Abstract
An important characteristic of a screening tool is its discriminant ability or the measure’s accuracy to distinguish between those with and without mental health problems. The current study examined the inter-rater agreement and screening concordance of the parent and teacher versions of SDQ at scale, subscale and item-levels, with the view of identifying the items that have the most informant discrepancies; and determining whether the concordance between parent and teacher reports on some items has the potential to influence decision making. Cross-sectional data from parent and teacher reports of the mental health functioning of a community sample of 299 students with and without disabilities from 75 different primary schools in Perth, Western Australia were analysed. The study found that: a) Intraclass correlations between parent and teacher ratings of children’s mental health using the SDQ at person level was fair on individual child level; b) The SDQ only demonstrated clinical utility when there was agreement between teacher and parent reports using the possible or 90% dichotomisation system; and c) Three individual items had positive likelihood ratio scores indicating clinical utility. Of note was the finding that the negative likelihood ratio or likelihood of disregarding the absence of a condition when both parents and teachers rate the item as absent was not significant. Taken together, these findings suggest that the SDQ is not optimised for use in community samples and that further psychometric evaluation of the SDQ in this context is clearly warranted.
Highlights
Methodological difficulties in the assessment of mental health problems in adolescence Mental health problems are relatively common in children and youth
Three individual items had LR+ scores indicating clinical utility: item 3, item, and item. If these items are flagged by both the teacher and parent this may indicate the probable presence of mental health problems that warrant further assessment
Given that the purpose of the Strength and Difficulties Questionnaire (SDQ) as a screening measure is to identify children at risk of mental health and behavioural problems, the low positive predictive value (PPV) is of concern
Summary
Methodological difficulties in the assessment of mental health problems in adolescence Mental health problems are relatively common in children and youth. More than 75% of all cases of severe mental illnesses are estimated to occur prior to the age of 25 years [1,2]. Australian estimates suggest a prevalence of 14% mental illness in the 4–17 year age bracket [3]; only one in four of the identified cases were receiving professional help [3]. Detection of mental health problems in children and youth is crucial, as evidence shows that left undetected, mental health problems tend to increase in severity with age and could be antecedents of chronic, complex, disabling and expensive complications in adult life [1,5,6,7]. Current screening methods rely on children and youth displaying certain symptoms, or impairments in everyday functioning, in order to identify them to be at risk and in need of further evaluation and potential treatment [8]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
