New Spanish Study Confirms a Modern Screening Tool Can Spot Childhood Anxiety Early

Anxiety is the most common mental health problem of childhood, yet it is also one of the easiest to miss. A child who refuses to go to school, avoids birthday parties, or lies awake worrying about catastrophes that will probably never happen may simply be labeled shy, difficult, or overly sensitive. When those patterns persist, they can harden into full anxiety disorders that undermine learning, friendships, and family life for years. That is why psychologists place such weight on screening questionnaires: a brief, reliable instrument administered in a classroom can flag children who need help long before their problems reach a clinic. A new study from Spain, published in Child Psychiatry & Human Development, puts one of the newest of these instruments, the Youth Anxiety Measure for DSM-5, through a rigorous statistical examination in a large community sample of school-aged children, and the results are reassuring for researchers and school practitioners alike.

The Youth Anxiety Measure for DSM-5, or YAM-5, was developed by an international team led by Peter Muris of Maastricht University to keep pace with the diagnostic revolution of 2013, when the American Psychiatric Association published the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders. Older screening tools, such as the widely used Spence Children’s Anxiety Scale and the Screen for Child Anxiety Related Emotional Disorders, were built around DSM-IV categories, and the DSM-5 reorganized anxiety in ways that matter for measurement. Separation anxiety disorder and selective mutism were moved into the anxiety disorders chapter, panic attacks received their own diagnostic specifier, and the criteria for social anxiety disorder and specific phobia were sharpened. The YAM-5 was designed from the ground up to mirror the current criteria. It consists of two parts: Part I assesses the symptoms of the major anxiety disorders, including separation anxiety, social anxiety, generalized anxiety, panic, and selective mutism, while Part II covers the specific fears and phobias that children commonly report, from animals and blood to heights and enclosed spaces.

Despite a growing international literature on the YAM-5, including validations in Arabic, Iranian, Portuguese, and Persian samples, most research has concentrated on Part I. Part II has remained comparatively understudied, and evidence covering both components in children as young as eight has been thin. The new study, conducted by Iván Fernández-Martínez, José P. Espada, María T. Gonzálvez, Alexandra Morales, and Mireia Orgilés of Miguel Hernández University in Elche together with Peter Muris, set out to fill that gap. The researchers recruited 515 Spanish-speaking children enrolled in primary education, with an average age of 9.82 years and a standard deviation of 1.20, meaning the sample spanned roughly ages eight to twelve. This community-based design is important: most children with anxiety problems never see a clinician, so a screening tool must prove itself in ordinary school populations, not only in treatment settings where symptoms are already severe.

The central technical question was factorial structure, the architecture of the questionnaire. If the YAM-5 truly measures distinct anxiety domains as its designers intended, then confirmatory factor analysis, a structural equation modeling technique that tests whether observed item responses can be explained by hypothesized latent factors, should recover the intended five-factor solution for each part. The researchers estimated their models with robust estimators suited to ordinal, Likert-type response data, following methodological work showing that treating such items as continuous can distort fit statistics, and they evaluated model fit against the conventional benchmarks established by Hu and Bentler, which weigh comparative fit indices and standardized residual errors. The verdict was clear: confirmatory factor analyses supported the original five-factor structure of both parts of the instrument. In other words, the questionnaire’s internal blueprint held up in Spanish children, with separation anxiety, social anxiety, generalized anxiety, panic-related symptoms, and the fear dimensions separating from one another just as theory predicts.

Structure alone is not enough; a scale must also produce scores that are internally consistent, meaning its items hang together and measure the same thing. The team examined reliability using methods appropriate for ordinal data, which estimate consistency from the ordered response categories rather than from assumptions of continuous measurement. The YAM-5 total scale and the total scores of Parts I and II demonstrated good-to-excellent internal consistency, while most of the individual subscales showed acceptable-to-good reliability. One nuance emerged: Part I, which taps the major anxiety disorders, showed stronger internal consistency than Part II, which covers specific fears and phobias. This pattern makes psychological sense. Fears of spiders, injections, or thunderstorms are common in childhood and often transient, so children’s responses to phobia items can be more variable, whereas symptoms of generalized or social anxiety tend to be more coherent experiences for a child to report.

