Children Archives - PsychTools

Description
The Revised Children’s Anxiety and Depression Scale (RCADS; Chorpita, Yim, Moffitt, Umemoto & Francis, 2000) is a 47-item self report measure which assesses the frequency of anxiety and depression symptoms in youth aged 8-18 years. The RCADS was developed in Hawaii, United States and is partly a revision of Spence’s Children’s Anxiety Scale (SCAS; 1997). The measure has a parent-version form as well as a short-form (RCADS-25; Ebesutani et al., 2012). The RCADS is composed of 6 scales, 5 of which are related to anxiety (separation anxiety disorder, social phobia, generalized anxiety disorder, panic disorder, obsessive compulsive disorder) and another one related to major depressive disorder. The scales are aligned with anxiety and depression diagnosis criteria in the DSM-IV. Individuals rate their answers on a 4-point likert scale ranging from “never” to “always”. The results can be scored manually or via the scoring software created by the authors. In terms of results, T-scores greater than 65 are borderline clinically significant whereas those above 75 are clinically significant. These T-scores indicate that the individual’s responses reflect anxiety and depression-related symptoms very similar to those of individuals who meet diagnostic criteria for that particular disorder or syndrome.

Psychometrics
The RCADS has good internal consistency with Cronbach alpha values ranging from .78 for social anxiety disorder to .88 for panic disorder in a clinical population (Chorpita, Moffitt & Gray, 2005) as well as acceptable internal consistency in the general population (Chorpita et al.,2000). Furthermore, the measure has good convergent validity with similar measures such as the Revised Children’s Manifest Anxiety Scale (RCMAS; Reynolds & Richmond, 1978), the Children’s Depression Inventory (CDI) and interview dimensional ratings (Chorpita et al., 2005). The RCADS also has favourable test-retest reliability for most scales with the social phobia scale being most reliable (0.80) and the obsessive compulsive disorder scale generally being the least reliable (0.65) when tested in a community sample of school children and adolescents (Chorpita et al., 2000). In terms of model fit, a study by Chorpita et al. (2005) using confirmatory factor analysis indicated an adequate model fit for a 6-factor model when compared to a 1 factor and a 2 factor model. The RCADS has been successfully validated in several countries including Australia (de Ross, Gullone & Chorpita,2002), Denmark (Esbjorn, Somhovd, Turnstedt & Reinholdt-Dunne, 2010), the Netherlands (Kosters, Chinapaw, Zwaanswijk, van der Wal & Koot, 2015) and Spain (Sandin, Valiente & Chorot, 2009) in clinical and school-based samples.

Use
The RCADS is available publicly and free of cost from www.childfirst.ucla.edu/resources.html. It can be used for both educational and professional purposes. However, if you want to use this tool for research purposes, permission is required from the authors. It’s a valuable tool for use with youth suspected of having an anxiety disorder or major depressive disorder as its scales reflect DSM-IV criteria and it’s one of the only anxiety measures that also measures depressive symptoms separately. Furthermore, the RCADS has been translated into several languages including Spanish, Chinese and French and due to its cross-cultural validations, it can be used with youth from different cultures. It should be noted that the RCADS is only standardized for grades 3 and above as T-Score conversions have not been developed for children younger than grade three. Therefore, the authors recommend using clinical judgement for interpreting raw scores for these children.

References

Chorpita, B. F., Moffitt, C. E., & Gray, J. (2005). Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behaviour research and therapy, 43(3), 309-322.

Chorpita, B. F., Yim, L., Moffitt, C., Umemoto, L. A., & Francis, S. E. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour research and therapy, 38(8), 835-855.

de Ross, R. L., Gullone, E., & Chorpita, B. F. (2002). The revised child anxiety and depression scale: a psychometric investigation with Australian youth. Behaviour Change, 19(02), 90-101.

Ebesutani, C., Reise, S. P., Chorpita, B. F., Ale, C., Regan, J., Young, J., … & Weisz, J. R. (2012). The Revised Child Anxiety and Depression Scale-Short Version: Scale reduction via exploratory bifactor modeling of the broad anxiety factor. Psychological Assessment, 24(4), 833.

Esbjørn, B. H., Sømhovd, M. J., Turnstedt, C., & Reinholdt-Dunne, M. L. (2012). Assessing the Revised Child Anxiety and Depression Scale (RCADS) in a national sample of Danish youth aged 8–16 years. PLoS One, 7(5), e37339.

