Establishing Clinical Cutoffs for Response and Remission on the Screen for Child Anxiety Related Emotional Disorders (SCARED)

Nicole E. Caporino*, Dara Sakolsky, Douglas M. Brodman, Joseph F. McGuire, John Piacentini, Tara S. Peris, Golda S. Ginsburg, John T. Walkup, Satish Iyengar, Philip C. Kendall, Boris Birmaher

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective To determine optimal percent reduction and raw score cutoffs on the parent- and child-report Screen for Child Anxiety Related Emotional Disorders (SCARED) for predicting treatment response and remission among youth with anxiety disorders. Method Data were obtained from youth (N = 438; 7–17 years old) who completed treatment in the Child/Adolescent Anxiety Multimodal treatment Study, a multisite, randomized clinical trial that examined the relative efficacy of medication (sertraline), cognitive-behavioral therapy (Coping Cat), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The parent- and youth-report SCARED were administered at pre- and posttreatment. Quality receiver operating characteristic methods evaluated the performance of various SCARED percent reduction and absolute cutoff scores in predicting treatment response and remission, as defined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule. Results Reductions of 55% on the SCARED-Parent and 50% on the SCARED-Youth optimally predicted treatment response. Posttreatment absolute raw scores of 10 (SCARED-Parent) and 12 (SCARED-Youth) optimally predicted remission in the total sample, although separate SCARED-Parent cutoffs for children (12–13) and adolescents (9) showed greatest quality of efficiency. Each cutoff significantly predicted response and remission at 6-month follow-up. Conclusion Results serve as guidelines for operationalizing treatment response and remission on the SCARED, which could help clinicians systematically monitor treatment outcomes of youth with anxiety disorders in a cost- and time-efficient manner. Clinical trial registration information—Child and Adolescent Anxiety Disorders (CAMS); http://clinicaltrials.gov/; NCT00052078.

Original languageEnglish (US)
Pages (from-to)696-702
Number of pages7
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume56
Issue number8
DOIs
StatePublished - Aug 1 2017

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Anxiety
Anxiety Disorders
Therapeutics
Separation Anxiety
Sertraline
Combined Modality Therapy
Cognitive Therapy
ROC Curve
Appointments and Schedules
Cats
Randomized Controlled Trials
Placebos
Clinical Trials
Guidelines
Interviews
Costs and Cost Analysis

Keywords

  • anxiety
  • measurement
  • treatment

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

Caporino, Nicole E. ; Sakolsky, Dara ; Brodman, Douglas M. ; McGuire, Joseph F. ; Piacentini, John ; Peris, Tara S. ; Ginsburg, Golda S. ; Walkup, John T. ; Iyengar, Satish ; Kendall, Philip C. ; Birmaher, Boris. / Establishing Clinical Cutoffs for Response and Remission on the Screen for Child Anxiety Related Emotional Disorders (SCARED). In: Journal of the American Academy of Child and Adolescent Psychiatry. 2017 ; Vol. 56, No. 8. pp. 696-702.
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abstract = "Objective To determine optimal percent reduction and raw score cutoffs on the parent- and child-report Screen for Child Anxiety Related Emotional Disorders (SCARED) for predicting treatment response and remission among youth with anxiety disorders. Method Data were obtained from youth (N = 438; 7–17 years old) who completed treatment in the Child/Adolescent Anxiety Multimodal treatment Study, a multisite, randomized clinical trial that examined the relative efficacy of medication (sertraline), cognitive-behavioral therapy (Coping Cat), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The parent- and youth-report SCARED were administered at pre- and posttreatment. Quality receiver operating characteristic methods evaluated the performance of various SCARED percent reduction and absolute cutoff scores in predicting treatment response and remission, as defined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule. Results Reductions of 55{\%} on the SCARED-Parent and 50{\%} on the SCARED-Youth optimally predicted treatment response. Posttreatment absolute raw scores of 10 (SCARED-Parent) and 12 (SCARED-Youth) optimally predicted remission in the total sample, although separate SCARED-Parent cutoffs for children (12–13) and adolescents (9) showed greatest quality of efficiency. Each cutoff significantly predicted response and remission at 6-month follow-up. Conclusion Results serve as guidelines for operationalizing treatment response and remission on the SCARED, which could help clinicians systematically monitor treatment outcomes of youth with anxiety disorders in a cost- and time-efficient manner. Clinical trial registration information—Child and Adolescent Anxiety Disorders (CAMS); http://clinicaltrials.gov/; NCT00052078.",
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author = "Caporino, {Nicole E.} and Dara Sakolsky and Brodman, {Douglas M.} and McGuire, {Joseph F.} and John Piacentini and Peris, {Tara S.} and Ginsburg, {Golda S.} and Walkup, {John T.} and Satish Iyengar and Kendall, {Philip C.} and Boris Birmaher",
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Caporino, NE, Sakolsky, D, Brodman, DM, McGuire, JF, Piacentini, J, Peris, TS, Ginsburg, GS, Walkup, JT, Iyengar, S, Kendall, PC & Birmaher, B 2017, 'Establishing Clinical Cutoffs for Response and Remission on the Screen for Child Anxiety Related Emotional Disorders (SCARED)', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 56, no. 8, pp. 696-702. https://doi.org/10.1016/j.jaac.2017.05.018

