Measuring Anxiety in Children: A Methodological Review of the Literature
Article Outline
This paper provides a comprehensive methodological review of the literature concerning anxiety measurement in children. Initially, a conceptual basis for anxiety measures is introduced, followed by specific approaches to measuring childhood anxiety based on 14 original articles. In particular, a variety of strategies that have been used in previous research are discussed in detail with theoretical underpinnings. Common approaches to measure anxiety such as self-reported instruments, observational ratings, and behavioral checklists are reviewed one by one with a critical look at the strengths and weaknesses of each of these approaches. While multiple measures of anxiety are available to assess the level of anxiety in children, selection of measurement approach should be an iterative process based on rigorous evaluation of evidence of reliability and cross-validation of the tool across different age groups of children.
Key Words: anxiety , child , epidemiologic measurement
No full text is available. To read the body of this article, please view the PDF online.
References
- *Indicates studies measuring anxiety in children that were included in the review.
- * . Manual for the child behavior checklist/4–18 and 1991 profile . Burlington, VT: University of Vermont, Department of Psychiatry; 1991;
- . Psychological problems in Turkish asthmatic children and their families . Allergologia et immunopathologia . 2003;31:282–287
- . In: Diagnostic and statistical manual of mental disorders: DSM-IV . 4th ed.. Washington, DC: American Psychiatric Association; 2000;p. 429–484
- . The relationship among social phobia, objective and perceived physiological reactivity, and anxiety sensitivity in an adolescent population . Journal of Anxiety Disorder . 2009;23:18–26
- * . The Preschool Behavior Questionnaire . Journal of Abnormal Child Psychology . 1977;5:256–275
- . Anxiety and depression in children and adolescents with sickle cell disease . Current Psychiatry Reports . 2007;9:114–121
- . Discriminating patterns of emotions in 10-and 11-year-old children's anxiety and depression . Journal of Personality and Social Psychology . 1986;51:852–857
- . In: The anxiety and phobia workbook . 4th ed.. Oakland, CA: New Harbinger Publications; 2006;p. 4–29
- * . Specificity in verbal and physiological indicants of anxiety . Perceptual and Motor Skills . 1969;29:663–675
- . The children's form of the manifest anxiety scale . Child Development . 1956;27:317–326
- . Comments on Drs. Lazarus and Averill's paper . In: Spielberger CD editors. Anxiety: Current trends in theory and research . New York: Academic Press; 1972;p. 285–290
- . The nature of anxiety: A review of thirteen multivariate analyses comprising 814 variables . Psychological Reports . 1958;4:351–388
- * . Assessment of worry in children of the Penn State Worry Questionnaire . Behavior Research and Therapy . 1997;35:569–581
- . Pain coping profiles in adolescents with chronic pain . Pain . 2008;140:368–375
- * . Child drawing: Hospital – an instrument designed to measure the emotional status of hospitalized school-aged children . Journal of Pediatric Nursing . 1999;14:2–9
- . Genetic testing for cancer in children: Short-term psychological effect . Archives of Pediatric and Adolescent Medicine . 1996;150:1131–1138
- When mom or dad has cancer: Markers of psychological distress in cancer patients, spouses, and children . Health Psychology . 1994;13:507–515
- . Predicting change in academic abilities after conformal radiation therapy for localized ependymoma . Journal of Clinical Oncology . 2008;26:3965–3970
- * . An S-R inventory of anxiousness . Psychological Monographs . 1962;536:1–33
- . Specificity in somatic responses to anxiety . Perceptual and Motor Skills . 1967;24:1183–1190
- * . Manifest anxiety: Unifactorial or multifactorial composition . Perceptual and Motor Skills . 1965;20:773–780
- . Effects of task difficulty on state-trait anxiety in emotionally disturbed children . Journal of Genetic Psychology . 1978;133:253–259
- . The problem of anxiety . New York: Norton; 1936;
- . Public and private heart rate feedback in social phobia: A manipulation of anxiety visibility . Cognitive Behaviour Therapy . 2004;33:36–45
- . Child sexual abuse prevention: Evaluation and one-year follow-up . Child Abuse & Neglect . 1991;15:123–138
- . Impact of parental anxiety on child emotional adjustment when a parent has cancer . Oncology Nursing Forum . 1997;24:655–661
- . Comments on Drs. Phillips, Martin, and Meyers' paper . In: Spielberger CD editors. Anxiety: Current trends in theory and research . New York: Academic Press; 1972;p. 465–468
- . Low-end specificity of childhood measures of emotional distress: Differential effects for depression and anxiety . Journal of Personality Assessment . 1996;67:258–271
- * . Field-dependence, anxiety, and personality . Perceptual and Motor Skills . 1974;38:1328
- . Children's attitudes toward behavior management techniques used by dentists . Journal of Dentistry for Children . 2007;74:4–9
