Screen for Child Anxiety Related Emotional Disorders Child Version (SCARED Child)

Abstract

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a 41-item self-report measure designed for children and adolescents aged 8 to 18 years. Its primary function is to provide a comprehensive screening for the presence and severity of various childhood anxiety disorders, aligning with the diagnostic categories outlined in the DSM-IV (Birmaher et al., 1997).

The scale is structured around five distinct factors that correspond to specific anxiety presentations: Somatic/Panic, General Anxiety, Separation Anxiety, Social Phobia, and School Phobia/Avoidance. The SCARED Child version is intended for use by clinicians as a quick screening instrument and a means of tracking symptom changes over time. It is strongly recommended that the child version be administered alongside the corresponding parent report version to maximize diagnostic accuracy, due to the moderate correlation observed between the two measures.

Keywords

SCARED, Child Anxiety, Adolescent Anxiety, Screening Tool, Panic disorder, Separation Anxiety, Social Phobia, Generalized Anxiety Disorder, Psychometrics.

Authors

Boris Birmaher, Suneeta Khetarpal, Melissa Cully, David Brent, S. McKenzie, Laurie Balach, Joan Kaufman, S. M. Neer.

Purpose

The principal purpose of the SCARED Child Version is to provide a rapid and efficient clinical screening of symptoms associated with major anxiety disorders in youth. By utilizing a multi-dimensional approach derived from the DSM-IV structure, the instrument aids clinicians in identifying children who exhibit clinically significant anxiety symptoms and may require a more intensive, structured diagnostic interview.

In addition to initial diagnosis, the scale is highly valuable for monitoring the longitudinal course of anxiety symptoms. Clinicians can use repeated administrations of the SCARED to track symptom intensity over the duration of treatment, thereby evaluating the efficacy of therapeutic interventions and documenting changes in the child’s emotional state.

Construct

The SCARED measures the psychological construct of childhood anxiety as manifested across several distinct clinical dimensions. This structure moves beyond a generalized measure of distress to capture specific patterns of emotional and physiological arousal characteristic of five major anxiety disorders.

The five core dimensions measured are:

• Somatic/Panic: Reflects physiological symptoms of anxiety (e.g., difficulty breathing, rapid heart rate, dizziness) and fears associated with panic attacks.
• General Anxiety: Captures excessive worry, generalized nervousness, and rumination about future outcomes or past events.
• Separation Anxiety: Measures distress and fear related to actual or anticipated separation from primary caregivers or home environments.
• Social Phobia: Assesses anxiety, shyness, and avoidance behaviors in social or performance situations where the child might be observed or judged by others.
• School Phobia/Avoidance: Focuses specifically on anxiety and fear regarding attending school.

Validity

The validity of the 41-item SCARED was established through rigorous testing, notably in a study involving 190 children and adolescents from an outpatient clinic (Birmaher et al., 1999). This research demonstrated good discriminant validity, as the scale successfully differentiated between children diagnosed with anxiety disorders (n=45) and those with non-anxiety disorders (n=145), based on clinician diagnoses.

Specifically, the total score and the scores for each of the five subscales on the child version significantly differentiated between anxious and non-anxious youth. The panic/somatic and separation anxiety factor scores on the parent version also showed strong discriminant properties. Further confirmation of the scale’s validity and cross-cultural utility has been provided by subsequent large-scale studies and meta-analyses (e.g., Hale et al., 2011), confirming its utility across diverse clinical and community samples.

Reliability

The reliability of the SCARED is supported by its consistent factor structure and strong inter-rater agreement between the child and parent versions. Birmaher et al. (1999) reported moderate correlations between the self-report (child) and informant-report (parent) versions, indicating that the measure consistently captures anxiety symptoms across different perspectives.

The scale’s robust internal consistency, confirmed in multiple validation studies, ensures that the items within each of the five subscales reliably measure their intended construct (e.g., all items designed to measure separation anxiety cluster together consistently). This psychometric strength makes the SCARED a dependable instrument for tracking clinical change.

Factor Analysis

Factor analysis performed during the development of the 41-item SCARED yielded a stable five-factor solution (Birmaher et al., 1999). This structure was intentional, designed to mirror the categorization of anxiety disorders found in the DSM-IV, providing a clinically relevant breakdown of symptom clusters.

The resulting five factors are:

1. Somatic/Panic: Items 1, 6, 9, 12, 15, 18, 19, 22, 24, 27, 30, 34, 38.
2. General Anxiety: Items 5, 7, 14, 21, 23, 28, 33, 35, 37.
3. Separation Anxiety: Items 4, 8, 13, 16, 20, 25, 29, 31.
4. Social Phobia: Items 3, 10, 26, 32, 39, 40, 41.
5. School Avoidance: Items 2, 11, 17, 36.

Instrument

Test Type: Self-report questionnaire / Clinical screening measure.

Format: 41 items rated on a 3-point Likert scale (0 to 2).

Language Available: English (and numerous international translations).

Population Group: Children and Adolescents.

Age Group: 8 to 18 years.

Population Details: Used effectively in both clinical populations (outpatient psychiatric settings) and non-clinical community samples.

Test Methodology: The child responds to statements based on feelings experienced over the last three months. Administration generally takes 10–15 minutes. For younger participants (8–11 years), the presence of an adult or clinician is recommended to clarify questions.

Keywords

Child assessment, Emotional disorders, SCARED, Psychometric properties, Separation Anxiety Disorder, Generalised Anxiety Disorder, Clinical screening.

Authors

Author ORCID Identifier: N/A

Affiliation Email addresses: N/A

Correspondence Address: Western Psychiatric Institute and Clinic, University of Pittsburgh (Affiliation at time of initial development in 1995).

Permissions & Fee and Test Year

The SCARED scale was initially developed and published in 1995 (conceptualization) and 1997 (psychometric characteristics of the 41-item version). The scale is widely used in research and clinical practice. Users should contact the original authors or the University of Pittsburgh for the most current information regarding licensing and usage permissions, though it is often available for non-commercial research use.

Reference’s

• Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child & Adolescent Psychiatry, 36(4), 545–553.
• Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study. Journal of the American academy of child & adolescent psychiatry, 38(10), 1230-1236.
• Hale WW, Crocetti E, Raaijmakers QA, Meeus WH. (2011). A meta‐analysis of the cross‐cultural psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED). Journal of Child Psychology and Psychiatry, 52(1), 80-90.
• Muris, P., Merckelbach, H., Ollendick, T., King, N., & Bogie, N. (2002). Three traditional and three new childhood anxiety questionnaires: Their reliability and validity in a normal adolescent sample. Behaviour research and therapy, 40(7), 753-772.

Items of the Screen for Child Anxiety Related Emotional Disorders Child Version (SCARED Child)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Below is a list of sentences that describe how people feel. Read each phrase and decide if it is “Not True or Hardly Ever True” or “Somewhat True or Sometimes True” or “Very True or Often True” for you. Then, for each sentence, check the box that corresponds to the response that seems to describe you for the last 3 months.