Abstract
Using a school-based (N = 1,060) and clinic-referred (N = 303) youth sample, the authors developed a 25-item shortened version of the Revised Child Anxiety and Depression Scale (RCADS) using Schmid-Leiman exploratory bifactor analysis to reduce client burden and administration time and thus improve the transportability characteristics of this youth anxiety and depression measure. Results revealed that all anxiety items primarily reflected a single "broad anxiety" dimension, which informed the development of a reduced 15-item Anxiety Total scale. Although specific DSM-oriented anxiety subscales were not included in this version, the items comprising the Anxiety Total scale were evenly pulled from the 5 anxiety-related content domains from the original RCADS. The resultant 15-item Anxiety Total scale evidenced significant correspondence with anxiety diagnostic groups based on structured clinical interviews. The scores from the 10-item Depression Total scale (retained from the original version) were also associated with acceptable reliability in the clinic-referred and school-based samples (α = .80 and .79, respectively); this is in contrast to the alternate 5-item shortened RCADS Depression Total scale previously developed by Muris, Meesters, and Schouten (2002), which evidenced depression scores of unacceptable reliability (α = .63). The shortened RCADS developed in the present study thus balances efficiency, breadth, and scale score reliability in a way that is potentially useful for repeated measurement in clinical settings as well as wide-scale screenings that assess anxiety and depressive problems. These future applications are discussed, as are recommendations for continued use of exploratory bifactor modeling in scale development.
Highlights
8 to 27% of children and adolescents experience the debilitating effects of anxiety and depression at some point in their development (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003; Lewinsohn, Zinbarg, Seeley, Lewinsohn & Sack, 1997)
The list of available, scientifically-supported anxiety and depression measures includes the Children’s Depression Inventory, the Multidimensional Anxiety Scale for Children, the Revised Children’s Manifest Anxiety Scale, the Screen for Child Anxiety Related Emotional Disorders, the State-Trait Anxiety Inventory for Children, and the Youth Self Report. These measures assess a range of both dimensional and trait behaviors associated with anxiety or depression, they were not developed based on current Diagnostic and Statistical Manual (DSM-IV; APA, 2004) nosology, thereby questioning whether these measures assess the same constructs of pathological anxiety and depression
Coefficient omega hierarchical was equal to .74 and .71 in the clinic-referred and school-based samples, respectively. This suggests that 74% and 71% of the variance of the Anxiety Total composite scores could be attributed to variance on the “broad anxiety” factor, which further supports that the scores obtained from the 37 anxiety items are largely reflective of a single common source (i.e., “broad anxiety”) and need not be scored using multidimensional scoring procedures, but as a primarily unidimensional anxiety construct
Summary
8 to 27% of children and adolescents experience the debilitating effects of anxiety and depression at some point in their development (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003; Lewinsohn, Zinbarg, Seeley, Lewinsohn & Sack, 1997). The list of available, scientifically-supported anxiety and depression measures includes the Children’s Depression Inventory, the Multidimensional Anxiety Scale for Children, the Revised Children’s Manifest Anxiety Scale, the Screen for Child Anxiety Related Emotional Disorders, the State-Trait Anxiety Inventory for Children, and the Youth Self Report These measures assess a range of both dimensional and trait behaviors associated with anxiety or depression, they were not developed based on current Diagnostic and Statistical Manual (DSM-IV; APA, 2004) nosology, thereby questioning whether these measures assess the same constructs of pathological anxiety and depression. The RCADS, for example, has recently been instituted as a mandatory pre- and post-treatment measure for all youths whose primary targeted problem area is anxiety in the Los Angeles county mental health sector
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