Development of a brief assessment tool to identify children with probable anxiety disorders

Author:

Reardon Tessa1ORCID,Ukoumunne Obioha C.2,Ball Susan2ORCID,Brown Paul3,Ford Tamsin4ORCID,Gray Alastair5,Hill Claire6,Jasper Bec7,Larkin Michael8,Macdonald Ian9,Morgan Fran10,Sancho Michelle11,Sniehotta Falko F.1213,Spence Susan H.14ORCID,Stainer Jason15,Stallard Paul16,Violato Mara5ORCID,iCATS Team 117,Creswell Cathy117ORCID

Affiliation:

1. Departments of Experimental Psychology and Psychiatry University of Oxford UK

2. NIHR ARC South West Peninsula (PenARC) Department of Health and Community Sciences Faculty of Health and Life Sciences University of Exeter UK

3. Bransgore C of E Primary School UK

4. University of Cambridge and Cambridge and Peterborough Foundation Trust UK

5. Health Economics Research Centre Nuffield Department of Population Health University of Oxford UK

6. School of Psychology & Clinical Language Sciences University of Reading UK

7. Parents and Carers Together Suffolk UK

8. Life and Health Sciences Aston University Birmingham UK

9. Charlie Waller Trust UK

10. Square Peg UK

11. West Berkshire Council Newbury UK

12. NIHR Policy Research Unit Behavioural Science Newcastle University UK

13. Division of Public Health Social and Preventive Medicine Center for Preventive Medicine and Digital Health (CPD) Universitätsmedizin Mannheim Heidelberg University Heidelberg Germany

14. School of Applied Psychology and Australian Institute of Suicide Research and Prevention Griffith University Australia

15. Stanley Primary School London UK

16. Department of Health University of Bath UK

17. Oxford NHS Foundation Trust UK

Abstract

AbstractBackgroundDifficulties identifying anxiety disorders in primary‐school aged children present significant barriers to timely access to support and intervention. This study aimed to develop a brief assessment tool that can identify children with anxiety disorders in community settings, with a high level of sensitivity and specificity.MethodsChildren (aged 8–11 years), and their parents/carers and teachers from 19 primary/junior schools in England each completed a pool of questionnaire items that assessed child anxiety symptoms and associated impact. Diagnostic assessments (Anxiety Disorder Interview Schedule for Children: Child and Parent interviews) were administered by independent assessors to determine the presence/absence of anxiety disorders in children. We created alternative candidate brief child‐, parent‐, teacher‐report questionnaires consisting of the ‘best’ items selected from the wider pool of completed items. We used exploratory factor analysis to reduce the item pool, and multivariable backward elimination logistic regression to identify items that were the strongest predictors of the presence/absence of an anxiety disorder.ResultsParents/carers of 646 children provided consent; child/parent/teacher‐report questionnaires were collected for 582/646/565 children respectively; and diagnostic outcome data were collected for 463 children. None of the brief child‐ nor teacher‐report questionnaires achieved acceptable sensitivity/specificity (<75%). Parent‐report questionnaires including between 2 and 9 items that assess anxiety symptoms and/or associated impact achieved acceptable sensitivity and specificity (≥75%).ConclusionsThe two‐item parent‐report measure that assesses distress and impairment associated with anxiety brings the advantage of brevity and has the potential to be used in community settings to improve identification of children with anxiety disorders.

Funder

Programme Grants for Applied Research

National Institute for Health and Care Research

Publisher

Wiley

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