The Screen for Child Anxiety Related Disorders (SCARED)

Abstract

The Screen for Child Anxiety Related Disorders (SCARED) is a validated, 41-item instrument designed for the rapid screening and assessment of various anxiety disorders in children and adolescents. Developed by Boris Birmaher and colleagues, the scale is available in both child self-report and parent-report versions, facilitating a multi-informant approach to clinical evaluation. The SCARED measures symptoms across five distinct anxiety domains, providing valuable differential diagnostic information for conditions such as Panic Disorder, Generalized Anxiety Disorder, and Social Anxiety Disorder.

Keywords

Child anxiety, SCARED, screening tool, anxiety assessment, pediatric mental health, Generalized Anxiety Disorder, Separation Anxiety Disorder, Social Phobia, school refusal.

Authors

Boris Birmaher, Suneeta Khetarpal, Marlane Cully, David Brent, Sandra McKenzie.

Purpose

The primary purpose of the Screen for Child Anxiety Related Disorders (SCARED) is to identify the presence and severity of anxiety disorders in youth, helping clinicians and researchers isolate potential problems early to ensure timely intervention. The instrument is intended strictly as a screening tool, not a definitive diagnostic measure, and is designed to flag children who require a more detailed clinical interview and diagnostic workup.

Its dual format—a version for the child and a parallel version for the parent—is crucial. This allows for the comparison of symptoms reported by the child’s internal experience versus those observed externally by a caregiver, which is essential given that children may lack the insight or vocabulary to fully express their internal distress.

Construct

The SCARED is structured to assess symptoms corresponding to five major categories of anxiety often observed in childhood, mapping closely to criteria outlined in standard diagnostic manuals like the DSM. By utilizing specific subscales, the instrument provides a profile of the child’s anxiety presentation rather than just a global score.

The five distinct psychological constructs measured by the scale are: Panic Disorder/Somatic Symptoms, Generalized Anxiety Disorder (GAD), Separation Anxiety Disorder, Social Anxiety Disorder (Social Phobia), and School Avoidance (or School Phobia).

Validity

The validity of the SCARED is strongly supported by the extensive psychometric properties evaluation conducted during its development and subsequent replication studies. The foundational research by Birmaher et al. (1999) established that the scale possesses strong construct validity, demonstrating that the five-factor structure reliably measures the intended anxiety constructs in both clinical and community samples.

The instrument has proven effective in differentiating between children diagnosed with specific anxiety disorders and those in non-anxious control groups, confirming its utility as a reliable screening mechanism in clinical settings. Furthermore, its validity is enhanced by the dual-report format, which allows for triangulation of data between the child and the parental perspective.

Reliability

The reliability of the SCARED is generally high across both reporter versions. The scale exhibits robust internal consistency, indicating that the 41 items consistently measure the underlying construct of anxiety. The high reliability coefficients reported in the literature confirm that the instrument is a stable and trustworthy measure for clinical and research applications involving pediatric anxiety disorders.

Factor Analysis

The SCARED is based on a robust five-factor structure derived from factor analytic studies. This structure allows for differential scoring, which is clinically informative beyond a simple total anxiety score. The items load onto the following specific factors, which correspond to distinct anxiety diagnoses:

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

A total score of ≥ 25 across all domains suggests the presence of an anxiety disorder, with scores exceeding 30 being highly specific indicators of clinical concern.

Instrument

Test Type: Screening Inventory/Rating Scale (Self-report and Parent-report)

Format: 41-item inventory rated on a 3-point Likert-type scale (0=Not True, 1=Somewhat True, 2=Very True).

Language Available: English (Numerous translations have been validated internationally).

Population Group: Children and adolescents suspected of having anxiety disorders.

Age Group: Typically used for youth aged 8 to 18 years old.

Population Details: Appropriate for use in clinical, educational, and research settings to screen for clinically significant anxiety symptoms.

Test Methodology: Respondents rate the frequency or truthfulness of statements describing feelings or behaviors over the past three months.

Keywords

Psychological screening, Likert scale, separation anxiety, panic attack, school phobia, child psychiatry, emotional disorders, clinical cutoff.

Authors

Author ORCID Identifier: N/A

Affiliation Email addresses: [email protected]

Correspondence Address: Western Psychiatric Institute and Clinic, University of Pittsburgh (U Pgh).

