Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in Brazilian children and adolescents

Psychometric Properties and Validity of the Screen for Child Anxiety Related Emotional Disorders: Parent Version (SCARED-P) in an Early Childhood Sample

The Screen for Child Anxiety Related Emotional Disorders: Parent Version (SCARED-P) was originally developed for use in middle childhood and adolescence. The present study examined the psychometric properties and validity of the SCARED-P in an early childhood sample (predominantly aged 4-7 years). The 41-item version of the SCARED-P was administered to the parents of 233 children (mean age = 6.31 years, SD = 1.08; females = 34.3%). Confirmatory factor analysis provided mixed support for the original five-factor model of the SCARED-P. The SCARED-P demonstrated good to excellent internal consistency (total α = .94, subscale α = .68-.89), and good construct validity with the Child Behavior Checklist, Strengths and Difficulties Questionnaire, and the Developmental and Well-being Assessment. These findings indicate overall initial support for the SCARED-P's utility as a measure of anxiety in early childhood, but further psychometric and validation studies are needed in larger community-based samples of young children.

The Effects of Cognitive Behavioral Group Therapy on Anxiety and Emotion Regulation in Thai Middle School Students

This quasi-experimental study examined the effects of Cognitive Behavioral Group Therapy (CBGT) in alleviating anxiety and enhancing emotion regulation in community-sample Thai middle school students. Forty-seven community-sample students in Grades 7–9 with elevated SCARED scores participated in this pre-post treatment–control study. Twenty-three in the treatment group attended the eight-session 2-hour semi-weekly CBGT. The remaining were the control group. Before and after the intervention, the participants completed the measures of anxiety and emotion regulation. Data obtained were subsequently analyzed using repeated-measures and between-groups MANOVAs. At post-intervention, the treatment group reported a significant decrease in anxiety but a significant increase in emotion regulation. Furthermore, when compared with the control group, their anxiety score was significantly lower but their emotion regulation score was significantly higher, respectively. Findings supported the benefits of CBGT in reducing anxiety in Thai middle school students and in enhancing their emotion regulation skills. Therapeutic implications for anxiety reduction were discussed.

Factor Structure and Measurement Invariance Across Age, Gender, and Clinical Status of the Screen for Children Anxiety Related Emotional Disorders

Abstract. The purpose of this study was to examine evidence of reliability, validity, and equity, for the Romanian version of The Screen for Child Anxiety Related Emotional Disorders (SCARED), the 41-item child- (1,106 children and adolescents ranging from 9 to 16 years old) and parent-ratings (485 parents). Both versions of the instrument showed moderate to high internal consistency, with most subscales reaching acceptable levels. Results showed support for the original five-factor structure of the scale. Positive correlations with other measures of anxiety symptoms, such as The Penn State Worry Questionnaire, The Social Anxiety Scale for Adolescents, The Children’s Automatic Thoughts Scale, whereas weak correlations with the syndrome scales for rule-breaking and aggressive behavior of the Youth Self-Report, respectively, Child Behavioral Checklist have demonstrated similar construct validity for the Romanian version of the scale as compared to the original one. Also, strict measurement invariance across age, gender, and clinical status was established. The current research provides evidence of reliability, validity, and equity for SCARED, arguing for its utility as a screening instrument for anxiety symptoms. Implications for theory, assessment, and future research are discussed.

Longitudinal Effects of the Pandemic and Confinement on the Anxiety Levels of a Sample of Spanish Children in Primary Education

(1) Background: The psychological effects of confinement due to the SARS-CoV-2 virus pandemic on children are only partially known. In Madrid, Spain, children suffered a strict confinement for 10 weeks and they returned to school under conditions that were far from normal. This work assesses the effects of the pandemic on the anxiety levels of a group of children living in Madrid. (2) Methods: Children were aged 6 to 11 years (N = 215). A self-report measure of anxiety was completed by participants at two time-points: (1) a few months before the beginning of the pandemic and (2) 1 year later. A smaller subgroup of participants also completed the measure during the confinement period (n = 60). (3) Results: A comparison of these three measures shows that the children’s anxiety was reduced during confinement, and that one year later these levels continue below those registered before the start of the pandemic. (4) Conclusions: These results contradict some previous studies, which found an increase in children’s anxiety as a result of confinement and the pandemic. The discussion considers protective and vulnerability factors in the context of the pandemic, which may affect children’s levels of anxiety.

Differential Item Functioning Based on Autism Features, IQ, and Age on the Screen for Child Anxiety Related Disorders (SCARED) Among Youth on the Autism Spectrum

Anxiety commonly occurs among youth on the autism spectrum, yet measurement of anxiety in this population is complicated by a number of factors, including potentially overlapping symptomatology, the child's intellectual functioning, and changes in anxiety across development. Moreover, few studies have examined the psychometric properties of anxiety measures in this population, and no study to date has tested whether there are systematic differences in the measurement of anxiety, or differential item functioning (DIF), across the high degree of heterogeneity and the developmental course of autism. To test this possibility, data were combined across multiple studies using the National Database for Autism Research, an NIH-funded data repository. Parent-report on the Screen for Child Anxiety Related Disorders (SCARED) and Social Communication Questionnaire (SCQ) were used as measures of anxiety and autism features, respectively. A confirmatory factor analysis indicated good fit of the literature standard five-factor structure. Moderated nonlinear factor analysis (MNLFA) revealed multiple items with intercept and loading DIF based on level of autism features, IQ, and age, especially for items related to social behavior. Therefore, although the measure's factor structure is consistent with that found in the general population, the SCARED may not capture differences in anxiety equivalently for all children on the spectrum and across their development. Clinicians and researchers need to be especially vigilant in measuring anxiety symptoms in children with autism by removing items flagged for DIF from the SCARED and/or by using multiple measures and informants. LAY ABSTRACT: Autistic youth often experience clinical levels of anxiety. Many tools used to measure anxiety were developed for the general population, but not for use with autistic youth. This study found that the Screen for Child Anxiety Related Disorders (SCARED) measures the same five dimensions of anxiety as in the general population. Parents, however, may respond differently to questions on the SCARED based on their child's autism features, intellectual functioning, and age, which impacts our ability to accurately measure anxiety among autistic youth.

