Swan, A. J., & Kendall, P. C. (2016). Fear and missing out: Youth anxiety and functional outcomes. Clinical Psychology: Science and Practice, 23(4), 417–435. https://doi.org/10.1111/cpsp.12169.
Trent, L. R., Buchanan, E., Ebesutani, C., Ale, C. M., Heiden, L., Hight, T. L., et al. (2013). A measurement invariance examination of the revised child anxiety and depression scale in a southern sample: Differential item functioning between African American and Caucasian youth. Assessment, 20(2), 175–187. https://doi.org/10.1177/1073191112450907.
Tucker, L. R., & Lewis, C. (1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika, 38(1), 1–10. https://doi.org/10.1007/BF02291170.
UNICEF. (2019). Measurement of mental health among adolescents at the population level (MMAP): An overview. https://data.unicef.org/resources/mmap-august-2019/
United States Census Bureau. (2013). American community survey [Data File]. Retrieved from: https://www.census.gov/data/tables/2013/demo/2009-2013-lang-tables.html
Verhey, B. (2001). The demobilization and reintegration of child soldiers: El Salvador case study. The World Bank. Available from www.worldbank.org(accessed September 7, 2020).
Weems, C. F., & Pina, A. A. (2010). The assessment of emotion regulation: Improving construct validity in research on psychopathology in youth: An introduction to the special section. Journal of Psychopathology and Behavioral Assessment, 32(1), 1–7. https://doi.org/10.1007/s10862-010-9178-5.
Funding
This work was supported by a United States Agency for International Development grant (AID-519-C-13-00002). The funding agency had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit this paper for publication.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of Interest/Competing Interests
John Young, Sujith Ramachandran, Regan Stewart, Rosaura Orengo-Aguayo, and Bruce F. Chorpita declare no conflicts of interest or competing interests.
Experiment Participants
Informed consent/assent was obtained from all individual participants included in the study.
Code Availability
Not applicable (no custom code employed).
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Young, J., Ramachandran, S., Stewart, R. et al. Psychometric Properties of the Spanish Revised Child Anxiety and Depression Scale 25-Item Version in El Salvador. J Psychopathol Behav Assess 43, 271–280 (2021). https://doi.org/10.1007/s10862-020-09843-2
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10862-020-09843-2