Permissions & Fee and Test Year

The SCARED was developed in October 1995. It is commonly used globally in clinical practice and research. Users should typically contact the primary institution (Western Psychiatric Institute and Clinic, University of Pittsburgh) or the authors for formal usage permissions, although the instrument is often distributed freely for academic and non-commercial clinical use.

Reference’s

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 and Adolescent Psychiatry, 38(10), 1230–6.

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

The following content presents the structure of the SCARED scale, including the instructions and sample items for both the Child and Parent versions, as originally designed by the authors.

Child Version – Page 1 of 2 (To be filled out by the CHILD)

Name:                                             

Date:                                                        

Directions:

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, fill in one circle that corresponds to the response that seems to describe you for the last 3 months.

0

Not True or Hardly Ever True

1

Somewhat True or Sometimes True

2

Very True or Often True

1.When I feel frightened, it is hard for me to breatheooo
2.I get headaches when I am at schoolooo
3.I don’t like to be with people I don’t know wellooo
4.I get scared if I sleep away from homeooo
5.I worry about other people liking meooo
6.When I get frightened, I feel like passing outooo
7.I am nervousooo
8.I follow my mother or father wherever they goooo
9.People tell me that I look nervousooo
10.I feel nervous with people I don’t know wellooo
11.My I get stomachaches at schoolooo
12.When I get frightened, I feel like I am going crazyooo
13.I worry about sleeping aloneooo
14.I worry about being as good as other kidsooo
15.When I get frightened, I feel like things are not realooo
16.I have nightmares about something bad happening to my par- entsooo
17.I worry about going to schoolooo
18.When I get frightened, my heart beats fastooo
19.I get shakyooo
20.I have nightmares about something bad happening to meooo

Screen for Child Anxiety Related Disorders (SCARED)

Child Version – Page 2 of 2 (To be filled out by the CHILD)

0

Not True or Hardly Ever True

1

Somewhat True or Sometimes True

2

Very True or Often True

21.I worry about things working out for meooo
22.When I get frightened, I sweat a lotooo
23.I am a worrierooo
24.I get really frightened for no reason at allooo
25.I am afraid to be alone in the houseooo
26.It is hard for me to talk with people I don’t know wellooo
27.When I get frightened, I feel like I am chokingooo
28.People tell me that I worry too muchooo
29.I don’t like to be away from my familyooo
30.I am afraid of having anxiety (or panic) attacksooo
31.I worry that something bad might happen to my parentsooo
32.I feel shy with people I don’t know wellooo
33.I worry about what is going to happen in the futureooo
34.When I get frightened, I feel like throwing upooo
35.I worry about how well I do thingsooo
36.I am scared to go to schoolooo
37.I worry about things that have already happenedooo
38.When I get frightened, I feel dizzyooo
39.I feel nervous when I am with other children or adults and I have to do something while they watch me (for example: read aloud, speak, play a game, play a sport) 

o

 

o

 

o

40.I feel nervous when I am going to parties, dances, or any place where there will be people that I don’t know wellooo
41.I am shyooo

*For children ages 8 to 11, it is recommended that the clinician explain all questions, or have the child answer the questionnaire sitting with an adult in case they have any questions.

Screen for Child Anxiety Related Disorders (SCARED)

Parent Version – Page 1 of 2 (To be filled out by the PARENT)

Name:                                             

Date:                                                     

Directions:

Below is a list of statements that describe how people feel. Read each statement carefully and decide if it is “Not True or Hardly Ever True” or “Somewhat True or Sometimes True” or “Very True or Often True” for your child. Then for each statement, fill in one circle that corresponds to the response that seems to describe your child for the last 3 months. Please respond to all statements as well as you can, even if some do not seem to concern your child.

0

Not True or Hardly Ever True

1

Somewhat True or Sometimes True

2

Very True or Often True

1.When my child feels frightened, it is hard for him/her to breatheooo
2.My child gets headaches when he/she is at schoolooo
3.My child doesn’t like to be with people he/she doesn’t know wellooo
4.My child gets scared if he/she sleeps away from homeooo
5.My child worries about other people liking him/herooo
6.When my child gets frightened, he/she feels like passing outooo
7.My child is nervousooo
8.My child follows me wherever I goooo
9.People tell me that my child looks nervousooo
10.My child feels nervous with people he/she doesn’t know wellooo
11.My child gets stomachaches at schoolooo
12.When my child gets frightened, he/she feels like he/she is going crazyooo
13.My child worries about sleeping aloneooo
14.My child worries about being as good as other kidsooo
15.When he/she gets frightened, he/she feels like things are not realooo
16.My child has nightmares about something bad happening to his/her parentsooo
17.My child worries about going to schoolooo
18.When my child gets frightened, his/her heart beats fastooo
19.He/she gets shakyooo
20.My child has nightmares about something bad happening to him/herooo