Adaptation of the Screen for Child Anxiety Related Emotional Disorders in Spanish with Nonspecific Intellectual Disability

Anxiety continues to be one of the most frequent disorders with typically developing children and youth. However, people with intellectual disability (ID) lack validated diagnostic tests backed by sufficient methodological rigor. Analyze the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in this clinical population, specifically in children and young Spanish with Nonspecific Intellectual Disability. Descriptive statistics and item analysis (N = 542), exploratory factorial analysis (n = 245) and confirmatory (n = 297) and scale reliability analyses were performed and evaluated the internal consistency with various indices (Cronbach's alpha and omega) and the stability of the measurement (test-retest) of the resulting scale with better goodness-of-adjustment indices. A new scale called SCARED-DI was obtained in this clinical sample with three factors and a smaller number of items (22), offering important goodness-of-fit indices (RMSEA [95% CI] 03[0.01; .04]; CFI = 0.99; TLI = 0.98; GFI = 0.88; AGFI = 0.89) and high internal consistency (α = 0.91; ω = 0.93) and adequate measurement stability (r_xx = 0.92). The importance of validating psychopathological anxiety tests for children and youth with ID in order to build good mental health is discussed, emphasizing the need to provide easy, short-duration tests on both cognitive and emotional aspects in this clinical sub-population. In addition, the results are assessed in terms of future research and practical implications. This new version of SCARED-ID represents a valid and reliable tool to evaluate the anxiety in people with intellectual disabilities.

Preliminary Study on Psychometric Properties of an Anxiety Scale in Down Syndrome with Anxiety Symptoms

BACKGROUND

anxiety remains one of the most common disorders in typically developing children and young adults. Adolescents with Down syndrome (DS) lack diagnostic tests for evaluation.

METHODS

this study evaluated the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders inventory in its self-report version in 63 adolescents with anxiety symptoms with DS. The inclusion criteria for the studies were trisomy 21 and a chronological age between 8 and 17 years. Psychometric properties arestrictly evaluated with the sample exceeding a cutoff point in anxiety symptomatology. A confirmatory factorial analysis tested two models for the new evaluation test.

RESULTS

both models confirmed a four-factor structure (somatic/panic, social phobia, generalized anxiety, and separation anxiety). Model 2, nevertheless, had fewer items and a better fit, and it also showed a high correlation with other anxiety detection measures and adequate internal consistency.

CONCLUSIONS

the importance of validating psychopathological anxiety tests for children and young people with DS in order to build good mental health is discussed, emphasizing the need to provide easy and short-term tests on cognitive and emotional aspects in people with intellectual disabilities.

Anxiety disorders in childhood are associated with youth IL-6 levels: A mediation study including metabolic stress and childhood traumatic events

Anxiety disorders (ADs) are chronic conditions that often have their onset in childhood and adolescence. Inflammation and oxidative stress markers have been associated with the vulnerability to ADs, however it is not known if ADs in childhood can influence these biomarkers levels longitudinally. This study aims to investigate a possible association between ADs and serum levels of IL-10, IL-6, IL-1β, TNF-α, BDNF, and protein carbonyl content, assessed after 5 years of follow-up. Moreover, we studied possible mediators for these associations, including physical activity, metabolic markers and childhood trauma. From 240 individuals evaluated at baseline, 73 were re-evaluated in the follow-up. Psychiatric diagnoses were assessed with the K-SADS or the MINI and child trauma questionnaire (CTQ) to evaluate presence of trauma. We searched serum levels of IL-10, IL-6, IL-1β and TNF-α (flow cytometry), BDNF (sandwich-ELISA) and carbonyl content in proteins (PCC method). We found a significant direct association between ADs at baseline and log IL-6 (B = 0.34, S.E. = 0.11, p = 0.002) and between AD and log BDNF (B = -0.10, S.E. = 0.05, p = 0.033) five years later. Searching for possible mediators of these association, we found that levels of HDL-cholesterol (ΔB = -0.148) partially mediated the association between ADs and IL-6. No significant mediators were found in the association between ADs and BDNF. Moreover, this association is no longer significant after controlling for the presence of depression. Our results demonstrated that previous AD diagnosis was associated with higher levels of IL-6 in the follow-up evaluation, suggesting that the presence of anxiety in childhood could influence altered inflammatory markers.

The Screen for Child Anxiety Related Emotional Disorders (SCARED): Informant Discrepancy, Measurement Invariance, and Test-Retest Reliability

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a measure widely used to assess childhood anxiety based on parent and child report. However, while the SCARED is a reliable, valid, and sensitive measure to screen for pediatric anxiety disorders, informant discrepancy can pose clinical and research challenges. The present study assesses informant discrepancy, measurement invariance, test-retest reliability, and external validity of the SCARED in 1092 anxious and healthy parent-child dyads. Our findings indicate that discrepancy does not vary systematically by the various clinical, demographic, and familial variables examined. There was support for strict measurement invariance, strong test-retest reliability, and adequate external validity with a clinician-rated measure of anxiety. These findings further support the utility of the SCARED in clinical and research settings, but low parent-child agreement highlights the need for further investigation of factors contributing to SCARED informant discrepancy.

Psychometric Properties of the SCARED in a Nationally Representative U.S. Sample of 5-12-Year-Olds

OBJECTIVE

To examine the factor structure of the Screen for Child Anxiety Related Emotional Disorders - Parent Report (SCARED-P) in young children and elucidate normative levels of parent-reported anxiety using a nationally representative sample of parents of children ages 5-12 years living in the United States.

METHOD

The 41-item SCARED-P was administered to parents of 1,570 youth who were selected to match the U.S. population on key demographic variables. SCARED-P model fit and mean score differences by age, race/ethnicity, and sex were assessed.

RESULTS

SCARED-P model fit and subscale reliability appeared almost identical in younger children (ages 5-8) and older children (ages 9-12), although model fit for a five-factor model was poor in both groups. Symptoms of generalized anxiety increased from age 5 to 12, while symptoms of separation anxiety disorder decreased. Parents reported significantly more symptoms of social anxiety in females than males. No significant differences by race/ethnicity were found for mean levels of anxiety or model fit.

CONCLUSIONS

The SCARED-P shows some utility as an anxiety screening instrument in a representative sample of U.S. youth as young as 5-years-old, but caution should be used when interpreting subscale scores.

