PSYCHOMETRIC VALIDATION OF THE SLOVENIAN VERSION  
OF THE REVISED CHILD ANXIETY AND DEPRESSION SCALE - 
CHILD AND PARENT VERSIONS (RCADS AND RCADS-P)
PSIHOMETRIČNA VALIDACIJA SLOVENSKE RAZLIČICE REVIDIRANE 
LESTVICE ANKSIOZNOSTI IN DEPRESIJE ZA OTROKE –  
OBLIKA ZA OTROKE (RCADS) IN STARŠE (RCADS-P)
Mojca PETRIČ1    , Katja KURNIK MESARIČ2,3*    , Jana KODRIČ3,4    , Peter JANJUŠEVIĆ5
1Psychiatric Hospital Begunje, Begunje na Gorenjskem 55, 4275 Begunje na Gorenjskem, Slovenia
 2University Medical Centre Ljubljana, Department of Nephrology, Zaloška cesta 7, 1000 Ljubljana, Slovenia
 3University of Ljubljana, Faculty of Arts, Department of Psychology, Aškerčeva cesta 2, 1000 Ljubljana, Slovenia
 4University Medical Centre Ljubljana, University Children’s Hospital, Child 
Psychiatry Unit, Bohoričeva ulica 20, 1000 Ljubljana, Slovenia
 5The Counselling Centre for Children, Adolescents and Parents Ljubljana, Gotska ulica 18, 1000 Ljubljana, Slovenia
Received: Feb 20, 2024
Accepted: Jun 10, 2024
Original scientific article
*Correspondence: katja.kurnik.mesaric@kclj.si
10.2478/sjph-2024-0022 Zdr Varst. 2024;63(4):164-171
164© National Institute of Public Health, Slovenia. 
Petrič M, Kurnik Mesarič K, Kodrič J, Janjušević P. Psychometric validation of the Slovenian version of the Revised Child Anxiety and Depression Scale -  
child and parent versions (RCADS and RCADS-P). Zdr Varst. 2024;63(4):164-171. doi: 10.2478/sjph-2024-0022.
ABSTRACT
Keywords: 
RCADS
RCADS-P
Anxiety
Depression 
Psychometric  
properties 
Children 
Adolescents
IZVLEČEK
Ključne besede: 
RCADS
RCADS-P
anksiozne motnje
depresije
psihometrične lastnosti
otroci
mladostniki
Objective: Anxiety and depression are common disorders in children and adolescents and can have a negative 
impact on their lives. The Revised Child Anxiety and Depression Scale – Child and Parent versions (RCADS 
and RCADS-P) are widely used standardized measurement tools, but the Slovenian versions have not yet been 
validated. The aim of the present study was to examine the psychometric properties of the Slovenian version of 
RCADS and RCADS-P in a representative Slovenian school sample. 
Methods: We examined the psychometric properties (factor structure, internal reliability, short-term stability, 
inter-rater agreement and convergent validity) of the Slovenian version of the RCADS and the RCADS-P in 754 
primary and secondary school students and parents of 485 students. The short-term stability of anxiety and 
depressive symptoms in youth was assessed in a subsample of 117 children and adolescents.
Results: Confirmatory factor analysis showed an acceptable fit of the 6-factor model with CFI=0.92, TLI=0.92 
and RMSEA=0.056 for RCADS and with CFI=0.93, TLI=0.92 and RMSEA=0.047 for RCADS-P. Cronbach’s α and 
McDonald’s ω ranged from 0.70 to 0.95 for the total scale and the six subscales. The subscales correlated 
significantly positively with the total Child Anxiety Life Interference Scale score.
Conclusion: The results affirm the good psychometric properties of the Slovenian versions of RCADS and 
RCADS-P within a school-based sample. There is a need in the future to examine psychometric properties in 
clinical samples and to provide normative data.
