Revised Child Anxiety and Depression Scale – Parent (RCADS-Parent)

The measure consists of six subscales that screen for high prevalence disorders in youth:

• Separation Anxiety Disorder: Assesses excessive fear or anxiety concerning separation from attachment figures.
• Social Phobia: Measures fear of social situations and potential negative evaluation from others.
• Generalised Anxiety Disorder: Evaluates excessive anxiety and worry across multiple situations.
• Panic Disorder: Assesses abrupt surge of intense fear or discomfort accompanied by somatic and cognitive symptoms.
• Obsessive-Compulsive Disorder: Measures presence of obsessions (recurrent, intrusive thoughts) and compulsions (repetitive behaviours aimed at reducing anxiety).
• Major Depressive Disorder: Assesses symptoms of depression such as low mood, anhedonia, worthlessness, and fatigue.

In addition to the subscales, a Total Internalising score that is a combination of all six subscales is provided that gives an overall indication of the level of internalising problems. A Total Anxiety score that is a combination of the five anxiety subscales provides an overall indication of anxiety problems.

A parallel self-report version, the RCADS-Child, can be used in conjunction with the RCADS-Parent to gather additional clinical information. The RCADS is well-suited for screening and monitoring of anxiety and depressive symptoms in youth.

Example RCADS-Parent Items

The RCADS-Parent yields a Total Internalising Scale (sum of all 6 subscales) and a Total Anxiety Scale (sum of 5 anxiety subscales) to provide an overall indication of symptom severity. Higher scores are indicative of more difficulties and greater symptom severity.

The RCADS provides raw scores for the six subscales that are converted to percentiles based on the child’s age group (8-10, 11-12, 13-14, 15-16, or 17-18 years) and gender (Ebesutani et al., 2011). A percentile of 50 reflects the average symptom level relative to age and gender-based peers, while increasingly higher percentiles indicate more severe symptoms (e.g. > 93.31st percentile signifies elevated symptoms).

A descriptor is provided based upon the following criteria:

• “Normal” = 84th percentile and below
• “Mild” = between 85th and 93.31st percentile
• “Elevated” = between the 93.32nd and 97.72nd percentile
• “Clinical” = 97.73rd percentile and above

The six subscales assessed by the RCADS-Parent are:

• Separation Anxiety Disorder (items 5, 9, 17, 18, 33, 45, 46):
  Assesses excessive fear or anxiety concerning separation from attachment figures.
• Social Phobia (items 4, 7, 8, 12, 20, 30, 32, 38, 43):
  Measures fear of social situations and potential negative evaluation from others.
• Generalised Anxiety Disorder (items 1, 13, 22, 27, 35, 37):
  Evaluates excessive anxiety and worry across multiple situations.
• Panic Disorder (items 3, 14, 24, 26, 28, 34, 36, 39, 41):
  Assesses abrupt surge of intense fear or discomfort accompanied by somatic and cognitive symptoms.
• Obsessive-Compulsive Disorder (items 10,16, 23, 31, 42, 44):
  Measures presence of obsessions (recurrent, intrusive thoughts) and compulsions (repetitive behaviours aimed at reducing anxiety).
• Major Depressive Disorder (items 2, 6, 11, 15, 19, 21, 25, 29, 40, 47):
  Assesses symptoms of depression such as low mood, anhedonia, worthlessness, and fatigue.

The RCADS subscales are best conceived as dimensional symptom clusters rather than diagnostic categories. Higher scores suggest greater symptom severity and clinical risk and should be integrated with clinical judgement to guide diagnostic formulation and treatment planning.

Plots demonstrating the subscale percentiles are presented upon first administration. Longitudinal plots are displayed for both the subscale percentiles and the Total Internalising percentile upon multiple administrations to enable tracking of symptoms over time.

The RCADS-Parent was validated in a community sample of 967 parents of children and adolescents (Ebesutani et al., 2011). The RCADS-Parent demonstrated high internal consistency (total score = 0.93), test-retest reliability (2-weeks = 0.69 – 0.89), and good convergent/divergent validity (r = 0.70 with CBCL Anxious/Depressed scale; Ebesutani et al., 2011). Factor analysis revealed that it also supported the 6 factor structure of the RCADS-Parent; separation anxiety disorder, social phobia, generalised anxiety, panic disorder, obsessive compulsive disorder and major depressive disorder (Ebesutani et al., 2011).

The Ebesutani et al. (2011) study provides normative data for children between 8-18 years of age, and is used to derive percentile scores. The grades are used to estimate the age of the children in the sample and is consistent with the official scoring (see https://rcads.ucla.edu/scoringoverview) for the Ebesutani et al. (2011) sample except that NovoPsych includes ages 8-10 in the Grade 3 & 4 bracket (whereas the official RCADS scoring sets this as ages 9-10 despite the Ebesutani et al. (2011) sample including 8-year olds). If gender is not specified for the client (or non-binary is selected), then a combined male/female and age 8-18 mean and standard deviation (as specified by Ebesutani et al. (2011)) is used for calculating the percentiles.

Descriptors are based upon T-Scores, however for ease of interpretation these scores are converted to percentiles:

• Normal = 84th percentile and below (equivalent to T Scores of 60 and below)
• Mild = between the 85th and 93.31st percentile (equivalent to T Scores of between 60.01 and 64.99)
• Elevated = between the 93.32nd and 97.72nd percentile (equivalent to T Scores between 65 and 69.99)
• Clinical = 97.73rd percentile and above (equivalent to T Scores of 70 and above)

A reliable change score has been determined by NovoPsych for the Internalising Score from data collected between July 2020 and July 2024 where clients had completed multiple RCADS-Parent assessments. All data was included in the analysis, so no data was removed based upon initial symptom severity. The resultant sample size was 4,664. The reliable change score was calculated using the Jacobson-Truax method of clinical significance classification (Jacobson & Truax, 1991) using calculated Cronbach alpha’s from the NovoPsych data. The internal reliability calculated for the Internalising Score was 0.95 and the reliable change score calculated was 14, indicating that scores that change 14 points or more are indicative of clinically significant change.

For comprehensive  information about the RCADS, see here. 

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