Strength and Difficulties Questionnaire - Teacher Report

Submitted by mholliday on Mon, 09/17/2012 - 15:35

Overview

Acronym: 
SDQ - teacher
Author(s): 
Robert Goodman, Ph. D.
Citation: 

Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A Research Note. Journal of Child Psychology and Psychiatry, 38(5), 581-586.

Obtain(Email/Website): 

www.sdqinfo.com

Cost: 
Free
Copyrighted: 
Yes
Measure Description: 

The SDQ is a widely and internationally used brief behavioralscreening instrument assessing child positive and negative attributes across 5 scales: 1) Emotional Symptoms, 2) Conduct Problems, 3) Hyperactivity/Inattention, 4) Peer Problems, 5)Prosocial Behavior. The measure also yields a Total Difficulties score. The SDQ was designed to be administered to parents or teachers in parallel versions, a child self-report version is also
available (each version is reviewed separately in this database).
 

The SDQ has been extensively researched with various populations and has been translated into over 40 languages. An extended version is available and includes an impact supplement that asks if the respondent thinks the young person has a problem, and if so, inquires about Chronicity, Distress, Social Impairment, and Burden for Others.

Domain(s) Assessed : 
Anxiety/Mood (Internalizing Symptoms)
Externalizing Symptoms
Relationships & Attachment
Cognition & Development
Language(s) : 
English
Afrikaans
Amharic
Arabic
Bangla
Basque
Bengali
Catalan
Chinese
Croatian
Czech
Danish
Dutch
Farsi/Persian
Finnish
French
Gallego
German
Greek
Gujarati
Hindi
Hungarian
Icelandic
Irish
Italian
Japanese
Khmer
Korean
Lithuanian
Macedonian
Malay
Norwegian
Polish
Portuguese
Punjabi
Romanian
Russian
Serbian
Sinahala (ese)
Slovene (ian)
Spanish
Swedish
Tamil
Thai
Turkish
Ukrainian
Urdu
Welsh
Other Language(s) Available: 
Gaelic
Age Range: 
3-16
Measure Type: 
Screening
# of Items: 
25
Measure Format: 
Questionnaire
Average Time to Complete (min): 
5
Reporter Type: 
Teacher/Day care provider
Average Time to Score (min): 
5
Periodicity: 
Standards SDQ is last 6 months. Follow-up (for intervention) is last month.
Response Format: 

3-point rating; 0 = Not True, 1 = Somewhat True, 2 = Certainly True

Materials Needed: 
Paper/Pencil
Other Materials Needed: 
Computer - optional
Sample Item(s): 
DomainsScaleSample Items
Total DifficultiesConduct ProblemsOften lies or cheats.
 Inattention-
Hyperactivity
Restless, overactive, cannot stay still for long.
 Emotional SymptomsHas many worries or often seems worried.
 Peer ProblemsPicked on or bullied by other youth.
 ProsocialConsiderate of other people's feelings.


Information Provided: 
Areas of Concern/Risks
Clinician Friendly Output
Continuous Assessment
Percentiles
Raw Scores
Standard Scores
Strengths

Training

Training to Interpret: 
Other
Other Training to Interpret: 
This SDQ is designed to be administered by researchers, clinicians, and educators. Specific data on training needed to administer and interpret is not provided.

Parallel/Alternate Forms

Parallel Form: 
No
Alternate Form: 
No
Different Age Forms: 
Yes
Altered Version Forms: 
Yes
Describe Alternative Forms: 

There are multiple versions of the SDQ to meet the needs of researchers and clinicians. All versions have the 25 items that comprise the scale.

Details are from the website (unless otherwise cited):
1. The teacher version is the same as the parent version but is reviewed separately in this database in order to present data specifically by reporter.

2. There is a parent/teacher version for 3-4 year olds. It contains 22 identical items. One item on reflectiveness is slightly reworded (original=“thinks
things out before acting”; 3-4 yr olds: “can stop and think things out before acting.”

2 items on antisocial behavior are replaced by items on oppositionality (original: “often lies or cheats”); 3-4 year olds: “often argumentative with adults” and original: steals from home, school or elsewhere”; 3-4 year olds: “can be spiteful to others.”

3. Multiple versions exist for different language groups.

4. An impact supplement is available, which first asks whether the respondent thinks the youth has a problem or not, and, if so, gathers data regarding chronicity, distress, social impairment, and burden to others.

