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Cross-cultural measurement invariance of the Revised Child Anxiety and Depression Scale across 11 world-wide societies

Published online by Cambridge University Press:  29 June 2016

D. Stevanovic*
Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
Z. Bagheri
Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran
O. Atilola
Lagos State University, Lagos, Nigeria
P. Vostanis
School of Psychology, Leicester University, Leicester, UK
D. Stupar
Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
P. Moreira
University Lusiada, Lisboa, Portugal
T. Franic
Child and Adolescent Psychiatry, School of Medicine, University of Split, Split, Croatia
N. Davidovic
Child and Adolescent Psychiatry, School of Medicine, University of Split, Split, Croatia
R. Knez
Medical School, University of Rijeka, Croatia
A. Nikšić
Department of Psychology, Faculty of Humanities and Social Sciences in Rijeka, Croatia
K. Dodig-Ćurković
Medical Faculty Osijek, University Health Center Osijek, Croatia
M. Avicenna
Faculty of Psychology, State Islamic University Syarif Hidayatullah, Jakarta, Indonesia
I. Multazam Noor
Dr Soeharto Heerdjan Mental Hospital, Jakarta, Indonesia
L. Nussbaum
Department of Child and Adolescent Psychiatry, University of Medicine and Pharmacy ‘Victor Babes’, Timisoara, Romania
A. Deljkovic
Mental Health Center Pljevlja, Montenegro
A. Aziz Thabet
Al Quds University, Gaza
P. Petrov
Department of Child and Adolescent Psychiatry, University Hospital St. Marina, Varna, Bulgaria
D. Ubalde
Department of Psychology, St. Dominic College of Asia, City of Bacoor, Philippines
L. A. Monteiro
Universidade Estacio de Sá in Rio de Janeiro, Brazil
R. Ribas
Federal University of Rio de Janeiro, Brazil
*Address for correspondence: D. Stevanovic, Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia. (Email:



In order to compare estimates by one assessment scale across various cultures/ethnic groups, an important aspect that needs to be demonstrated is that its construct across these groups is invariant when measured using a similar and simultaneous approach (i.e., demonstrated cross-cultural measurement invariance). One of the methods for evaluating measurement invariance is testing for differential item functioning (DIF), which assesses whether different groups respond differently to particular items. The aim of this study was to evaluate the cross-cultural measurement invariance of the Revised Child Anxiety and Depression Scale (RCADS) in societies with different socioeconomic, cultural, and religious backgrounds.


The study was organised by the International Child Mental Health Study Group. Self-reported data were collected from adolescents residing in 11 countries: Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestinian Territories, the Philippines, Portugal, Romania and Serbia. The multiple-indicators multiple-causes model was used to test the RCADS items for DIF across the countries.


Ten items exhibited DIF considering all cross-country comparisons. Only one or two items were flagged with DIF in the head-to-head comparisons, while there were three to five items flagged with DIF, when one country was compared with the others. Even with all cross-culturally non-invariant items removed from nine language versions tested, the original factor model representing six anxiety and depressive symptoms subscales was not significantly violated.


There is clear evidence that relatively small number of the RCADS items is non-invariant, especially when comparing two different cultural/ethnic groups, which indicates on its sound cross-cultural validity and suitability for cross-cultural comparisons in adolescent anxiety and depressive symptoms.

Original Articles
Copyright © Cambridge University Press 2016 

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There was an error of omission in the title that has now been corrected and a notice has been published providing details.


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