The Validity of the Screen for Child Anxiety Related Emotional Disorders for Assessment of Anxiety Disorders Among Kenyan Youth

Abstract

This study investigated the structural equivalence of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the assessment of anxiety disorders among youth (8-16 years) from low social economic backgrounds in Kenya. Respondents were 163 students from two mixed-sex public primary day schools, whose first language was either the native language or Swahili. They completed the SCARED (English version), a 41-item questionnaire with a cutoff score of 25 out of 82 for presence of anxiety disorders. The overall prevalence rate and severity was 79.1% (Mean [μ] =33.67) and for the different syndromes it was; (separation anxiety; 78.5%, μ =7.36, 5 items, generalized anxiety; 35.6%, μ =6.96, 9 items, panic disorder;

72.4%, μ =10.06, 13 items, social anxiety; 83%, μ =7.45, 8 items, significant school avoidance; 29.4%, μ= 1.85, 3 items). An exploratory factor analysis revealed that 37 of the 41 items had high loadings (0.453- 0.826) showing that the SCARED could assess anxiety for this sample. As for the different anxiety syndromes, a 14-factor model was produced where only 3 factors (generalized anxiety, panic disorder, social anxiety) had items loading accordingly, each having only 4 items. The inability of the items to load into the sub-scales accordingly may be attributed to a combination of cultural differences between Kenyan children and the Western children on whom the scale was initially normed. In addition, the complexity of the sentence structures of some items, which may have been confusing for the non-native English-speaking students. Nevertheless, the SCARED can be used as a measure for prevalence and severity of overall anxiety disorders, but caution needs to be taken when differentiating between the anxiety syndromes in these differing cultural contexts.