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Original Article

Psychometric Properties of the Strengths and Difficulties Questionnaire in Children Aged 5–12 Years Across Seven European Countries

Published Online:https://doi.org/10.1027/1015-5759/a000489

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

  • Achenbach, T. M. & Edelbrock, C. S. (1983). Manual for the child behavior checklist: And revised child behavior profile. Burlington, VT: Department of Psychiatry, University of Vermont. First citation in articleGoogle Scholar

  • Alyahri, A. & Goodman, R. (2006). Validation of the Arabic Strengths and Difficulties Questionnaire and the development and well-being assessment. Eastern Mediterranean Health Journal, 12(2), 138–146. First citation in articleGoogle Scholar

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association. First citation in articleGoogle Scholar

  • Becker, A., Woerner, W., Hasselhorn, M., Banaschewski, T. & Rothenberger, A. (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 First citation in articleCrossrefGoogle Scholar

  • Cohen, J. (1977). Statistical power analysis for the behavioral sciences (Revised ed.). New York, NY: Academic Press. First citation in articleGoogle Scholar

  • Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G. & Angold, A. (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 First citation in articleCrossrefGoogle Scholar

  • De Los Reyes, A., Augenstein, T. M., Wang, M., Thomas, S. A., Drabick, D. A., Burgers, D. E. & Rabinowitz, J. (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 First citation in articleCrossrefGoogle Scholar

  • DeLong, E. R., DeLong, D. M. & Clarke-Pearson, D. L. (1988). Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach. Biometrics, 43, 837–845. First citation in articleCrossrefGoogle Scholar

  • Di Riso, D., Salcuni, S., Chessa, D., Raudino, A., Lis, A. & Altoè, G. (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 First citation in articleCrossrefGoogle Scholar

  • Diedenhofen, B. & Musch, J. (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. First citation in articleGoogle Scholar

  • Dursun, O., Guvenir, T., Aras, S., Ergin, C., Mutlu, C., Baydur, H., … Iscanli, L. (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 First citation in articleCrossrefGoogle Scholar

  • Fleitlich-Bilyk, B. & Goodman, R. (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 First citation in articleCrossrefGoogle Scholar

  • Ford, T., Goodman, R. & Meltzer, H. (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 First citation in articleCrossrefGoogle Scholar

  • Gintilienė, G., Girdzijauskienė, S., Černiauskaitė, D., Lesinskienė, S., Povilaitis, R. & Pūras, D. (2004). Lietuviškas SDQ – standartizuotas mokyklinio amžiaus vaikų „galių ir sunkumų klausimynas “ [Lithuanian SDQ – The standardized Strengths and Difficulties Questionnaire]. Psichologija, 29, 88–105. First citation in articleCrossrefGoogle Scholar

  • Goodman, A., Heiervang, E., Fleitlich-Bilyk, B., Alyahri, A., Patel, V., Mullick, M. I., … Goodman, R. (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 First citation in articleCrossrefGoogle Scholar

  • Goodman, A., Lamping, D. L. & Ploubidis, G. B. (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 First citation in articleCrossrefGoogle Scholar

  • Goodman, R. (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 First citation in articleCrossrefGoogle Scholar

  • Goodman, R. (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. First citation in articleCrossrefGoogle Scholar

  • Goodman, R. (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 First citation in articleCrossrefGoogle Scholar

  • Goodman, R., Ford, T., Richards, H., Gatward, R. & Meltzer, H. (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. First citation in articleCrossrefGoogle Scholar

  • Goodman, R., Ford, T., Simmons, H., Gatward, R. & Meltzer, H. (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. First citation in articleCrossrefGoogle Scholar

  • Gudmundsson, E. (2009). Guidelines for translating and adapting psychological instruments. Nordic Psychology, 61, 29–45. First citation in articleLinkGoogle Scholar

  • Güvenir, T., Özbek, A., Baykara, B., Arkar, H., Şentürk, B. & İncekaş, S. (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. First citation in articleGoogle Scholar

  • Klasen, H., Woerner, W., Rothenberger, A. & Goodman, R. (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. First citation in articleGoogle Scholar

  • Klasen, H., Woerner, W., Wolke, D., Meyer, R., Overmeyer, S., Kaschnitz, W. E., … Goodman, R. (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. First citation in articleCrossrefGoogle Scholar

  • Koskelainen, M., Sourander, A. & Kaljonen, A. (2000). The Strengths and Difficulties Questionnaire among Finnish school-aged children and adolescents. European Journal of Child and Adolescent Psychiatry, 9, 277–284. First citation in articleCrossrefGoogle Scholar

  • Kovess-Masfety, V., Husky, M. M., Keyes, K., Hamilton, A., Pez, O., Bitfoi, A., … Mihova, Z. (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 First citation in articleCrossrefGoogle Scholar

  • Kovess-Masfety, V., Van Engelen, J., Stone, L., Otten, R., Carta, M. G., Bitfoi, A., … Mihova, Z. (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 First citation in articleCrossrefGoogle Scholar

  • Kovess, V., Carta, M. G., Pez, O., Bitfoi, A., Koç, C., Goelitz, D., … Otten, R. (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 First citation in articleCrossrefGoogle Scholar

  • Kuijpers, R. C., Otten, R., Krol, N. P., Vermulst, A. A. & Engels, R. C. (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 First citation in articleCrossrefGoogle Scholar

  • Marzocchi, G., Capron, C., Di Pietro, M., Duran Tauleria, E., Duyme, M., Frigerio, A., … Thérond, C. (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 First citation in articleCrossrefGoogle Scholar

  • Meltzer, H., Gatward, R., Goodman, R. & Ford, T. (2000). Mental health of children and adolescents in Great Britain. London, UK: TSO. First citation in articleCrossrefGoogle Scholar

  • Muris, P., Meesters, C. & van den Berg, F. (2003). The Strengths and Difficulties Questionnaire (SDQ). European Child & Adolescent Psychiatry, 12, 1–8. https://doi.org/10.1007/s00787-003-0298-2 First citation in articleCrossrefGoogle Scholar

  • Niclasen, J., Teasdale, T. W., Andersen, A.-M. N., Skovgaard, A. M., Elberling, H. & Obel, C. (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 First citation in articleCrossrefGoogle Scholar

  • Rønning, J., Handegaard, B., Sourander, A. & Mørch, W.-T. (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 First citation in articleCrossrefGoogle Scholar

  • Shojaei, T., Wazana, A., Pitrou, I. & Kovess, V. (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 First citation in articleCrossrefGoogle Scholar

  • Stone, L. L., Otten, R., Engels, R. C., Vermulst, A. A. & Janssens, J. M. (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 First citation in articleCrossrefGoogle Scholar

  • Van Widenfelt, B. M., Goedhart, A. W., Treffers, P. D. & Goodman, R. (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 First citation in articleCrossrefGoogle Scholar

  • Van Widenfelt, B. M., Treffers, P. D., De Beurs, E., Siebelink, B. M. & Koudijs, E. (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 First citation in articleCrossrefGoogle Scholar

  • Vander Stoep, A., Weiss, N., Saldanha, E., Cheney, D. & Cohen, P. (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. First citation in articleCrossrefGoogle Scholar

  • Wittchen, H.-U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., Jönsson, B., … Faravelli, C. (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. First citation in articleCrossrefGoogle Scholar