Psychometric Evaluation of Two Short Versions of the Revised Child Anxiety and Depression Scale

Abstract Background Anxiety and depression are common in children and adolescents. These disorders can be detected via self-report screening questionnaires in a non-clinical setting like the school environment. Two short versions of the Revised Child Anxiety and Depression Scale (i.e., RCADS-25 and RCADS-20) seem to be feasible for administering in schools. However, it should be examined whether its promising psychometric properties can be replicated and whether knowledge on remaining psychometric properties can be added. This study evaluates the psychometric properties of the RCADS-25 and RCADS-20 used as screening instruments for anxiety and depression in schoolchildren and adolescents. Methods The RCADS-25 was completed by 69,487 schoolchildren and adolescents age 8 to 18 years. The RCADS-25/RCADS-20 broad anxiety scale (15 items), the RCADS-25 major depressive disorder (MDD) scale (10 items), and the RCADS-20 MDD scale (5 items) were assessed on construct validity (structural validity and hypotheses testing), reliability (internal consistency and test-retest reliability), and criterion validity in conformance with internationally consensus-based COSMIN definitions, taxonomy and quality criteria. Results The RCADS-25/RCADS-20 broad anxiety scale demonstrated a sufficient structural validity (CFI = 0.98, TLI = 0.99, RMSEA = 0.03, SRMR = 0.03), internal consistency (alpha = 0.82), test-retest reliability (ICC = 0.73), criterion validity (AUC = 0.79), and all four hypotheses concerning construct validity were confirmed. The RCADS-25 MDD scale demonstrated a sufficient test-retest reliability (ICC=0.70), and three out of four hypotheses testing construct validity were confirmed, but its structural validity was suspect (CFI = 0.89, TLI = 0.94, RMSEA = 0.09, SRMR = 0.06). The RCADS-20 MDD scale demonstrated a sufficient structural validity (CFI = 0.97, TLI = 0.97, RMSEA = 0.08, SRMR = 0.04) and internal consistency (alpha = 0.72), but two out of four hypotheses concerning construct validity were confirmed, while the test-retest reliability (ICC = 0.60) seemed insufficient. Conclusions The RCADS-25/RCADS-20 broad anxiety scale seems valid and reliable for screening schoolchildren and adolescents, but the RCADS-25 and RCADS-20 MDD scales show shortcomings. An MDD scale of seven items that showed acceptable psychometric properties is recommended.