SCARED Parent Version Anxiety Screening Tool (ages 8-18 years)

Patient's Name:

Patient's Date of Birth:

Today's Date:

Directions:

Below is a list of sentences that describe how people feel. Read each phrase and decide if it is “Not True or Hardly Ever True” or “Somewhat True or Sometimes True” or “Very True or Often True” for your child. Then, for each statement, select the box that corresponds to the response that seems to describe your child for the last 3 months. Please respond to all statements as well as you can, even if some do not seem to concern your child.

1. When my child feels frightened, it is hard for him/her to breathe.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

2. My child gets headaches when he/she is at school.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SCH

3. My child doesn’t like to be with people he/she doesn't know well.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SOC

4. My child gets scared if he/she sleeps away from home.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SEP

5. My child worries about other people liking him/her.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

GA

6. When my child gets frightened, he/she feels like passing out.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

7. My child is nervous.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

GA

8. My child follows me wherever I go.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SEP

9. People tell me that my child looks nervous.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

10. My child feels nervous with people he/she doesn’t know well.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SOC

11. My child gets stomachaches at school.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SCH

12. When my child gets frightened, he/she feels like he/she is going crazy.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

13. My child worries about sleeping alone.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SEP

14. My child worries about being as good as other kids.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

GA

15. When my child gets frightened, he/she feels like things are not real.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

16. My child has nightmares about something bad happening to his/her parents.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SEP

17. My child worries about going to school.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SCH

18. When my child gets frightened, his/her heart beats fast.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

19. He/she gets shaky.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

20. My child has nightmares about something bad happening to him/her.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SEP

21. My child worries about thins working out for him/her.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

GA

22. When my child gets frightened, he/she sweats a lot.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

23. My child is a worrier.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

GA

24. My chuild gets really frightened for no reason at all.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

25. My child is afraid to be alone in the house.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SEP

26. It is hard for my child to talk with peaple he/she doesn't know well.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SOC

27. When my child gets frightened, he/she feels like he/she is choking.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

28. People tell me that my child worries too much.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

GA

29. My child doesn't like to be away from his/her family.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SEP

30. My child is afraid of having anxiety (or panic) attacks.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

31. My child worries that something bad might happen to his/her parents.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SEP

32. My child feels shy with people he/she doesn't know welll.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SOC

33. My child is worries about what is going to happen in the future.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

GA

34. When my child gets frightened, he/she feels like throwing up.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

35. My child worries about how well he/she does things.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

GA

36. MY child is scared to go to school.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SCH

37. My child worries about things that have already happened.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

GA

38. When my child gets frightened, he/she feels dizzy.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

PA/SO

39. My child feels nervous when he/she with other children or adults and he/she has to do something while him/her (for example: read aloud speak, play, a game, play a sport).

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SOC

40. My child feels nervous when he/she is going to parties, dances, or any place where there will be people that he/she doesn't know well.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SOC

41. My child is shy.

Not True or Hardly Ever True (0) Somewhat True or Sometimes True (1) Very True or Often True (2)

SOC

The SCARED is available at no cost at www.pediatricbipolar.pitt.edu under resources/instruments.

January 19, 2018

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