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Validation of the Kriol and Belizean English Adaptation of the Revised Children's Anxiety and Depression Scale for Use With Adolescents in Belize
UNICEF, USA; Karolinska Institutet, Sweden.ORCID iD: 0000-0003-1971-7055
Swedish Red Cross University, Department of Health Sciences. Karolinska Institutet, Sweden.ORCID iD: 0000-0002-4111-9708
Karolinska Institutet, Sweden.
University of Amsterdam, Netherlands.
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2023 (English)In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972, Vol. 72, no S1, p. S40-S51Article in journal (Refereed) Published
Abstract [en]

Purpose: To validate a culturally-adapted Kriol and Belizean English version of the Revised Children's Anxiety and Depression Scale (RCADS) through comparison with clinical diagnoses made using the Kiddie Schedule of Affective Disorders and Schizophrenia.

Methods: Participants comprised of 256 adolescents aged 10-14 years and 15-19 years, who completed the adapted RCADS (10 depression items, 12 anxiety items) in one-on-one interviews, followed by a diagnostic assessment using Kiddie Schedule of Affective Disorders and Schizophrenia administered by trained clinicians. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratios, area under the curve (AUC), and Youden's Index were calculated for RCADS cutoffs and scores on the total scale and anxiety and depression subscales.

Results: For adolescents aged 10-14 years (n = 161), the AUC was 0.72 for the full scale, 0.67 for anxiety subscale, and 0.76 for depression subscale. For adolescents aged 15-19 years (n = 95), the AUCs were 0.82, 0.77, and 0.83. Most depression items performed well in discriminating those with and without diagnoses. Separation anxiety items performed poorly. "Thoughts of death" were common even among adolescents not meeting diagnostic criteria. The RCADS depression subscale presented the strongest psychometric properties with adolescents aged 15-19 years (at cutoff of 13, sensitivity = 0.83, specificity = 0.77, positive predictive value = 0.47, negative predictive value = 0.95, odds ratio = 15.96).

Conclusion: The adapted RCADS-22 had acceptable categorization for adolescents aged 10-14 years and excellent categorization for adolescents aged 15-19 years; therefore, the tool is recommended for use among the latter age group. Based on sensitivity and specificity values at different cutoffs, guidance is provided to select different thresholds to suit clinical, public health, or other uses to detect and quantify adolescent depression and anxiety in Belize.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 72, no S1, p. S40-S51
Keywords [en]
Gold standard validation, Clinical validation, Adolescent, Anxiety, Depression, Assessments, Developing countries, Mental health, Questionnaires, Validation, Psychometrics, RCADS, Belize
National Category
Pediatrics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:rkh:diva-4428DOI: 10.1016/j.jadohealth.2022.10.002PubMedID: 36400635OAI: oai:DiVA.org:rkh-4428DiVA, id: diva2:1718979
Funder
Bill and Melinda Gates Foundation, INV-001395Available from: 2022-12-14 Created: 2022-12-14 Last updated: 2023-01-03

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Åhs, Jill W.

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