Improving screening cut-off scores for DSM-5 adolescent anxiety disorder symptom dimensions with the Screen for Child Anxiety Related Emotional Disorders (SCARED)

Abstract

Presently most adolescent anxiety disorder screening instruments make their determination of running a high risk for an anxiety disorder on the basis of a cut-off score measured by a single screening which can lead to false positives. Therefore, the goal of this study is to examine whether a repeated administration of the SCARED screening instrument for DSM-5 anxiety disorder symptoms could help in the detection of true positives while also avoiding false positives. Participants were 923 early adolescents from the general community.The adolescents’ ages at the first annual screening ranged from 10 to 15 with an average of 12.5 years. In a prospective five-year longitudinal design, the adolescents completed the SCARED screening instrument for anxiety disorder symptoms on a yearly basis. To detect true positives and avoid false positives, the data were analyzed with Receiver Operating Characteristics (ROC) cut-off score analyses. ROC cut-off score analyses revealed that the sensitivity and specificity of high risk were greatly improved for repeated screenings above those of a single screening. The findings of this study demonstrate that a screening instrument (such as the SCARED) should be administered not just once but several times in order to better determine true positives and avoid false positives.