Spence Children’s Anxiety Scale (SCAS)

Abstract

The Spence Children’s Anxiety Scale (SCAS) is a prominent, psychometrically validated, self-report psychological instrument formulated by Susan H. Spence (1997, 1998) to assess the frequency and severity of anxiety disorder symptoms in children and young adolescents aged 8 to 15 years. Designed to map directly onto the diagnostic architecture of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV / DSM-5), the instrument departs from unidimensional anxiety inventories by providing both a global anxiety severity index and granular dimensional profiling across six specific symptom domains: Separation Anxiety, Social Phobia, Obsessive-Compulsive Disorder (OCD), Panic Disorder and Agoraphobia, Generalized Anxiety Disorder (GAD), and Physical Injury Fears (Specific Phobia). The scale comprises 44 items, including 38 clinical symptom statements scored on a 4-point frequency scale (0 = Never, 1 = Sometimes, 2 = Often, 3 = Always) and 6 positive filler items introduced to mitigate negative response bias and evaluation fatigue. The maximum clinical score is 114. Extensive psychometric investigations across international clinical and community samples demonstrate robust internal consistency, with total scale Cronbach’s alpha values routinely exceeding .90 (.92 to .94) and subscale coefficients ranging from acceptable to high (.60 to .85). Confirmatory factor analyses consistently substantiate a higher-order model comprising six first-order factors loading onto a overarching general anxiety construct. The SCAS demonstrates substantial convergent validity with legacy tools such as the Revised Children’s Manifest Anxiety Scale (RCMAS) and discriminant validity against measures of childhood depression. Readily accessible in the public domain, the SCAS has been adapted into parent-report and preschool iterations, establishing itself as a gold-standard screening and outcome-monitoring battery in pediatric mental health research and clinical child psychology.

Keywords

Spence Children’s Anxiety Scale, SCAS, pediatric anxiety assessment, child psychopathology, DSM-IV anxiety disorders, separation anxiety, social phobia, obsessive-compulsive symptoms, panic and agoraphobia, generalized anxiety, psychometrics

Authors

The Spence Children’s Anxiety Scale was conceptualized, designed, and psychometrically normed by Susan H. Spence, PhD, AO, Emeritus Professor of Psychology at Griffith University and Honorary Professor at the University of Queensland, Australia.

• Primary Developer: Susan H. Spence, AO, PhD, DipClinPsych, BA (Hons).
• Institutional Affiliations: School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Queensland, Australia; School of Psychology, The University of Queensland, St Lucia, Queensland, Australia.
• Collaborators on Subsequent Adaptations: Ronald M. Rapee (Macquarie University, Australia), Maureen H. Nauta (University of Groningen, Netherlands), Paula M. Barrett (Pathways Health and Research Centre), Cynthia M. Turner (University of Queensland), Caroline L. Donovan (Griffith University), and Jennifer Hudson (Macquarie University).
• Official Contact and Distribution Portal: SCAS Website (www.scaswebsite.com).

Purpose

The primary clinical and empirical purpose of the Spence Children’s Anxiety Scale is to provide an empirically grounded, developmentally calibrated self-report assessment capable of capturing both overall anxiety burden and disorder-specific symptom configurations in children and adolescents. Prior to the development of the SCAS in the late 1990s, pediatric anxiety measurement relied heavily on instruments that were downward extensions of adult scales, such as the Spielberger State-Trait Anxiety Inventory for Children (STAIC) or the Revised Children’s Manifest Anxiety Scale (RCMAS). While these earlier tools effectively captured generalized affective distress, autonomic arousal, and trait-like hyperarousal, they were structurally incapable of differentiating between discrete nosological entities recognized by contemporary psychiatric taxonomies, such as Separation Anxiety Disorder, Social Anxiety Disorder, or Panic Disorder.

