- Pages: 11
- Word count: 2648
- Category: Anxiety Disorder
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The Multidimensional Anxiety Scale for Children, 2nd Edition (MASC 2), published in 2013, is the revised version of the original MASC assessment, published in 1997. The purpose of the MASC 2 is to serve as a comprehensive tool to detect, diagnose, and treat anxiety symptoms, in terms of severity and range, in children and adolescents ages 8 to 19. The test is available in two forms, the 50 item, Likert style, self-report version for children (MASC 2-SR) and the version for parents for reporting their child’s anxiety symptoms. Available in two delivery formats, online and paper and pencil, the test assesses anxiety on six scales and four subscales and may be administered by level B professionals or parents. Scoring is done online, with software, or by hand. The MASC 2 features a multi-rater approach and reports are available for assessment, progress, and comparison. Normative data for the MASC 2 is based on 1,800 children and 1,600 adults throughout Canada and balanced in terms of geography, race, ethnicity, and education levels. Findings indicate that test-retest, internal consistency, and inter-rater reliability were acceptable in the MASC 2 while validity was also acceptable. Also notable was evidence showing that the MASC 2 can distinguish between clinical and non-clinical subjects and between youth in the general population and those with specific anxiety disorders. Strengths regarding the MASC 2 are its comprehensive qualities, its simplicity and visual appeal. Limitations of the test involve its lack of clarity in administration instructions, the idea that untrained individuals can administer the test, and its lack of generalization to ethnic populations.
Test Critique. General Information
The Multidimensional Anxiety Scale for Children (MASC) was developed by John S. March, MD, MPH in 1997. The second version, MASC 2, was published in 2013 by Multi-Health Systems. The test was designed to be administered to children and adolescents ages 8 through 19 for the detection, diagnosis, treatment, and anxiety (MHS Assessments, n.d.).
There are three separate costs associated with the MASC 2 assessment, depending on the mode of application. There is a complete kit version of the test available for $261, a software version for $405, and an online version for $208. Purchased separately, MASC 2 self-report and parent forms may be purchased for $3.75 each for the online version, and $67 for each type of form for the software and hand scored versions in packs of 25 each. Other materials include the software scoring program (USB Key and installation only) for $180, the MASC 2 manual for $97, and a MASC 2 CE manual quiz for $45. Online access to the MASC 2 is available through the MHS Assessments website on the MASC 2 description page (MHS Assessments, n.d.).
There are two forms of the MASC 2, which are the MASC 2-SR, which is the self-report version for children and adolescents to report their personal symptoms of anxiety, and a MASC 2-P, which is intended for parents to report the anxiety symptoms of their children (Carlson, Geisinger, & Jonson, 2014).
Soon after March developed the original Multidimensional Anxiety Scale for Children in the mid 1990s, it was considered the gold standard and an advancement over previous childhood anxiety assessments of the time (Watson, Hoiles, Egan, & Limburg, 2014). The revised, MASC 2 version maintains many of the components of the original version of the test (MASC), like, age bands, such as 8-11, 12-15, and ages 16-19, but renamed certain categories in order to create more specific targeting for test assessors. What was previously named the Separation/Panic scale is now called the Separation Anxiety/Phobias scale, and the Somatic/Autonomic subscale was re-labeled the Panic subscale. Two new scales were also added, the Obsessions & Compulsions scale and the GAD Index (Fraccaro, Stelnicki, & Nordstokke, 2015). Test results are structured in algorithm form for the most common interpretations of the scores (MHS Assessments, n.d.).
In terms of testing and assessment assumptions, the MASC 2 assumes that anxiety states exist and can be measured and quantified. The MASC 2 also assumes that phenomena can be pinpointed, such as anxiety, and examined further. From the information regarding the norm and control groups regarding the MASC 2, it is clear that various sources have been obtained in order to formulate more concise and accurate findings. Also, in keeping with test and assessment assumptions, it is evident that the MASC 2, like all tests and measurements, contains some errors. It possesses both strengths, such as simplicity and comprehensive qualities, and weaknesses, such as standardization issues. The MASC 2 also assumes that the behavior exhibited during the test will predict behavior outside of the test. In terms of benefits to society, it could be argued that the MASC 2 assists in developing more well-adjusted citizenry who are more productive when unencumbered by debilitating psychological issues, such as anxiety related issues (Cohen & Swerdlik, 2009).
