Self-report Strengths And Difficulties Questionnaire Research Articles

Psychometric properties and normative data of the Latvian and Russian language versions of the strengths and difficulties questionnaire (SDQ) in the Latvian general adolescent population

Objectives Mental health screening instruments are essential in population health research and clinical practice. The strengths and difficulties questionnaire (SDQ) self-report version has been widely used across the globe to screen for mental health problems in adolescent populations. This study aimed to explore the psychometric properties of the Latvian and Russian language versions of the SDQ in a representative sample of a general population of Latvian adolescents and establish the population-based normative scores. Materials and methods This analysis was based on data from the international Health Behaviour in School-aged Children study year 2017/2018 Latvian database. The sample comprised 2683 Latvian and 1321 Russian-speaking 11-, 13-, and 15-year-old adolescents. Results Significant language-based variance was observed in the mean scores of the externalising subscales of the SDQ, with Latvian-speaking adolescents reporting higher levels of conduct problems and hyperactivity. The reliability was satisfactory (ordinal alpha >0.7) only for the prosocial behaviour, emotional, internalising problems, and total difficulties subscales, while conduct, hyperactivity, peer, and externalising problems scales demonstrated lower internal consistency (ordinal alpha 0.5–0.7). Confirmatory factor analysis (CFA) did not support the hypothesised narrow-band five-factor or broad-band three-factor structure of the SDQ. The normative banding scores were calculated for both language variants. Conclusions This study suggests that the self-report SDQ must be used cautiously in Latvian adolescents because some SDQ subscales lack reliability. When used in population research, the internalising subscales seem more reliable than the externalising ones. More research is needed regarding the reliability of the SDQ in clinical adolescent populations.

A clinical follow-up study of dialectical behavior therapy skills groups among female adolescents diagnosed with depressive disorder.

Our aim was to evaluate longitudinal data for adolescents who were treated with Dialectical Behavior therapy (DBT) skills groups having been previously diagnosed with depressive disorder. Intervention with an observational cross-sectional design was implemented to evaluate the treatment outcome of a 10-week DBT skills groups with female adolescents with depression. After the patients were identified for enrollment, parents and adolescents were evaluated with psychometric measurements pre-, post-intervention, and at one-year follow-up. Repeated measures analysis was undertaken with the Child Depression Inventory (CDI), Pediatric Quality of Life Inventory (PedsQL) and Strengths and Difficulties Questionnaire (SDQ) for participants. Statistical significance was detected for self-report CDI scores and both self-report and parent SDQ and PedsQL scores. This study is the first DBT intervention in Turkish children, shows that a group DBT skills groups training can be adapted and put into practice successfully with depressed Turkish adolescents.

Gender difference in the change of adolescents' mental health and subjective wellbeing trajectories.

Gender differences in adolescents’ mental health problems have been extensively reported. Yet, there is limited research in exploring longitudinal trends in mental health and wellbeing between boys and girls. This study investigated any emerging developmental trends of gender differences in mental health problems and subjective wellbeing for young people from early to mid-adolescence in England. A longitudinal group of 8612 young people’s mental health and subjective wellbeing trajectories were investigated between the period of ages 11/12 and 13/14. Mental health difficulties and subjective wellbeing were measured using the child self-report Strengths and Difficulties Questionnaire (SDQ) and Short Warwick and Edinburgh Wellbeing Scale (SWEMWBS), respectively. Any gender difference in the change of adolescents’ mental health and subjective wellbeing over 3 year period were estimated using multi-level regression while accounting for various socio-demographic and resilience factors. Young people are at increased risk of mental health problems between the ages of 11 and 14, particularly girls. The overall difficulty levels reported by girls were significantly higher than boys across a range of mental health problems and subjective wellbeing. These developmental trends persisted after controlling for a broad range of potential confounders. Young people has shown clear signs of mental distress as they get older. This escalation was particularly evident among girls. Distress can come at the time of significant physical, emotional, and social changes in an adolescents’ life, and can be heightened during secondary school transition. This evidence highlights the importance of early intervention to reduce risk of distress.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00787-022-01961-4.