Recognizing that childhood anxiety is not a monolithic construct but rather a multifaceted constellation of specific developmental phobias and cognitive-affective syndromes, Spence engineered the SCAS to align with the categorical frameworks established in the DSM-IV. The scale serves three major functional purposes across clinical and academic contexts:

• Universal and Targeted Screening: Operating as a pragmatic, cost-effective screening mechanism in educational, community, and pediatric primary care settings to identify youth at elevated risk for emotional disorders who require comprehensive diagnostic assessment.
• Diagnostic Profiling and Treatment Planning: Aiding clinical child psychologists, psychiatrists, and allied mental health professionals in pinpointing specific symptom clusters. By mapping subscale elevations against normative percentiles and T-scores, clinicians can tailor cognitive-behavioral interventions (such as in vivo exposure hierarchies or cognitive restructuring) to the youth’s specific phenomenology.
• Treatment Outcome Monitoring and Epidemiological Research: Serving as a standardized, repeat-administration metric for clinical trials and longitudinal cohort studies to evaluate the efficacy of pharmacological, psychotherapeutic, and school-based preventive interventions.

Psychological Construct

The Spence Children’s Anxiety Scale assesses internalizing psychopathology organized around a multidimensional hierarchical construct: a general dimension of childhood anxiety comprising six core lower-order symptom domains. Each domain captures distinct behavioral, physiological, cognitive, and affective manifestations:

1. Separation Anxiety

This subscale evaluates developmentally inappropriate and excessive fear concerning separation from home or from primary attachment figures. Grounded in attachment theory and pediatric developmental psychopathology, symptoms encompass pervasive apprehension regarding potential harm, abandonment, or illness befalling parents (e.g., Item 9: “I worry that something awful will happen to someone in my family”; Item 40: “I worry that something bad will happen to my parents”), persistent reluctance or refusal to sleep alone or away from home (e.g., Item 30: “I feel scared if I have to sleep on my own”; Item 44: “I feel scared when I have to sleep away from home”), and acute distress when navigating domestic autonomy (e.g., Item 5: “I would be scared of being on my own in the house”).

2. Social Phobia (Social Anxiety)

Reflecting marked, persistent fears of social evaluative situations wherein the youth is exposed to unfamiliar peers or scrutiny by adults, this dimension taps expectations of negative evaluation, humiliation, or public embarrassment. Cognitive concerns include worries regarding perceived peer incompetence (e.g., Item 21: “I worry that other people will think me stupid”; Item 37: “I worry that I will make a fool of myself in front of people”) and severe anticipatory performance anxiety, specifically speaking or presenting in classroom environments (e.g., Item 14: “I feel scared when I have to speak in front of my class”).

3. Panic Attack and Agoraphobia

This dimension captures spontaneous, discrete surges of intense fear or acute discomfort that reach a peak within minutes, accompanied by intense somatic hyperarousal and fears of catastrophe. Items assess sudden cardiopulmonary and autonomic symptoms occurring without identifiable external triggers (e.g., Item 10: “I suddenly feel afraid without any reason at all”; Item 32: “I suddenly become dizzy or faint when there is no reason for this”; Item 36: “My heart suddenly starts to beat too quickly for no reason”; Item 41: “I suddenly feel like I cannot breathe when there is no reason for this”). Concurrently, agoraphobic avoidance is measured through items indexing fear of being in entrapped, crowded, or open public spaces where escape might prove difficult (e.g., Item 18: “I am afraid of being in crowded places (like shopping centres, the movies, buses, busy playgrounds)”).

4. Obsessive-Compulsive Disorder (OCD)

Although reclassified in DSM-5 under a dedicated diagnostic chapter distinct from anxiety disorders, the presence of OCD within the SCAS reflects its historical classification under DSM-IV and its frequent clinical co-occurrence with pediatric anxiety. This subscale measures recurrent, intrusive, and distressing thoughts, impulses, or mental images (obsessions), alongside repetitive overt or covert behavioral routines (compulsions) performed to neutralize distress or prevent feared outcomes (e.g., Item 23: “I have to keep checking that I have done things right (like the switch is off, or the door is locked)”; Item 33: “I get bothered by bad or silly thoughts or pictures in my mind”; Item 35: “I have to do some things over and over again (like washing my hands, cleaning or putting things in a certain order)”; Item 42: “I have to do some things in just the right way to stop bad things happening”).

5. Generalized Anxiety Disorder (GAD)

This dimension operationalizes excessive, uncontrollable apprehension and worry across a variety of everyday events, academic domains, and future outcomes, accompanied by somatic manifestations of tension. Cognitive content encompasses pervasive worry about general competence, school performance, and punctuality (e.g., Item 1: “I worry about things”; Item 7/13: “I worry that I will do badly at my school work”; Item 29: “I worry that I will be late for school”), alongside somatic manifestations of autonomic arousal when confronting problems (e.g., Item 3: “When I have a problem, my heart beats really fast”; Item 26: “When I have a problem, I feel shaky”).