Namen: Anksiozne motnje in depresija sodijo med pogostejše težave z duševnim zdravjem pri otrocih in 
mladostnikih. Revidirana lestvica anksioznosti in depresivnosti za otroke – oblika za otroke (RCADS) in starše 
(RCADS-P) je v svetu pogosto uporabljen, standardiziran merski pripomoček za ocenjevanje anksioznosti in 
depresivnosti pri otrocih in mladostnikih, ki pa v Sloveniji še ni bil psihometrično preverjen. Namen raziskave 
je bil preveriti psihometrične značilnosti slovenske oblike lestvic RCADS in RCADS-P na reprezentativnem vzorcu 
slovenskih osnovnošolcev in srednješolcev.
Metoda: Na vzorcu 754 otrok in mladostnikov ter 485 staršev smo preučevali psihometrične značilnosti (faktorsko 
strukturo vprašalnika, notranjo zanesljivost, kratkoročno stabilnost – retestno zanesljivost, strinjanje med 
ocenjevalci in konvergentno veljavnost) slovenske oblike vprašalnikov RCADS in RCADS-P. Kratkoročna stabilnost 
anksioznih in depresivnih simptomov je bila ocenjena v podvzorcu 117 otrok in mladostnikov.
Rezultati: Konfirmatorna faktorska analiza je pokazala sprejemljivo ustreznost šest-faktorskega modela z 
indeksi prileganja CFI = 0,92, TLI = 0,92 in RMSEA = 0,056 za obliko za otroke in mladostnike (RCADS), ter z indeksi 
prileganja CFI = 0,93, TLI = 0,92 in RMSEA = 0,047 za obliko za starše (RCADS-P). Koeficienti notranje zanesljivosti 
(Cronbachova α in McDonaldova ω) so se gibali med 0,70 in 0,95 za celotno lestvico in podlestvice. Podlestvice so 
bile pomembno pozitivno povezane s skupnim rezultatom lestvice CALIS, ki ocenjuje vpliv tesnobe na življenje 
otrok, mladostnikov in njihovih staršev.  
Zaključek: Rezultati potrjujejo ustrezne psihometrične lastnosti slovenskih oblik lestvic RCADS in RCADS-P pri 
šolskem vzorcu otrok in mladostnikov. V prihodnosti bi bilo potrebno lestvici preveriti tudi pri kliničnih vzorcih 
otrok ter zagotoviti normativne podatke za rabo lestvic.
1 INTRODUCTION
Internalising disorders affect a substantial number of 
children and adolescents and are a major health priority 
because of their negative impact on later health, 
education and well-being (1–3). An increase in internalising 
symptoms and disorders in children and adolescents had 
already begun before the COVID-19 pandemic (4–6), and 
the prevalence of anxiety and depression disorders in 
children and adolescents increased significantly during the 
pandemic (7). A meta-analysis revealed an overall pooled 
prevalence of anxiety and depression of 32% in children 
and adolescents after the COVID-19 pandemic (8). There is 
high comorbidity between anxiety and depression (2, 9). 
Internalising disorders in childhood and adolescence 
are associated with impaired social functioning, peer 
difficulties, academic difficulties and underachievement, 
as well as psychopathology in adulthood (anxiety disorders, 
depression, substance abuse), and represent a severe 
social and economic burden (10–15). Early identification 
and treatment of internalising disorders in childhood 
and adolescence is important for reducing the negative 
impact of such disorders. One of the barriers to early 
identification of internalising symptoms and assessment 
of the treatment outcomes is the lack of comprehensive, 
consensus and valid measurement tools (16, 17). 