Home-based exercise program for adolescents with juvenile dermatomyositis quarantined during COVID-19 pandemic: a mixed methods study

BackgroundExercise has been suggested to prevent deterioration of health-related quality of life (HRQL) and overall health in pediatric rheumatologic diseases during the COVID-19 pandemic. Herein we describe the effects of a 12-week, home-based, exercise program on overall health and quality of life among quarantined patients with juvenile dermatomyositis (JDM).MethodThis prospective, quasi-experimental, mixed methods (qualitative and quantitative) study was conducted between July and December 2020, during the most restricted period of COVID-19 pandemic in Brazil. The home-based exercise program consisted of a 12-week, three-times-a-week, aerobic and strengthening (bodyweight) training program. Qualitative data were systematically evaluated. Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory (PedsQOL) and Pittsburgh Sleep Quality Index (PSQI) evaluate symptoms of mental health disorder, HRQL, and quality of sleep.Findings11 patients (out of 27) met the inclusion criteria (91% female; mean ± SD age: 13.5 ± 3.2 years). Adherence to the intervention was 72.6%. Barriers to exercise involved poor internet connectivity, excessive weekly sessions, and other commitments. Even though not statistically significant, Self-report SDQ subscales Total Difficulties Score, Emotional Problems Score, and PedsQOL School Functioning Score improved after intervention (− 2.4; 95%confidence interval [CI] -5.1; 0.2, p = 0.06; − 1.0; 95%CI -2.2; 0.2, p = 0.09 and; 11.7; 95%CI -2.5; 25.8, p = 0.09, respectively). Remaining SDQ subscales were not altered. Six themes emerged from patients’ and parents’ comments (qualitative results). Patients engaged in exercise reported other health-related benefits including increased motivation, concentration and strength.InterpretationA home-based exercise program was associated with qualitative perceptions of improvements in overall health and HRQL by quarantined adolescents with JDM during COVID-19 pandemic. Lessons from this trial may help developing interventions focused on tackling physical inactivity in JDM.

The strengths and difficulties questionnaire self-report: sensitivity and specificity testing to identify conduct problems in Indonesian adolescents

PurposeThe Strengths and Difficulties Questionnaire (SDQ) has been validated as a screening tool for identifying difficulties in adolescents in various countries. According to the results, the SDQ needs clinical evaluations to discriminate between adolescents with and without problems. This study is part of a research group that developed the self-report Indonesian version of the SDQ. Therefore, this study aims to evaluate the sensitivity and specificity of the self-report Indonesian version of the SDQ conduct problems subscale and identify the optimum cut-off score for Indonesian adolescents.Design/methodology/approachThis study was a double-blind non-experimental study, in which the self-report SDQ score was compared to the diagnostic interview. Participants that completed the SDQ were 708 10th-grade students in Jakarta, with 40 students from the sample randomly selected through the double-blind technique for the diagnostic interview.FindingsCrosstab’s analysis showed that the SDQ conduct problems subscale had a sensitivity value of 77.3% and a specificity value of 83.3%. Receiver operating characteristics analysis showed that the cut-off score of 4 used in this study is ideal for identifying individuals with conduct problems.Originality/valueThe SDQ has good accuracy for screening conduct problems among adolescents. Moreover, it will be helpful for parents, teachers, professionals and adolescents to screening conduct problems.

Revising the self-report strengths and difficulties questionnaire for cross-country comparisons of adolescent mental health problems: the SDQ-R

The Strengths and Difficulties Questionnaire (SDQ) has been used in many epidemiological studies to assess adolescent mental health problems, but cross-country comparisons of the self-report SDQ are scarce and so far failed to find a good-fitting, common, invariant measurement model across countries. The present study aims to evaluate and establish a version of the self-report SDQ that allows for a valid cross-country comparison of adolescent self-reported mental health problems. Using the Health Behaviour in School-aged Children study, the measurement model and measurement invariance of the 20 items of the self-report SDQ measuring adolescent mental health problems were evaluated. Nationally representative samples of 11-, 13- and 15-year old adolescents (n = 33 233) from seven countries of different regions in Europe (Bulgaria, Germany, Greece, the Netherlands, Poland, Romania, Slovenia) were used. In order to establish a good-fitting and common measurement model, the five reverse worded items of the self-report SDQ had to be removed. Using this revised version of the self-report SDQ, the SDQ-R, partial measurement invariance was established, indicating that latent factor means assessing conduct problems, emotional symptoms, peer relationships problems and hyperactivity-inattention problems could be validly compared across the countries in this study. Results showed that adolescents in Greece scored relatively low on almost all problem subscales, whereas adolescents in Poland scored relatively high on almost all problem subscales. Adolescents in the Netherlands reported the most divergent profile of mental health problems with the lowest levels of conduct problems, low levels of emotional symptoms and peer relationship problems, but the highest levels of hyperactivity-inattention problems. With six factor loadings being non-invariant, partial measurement invariance was established, indicating that the 15-item SDQ-R could be used in our cross-country comparison of adolescent mental health problems. To move the field of internationally comparative research on adolescent mental health forward, studies should test the applicability of the SDQ-R in other countries in- and outside Europe, continue to develop the SDQ-R as a cross-country invariant measure of adolescent mental health, and examine explanations for the found country differences in adolescent mental health problems.