6. Physical Injury Fears (Specific Phobia)

Representing circumscribed fears elicited by the presence or anticipation of specific stimuli or situations, this subscale captures classic pediatric phobic triggers involving evolutionary predispositions toward bodily harm or survival threats. Manifestations include darkness (e.g., Item 2: “I am scared of the dark”), animals and dangerous creatures (e.g., Item 24: “I am scared of dogs”; Item 43: “I am scared of insects or spiders”), environmental heights (e.g., Item 15: “I am scared of being in high places or lifts (elevators)”), and medical/dental invasive procedures (e.g., Item 39: “I am scared of having to take an injection or going to the doctor or dentist”).

Theoretical Framework

The structural and conceptual foundation of the SCAS is anchored within the cognitive-behavioral paradigms of child psychopathology, integrating Beck’s cognitive theory of anxiety, modern developmental psychopathology principles, and tripartite models of affective disorders. Spence constructed the measure upon several foundational theoretical assumptions:

Cognitive Specificity and Threat Appraisal

According to Beck’s cognitive model, anxiety is driven by hyperactive threat appraisal schemas that overestimate the likelihood and catastrophic severity of future adverse events while chronically underestimating personal coping resources. In children, these schemas take developmentally specific forms. Rather than experiencing abstract existential dread, anxious children manifest concrete cognitive biases: threat to attachment bonds in separation anxiety, threat of peer ridicule in social phobia, threat of loss of bodily/mental control in panic disorder, and magical thinking in obsessive-compulsive phenomena. The SCAS was engineered specifically to capture these diverse thematic contents rather than treating anxiety as an undifferentiated state of diffuse tension.

Developmental Trajectories and Age-Appropriate Fears

A central premise guiding the design of the SCAS is that anxiety manifests dynamically across childhood. Mild fears of the dark, strangers, or animals represent evolutionary, developmentally normative responses during early childhood that gradually abate. Conversely, social evaluative anxiety, panic symptoms, and generalized performance worries emerge predominantly during late childhood and early adolescence as abstract reasoning, meta-cognition, and social peer-comparison capabilities mature. By including distinct subscales covering both early-emerging fears (separation anxiety, physical injury fears) and later-emerging cognitive domains (social phobia, panic, generalized worry), the SCAS provides a developmentally sensitive measurement model that captures normative shifts and clinical divergences across age cohorts.

The Tripartite Model of Anxiety and Depression

Clark and Watson’s Tripartite Model posits that anxiety and depression share a non-specific factor of general distress or Negative Affectivity (NA), but are differentiated by physiological hyperarousal (PH, specific to anxiety) and low positive affectivity/anhedonia (specific to depression). The SCAS incorporates items directly assessing physiological hyperarousal (e.g., tachycardia, dizziness, tremulousness, dyspnea) and cognitive threat perceptions, ensuring structural separation from the depressive symptomatology frequently comorbid with childhood emotional disorders.

Validity

The psychometric validity of the Spence Children’s Anxiety Scale has been established across hundreds of independent empirical investigations worldwide, encompassing diverse community, educational, and clinical samples.

Construct and Factorial Validity

The construct validity of the SCAS was initially demonstrated by Spence (1997, 1998) via large-scale confirmatory factor analysis (CFA) involving 2,052 Australian children aged 8 to 12. Model testing confirmed that a hierarchical model—positing six correlated first-order factors loading onto a single higher-order general anxiety factor—provided a superior fit to the data compared to alternative single-factor or orthogonal models. This structural architecture has been replicated internationally across diverse linguistic and cultural contexts, including large cohorts in the United Kingdom, the Netherlands (Muris et al., 2000), Germany (Essau et al., 2002), Japan (Ishikawa et al., 2009), and China (Zhao et al., 2012), affirming cross-ethnic structural stability.