The MASC 2 is a comprehensive, self-report assessment of children and adolescents ages 8 to 19 years. The test is designed on a narrowly defined construct (anxiety) where subjects are tested on six main scales: separation anxiety/phobias, social anxiety, GAD index, obsessions and compulsions, physical symptoms, and harm avoidance. There are also four subscales, which consist of Humiliation/Rejection, Performance Fears, Panic, and Tension/Restlessness. The test contains 50 items and is designed at a third-grade reading level. As the name suggests, the MASC 2 is a multidimensional construct and was designed to build upon the earlier MASC version with 18 more questions to create a more extensive and effective method for detecting anxiety in light of increasing levels of anxiety cases in the population that are estimated to have risen to almost 30% (Carlson, et al., 2014).
The purpose of the test is to act as a comprehensive assessment tool to identify various areas of elevated anxiety symptoms in children and adolescents from ages 8 to 19. Subsequently, the test is intended to serve as an early detection tool, assessing intervention efficacy, alleviating anxiety symptoms, and for use in basic research. The MASC 2 is structured in subjective fashion as a self-reporting test, utilizing a Likert type of scale with a range of possible answers to 50 questions from never-to-often that indicate the current emotional and physical state of the test taker. A sample question on the humiliation/rejection subscale of the test would look similar to this: If I raised my hand and got the wrong answer, I would be laughed at. To which the child or adolescent would mark the appropriate response based on their reaction to the statement (MHS Assessments, n.d.).
Regarding test administration for the MASC 2, procedures are simple and brief when compared to other assessments. The time to administer the 50 items on the test is 15 minutes, online or in paper and pencil form (MHS Assessments, n.d.). Administration is level B and scoring can be done online, with software, or it may be hand scored. Although graduate level psychometric training is recommended, the MASC 2 may also be administered without this training (Fraccaro, et al., 2015). Also, in relation to scoring, the MASC 2 features a multi-rater approach where results of the test can be combined with the results from up to five raters. Reports are available in three forms. The first form, assessment, indicates the individual child’s scores, which scales and subscales may be elevated, and how the child compares to other children. The progress report compares and contrasts how the child has changed over time compared to up to four other MASC 2 test administrations given to that child. Finally, the comparative report compares the child’s responses with those of the parents, allowing a multiple perspective approach to the sources of the child’s anxiety symptoms (MHS Assessments, n.d.). Regarding special testing conditions, no specific parameters were discovered by the author. This has been reinforced by Fraccaro, et al. (2015) who point out that test guidelines are rather non-specific (Fraccaro, et al., 2015).
The normative samples for the MASC 2 consisted of 1,800 U.S and Canadian children and adolescents and 1,600 parents. Genders and ages were balanced across samples, and variables, such as geographical regions, race and ethnicity, and the education levels of the parents were statistically weighted to correspond with census targets in the U.S. and Canada. Data was also collected from a clinical sample of 824 subjects within the target age range of 8 to 19 years who had been diagnosed with Separation Anxiety, Social Phobia, Generalized Anxiety Disorder (GAD), Panic Disorder, Obsessive Compulsive Disorder, ADHD, and Depression (MHS Assessments, n.d.).
In terms of the adequacy of the standardization and norm groups, Fraccaro, et al. (2015) assert that the norming sample failed to specify the names of the three Canadian provinces in which groups were tested. This could be significant in the sense that Canadian provinces may differ significantly and are not homogeneous (Fraccaro, et al., 2015).
Regarding the reliability of the MASC 2, Cronbach’s alpha values with a .92 for the total score on the self-report and a .89 for the parent total score were revealed. Test-retest reliability was based on 1 to 4-week intervals between testing (MHS Assessments, n.d.) and results indicated that test-retest, internal consistency, and inter-rater reliability were acceptable (Kaat & Lecavalier, 2015). The r for the parent total score was .93, indicating very high reliability, and the self-report total score was .89, indicating high reliability (MHS Assessments, n.d.).