5. There are follow-up questionnaires for use at posttest, following an intervention. This version has the 25 basic items, the impact question, and 2 follow-up questions regarding change due to intervention. The timeframe for this measure is also changed from “last six months or this school year” to “last month.”

6. There is an Adolescent Self-Report version, which is also reviewed in this database. The wording on this version is slightly different.

7. There is a computerized version developed for the Child Self-Report version. This version was examined with a group of children aged 8-15. No differences were found between means when the measure was completed on the computer versus on paper in a clinic sample.

Psychometrics

Norms : 
Clinical Populations
Age Groups
Gender
Demographics
Notes on Psychometric Norms: 

Normative data has been obtained in several countries, using several translations of the SDQ (see website). Two of the largest scale normative
studies have been conducted in the United Kingdom and in the United States.

1. UK
Normative data was obtained on a total of 10,438 children aged 5 to 15.
Information was obtained from:
10,298 parents (99% of sample)
8,208 teachers (79% of sample)
4,228 children, aged 11-15 (93% of this age band)
Samples of children aged 5-10 and 11-15: 50% male and 50% female; from
urban, semi-rural, and rural areas.
Note: For children aged 5-10, there are parent and teacher norms, by child
gender, but there are no norms for self-report. For children aged 11-15,
there are norms for Parent, Teacher, and Self-Report by gender.

2. UNITED STATES
The SDQ was included in the 2001 National Health Interview Survey (NHIS) conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention.

Information on the sample child was obtained from a knowledgeable adult residing in the household.

Of the 10,367 children in the survey who were aged 4-17, there was complete data for 9,878 children on all sections of the SDQ, and normative
data is available for this sample.

The sample included children aged 4-7, 8-10, and 11-14; and had equal representation from both genders.
Respondents included parents (biological, adoptive, or step: 92%) and grandparents (4.4%).
Norms are available on the website and in Bourdon, Goodman, Rae, Simpson, & Koretz (2005).
Note: Normative data are available only for the Parent Report, but not for Child or Teacher report. They are available by gender and age (4-7, 8-10,
11-14, 15-17).

Clinical Cutoffs: 
No
If Yes, Specify Cutoffs: 
While there are no cutoffs, scores at or above the 90th percentile are used to predict psychiatric disorder.
Reliability: 
Type:RatingStatisticsMinMaxAvg
Test-RetestAcceptablePearson correlation0.620.820.74
Internal ConsistencyAcceptableCronbach's Alpha0.70.880.81
Inter-raterQuestionnablePearson correlation0.250.480.37
References for Reliability: 

The internal consistency and inter-rater reliability (Parent x Teacher) data presented in the table above are from Goodman (2001) because in this database we typically report reliabilities presented by the measure’s author. Test-retest data are from Mellor (2004) because they are reported separately by scale, and the timeframe is more appropriate and comparable to other studies. Additional psychometric data from studies conducted in
other countries are presented when they were available in the Notes in the “Content Validity” section (under “USE IN OTHER COUNTRIES”).

1. Goodman (2001)
TEST-RETEST RELIABILITY
Stability of scores over a 4-6 month interval: mean test-retest stability was .62.
INTERNAL CONSISTENCY (alpha)
TEACHER
Total (.87), Emotional Symptoms (.78), Conduct Problems (.74), Hyperactivity/Inattention
(.88), Peer Problems (.70), Prosocial Behavior (.84), Impact (.85)
INTER-RATER RELIABILITY
Correlations between raters using Pearson product moment correlation: as reported by
Goodman, nearly all correlations were greater than those reported in a meta-analysis of
cross-informant correlations (Achenbach et al., 1987).
Parent x Teacher:
Total Difficulties (.46), Emotional Symptoms (.27), Conduct Problems (.37),
Hyperactivity/Inattention (.48), Peer Problems (.37), Prosocial Behavior (.25), Impact (.37)
Teacher x Child:
Total Difficulties (.33), Emotional Symptoms (.21), Conduct Problems (.30),
Hyperactivity/Inattention (.32), Peer Problems (.29), Prosocial Behavior (.23), Impact (.23)


