Psychometric Properties of the Strengths and Difficulties Questionnaire in Children Aged 5–12 Years Across Seven European Countries
Abstract
Abstract. The Strengths and Difficulties Questionnaire (SDQ) has been used extensively to screen for possible mental disorders in epidemiological studies around the world. The present study aimed to compare the internal consistency of both the parent- and teacher-SDQ across seven European countries: Italy, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey, and to determine the ability of the SDQ to discriminate cases from non-cases of disorders against the well-established Development and Well-Being Assessment (DAWBA). The sample included 541 assessments of children aged 5–12 years. Internal consistency ranged from .74 to .85 for the teacher-SDQ, and .60 to .85 for the parent-SDQ with significant between-country differences. The SDQ further proved to be an adequate screening instrument for the detection of any mental disorder (area under the receiving operator characteristic [AUROC] = .74, 95% CI: .69–.78), and for externalizing disorders in particular (AUROC = .80, 95% CI: .76–.84). There were no differences in AUROC between countries (p = .09), yet sample sizes were limited thus restricting our ability to detect between-country differences in AUROCs. The results reinforce existing research on the SDQ and support its use in detecting probable cases of psychiatric disorders in children across Europe.
References
1983). Manual for the child behavior checklist: And revised child behavior profile. Burlington, VT: Department of Psychiatry, University of Vermont.
(2006). Validation of the Arabic Strengths and Difficulties Questionnaire and the development and well-being assessment. Eastern Mediterranean Health Journal, 12(2), 138–146.
(1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.
. (2004). Validation of the parent and teacher SDQ in a clinical sample. European Child & Adolescent Psychiatry, 13, ii11–ii16. https://doi.org/10.1007/s00787-004-2003-5
(1977). Statistical power analysis for the behavioral sciences (Revised ed.). New York, NY: Academic Press.
(2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837–844. https://doi.org/10.1001/archpsyc.60.8.837
(2015). The validity of the multi-informant approach to assessing child and adolescent mental health. Psychological Bulletin, 141, 858. https://doi.org/10.1037/a0038498
(1988). Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach. Biometrics, 43, 837–845.
(2010). The strengths and difficulties questionnaire (SDQ). Early evidence of its reliability and validity in a community sample of Italian children. Personality and Individual Differences, 49, 570–575. https://doi.org/10.1016/j.paid.2010.05.005
(2016). Cocron: A web interface and r package for the statistical comparison of Cronbach’s alpha coefficients. International Journal of Internet Science, 11, 51–60.
(2013). A new diagnostic approach for Turkish speaking populations DAWBA Turkish version. Epidemiology and Psychiatric Sciences, 22, 275–282. https://doi.org/10.1017/S2045796012000479
(2004). Prevalence of child and adolescent psychiatric disorders in southeast brazil. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 727–734. https://doi.org/10.1097/01.chi.0000120021.14101.ca
(2003). The british child and adolescent mental health survey 1999: The prevalence of DSM-IV disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 1203–1211. https://doi.org/10.1097/00004583-200310000-00011
(2004). Lietuviškas SDQ – standartizuotas mokyklinio amžiaus vaikų „galių ir sunkumų klausimynas “
([Lithuanian SDQ – The standardized Strengths and Difficulties Questionnaire] . Psichologija, 29, 88–105.2012). Cross-national differences in questionnaires do not necessarily reflect comparable differences in disorder prevalence. Social Psychiatry and Psychiatric Epidemiology, 47, 1321–1331. https://doi.org/10.1007/s00127-011-0440-2
(2010). When to use broader internalising and externalising subscales instead of the hypothesised five subscales on the Strengths and Difficulties Questionnaire (SDQ): Data from British parents, teachers and children. Journal of Abnormal Child Psychology, 38, 1179–1191. https://doi.org/10.1007/s10802-010-9434-x
(1997). The Strengths and Difficulties Questionnaire: A research note. Journal Child Psychol Psychiatry, 38, 581–586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x
(1999). The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. Journal of Child Psychology and Psychiatry, 40, 791–799.
