This study evaluates SENA’s accuracy in detecting emotional disorders and suicidal thoughts

SENA showed good sensitivity (78.5%-80.4%) but moderate specificity (65.9%-66.1%).

SENA showed high sensitivity for generalized anxiety, social anxiety, and PTSD.

SENA is useful for early screening but requires refined thresholds for better specificity.

Results have implications for improving screening in educational & clinical settings.

To evaluate the diagnostic accuracy of the System for the Assessment of Children and Adolescents (SENA) in identifying emotional disorders and suicidal thoughts and behaviors. SENA is a widely used Spanish screening tool for assessing emotional and behavioral symptoms in youth.

526 primary and secondary pupils aged 8-16 in several Spanish regions (a subset of the EmoChild Project, n=5,652 completed SENA), completed the SENA and underwent with clinical interviews using KSADS-COMP within 3 months. We screened potential participants by identifying possible positive and negative cases based on a T-score equivalent to the 75th percentile and served as a cut-off point for accessing a diagnostic interview.

SENA’s Emotional subscale showed a sensitivity (SN) of 78.5% in children and 80.4% in adolescents for detecting any emotional disorder, with specificities (SP) of 65.9% and 66.1%, and Area Under the ROC curve (AUC) of .74 in children and .73 in adolescents. AUCs were adequate for all subscales (0.72-0.93) other than obsessive compulsive disorder (AUC=.67). Specific subscales performed best: Generalized Anxiety Disorder (SN=100%, SP=88.4%) and Social Anxiety Disorder-SAD (SN = 91.4%, SP = 80.3%) in children, and SAD (SN=88.1%, SP=72.5%), Post-Traumatic Stress Disorder (SN=81.2%, SP=68.2%) and suicidal thoughts in adolescents (SN=84.5%, SP=73.8%).

SENA is a valuable screening tool for educational and clinical settings, facilitating early intervention through a standardized and user-friendly assessment. Nevertheless, there is need for refined thresholds to enhance specificity and clinical alignment.

emotional disorders

suicidal ideation

youth

mental health

diagnostic accuracy

© 2026 The Authors. Published by Elsevier B.V.