Spence Children's Anxiety Scale Research Articles

Childhood Anxiety Sensitivity Index Factors Predict Unique Variance in DSM‐IV Anxiety Disorder Symptoms

Anxiety sensitivity (AS) is an established cognitive risk factor for anxiety disorders. In children and adolescents, AS is usually measured with the Childhood Anxiety Sensitivity Index (CASI). Factor analytic studies suggest that the CASI is comprised of 3 lower‐order factors pertaining to Physical, Psychological and Social Concerns. There has been little research on the validity of these lower‐order factors. We examined the concurrent and incremental validity of the CASI and its lower‐order factors in a non‐clinical sample of 349 children and adolescents. CASI scores predicted symptoms of DSM‐IV anxiety disorder subtypes as measured by the Spence Children's Anxiety Scale (SCAS) after accounting for variance due to State‐Trait Anxiety Inventory scores. CASI Physical Concerns scores incrementally predicted scores on each of the SCAS scales, whereas scores on the Social and Psychological Concerns subscales incrementally predicted scores on conceptually related symptom scales (e.g. CASI Social Concerns scores predicted Social Phobia symptoms). Overall, this study demonstrates that there is added value in measuring AS factors in children and adolescents.

Structure, developmental course, and correlates of children's anxiety disorder-related behavior in a Hellenic community sample

The generality of the DSM-IV diagnostic structure for children's anxiety disorders, as measured by the Spence Children's Anxiety Scale (SCAS) was investigated with a Greek-language version of the scale. An exploratory factor analysis produced a six-factor solution in general accord with the DSM-IV-based theoretical structure of responding. However, a generalized anxiety factor incorporated three unexpected items interpreted as representing excessive worry, including two items intended to measure obsessions, raising the question of children's ability to discriminate the intrusiveness of vexatious cognition. Anxiety scores were negatively correlated with school adjustment and performance, and decreased with age, with the exception of social phobia scores, which increased. Anxiety scores were substantially higher than those observed in most cultures, particularly on social phobia and compulsive behavior subscales. Hellenic children might regard compulsive behaviors as more socially acceptable than other anxiety disorder-related behaviors, whereas higher overall anxiety scores appear to be related to socio-economic circumstances.

The effects of chronic renal failure on siblings

It is well recognised that chronic illness in children can have a significant effect upon siblings, but their viewpoints need to be sought if we are to change our practice. We conducted semi-structured interviews at home with 15 siblings (8 males) aged 8-12 years whose brother/sister were on chronic dialysis or had received or were waiting for a renal transplant. The interviews were analysed using a grounded theory approach. The children also completed the Spence Children's Anxiety Scale (SCAS), which revealed no statistically significant evidence that they were exhibiting chronic clinical anxiety. Qualitative data indicated that siblings had a variety of concerns concerning their own health and that of their siblings and worried about the effects on family routine and separation from parents. The siblings felt more protective towards their chronically ill sibling and felt that they themselves needed to be more grown up. The study has implications for our clinical practice in that our psychosocial assessment of families needs to include an assessment of sibling needs and siblings should be involved when preparing patients for chronic renal failure treatment. The importance of maintaining family routines should be emphasised, as well as trying to involve siblings in unit activities.

Developmental Differences in Universal Preventive Intervention for Child Anxiety

We compared the effects of a universal school-based preventive intervention for child anxiety at two developmental stages. Six hundred and ninety-two participants enrolled in either grade 6 ( n= 293), children aged between 9 and 10 years, or grade 9 ( n= 399), children aged between 14 and 16 years, were allocated to either a school-based cognitive-behavioural intervention or to a monitoring group. Participants completed the Spence Child Anxiety Scale and the Child Depression Inventory and were stratified into low-, moderate-And high-risk groups based on their anxiety scores at the start of the study. The effects of the prevention programme were evaluated at post- and 12-month follow-up intervals. Post-study results indicated significant reductions in anxiety ( p< .001) and depression ( p< .05) across high- and moderate-risk groups in both the intervention and monitoring conditions. This trend was evident at 12-month follow-up, however, reductions in anxiety were greater in the intervention condition ( p< .05). At post assessment, grade 6 participants showed significant changes in anxiety compared with grade 9 participants ( p< .001), although both primary and secondary school participants showed equal reductions in anxiety at 12-month follow-up. Overall, findings suggest that universal intervention is potentially successful in reducing anxiety symptoms in children. Primary school children reported the greatest changes in anxiety symptoms, suggesting that earlier preventive intervention is potentially more advantageous than later intervention in adolescence. The implications and limitations of this study and directions for future research are discussed.

Anxiety symptoms in Japanese and in German children

The purpose of this study was to compare the frequency of anxiety symptoms and their association with gender and age in Japanese and German children using the Spence Children’s Anxiety Scale (SCAS). A total of 1837 children (862 from Germany and 975 from Japan) between the age of 8 and 12 years were investigated. Results revealed that German children reported significantly higher symptoms of separation anxiety, social phobia, obsessive compulsive disorder, and generalized anxiety disorder than Japanese children. Conversely, Japanese children reported significantly higher scores on symptoms related to physical injury fear. In both countries, girls scored higher than boys on all the scales of the SCAS. Symptoms of separation anxiety and panic decreased with age, whereas social phobia increased with age. The findings underscore the impact of culture on children’s anxiety.