Perceived maternal care is associated with emotional eating in young adults

INTRODUCTION

Early life adversity, including the perception of poor quality of maternal care, is associated with long-term metabolic and psychosocial consequences. The negative quality of mother/child relationship is associated with emotional overeating in young children, which is defined by eating in response to emotional arousal states such as fear, anger or anxiety. However, it is not known if this association persists through adolescence. Therefore, we aimed at verifying if maternal care during infancy can influence emotional eating in young adults.

METHODS

Seventy-five adolescents, residents of Porto Alegre, who participated in the PROTAIA Program (anxiety disorder in childhood and adolescence program), answered the Parental Bonding Instrument (PBI - assessment of perceived maternal care), and the Dutch Eating Behavior Questionnaire (DEBQ). Regression analysis models were built to predict Emotional Eating, a domain of the DEBQ, using maternal care, gender, and anxiety as independent variables.

RESULTS

The model was statistically significant when adjusted for potential confounders (r² = 0.272; p < 0.0001). Emotional eating was significantly predicted by levels of maternal care, anxiety and gender (beta = -0.316; p = 0.006).

CONCLUSION

The results demonstrated a negative association between the quality of maternal care and emotional eating in young adults, suggesting that the early environment could be involved on the development of eating disorders or on the differential eating behavior in adolescents with emotional disorders.

Screening for childhood anxiety: A meta-analysis of the screen for child anxiety related emotional disorders

BACKGROUND

The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a commonly used instrument that evaluates anxiety symptoms in children and adolescents.

METHODS

This meta-analysis examined the psychometric properties of the SCARED instrument, including total instrument and subscale internal reliabilities for the parent and child versions, test-retest reliabilities, and the extent to which responses from the parent version correspond with responses from the child version. Databases reviewed included ERIC, PubMed, PsycINFO, ProQuest Dissertations and Theses, and Google Scholar RESULTS: Responses to the SCARED instrument for children and parents using a mixture of the 38-, 41-, 66-, 69-, and 71-item versions of the SCARED were analyzed for 65 studies conducted between 1997 and 2017. The results from the random-effects models suggested homogeneity of variance for all the effects examined. The weighted averages of the psychometric properties indicated the parent and child versions of the SCARED have exhibited excellent internal consistencies on the total score, panic disorder, generalized anxiety, separation anxiety, social anxiety, post-traumatic stress, and animal phobia subscales. Furthermore, the SCARED demonstrated moderate to large test-retest reliabilities and moderate to large parent-child agreement rates. The school avoidance, obsessive-compulsive disorder, blood phobia, and situational phobia subscales did not demonstrate reliabilities considered appropriate for a screening instrument.

LIMITATIONS

Publications that could not be translated to English or could not be retrieved due to not being published or archived were not included in the analysis.

CONCLUSIONS

Overall the child and parent versions of the SCARED have robust psychometric properties and perform consistently well in community and clinical settings across various countries. The SCARED is clinically relevant as mental health providers and researchers can use it during diagnostic procedures and to monitor intervention effectiveness.

DNA methylation in adolescents with anxiety disorder: a longitudinal study

Anxiety disorders (AD) typically manifest in children and adolescents and might persist into adulthood. However, there are still few data concerning epigenetic mechanisms associated with onset, persistence or remission of AD over time. We investigated a cohort of adolescents and young adults at baseline (age; 13.19 ± 2.38) and after 5 years and classified them according to the AD diagnosis and their longitudinal trajectories into 4 groups: (1) Typically Developing Comparisons (TDC; control group, n = 14); (2) Incident (AD in the second evaluation only, n = 11); (3) Persistent (AD in both evaluations, n = 14) and (4) Remittent (AD in the first evaluation only, n = 8). DNA methylation was evaluated with the Infinium HumanMethylation450 BeadChip from saliva samples collected at both evaluations. Gene set enrichment analysis was applied to consider biological pathways. We found decreased DNA methylation in TDC group while the chronic cases of AD presented hypermethylation in central nervous system development pathways. Moreover, we showed that this persistent group also presented hypermethylation while the other three groups were associated with hypomethylation in nervous system development pathway. Incidence and remission groups were associated with increased and decreased methylation in neuron development pathways, respectively. Larger studies are likely to detect specific genes relevant to AD.

Disentangling the mental health impact of childhood abuse and neglect: A replication and extension study in a Brazilian sample of high-risk youth

Childhood maltreatment is a key predictor of mental health problems across the life span. Yet, how maltreatment types independently and jointly influence the risk for psychiatric problems remains unclear. The aim of the study was two-fold: first, to replicate recent findings regarding the impact of maltreatment types on youth psychiatric symptoms, based on a Brazilian sample of high-risk adolescents (n = 347; age range = 11-17 yrs), and second, to extend existing findings by examining whether this relationship is mediated by bullying victimization and/or perpetration. Measures included self-report ratings of childhood maltreatment and peer victimization, as well as multi-informant reports of internalizing and externalizing symptoms. Consistent with prior research, we found that: (i) maltreatment types often co-occurred; (ii) there was a linear association between number of maltreatment types experienced and symptom severity (i.e. cumulative effect); and (iii) emotional abuse emerged as the most consistent independent predictor of poor mental health across domains, raters, and gender. Additionally, this study extends previous findings by showing that the influence of maltreatment on psychiatric outcomes is partially mediated by peer victimization, but not by bullying perpetration. In conclusion, these findings expand our understanding of the heterogeneity in individual responses to maltreatment as well as highlighting emotional abuse as an important predictor of poor mental health.

Family dysfunction and anxiety in adolescents: A moderated mediation model of self-esteem and perceived school stress

This 18-month longitudinal study examined a moderated mediation model addressing the psychosocial mechanisms that account for the association between family dysfunction and anxiety. A sample of 847 Chinese early adolescents (M age = 12.96 years, SD = 0.67) completed questionnaires assessing family dysfunction, self-esteem, perceived school stress, and anxiety on three occasions at 6-month intervals. After gender and socioeconomic status were included as covariates, the results revealed that family dysfunction was significantly associated with adolescents' anxiety. Moreover, self-esteem partially mediated the relation between family dysfunction and anxiety, and perceived school stress moderated the mediation process in the family dysfunction to anxiety path and in the self-esteem to anxiety path. The findings suggested that both social contextual factors (e.g., family dysfunction and school stress) and self-system factors (e.g., low self-esteem) are risk factors for increased anxiety levels in adolescents. Limitations and practical applications of the study were discussed.