Screen for Child Anxiety Related Disorders (SCARED)

Parent Version – Page 2 of 2 (To be filled out by the PARENT)

0

Not True or Hardly Ever True

1

Somewhat True or Sometimes True

2

Very True or Often True

21.My child worries about things working out for him/herooo
22.When my child gets frightened, he/she sweats a lotooo
23.My child is a worrierooo
24.My child gets really frightened for no reason at allooo
25.My child is afraid to be alone in the houseooo
26.It is hard for my child to talk with people he/she doesn’t know wellooo
27.When my child gets frightened, he/she feels like he/she is chokingooo
28.People tell me that my child worries too muchooo
29.My child doesn’t like to be away from his/her familyooo
30.My child is afraid of having anxiety (or panic) attacksooo
31.My child worries that something bad might happen to his/her parentsooo
32.My child feels shy with people he/she doesn’t know wellooo
33.My child worries about what is going to happen in the futureooo
34.When my child gets frightened, he/she feels like throwing upooo
35.My child worries about how well he/she does thingsooo
36.My child is scared to go to schoolooo
37.My child worries about things that have already happenedooo
38.When my child gets frightened, he/she feels dizzyooo
 

39.

My child feels nervous when he/she is with other children or adults and he/she has to do something while they watch him/her (for example: read aloud, speak, play a game, play a sport) 

o

 

o

 

o

40.My child feels nervous when he/she is going to parties, dances, or any place where there will be people that he/she doesn’t know wellooo
41.My child is shyooo

Developed by Boris Birmaher, MD, Suneeta Khetarpal, MD, Marlane Cully, MEd, David Brent, MD, and Sandra McKenzie, PhD. Western Psychiatric Institute and Clinic, University of Pgh. (10/95). Email: [email protected]

SCARED Rating Scale Scoring Aide

Use with Parent and Child Versions

  • 0 = not true or hardly true
  • 1 = somewhat true or sometimes true 2 = very true or often true

SCORING

  • A total score of ≥ 25 may indicate the presence of an anxiety disorder. Scores higher than 30 are more specific.
  • A score of 7 for items 1, 6, 9, 12, 15, 18, 19, 22, 24, 27, 30, 34, 38 may indicate panic disorder or Significant Somatic Symptoms.
  • A score of 9 for items 5, 7, 14, 21, 23, 28, 33, 35, 37 may indicate Generalized Anxiety Disorder.
  • A score of 5 for items 4, 8, 13, 16, 20, 25, 29, 31 may indicate Separation Anxiety Disorder.
  • A score of 8 for items 3, 10, 26, 32, 39, 40, 41 may indicate Social Anxiety Disorder.
  • A score of 3 for items 2, 11, 17, 36 may indicate Significant School Avoidance.

Total anxiety ≥ 25

Cite this article

Mohammed looti (2025). The Screen for Child Anxiety Related Disorders (SCARED). Psychological Scales & Instruments Database. Retrieved from https://db.arabpsychology.com/scales/the-screen-for-child-anxiety-related-disorders-scared/

Mohammed looti. "The Screen for Child Anxiety Related Disorders (SCARED)." Psychological Scales & Instruments Database, 24 Oct. 2025, https://db.arabpsychology.com/scales/the-screen-for-child-anxiety-related-disorders-scared/.

Mohammed looti. "The Screen for Child Anxiety Related Disorders (SCARED)." Psychological Scales & Instruments Database, 2025. https://db.arabpsychology.com/scales/the-screen-for-child-anxiety-related-disorders-scared/.

Mohammed looti (2025) 'The Screen for Child Anxiety Related Disorders (SCARED)', Psychological Scales & Instruments Database. Available at: https://db.arabpsychology.com/scales/the-screen-for-child-anxiety-related-disorders-scared/.

[1] Mohammed looti, "The Screen for Child Anxiety Related Disorders (SCARED)," Psychological Scales & Instruments Database, vol. X, no. Y, ص Z-Z, October, 2025.

Mohammed looti. The Screen for Child Anxiety Related Disorders (SCARED). Psychological Scales & Instruments Database. 2025;vol(issue):pages.

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