Kösters, M. P., Chinapaw, M. J., Zwaanswijk, M., van der Wal, M. F., & Koot, H. M. (2015). Structure, reliability, and validity of the revised child anxiety and depression scale (RCADS) in a multi-ethnic urban sample of Dutch children. BMC psychiatry, 15(1), 132.

Reynolds, C. R., & Richmond, B. O. (1978). What I think and feel: A revised measure of children’s manifest anxiety. Journal of abnormal child psychology, 6(2), 271-280.

Sandín, B., Valiente, R. M., & Chorot, P. (2009). RCADS: evaluación de los síntomas de los trastornos de ansiedad y depresión en niñosy adolescentes. Revista de Psicopatología y Psicología Clínica, 14(3), 193-206.

Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour research and therapy, 36(5), 545-566.

The Brief Problem Checklist (BPC) is a measure designed by Chorpita et al. (2010) to periodically assess the clinical progress of a child over the course of psychological treatment. The scale measures internalising and externalising problems found in children aged 7-13, and such feedback can be used by a clinician to track outcomes and to adjust treatment. The scale is presented in an interview format which contains twelve items, and there is both a child and caregiver version. The BPC is intended to be conducted via an over-the-phone interview at weekly intervals during treatment. The burden for families partaking in such frequent interviews is believed to be minimal, as Chorpita et al. (2010) found that on average the administration time takes less than one minute.

The measure was developed in the USA, and the normed sample was composed of American children (aged 7 -13 years old) who were offered treatment due to a range of problems that could be subsumed under the broad categories of anxiety, depression, or disruptive behaviour (Chorpita et al., 2010). The BPC interviews yield three scales; a Total Problems scale, and Internalising scale, and an Externalising scale. When answering the questions, children and care-givers are required to rate how true the 12 items are in reference to the previous week, using a 3-point Likert scale. Example items include: “I disobey my parents or people at school” (caregiver version: “disobedient at home or school”) and “I threaten to hurt people” (caregiver version: “threatens people”).

To create items for the BPC, Chorpita et al. (2010) applied factor analysis to both the Child Behaviour Checklist (CBCL) and the Youth Self-Report (YSR); two instruments which are widely used and established as evidence-based measures. Items with high factor loadings across both the CBCL and YSR were chosen, leading to the identification of 14 internalising items and 20 externalising items. Items were then selected based on their ability to maximise information pertaining to the clinical change of the client. The resultant 12 items were subjected to exploratory factor analysis using maximum likelihood estimation. A two-factor solution was drawn from the following scree plot, and the factors were extracted and subjected to promax rotation. The resultant factors corresponded to the Externalising and Internalising scales of the BPC.

To determine convergent validity the scales of the BPC were correlated with corresponding scales from the CBCL and YSR (Chorpita et al., 2010). Each BPC scale (Internalising, Externalising, and Total Problems) was highly significantly correlated to scales on both the YSR (coefficients at .61 or above) and the CBCL (coefficients at .56 or above). A longitudinal examination of BPC interview data across 6 months of treatment demonstrated that the BPC is capable of significantly predicting change in related measurements of symptomology (ie. the CBCL and YSR), providing strong evidence for its clinical utility. Test-retest coefficients across an average period of 8-9 days ranged from .72 to .79 for each of the BPC subscales. The agreement of the child and caregiver versions of the scale were examined and produced correlations ranging from .19 to .31; findings which are comparable to the literature comparing parent-child symptom agreement (Chorpita et al., 2010).

The BPC can be readily accessed online and is available for both commercial and research purposes. Due to the relatively new construction of the measure and its potential to quickly and efficiently monitor clinical change in children, the BPC holds both great practical relevance and would benefit from further psychometric testing and cross-cultural validation. No major revisions of the BPC have occurred to the author’s knowledge.

References

Chorpita, B. F., Reise, S., Weisz, J. R., Grubbs, K., Becker, K. D., Krull, J. L., & The Research Network on Youth Mental Health. (2010). Evaluation of the Brief Problem Cheklist: Child and caregiver interviews to measure clinical progress. Journal of Consulting and Clinical Psychology, 78(4), 526-536. doi: 10.1037/a0019602

BPC Links:

Child version: http://www.childfirst.ucla.edu/Brief%20Problem%20Checklist%20-%20Child.pdf Parent Version: http://www.childfirst.ucla.edu/Brief%20Problem%20Checklist%20-%20Parent.pdf