Scale of parent reported truth of statement: Worries that something bad will happen to people he/she is close to, for agesfor ages 3 to 7 of the NIH Toolbox Emotion Domain Fear Separation Anxiety Parent Report Fixed Form

2016-06-23

The Confluence of Mental, Physical, Social, and Academic Difficulties in Middle Childhood. II: Developing the MacArthur Health and Behavior Questionnaire. J. Am. Acad. Child Adolesc. Psychiatry. 2002;41(5):588-603. Jeff Armstrong, Department of Psychiatry, Wisconsin Psychiatric Institute and Clinics, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison WI, 537 9, jmarmstrong2@wisc.edu. For more information on scoring, please refer to the NIH Toolbox Scoring and Interpretation Guide: http://www.nihtoolbox.org/WhatAndWhy/Scoring%20Manual/NIH%20Toolbox%20Scoring%20and%20Interpretation%20Manual%209-27 12.pdf

The NIH Toolbox Fear-Separation Anxiety Survey is a parent-report measure for ages 3 to 7 assessing fear of being separated from home and from loved ones. It is a 7 item fixed length form. Each item administered has a 3-point scale, ranging from never or not true to often or very true. Higher scores are indicative of more parent-reported child separation anxiety.

Please indicate how often or true the behavior is of your child: Worries that something bad will happen to people he/she is close to.