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Depress Anxiety. 2008;25(8):E27-35. doi: 10.1002/da.20468.

Measures matter: the relative contribution of anxiety and depression to suicidal ideation in clinically referred anxious youth using brief versus full length questionnaires.

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Child Anxiety and Phobia Program, Department of Psychology, Florida International University, Miami, Florida 33199, USA.



A cross-sectional design was used to examine links between suicidal ideation, depression, and anxiety using brief [Stark and Laurent, 2001: J Clin Child Psychol 30:552-567] and full length versions of the Children's Depression Inventory [CDI; Kovacs, 1980/1981: Acta Paedopsychiatr 46:305-315] and Revised Children's Manifest Anxiety Scale [RCMAS; Reynolds and Richmond, 1985: Revised Children's Manifest Anxiety Scale. California: Western Psychological Services].


The sample consisted of 252 children and adolescents (ages 7-16 years, M=9.94 years (SD=2.4)) seeking treatment at a childhood anxiety disorders specialty research clinic.


Using structural equation modeling, results indicated that the relative contribution of anxiety and depression in the presence of suicidal ideation varies depending on the measures used. Specifically, anxiety had a significant direct and indirect effect on suicidal ideation presence using a brief version of the RCMAS, but only an indirect effect using the full length version. Depression had a significant direct effect on suicidal ideation presence using both brief and full versions of the CDI.


These findings suggest that anxiety may play a role in predicting suicidal ideation in clinic-referred anxious youth, but whether this role is detected depends on the measurement strategy. Given that "measures matter," future studies using similar as well as different samples as the one used in this study need to consider careful measurement strategies, as different findings may emerge depending on whether brief or full length versions of questionnaires are used.

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