Ginsburg Golda S, Keeton Courtney P, Drazdowski Tess K, Riddle Mark A
Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, 550 North Broadway Suite 202, Baltimore, MD 21205, USA.
Child Youth Care Forum. 2011 Apr;40(2):93-105. doi: 10.1007/s10566-010-9125-3. Epub 2010 Oct 6.
Clinician ratings of anxiety hold the promise of clarifying discrepancies often found between child and parent reports of anxiety. The Pediatric Anxiety Rating Scale (PARS) is a clinician-administered instrument that assesses the frequency, severity, and impairment of common pediatric anxiety disorders and has been used as a primary outcome measure in several landmark treatment trials. However, no data on nonanxious youth have been published. The purpose of this study was to address this gap by examining clinician's ratings of anxiety on the PARS in a volunteer sample of youth without anxiety disorders ( = 84; ages 7-12; 51% female, 75% Caucasian). The nonanxious sample was comprised of youth with (At-risk; = 36) and without (Healthy; = 48) anxious parents. Data were also used to evaluate the reliability (i.e., internal consistency), convergent, and divergent validity of the clinician-rated PARS. In addition, a receiver operating curve analysis was used to determine optimum cut off scores indicative of clinical levels of anxiety by comparing PARS scores between these nonanxious youth and a clinically anxious sample ( = 77) randomized in the Research Units of Pediatric Psychopharmacology (RUPP) anxiety study (RUPP 2001). Results indicated that anxious and nonanxious youth were significantly different on all PARS severity items. Optimum cutoff scores of 11.5 (5-item total score) and 17.5 (7-item total score) discriminated youth with and without anxiety disorders. Cronbach alphas for the Healthy and At-risk sample were .90 and .91 and .75 and .81 for the 5- and 7-item total PARS scores respectively, supporting the measure's internal consistency among nonanxious youth. PARS total scores were positively correlated with other measures of anxiety (i.e., the Screen for Child Anxiety Related Emotional Disorders) for the At-risk but not Healthy subsample. PARS scores were not significantly correlated with depressive symptoms (i.e., Children's Depression Inventory). Overall, findings support the utility of clinician's assessments of anxiety symptoms for nonanxious youth. Using the PARS can help facilitate determining whether a child's anxiety level is more similar to those with or without an anxiety disorder.
临床医生对焦虑的评分有望澄清儿童和家长报告的焦虑之间常见的差异。儿科焦虑评定量表（PARS）是一种由临床医生实施的工具，用于评估常见儿科焦虑症的频率、严重程度和损害程度，并且已在多项具有里程碑意义的治疗试验中用作主要结局指标。然而，尚未发表关于无焦虑青少年的数据。本研究的目的是通过在一个无焦虑症的青少年志愿者样本（n = 84；年龄7 - 12岁；51%为女性，75%为白种人）中检查临床医生对PARS焦虑的评分来填补这一空白。无焦虑样本包括有焦虑父母的青少年（风险组；n = 36）和无焦虑父母的青少年（健康组；n = 48）。数据还用于评估临床医生评定的PARS的信度（即内部一致性）、聚合效度和区分效度。此外，通过比较这些无焦虑青少年与在儿科精神药理学研究单位（RUPP）焦虑研究（RUPP 2001）中随机分组的临床焦虑样本（n = 77）的PARS分数，使用接受者操作特征曲线分析来确定指示临床焦虑水平的最佳临界分数。结果表明，在所有PARS严重程度项目上，焦虑和无焦虑青少年存在显著差异。11.5（5项总分）和17.5（7项总分）的最佳临界分数区分了有无焦虑症的青少年。健康组和风险组样本的Cronbach α系数，5项和7项PARS总分分别为0.90和0.91以及0.75和0.81，支持该量表在无焦虑青少年中的内部一致性。对于风险组而非健康亚样本，PARS总分与其他焦虑测量指标（即儿童焦虑相关情绪障碍筛查量表）呈正相关。PARS分数与抑郁症状（即儿童抑郁量表）无显著相关性。总体而言，研究结果支持临床医生对无焦虑青少年焦虑症状评估的效用。使用PARS有助于确定儿童的焦虑水平与有或无焦虑症的儿童更为相似。
