Validation of the Arabic Revised Manifest Childhood Anxiety Scale (RCMAS) in the Palestinian Context

Abstract

The current study aimed at discovering and testing the psychometric properties of the RCMAS-2 (Arabic Version) in the Palestinian context in terms of construct validity and reliability by evaluating the factorial stability of the RCMAS-2. Furthermore, it aimed at revealing the potential impacts of gender, age, and place of residence on anxiety level among the Palestinian children 6-19 years old in the Nablus governorate. In addition, this study evaluated the extent that RCMAS-2 could meet the anxiety criteria according to DSM-5. A quantitative, cross-sectional, descriptive design was used to achieve the objectives of the study. The translated and adapted RCMAS-2 was used to collect data from (201) children (109 males and 92 females) who were selected by a stratified random sampling technique, that to represent gender and locations of residence of children. Moreover, in order to discover to what extent RCMAS-2 meets anxiety criteria according to DSM-5; the convergent validity was assessed using the DSM-5 Level 2 of Anxiety-Parent/Guardian of child age 6-17 as a gold standard tool. Multivariate correlational and structural equation modeling [SEM] by confirmatory factor analysis [CFA] and multiple regression statistical analyses were performed in this study. The findings confirmed the stability of factor structure, validity, and internal consistency of RCMAS-2 for measuring anxiety among Palestinian children. The goodness-of-fit indicators for the RCMAS-2 provided good evidences to accept the proposed model where CFI = 0.904, IFI = 0.906, AGFI = 0.807, and RMSEA = 0.042. Cronbach’s alpha for each of the subscales and total scale were PHY = 0.763, WOR = 0.846, SOC = 0.864, and the RCMAS-2 = 0.910. The result emphasized that the RCMAS-2 has convergent validity and is suitable as a research tool among the Palestinian children population and meets the anxiety criteria according to DSM-5. The findings revealed that about 39% of the Palestinian children exhibited clinically significant levels of anxiety. About 7% of the variance in the score for the anxiety was due to place of residence and in favor to children from camps. A cutoff point of ≥ 21 (percentile: 65th) based on ROC analysis revealed a significant predictive power of the RCMAS-2 scale for the DSM-5 Level 2 of Anxiety-Parent/Guardian scale. The area under the curve [AUC] equals .89 (p < .001, 95% CI = .84-.94), sensitivity .80, and specificity .80. In light of the findings, the current study recommended the use of the RCMAS-2 in clinical settings in Palestine because the findings revealed good psychometric evidence.