- * . An investigation of somatic anxiety and intelligence in children using the Kaufman-ABC and an APPLE Iie program measuring heart rate . Perceptual and Motor Skills . 1990;70:387–394
- Impact of tonsillectomy on pediatric psychological status . International Journal of Pediatric Otorhinolaryngology . 2008;72:1359–1363
- . Primary process thinking and anxiety in children . Journal of Personality . 1988;52:254–262
- . Rating scales to assess depression in preschool children . Acta Paedopsychiatry . 1981;46:305–315
- . The life situation of parents over the first year after their child's cancer diagnosis . Acta Paediatrica . 2004;93:1654–1660
- . Emotion and cognition: with special reference to anxiety . In: Spielberger CD editors. Anxiety: Current trends in theory and research . New York: Academic Press; 1972;p. 241–283
- * . Palmar sweating and transitory anxiety in children . Child Development . 1965;36:115–124
- . Psychosocial functioning in pediatric inflammatory bowel disease . Inflammatory Bowel Diseases . 2006;12:239–244
- . The meaning of anxiety . New York: Ronald Press; 1950;
- . Development and validation of the Penn State Worry Questionnaire . Behavior Research and Therapy . 1990;28:487–495
- . Prevalence of psychological problems amongst Iranian immigrant children and adolescents in UK . Iranian Journal of Psychiatry . 2006;1:12–18
- . Adjustment responses of children and their mothers to cancer: Self-care and anxiety . Oncology Nursing Forum . 1997;24:519–525
- . Psychiatric morbidity, stressors, impact, and burden in juvenile idiopathic arthritis . Journal of Health, Population, and Nutrition . 2005;23:142–149
- . The psychology of intelligence . London: Routledge; 1950;
- * . Analysis of general anxiety scale for children and draw-a-person measures of general anxiety level of elementary school children . Perceptual and Motor Skills . 1975;41:995–1007
- * . The development and validation of a behavior rating scale for blood sampling with children . Heart & Lung . 1984;13:540–545
- . Concurrent validity of What I think and feel: A revised measure of children's manifest anxiety . Journal of Abnormal Child Psychology . 1980;6:271–280
- * . What I think and feel: A revised measure of children's manifest anxiety . Journal of Abnormal Child Psychology . 1978;6:271–280
- Quality of life and behavioral follow-up study of pediatric survivors of craniopharyngioma . Journal of Neurosurgery . 2005;103:302–311
- Behavioral and social outcomes in adolescent survivors of childhood cancer: A report from the childhood cancer survivor study . Journal of Clinical Oncology . 2007;25:3649–3656
- . Psychosocial functioning of young adolescent and adult survivors of childhood cancer . Support Care in Cancer . 2008;16:29–36
- . Assessment of children's anxiety throughout dental treatment by their drawings . Journal of Dentistry for Children . 1982;49:99–106
- . Human figure drawings as a measure of the child's response to dental visits . Journal of Dentistry for Children . 1977;44:438–442
- . Theory and research on anxiety . In: Spielberger CD editors. Anxiety and behavior . New York: Academic Press; 1966;p. 3–20
- . Conceptual and methodological issues in anxiety research . In: Spielberger CD editors. Anxiety: Current trends in theory and research . New York: Academic Press; 1972;p. 481–493
- * . Manual for the State-Trait Anxiety Inventory for Children . Palo Alto, CA: Consulting Psychologists Press; 1973;
- . Social and emotional adjustment in young survivors of childhood cancer . Supportive Care in Cancer . 2001;9:489–513
- . Quality of life and current coping in young adult survivors of childhood cancer: Positive expectations about the further course of the disease were correlated with better quality of life . Psychooncology . 2006;15:31–43
- . The interpersonal theory of psychiatry . New York: Norton; 1953;
- . Alexithymia in adolescents with chronic fatigue syndrome . Journal of Psychosomatic Research . 2007;63:377–380
- . Self-esteem, depression and anxiety among Swedish children and adolescents on and off cancer treatment . Acta Paediatrica . 2000;89:229–236
- . Understanding anxiety and depression: Their relation to negative and positive affective states . In: Kendall PC , Watson D editor. Anxiety and depression: Distinctive and overlapping features . San Diego, CA: Academic Press; 1989;p. 3–26
- . Adjustment of children and adolescents to parental cancer . Cancer . 1996;77:1409–1418
- Wesley, R. L. (1988). Social support and health outcomes associated with children with sickle cell disease. Unpublished doctoral dissertation, University of Maryland, Baltimore, Maryland, USA.
- . Emotional adaptation in children after liver transplantation . Journal of Pediatrics . 1991;119:880–887
- . Competence of and emotional/behavioral problems in pediatric oncology patients in Taiwan . Cancer Nursing . 2004;27:413–422
PII: S1976-1317(09)60016-5
doi:10.1016/S1976-1317(09)60016-5
© 2009 Korean Society of Nursing Science. Published by Elsevier Inc. All rights reserved.