Three new childhood anxiety scales have comparable reliability and validity to traditional diagnostic scales

(2002) Behaviour Research and Therapy 40, 753; Muris P, Merckelbach H, Ollendick T et al. . Three traditional and three new childhood anxiety questionnaires: their reliability and validity in a...

DSM-IV–Defined Anxiety Disorder Symptoms in South African Children

To examine -defined anxiety disorder symptoms in a large sample of normal South African schoolchildren. Children completed two self-report questionnaires: the Spence Children's Anxiety Scale (SCAS) and the 41-item version of the Screen for Child Anxiety Related Emotional Disorders (SCARED). Psychometric properties of the SCAS and the SCARED were moderate (convergent validity) to sufficient (reliability). Factor analyses yielded evidence for the presence of a number of hypothesized anxiety categories (i.e., social phobia, panic disorder, fears, and generalized anxiety disorder). Furthermore, anxiety levels of South African children were higher than those of Western (i.e., Dutch) children. Differences were found with regard to the content of prevalent anxiety symptoms among South African and Western children. Although psychometric properties of the SCAS and the SCARED in South African children somewhat deviated from those obtained in Western countries, both scales seem to be useful for assessing childhood anxiety symptoms in this country.

Symptoms of Anxiety Disorders and Teacher-Reported School Functioning of Normal Children

Correlations between scores on the Spence Children's Anxiety Scale, a questionnaire for measuring symptoms of anxiety disorders and a report of school functioning by teachers were computed for 317 primary school children and 13 teachers in The Netherlands. Analysis showed a small but significant negative correlation between scores for total anxiety and school functioning (r = -.20, p < .001). The finding is consistent with the notion that high symptoms indicating anxiety disorders in children are accompanied by less optimal functioning in school.

Psychometric properties of the Spence Children’s Anxiety Scale with young adolescents

The psychometric properties of the Spence Children’s Anxiety Scale (SCAS) were examined with 875 adolescents aged 13 and 14 years. This self-report measure was designed to evaluate symptoms relating to separation anxiety, social phobia, obsessive-compulsive disorder, panic-agoraphobia, generalized anxiety, and fears of physical injury. Results of confirmatory and exploratory factor analyses supported six factors consistent with the hypothesized subtypes of anxiety. There was support also for a model in which the first-order factors loaded significantly on a single second-order factor of anxiety in general. The internal consistency of the total score and sub-scales was high, and 12-week test–retest reliability was satisfactory. The SCAS correlated strongly with a frequently used child self-report measure of anxiety and significantly, albeit at a lower level, with a measure of depression.

Three traditional and three new childhood anxiety questionnaires: their reliability and validity in a normal adolescent sample

The current study examined the psychometrics of three traditional [i.e., the trait anxiety version of the State–Trait Anxiety Inventory for Children (STAIC), the Revised Children's Manifest Anxiety Scale (RCMAS), and the Fear Survey Schedule for Children – Revised (FSSC-R)] and three new childhood anxiety scales [the Multidimensional Anxiety Scale for Children (MASC), the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Spence Children's Anxiety Scale (SCAS)] in a large sample of normal adolescents ( N=521). Childhood anxiety scales were generally found to be reliable in terms of internal consistency. Furthermore, evidence was obtained for the convergent and divergent validity of the various anxiety questionnaires. That is, anxiety questionnaire scores were found to be substantially intercorrelated. Particularly strong associations were found between total scores of the STAIC and the RCMAS, total scores of the SCARED and the SCAS, and between subscales that intend to measure specific categories of anxiety symptoms. Childhood anxiety questionnaires were substantially connected to an index of depression, although correlations among anxiety questionnaires were generally higher than those between anxiety scales and a measure of depression.

Reliability and validity of the Spence Children's Anxiety Scale and the Screen for Child Anxiety Related Emotional Disorders in German children

The reliability and validity of the Spence Children's Anxiety Scale (SCAS) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) were evaluated in a sample of 556 German primary school children. Both the SCAS (alpha=0.92) and the SCARED (alpha=0.91) were demonstrated to have high internal consistency. The validity of the SCAS and the SCARED was supported by a number of findings. First, in agreement with previous studies, girls displayed significantly higher levels of anxiety symptoms than boys. Furthermore, SCAS and SCARED scores were substantially interrelated. Finally, significant correlations were found between these two measures of anxiety symptoms and the Youth Self-Report and the Columbia Impairment Scale. The utility of the SCAS and the SCARED as screening instruments for anxiety symptoms in children is briefly discussed.

