Screen for Child Anxiety Related Emotional Disorders – Chinese Version

Description

Some emotions are naturally present from birth, and anxiety is one of them. Almost everyone has experienced anxiety at some point. Typically, anxiety is seen as an unpleasant feeling of unease and worry, which is a reactive response to perceived threats in the future. It is a common psychological phenomenon that manifests in psychological symptoms such as tension, irritability, worry, restlessness, fear, and panic, as well as physiological symptoms like sweating, heart discomfort, and fatigue. Anxiety is a common mental disorder among children and adolescents. A study from 2020 indicated that the prevalence of anxiety in children was 13.2% for males and 15.1% for females. Data from The Lancet in 2018 revealed that the median age for the onset of anxiety and impulse control disorders is between 11 and 15 years old.

Anxiety disorders in children consist of two parts: the first is similar to that in adults, including generalized anxiety disorder (广泛性焦虑障碍, GAD), panic disorder, and obsessive-compulsive disorder; the second is specific to childhood, including childhood separation anxiety disorder, childhood phobic anxiety disorder, childhood social anxiety disorder, and selective mutism. Some types of anxiety disorders may improve after adolescence, but they can also persist into early adulthood or longer, hindering the long-term psychological development, academic progress, and interpersonal relationships of the affected children. As a common emotion, the impact of anxiety is not necessarily negative. Normal levels of anxiety in children, particularly in specific situations, are considered normal reactions and do not require excessive concern. However, if a child’s anxiety is not temporary but continuous and accumulative, manifesting as excessive fear, worry, and physiological responses, and if left unaddressed, the anxious state may persist, potentially extending to other situations and becoming abnormal or pathological.

In the short term, excessive anxiety can affect psychological health, peer relationships, and academic performance. In the long term, anxiety can impact self-esteem, happiness, and other psychological qualities, increase the risk of physiological diseases, provoke maladaptive behaviors, and impede social development, closely related to depression. Furthermore, anxiety symptoms during childhood or adolescence can evoke anxiety in adulthood. Even if anxiety symptoms during adolescence do not persist, prolonged exposure to anxious feelings can lead to other emotional issues, particularly depression.

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Purpose

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Test Year

The screening scale was developed by Birmaher in 1997, and subsequent modifications were made by domestic scholars. The study for its effectiveness was conducted between October 2001 and April 2002.

Administration Method and Scoring

The Children’s Anxiety Disorders Screening Scale consists of five factors: separation anxiety, somatization/panic, school fear, social fear, and generalized anxiety (焦虑症状五个因子). Each factor has a specific number of questions: 8, 13, 4, 7, and 9 items, respectively, totaling 41 items. The scale uses a scoring system of 0-2, where scores from low to high represent “no problem,” “sometimes a problem,” and “often a problem.” The level of anxiety is determined by the aggregate score, with higher scores indicating higher levels of anxiety.

Reliability and Validity

The retest reliability of the scale ranges from 0.567 to 0.608, with a half-section reliability of 0.88. The Cronbach’s alpha coefficient ranges from 0.43 to 0.89, and the items are easy for children to understand. The scale is suitable for clinical screening of anxiety disorders in children and for research surveys (it is applicable to children and adolescents aged 6-16 years).

Factors and Subscales

The scale consists of five factors:
1. Separation Anxiety (分离性焦虑)
2. Somatization/Panic (躯体化/惊恐)
3. School Fear (学校恐惧)
4. Social Fear (社交恐惧)
5. Generalized Anxiety (广泛性焦虑)

Keywords

Children, Anxiety, Mental Health, Screening, Psychological Disorders

Items in Chinese

1. 当我感到害怕时，出现呼吸困难（出气不顺）
2. 我在学校时感到头痛
3. 我不喜欢与不太熟悉的人在一起
4. 如果我不在家里睡觉，就觉得内心不安
5. 我经常担心别人是不是喜欢我
6. 当我害怕时，感到马上要死去似的
7. 我总是感到紧张不安
8. 父母无论去哪里我总是离不开他们
9. 别人说我好像很紧张的样子
10. 当我与不熟悉的人在一起时就感到紧张
11. 在学校时就出现肚子痛
12. 当我害怕时，自己感觉快要发疯
13. 我总担心让我自己一个人睡觉
14. 我担心自己不像其他孩子一样好
15. 当我害怕时，感到恍恍惚惚，好像周围的一切不真实似的
16. 我梦见父母发生了不幸的事情
17. 我担心又要去上学
18. 我害怕时，心跳会加快
19. 我手脚发抖打颤
20. 我梦见发生了对我不利的事情
21. 我对于一些精心为我而安排的事感到不安和不自在
22. 当我害怕时，我会出汗
23. 我是一个忧虑的人
24. 我无缘无故地感到害怕
25. 我害怕一个人待在家里
26. 我觉得和不熟悉的人说话很困难
27. 我害怕时感到不能呼吸
28. 别人说我担心得太多了
29. 我不愿离开自己的家
30. 我担心以前那种紧张(或惊恐)的感觉再次出现
31. 我总担心父母会出事
32. 当我与不熟悉的人在一起时，觉得害羞
33. 我担心将来会发生什么事情
34. 我害怕时感到恶心、想吐
35. 我担心自己能不能把事情做好
36. 我害怕去上学
37. 我担忧已发生了什么事
38. 我害怕时，感到头昏
39. 当我与其他伙伴或大人在一起做事情时(如在朗读、说话、游戏、做体育活动时)，如果他们看着我，我就感到紧张
40. 当我去参加活动、跳舞或者有不熟悉的人在场时，就感到紧张
41. 我是一个害羞的人。

Items in English

1. When I feel scared, I have difficulty breathing.
2. I have a headache when I am at school.
3. I do not like being with people I don’t know well.
4. I feel uneasy if I don’t sleep at home.
5. I often worry if others like me.
6. When I am scared, I feel like I’m going to die.
7. I always feel tense and uneasy.
8. I can’t be away from my parents no matter where they go.
9. Others say I seem very nervous.
10. I feel anxious when I’m with unfamiliar people.
11. I get stomachaches when I’m at school.
12. When I’m scared, I feel like I’m going crazy.
13. I always worry about being left alone to sleep.
14. I worry that I’m not as good as other kids.
15. When I’m scared, I feel dazed, as if everything around me is unreal.
16. I dream about my parents having unfortunate happenings.
17. I worry about having to go to school again.
18. When I’m scared, my heart beats faster.
19. My hands and feet tremble.
20. I dream that something bad happens to me.
21. I feel uneasy and uncomfortable about some things carefully arranged for me.
22. I sweat when I’m scared.
23. I am a worrying person.
24. I feel scared for no reason.
25. I’m afraid to be alone at home.
26. I find it difficult to talk to people I don’t know well.
27. I feel like I can’t breathe when I’m scared.
28. Others say that I worry too much.
29. I don’t want to leave my house.
30. I worry that I will feel that tension (or panic) again.
31. I always worry that something will happen to my parents.
32. I feel shy when I’m with unfamiliar people.
33. I worry about what might happen in the future.
34. When I’m scared, I feel nauseous.
35. I worry if I can do things well.
36. I’m afraid to go to school.
37. I worry about what has already happened.
38. When I’m scared, I feel dizzy.
39. When I am doing things with other peers or adults (like reading, speaking, playing, or doing physical activities), I feel tense if they are watching me.
40. I feel anxious when going to events, dancing, or around unfamiliar people.
41. I am a shy person.

References

Birmaher, et al., 1997; Data collection from October 2001 to April 2002 in 14 major cities across the country.