Discriminant validity, diagnostic utility, and parent-child agreement on the Screen for Child Anxiety Related Emotional Disorders (SCARED) in treatment- and non-treatment-seeking youth

The Screen for Child Anxiety and Related Emotional Disorder (SCARED) may be differentially sensitive to detecting specific or comorbid anxiety diagnoses in treatment-seeking and non-treatment-seeking youth. We assessed the SCARED's discriminant validity, diagnostic utility, and informant agreement using parent- and self-report from healthy and treatment-seeking anxious youth (Study 1, N=585) and from non-treatment-seeking anxious youth (Study 2, N=331) diagnosed with generalized anxiety disorder (GAD), social anxiety disorder (SAD), or comorbid GAD+SAD. Among treatment-seeking youth, the SCARED showed good diagnostic utility and specificity, differentiating healthy, comorbid, and non-comorbid anxious youth. Child-parent agreement was modest: healthy child self-reports were higher than parent-reports whereas anxious child self-reports were similar or lower than parent-reports. Less consistent results emerged for diagnostic utility, specificity, and informant agreement among non-treatment-seeking youth. Given the number of non-treatment seeking anxious youth (N=33), generalizability of these findings may be limited. Together, results suggest informants may provide distinct information about children's anxiety symptoms.

The factorial structure of the SCARED-R in a Portuguese community sample

Aim

To evaluate the three-, four-, five- and nine-factor structures of the Screen for Child Anxiety Related Emotional Disorders - revised version (SCARED-R) in a Portuguese sample. We further aimed at assessing the gender and age patterns of anxiety symptoms.

Method

The Portuguese version of the SCARED-R was administered to a community sample of 1,314 children, aged 10-13 years. Confirmatory factorial analysis and multivariate analysis of variance (MANOVA) were employed.

Results

The five-, four- and three-factor models presented an acceptable fit to the data. An unacceptable fit to the data was obtained for the one-factor model. The refined nine-factor model presented good fit to the data after the removal of items with low factorial weights. Based on theoretical considerations, this nine-factor model was considered the best model for assessing children’s anxiety symptoms. A hierarchical structure with a second-order factor called "General Anxiety" was proposed. Adequate internal consistency and criterion related validity were demonstrated. Effects of gender and age on the anxiety scores were found.

Conclusion

The SCARED-R is a reliable tool for screening anxiety symptoms, and can be initially administered to identify children at high risk for specific DSM-IV defined anxiety disorders.

Attention, memory, visuoconstructive, and executive task performance in adolescents with anxiety disorders: a case-control community study

Abstract Objective: The aim of the present study was to assess children and adolescents with mild and severe anxiety disorders for their performance in attention, verbal episodic memory, working memory, visuoconstructive skills, executive functions, and cognitive global functioning and conduct comparative analyses with the performance of children free from anxiety disorders. Methods: Our sample comprised 68 children and adolescents aged 10 to 17 years (41 with current diagnoses of anxiety disorders and 27 controls) selected from a larger cross-sectional community sample of adolescents. Children and adolescents with anxiety disorders were categorized into two groups on the basis of anxiety severity (mild or severe). All participants underwent a neuropsychological assessment battery to evaluate attention, verbal episodic memory, working memory, visuoconstructive skills, and executive and cognitive functions. Results: No differences were found in any neuropsychological tests, with the single exception that the group with mild anxiety had better performance on the Digit Span backward test compared to subjects with severe anxiety and to controls (p = 0.041; η2 = 0.11). Conclusions: Not only might anxiety disorders spare main cognitive functions during adolescence, they may even enhance certain working memory processes.

Interaction between perceived maternal care, anxiety symptoms, and the neurobehavioral response to palatable foods in adolescents

Studies in rodents have shown that early life trauma leads to anxiety, increased stress responses to threatening situations, and modifies food intake in a new environment. However, these associations are still to be tested in humans. This study aimed to verify complex interactions among anxiety diagnosis, maternal care, and baseline cortisol on food intake in a new environment in humans. A community sample of 32 adolescents and young adults was evaluated for: psychiatric diagnosis using standardized interviews, maternal care using the Parental Bonding Inventory (PBI), caloric consumption in a new environment (meal choice at a snack bar), and salivary cortisol. They also performed a brain fMRI task including the visualization of palatable foods vs. neutral items. The study found a three-way interaction between anxiety diagnosis, maternal care, and baseline cortisol levels on the total calories consumed (snacks) in a new environment. This interaction means that for those with high maternal care, there were no significant associations between cortisol levels and food intake in a new environment. However, for those with low maternal care and who have an anxiety disorder (affected), cortisol was associated with higher food intake; whereas for those with low maternal care and who did not have an anxiety disorder (resilient), cortisol was negatively associated with lower food intake. In addition, higher anxiety symptoms were associated with decreased activation in the superior and middle frontal gyrus when visualizing palatable vs. neutral items in those reporting high maternal care. These results in humans mimic experimental research findings and demonstrate that a combination of anxiety diagnosis and maternal care moderate the relationship between the HPA axis functioning, anxiety, and feeding behavior in adolescents and young adults.

Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Non-Clinical Sample of Children and Adolescents in Saudi Arabia

This paper examined the reliability, convergent validity and factor structure of the self-report Screen for Child Anxiety Disorders (SCARED; Birmaher et al. in J Am Acad Child Adolesc Psychiatry 36:545-553, 1997) in a large community sample of children and adolescents in Saudi Arabia. The questionnaire showed moderate to high internal consistency and satisfactory test-retest reliability over a 2 week period. In addition, there were significant positive correlations between reported anxiety symptoms with parent report behavioural difficulties. The five factor structure model of the SCARED also had a good model fit in this population. The results showed that self-report anxiety symptoms decreased with age (for boys and not girls) and were higher in adolescent girls. The results suggest that the SCARED could be useful in this population to identify individuals who are at risk of developing anxiety disorders in childhood with a view to implementing prevention and intervention methods to ensure positive developmental outcome over time.

What can HPA axis-linked genes tell us about anxiety disorders in adolescents?

