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The Multidimensional Anxiety Scale for Children 2

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shelley sullivan

on 11 June 2015

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Transcript of The Multidimensional Anxiety Scale for Children 2

4 Uses
Rationale for Development
NEW
Functional Features of the MASC 2
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New:

2 questionnaire forms (self-report and parent-report); both the structure of the forms and actual items are parallel.


New:

added scales to capture additional dimensions of anxiety—the GAD Index and the Anxiety Probability score, which captures the likelihood of a youth having at least 1 anxiety disorder.


Inconsistency Index:
Response style score: items that are cross-validated for consistency of response. Inconsistent responses create a total Inconsistency Index score.


Anxiety Probability Index
is determined by the combined number of elevated T-scores

6
Scales and
4
subscales of dimensions of anxiety:
to be used as an adjunct to the process of diagnosing anxiety disorders

to aid in the early identification of anxiety-prone youths

to monitor treatment effects and outcomes; and

Research purposes (epidemiological, clinical, normal and abnormal development, etc.).
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Development
distinct diagnostic criteria for anxiety disorders in children were not developed until the DSM III (1980) (which included developmental context)

The original MASC came out in 1997 and was first to look at the range, constellation, and severity of anxiety symptoms in children rather than any specific anxiety construct,
from the youth's point of view

Purpose
the MASC 2 is an updated version of the original MASC
it is a comprehensive assessment of the dimensions of anxiety
indexes a range and severity of anxiety symptoms in children and youth aged 8 to 19
includes a broad range of emotional, physical, cognitive, and behavioral symptoms of anxiety.
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(John Marsh, 2013)
The Multidimensional
Anxiety Scale
for Children 2


existing self-report assessment tools at the time were adaptations of adult scales

available scales lacked adequate symptom coverage

developmental trends and gender differences can be seen in anxiety symptoms

presentation of anxiety symptoms can be different from adults due to environmental and societal contexts (youth may under report)

gender and age norms were needed to differentiate normal from pathological anxiety
Administration
• may be used with individuals or groups

• 50 item paper/pencil questionnaire using a Likert-type scale (never, rarely, sometimes, often). Online administration available allowing remote testing

• Takes approximately 15 minutes to administer

• Easy readability (Grade 2 equivalent for SR; Grade 2.2 equivalent for PR). Reading assistance allowable for those with weak reading skills

• Meant for English-speakers

• Paper-pencil form has an internal scoring sheet;
online scoring and interpretation available

Dimensions of Anxiety Scales and Subscales across 4 Symptom Dimensions: emotional, physical,cognitive, and behavioural


Scales:
Subscales: # of Items
______________________________________________________________
1. Separation Anxiety/ Phobia 9
2. Generalized Anxiety Disorder Index 10
3. Social Anxiety
a. Humiliation/ Rejection 5
b. Performance Fears 4
4. Obsessive Compusive 10
5. Physical Symptoms
a. Panic 7
b. Tense/ Restless 5
6.Harm Avoidance 8
_____________________________________________________________

Total Items 50
Standardization Samples and Norms
Large Samples, representative of the population 8-19 years

Self-Report: N = 1,800
Parent Report: N=1,600

The normative data were weighted to match the U.S. Census and the Canadian Census.

Participants in the samples were representative of the population (gender, age) and proportionally stratified by race/ethnicity. (Asian, Black, Hispanic/Latino, White, other)

Population samples are representative of 23 US states and 3 Canadian provinces (provinces not specified)
(4 geographic regions: Northeast, Midwest, South, West)
Age, gender, and parental education levels were covariates

Is it generalizable?
Scoring, Reporting, and Interpreting
Scoring Options:

easy scoring grid form
online scoring available
scoring software available
MAC and PC friendly
Inconsistency Index
Scales and Subscales
Self-Report Form

