title: Child dental fear as measured with the Dental Subscale of the Children's Fear Survey Schedule: the impact of referral status and type of informant (child versus parent).
abstract: OBJECTIVE
  The first aim of this methodological study was to investigate the agreement between self-ratings of Children's Fear Survey Schedule (CFSS-DS). The second aim was to explore using differentiated cut-off scores, and to compare these cut-off scores with those commonly used.
  
  
  METHODS
  Three different data collections included study groups (n = 497) of children and adolescents who had been referred to specialized pediatric dentistry clinics, and reference groups (n = 499) of dental patients and children rating the analyses were limited to the Östergötland sample (n = 210 + 228). Patients and their accompanying parents (mainly mothers) were asked to fill in the CFSS-DS independently. Cut-off scores on the CFSS-DS scale were determined using receiver-operating characteristic analysis; patient-parent agreement was illustrated with Bland-Altman plots.
  
  
  RESULTS
  The patient-parent agreement was modest, particularly among those who were referred because of dental behaviour management problems (DBMP). Cut-off scores differentiated by age and gender, suggested by exploration according to two different methods, were with few exceptions clearly below the standard cut-off score.
  
  
  CONCLUSIONS
  [corrected] The validity of parental ratings of their children dental fear should be questioned, particularly in high-fear populations. Self-ratings should, as far as possible, be used to complement parental ratings. One consequence of using the standard cut-off score is the risk of overlooking some patients needs for special attention. Further research is needed to establish and validate age-and gender-differentiated cut-off scores on the CFSS-DS.
authors.affiliation: Department of Pedodontics, Postgraduate Dental Education Center, Public Dental Service, Örebro, Örebro, Sweden Institute of Odontology, the Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden Department of Psychology, University of Gothenburg, Göteborg, Sweden Department of Statistics, Örebro University, Örebro, Sweden Clinical Research Centre, Örebro University Hospital, Örebro, Sweden Unit of Dental Behavioural Sciences, Institute of Odontology, the Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Gustafsson
authors.forename: K
authors.initials: K
authors.lastname: Arnrup
authors.forename: A G
authors.initials: AG
authors.lastname: Broberg
authors.forename: L
authors.initials: L
authors.lastname: Bodin
authors.forename: U
authors.initials: U
authors.lastname: Berggren
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D016854:Dental Anxiety / Q000523:psychology*; D019140:Dental Care for Children; D005260:Female; D006801:Humans; D008297:Male; D011581:Psychological Tests