Initial elevation bias in child anxiety symptoms: A systematic review and meta-analysis.
Year: 2026
Type: article
Study designs: Systematic Review, Meta-Analysis
Abstract: = 9,224 children) met inclusion criteria: 46 clinical samples, 37 risk samples, and 23 community samples. For child-rated anxiety, a weighted average effect of -0.25 (95% CI [-0.30, -0.21]) was found between the first and second assessments and -0.09 (95% CI [-0.18, -0.01]) between the second and third assessments. Metaregression showed that clinical and risk samples had larger decreases in anxiety scores, while the Screen for Child Anxiety-Related Emotional Disorders measure exhibited smaller decreases. For parent-rated child anxiety, the effect was -0.12 (95% CI [-0.17, -0.06]) between the first and second assessment. The findings support the presence of initial elevation bias mainly in child-reported anxiety. The results are unlikely to be explained by maturation, real improvements, or selective attrition, and they extend beyond the effects of regression to the mean as they appear even in community samples. Initial elevation bias complicates the interpretation of child anxiety ratings and has important implications for clinical practice and research. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Source: Psychological Assessment
DOI: 10.1037/pas0001458
Institutions: Karolinska Institutet, Stockholm Health Care Services
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
OpenAlex ID: W7130504451
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