Full Answer Section

Instrument Analysis: Assessing Anxiety and OCD in Children and Adolescents

Here’s an analysis of instruments for diagnosing anxiety and OCD in children and adolescents, focusing on the psychometrics, limitations, and appropriateness:

Anxiety in Children and Adolescents:

Instrument: The Screen for Child Anxiety Related Emotional Disorders (SCARED) (Birmaher et al., 1999)

Scholarly Article: “The Screen for Child Anxiety Related Emotional Disorders (SCARED): A Reliable and Valid Instrument for Assessing Anxiety Disorders in Children and Adolescents” by Birmaher et al. (1999).

Appropriateness for Diagnosis:

• Designed for Comprehensive Assessment: The SCARED is not a standalone diagnostic tool. While it provides a comprehensive screen for anxiety-related disorders, it is intended to be part of a comprehensive assessment that includes clinical interview and other relevant information. The developers emphasize this in their publication.

Measurement of Patient Response to Therapy:

• Limited Usefulness: The SCARED is primarily designed for screening and diagnosis, not for measuring treatment outcomes. Other instruments specifically developed for measuring change over time are better suited for tracking therapeutic response.

Psychometrics:

• Reliability: Demonstrated high internal consistency reliability (alpha coefficients typically above .80). Test-retest reliability has also been supported.

• Validity: The SCARED demonstrates good concurrent validity with other standardized anxiety measures and predictive validity in identifying children at risk for future anxiety disorders.

Limitations:

• Self-Report: The SCARED relies on self-report, which can be influenced by factors like child’s age, comprehension, and willingness to disclose information.

• Limited Scope: While comprehensive, the SCARED does not assess all anxiety disorders (e.g., social anxiety, generalized anxiety).

• Cultural Considerations: May need to be adapted for use with culturally diverse populations to ensure appropriate interpretation and translation.

OCD in Children and Adolescents:

Instrument: The Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) (March et al., 1994)

Scholarly Article: “The Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS): A Multidimensional Diagnostic and Severity Measure for Obsessive-Compulsive Disorder in Children and Adolescents” by March et al. (1994).

Appropriateness for Diagnosis:

• Designed for Diagnosis and Severity: The CY-BOCS is a widely accepted, reliable, and valid instrument for diagnosing OCD in children and adolescents. It provides a comprehensive assessment of the severity of symptoms.

Measurement of Patient Response to Therapy:

• Useful for Measuring Change: The CY-BOCS is frequently used to track changes in symptom severity over time, making it valuable for monitoring treatment effectiveness.

Psychometrics:

• Reliability: High internal consistency (alpha coefficients typically above .90) and test-retest reliability.

• Validity: Demonstrated good concurrent validity with other OCD measures and good predictive validity for identifying individuals with OCD.

Limitations:

• Time-Consuming: The CY-BOCS is a structured interview that can be time-consuming to administer, potentially limiting its use in busy clinical settings.

• Clinician Expertise: Requires experienced clinicians trained in administering and scoring the CY-BOCS accurately.

• Cultural Considerations: May need adaptations for use with culturally diverse populations.

Conclusion:

Both the SCARED and CY-BOCS are valuable instruments for assessing anxiety and OCD in children and adolescents. However, it’s important to recognize that neither is a standalone diagnostic tool. They are best used within a comprehensive assessment process that includes clinical interview, behavioral observation, and review of relevant information.