Introduction: Anxiety disorders (AD) share features of both anxiety and fear linked to stress response. The hypothalamic-pituitary-adrenal (HPA) axis is considered the core biological pathway of the stress system and it is known that an inappropriate response to environmental stimuli may be related to individual genetic vulnerability in HPA-linked genes. Despite the biological plausibility of a relationship between the HPA axis and AD, few studies have investigated associations between genetic polymorphisms linked to the HPA axis and this complex disorder. Objective: To investigate whether AD are associated with genetic polymorphisms in HPA-linked genes in adolescents. Methods: Our study consisted of a cross-sectional evaluation of a community sample comprising a total of 228 adolescents (131 cases of AD). We extracted DNA from saliva and genotyped polymorphisms in HPA-linked genes (FKBP5: rs3800373, rs9296158, rs1360780, rs9470080 and rs4713916; NR3C1: rs6198; CRHR1: rs878886; and SERPINA6: rs746530) with real time polymerase chain reaction (PCR). The instruments used to diagnose and assess the severity of AD were the Schedule for Affective Disorder and Schizophrenia for School-Age Children - Present and Lifetime (K-SADS-PL) and the Screen for Child and Anxiety related Emotional Disorders (SCARED). Results: We failed to detect any associations between AD and genetic polymorphisms in HPA-linked genes (p > 0.05). Conclusion: To our knowledge, this is the first study evaluating these specific polymorphisms in relation to AD in adolescents, which encourages us to design further research on the subject.

Factor Structure of the Screen for Child Anxiety-Related Emotional Disorders (SCARED) in a Community Sample of Hong Kong Chinese Adolescents

The current study tested the factor structure of the 41-item SCARED in assessing anxiety in a sample of Hong Kong adolescents. Data were collected from 5,226 youths (54.5 % boys) aged 12-18. Results showed that the scale and the five subscales had high internal consistency. However, confirmatory factor analyses showed that the original five-factor model did not fit the data collected in this sample. Instead, the results revealed a seven-factor model consisting of one second-order factor of anxiety and seven first-order factors: the four original factors of General Anxiety, Panic/Somatic Syndromes, Social Anxiety, and School Phobia and three new factors representing different aspects of Separation Anxiety. Group invariance in the Boys and Girls models was found. It is recommended that the three new factors (Fear of Loneliness, Separation Fear, Worry about Harm) be further developed by adding new items so as to enhance the content and construct validities of the SCARED when used with Hong Kong adolescents.

Die Erfassung von Ängsten im Urteil von Kindern/Jugendlichen und ihren Eltern

Zusammenfassung. Ziel dieser Arbeit ist die Analyse der psychometrischen Qualität des Fremd- und des Selbstbeurteilungsbogens zur Erfassung von Angst- und Zwangsstörungen (FBB-ANZ/SBB-ANZ) in zwei klinischen Stichproben (n = 182 bzw. n = 130). Ergänzend wurde die Faktorenstruktur der Bögen in zwei Feldstichproben (n = 724 bzw. n = 281) untersucht. Für die Skalen beider Fragebögen ergaben sich größtenteils zufriedenstellende interne Konsistenzen (.59 ≤ α ≤ .93). Exploratorische Hauptachsenanalysen mit Promax-Rotation ergaben stichprobenübergreifend für beide Fragebögen Faktoren, welche die a priori definierten, ICD-10- und DSM-IV-basierten Subskalen weitgehend abbilden. Zwischen den Subskalen innerhalb der Fragebögen zeigten sich geringe bis moderate Interkorrelationen, die für eine gute Abgrenzbarkeit der Skalen sprechen. Es fanden sich größtenteils moderate Beurteilerübereinstimmungen zwischen den korrespondierenden Skalen des Fremd- und Selbstbeurteilungsbogens. Die Ergebnisse weisen darauf hin, dass die Fragebögen überwiegend reliable und valide Instrumente darstellen. Weiterer Untersuchungsbedarf besteht insbesondere hinsichtlich der konvergenten und divergenten Validität der Subskalen.

Association between anxiety symptoms and problematic alcohol use in adolescents

BACKGROUND

Anxiety disorders are highly prevalent, affecting approximately 10% of individuals throughout life; its onset can be detected since early childhood or adolescence. Studies in adults have shown that anxiety disorders are associated with alcohol abuse, but few studies have investigated the association between anxiety symptoms and problematic alcohol use in early ages.

OBJECTIVE

To evaluate if anxiety symptoms are associated with problematic alcohol use in young subjects.

METHODS

A total of 239 individuals aged 10-17 years were randomly selected from schools located in the catchment area of Hospital de Clínicas de Porto Alegre. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) was used to evaluate the presence of anxiety symptoms, and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), to evaluate alcohol use.

RESULTS

One hundred twenty-seven individuals (53.1% ) reported having already used alcohol. Of these, 14 individuals showed problematic alcohol use (5.8% ). There was no association between lifetime use of alcohol and anxiety symptoms, but mean SCARED scores in individuals with problematic alcohol use was higher if compared to those without problematic use, even after adjustment for age and gender (29.9±8.5 vs. 23.7±11.8, p < 0.001).

CONCLUSIONS

Despite the limitation of a cross-sectional design, our study suggests that anxiety symptoms are associated with problematic alcohol use early in life.

High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results

The objective of this study is to present the rationale, methods, design and preliminary results from the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders. We describe the sample selection and the components of each phases of the study, its instruments, tasks and procedures. Preliminary results are limited to the baseline phase and encompass: (i) the efficacy of the oversampling procedure used to increase the frequency of both child and family psychopathology; (ii) interrater reliability and (iii) the role of differential participation rate. A total of 9937 children from 57 schools participated in the screening procedures. From those 2512 (random = 958; high risk = 1554) were further evaluated with diagnostic instruments. The prevalence of any child mental disorder in the random strata and high-risk strata was 19.9% and 29.7%. The oversampling procedure was successful in selecting a sample with higher family rates of any mental disorders according to diagnostic instruments. Interrater reliability (kappa) for the main diagnostic instrument range from 0.72 (hyperkinetic disorders) to 0.84 (emotional disorders). The screening instrument was successful in selecting a sub-sample with "high risk" for developing mental disorders. This study may help advance the field of child psychiatry and ultimately provide useful clinical information.