The Revised Child Anxiety and Depression scale (RCADS 
and RCADS-P (18)) is currently one of the most widely 
used assessment tools in clinical and nonclinical settings 
for screening, differentiating and monitoring anxiety and 
depression symptoms in young people, which allows for 
the collection of data from multiple informants. Both 
child and parent versions measure symptoms of anxiety 
and depression that are included in the DSM criteria 
for separation anxiety disorder (SAD), social phobia 
(SP), generalized anxiety disorder (GAD), panic disorder 
(PD), obsessive-compulsive disorder (OCD), and major 
depressive disorder (MDD). Although obsessive compulsive 
disorder is categorized as Obsessive–Compulsive and 
Related Disorders rather than an anxiety disorder in 
DSM-5, it is clinically appropriate to continue to assess 
for OCD along with the anxiety disorders included in the 
RCADS measure, because of high comorbidity and common 
treatment components (19). 
Favourable reliability, validity and a six-factor structure 
consistent with DSM-IV criteria for anxiety disorders and 
depression, have been proven for RCADS and RCADS-P in 
clinical and nonclinical groups of English-speaking children 
and adolescents and their parents (19–22). The RCADS 
has been translated into 26 languages and the RCADS-P 
into 20 languages. The translations are available on the 
official website (https://rcads.ucla.edu/versions). Sound 
psychometric properties have been replicated in clinical 
and nonclinical samples for both versions (17, 23–32). 
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In Slovenia, there are two comprehensive assessment tools 
for internalizing and externalizing disorders in children 
and adolescents: the Achenbach System of Empirically 
Based Assessment (Child Behaviour Checklist - CBCL; 
Youth Self Report – YSR, Teacher Report Form – TRF) (33) 
and Strengths and Difficulties Questionnaire – SDQ (34). 
They have not yet been psychometrically examined in 
the Slovenian sample. Given the increase in symptoms 
of internalising disorders in children and adolescents, 
there is a need for reliable and valid assessment tools for 
internalising problems in childhood and adolescence. The 
RCADS is a freely available, valid tool, with the option of 
multiple informant assessment, and can serve not only as 
a screening tool but also as a diagnostic and treatment 
monitoring/assessment tool (35). The RCADS is available 
to users who read and agree to the terms of use, which 
are provided in the User’s Guide (18). The RCADS may be 
used for educational, professional and research purposes. 
The aim of the study was to investigate the psychometric 
and structural properties of the Slovenian versions of 
RCADS and RCADS-P in a nonclinical sample of children 
and adolescents aged 10 to 18 years. Based on previous 
research we hypothesized that the results of this study 
would confirm the reliability and validity of the six-factor 
Slovenian RCADS and RCADS-P. A secondary aim of the 
study was to assess parent-child agreement and short-
term reliability of the child version of the RCADS.
2 METHOD 
2.1 Participants 
For our study we considered primary and secondary school 
students (female and male), aged from 10 to 18 years from 
all the Slovenian regions and their parents. We reached 
out to Slovenian public primary and secondary schools. 
Sample characteristics are described in the results in 
section 3. 1.
2.2 Measures
The Revised Child Anxiety and Depression Scale (RCADS) 
(18,36) and the Revised Child Anxiety and Depression Scale 
– Parent Version (RCADS-P) (18,36) are questionnaires 
with 47 items that were developed to assess anxiety and 
depression symptoms in children and adolescents aged 8 
to 18 years. The items are rated on a 4-point Likert-scale. 
It comprises 6 subscales: separation anxiety disorder 
(SAD), social phobia (SP), generalized anxiety disorder 
(GAD), panic disorder (PD), obsessive compulsive disorder 
(OCD), and major depressive disorder (MDD). The sum of 
all six subscales results in the Total Internalizing Scale. 
The RCADS and the RCADS-P were translated into Slovenian 
with the permission of the authors and according to the 
translation terms and author’s instructions (https://rcads.
ucla.edu/node/15). The translation was approved by the 
10.2478/sjph-2024-0022 Zdr Varst. 2024;63(4):164-171
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authors. The Slovenian versions of the RCADS and RCADS-P 
are available at https://rcads.ucla.edu/versions.
