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Child & Youth Mental Health Algorithm - GPSC

Child & Youth Mental Health Algorithm - GPSC

Anxiety Assessment

Anxiety Assessment ToolsScared QuestionnaireParentWeissSymptom Record (WSR)Scared QuestionnaireChild / YouthWeissInstructionsChildren’s Yale-BrownObsessive Compulsive ScaleSocial Anxiety Scalefor Adolescents (K-GSADS-A)

SCARED – Child VersionPg. 1 of 3 (To be filled out by the CHILD/TEEN) (Birmaher, Kheterpal, Cully, Brent and McKenzie,1995)Name:Date:Directions:Below is a list of sentences that describe how people feel. Read each phrase and decide if it is “Not True or HardlyEver True” or “Somewhat True or Sometimes True” or “Very True or Often True” for you. Then for each sentence,fill in one circle that corresponds to the response that seems to describe you for the last 3 months.1. When I feel frightened, it is hard to breathe.2. I get headaches when I am at school.3. I don’t like to be with people I don’t knowwell.4. I get scared if I sleep away from home.5. I worry about other people liking me.6. When I get frightened, I feel like passingout.7. I am nervous.8. I follow my mother or father wherever theygo.9. People tell me that I look nervous.10. I feel nervous with people I don’t knowwell.11. I get stomachaches at school.12. When I get frightened, I feel like I am goingcrazy.13. I worry about sleeping alone.14. I worry about being as good as other kids.15. When I get frightened, I feel like things arenot real.16. I have nightmares about something badhappening to my parents.17. I worry about going to school.18. When I get frightened, my heart beats fast.19. I get shaky.20. I have nightmares about something badhappening to me.0Not TrueHardlyEver True1SomewhatTrue orSometimesTrue2Very Trueor Often True55_CYMH_PSP_SCARED_Child_2012_01_03 (2).doc 1 of 3

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