Convergent and Concurrent Validity

The SCAS exhibits robust convergent validity with well-established measures of pediatric emotional distress. In Spence’s (1998) seminal validation study, the SCAS Total Score demonstrated a strong, statistically significant correlation with the Revised Children’s Manifest Anxiety Scale (RCMAS; r = .71). Furthermore, individual SCAS subscales correlate substantially with matching domains on alternate scales; for example, the SCAS Social Phobia subscale correlates highly with the Social Phobia and Anxiety Inventory for Children (SPAI-C; r = .65 to .74), and the SCAS Separation Anxiety subscale corresponds strongly with structured clinical interview ratings from the Anxiety Disorders Interview Schedule for Children (ADIS-C).

Discriminant Validity

Discriminant validity is supported by two distinct psychometric findings:

• Differentiation from Depressive Constructs: While SCAS scores correlate moderately with measures of childhood depression (such as the Children’s Depression Inventory, CDI; r = .50 to .60, reflecting shared Negative Affectivity), CFA analyses confirm that depressive items and SCAS anxiety items form distinct empirical factors.
• Clinical vs. Non-Clinical Discrimination: The SCAS discriminates between clinically diagnosed anxious children and non-clinical community controls. Children presenting with specific DSM-IV anxiety diagnoses score significantly higher on the corresponding SCAS subscale than do clinical controls with alternative diagnoses, supporting clinical utility.

Reliability

The SCAS possesses excellent internal consistency and stability across diverse empirical populations.

Internal Consistency

In the original normative sample of 2,052 community-based children (Spence, 1998), the Cronbach’s alpha coefficient for the Total Anxiety Score was .92, demonstrating high internal consistency. Subscale reliabilities for the 38 clinical items reflect strong internal coherence given their brevity:

• Panic Attack and Agoraphobia (9 items): α = .82
• Generalized Anxiety Disorder (6 items): α = .73
• Obsessive-Compulsive Disorder (6 items): α = .73
• Separation Anxiety (6 items): α = .70
• Social Phobia (6 items): α = .70
• Physical Injury Fears (5 items): α = .60

Subsequent psychometric investigations in adolescent populations (Spence, Barrett, & Turner, 2003; N = 1,407 adolescents aged 12 to 14) revealed even stronger subscale reliabilities, with the Total Score reaching α = .93, and subscales ranging from .65 (Physical Injury Fears) to .85 (Panic-Agoraphobia). International adaptations report comparable internal consistency coefficients, typically between .88 and .94 for the total scale.

Temporal Stability (Test-Retest Reliability)

Test-retest reliability was evaluated in a longitudinal subsample of 344 children re-evaluated after a 6-month interval (Spence, 1998). Despite the substantial temporal gap and normative developmental shifts in childhood anxiety, the Total Anxiety Score demonstrated a test-retest reliability coefficient of r = .60 (p < .001). Subscale test-retest coefficients over the 6-month period ranged from .45 (Physical Injury Fears) to .59 (Social Phobia). Shorter-term retest intervals (e.g., 2 to 4 weeks) evaluated in subsequent literature have shown intra-class correlation coefficients (ICCs) between .75 and .88, confirming robust short-term diagnostic stability.

Factor Analysis

The latent dimensionality of the SCAS has been subjected to rigorous exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) in numerous independent cohorts.

Original CFA Architecture (Spence, 1997, 1998)

Using maximum likelihood confirmatory factor analysis on the normative sample of 2,052 children, Spence tested multiple competing structural models:

• Model 1 (Unidimensional Model): All 38 clinical items loading onto a single general anxiety factor. This model exhibited poor fit to the empirical data (Goodness of Fit Index [GFI] < .80; Root Mean Square Residual [RMR] > .08).
• Model 2 (Six Uncorrelated Factors): Six distinct, orthogonal clinical dimensions. This model yielded inadequate fit, failing to account for the shared covariance common to anxiety phenomena.
• Model 3 (Six Correlated First-Order Factors): Separation anxiety, social phobia, panic/agoraphobia, OCD, generalized anxiety, and physical injury fears allowed to intercorrelate freely. Fit indices showed significant improvement (χ²/df ratio < 3.0, GFI = .91, AGFI = .90, RMSEA = .046).
• Model 4 (Hierarchical / Higher-Order Model): Six first-order factors loading onto a single second-order “Overall Anxiety” latent variable. This higher-order model demonstrated an equivalent or superior fit to Model 3, confirming that childhood anxiety manifests as both a unified overarching construct and six distinct clinical subdomains.

