Structure, reliability, and validity of the revised child anxiety and depression scale (RCADS) in a multi-ethnic urban sample of Dutch children

BACKGROUND Although anxiety and, to a lesser extent, depression are highly prevalent in children, these problems are, difficult to identify. The Revised Anxiety and Depression Scale (RCADS) assesses self-reported symptoms of anxiety and depression in youth. METHODS The present study examined the factor structure, internal consistency, short-term stability, and validity including sensitivity to change of the RCADS in a multi-ethnic urban sample of 3636 Dutch children aged 8 to 13 years old. RESULTS Results indicate that the RCADS is a reliable and valid instrument. The original 6-factor structure was replicated to a fair extent in the present study (RMSEA = 0.048) and internal consistency was good (αs = 0.70-0.96). ICCs for short-term stability were 0.76 to 0.86. Girls and children who indicated wishing to participate in a program targeting anxiety and depression had higher RCADS scores. Sensitivity to change analyses showed that the RCADS can detect changes in anxiety and depression symptoms in children who participated in a preventive intervention. The study showed low agreement between teacher and self-reported internalizing problems, even for children scoring above the 90(th) percentile of the RCADS, indicating a high level of problems, emphasizing the need to also take child reports into account when screening for anxiety and depression in children. CONCLUSION This study shows that the RCADS can yield reliable data on a diversity of anxiety disorders and depression in urban children aged 8-13 from very diverse ethnic backgrounds. TRIAL REGISTRATION Netherlands Trial Register: NTR2397 . Registered 30 June 2010.