Correction to: Psychometric Comparability of Self-Report by Children Aged 9–10 versus 11 Years on the Strengths and Difficulties Questionnaire (SDQ)

Background: The 25-item Strengths and Difficulties Questionnaire (SDQ) is a popular screening instrument that assesses childhood psychopathology and prosocial behaviour. While the value of acquiring multi-informant perspectives in the assessment of childhood psychopathology is recognised, the use of the self-report version of the questionnaire is recommended only for children aged 11 years and older. This study aimed to evaluate the psychometric comparability of self-report on the SDQ by children aged 9-10 years relative to children aged 11 years using item response modelling. Methods: Item response models were used in a community sample of 7,959 children to investigate the structure, item characteristics, and age differences related to self-report by children aged 9-10 years (n=6,004), relative to children aged 11 years (n=1,955), on the SDQ. Results: Internalizing, externalizing, and prosocial factors explained the covariance of the questionnaire items. There were statistically significant age-related differences on only two items (the “worries” and “distractible” items), but these differences were small in magnitude and did not affect the precision of measurement of the SDQ. Conclusions: Self-report by children aged 9 and 10 years on the SDQ is psychometrically comparable to reports by children aged 11 years after controlling for differences in latent severity. This work expands the utility of the self-report SDQ to children aged as young as 9 years.

Psychometric Comparability of Self-Report by Children Aged 9–10 versus 11 Years on the Strengths and Difficulties Questionnaire (SDQ)

The 25-item Strengths and Difficulties Questionnaire (SDQ) is a popular screening instrument that assesses childhood psychopathology and prosocial behaviour. While the value of acquiring multi-informant perspectives in the assessment of childhood psychopathology is recognised, the use of the self-report version of the questionnaire is recommended only for children aged 11 years and older. This study aimed to evaluate the psychometric comparability of self-report on the SDQ by children aged 9–10 years relative to children aged 11 years using item response modelling. Item response models were used in a community sample of 7959 children to investigate the structure, item characteristics, and age differences related to self-report by children aged 9–10 years (n = 6004), relative to children aged 11 years (n = 1955), on the SDQ. Internalizing, externalizing, and prosocial factors explained the covariance of the questionnaire items. There were statistically significant age-related differences on only two items (the “worries” and “distractible” items), but these differences were small in magnitude and did not affect the precision of measurement of the SDQ. Self-report by children aged 9 and 10 years on the SDQ is psychometrically comparable to reports by children aged 11 years after controlling for differences in latent severity. This work expands the utility of the self-report SDQ to children aged as young as 9 years.

The young adult Strengths and Difficulties Questionnaire (SDQ) in routine clinical practice

Expansion of the youth mental health sector has exposed a need for an outcome measure for young adults accessing services. The Strengths and Difficulties Questionnaire (SDQ) is a widely used consumer and carer outcome measure for children and adolescents. The aim of this study was to evaluate the psychometric properties of a young adult SDQ. The young adult SDQ was introduced for routine clinical practice at Eastern Health Child and Youth Mental Health Service (EH-CYMHS), complementing the well-established adolescent and child versions. Data for adolescents (aged 12–17) and young adults (aged 18–25) where both self-report and parent SDQs had been completed at entry point to the service were extracted from a two-year period. Overall, paired cases involved 532 adolescents and 125 young adults. Across both self-report and parent SDQs, a similar pattern of results was found between adolescents and young adults on mean scores, inter-scale correlations, internal consistency, and inter-rater agreement. The findings of the current study support the use of the young adult SDQ in public mental health as an instrument whose psychometric properties, to date, appear consistent with those of the adolescent version. Further investigation is warranted.

