Screen for Child Anxiety Related Disorders (SCARED) - Child Version

Screen for Child Anxiety Related Disorders (SCARED) - Child Version

Screen for Child Anxiety Related Disorders (SCARED) - Child Version

(To be filled out by the CHILD)
Patient Name:*
Today's Date:*

MonthDayYear
Date
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. I get scared easily.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
2. I get scared when I sleep away from home.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
3. People tell me that I worry too much.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
4. I get scared if I sleep away from home.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
5. I worry about things working out for me.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
6. I am nervous.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
7. I follow my mother or father wherever they go.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
8. People tell me that I look nervous.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
9. I feel nervous with people I don’t know well.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
10. I get scared to go to school.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
11. I worry about things that happen in the future.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
12. When I get frightened, I feel shaky.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
13. I worry about being as good as other kids.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
14. When I get frightened, I sweat a lot.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
15. I am a worrier.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
16. I need to be with people I know to feel comfortable.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
17. When I get frightened, I feel like I am going crazy.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
18. I can’t concentrate when I’m frightened.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
19. When I get frightened, I feel like things are not real.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
20. I worry about being away from my parents.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
21. When I get frightened, my heart beats fast.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
22. I get shaky.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
23. I worry that something bad might happen to my parents.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
24. When I get frightened, I feel like I might faint or pass out.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
25. I feel nervous when I’m with other children or adults and I have to do something while they watch me (like read aloud or play a game).*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
26. I feel nervous when I’m going to parties, dances, or any place where there will be people I don’t know well.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
27. I am shy.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
28. I feel nervous when I’m with other children I don’t know well.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
29. I worry about what others think of me.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
30. I feel nervous when I have to perform in front of others.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
31. I feel nervous when I am going to be away from home.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
32. I feel nervous about going places by myself.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
33. I get a sick feeling in my stomach when I’m about to leave home.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
34. I worry that something awful will happen to someone in my family.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
35. When I get frightened, I feel like I’m choking.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
36. When I get frightened, I feel like throwing up.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
37. When I get frightened, I feel dizzy.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
38. When I get frightened, I have trouble catching my breath.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
39. I feel like I have to be perfect.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
40. I have to be the best at everything.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
41. I feel like something bad is going to happen.*

0 = Not True or Hardly Ever True1 = Somewhat True or Sometimes True2 = Very True or Often True
Panic_Somatic_Score
Generalized_Anxiety_Score
Separation_Anxiety_Score
Social_Phobia_Score
School_Avoidance_Score
total_score
Your results:
- Panic/Somatic: {panic_somatic_score}
- Generalized Anxiety: {generalized_anxiety_score}
- Separation Anxiety: {separation_anxiety_score}
- Social Phobia: {social_phobia_score}
- School Avoidance: {school_avoidance_score}
- Total Score: {total_score}
Should be Empty: