Case Studies in Abnormal Child and Adolescent Psychology. Robert Weis
Test?
The Screen for Child Anxiety Related Emotional Disorders (SCARED) is one of the most widely used and well-validated measures of anxiety for children and adolescents (Birmaher et al., 1997). The current version of the SCARED is a questionnaire that assesses all of the major DSM-5 anxiety disorders, obsessive–compulsive disorder, posttraumatic stress disorder, and school refusal (Bodden, Bögels, & Muris, 2009). It can be administered to parents or youths aged 8 to 18 years. Here are some sample items (and the disorder they measure):
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When frightened, I feel dizzy … (panic disorder)
I worry about the future … (generalized anxiety disorder)
I don’t like being away from my family … (separation anxiety disorder)
It’s hard for me to talk with people I don’t know … (social phobia)
I’m scared to go to school … (school refusal)
Let’s imagine that it’s 1997 and we have been asked to evaluate the reliability and validity of the SCARED. The Spice Girls and Backstreet Boys are playing on a CD in the background and we’re ready to get to work!
Discussion Questions
1 The developers of the SCARED wanted to create a brief questionnaire that might identify children at risk for anxiety and related disorders. At that time, there were already several structured interviews that clinicians could use to identify anxiety disorders in children. Why did the researchers want to create a questionnaire, too?
2 The SCARED is a questionnaire that can be administered to both parents and children separately. Why was it important for the test’s authors to develop a screening instrument that could be administered to both adults and children?
3 The SCARED is a norm-referenced test. What does it mean when we say that a test is “norm-referenced?” If we wanted to create the SCARED as a norm-referenced test, what would we need to do?
4 How might we assess the test-retest reliability of the SCARED?
5 How might we assess the internal consistency of the SCARED?
6 What is validity? Can a test be valid without being reliable?
7 How might we assess the content validity of the SCARED?
8 How might we assess the construct validity of the SCARED?
9 How might we assess the criterion-related validity of the SCARED?
References
Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 545–553.
Bodden, D. H., Bögels, S. M., & Muris, P. (2009). The diagnostic utility of the Screen for Child Anxiety Related Emotional Disorders-71 (SCARED-71). Behavior Research and Therapy, 47, 418–425.
This case study accompanies the textbook: Weis, R. (2021). Introduction to abnormal child and adolescent psychology (4th ed.). Thousand Oaks, CA: Sage. Answers appear in the online instructor resources. Visit https://sagepub.com.
Case Study: Val Revised: Applying the Systems of Psychotherapy
There are hundreds of different systems or “schools” of psychotherapy. Chapter 4 in the text presents five broad approaches to therapy that are most often used with children and adolescents.
Let’s look at the case of Val once again, the adolescent with an opioid use disorder. If you were Val’s therapist, what approach to treatment would you recommend? If you were Val, what approach to treatment would you prefer?
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Description
Valerie Connell was a 16-year-old girl who was referred to an inpatient residential treatment program for adolescents with substance use disorders. Val was ordered to participate in treatment by the juvenile court after she was arrested for opioid possession and distribution.
Val grew up in a western suburb of Chicago. Her father was a musician with a history of alcohol and marijuana use problems. He left Val and her mother when Val was 5 years old. Although he continued to live in the Chicago area, he had only occasional contact with Val. Val had mixed feelings about her father. On one hand, she was attracted to his glamorous lifestyle: performing, traveling, and socializing. On the other hand, she resented his decision to abandon his family when she was so young and harbored anger toward him because of the many times he disappointed her over the years. “If your own dad doesn’t care about you, no one will,” said Val. “I saw myself as pretty worthless—like no one will ever really love me.”
Val’s mother also had a history of alcohol use. She became pregnant with Val when she was 17, a single parent by the time she was 22, and a recovering alcoholic by the time she was 26. Mrs. Connell attends Alcoholics Anonymous meetings to maintain her sobriety and supports herself and Val by working two jobs. Long hours limit her ability to be involved in Val’s school or extracurricular activities. Although she says, “Val means the world to me—the one thing I live for,” she admits that stress at work and concerns about her ability to pay the bills “sometimes cause me to lose my temper with her.”
Val exhibited problems with hyperactivity and oppositional behavior as a preschooler. “She was a handful,” recalled her mother. “She’d always be on the go, she never wanted to be quiet and listen to me. If I would tell her to do something, she’d ignore me, yell, or scream.” Val’s disruptive behavior persisted into elementary school. Her pediatrician prescribed stimulant medication to manage her hyperactive-impulsive behavior, but it had little effect on her defiance and tantrums. By the time Val was in the third grade, she was behind her classmates in reading and math and had gained a reputation as a troublemaker.
Val’s substance use began with her transition to middle school. She was referred to a special education program for children with behavior problems and learning disabilities. She quickly made friends with several girls who introduced her to smoking (age 12) and marijuana (age 13). Although she tried alcohol at approximately the same age, she did not like its taste and limited its use to parties and social gatherings. By the time Val was 14 years old, she was using marijuana several times per week and drinking five to six sweet alcoholic drinks at parties on the weekends. She found it easy to hide her substance use from her mother.
Val transitioned to an alternative high school during her freshman year. “All of the kids there used drugs,” Val recalled. Her 17-year-old boyfriend introduced her to prescription pain medication. Val’s favorite combination was OxyContin in the morning followed by Roxicodone periodically throughout the school day. She quickly became known as the “Oxy and Roxy” girl. “I’d sleep during class, slur my speech, didn’t care about anything,” she recalled. “The teachers didn’t say anything to me because I didn’t cause trouble, so I kept on going.” Val obtained $10 pills from her boyfriend and sold them to classmates for $25, pocketing the profits to support her own drug use.
“I first used heroin with my boyfriend—a different boyfriend—during my sophomore year,” Val reported. “I was afraid of needles so I snorted it. The feeling was excellent, like all the pain in my life was taken away. I could relax, stay still, and not worry about school or family. Snorting worked much faster than taking pills and the effects of heroin were much better.” Within 6 months, Val was