Dimensions of youth psychopathy differentially predict concurrent pro- and antisocial behavior.

Objective:To investigate the unique contribution of narcissism and impulsivity, in addition to callous-unemotional (CU) traits, in explaining concurrent prosocial and antisocial behavior.Method:Two hundred and forty-nine schoolchildren (53% female; age 9-12 years) completed the self-report Strengths and Difficulties Questionnaire (SDQ) and the Antisocial Process Screening Device (APSD). Two statistical models were tested, predicting conduct problems (CP) and prosocial behavior (PB). In the first one, CU traits and gender were entered into the equation. The second model added narcissism and impulsivity.Results:Gender, narcissism and impulsivity, but not CU, were statistically significant predictors of CP in the second model (F3,226 = 45.07, p < 0.001, R2 = 43.7%; betas: gender = -0.20, narcissism = 0.29, impulsivity = 0.36, CU = 0.06). PB was significantly predicted by all domains except gender (F3,226 = 42.57, p < 0.001, R2 = 42.4%; betas: gender = 0.08, narcissism = -0.16, impulsivity = -0.23, CU = -0.41).Conclusion:Our results confirmed that CU traits refer to a distinct manifestation of psychopathy in youth, but we also found that narcissism and impulsivity are equally important when predicting CP. Previous reports of sex differences on APSD and SDQ domains were also corroborated.

Psychometric Properties of the Self-report Strengths and Difficulties Questionnaire (SDQ) in a Nigerian Adolescents Sample

Psychometric Properties of the Self-report Strengths and Difficulties Questionnaire (SDQ) in a Nigerian Adolescents Sample

Mental health problems in a regional population of Australian adolescents: association with socio-demographic characteristics.

BackgroundPopulation level data regarding the general mental health status, and the socio-demographic factors associated with the mental health status of adolescents in Australia aged 12–16 years is limited. This study assessed prevalence of mental health problems in a regional population of Australian students in Grades 7–10, and investigated associations between mental health problems and socio-demographic factors.MethodsA web-based survey was conducted in 21 secondary schools located in disadvantaged local government areas in one regional local health district of NSW Australia. Mental health problems were measured using the youth self-report Strengths and Difficulties Questionnaire (SDQ) total SDQ score and three subscale scores (internalising problems, externalising problems and prosocial behaviour). Associations between each SDQ outcome and student socio-demographic characteristics (age, gender, Aboriginal and/or Torres Strait Islander Status, remoteness of residential location and socio-economic disadvantage) were investigated.ResultsData are reported for 6793 students aged 12–16 years. Nineteen percent of participants scored in the ‘very high’ range for the total SDQ, 18.0 % for internalising problems, 11.3 % for externalising problems and 8.9 % for prosocial behaviour problems. Gender and Aboriginal status were associated with all four SDQ outcomes, while age was associated with two, excluding externalising problems and prosocial behaviour. Aboriginal adolescents scored higher for mental health problems than non-Aboriginal adolescents for all four SDQ outcomes. Females scored higher than males for total SDQ and internalising problems, with mean difference greatest at age 15. Males scored higher for externalising problems and lower for prosocial behaviour than females.ConclusionsThe finding that mental health problems significantly varied by age, gender and Aboriginality may suggest a need for tailored interventions for groups of adolescents with highest levels of mental health problems.Trial Registration ANZCTR ACTRN12611000606987. Registered 14/06/2011.

Validating Screening Tool in Malayalam for Mental Disorders.