Relations between anxiety sensitivity and panic symptoms in nonreferred children and adolescents

Anxiety sensitivity (AS), the fear of anxiety-related sensations, has been posited to be a cognitive risk factor for the development of anxiety disorders but has been understudied in youth. The purpose of the present investigations was to evaluate relations between AS and panic symptoms in nonreferred children and adolescents. In Study 1, ( N=113, mean age, 13.98), scores on the Childhood Anxiety Sensitivity Index (CASI) predicted the experience of uncued panic attacks after controlling for general anxiety and depression, although the total variance accounted for was small. In Study 2 ( N=52; mean age, 9.48), the Panic/Agoraphobia subscale of the Spence Children's Anxiety Scale was used as the criterion variable. CASI score again predicted panic symptoms after controlling for trait anxiety and depression. Identification of a risk factor for panic attacks and panic disorder in youth will have important implications for etiologic theory, intervention, and prevention.

Threat Perception Bias in Nonreferred, Socially Anxious Children

Investigated whether socially anxious children display a threat perception bias. A sample of 252 primary school children ages 8 to 13 years were exposed to ambiguous stories of social situations and instructed to find out as quickly as possible whether a story was scary. Furthermore, children were invited to tell how each story would end and to judge how they would feel when actually confronted with that situation. The main results can be summarized as follows. First, socially anxious children displayed lower thresholds for threat perception than control children. In other words, compared with control children, socially anxious children needed to hear fewer sentences of a story before deciding it was scary. Furthermore, socially anxious children more frequently perceived threat while listening to the stories than did control children. Finally, socially anxious children more often interpreted the stories as threatening and displayed higher levels of negative feelings and cognitions in relation to these stories compared with control children. These findings fit nicely in current information-processing theories of childhood anxiety. An additional aim of this study was to investigate the convergent validity of the social phobia scales of 2 recently developed self-report questionnaires for measuring anxiety disorder symptoms in children: the Spence Children's Anxiety Scale (Spence, 1998) and the Screen for Child Anxiety Related Emotional Disorders (Birmaher et al., 1997). Results indicated that the social phobia scale of the Spence Children's Anxiety Scale and the extended social phobia scale of the Screen for Child Anxiety Related Emotional Disorders correlated substantially with a specific measure of social anxiety, the Social Anxiety Scale for Children-Revised.

Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale

The practical significance of assessing disorders of emotion in children is well documented, yet few scales exist that possess conceptual if not empirical relevance to dimensions of DSM anxiety or depressive disorders. The current study evaluated an adaptation of a recently developed anxiety measure (Spence Children's Anxiety Scale; [Spence, S. H. (1997). Structure of anxiety symptoms among children: a confirmatory factor-analytic study. Journal of Abnormal Psychology, 106, 280–297; Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36, 545–566]), revised to correspond to dimensions of several DSM-IV anxiety disorders as well as major depression. This investigation involved initial evaluation of the factorial validity of the revised measure in a school sample of 1641 children and adolescents and reliability and validity in an independent sample of 246 children and adolescents. Results yielded an item set and factor definitions that demonstrated structure consistent with DSM-IV anxiety disorders and depression. The revised factor structure and definitions were further supported by the reliability and validity analyses. Some implications for assessment of childhood anxiety and depressive disorders are discussed.

Correlations among two self-report questionnaires for measuring DSM-defined anxiety disorder symptoms in children: the Screen for Child Anxiety Related Emotional Disorders and the Spence Children’s Anxiety Scale

The Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Spence Children’s Anxiety Scale (SCAS) are recently developed self-report questionnaires for measuring DSM-IV defined anxiety disorder symptoms in children. The present study examined correlations among these measures in a large sample of Dutch school children (N=1011). Results showed that there was a strong correlation between the total anxiety scores of these instruments (r=0.89). Furthermore, most of the SCARED subscales were found to be convincingly connected to their SCAS counterparts. Finally, a confirmatory factor analysis revealed that SCARED and SCAS anxiety disorder subscales loaded uniquely on separate but intercorrelated factors (i.e., the DSM-IV anxiety disorder categories). These findings can be taken as evidence for the concurrent validity of the SCARED and the SCAS. Although these measures were developed independently, they seem to measure highly similar constructs, viz anxiety symptoms which can be clustered into the anxiety disorder categories as described in the DSM-IV.

A measure of anxiety symptoms among children

The Spence Children's Anxiety Scale (SCAS) is a child self-report measure designed to evaluate symptoms relating to separation anxiety, social phobia, obsessive-compulsive disorder, panicagoraphobia, generalized anxiety and fears of physical injury. The results of confirmatory and exploratory factor analyses supported six factors consistent with the hypothesized diagnostic categories. There was support also for a model in which the 1st-order factors loaded significantly on a single 2nd-order factor of anxiety in general. The internal consistency of the total score and subscales was high and 6 month test-retest reliability was acceptable. The SCAS correlated strongly with a frequently used child self-report measure of anxiety. Comparisons between clinically anxious and control children showed significant differences in total SCAS scores, with subscale scores reflecting the type of presenting anxiety disorder of the clinical samples.