In terms of validity, there is strong evidence of acceptability for the MASC 2. Data was collected from three separate samples of children who had been diagnosed with anxiety disorders and then compared to scores from the norm sample for total score and three different scales: Separation Anxiety/Phobias, Social Anxiety, and GAD. Evidence shows that the MASC 2 can accurately and effectively distinguish between non-clinical and clinical subjects and between children in the general population and those with specific anxiety disorders (MSH Assessments, n.d.). This is a notable feature of the MASC 2. Kaat and Lecavalier (2015) point out, self-reporting is not likely to otherwise distinguish one group from another (Kaat & Lecavalier, 2015).
From evidence based on the MHS Assessments (n.d.) website and the brochure it provides, the author feels that the design and structure is appealing and easily understood. The simple and colorful appearance of materials may give the impression that the test is being marketed to a general audience, even though there is a level B test administration recommendation. Fraccaro, et. al (2015) believe that the simplicity and brevity of administration is of particular appeal and they feel that the MASC 2 is a simple test to administer and the procedures are clear, as outlined in the test manual (Fraccaro, et al., 2015).
Administration of the MASC 2 is simple and understandable by most test takers at the age levels it targets and is considerably brief, requiring only 15 minutes online or in pencil paper form and can be completed anywhere. Scoring is also simple and can be done either online, through software, or hand scored. Although the test administration is uncomplicated and brief, the test interpretation will vary depending on the level of expertise and training of the individual analyzing the results. However, online and software scoring platforms present the test results data in clear, color coded, graphs and charts accompanied by explanations (MHS Assessments, n.d.).
Summary Evaluation and Critique
Strengths of the MASC 2 include an up-to-date and comprehensive revision of the original test with the addition of more items. One of the more notable and positive updates of the second version is the Anxiety Probability Score, which allows for the quick assessment of a likelihood that a child or adolescent will develop an anxiety disorder. Other strengths of the MASC 2 are its simplicity and lighthearted tone and appearance, it is a simple test to administer, score, and interpret, and it can be taken remotely. The MASC 2 also has the advantage of serving multiple purposes, such as program evaluation, progress assessment, individual and group assessments, and research. It can also be administered as a shorter and more targeted alternative to other, more comprehensive assessments, like, the CBRS-SR (Fraccaro, et al., 2015).
Weaknesses of the MASC 2 include the chance that standardization of the test may be compromised by the non-specific administration instructions creating possible issues with the test’s reliability and validity. For example, this test approach allows a great deal of flexibility in how a mental health professional administers the test and is a detriment to the standardization and interpretation of the test. This is compounded by the fact that untrained individuals, such as parents, are allowed to administer the test. Another limitation of the MASC 2 is in relationship to the simple instructions pertaining to the parent reports regarding their child’s behavior. The MASC 2 manual is unclear as to whether these reports should be done separately or together, which may create problems with test consistency if completed together. Fraccaro, et al. (2015) note that further limitations regarding the MASC 2 involve the lack of generalization to ethnic groups other than Hispanic/Latino, African American, and Caucasian (Fraccaro, et al., 2015).
Recommendations for uses of the MASC 2 test would be to utilize it as a companion test to several other anxiety assessment instruments. Understanding the previously stated weaknesses of this test, primarily pertaining to the relaxed administration procedures and risks to standardization, it would be advisable to combine the MASC 2 with other standardized tests with more stringent and exacting administration guidelines. Overall, the MASC 2 is an effective initial screening, intervention, and progress tool and is appealing to professionals in private practice and in school settings (Fraccaro, et al., 2015).
Revisions suggested for the MASC 2 would primarily center around the issues pertaining to the current unstructured administration of the test. A more detailed set of instructions would improve the standardization of the test and ensure greater reliability and validity. However, it is the opinion of the author that the instructions not be allowed to become so regimented that they compromise the simplicity and brevity of the test that makes its current version appealing. With this said, reliability and validity may also be improved if variable parameters are provided and controlled for in the MASC 2 test manual and administration and scoring are done by psychometrically trained individuals at the B level as recommended by the publisher. Another improvement, as stated earlier as a weakness of the test, would be to clarify instructions regarding the MASC 2-P version of the test to state whether or not parents should report individually or together. However, also as stated, individual parent reports would be more beneficial than combined reports for better results.
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