(2001). Psychometric properties of the Strengths and Difficulties Questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1337–1345. https://doi.org/10.1097/00004583-200111000-00015
(2000). The development and well-being assessment: Description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology and Psychiatry, 41, 645–655.
(2000). Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. The British Journal of Psychiatry, 177, 534–539.
(2009). Guidelines for translating and adapting psychological instruments. Nordic Psychology, 61, 29–45.
(2008). Psychometric properties of the Turkish version of the Strengths and Difficulties Questionnaire (SDQ). Çocuk ve Gençlik Ruh Sağlığı Dergisi/Turkish Journal of Child and Adolescent Mental Health, 15, 65–74.
(2003). German version of the Strengths and Difficulties Questionnaire (SDQ-German) – Overview and evaluation of initial validation and normative results. Praxis der Kinderpsychologie und Kinderpsychiatrie, 52, 491–502.
(2000). Comparing the German versions of the Strengths and Difficulties Questionnaire (SDQ-Deu) and the Child Behavior Checklist. European Child & Adolescent Psychiatry, 9, 271–276.
(2000). The Strengths and Difficulties Questionnaire among Finnish school-aged children and adolescents. European Journal of Child and Adolescent Psychiatry, 9, 277–284.
(2016). Comparing the prevalence of mental health problems in children 6–11 across Europe. Social Psychiatry and Psychiatric Epidemiology, 51, 1093–1103. https://doi.org/10.1007/s00127-016-1253-0
(2017). Unmet need for specialty mental health services among children across Europe. Psychiatric Services, 68, 789–795. https://doi.org/10.1176/appi.ps.201600409
(2015). The school children mental health in Europe (SCMHE) project: Design and first results. Clinical Practice and Epidemiology in Mental Health CP & EMH, 11, 113–123. https://doi.org/10.2174/1745017901511010113
(2013). The reliability and validity of the dominic interactive: A computerized child report instrument for mental health problems. Child & Youth Care Forum, 42(1), 35–52. https://doi.org/10.1007/s10566-012-9185-7
(2004). The use of the Strengths and Difficulties Questionnaire (SDQ) in southern European countries. European Child & Adolescent Psychiatry, 13, ii40–ii46. https://doi.org/10.1007/s00787-004-2007-1
(2000). Mental health of children and adolescents in Great Britain. London, UK: TSO.
(2003). The Strengths and Difficulties Questionnaire (SDQ). European Child & Adolescent Psychiatry, 12, 1–8. https://doi.org/10.1007/s00787-003-0298-2
(2012). Psychometric properties of the Danish Strengths and Difficulties Questionnaire: The SDQ assessed for more than 70,000 raters in four different cohorts. PLoS One, 7, e32025. https://doi.org/10.1371/journal.pone.0032025
(2004). The Strengths and Difficulties Self-Report Questionnaire as a screening instrument in Norwegian community samples. European Child & Adolescent Psychiatry, 13, 73–82. https://doi.org/10.1007/s00787-004-0356-4
(2009). The Strengths and Difficulties Questionnaire: Validation study in French school-aged children and cross-cultural comparisons. Social Psychiatry and Psychiatric Epidemiology, 44, 740–747. https://doi.org/10.1007/s00127-008-0489-8
(2010). Psychometric properties of the parent and teacher versions of the Strengths and Difficulties Questionnaire for 4- to 12-year-olds: A review. Clinical child and family psychology review, 13, 254–274. https://doi.org/10.1007/s10567-010-0071-2
(2003). Dutch version of the Strengths and Difficulties Questionnaire (SDQ). European Child & Adolescent Psychiatry, 12, 281–289. https://doi.org/10.1007/s00787-003-0341-3
(2005). Translation and cross-cultural adaptation of assessment instruments used in psychological research with children and families. Clinical Child and Family Psychology Review, 8, 135–147. https://doi.org/10.1007/s10567-005-4752-1
(2003). What proportion of failure to complete secondary school in the US population is attributable to adolescent psychiatric disorder? Journal of Behavioral Health Services & Research, 30, 119–124.
(2011). The size and burden of mental disorders and other disorders of the brain in Europe 2010. European Neuropsychopharmacology, 21, 655–679. https://doi.org/10.1016/j.euroneuro.2011.07.018.
(