The Utility of Clinicians Ratings of Anxiety Using the Pediatric Anxiety Rating Scale (PARS)
- 470 Downloads
Clinician ratings of anxiety hold the promise of clarifying discrepancies often found between child and parent reports of anxiety. The Pediatric Anxiety Rating Scale (PARS) is a clinician-administered instrument that assesses the frequency, severity, and impairment of common pediatric anxiety disorders and has been used as a primary outcome measure in several landmark treatment trials. However, no data on nonanxious youth have been published. The purpose of this study was to address this gap by examining clinician’s ratings of anxiety on the PARS in a volunteer sample of youth without anxiety disorders (n = 84; ages 7–12; 51% female, 75% Caucasian). The nonanxious sample was comprised of youth with (At-risk; n = 36) and without (Healthy; n = 48) anxious parents. Data were also used to evaluate the reliability (i.e., internal consistency), convergent, and divergent validity of the clinician-rated PARS. In addition, a receiver operating curve analysis was used to determine optimum cut off scores indicative of clinical levels of anxiety by comparing PARS scores between these nonanxious youth and a clinically anxious sample (n = 77) randomized in the Research Units of Pediatric Psychopharmacology (RUPP) anxiety study (RUPP 2001). Results indicated that anxious and nonanxious youth were significantly different on all PARS severity items. Optimum cutoff scores of 11.5 (5-item total score) and 17.5 (7-item total score) discriminated youth with and without anxiety disorders. Cronbach alphas for the Healthy and At-risk sample were .90 and .91 and .75 and .81 for the 5- and 7-item total PARS scores respectively, supporting the measure’s internal consistency among nonanxious youth. PARS total scores were positively correlated with other measures of anxiety (i.e., the Screen for Child Anxiety Related Emotional Disorders) for the At-risk but not Healthy subsample. PARS scores were not significantly correlated with depressive symptoms (i.e., Children’s Depression Inventory). Overall, findings support the utility of clinician’s assessments of anxiety symptoms for nonanxious youth. Using the PARS can help facilitate determining whether a child’s anxiety level is more similar to those with or without an anxiety disorder.
KeywordsAnxiety Children Adolescents Rating scales Assessment
This study was supported by a grant from the National Institute of Mental Health (K23 MH63427-02) awarded to the first author and by an unrestricted-investigator initiated research grant from Pfizer awarded to the first and third authors.
- Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the screen for child anxiety related emotional disorders (SCARED): A replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–1236.PubMedCrossRefGoogle Scholar
- Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., et al. (1997). The screen for child anxiety related emotional disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 545–553.PubMedCrossRefGoogle Scholar
- Ginsburg, G. S., & Riddle, M. (2005). Pediatric anxiety rating scale: Revisions and normative data. Groton: Grant from Pfizer Pharmaceuticals.Google Scholar
- Kovacs, M. (1992). Children’s depression inventory (CDI) manual. North Tonawanda, NY: Multi-Health Systems, Inc.Google Scholar
- Leckman, J. F., Riddle, M. A., Hardin, M. T., Ort, S. I., Swartz, K. L., Stevenson, J., et al. (1989). The Yale Global Tic Severity Scale: Initial testing of a clinician-rated scale of tic severity. Journal of the American Academy of Child and Adolescent Psychiatry, 28(4), 566–573.PubMedCrossRefGoogle Scholar
- Muris, P., Merckelbach, H., Mayer, B., van Brakel, A., Thissen, S., Moulaert, V., et al. (1998). The screen for child anxiety related emotional disorders (SCARED) and traditional childhood anxiety measures. Journal of Behavior Therapy and Experimental Psychiatry, 29(4), 327–339.PubMedCrossRefGoogle Scholar
- Pintea, S., & Moldovan, R. (2009). The receiver-operating characteristic (ROC) analysis: Fundamentals and applications in clinical psychology. Journal of Cognitive and Behavioral Psychotherapies, 9(1), 49–66.Google Scholar
- Poznanski, E. O., & Mokros, H. B. (1996). Children’s depression rating scale (CDRS-R). Austin, TX: Pro-Ed.Google Scholar
- Silverman, W., & Albano, A. (1996). The anxiety disorders interview schedule for children–IV (Child and parent versions). San Antonio, TX: Psychological Corporation.Google Scholar
- Silverman, W. K., Saavedra, L. M., & Pina, A. A. (2001). Test-retest reliability of anxiety symptoms and diagnoses with anxiety disorders interview schedule for DSM-IV: Child and parent versions. Journal of the American Academy of Child and Adolescent Psychiatry, 40(8), 937–944.PubMedCrossRefGoogle Scholar