The Child Anxiety Life Interference Scale (CALIS) (37) is 
a measure of the interference of anxiety on the lives of 
children and parents. The child version consists of 9 items, 
divided into two subscales (Outside home interference 
and Inside home interference) and total score. The parent 
version consists of 16 items divided into three subscales 
(Outside home interference, Inside home interference 
and Parent life interference) and total score. All items 
are rated on a five-point Likert scale (37). In the present 
study, we used the official translation, which was made 
according to the author’s terms and guidelines (38) and 
was approved by the authors. The CALIS demonstrated 
strong psychometric properties in other languages (37, 39–
41). The internal consistencies in our sample were for the 
children version ω=0.89 for total score, ω=0.86 for Outside 
home interference and 0.75 for Inside home interference. 
For the parent version, the internal consistencies 
were ω=0.93 for total score, ω=0.87 for Outside home 
interference, ω=0.80 for Inside home interference, and 
ω=0.90 for Parent life interference. 
2.3 Procedure 
The Ethics Committee of the Faculty of Arts at the 
University of Ljubljana approved the present study. We 
ensured that all participants - children, adolescents and 
their parents - were fully informed about the study, and 
they signed informed consent. 
Drawing on data from the Statistical Office of the Republic 
of Slovenia regarding the number of students by gender in 
the Eastern and Western Cohesion Regions of Slovenia, we 
contacted sixteen primary and eleven secondary schools 
across both Slovenian regions (quota sampling). Out of the 
schools contacted, 12 primary and 11 secondary schools 
agreed to participate. School counsellors informed all 
students and their parents about the study and invited 
them to participate. However, only those students who 
themselves and their parents provided informed consent 
were enrolled in the study. Parents received questionnaires 
from children and completed them at home. The children 
completed the questionnaires in their classrooms, where a 
school counsellor was present to assist with any questions. 
Attrition rates are described in Results, section 3. 1. 
After a three-month interval, a re-assessment was 
conducted with children from three schools (one 
elementary and two secondary) that agreed to participated 
in this step. A total of 129 questionnaires (17% from the 
original sample) were sent to schools to be distributed 
to all children and parents from these three schools. The 
questionnaires were completed in schools or at home. 
Attrition rates are described in Results, section 3. 1.  
2.4 Statistical analysis 
The confirmatory factor analysis (CFA) was performed with 
MPlus version 7.7. (42) to assess how well the empirical data 
fit a theoretical six-factor model confirmed in previous 
studies (17, 18, 24, 25, 27, 29, 30, 36). Three alternative 
models identified from the literature (43) that represent 
various competing conceptualizations of the relations 
among internalizing symptoms were tested as well (a 
single-factor model of internalising disorders, correlated 
two-factor model of anxiety and depression and five-factor 
model, combining GAD and MDD into a single factor). The 
analysis was conducted separately for child and parent 
versions of the questionnaire. We treated the 4-item Likert 
scale as categorical and therefore chose weighted least 
squares with mean and variance adjustment (WLSMV) as 
the estimation method for analysis. Goodness of fit was 
assessed using a chi-square statistic (χ2), Comparative Fit 
Index (CFI) (44), Tucker-Lewis Index (TLI) (45) and Root 
Mean Square Error of Approximation (RMSEA) (46) with 
90% confidence interval. CFI and TLI values between 0.90 
and 0.95 indicate an adequate model fit, and CFI and TLI 
values above 0.95 indicate a good fit. RMSEA values above 
0.05 and below 0.08 indicate an adequate fit and values 
below 0.05 indicate a good fit (47, 48). 
All other statistical analyses were performed using IBM 
SPSS Statistics for Windows, version 29. Missing data 
across all RCADS subscales were managed in accordance 
with the questionnaire authors’ recommendations, with 
calculations performed for each scale only if it contained 
fewer than two missing items (18, 36). The internal 
consistency of the questionnaire was assessed using 
Cronbach’s Alpha (α) (49) and McDonald’s omega (ω) (50). 
