Investigating the Structure of Anxiety Symptoms among Romanian Preschoolers Using the Spence Preschool Anxiety Scales
Benga, Oana, Tincas, Ioana, Visu-Petra, Laura, Cognitie, Creier, Comportament
The purpose of this study was to test the psychometric properties of the Spence Preschool Anxiety Scales (Spence, Rapee, McDonald, & Ingram, 2001) in a Romanian sample of preschoolers. The measure was completed by 718 mothers and 95 fathers of children aged 3 to 7 years. Regarding the structure of anxiety symptoms, (exploratory) principal components analysis and confirmatory factor analysis indicated either a four- or a five-factor solution as the best fit for the data. Due to the small differences between these models and to theoretical arguments, a model with five intercorrelated factors (social anxiety, physical injury fears, obsessivecompulsive disorder, separation anxiety and generalized anxiety), or one with an additional higher-order "anxiety" factor were preferred (although a four-factor model also provided a good fit for the data). There was also evidence for the construct validity of the instrument. We found good or acceptable internal consistency indices, while test-retest reliability was relatively low. Anxiety scores were generally higher than the ones reported by Spence et al. (2001). Symptoms of physical injury fears and social anxiety were the most common, but we found limited evidence for gender or age differences.
KEYWORDS: anxiety, preschoolers, Spence Preschool Anxiety Scales, confirmatory factor analysis.
Anxiety represents a highly prevalent childhood disorder (see Cartwright-Hatton, McNicol, & Doubleday, 2006, for a review), with an early onset (Gregory et al., 2007; Kessler, Berglund, Demler, & Jin, & Walters, 2005), and with a dramatic impact upon the individual's developmental trajectory, predicting increased risk for adult mental disorders, substance use and academic underachievement (Kendall, Safford, Flannery-Schroeder, & Webb, 2004; Pine, Cohen, Gurley, Brook, & Ma, 1998; Woodword & Fergusson, 2001). Looking at the very early precursors of anxiety, a series of symptoms has been considered to present clinical significance, especially if their intensity, frequency, and duration surpass the typical "ontogenetic parade" of childhood fears (Scarr & Salapatek, 1970). However, even if there is a documented clinical significance of such early symptoms, their clustering into distinct categories, similar to adult diagnostic criteria has generated a longstanding debate in developmental psychopathology research (e.g., Costello, Egger, & Angold, 2004; Weems & Stickle, 2005).
Three main classification approaches have been used in research with preschoolers (as reviewed by Egger & Angold, 2006): 1) the use of "clinically significant" cutoff scores on symptom checklists; 2) interviews derived from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV, American Psychiatric Association, 1994), or 3) the Diagnostic Classification 0-3 (2005). We will focus on the benefits and problems associated with using DSM-IV criteria in very young children, since this is a prevailing approach used by practitioners in the field, which also constitutes the foundation for developing the preschool anxiety scales analyzed in this paper.
There are several arguments in favor of a DSM-based approach to early anxiety symptoms: the validation of such an approach for older children (e.g. Spence, 1997), some preliminary evidence that standard diagnostic constructs can be identified in young children (Egger et al., 2006; Task Force on Research Diagnostic Criteria: Infancy and Preschool-RDC-IP, 2003; Spence and collaborators, 2001, 2010), plus practical arguments regarding its accessibility and ease of use for practitioners. However, there are several reasons to apply DSM criteria with great caution when conducting research with preschoolers. To name just a few objections, DSM-defined disorders in young children are characterized by: 1) a high degree of comorbidity between different diagnostic categories (Weems, 2008); 2) developmental insensitivity, since they are relatively similar for children from 0 to 18 years old; 3) subjectivity, resulting from a lack of well-defined behavioral descriptors. …