Beyond reliability, the study examined three forms of validity evidence that together reveal whether a questionnaire measures what it claims and nothing else. Convergent validity asks whether YAM-5 scores correlate strongly with other established measures of anxiety, and the researchers found the expected positive associations, indicating that children who scored high on the new scale also reported elevated anxiety on comparison instruments. Divergent and discriminant validity address the opposite concern: whether the scale can distinguish anxiety from related but separate constructs, such as depression or general behavioral difficulties, and whether it differentiates between children in theoretically meaningful ways. Evidence for both was found, supporting the instrument’s specificity. This matters practically, because anxiety and depression overlap heavily in youth, and a screener that cannot tell them apart risks misdirecting scarce intervention resources.

The Spanish validation also carries lessons about cross-cultural test adaptation. Translating a psychological questionnaire is not a matter of swapping words; international guidelines from researchers such as Ronald Hambleton and the International Test Commission require careful forward and back translation, review of item relevance and comprehensibility in the target culture, and statistical verification that the underlying factor structure survives the journey. Childhood fears in particular can be culturally inflected, and idioms of worry differ across languages. The fact that the five-factor structure and the reliability profile of the YAM-5 replicated in a Spanish community sample, consistent with prior validations in Dutch, Arabic, Iranian, Portuguese, and Persian populations, strengthens the case that the instrument captures something universal about childhood anxiety rather than a culture-bound expression of it.

The stakes of this measurement work are far from academic. Recent estimates drawing on the Global Burden of Disease study indicate that mental disorders affecting children and adolescents impose a substantial worldwide burden of disability, and European meta-analyses confirm that anxiety disorders are among the most prevalent conditions in this age group. Longitudinal research following children from preschool into adolescence shows that anxiety symptoms are not always passing phases; for a meaningful share of young people they persist and evolve, predicting later emotional difficulties. Early identification is therefore one of the most cost-effective levers available to public health, and school-based screening is the natural delivery mechanism, because schools reach nearly all children regardless of whether their families would ever seek mental health care. A validated Spanish-language YAM-5 gives school psychologists and pediatric services in Spain, and in Spanish-speaking communities elsewhere, a diagnostic tool aligned with the criteria clinicians actually use.

The study’s authors are candid about the boundaries of what a single investigation can establish. Their sample was a community group rather than a clinical one, so the findings speak most directly to screening and epidemiological use; further work in referred and diagnosed samples would extend the picture. Test-retest stability over time, sensitivity to treatment-related change, and parent-report versions of the Spanish adaptation remain open questions, as does the performance of Part II, whose psychometric footing is newer. The researchers also note that data cannot be shared openly in order to protect the privacy of the participating children, a constraint familiar to anyone working with minors. Still, the convergence of evidence is striking: across languages, countries, and age bands, the YAM-5 keeps reproducing its intended structure and producing dependable scores.

For a field often criticized for clinging to instruments built for an older diagnostic era, the study offers a quiet but consequential advance. It suggests that schools and clinics serving Spanish-speaking children can now screen for anxiety with a tool that matches the DSM-5, that the often-neglected phobia component of the measure works as designed, and that the questionnaire performs well in children as young as eight, an age at which intervention can still redirect developmental trajectories. Anxiety disorders in childhood are treatable, and treatments work best when problems are caught early. A questionnaire that reliably finds the worried child in the back row of a classroom, the one whose fear of dogs keeps her from walking to a friend’s house, or the one whose mind races at bedtime, is not a glamorous piece of science. But multiplied across thousands of classrooms, it may be one of the more consequential.

Subject of Research: Psychometric validation of the Youth Anxiety Measure for DSM-5 in Spanish school-aged children

Article Title: Psychometric Evaluation of the Youth Anxiety Measure for DSM-5 (YAM-5) in a Community Sample of Spanish School-Aged Children

Article References: Fernández-Martínez, I., Espada, J. P., Gonzálvez, M. T., Morales, A., Orgilés, M., & Muris, P. (2026). Psychometric Evaluation of the Youth Anxiety Measure for DSM-5 (YAM-5) in a Community Sample of Spanish School-Aged Children. Child Psychiatry & Human Development. https://doi.org/10.1007/s10578-026-02093-5

Image Credits: AI Generated

DOI: 10.1007/s10578-026-02093-5

Keywords: childhood anxiety, YAM-5, DSM-5, psychometrics, screening, confirmatory factor analysis, school-aged children, Spain, anxiety disorders, phobias, reliability, validity