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ADad 2: The Validation of the Screen for Child Anxiety Related Emotional Disorders for Anxiety Disorders Among Adolescents in a Rural Community Population in India

  • Special Supplement on Adolescent Care Counseling
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

Screen for Child Anxiety Related Emotional Disorders (SCARED), a measure found useful in different settings and cultures has not been validated in the subcontinent. This study validated this measure for identifying Anxiety Disorder (AD) among adolescents in an Indian community context.

Methods

Five hundred adolescents were assessed with SCARED and DSM-IV-TR reference standard for diagnosis of AD. The interviewers were experienced raters who were further trained to interview participants using Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL). Sensitivity, specificity, likelihood ratios and predictive values for various SCARED cut-off scores were calculated. Test-retest reliability and inter-rater reliability of SCARED were examined. The dichotomized SCARED score was correlated with the DSM-IV-TR clinical diagnosis of AD to establish the criterion validity of SCARED as a measure of AD.

Results

A SCARED total score of ≥21(Sn = 84.62 %, Sp = 87.36 %; AUC = 90 %) is suggested for diagnostic use in Indian population. Specific threshold scores were identified for the Panic Disorder, Generalized Anxiety Disorder, Separation Anxiety Disorder and Social Anxiety Disorder subscales. The inter-rater reliability (ICC = 0.87) and test-retest reliability (ICC = 0.90) for SCARED is good. Besides the adequate face and content validity, SCARED demonstrates good internal consistency (Cronbach’s α = 0.89) and item-total correlation. There is a high concordance rate with the reference standard, DSM-IV-TR diagnosis [81 %; Cohen’s κ = 0.42 (95 % CI = 0.31 to 0.52); P = 0.001] in classifying AD.

Conclusions

SCARED has adequate psychometric properties and is now available for clinical and research work in India.

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Conflict of Interest

None.

Role of Funding Source

Supported by an intramural grant from Child Development Centre, Thiruvanathapuram.

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Authors and Affiliations

  1. Child and Adolescent Psychiatry Unit, Christian Medical College, Vellore, 632 002, Tamil Nadu, South India

    Paul Swamidhas Sudhakar Russell, Sushila Russell & Anupama Zeena Sequeira

  2. Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, Kerala, South India

    M. K. C. Nair, Vinod Shanmukham Subramaniam, Suma Nazeema & Babu George

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  1. Paul Swamidhas Sudhakar Russell
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  2. M. K. C. Nair
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  3. Sushila Russell
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  5. Anupama Zeena Sequeira
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  6. Suma Nazeema
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Correspondence to Paul Swamidhas Sudhakar Russell.

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Russell, P.S.S., Nair, M.K.C., Russell, S. et al. ADad 2: The Validation of the Screen for Child Anxiety Related Emotional Disorders for Anxiety Disorders Among Adolescents in a Rural Community Population in India. Indian J Pediatr 80 (Suppl 2), 139–143 (2013). https://doi.org/10.1007/s12098-013-1233-2

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  • DOI: https://doi.org/10.1007/s12098-013-1233-2

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