50 items
Likert-type scale
easy readability (grade 2)
15 minutes to administer
Parent-Report Form
parallel in content and form
Utility
can be employed for the assessment of individuals and groups

the evaluation of interventions and programs

progress monitoring of individuals, treatment planning

research purposes

Limitations
Although the standardization procedures appear to be adequate, the MASC 2’s representativeness for
Canadian
youth, nontraditional families (i.e.,with a single father), urban/rural populations differences, and some racial/ethnic groups is questioned.
Cautions/ Ethical Use
not suitable as a stand-alone tool for assessment, diagnosis ,or treatment planning; useful as an adjuct tool

not to be used with an unwilling or resistant participant

not to be used with anyone disoriented, severely impaired, or not proficient in English.

Administrator should have B-level qualifications Individuals who don’t have qualifications may not interpret results; a qualified person must do this

Users must also be a member of a professional body with ethical standards or regulated professionals in psychology, education, social work, or allied field.


Report Types
1. Assessment Reports for Individuals

2. Progress Report: an overview of change over time by combining and comparing results of up to 4 administrations

3. Comparative Report: a multi-rater perspective that combines youth scores with parents
Quick
Youth-friendly format and readability increase likelihood of valid responses
Can use it as a screening tool for inclusion/exclusion criteria for groups
Can determine if a youth has 1 or more co-morbid anxiety disorders
Can use it with large groups as a screening tool to identify those who are anxiety prone, or who may benefit from intervention or support (Probability Score Index)
Can be compared with results from other instruments
Can use it repeatedly to assess client change over time
Can use it as a pre-and post-test to evaluate the effects of a treatment program or intervention

Reliability
Internal Consistency and Test-Retest

Cronbach’s Alpha (interrelatedness of items; length): coefficients are presented for normative sample, and for those with a diagnosed anxiety disorder (non-clinical and clinical groups)

Test-Retest: Test–retest reliability was assessed using a sample of 98 adolescents and 95 parents who completed the MASC 2–SR and MASC 2–P, respectively. Forms were completed twice with 1 to 4 weeks separating administrations. Initial scores were correlated from
those of the retest. Corrected correlation values for the MASC 2 forms ranged from .80 to .94, all significant at p < .001.

Confidence Intervals were 95%. Between 86.7% to 95.9% of the scores changes by less than 1 standard deviation. These results indicate strong test–retest reliability of MASC 2–SR and MASC 2–P

Discriminative Validity

As an additional source of validity information, the MASC 2 Anxiety Scales’ target groups were examined and compared on all scales.

Multivariate and covariate analyses of clinical and non-clinical groups were compared.
Group membership was the independent variable; other demographic variables were covariates. Multiple groups were assigned to each scale and subscale. The effect of group membership was p<.01 for all scales.

Clinical groups scored significantly higher on all scales, with moderate to large effect sizes.
Youth diagnosed with separation anxiety disorder, GAD, and social phobia scored highest on the Separation Anxiety/Phobias scale, GAD Index, and Social Anxiety: Total scale, respectively.

These results provide further support for the discriminative validity of the MASC 2.

Able to discriminate between general population youths and youths with various clinical disorders



T- Scores

• Compared to Beck Youth Inventory-Anxiety (Beck, Beck, & Jolly, 2001) and the Conners Comprehensive Behaviour Rating Scale-Parent (Conners, 2008)
• BAI-Y and the MASC 2 SR moderately to highly corrected was .73. All other scales, subscales were relatively similar

Convergent Validity
Inter-rater Consistency
Examining inter-rater scores provides a way to examine construct validity because the same behaviour is being rated by 2 people.
Additional evidence of the MASC 2’s construct validity evidence was gathered by comparing scores across self and parent ratings.
Advantages
Generalizability
Analyses were conducted to determine whether there was similarity of scores across race/ethnic groups from the normative samples.

Differences in sample groups were statistically controlled; separate analyses were done on items and scales/subscales. All scores and groups were compared and Type 1 errors controlled for. (“Other” was omitted from this analasis).

No meaningful differences were found between racial groups.
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