International Journal of Clinical Science and Medical Research

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.

Anxiety, SCARED, Adolescents, Children, Assessment, Culture, Emotions, Relevance, Validity

1. Amani, M. (2022). Prevalence and Predictors of Anxiety Disorder among Adolescents In  Selected Mixed Public Secondary Schools In Dagoretti South Sub County, Nairobi County, Kenya. [Unpublished Master’s Thesis]. Daystar University, Nairobi, Kenya.
2. American Psychiatric Association [APA]. (2013). Diagnostic and Statistical Manual of  Mental Disorders (5th ed.). American Psychiatric Publishing. 
3. Ang C. S. (2020). Anxiety in Malaysian children and adolescents: validation of the Screen for Child Anxiety Related Emotional Disorders (SCARED). Trends in psychiatry and psychotherapy, 42(1), 7–15. https://doi.org/10.1590/2237-6089-2018-0109 
4. Arab, A., Keshky, M.E., & Hadwin, J.A. (2016). Psychometric properties of the Screen for Child Anxiety and Related Emotional Disorders (SCARED) in a non-clinical sample of children and adolescents in Saudi Arabia. Child Psychiatry and Human Development, 47, 554-562. https://doi.org/10.1007/s10578-015-0589-0 
5. California Evidence-Based Clearing House for Child Welfare. (n.d). Screen For  Childhood Anxiety Related Emotional Disorders (SCARED). Developers; Birmaher, B., Brent, D., Chiappetta, L., Bridge, J., Monga, S. Baugher, M. Western Psychiatric Institute & Clinic, Department of Child Psychology. 
6. Canals, J., Voltas, N., Hernández-Martínez, C., Cosi, S., & Arija, V. (2019). Prevalence  of DSM-5 anxiety disorders, comorbidity, and persistence of symptoms in Spanish early adolescents. Eur Child Adolesc Psychiatry, 28(1), 131-143. https://doi.org/10.1007/s00787-018-1207-z. 
7. Dzokoto, Vivian. (2010). Different ways of feeling: Emotion and somatic awareness in  Ghanaians and Euro-Americans. Journal of Social, Evolutionary, and Cultural Psychology. 4. 68. 10.1037/h0099299. 
8. Ivarsson, T., Skarphedinsson, G., Andersson, M., & Jarbin, H. (2018). The validity of the Screen for Child Anxiety Related Emotional Disorders Revised (SCARED-R) scale and sub-scales in Swedish youth. Child Psychiatry and Human Development, 49,234.https://doi.org/10.1007/s10578-017-0746-8 
9. Lindquist, K. A., MacCormack, J. K., & Shablack, H. (2015). The role of language in  emotion: predictions from psychological constructionism. Frontiers in psychology, 6, 444. https://doi.org/10.3389/fpsyg.2015.00444 
10. Mathenge, J., Ayuya C., Ongaro K.,&  Khasakhala L. (2019). Prevalence and Correlation of  Anxiety Disorders among Primary School Children in Nairobi, Kenya. International 
11. Journal of Humanities Social Sciences and Education (IJHSSE) Volume 6, Issue 12, December 2019, PP 134-138 ISSN 2349-0373 (Print) & ISSN 2349-0381 (Online) http://dx.doi.org/10.20431/2349-0381.0612011 www.arcjournals.org 
12. Mohammadi, M.R., Pourdehghan, P., Mostafavi, S.A., Hooshyari, Z., Ahmadi, N.,  Khaleghi, A. (2020). Generalized anxiety disorder: Prevalence, predictors, and comorbidity in children and adolescents. J Anxiety Disord., 73:102234. 1016/j.janxdis.2020.102234. 
13. Muris, P., Loxton, H., Neumann, A., Plessis, M., King, N., & Ollendick, T.(2006). DSM- defined anxiety disorders symptoms in South African youths: Their assessment and relationship with perceived parental rearing behaviors. Behavior Research and Therapy, 44(6), 883-896. 
14. Muris, P., & Steerneman, P. (2010). The revised version of the Screen for Child  Anxiety Related Emotional Disorders (SCARED‐R): First evidence for its reliability and validity in a clinical sample. British Journal of Psychology. 
15. Ndetei, D. M., Khasakhala, L., Seedat, S., Syanda, J., Ongecha-Owuor, F., Kokonya,  D.A., & Mutiso, V.  (2008). Psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) amongst Nairobi public secondary school children, Kenya. Journal of Child and Adolescent Mental Health, 20(2),101-109.https://doi.org/10.2989/JCAMH.2008.20.2.6.689
16. Olofsdotter, S., Vadlin, S.,Sonnby, K.,  Furmark, Nilsson, K. (2016).  Anxiety disorders  among adolescents referred to general psychiatry for multiple causes: Clinical presentation, prevalence, and comorbidity.  Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 4(2), 55-64, https://doi.org/10.21307/sjcapp2016-010 
17. Russell, P. S., Nair, M. K., Russell, S., Subramaniam, V. S., Sequeira, A. Z., Nazeema, S., & George, B. (2013). ADad 2: the validation of the Screen for Child Anxiety Related Emotional Disorders for Anxiety Disorders among adolescents in a rural community population in India. Indian journal of pediatrics, 80 Suppl 2, S139–S143. https://doi.org/10.1007/s12098-013-1233-2 
18. Su, L., Wang, K., Fan, F., Su, Y., & Gao, X. (2008). Reliability and validity of the screen for child anxiety related emotional disorders (SCARED) in Chinese children. Journal of Anxiety Disorders, 22(4), 612–621. https://doi.org/10.1016/J.JANXDIS.2007.05.011