Childhood anxiety in a diverse primary care population: parent-child reports, ethnicity and SCARED factor structure.
OBJECTIVE
To explore in a multiethnic primary care population the impact of child gender and of race/ethnicity on parent and child reports of school-age anxiety and on the factor structure of the Screen for Childhood Anxiety and Related Emotional Disorders (SCARED).


METHODS
A consecutive sample of 515 children (8 to <13 years) and their parent presenting for primary care completed self-report (C) and parent-report (P) versions of the SCARED-41.


RESULTS
Neither SCARED scores nor parent-child difference varied significantly with race/ethnicity. Predictors of higher SCARED scores were less parental education, younger child age and female gender. Exploratory factor analysis conducted separately for SCARED-C and SCARED-P yielded four factors. There was large variation in factor structure between SCARED-C and SCARED-P and across ethnic and gender subgroups, greatest for somatic/panic/generalized anxiety and Hispanic children.


CONCLUSIONS
Primary care triage of anxious children requires data from both the parent and child and must go beyond cross-sectional symptom inventories. Clinicians must elicit from each family their perhaps culturally bound interpretation of the child's somatic and psychological symptoms.
Wren
Frances J
FJ
Drs. Wren and Heiden, Mr. Berg, Ms. Ohlson, and Ms. Kinnamon are with the Divisions of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, CA; Dr. Bernal is with Kaiser Permanente Northern California, San Jose; Drs. Bridge and Birmaher are with the Department of Psychiatry, University of Pittsburgh; and Dr. Heiden is with the Department of Psychology, San Jose State University, San Jose, CA. Electronic address: fwren@stanford.edu.
Berg
Eric A
EA
Drs. Wren and Heiden, Mr. Berg, Ms. Ohlson, and Ms. Kinnamon are with the Divisions of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, CA; Dr. Bernal is with Kaiser Permanente Northern California, San Jose; Drs. Bridge and Birmaher are with the Department of Psychiatry, University of Pittsburgh; and Dr. Heiden is with the Department of Psychology, San Jose State University, San Jose, CA.
Heiden
Lynda A
LA
Drs. Wren and Heiden, Mr. Berg, Ms. Ohlson, and Ms. Kinnamon are with the Divisions of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, CA; Dr. Bernal is with Kaiser Permanente Northern California, San Jose; Drs. Bridge and Birmaher are with the Department of Psychiatry, University of Pittsburgh; and Dr. Heiden is with the Department of Psychology, San Jose State University, San Jose, CA.
Kinnamon
Carolyn J
CJ
Drs. Wren and Heiden, Mr. Berg, Ms. Ohlson, and Ms. Kinnamon are with the Divisions of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, CA; Dr. Bernal is with Kaiser Permanente Northern California, San Jose; Drs. Bridge and Birmaher are with the Department of Psychiatry, University of Pittsburgh; and Dr. Heiden is with the Department of Psychology, San Jose State University, San Jose, CA.
Ohlson
Lirio A
LA
Drs. Wren and Heiden, Mr. Berg, Ms. Ohlson, and Ms. Kinnamon are with the Divisions of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, CA; Dr. Bernal is with Kaiser Permanente Northern California, San Jose; Drs. Bridge and Birmaher are with the Department of Psychiatry, University of Pittsburgh; and Dr. Heiden is with the Department of Psychology, San Jose State University, San Jose, CA.
Bridge
Jeffrey A
JA
Drs. Wren and Heiden, Mr. Berg, Ms. Ohlson, and Ms. Kinnamon are with the Divisions of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, CA; Dr. Bernal is with Kaiser Permanente Northern California, San Jose; Drs. Bridge and Birmaher are with the Department of Psychiatry, University of Pittsburgh; and Dr. Heiden is with the Department of Psychology, San Jose State University, San Jose, CA.
Birmaher
Boris
B
Drs. Wren and Heiden, Mr. Berg, Ms. Ohlson, and Ms. Kinnamon are with the Divisions of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, CA; Dr. Bernal is with Kaiser Permanente Northern California, San Jose; Drs. Bridge and Birmaher are with the Department of Psychiatry, University of Pittsburgh; and Dr. Heiden is with the Department of Psychology, San Jose State University, San Jose, CA.
Bernal
M Pilar
MP
Drs. Wren and Heiden, Mr. Berg, Ms. Ohlson, and Ms. Kinnamon are with the Divisions of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, CA; Dr. Bernal is with Kaiser Permanente Northern California, San Jose; Drs. Bridge and Birmaher are with the Department of Psychiatry, University of Pittsburgh; and Dr. Heiden is with the Department of Psychology, San Jose State University, San Jose, CA.
D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D002648:Child; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D015588:Observer Variation; D016584:Panic Disorder / Q000453:epidemiology; D010287:Parent-Child Relations; D011320:Primary Health Care / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires