Encuesta

RESEARCH

UPDATE

REVIEW

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.

Ten-Year Review ofRating Scales. II: Scales for Internalizing Disorders
KATHLEEN MYERS, M.D., M.P.H., M.S., AND NANCY C. WINTERS, M.D.
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 multiplecitations 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 theirsuitability 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 canreliably, 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. J. Am. Acad. Child Adolesc.Psychiatry, 2002, 41(6):634–659. Key Words: depression-rating scales, anxiety-rating scales, measurement, assessment.

This article is the second in a series of 10-year updates on the use of rating scales in child and adolescent psychiatry. In the first article, we discussed definitions, variability of scales, psychometric properties, and practical issues in scale selection (Myers and Winters, 2002).We also described the procedures used in selecting scales presented in this series. In brief, we decided to present recently developed scales as well as older scales developed more than 10 years ago but with continued applications over the past decade. Similar to the review of newer scales, review of these older scales includes their original develAccepted January 3, 2002. Dr. Myers is AssociateProfessor at the University of Washington School of Medicine and Director of Consultation-Liaison Psychiatry at Children’s Hospital and Regional Medical Center (CHRMC), Seattle. Dr. Winters is Assistant Professor and Director of Training at Oregon Health Sciences University, Portland. Correspondence to Dr. Myers, Division of Child Psychiatry CH-13, CHRMC, Box 5371, 4800 Sand Point Way, N.E.,Seattle, WA 98105. 0890-8567/02/4106–0634 2002 by the American Academy of Child and Adolescent Psychiatry.

opment, psychometric properties, functioning, and recent applications. Over the past decade, these older scales may have been revised, reexamined psychometrically, applied to different populations, or simply used widely. However, they have not been reviewed in relation to other available scales.Therefore, we thought that a 10-year update would benefit from comparing the functioning of both older and newer scales. To select the most appropriate scales for inclusion here, we reviewed scales cited in the child and adolescent psychiatric literature over the past 25 years. Older scales were selected for inclusion that have long track records in research and clinical work, established...