Anxiety disorders and anxiety-related traits and serotonin transporter gene-linked polymorphic region (5-HTTLPR) in adolescents: case-control and trio studies

The role of the serotonin transporter gene-linked polymorphic region (5-HTTLPR) in anxiety disorder and anxiety-related traits is controversial. Besides this study, few studies have evaluated the triallelic genotype in adolescents. The aim of this study was to investigate whether anxiety disorders and anxiety-related traits are associated with 5-HTTLPR (biallelic and triallelic) in adolescents, integrating both case-control-based and family-based designs in a community sample. This is a cross-sectional community study of 504 individuals and their families: 225 adolescents (129 adolescents with anxiety disorder and 96 controls) and their biological families. We assessed psychiatric diagnosis using the Kiddie Schedule for Affective Disorders and Schizophrenia. The Temperament and Character Inventory and the Resnick Behavioral Inhibition Scale were used to evaluate harm avoidance and behavioral inhibition. DNA was extracted from saliva and genotyped, including biallelic and triallelic 5-HTTLPR classification, by PCR-RFLP followed by agarose gel electrophoresis. We were not able to find any associations between 5-HTTLPR and anxiety-related phenotypes in both case-control and trio analyses. Further investigation and meta-analytic studies are needed to better clarify the inconsistent results with regard to the association between 5-HTTLPR and anxiety-related phenotypes in adolescents.

Screen for child anxiety related emotional disorders: are subscale scores reliable? A bifactor model analysis

The aim of this study was to investigate the utility of creating and scoring subscales for the self-report version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) by examining whether subscale scores provide reliable information after accounting for a general anxiety factor in a bifactor model analysis. A total of 2420 children aged 9-18 answered the SCARED in their schools. Results suggested adequate fit of the bifactor model. The SCARED score variance was hardly influenced by the specific domains after controlling for the common variance in the general factor. The explained common variance (ECV) for the general factor was large (63.96%). After accounting for the general total score (ωh=.83), subscale scores provided very little reliable information (ωh ranged from .005 to .04). Practitioners that use the SCARED should be careful when scoring and interpreting the instrument subscales since there is more common variance to them than specific variance.

Dysfunctional family environments and childhood psychopathology: the role of psychiatric comorbidity

INTRODUCTION

The study of the association between specific characteristics of family environments and different types of psychopathology may contribute to our understanding of these complex disorders and ultimately inform therapeutics.

OBJECTIVE

To compare the family characteristics of four groups: typically developing children; children with anxiety disorders only; children with externalizing disorders only; and children with both anxiety and externalizing disorders.

METHODS

This study enrolled 115 individuals from the community. Child psychiatrists made psychiatric diagnoses using a structured clinical interview. The Family Environment scale was used to evaluate six domains of family function.

RESULTS

The group with both anxiety and externalizing disorders had higher levels of conflict in family environment and lower levels of organization when compared with typically developing children. In addition, internalizing and externalizing symptoms were positively associated with conflict and negatively with organization. Maternal depressive and anxious symptoms were also associated with higher conflict and lower organization scores.

CONCLUSION

An important between-group difference in comorbid cases of anxiety and behavioral disorders suggests that children with this comorbidity are potential candidates for family interventions to address family conflicts and organizational aspects.

Analysis of the School Anxiety Inventory in Brazil Using the Rasch Rating Scale Model

This study assessed the quality of the items of the School Anxiety Inventory using the Rating-Scale Rasch model. The Inventory was administered to 253 grade school pupils, ranging in age from 9 to 12 yr. ( M = 10.2 yr., SD = 0.98); most were girls (52.8%). The results showed that the items and participants adequately fit the Rasch model. The average anxiety of these children was 0.32 logits ( SD = 1.60). The inventory items revealed good reliability (Item Reliability Index = 0.98; Cronbach's α = .74), and the fit indicators for the response categories were adequate for 50% of the items, while the other items revealed dichotomous responses. No item functioned differentially for boys and girls. The psychometric properties of the inventory were good enough to encourage plans for further development.

Psychometric properties of the Brazilian-Portuguese version of the Spence Children's Anxiety Scale (SCAS): self- and parent-report versions

This study examined the psychometric properties of the Spence Children's Anxiety Scale (SCAS) self- and parent-report versions in a community (n=712) and a clinical (n=70) sample of Brazilian children and adolescents. Confirmatory factor analysis conducted in the community sample provided support to the original six correlated factors model of the SCAS. Moreover, the SCAS demonstrated good internal consistency, convergent and divergent validity, and a significant informant effect on the total score with higher anxiety levels in the self-report than in the parent-report version. Considering the clinical sample, we could demonstrate that the SCAS total scores have good discriminant validity differentiating: (a) anxious, community, and negative screening groups; and (b) children diagnosed with different severity levels of anxiety disorders. Our findings suggest that the SCAS (self- and parent-report versions) is suitable for assessing anxiety symptoms in Brazilian children and adolescents in community and clinical settings.

Correlation between n-3 polyunsaturated fatty acids consumption and BDNF peripheral levels in adolescents

Background

Although several studies have reported an association between mental disorders and serum levels of brain-derived neurotrophic factor (BDNF), this association is still poorly understood. The study of factors associated with both BDNF levels and mental disorders, such as n-3 polyunsaturated fatty acids (n-3 PUFAs), may help to elucidate the mechanisms mediating the relationship between the two variables. Therefore, the present study aimed to evaluate whether the intake n-3 PUFAs correlates with serum levels of BDNF.

Findings

This study involved 137 adolescents drawn from a community sample, including a group with high levels of anxiety, assessed using the Screen for Children and Anxiety Related Emotional Disorders. Blood samples were collected and serum BDNF levels were measured. n-3 PUFAs were estimated using a food frequency questionnaire for adolescents. Correlations were performed to assess the association between n-3 PUFAs intake and BDNF levels. Effects of potential confounders (total fat consumption, age, gender and anxiety) were examined using linear regression models. There was a direct correlation between n-3 PUFAs consumption and serum BDNF levels, which remained significant even after accounting for potential confounders.

Conclusions

We were able to detect a correlation between n-3 PUFAs intake and peripheral BDNF levels. Our study was limited by its small sample size, and our external validity may be restricted by the oversampling of anxious adolescents. Our findings may help determine the nature of the association between mental disorders and serum levels of BDNF. However, more studies are needed to elucidate the possible mechanisms by which n-3 PUFAs intake affects BDNF levels, and how this may lead to an increased vulnerability to psychiatric disorders.

Validation of the Kirundi versions of brief self-rating scales for common mental disorders among children in Burundi

BACKGROUND

In Sub Saharan Africa, there has been limited research on instruments to identify specific mental disorders in children in conflict-affected settings. This study evaluates the psychometric properties of three self-report scales for child mental disorder in order to inform an emerging child mental health programme in post-conflict Burundi.