2. Mellor (2004) conducted a psychometric study to examine the use of the SDQ Parent, Teacher, and Child versions in a sample of 917 randomly selected Australian children aged 7-17.
TEST-RETEST RELIABILITY (Teachers): subset of 120 families over a 2-week period.
Total Difficulties (.74), Emotional Symptoms (.64), Conduct Problems (.67),
Hyperactivity/Inattention (.77), Peer Problems (.82), Prosocial (.78)
INTERNAL CONSISTENCY (alpha)
TEACHERS
Total Difficulties (.76), Emotional Symptoms (.77), Conduct Problems (.75),
Hyperactivity/Inattention (.87), Peer Problems (.71), Prosocial (.83)
INTERRATER RELIABILITY
Correlations among reporters: All correlations (e.g., Parent and Teacher, Parent and Child, Teacher and Child) were significant at p<.01 and ranged from .18-.50 (average
correlation=.37).
PARENT-TEACHER
Total Difficulties (.46), Emotional Symptoms (.31), Conduct Problems (.34),
Hyperactivity/Inattention (.46), Peer Problems (.39), Prosocial (.30)
TEACHER-CHILD
Total Difficulties (.36), Emotional Symptoms (.24), Conduct Problems (.39),
Hyperactivity/Inattention (.44), Peer Problems (.35), Prosocial (.29)


3. Muris & Maas (2004) used the SDQ (Parent and Teacher versions) with institutionalized and non-institutionalized children with below-average intellectual abilities. They reported the alphas for most scales were well above .70, excepting the Peer Problems and Prosocial Behavior of the Teacher Report version. They also reported correlations between caregivers and teachers as ranging from .24 (Emotional Symptoms) to .56 (Total Difficulties Score).

Content Validity Evaluated: 
Yes
References for Content Validity: 

As described by Goodman (1997) the SDQ was designed with the following specifications:
1. Applicable to children aged 4-16.
2. One version for parents and teachers and a similar version for child self-report.
3. Both strengths and difficulties well represented.
4. 5 items each on five relevant dimensions (Conduct Problems, Emotional Symptoms, Hyperactivity/Inattention, Peer Relationships, and Prosocial Behavior). The dimensions selected were based on factors identified in an analysis of an expanded version of the Rutter parent questionnaire (Goodman, 1994).

Items were also based on nosological concepts and on concepts that underpin the Diagnostic and Statistical Manual of Mental Disorders (4th Ed.) and the ICD-10 (Goodman & Scott, 1999). For example, items in the SDQ Hyperactivity/Inattention scale were selected because they reflect key symptoms for a DSM-IV diagnosis of ADHD or ICD-10 diagnosis of hyperkinesis.As described by Goodman (1997) the SDQ was designed with the following specifications:
1. Applicable to children aged 4-16.
2. One version for parents and teachers and a similar version for child self-report.
3. Both strengths and difficulties well represented.
4. 5 items each on five relevant dimensions (Conduct Problems, Emotional Symptoms, Hyperactivity/Inattention, Peer Relationships, and Prosocial Behavior). The dimensions selected were based on factors identified in an analysis of an expanded version of the Rutter parent questionnaire (Goodman, 1994).

Items were also based on nosological concepts and on concepts that underpin the Diagnostic and Statistical Manual of Mental Disorders (4th Ed.) and the ICD-10 (Goodman & Scott, 1999). For example, items in the SDQ Hyperactivity/Inattention scale were selected because they reflect key symptoms for a DSM-IV diagnosis of ADHD or ICD-10 diagnosis of hyperkinesis.

Construct Validity Evaluated: 
Yes
Construct Validity: 
Validity TypeNot knownNot foundNonclincal SamplesClinical SamplesDiverse Samples
Convergent/ConcurrentYesYes
DiscriminantYesYesYes
Sensitive to ChangeYesYesYes
Intervention EffectsYesYesYes
Sensitive to Theoretically Distinct GroupsYesYesYes
Factorial ValidityYes
References for Construct Validity: 

Only studies that administered the SDQ Teacher version were included in the summary below. Given the large number of studies that involved the SDQ, not all were reviewed. We focused the review on the use of the measure with trauma-exposed and diverse populations. Although studies are grouped by headings (e.g., “USE WITH TRAUMA-EXPOSED POPULATIONS” and “USE IN OTHER COUNTRIES”), there is a lot of overlap between categories.