Valid screening tools are needed to identify Indian children and adolescents with mental health problems, both for clinical or research purposes. The present study validated the Strengths and Difficulties Questionnaire (SDQ) in Malayalam across different informants and sub-scales. A sample of 150 children and adolescents seen in a psychiatric clinic for children in Kerala, India was compared to a community sample of 1984 children from six surrounding urban and rural districts. Children in clinic and community samples were screened with the parent-report SDQ; those over 11 y completed the self-report SDQ. The community sample was also screened with the teacher-report SDQ and the clinical sample received formal diagnoses from a child psychiatrist blind to SDQ scores. The discriminative validity of the SDQ was investigated using Receiver Operator Characteristic (ROC) curves and by assessing Area Under the Curve (AUC). The SDQ discriminated reliably between clinical and community samples for the SDQ total score and its subscales. Within the clinic sample, 49 % of patients qualified for more than one broad diagnostic grouping. The SDQ discriminated between diagnostic categories in the clinic sample, but did so most effectively for conduct disorders. Based on the cut-offs that generated the highest combined value of sensitivity and specificity, the estimated rate of psychiatric disorder in the community sample was 13.6 % (parent-report) and 7.3 % (self-report). The SDQ is a useful screening tool for child and adolescent mental disorders for Malayalam speakers in Kerala, India.

The validation of the self‐report Strengths and Difficulties Questionnaire for use by 6‐ to 10‐year‐old children in the UK

To examine the factor structure of the self-report Strengths and Difficulties Questionnaire (SDQ) for data from a sample of British children aged 6-10 years. The self-report SDQ was administered to 900 children aged 6-10 years via interviews with trained counsellors. Confirmatory and exploratory factor analyses showed that a two-factor solution comprising 'externalizing and peer problems' and 'internalizing problems' fit the data well for both the 6- to 7- and 8- to 10-year-old samples. The factors were correlated in both samples. Children between 6 and 10 years of age provided meaningful SDQ data. The identified two-factor model maps broadly onto the constructs of externalizing and internalizing behaviour.

Reliability and validity of the Strengths and Difficulties Questionnaire in Greek adolescents and their parents

The Strengths and Difficulties Questionnaire (SDQ) is a brief screening measure of emotional and behavioural difficulties in children and adolescents. The aim of this study was to assess reliability and validity of the Greek version of the SDQ. A representative Greek sample of 1194 adolescents (aged 11 to 17 years) and their parents completed the SDQ along with other measures. Internal consistency reliability was determined by calculation of the Cronbach α coefficient. Varimax Orthogonal Transformation was conducted to test the factor structure of the questionnaire. Validity was further examined by investigating the correlation of the SDQ with the KIDSCREEN questionnaire and its association with demographic factors. The inter-rater agreement between parent and self-reports was analyzed with Pearson’s correlation coefficient. Intra-class correlation coefficients (ICCs) were computed to determine test-retest stability. For both parent and the self-report SDQ versions, most items loaded onto their predicted factors in consistency with the originally proposed five-factor structure. Internal consistency reliability was acceptable with a Cronbach α above 0.70 for all SDQ scales except for conduct and peer problems. Inter-rater correlations ranged from 0.33 to 0.45. Test-retest stability was good (ICCs > 0.60). Correlation coefficients between the SDQ and KIDSCREEN questionnaire were significant. Small effect sizes (d > 0.5) of the socioeconomic status were found for all of the SDQ scale mean scores. In conclusion, the SDQ was found to have satisfying psychometric properties and could be suitable for assessing emotional and behavioural problems in Greek adolescents.

Is the impact of atopic disease on children and adolescents’ health related quality of life modified by mental health? Results from a population-based cross-sectional study

BackgroundEczema, asthma and hay fever are global health problems and their prevalence has increased considerably over the last decades. All appear to share an underlying atopic diathesis but their aetiology is considered to be multifactorial. They have been linked to decreases in health related quality of life (HRQoL) in adults, children/adolescents and/or parents of children. Research also suggests an association of the three conditions with mental health, which in turn is related to HRQoL decreases. We aimed to assess whether the impact of any of the three conditions on HRQoL is modified by presence of mental health problems.MethodsThe impact of occurrence of the three conditions within the past four weeks and 12 months on HRQoL, as measured by the ‘Quality of Life in Children – Revised’ (KINDL-R) questionnaire was analysed by use of the complex sample general linear model in a population-based sample (N = 6518) of children and adolescents aged 11 – 17. Analyses were adjusted for the other atopic conditions, sociodemographic and clinical variables and stratified for mental health as measured by the Strengths and Difficulties Questionnaire (SDQ) (normal n = 5697, borderline n = 609, abnormal n = 193).ResultsEczema and hay fever within the past four weeks were significantly associated with decreased total or certain subscales of KINDL-R after adjusting for all other variables when no mental health abnormalities were present while asthma was associated with better HRQoL in these individuals. However, when mental health problems were present, eczema was positively associated with several subscales and the positive impact of asthma was stronger. The presence of mental health problems accentuated the negative relationship between hay fever and HRQoL (stronger negative impact). However, due to decreasing numbers in the group with mental health problems only few associations reached statistical significance.ConclusionsWhile the results suggest mental health to have a modifying effect on the relationship between some atopic conditions and HRQoL caution needs to be exercised in interpreting the results: First, the groups with borderline or abnormal mental health were comparably smaller than the group with normal mental health. In the group with normal mental health small effects were more likely to become significant than in the other two groups. Secondly some problems regarding the validity of the self-report SDQ still remain.