Reliability values above 0.70 are acceptable and above 
0.80 are high (51). For the retest reliability analysis, an 
interclass correlation coefficient (ICC) was used with a 
two-way mixed-effects model with an average measure 
unit and absolute agreement definition. ICCs of 0.70 or 
higher are adequate (52).
To assess the convergent validity, we examined the 
correspondence between RCADS total scores and subscale 
scores and CALIS total scores. We assumed that the 
correlations between the RCADS and CALIS scores would 
be positive and significant, which could confirm the 
convergent validity of the Slovenian RCADS.
3 RESULTS 
3.1 Sample description
Of the 878 children and adolescents and their parents who 
agreed to participate, 754 (86%) children and adolescents 
and 485 (64% of those whose children responded) parents 
returned the questionnaires. The sample consisted of 
456 (60.5%) female and 289 (39.5%) male primary and 
secondary school students, aged 10–18 years (M 13.27, SD 
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167
2.08). 532 (70.6%) of the participants attended primary 
school and 222 (29.4%) attended secondary school. The 
average age of the boys was 13.19 (SD=2.08) and of the girls 
13.32 (SD=2.07). Of those who were invited in the follow-
up after three months, 117 children and adolescents (91%) 
and 36 parents (31% of those whose children responded) 
returned the questionnaires.
3.2 Factor structure 
First, the factor structure of the RCADS was investigated. 
Table 1 presents the fit statistics for competing models, 
separately for child version (RCADS) and parent version 
(RCADS-P).
Statistics for competing models, for child version (RCADS) and parent version (RCADS-P).
Descriptive statistics for RCADS.
Note: RCADS=RCADS Child; RCADS-P=RCADS Parent: Total=Total RCADS Score; GAD=Generalised Anxiety; SP=Social Phobia; 
SAD=Separation Anxiety Disorder; PD=Panic Disorder; OCD=Obsessive Compulsive Disorder; MDD=Major Depressive Disorder.
Note: χ2=chi-square; df=degrees of freedom; CFI=comparative fit index; TLI=Tucker-Lewis fit index; RMSEA=root mean square error of 
approximation; CI=90 % confidence interval for RMSEA
Model χ2
M (SD) M (SD) Girls (N=465)Skew. αMed M (SD) Boys (N=289)Kurt. ω
df p CFI TLI RMSEA 90% CI (RMSEA)
Table 1.
Table 2.
RCADS
RCADS-P
6 factor 
5 factor
2 factor
1 factor 
Total
SAD
GAD
PD
SP
OCD
MDD
6 factor 
5 factor
2 factor
1 factor
3436.856
3653.978
4520.724
4728.787
37.64 (21.8)
3.77 (3.27)
5.72 (3.46)
5.65 (4.77)
10.85 (5.43)
4.56 (3.25)
7.30 (5.07)
42.77 (21.93)
4.44 (3.42)
6.44 (3.48)
6.63 (5.17)
12.11 (5.37)
5.03 (3.34)
8.11 (5.31)
0.93
1.09
0.81
1.28
0.51
0.93
1.06
0.95
0.71
0.82
0.86
0.86
0.74
0.87
35.0
3.0
5.0
4.0
10.0
4.0
6.0
29.96 (17.43)
2.68 (2.66)
4.56 (3.08)
4.08 (3.35)
8.78 (4.88)
3.81 (2.95)
5.99 (4.34)
0.90
0.99
0.51
1.51
-0.03
0.88
1.03
0.95
0.70
0.82
0.86
0.86
0.74
0.86
1019
1024
1033
1034
0.000
0.000
0.000
0.000
0.922
0.916
0.888
0.880
0.918
0.911
0.883
0.875
0.056
0.058
0.067
0.069
0.054– 0.058
0.056–0.060
0.065–0.069
0.067–0.071
2119.913
2261.578
2572.491
2703.374
1019
1024
1033
1034
0.000
0.000
0.000
0.000
0.927
0.918
0.898
0.890
0.923
0.914
0.893
0.885
0.047
0.050
0.055
0.058
0.044–0.050
0.047–0.053
0.053–0.058
0.055–0.060
As seen in Table 1, the original six-factor model showed 
acceptable fit with the data for both child and parent 
versions. All factor loadings were significant and ranged 
from 0.43 to 0.86 for the child version and from 0.42 to 
0.89 for the parent version. Poorer model fit was observed 
for one-, two- and five-factor models in comparison to the 
six-factor model.  