Establishing Clinical Cutoffs for Response and Remission on the Screen for Child Anxiety Related Emotional Disorders (SCARED). / Caporino, Nicole E.; Sakolsky, Dara; Brodman, Douglas M.; McGuire, Joseph F.; Piacentini, John; Peris, Tara S.; Ginsburg, Golda S.; Walkup, John T.; Iyengar, Satish; Kendall, Philip C.; Birmaher, Boris.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 56, No. 8, 01.08.2017, p. 696-702.

Research output: Contribution to journalArticle

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T1 - Establishing Clinical Cutoffs for Response and Remission on the Screen for Child Anxiety Related Emotional Disorders (SCARED)

AU - Caporino, Nicole E.

AU - Sakolsky, Dara

AU - Brodman, Douglas M.

AU - McGuire, Joseph F.

AU - Piacentini, John

AU - Peris, Tara S.

AU - Ginsburg, Golda S.

AU - Walkup, John T.

AU - Iyengar, Satish

AU - Kendall, Philip C.

AU - Birmaher, Boris

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N2 - Objective To determine optimal percent reduction and raw score cutoffs on the parent- and child-report Screen for Child Anxiety Related Emotional Disorders (SCARED) for predicting treatment response and remission among youth with anxiety disorders. Method Data were obtained from youth (N = 438; 7–17 years old) who completed treatment in the Child/Adolescent Anxiety Multimodal treatment Study, a multisite, randomized clinical trial that examined the relative efficacy of medication (sertraline), cognitive-behavioral therapy (Coping Cat), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The parent- and youth-report SCARED were administered at pre- and posttreatment. Quality receiver operating characteristic methods evaluated the performance of various SCARED percent reduction and absolute cutoff scores in predicting treatment response and remission, as defined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule. Results Reductions of 55% on the SCARED-Parent and 50% on the SCARED-Youth optimally predicted treatment response. Posttreatment absolute raw scores of 10 (SCARED-Parent) and 12 (SCARED-Youth) optimally predicted remission in the total sample, although separate SCARED-Parent cutoffs for children (12–13) and adolescents (9) showed greatest quality of efficiency. Each cutoff significantly predicted response and remission at 6-month follow-up. Conclusion Results serve as guidelines for operationalizing treatment response and remission on the SCARED, which could help clinicians systematically monitor treatment outcomes of youth with anxiety disorders in a cost- and time-efficient manner. Clinical trial registration information—Child and Adolescent Anxiety Disorders (CAMS); http://clinicaltrials.gov/; NCT00052078.

AB - Objective To determine optimal percent reduction and raw score cutoffs on the parent- and child-report Screen for Child Anxiety Related Emotional Disorders (SCARED) for predicting treatment response and remission among youth with anxiety disorders. Method Data were obtained from youth (N = 438; 7–17 years old) who completed treatment in the Child/Adolescent Anxiety Multimodal treatment Study, a multisite, randomized clinical trial that examined the relative efficacy of medication (sertraline), cognitive-behavioral therapy (Coping Cat), their combination, and pill placebo for the treatment of separation anxiety disorder, generalized anxiety disorder, and social phobia. The parent- and youth-report SCARED were administered at pre- and posttreatment. Quality receiver operating characteristic methods evaluated the performance of various SCARED percent reduction and absolute cutoff scores in predicting treatment response and remission, as defined by posttreatment ratings on the Clinical Global Impression scales and the Anxiety Disorders Interview Schedule. Results Reductions of 55% on the SCARED-Parent and 50% on the SCARED-Youth optimally predicted treatment response. Posttreatment absolute raw scores of 10 (SCARED-Parent) and 12 (SCARED-Youth) optimally predicted remission in the total sample, although separate SCARED-Parent cutoffs for children (12–13) and adolescents (9) showed greatest quality of efficiency. Each cutoff significantly predicted response and remission at 6-month follow-up. Conclusion Results serve as guidelines for operationalizing treatment response and remission on the SCARED, which could help clinicians systematically monitor treatment outcomes of youth with anxiety disorders in a cost- and time-efficient manner. Clinical trial registration information—Child and Adolescent Anxiety Disorders (CAMS); http://clinicaltrials.gov/; NCT00052078.

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