RESEARCH UPDATE REVIEW
Ten-Year Review of Rating Scales. II: Scales for Internalizing Disorders

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ABSTRACT

Objective

This article, the second in the Journal’ s series of 10-year updates on rating scales, summarizes scales assessing internalizing disorders.

Method

The authors sampled articles on mood and anxiety disorders over the past 25 years, selected scales with multiple citations over many years, and reviewed their properties. Those with adequate psychometric properties, plus continued wide literature citations or a current special niche, are presented here.

Results

Rating scales for depression were developed and/or examined in the 1980s. Despite generally strong properties, they lack clear construct validity. Most have parent-report forms that broaden their suitability with youths. Anxiety scales were developed bimodally. Those developed in the 1960s to 1970s were downward modifications of adult scales. They have been criticized for unclear constructs and unsuitability for youths. Newer scales developed in the 1990s have addressed these problems and have parent-report forms. However, their utility is still being determined.

Conclusions

Rating scales can reliably, validly, and efficiently measure youths’ internalizing psychopathology. They have great utility in research, treatment planning, and accountability in practice. However, the user must define the goals of measurement, consider the construct the scale measures, and use the scale within its defined capabilities. The use of more than one scale for a task is recommended.

Section snippets

MOOD DISORDERS RATING SCALES

Mood disorders in children and adolescents were elucidated in the 1980s. Therefore, most depression-rating scales were developed at that time, and references to their development date to that decade. However, because many of these scales continue to be examined and widely used, there is a rich database on their applications over the past decade.

ANXIETY-RATING SCALES

Anxiety was among the first juvenile symptoms evaluated with rating scales. Older scales developed during the 1950s to 1970s represented downward extensions of adult scales and had questionable developmental relevance. The recently renewed interest in juvenile anxiety disorders has led to the development of several new anxiety-rating scales that have overcome deficits of older scales (Greenhill et al., 1998).

Anxiety-rating scales for youths face special challenges. Anxiety disorders comprise

SUMMARY AND CONCLUSIONS

Depression-rating scales and anxiety-rating scales offer great utility for elucidating youths’ internalizing psychopathology, treatment planning, following treatment course, and assuring accountability in practice. However, they cannot be used casually. The potential user must consider a particular scale in relation to the problem to be assessed, characteristics of the sample, properties of the scale, and the goals of assessment. All of the reviewed scales have strengths and weaknesses.

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  • Cited by (0)

    This series of 10-year updates in child and adolescent psychiatry began in July 1996. Topics are selected in consultation with the AACAP Committee on Recertification, both for the importance of new research and its clinical or developmental significance. The authors have been asked to place an asterisk before the five or six most seminal references.

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