METHODS

Trained lay interviewers administered local language versions of three self-report scales, the Depression Self-Rating Scale (DSRS), the Child PSTD Symptom Scale (CPSS) and the Screen for Child Anxiety Related Emotional Disorders (SCARED-41), to a sample of 65 primary school children in Burundi. The test scores were compared with an external 'gold standard' criterion: the outcomes of a comprehensive semistructured clinical psychiatric interview for children according the DSM-IV criteria (the Schedule for Affective Disorders and Schizophrenia for School-Age Children - K-SADS-PL).

RESULTS

The DSRS has an area under the curve (AUC) of 0.85 with a confidence interval (c.i.) of 0.73-0.97. With a cut-off point of 19, the sensitivity was 0.64, and the specificity was 0.88. For the CPSS, with a cut-off point of 26, the AUC was 0.78 (c.i.: 0.62-0.95) with a sensitivity of 0.71 and a specificity of 0.83. The AUC for the SCARED-41, with a cut-off point of 44, was 0.69 (c.i.: 0.54-0.84) with a sensitivity of 0.55 and a specificity of 0.90.

CONCLUSIONS

The DSRS and CPSS showed good utility in detecting depressive disorder and posttraumatic stress disorder in Burundian children, but cut-off points had to be put considerably higher than in western norm populations. The psychometric properties of the SCARED-41 to identify anxiety disorders were less strong. The DSRS and CPSS have acceptable properties, and they could be used in clinical practice as part of a two-stage screening procedure in public mental health programmes in Burundi and in similar cultural and linguistic settings in the African Great Lakes region.

Pediatric anxiety disorders: from neuroscience to evidence-based clinical practice

The objective of this narrative review of the literature is to describe the epidemiology, etiology, pathophysiology, diagnosis, and treatment of pediatric anxiety disorders. We aim to guide clinicians in understanding the biology of anxiety disorders and to provide general guidelines for the proper diagnoses and treatment of these conditions early in life. Anxiety disorders are prevalent, associated with a number of negative life outcomes, and currently under-recognized and under-treated. The etiology involves both genes and environmental influences modifying the neural substrate in a complex interplay. Research on pathophysiology is still in its infancy, but some brain regions, such as the amygdala and the prefrontal cortex, have been implicated in fear and anxiety. Current practice is to establish diagnosis based purely on clinical features, derived from clinical interviews with the child, parents, and teachers. Treatment is effective using medication, cognitive behavioral therapy, or a combination of both. An introduction to the neuroscience behind anxiety disorders combined with an evidence-based approach may help clinicians to understand these disorders and treat them properly in childhood.

Victims and bully-victims but not bullies are groups associated with anxiety symptomatology among Brazilian children and adolescents

School bullying is frequent and is associated with a broad spectrum of psychiatric problems. The aims of this study were to examine the prevalence of bullying behaviors in a large sample of Brazilian children and adolescents and to investigate the association between bullying behaviors and DSM-IV anxiety symptomatology. This cross-sectional study involved completion of a questionnaire about bullying behaviors and their frequency and the Screen for Child Anxiety-Related Emotional Disorders (SCARED) that is a self-report screening tool for childhood anxiety disorders by 2,355 students. A total of 22.9 % of the sample reported frequent involvement in bullying, as a bully (7.6 %), as a victim (5.7 %), or as a bully-victim (9.6 %). In general, our findings showed that students involved in bullying behaviors, as victims or bully-victims, were more likely to have higher scores in SCARED total and its subscales than bullies and than uninvolved students. The prevalence of bullying behaviors among Brazilian youth is about average when compared with previous samples described in the literature. Victims and bully-victims, but no bullies, are groups associated with higher anxiety symptomatology.

Reliability and validity of the Arabic Screen for Child Anxiety Related Emotional Disorders (SCARED) in a clinical sample

This study aimed at investigating the reliability and validity of the Arabic Screen for Child Anxiety Related Emotional Disorders (SCARED) as a first child and adolescent anxiety screening tool in the Arab World. The English parent (SCARED-P) and child (SCARED-C) versions were translated into Arabic and administered along with the Arabic Strengths and Difficulties Questionnaire (SDQ) to 77 parents and 67 children attending a Psychiatry clinic. DSM-IV-TR diagnoses were made by a psychiatrist without knowledge of the scale scores. Internal consistency was confirmed by Cronbach's α=0.92 for SCARED-P and 0.91 for SCARED-C. Their subscales had internal consistencies between 0.65 and 0.89. Parent-child agreement was r=0.67, p<0.001. SCARED-P demonstrated good discriminant validity between participants with anxiety disorders and those with other psychiatric disorders (t(72)=3.13, p=0.003). For SCARED-C, this difference was significant when participants with depressive disorders were excluded (t(43)=2.58, p=0.01). Convergent validity was evident through a significant correlation between SCARED-P and the parent SDQ emotional subscale (r=0.70, p<0.001), and SCARED-C and the child SDQ emotional subscale (r=0.70, p<0.001). Divergent validity with the SDQ hyperactivity subscale was observed as no significant correlation was found. Overall, the Arabic SCARED demonstrated satisfactory psychometric properties in a clinical sample in Lebanon.

Psychometric properties of the Persian version of the screen for child anxiety-related emotional disorders (SCARED)

The present study examined the psychometric properties of the Persian translation of the Screen for Child Anxiety-Related Emotional Disorders-child version (SCARED-C) in a community sample of 557 children, aged 9-13 years, in the city of Isfahan, Iran. In addition to the SCARED-C, all the participants completed the Revised Children's Manifest Anxiety Scale (RCMAS) and the Children's Depression Inventory (CDI). The SCARED-C demonstrated moderate to high internal consistency (alpha=0.59-0.80) and good convergent and divergent validity. The one-factor and the five-factor model of the SCARED-C fitted the data moderately. However, the five-factor model had a significantly better fit than the one-factor model (Δχ(2)=287.346, df=10, P<.001). These findings showed that SCARED-C can be used as a reliable and valid measure of anxiety symptoms among children in Iran.

Sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a community-based study

The aim of this cross-sectional community-based study was to examine the sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED) to the diagnosis of anxiety disorders (AD). Participants were 119 students aged 9-18. Psychiatric diagnoses were assessed by a psychiatrist throughout a structural clinical interview (K-SADS-PL). Forty-four participants had positive diagnosis for at least one AD. The total score of the SCARED significantly differentiated anxious from non-anxious children with an optimal cutoff point of 22 (sensitivity = 81.8 %; specificity = 52.0 %). SCARED subscales of social phobia and separation anxiety disorder, but not generalized anxiety disorder, revealed better discrimination proprieties than total scores to screen for that specific disorder (p < .05). Both total and specific SCARED scores presented moderate sensitivity and specificity for detecting AD in a community sample. Investigators interested in screening for specific AD, rather than the group of AD, may benefit from using the specific subscales.

Cognitive-behavioral group therapy for youths with anxiety disorders in the community: effectiveness in low and middle income countries

BACKGROUND

Although cognitive-behavioral therapy (CBT) is established as a first line treatment for anxiety disorders in children and adolescents, there is little evidence about the effectiveness of CBT protocols in cases identified in the community in low and middle income countries (LaMICs).

AIMS

To evaluate the effectiveness of group CBT protocol for youths with anxiety disorders identified in a community sample in LaMICs.

METHOD

A total of 14 sessions of group CBT for youths and 2 concurrent sessions for parents based on Kendall's Coping Cat program were offered. Participants were selected from a cross-sectional community study; 45 subjects fulfilled inclusion criteria and 28 agreed to participate in the open clinical trial. Treatment effectiveness was evaluated with standard clinical, self- and parent-rated measures of anxiety, depression, externalizing symptoms and quality of life (QoL).

RESULTS

Twenty youths completed the protocol. All scales showed an improvement of anxiety and reduction in externalizing symptoms over time, with a moderate to large effect size (d = 0.59 to 2.06; p < .05), but not in depressive symptoms or QoL.

CONCLUSIONS

Consistent with previous evidence, group CBT is effective in treating anxiety disorders in youths. Results encourage further randomized clinical trials using CBT protocols adapted and developed to be used in LaMICs.

Evaluación de la motivación académica y la ansiedad escolar y posibles relaciones entre ellas

La motivación académica y la ansiedad en el contexto académico son factores determinantes en la vida del alumno, tanto desde el punto de vista emocional como de rendimiento. El objeto de este estudio fue evaluar la motivación y la ansiedad académica en estudiantes y realizar análisis de correlación y regresión entre la motivación académica y la ansiedad escolar. Los niños obtuvieron puntuaciones bajas de ansiedad y moderadas de motivación general, niveles por encima del promedio de motivación extrínseca y por debajo del promedio de motivación intrínseca. El análisis de correlación indicó que todas las correlaciones fueron significativas y que todas fueron positivas, excepto las correlaciones entre la ansiedad y la motivación intrínseca y entre la motivación intrínseca y extrínseca, que fueron negativas. El análisis de regresión reveló que la motivación extrínseca explica una parte significativa de la ansiedad. Esos datos elucidan la relación existente entre los dos tipos de motivación y la ansiedad escolar.

Associations between parenting behavior and anxiety in a rodent model and a clinical sample: relationship to peripheral BDNF levels

Adverse early-life environment is associated with anxiety-like behaviors and disorders. Brain-derived neurotrophic factor (BDNF) is sensitive to this environment and could be a marker of underlying brain changes. We aimed at evaluating the development of anxiety-like behaviors in a rat model of early adversity, as well as the possible association with BDNF levels. Similar associations were investigated in a sample of adolescent humans. For the rat study, Wistar rat litters were divided into: early-life stress (ELS, limited access to nesting material) and control groups. Maternal behavior was observed from days 1 to 9 of life and, as adults, rats were subjected to behavioral testing and BDNF measurements in plasma, hippocampus, amygdala and periaqueductal gray. For the human study, 129 adolescents were evaluated for anxiety symptoms and perceived parental care. Serum BDNF levels and the Val66Met polymorphism of the BDNF gene were investigated. We found that ELS dams showed more pure contact, that is, contact with low care and high control, toward pups, and their adult offspring demonstrated higher anxiety-like behaviors and plasma BDNF. Also the pure contact correlated positively with adult peripheral BDNF. Similarly in humans, there was a positive correlation between maternal overprotection and serum BDNF only in Met carriers. We also found negative correlations between maternal warmth and separation anxiety, social phobia and school phobia. Finally, our translational approach revealed that ELS, mediated through variations in maternal care, is associated with anxiety in both rats and humans and increased peripheral BDNF may be marking these phenomena.

Brazilian Portuguese version of the Spence Children's Anxiety Scale (SCAS-Brasil)

Objective: To describe the cross-cultural adaptation of the Spence Children's Anxiety Scale (SCAS) for use in Brazil. Methods: Cross-cultural adaptation followed a four-step process, based on specialized literature: 1) investigation of conceptual and item equivalence; 2) translation and back-translation; 3) pretest; and 4) investigation of operational equivalence. All these procedures were carried out for both the child and the parent versions of the SCAS. Results: A final Brazilian version of the instrument, named SCAS-Brasil, was defined and is presented. Conclusion: The SCAS-Brasil instrument seems to be very similar to the original SCAS in terms of conceptual and item equivalence, semantics, and operational equivalence, suggesting that future cross-cultural studies may benefit from this early version. As a result, a new instrument is now available for the assessment of childhood anxiety symptoms in community, clinical, and research settings.

Reliability and convergent validity of the Childhood Anxiety Sensitivity Index in children and adolescents

OBJECTIVE: The purpose of this study was to examine the reliability and the convergent validity of the Children Anxiety Sensitivity Index (CASI) with DSM-IV anxiety disorder symptoms, by comparison with the Screen for Child Anxiety Related Emotional Disorders (SCARED), in a community sample of Brazilian children and adolescents. METHODS: Children and adolescents from five schools were selected from a larger study that aimed to assess different aspects of childhood anxiety disorders. All participants completed the CASI and the SCARED. RESULTS: This study supported the reliability of the CASI total score. Girls reported higher total anxiety sensitivity scores than boys and there were no differences in total anxiety sensitivity scores between children and adolescents. This study showed moderate to high correlations between the CASI scores with SCARED scores, all correlations coefficients being positive and significant. CONCLUSIONS: Our findings demonstrate an appropriate reliability and evidence of convergent validity in the CASI in a sample of Brazilian children and adolescents.