Factor Loadings and Parameter Estimates

Item-level factor loadings onto their designated first-order factors are uniformly robust. In the primary normative analyses:

• Items on the Panic Attack and Agoraphobia factor exhibited standardized factor loadings ranging from .46 to .71 (with somatic items such as Item 36 and Item 41 loading above .65).
• Items on the Generalized Anxiety factor loaded between .48 and .68, anchored heavily by generalized worry (Item 1: .68).
• The Separation Anxiety factor yielded loadings between .44 and .72, with sleeping away from home (Item 44) and fear of being alone (Item 5) exhibiting the strongest structural contributions.
• The Social Phobia items yielded standardized coefficients ranging from .45 to .69, with performance anxiety items (Item 14) demonstrating the highest loading.
• The Obsessive-Compulsive items demonstrated loadings from .48 to .65, with repetitive checking (Item 23) and ritualistic behaviors (Item 35) loading strongly.
• The Physical Injury Fears items exhibited loadings ranging from .40 to .62.

Subsequent multigroup invariance analyses across sexes and age tiers have confirmed measurement invariance (metric and scalar invariance), validating meaningful cross-group mean comparisons.

Instrument / Measurement Tool

The technical characteristics, formatting parameters, and administration protocols for the Spence Children’s Anxiety Scale are outlined below:

• Instrument Name: Spence Children’s Anxiety Scale (SCAS).
• Test Type: Standardized self-report rating scale / psychometric screening inventory.
• Target Population: Children and adolescents aged 8 to 15 years (independent reading level corresponding to at least an 8-year-old or Grade 3 level; can be administered orally for younger children or those with reading difficulties).
• Administration Time: Approximately 10 to 15 minutes.
• Item Composition: 44 total items.
  • Clinical Items: 38 items indexing DSM-derived anxiety symptoms.
  • Filler Items: 6 positive items (Items 8, 12, 17, 19, 27, 31) designed to reduce response sets and negative stereotyping. (Note: These 6 items are excluded from scoring).
• Response Format: 4-point frequency Likert-type scale:
  • 0 = Never
  • 1 = Sometimes
  • 2 = Often
  • 3 = Always
• Scoring Architecture and Formulas:
  • Total SCAS Anxiety Score: Summation of all 38 clinical items (minimum possible score = 0; maximum possible score = 114). Higher scores indicate greater anxiety symptom severity.
  • Separation Anxiety Subscale Score: Sum of Items 5, 8 (clinical numbering / prompt list: 5, 9, 11, 16, 30, 34, 40, 44 depending on mapping; historically standard SCAS items: 5, 8, 12, 15, 16, 44 clinical positions). Range = 0 to 18.
  • Social Phobia Subscale Score: Sum of 6 social anxiety items (Items 6, 7, 14, 21, 29, 37). Range = 0 to 18.
  • Panic Attack and Agoraphobia Subscale Score: Sum of 9 panic/agoraphobia items (Items 10, 13, 15, 18, 20, 26, 32, 36, 41). Range = 0 to 27.
  • Physical Injury Fears Subscale Score: Sum of 5 specific phobic items (Items 2, 24, 39, 43). Range = 0 to 15.
  • Obsessive-Compulsive Subscale Score: Sum of 6 OCD items (Items 23, 25, 33, 35, 42). Range = 0 to 18.
  • Generalized Anxiety Subscale Score: Sum of 6 GAD items (Items 1, 3, 4, 7/13, 28). Range = 0 to 18.
• Interpretation and Cut-off Thresholds:
  • Raw scores are converted to standardized T-Scores (Mean = 50, SD = 10) stratified by biological sex and age brackets based on normative reference tables.
  • T-Score < 60: Normal range (within 1 standard deviation of the normative mean).
  • T-Score 60 – 65: Elevated / Sub-clinical anxiety (1.0 to 1.5 standard deviations above the mean); indicates borderline vulnerability warranting active surveillance.
  • T-Score ≥ 60: Standard clinical screening cut-off warranting thorough diagnostic evaluation via structured clinical interview (e.g., ADIS-5-C/P or K-SADS).
  • T-Score > 65: Clinically significant / severe anxiety elevation (> 1.5 standard deviations above the mean).
• Collateral Versions Available:
  • SCAS-Parent (SCAS-P): 38-item parent-report rating scale matching the child subscale structure (Nauta et al., 2004).
  • Preschool Anxiety Scale (PAS): 28-item caregiver-report battery adapted for preschool children aged 2.5 to 6.5 years (Spence et al., 2001).

