Utility of SCARED Screening Tool for Comorbid Anxiety Disorders in Children

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SCARED is a valuable tool, but like many tools, there may be more or less productive ways to utilize it across a wide variety of studies.
SCARED is a valuable tool, but like many tools, there may be more or less productive ways to utilize it across a wide variety of studies.

The Screen for Child Anxiety and Related Emotional Disorder (SCARED) was shown to have good diagnostic utility and specificity in distinguishing healthy children as well as comorbid, and non-comorbid anxiety in treatment-seeking children, but was less discriminating in non-treatment-seeking children, according to research published in the Journal of Anxiety Disorders.

To evaluate the discriminant validity, diagnostic utility, and informant agreement of SCARED, researchers tested the screen in 2 separate studies evaluating treatment-seeking anxious youth compared with healthy controls (N=585) and non-treatment-seeking anxious youth compared with healthy controls (N=331). Enrolled children with anxiety were previously diagnosed with generalized anxiety disorder, social anxiety disorder, or comorbid generalized anxiety disorder and social anxiety disorder.

In the treatment-seeking youth, SCARED was shown to discriminate between healthy patients, patients with comorbid anxiety disorders, and patients with non-comorbid anxiety disorders based on child scores (P <.001) and parent scores (P <.001). In a similar manner, SCARED diagnostic utility was good, with modest agreement between parents and children.

In non-treatment-seeking children, SCARED was shown to have less consistent diagnostic utility, specificity, and informant agreement between children and parents.

The study investigators concluded that the results "demonstrated various aspects of the psychometric properties of [the] SCARED." They noted that "[the] SCARED is a valuable tool, but that like many tools, there may be more or less productive ways to utilize it across a wide variety of studies. Thus, clinicians and researchers should carefully consider the context in which they plan to utilize [the] SCARED."

Reference

Rappaport BI, Pagliaccio D, Pine DS, Klein DN, Jarcho JM. Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatment-seeking youth. J Anxiety Disord. 2017;51:22-31.

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