Abstract
BackgroundAnxiety and depression are common in children and adolescents, which can be detected via self-report questionnaires in non-clinical settings like the school environment. Two short versions of the Revised Child Anxiety and Depression Scale (i.e., RCADS-25 and RCADS-20) seem to be feasible for administering at schools. The present study evaluated the psychometric properties of the RCADS-25 and RCADS-20 used as screening instruments for anxiety and depression in a general population of schoolchildren and adolescents.MethodsThe RCADS-25 was completed by 69,487 schoolchildren and adolescents aged 8 to 18. The RCADS-25 and RCADS-20 broad anxiety scales are equal (15 items), but there are two versions of the major depressive disorder (MDD) scale: the RCADS-25 MDD scale (10 items) and the RCADS-20 MDD scale (5 items). The three scales were assessed on structural validity, internal consistency, test-retest reliability, criterion validity, and hypotheses for construct validity.ResultsThe RCADS-25/RCADS-20 broad anxiety scale demonstrated a sufficient structural validity (CFI = 0.98, TLI = 0.99, RMSEA = 0.03, SRMR = 0.03), internal consistency (alpha = 0.82), test-retest reliability (ICC = 0.73), criterion validity (AUC = 0.79), and all four hypotheses concerning construct validity were confirmed. The RCADS-25 MDD scale demonstrated a sufficient test-retest reliability (ICC = 0.70) and three out of four hypotheses concerning construct validity were confirmed, but its structural validity was suspect (CFI = 0.89, TLI = 0.94, RMSEA = 0.09, SRMR = 0.06). The RCADS-20 MDD scale demonstrated a sufficient structural validity (CFI = 0.97, TLI = 0.97, RMSEA = 0.08, SRMR = 0.04) and internal consistency (alpha = 0.72). Two out of four hypotheses concerning construct validity were confirmed. The test-retest reliability (ICC = 0.60) was insufficient. Since both MDD scales showed shortcomings, the shortening of the RCADS-25 MDD scale was re-examined post hoc by principal component and reliability analyses. The result was an MDD scale with seven items.ConclusionsThe RCADS-25/RCADS-20 broad anxiety scale is valid and reliable for screening schoolchildren and adolescents, but the RCADS-25 and RCADS-20 MDD scales showed shortcomings. An MDD scale of seven items showed acceptable psychometric properties.
Highlights
Anxiety and depression are common in children and adolescents, which can be detected via selfreport questionnaires in non-clinical settings like the school environment
The present study offers a comprehensive overview of the structural validity, internal consistency, test-retest reliability, criterion validity, and hypotheses testing for construct validity of the Revised Child Anxiety and Depression Scale (RCADS)-25 and the RCADS-20 subscales according to the internationally consensusbased COSMIN taxonomy, definitions, and quality criteria of measurement properties [18,19,20]
Participants and procedures Participants were 70,777 schoolchildren and adolescents aged 8 to 18 who completed the RCADS-25 online at school; 69,487 students completed the RCADS-25 without too many missing values
Summary
Anxiety and depression are common in children and adolescents, which can be detected via selfreport questionnaires in non-clinical settings like the school environment. Anxiety and depression might recur or lead to other problems later in life, like substance abuse or dependence, suicidal behavior, educational underachievement, unemployment, and early parenthood [3,4,5,6]. To prevent these problems, it is important that children and adolescents with anxiety and depression are detected and offered an intervention as early as possible [7, 8]. To be feasible in a school environment, these questionnaires should be affordable and as short as possible [9], especially when these need to be included in a screening battery Importantly, they should demonstrate good psychometric properties for screening in a general population
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