Screen for Child Anxiety Related Disorders (SCARED)

Child Version - Page 1 of 2 (To be filled out by the CHILD)

Directions: Below is a list of sentences that describe how people feel. Read each phrase and decide if it is "Not True or Hardly Ever True" or "Somewhat True or Sometimes True" or "Very True or Often True" for you. Then for each sentence, fill in one circle that corresponds to the response that seems to describe you for the last 3 months.

1 0 Not TrueVery True Somewhat or Often or HardlyTrue or Ever TrueSometimesTrue True

1.When I feel frightened, it is hard for me to breathe 2.I get headaches when I am at school 3.I don't like to be with people I don't know well 4.I get scared if I sleep away from home 5.I worry about other people liking me 6.When I get frightened, I feel like passing out

8.I follow my mother or father wherever they go 9.People tell me that I look nervous 10.I feel nervous with people I don't know well 11.My I get stomachaches at school 12.When I get frightened, I feel like I am going crazy 13.I worry about sleeping alone 14.| worry about being as good as other kids 15.When I get frightened, I feel like things are not real I have nightmares about something bad happening to my par- 16. ents 17.I worry about going to school 18.When I get frightened, my heart beats fast 19.I get shaky 20.I have nightmares about something bad happening to me

Child Version - Page 2 of 2 (To be filled out by the CHILD)

01 Not TrueSomewhat or HardlyTrue or SometimesTrue Ever True True

21.I worry about things working out for me 22.When I get frightened, I sweat a lot

24.I get really frightened for no reason at all

25.I am afraid to be alone in the house

26.It is hard for me to talk with people I don't know well 27.When I get frightened, I feel like I am choking 28.People tell me that I worry too much 29.I don't like to be away from my family 30.I am afraid of having anxiety (or panic) attacks 31.I worry that something bad might happen to my parents 32.I feel shy with people I don't know well 33.I worry about what is going to happen in the future 34.When I get frightened, I feel like throwing up 35.I worry about how well I do things 36.I am scared to go to school 37.I worry about things that have already happened 38.When I get frightened, I feel dizzy I feel nervous when | am with other children or adults and I have 39.to do something while they watch me (for example: read aloud, speak, play a game, play a sport) I feel nervous when | am going to parties, dances, or any place 40. where there will be people that I don't know well 41.I am shy

*For children ages 8 to 11, it is recommended that the clinician explain all questions, or have the child answer the questionnaire sitting with an adult in case they have any questions. Developed by Boris Birmaher, MD, Suneeta Khetarpal, MD, Marlane Cully, MEd, David Brent, MD, and Sandra McKenzie, PhD. Western Psychiatric Institute and Clinic, University of Pgh. (10/95 Email: birmaherb@msx.upmc.edu

Parent Version - Page 1 of 2 (To be filled out by the PARENT)

Below is a list of statements that describe how people feel. Read each statement carefully and decide if it is "Not True or Hardly Ever True" or "Somewhat True or Sometimes True" or "Very True or Often True" for your child. Then for each statement, fill in one circle that corresponds to the response that seems to describe your child for the last 3 months. Please respond to all statements as well as you can, even if some do not seem to concern your child.

2 01 Not TrueVery True Somewhat or HardlyTrue oror Often Ever TrueSometimesTrue True

1.When my child feels frightened, it is hard for him/her to breathe 2.My child gets headaches when he/she is at school 3.My child doesn't like to be with people he/she doesn't know well 4.My child gets scared if he/she sleeps away from home 5. My child worries about other people liking him/her 6.When my child gets frightened, he/she feels like passing out 7.My child is nervous 8.My child follows me wherever I go 9.People tell me that my child looks nervous 10. My child feels nervous with people he/she doesn't know well 11. My child gets stomachaches at school When my child gets frightened, he/she feels like he/she is going 12. crazy 13.My child worries about sleeping alone 14.My child worries about being as good as other kids 15.When he/she gets frightened, he/she feels like things are not real My child has nightmares about something bad happening to his/her 16. parents 17.My child worries about going to school 18.When my child gets frightened, his/her heart beats fast 19. 20. My child has nightmares about something bad happening to him/hero

Parent Version - Page 2 of 2 (To be filled out by the PARENT)

1 0 Somewhat Not True or HardlyTrue or Ever TrueSometimes True

21.My child worries about things working out for him/her 22.When my child gets frightened, he/she sweats a lot 23.My child is a worrier 24.My child gets really frightened for no reason at all 25.My child is afraid to be alone in the house 26.It is hard for my child to talk with people he/she doesn't know well 27.When my child gets frightened, he/she feels like he/she is choking 28.People tell me that my child worries too much 29.My child doesn't like to be away from his/her family 30.My child is afraid of having anxiety (or panic) attacks My child worries that something bad might happen to his/her 31. parents 32.My child feels shy with people he/she doesn't know well 33.My child worries about what is going to happen in the future 34.When my child gets frightened, he/she feels like throwing up 35.My child worries about how well he/she does things 36.My child is scared to go to school 37.My child worries about things that have already happened 38.When my child gets frightened, he/she feels dizzy My child feels nervous when he/she is with other children or adults 39.and he/she has to do something while they watch him/her (for example: read aloud, speak, play a game, play a sport)

My child feels nervous when he/she is going to parties, dances, or 40. any place where there will be people that he/she doesn't know well 41.My child is shy

Developed by Boris Birmaher, MD, Suneeta Khetarpal, MD, Marlane Cully, MEd, David Brent, MD, and Sandra McKenzie, PhD. Western Psychiatric Institute and Clinic, University of Pgh. (10/95 Email: birmaherb@msx.upmc.edu

Use with Parent and Child Versions

8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 Total

0 = not true or hardly true 1 = somewhat true or sometimes true 2 = very true or often true

A total score of 25 may indicate the presence of an Anxiety Disorder. Scores higher than 30 are more specific. A score of 7 for items 1, 6, 9, 12, 15, 18, 19, 22, 24, 27, 30, 34, 38 may indicate Panic Disorder or Significant Somatic Symptoms. A score of 9 for items 5, 7, 14, 21, 23, 28, 33, 35, 37 may indicate Generalized Anxiety Disorder. A score of 5 for items 4, 8, 13, 16, 20, 25, 29, 31 may indicate Separation Anxiety Disorder. A score of 8 for items 3, 10, 26, 32, 39, 40, 41 may indicate Social Anxiety Disorder. A score of 3 for items 2, 11, 17, 36 may indicate Significant School Avoidance.

Cutoff CutoffCutoffCutoffCutoff = 7 5= 3 8 9