Abstract

BackgroundDuring conflict, children and adolescents are at increased risk of mental health problems and in particular, anxiety and depression. However, mental health screening in conflict settings is problematic and carries risk making the need for fast, easy-to-administer, screening instruments paramount. The shortened version of the Revised Child Anxiety and Depression Scale (RCADS-25) is one method of rapidly assessing anxiety and depressive symptoms in youths. This self-report questionnaire demonstrates good internal consistency and diagnostic capacity in clinical and non-clinical populations. Nevertheless, few studies have tested the psychometric properties of translated versions of the RCADS-25 limiting its applicability worldwide.ObjectivesTo expand the reach and utility of the RCADS-25, the present study sought to develop an Arabic version of the instrument (RCADS25-Arabic) and to explore its reliability and underlying factor structure. In light of changes to DSM classification, the effects of removing indicator variables for obsessive-compulsive disorder on the psychometrics of the RCADS25-Arabic were also explored.MethodThe scale was back translated into Modern Standard Arabic and administered to 250 Arabic speaking schoolchildren between 8 and 15 years of age in Syria. Mean and standard deviation were used to characterise the sample and summarize scores. The reliability and factor structure of the RCADS25-Arabic was explored using confirmatory factor analysis.ResultsFemales were 127 and mean age was 12.11 ± SD 2.35. Males scored lower on anxiety (M 15.05 SD ± 8.0, t(248) = − 3.15, p = .003, d = 0.39) and internalizing factors (M 26.1 SD ± 13.1, t(248) = − 2.36, p = .0160, d = 0.31) with no statistical gender difference recorded for depression (t(248) = − 1.27, p = .202). Fit statistics were good for two- and one-factor solutions (χ2/df = 1.65, RMSEA 0.051, CFI .91, TLI .90 and χ2/df = 1.64 and RMSEA 0.051, CFI .91 and TLI .89 respectively). DIFFTEST showed no significant difference between models (χ2diff (1) = 0.03, p < 0.86) indicating a one-factor (internalizing) solution was preferable. No improvement in scale integrity was found after deleting obsessive-compulsive disorder items.ConclusionThe RCADS25-Arabic is useful for rapid screening of depression and anxiety but is better used to identify a one-factor internalizing construct. Obsessive-compulsive disorder items should be retained in the RCADS-25.

Highlights

  • In a recent global meta-analysis, the pooled prevalence of mental disorders in children and adolescents was 13.4% (CI 95% 11.3–15.9) [37]

  • Fit statistics were good for twoand one-factor solutions (χ2/df = 1.65, root mean square error of approximation (RMSEA) 0.051, Comparative Fit Index (CFI) .91, Tucker-Lewis Index (TLI) .90 and χ2/df = 1.64 and RMSEA 0.051, CFI .91 and TLI .89 respectively)

  • As a twofactor solution with depression and anxiety as latent factors has been established in studies of the full Revised Child Anxiety and Depression Scale (RCADS) (e.g. [13]), we looked to confirm this model

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Summary

Introduction

In a recent global meta-analysis, the pooled prevalence of mental disorders in children and adolescents was 13.4% (CI 95% 11.3–15.9) [37]. Anxiety and depression have been shown to increase in children and adolescents [7] These authors report pooled estimates of 43, and 27% for each disorder respectively, follow-up studies show conflict related mental health can improve in a short period of time [38]. Surveying vulnerable populations in these areas can be complicated by on-going fighting or access restrictions from state or military actors These problems highlight the necessity for quality diagnostic and screening tools in Arabic that are quick to administer and available to distribute. The shortened version of the Revised Child Anxiety and Depression Scale (RCADS-25) is one method of rapidly assessing anxiety and depressive symptoms in youths This self-report questionnaire demonstrates good internal consistency and diagnostic capacity in clinical and non-clinical populations. Few studies have tested the psychometric properties of translated versions of the RCADS-25 limiting its applicability worldwide

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