Revised Children’s Anxiety and Depression Scale (RCADS): Psychometric Properties in a Clinical Sample in the United Kingdom

Abstract

Background: Routine Outcome monitoring has become a principle element in the transformation of mental health services for children and young people in the UK and promoted by the CYP Improving Access to Psychological Therapies (IAPT) program. Collecting data on the outcome of therapeutic interventions is a required element of the mental health data set within NHS settings. The Revised Child’s Anxiety and Depression Scale (RCADS) has been identified as a useful tool based on the normative studies of US populations. There has, however, been no evaluation of RCADS for a UK population. Because of the data available, the current study provides an initial assessment of the validity and reliability of the RCADS in a United Kingdom (UK) clinical sample. Children had been referred to a community mental health and emotional wellbeing service for children and young people presenting with mild to moderate difficulties, in the East of England. Methods: A sample of 1920 CYP (equivalent numbers of boys and girls, aged 7.9 to 18 years), completed the RCADS as part of routine assessment. Parents also completed the RCADS-P for comparison. Tests of normality, internal consistency, factor analysis and correlation were conducted on child and parent raw scores. Results: The current study identified the psychometric properties of RCADS for a UK clinical sample. RCADS showed a simple structure where all six variables loaded highly on the one factor of Separation Anxiety. RCADS showed good internal consistency with positive and highly significant correlations between subscales as well as between child and parents reports. Conclusions: All six subscales were found to be necessary part of RCADS. Indications are that RCADS shows promising clinical utility as a valid and reliable measure for assessing children with Anxiety and Depression in the UK. Future research needs to include a confirmatory factor analysis and assessment of a reliable clinical cut off-score for a UK clinical population.