Validity and reliability of the Amharic version Revised Child Anxiety and Depression Scale (RCADS-25) in pediatric oncology

BACKGROUND: The short form of the Revised Child Anxiety and Depression Scale (RCADS-25) has been frequently used for assessing anxiety and depression in clinical and community samples. However, the Amharic version of RCADS-25 (RCADS-25(A)) has not been validated. This study aimed to evaluate the validity and reliability of RCADS-25(A) in pediatric oncology. METHODS: This study included 142 children aged 8-18 years. The reliability of the scale was assessed by calculating internal consistency and test-retest reliability. Convergent validity was assessed by examining the correlation between the RCADS-25(A) and the Pediatric Quality of Life Inventory 4.0 Generic Core Scale (PedsQL™ 4.0 GCS). Confirmatory factor analysis was conducted to evaluate the two-factor structure of RCADS-25 identified in the original version. RESULTS: The mean age of the participants was 11.6 ± 3.2 years. The RCADS-25(A) demonstrated evidence of good validity and reliability. Cronbach's alpha coefficients were 0.95, 0.94, and 0.96 for the anxiety subscale, depression subscale, and total scale, respectively, while intraclass correlation coefficients were 0.81, 0.80, and 0.87 for the same domains, indicating good test-retest reliability. The RCADS-25(A) correlated significantly with PedsQL™ 4.0 GCS (r = -0.97, p < 0.001). Confirmatory factor analysis supported the two-factor model (χ2/df = 1.44; CFI = 0.95; RMSEA = 0.06; SRMR = 0.05; TLI = 0.95). CONCLUSIONS: The RCADS-25(A) appears to demonstrate promising validity and reliability, suggesting its potential utility for assessing anxiety and depression in pediatric oncology. The findings underscore the need for further validation studies employing larger and more diverse samples, as well as the adoption of multimethod assessment approaches. The use of parent-report versions and studies in other populations and Ethiopian languages are highlighted to further establish the scale's psychometric properties and cross-cultural applicability.