3.3 Descriptive statistics, reliability and validity
3.3.1. Descriptive statistics
The means, standard deviations, medians, skewness, 
kurtosis and internal consistency coefficients for the 
RCADS child and parent versions for the entire sample are 
shown in Tables 2 and 3.
Descriptive statistics for RCADS-P.
Note: RCADS=RCADS Child; RCADS-P=RCADS Parent: Total=Total RCADS Score; GAD=Generalised Anxiety; SP=Social Phobia; 
SAD=Separation Anxiety Disorder; PD=Panic Disorder; OCD=Obsessive Compulsive Disorder; MDD=Major Depressive Disorder
M (SD) M (SD) Girls (N=313)Skew. αMed M (SD) Boys (N=172)Kurt. ω
Table 3.
Total
SAD
GAD
PD
SP
OCD
MDD
23.60 (13.45)
2.72 (2.72)
3.84 (2.54)
2.19 (2.35)
8.55 (4.18)
1.79 (2.09)
4.61 (3.38)
24.05 (13.01)
2.76 (2.57)
3.97 (4.51)
2.34 (2.53)
8.78 (4.18)
1.73 (1.87)
4.61 (3.30)
0.81
1.48
0.78
2.16
0.55
2.07
0.82
0.93
0.72
0.79
0.74
0.83
0.71
0.80
22.0
2.0
3.0
4.0
8.0
1.0
4.0
22.79 (14.22)
2.63 (2.98)
3.6 (2.58)
1.93 (1.96)
8.14 (4.16)
1.88 (2.44)
4.6 (3.52)
0.65
2.76
0.33
7.87
0.69
6.74
0.76
0.94
0.72
0.81
0.73
0.83
0.70
0.81
10.2478/sjph-2024-0022 Zdr Varst. 2024;63(4):164-171
168
3.3.2 Internal consistency
Good internal consistency was found for all subscales and 
for total score of the child and parent versions. Tables 2 
and 3 show the Alpha and Omega coefficients. 
3.3.3 Retest reliability
Short-term stability was good with ICC’s>0.75 and 
statistically significant (p<0.001) for the child version 
(ICCsad=0.82; ICCgad=0.82; ICCpd=0.79; ICCsP=0.90; 
ICCocd=0.77; ICCmdd=0.87; ICCtot=0.88).
3.3.4 Inter-rater reliability
Interclass correlations (ICC) were conducted between 
parent and child ratings on the RCADS (sub)scales. 
Parent-child agreement was low for most subscales 
(below 0.50) and statistically significant for all subscales 
(p<0.001): ICCsad=0.54; ICCgad=0.44; ICCpd=0.27; ICCsp=0.49; 
ICCocd=0.23; ICCmdd=0.44; ICCtot=0.40.
There were no significant differences in the mean results 
for children and adolescents with or without parental 
reports (ptot=0.24; psad=0.09; pgad=0.42; ppd=0.53; psp=0.29; 
pocd=0.44; pmdd=0.31).
3.3.5 Convergent validity
RCADS total score and CALIS total score correlated 
statistically significantly (p<0.001) for children (r=0.59) 
and for parents (r=0.66). 
Subscales for children correlated: rsad=0.48; rgad=0.50; 
rpd=0.45; rsp=0.51; rocd=0.47; rmdd=0.55. Subscales for 
parents correlated: rsad=0.44; rgad=0.54; rpd=0.46; rsp=0.52; 
rocd=0.52; rmdd=0.62.
