(PS4-18) Validating the Revised Child Anxiety and Depression Scale-short Version (RCADS-25) in Chinese Adolescents

Background: Youth anxiety and depression are rising concerns worldwide. The identification of youth anxiety and depression in previously unexamined sociocultural contexts is paramount to avoid exacerbating existing disparities in access to treatment. The Revised Child Anxiety and Depression Scale (RCADS) is one of the most widely used screening measures and has already shown applicability to various cultures, making it a promising tool for early identification of common youth mental health issues in diverse communities. While the RCADS’s psychometric properties vary across cultures, research has not investigated its applicability in Chinese youth. This study evaluated the psychometric properties of the RCADS 25-item short version (RCADS-25) in Chinese schoolchildren, a population that urgently needs mental health care.

Methods: 534 adolescents (age 9-12 years, 4th-5th grade) in China self-rated RCADS-25, positive-negative affect, and psychological resilience, while parents rated child’s internalizing and externalizing behaviors. The RCADS-25’s structural validity was assessed with five confirmatory factor analysis (CFA) models with different theoretical bases. Measurement invariance between sex and grade was assessed by two-factor CFA. Reliability was assessed by Cronbach’s alpha, and concurrent validity with parent-rated behavioral problems was assessed by multivariate analysis of variance (MANOVA) and receiver operating characteristic (ROC) curve analysis. Correlation tests were used to assess the RCADS-25’s convergent validity with related measures such as positive and negative affect.  

Results: The fit indices supported a two-factor model that includes a Total Depression scale and a Total Anxiety scale. The RCADS-25 demonstrated adequate reliability (𝛼 = 0.91) and convergent validity with related measures. Higher RCADS-25 scores predicted greater negative affect and behavioral difficulties, as well as lower positive affect and psychological resilience. Adolescents with elevated behavioral difficulties had higher RCADS-25 Total Depression scores than those with normal-level difficulties. Girls and younger adolescents reported higher anxiety scores.

Conclusion: The 25-item short version of the Revised Child Anxiety and Depression Scale is a reliable and valid screening tool for risk of anxiety and depression among adolescents from Chinese cultural background. This brief self-report measure is feasible for use in school settings worldwide. It shows overall consistent results with parent-reports of symptoms and can effectively distinguish at-risk students from normal samples.