Using the Dutch multi-informant Strengths and Difficulties Questionnaire (SDQ) to predict adolescent psychiatric diagnoses

J Vugteveen,A De Bildt,C A Hartman,M E Timmerman

doi:10.1007/s00787-018-1127-y

Abstract

Knowledge on the validity of the Strengths and Difficulties Questionnaire (SDQ) among adolescents is limited but essential for the interpretation of SDQ scores preceding the diagnostic process. This study assessed the predictive and discriminative value of adolescent- and parent-rated SDQ scores for psychiatric disorders, diagnosed by professionals in outpatient community clinics, in a sample of 2753 Dutch adolescents aged 12–17. Per disorder, the predictive accuracy of the SDQ scale that is contentwise related to that particular disorder and the SDQ impact scale was assessed. That is, 24 logistic regression analyses were performed, for each combination of DSM-IV diagnosis [4: Attention-Deficit/Hyperactivity Disorder (ADHD), Conduct/Oppositional Defiant Disorder (CD/ODD), Anxiety/Mood disorder, Autism Spectrum Disorder (ASD)], informant (3: adolescent, parent, both), and SDQ scale(s) (2; related scale only, related scale and impact scale). Additional logistic regression analyses were performed to assess the discriminative strength of the SDQ scales. The results show both fair predictive strength and fair discriminative strength for the adolescent- and parent-reported hyperactivity scales, the parent-reported conduct scale, and the parent-reported social and prosocial scales, indicating that these scales provide useful information about the presence of ADHD, CD/ODD, and ASD, respectively. The SDQ emotional scale showed to be insufficiently predictive. The findings suggest that parent-rated SDQ scores can be used to provide clinicians with a preliminary impression of the type of problems for ADHD, CD/ODD, and ASD, and adolescent for ADHD.

Highlights

Adolescence is a developmental period associated with physical change, psychological development, and social adjustments while in the process of acquiring independence
The aim of our study was to examine how well-specific types of psychiatric disorders, diagnosed in outpatient community clinics, could be predicted from Dutch Strengths and Difficulties Questionnaire (SDQ) scales in a large clinical sample of 12–17 years and to investigate whether the accuracy of the prediction depended on the type of informant that was used
In the absence of any further indication of appropriate cut-off scores for the Dutch population and knowing that working with cut-off values entails using limited information from SDQ scale scores, we proceeded to investigate the predictive and discriminative strength of the SDQ scales by estimating prediction models

Summary

Introduction

Adolescence is a developmental period associated with physical change, psychological development, and social adjustments while in the process of acquiring independence. The complexity of these coexisting processes leaves adolescents vulnerable to psychiatric disorders [1,2,3]. In outpatient clinics, screening questionnaires are often used as part of the diagnostic process by quickly generating a first impression of the problems at hand. Given the large numbers of adolescents and their parents that fill in such screening questionnaires, a continued research focus should be on how their scores can be helpful in the diagnostic process. The SDQ can be completed by adolescents themselves (aged 11–16) as well as by parents and/or teachers

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