4 DISCUSSION
The original factor structure of the RCADS was confirmed 
in our sample (18, 36). The results indicate that the six-
factor structure provides satisfactory fit for both the child 
version and the parent version of the RCADS. The six-
factor structure was also validated in various nonclinical 
samples, including French (25), Danish(23), Dutch (24), 
German (28), Irish (21), Norwegian (17) and Chinese (31) 
populations, as well as in a Turkish clinical sample (29). 
In addition, the six-factor structure for the parent version 
was confirmed in a Spanish school sample (27), in the 
original sample (43), in a Turkish clinical sample (30), and 
in a sample of youth with ADHD (53). The fit indexes for 
the child version were similar to those reported in the 
literature. Previous studies showed a CFI for the child 
version between 0.83 and 0.92 (17, 23–25, 29, 31, 32) and 
for the parent version from 0.87 to 0.94 (27, 30, 43, 53), and 
RMSEA for the child version between 0.034 and 0.052 (17, 
23–25, 29, 31, 32) and for the parent version from 0.040 to 
0.079 (27, 30, 43, 53). The internal consistency of the total 
scale was excellent for both the child and parent versions 
and was consistent with previous studies from several 
countries (54). The internal consistency of the subscales 
for the child and parent versions was good. Short-term 
reliability was good and statistically significant, and the 
ICC coefficients were like the short-term reliability of the 
Danish sample (24). Convergent validity was supported by 
statistically significant positive correlations of RCADS total 
and subscale scores with CALIS total scores suggesting 
that higher levels of internalizing symptoms in youth 
significantly affect their everyday functioning as well as 
the everyday functioning of parents. 
The mean score of the total RCADS scale was higher in 
our sample than in other nonclinical samples, where 
scores ranged from 22.3 to 32.3 (23, 24, 28), except for 
the Norwegian sample, where the mean score for the 
total scale was higher - 50.7 (17). The mean score of the 
RCADS-P total scale was comparable to other studies in 
nonclinical samples (27, 43).
As can be seen from Tables 2 and 3, the parents reported 
a lower level of symptoms on all scales compared to 
the children. For most (sub)scales, agreement between 
parents and children was low (below 0.50), except for 
the SAD subscale, where agreement was moderate. 
Agreement was higher than in a previous study with a 
nonclinical sample, in which coefficients ranged from 
0.14 to 0.39; in that study, agreement was also highest 
for the SAD subscale (43). The results suggest that parent-
child agreement differs for different types of anxiety. In 
a clinical sample of adolescents, the agreement between 
adolescents and parents was slightly higher than in our 
sample; the coefficients ranged from 0.26 to 0.61 (55). 
Our results are consistent with the findings of a systematic 
review of previous studies, showing low to moderate 
agreement between children and parents in internalising 
disorders, which are not always easily detected by 
parents. (56). 
The RCADS and RCADS-P are freely available, valid, and 
valuable measurement tools for assessing anxiety and 
depression symptoms in children and adolescents. RCADS 
was chosen with international consensus on a standard 
set of outcome measures for child and youth anxiety 
and depression (16). RCADS is aligned with DSM criteria 
and can be used to identify individuals who are at higher 
risk for developing an internalizing disorder and to offer 
them appropriate early intervention or treatment. RCADS 
allows for the simultaneous assessment of anxiety and 
depression which has very important clinical implications, 
as anxiety and depression are highly comorbid disorders (2, 
9). Another potential use of RCADS is to assess treatment 
efficacy (35), which would be very valuable as we do not 
have psychometrically validated measures for this use 
in Slovenia. In clinical samples, both the RCADS and the 
RCADS-P also show good psychometric properties. They 
can be used to identify young people with anxiety and 
depression, and they are useful to clarify additional areas 
for assessment (20, 55, 57). The RCADS-P has been shown 
to be diagnostically efficient, sensitive, and fairly specific 
in diagnosing internalizing disorders in a clinical sample of 
children and adolescents with ADHD (53). It has also been 
shown to be useful in assessing internalizing problems in 
young people with autism spectrum disorders (58). 