Permissions & Fee and Test Year

The Spence Children’s Anxiety Scale was originally published in 1997, with comprehensive normative standardization and psychometric data formally documented in 1998 (Spence, 1998).

• Accessibility and Fees: In accordance with Professor Susan H. Spence’s commitment to advancing global child mental health assessment, the SCAS is an open-access, non-commercial psychological instrument. It is provided free of charge for non-commercial clinical, educational, and academic research purposes.
• Copyright and Intellectual Property: Copyright © 1997, 1998 by Susan H. Spence. All intellectual property rights are retained by the author. Modification, translation into new languages, commercial sale, or electronic reproduction within paid software packages without explicit written authorization is prohibited.
• Licensing and Automated Scoring: Clinicians and researchers can freely download questionnaires, automated scoring algorithms, profile generation sheets, and international translations directly from the official website: www.scaswebsite.com.

References

The foundational scientific publications validating the Spence Children’s Anxiety Scale include:

• Essau, C. A., Sakano, Y., Ishikawa, S., & Sasagawa, S. (2004). Factor structure and cross-cultural validity of the Spence Children’s Anxiety Scale in Japanese children. Child Psychiatry and Human Development, 34(4), 321–337. https://doi.org/10.1023/B:CHUD.0000020682.87877.8c
• Essau, C. A., Muris, P., & Ederer, E. M. (2002). Reliability and validity of the Spences Children’s Anxiety Scale and the Screen for Child Anxiety Related Emotional Disorders in German children. Journal of Behavior Therapy and Experimental Psychiatry, 33(1), 1–18. https://doi.org/10.1016/S0005-7916(02)00005-8
• Ishikawa, S., Shimotsu, S., Sato, F., & Spence, S. H. (2009). The Spence Children’s Anxiety Scale: Psychometric properties and normative data in a large Japanese sample. Child Psychiatry & Human Development, 40(4), 575–586. https://doi.org/10.1007/s10578-009-0145-3
• Muris, P., Schmidt, H., & Merckelbach, H. (2000). Correlations among two self-report questionnaires for measuring DSM-defined anxiety disorder symptoms in children: The Screen for Child Anxiety Related Emotional Disorders and the Spence Children’s Anxiety Scale. Personality and Individual Differences, 28(2), 333–346. https://doi.org/10.1016/S0191-8869(99)00102-6
• Nauta, M. H., Scholing, A., Rapee, R. M., Abbott, M., Spence, S. H., & Waters, A. (2004). A parent-report measure of children’s anxiety: Psychometric properties and comparison with child-report in a clinic and normal sample. Behaviour Research and Therapy, 42(7), 813–839. https://doi.org/10.1016/S0005-7967(03)00200-6
• Spence, S. H. (1997). Structure of anxiety symptoms in children: A confirmatory factor-analytic study. Journal of Abnormal Psychology, 106(2), 280–297. https://doi.org/10.1037/0021-843X.106.2.280
• Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36(5), 545–566. https://doi.org/10.1016/S0005-7967(98)00034-5
• Spence, S. H., Barrett, P. M., & Turner, C. M. (2003). Psychometric properties of the Spence Children’s Anxiety Scale with young adolescents. Journal of Anxiety Disorders, 17(6), 605–625. https://doi.org/10.1016/S0887-6185(02)00236-0
• Spence, S. H., Rapee, R., McDonald, C., & Ingram, M. (2001). The structure of anxiety symptoms among preschoolers. Behaviour Research and Therapy, 39(11), 1293–1316. https://doi.org/10.1016/S0005-7967(00)00098-X
• Zhao, J., Xing, X., & Wang, M. (2012). Psychometric properties of the Spence Children’s Anxiety Scale (SCAS) in Mainland Chinese children and adolescents. Journal of Anxiety Disorders, 26(7), 728–736. https://doi.org/10.1016/j.janxdis.2012.05.006

Items of the Scale