The Strengths and Difficulties Questionnaire (SDQ). Early evidence of its reliability and validity in a community sample of Italian children

The aim of this pilot study was to contribute to the validation of the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1999; 2001) administered to a community sample of 1394 Italian children aged 8–10 years. Significant differences were found according to gender. The internal consistency of the Total Difficulties Score was good. The reliability of the self-report SDQ subscales was somewhat less satisfactory. A confirmatory factor analysis carried out on the overall sample led to three interpretable factors. While the self-report SDQ was designed for youths aged 11 years and over, the current data confirm that the scale may provide valid information about psychopathological symptoms in children as young as 8 years.

Confirmatory Factor Analysis of the Adolescent Self-Report Strengths and Difficulties Questionnaire

Abstract. The Strengths and Difficulties Questionnaire (SDQ) is a widely used 25-item screening test for emotional and behavioral problems in children and adolescents. This study attempted to critically examine the factor structure of the adolescent self-report version. As part of an ongoing longitudinal cohort study, a total of 3,753 pupils completed the SDQ when aged 12. Both three- and five-factor exploratory factor analysis models were estimated. A number of deviations from the hypothesized SDQ structure were observed, including a lack of unidimensionality within particular subscales, cross-loadings, and items failing to load on any factor. Model fit of the confirmatory factor analysis model was modest, providing limited support for the hypothesized five-component structure. The analyses suggested a number of weaknesses within the component structure of the self-report SDQ, particularly in relation to the reverse-coded items.

Psychometric Properties of the French Version of the Self-Report and Teacher Strengths and Difficulties Questionnaire (SDQ)

Abstract. This study was the first attempt at determining the psychometric properties of the French self-report and teacher Strengths and Difficulties Questionnaire (SDQ) versions. An epidemiological sample of 1,400 youths (12.8 ± 0.69 years), second-year schoolchildren (boys n = 692, girls n = 708), and their teachers completed the SDQ. The analyses assessed (1) reliability using the internal consistency and test-retest methods; (2) validity by means of homogeneity measures, factor analyses, and criterion group methods; and (3) inter-rater agreement. Cut-off scores were also determined. Gender was considered for factor and cut-off analyses. Psychometric properties were satisfactory for the total difficulties scale both for the self-report and teacher SDQs (although somewhat less so for the self-report subscales). The five-factor structure theoretically expected was confirmed for both SDQs. Scores above the 90th percentile were associated with an increase in the number of at-risk youths from two groups (school failure or referred for psychological care). The current data demonstrated that the French SDQ versions could accurately measure psychopathological symptoms in youths and be considered as screening tools whose validity would appear to be promising.

The self‐report version of the Strengths and Difficulties Questionnaire: Its psychometric properties in 8‐ to 13‐year‐old non‐clinical children

To examine the reliability and validity of the self-report version of the Strengths and Difficulties Questionnaire (SDQ) in relatively young children. The SDQ was administered to a large sample of non-clinical children (n = 1111) aged 8-13 years. In a subsample (n = 439), self-report SDQ scores of children with and without behaviour problems were compared, and related to the teacher version of the SDQ, the Youth Self-Report and the Teacher Report Form. Although the reliability of the self-report SDQ was somewhat less satisfactory in the younger children of our sample, most other psychometric properties were acceptable and comparable to those obtained in older youths. While the self-report SDQ was designed for youths aged 11 years and above, the current data seem to suggest that the scale may provide useful information about psychopathological symptoms in children as young as 8 years old.