The present study has both strengths and limitations. We 
aimed for a high degree of generalizability of the results 
for our study. The sample was carefully selected in terms 
of representativeness of population; we took into account 
factors such as gender, age, geographical distribution 
and inclusion of different school types. In our study, 
we considered the assessment of contextual variations 
through a multi-informant assessment involving children, 
adolescents and parents. To ensure the reliability of our 
results, we repeated the assessment three months later 
and conducted a retest with a subsample of participants. 
One of the main limitations of our study is use of a 
nonclinical population. To gain an insight into the value 
of the RCADS for clinical use, a replication of the present 
study in a clinical sample would be necessary in the future. 
Another limitation is limited assessment of validity, which 
could be extended by using other measures of anxiety and 
depression in children and adolescents and by investigating 
discriminant validity. In our sample, there was a gender 
imbalance - the sample had more girls (60.5%) than boys - 
and that could have an impact on our results. A suggestion 
for future research would be to examine the psychometric 
properties of RCADS and RCADS-P in clinical samples. It 
would also be beneficial to compare the results of RCADS 
and RCADS-P with those of other pure measures of anxiety 
and depression and with clinical interviews. Further 
research is required to assess the effectiveness of RCADS 
and RCADS-P in predicting clinical diagnoses of anxiety 
and depressive disorders within the Slovenian population. 
Additionally, to utilize RCADS and RCADS-P for screening 
purposes, it is essential to determine whether the original 
cut-off scores are appropriate for the Slovenian population.
There is a need for valid and psychometrically robust tools 
in the Slovenian language.  In recent years, significant 
progress has been made in this area, with an increasing 
number of questionnaires from various fields being 
adapted and psychometrically validated (59–61). This 
study aims to contribute to this progress by providing a 
psychometric validation of RCADS and RCADS-P.
5 CONCLUSION
In conclusion, the Slovenian version of RCADS and 
RCADS-P has adequate psychometric properties. The 
factor structure favours a six-factor model, and internal 
consistency and convergent validity are high. The 
Slovenian version of RCADS and RCADS-P are valid and 
reliable instruments for measuring anxiety and depression 
symptoms. Further research is needed for validation in a 
clinical setting and for providing normative data for both 
school and clinical samples. 
ACKNOWLEDGMENTS
We thank psychologists Lidija Magajna, Daša Vervega and 
Mateja Hudoklin from the Counselling Centre for Children, 
Adolescents, and Parents Ljubljana for their invaluable 
help with the data collection, and psychologists Gaja Zager 
Kocjan and Luka Komidar from the University of Ljubljana 
for their consultations. Our sincere thanks also go to all 
participating children, adolescents, parents, schools and 
school psychologists for their important contributions to 
this study.
10.2478/sjph-2024-0022 Zdr Varst. 2024;63(4):164-171
169
CONFLICTS OF INTEREST
The authors declare that they have no competing or 
potential conflicts of interest.
FUNDING 
KKM is funded by the Slovenian Research Agency under 
the Young Researcher Programme and is a PhD student at 
the University of Ljubljana.
ETHICAL APPROVAL
The Ethics Committee of the Faculty of Arts, University of 
Ljubljana approved the study. The children, adolescents 
and parents were informed verbally and in writing about 
the study, and written informed consent was obtained.
AVAILABILITY OF DATA AND MATERIALS
The data presented in this study can be obtained upon 
request from the corresponding author.
CONTRIBUTORSHIP
All authors were involved in writing the paper and gave 
final approval of the submitted and published versions.
ORCID
Mojca Petrič: 
http://orchid.org/0000-0002-1419-6118
Jana Kodrič: 
http://orchid.org/0000-0003-4522-3788
Katja Kurnik Mesarič: 
http://orchid.org/0000-0002-6312-4903
Peter Janjušević: 
http://orchid.org/0000-0003-1165-6729
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