Child anxiety symptoms were assessed using the SCARED parent and child versions. The SCARED-P and SCARED-C each consist of 41 items that assess a child’s recent anxiety symptoms. Participants respond on a 3-point Likert scale of 0 (Not True or Hardly Ever True), 1 (Somewhat or Sometimes True), or 2 (Very True or Often True). Prior confirmatory factory analyses suggest that the instrument measures five distinct domains of anxiety [4 (link), 8 (link), 22 (link)]. Thus, in addition to total scores, five subscales were examined: generalized anxiety symptoms (nine items), separation anxiety symptoms (five items), social anxiety symptoms (eight items), panic or somatic symptoms (seven items), and school avoidance (three items). A total score of 25 or above has been suggested to indicate the presence of clinically significant anxiety [3 (link), 5 (link)].
Clinicians rated children’s anxiety severity during the previous week using the Pediatric Anxiety Rating Scale (PARS), a 50-item checklist examining symptoms of social, separation, and generalized anxiety, specific phobias, and physical symptoms [23 (link)]. Recent studies have found the PARS to be psychometrically reliable and valid, and it has been used as an outcome measure for several treatment studies [24 (link)–26 (link)]. Clinicians integrated parent and child report during interview assessment to rate seven areas of anxiety severity (number of symptoms, frequency, severity of distress associated with anxiety symptoms, severity of physical symptoms, avoidance, interference at home, and interference outside of home). A score of 3 on each of these 5-point scales reflects a clinically significant level of anxiety. Composite PARS scores were calculated by summing 5 of the 7 items (number of symptoms and severity of physical symptoms were excluded as they are likely less related to overall anxiety severity and tend to be highly skewed). PARS scores were only available for a subset of (n = 213) youth with a diagnosed anxiety disorder, and all scores reflected anxiety prior to beginning treatment at NIMH.
Children’s age, sex, ethnicity, and family socioeconomic status (SES) were assessed using a demographics questionnaire. Highest parental educational attainment and annual income were used as markers of SES. The Weschler Abbreviated Scale of Intelligence II (WASI [27 ]) was used to assess child IQ. The Family Risk Factor Checklist (FRFC [28 (link)]) is a 48-item measure that assesses children’s exposure to environmental/family-related risk (five subscales: adverse life events & instability, family structures & SES, parenting practices, parental verbal conflict, and mood problems). Higher scores indicate greater exposure to family risk factors. Demographic and clinical characteristics of the sample are summarized inTable 1 .
Clinicians rated children’s anxiety severity during the previous week using the Pediatric Anxiety Rating Scale (PARS), a 50-item checklist examining symptoms of social, separation, and generalized anxiety, specific phobias, and physical symptoms [23 (link)]. Recent studies have found the PARS to be psychometrically reliable and valid, and it has been used as an outcome measure for several treatment studies [24 (link)–26 (link)]. Clinicians integrated parent and child report during interview assessment to rate seven areas of anxiety severity (number of symptoms, frequency, severity of distress associated with anxiety symptoms, severity of physical symptoms, avoidance, interference at home, and interference outside of home). A score of 3 on each of these 5-point scales reflects a clinically significant level of anxiety. Composite PARS scores were calculated by summing 5 of the 7 items (number of symptoms and severity of physical symptoms were excluded as they are likely less related to overall anxiety severity and tend to be highly skewed). PARS scores were only available for a subset of (n = 213) youth with a diagnosed anxiety disorder, and all scores reflected anxiety prior to beginning treatment at NIMH.
Children’s age, sex, ethnicity, and family socioeconomic status (SES) were assessed using a demographics questionnaire. Highest parental educational attainment and annual income were used as markers of SES. The Weschler Abbreviated Scale of Intelligence II (WASI [27 ]) was used to assess child IQ. The Family Risk Factor Checklist (FRFC [28 (link)]) is a 48-item measure that assesses children’s exposure to environmental/family-related risk (five subscales: adverse life events & instability, family structures & SES, parenting practices, parental verbal conflict, and mood problems). Higher scores indicate greater exposure to family risk factors. Demographic and clinical characteristics of the sample are summarized in