The SDQ Teacher version, along with other SDQ versions, has been used in many studies of conduct disorder and behavior problems including twin studies examining genetic and environmental influences (e.g., Saudino, Ronald, & Plomin, 2005; Scourfield, Van den Bree, Martin, & McGuffin, 2004).
With regard to validity, the SDQ was found to correlate significantly with the Rutter (Teacher Report Total Deviance on the Rutter and Total Difficulties on SDQ: r=.92; Goodman, 1997). Diagnoses made using the SDQ (Parent and Teacher reports combined) were compared to clinicians’ diagnoses of DSM-IV disorders (Mathai, Anderson, & Bourne, 2004). Significant correlations were found between clinical diagnoses and SDQ prediction (Hyperactivity Disorder (Kendall’s tau-b=.44, p<.001); Conduct Disorder (.56, p<.001); Emotional Disorder (.39, p<.001).

The SDQ also appears to discriminate between groups of children. ROC analyses showed that the SDQ and Rutter questionnaires had equivalent
predictive validity, with respect to their ability to discriminate between psychiatric and dental clinic samples (Goodman, 1997). Another study reported that institutionalized children scored higher than did non-institutionalized children on total difficulties scores and on Hyperactivity, Emotional Problems, and Conduct Problems (Muris & Maas, 2004).

USE WITH DIVERSE POPULATIONS
1. All versions of the SDQ (Child, Parent, and Teacher) were found to have acceptable internal consistency and validity and to be considered a robust
measure for children and adolescents with intellectual disabilities (Emerson, 2005).

2. In England the use of the SDQ Teacher and Parent versions was examined in a sample of strictly Orthodox preschool children aged 3 to 4 (Lindsey, Frosh, Loewenthal, & Spitzer, 2003).


USE IN OTHER COUNTRIES
The SDQ has been used in many countries to examine rates of psychopathology. Studies have also examined the psychometrics of the measure in different countries. Many of these studies are detailed below.
1. Woerner et al. (2004) reported on the use of the SDQ overseas (beyond
Europe) in Brazil, Canada, the Middle East, Asia, and Australia. They report that
the data provides support for the psychometric properties of the measure.


BANGLADESH
1. Mullick & Goodman (2001) examined the psychometrics of a Bangla version (translated and back-translated) with a sample of 99 clinic and 162 community Bangladeshi children aged 4-16. They found that SDQ scores distinguish between community and clinic samples, and between children with different psychiatric diagnoses. Using ROC curves for each SDQ scale, AUC (Area under curve) = >.80 were found for Total Impact, Conduct Problems, and Hyperactivity. For Parent, Teacher, and Child reports, Emotional Symptoms were able to distinguish between clinic cases with and
without an emotional disorder; Conduct Problems were able to distinguish between clinic cases with and without conduct disorder; and Hyperactivity was able to distinguish between those with and without a hyperactivity disorder.


GAZA
1. A study of Arab children living in the Gaza Strip suggests that the standard factor structure may not be appropriate for these children and that certain items appeared to have different meaning for these participants compared to Western participants (Thabet, Stretch, & Vostanis, 2000).


BRAZIL
1. Cury & Golfeto (2003) used Brazilian Teacher and Parent versions of the SDQ and suggested that the SDQ may be useful for preliminary screening of possible psychiatric disorders. The article was not reviewed, as it is in Portuguese.

2. The SDQ (Parent, Teacher, and Child versions) was also used in another
study that examined child mental health problems in a rural African-Brazilian
community (Goodman, dos Santos, Nunes, de Miranda, Fleitlich-Bilyk, & Filho,
2005). The authors report significant agreement between the SDQ and the
Development and Well-Being Assessment (DAWBA).


SOUTHERN EUROPEAN COUNTRIES
Marzocchi, Capron, Di Pietro, Tauleria, Duyme, Frigerio, et al. (2004) described
the use of the SDQ in Southern European countries (Italy, Spain, Portugal,
Croatia, France).

SPANISH SDQ
The Spanish version of the SDQ has been used in a number of studies.
1. García, Goodman, Mazaira, Torres, Rodríguez-Sacristán, Hervas & Fuentes (2000) reported on the initial psychometrics comparing the SDQ with the CBCL and Child Behavior Questionnaire.

2. García Cortázar, Mazaira, & Goodman (2000) examined the psychometrics of the Spanish Parent and Teacher SDQs in a sample of 132 clinic children and 48 pediatric patients in Spain. The abstract of the article suggests that the SDQ discriminated between the two groups and had satisfactory validity.

GREEK
1. Bibou-Nakou, Kiosseoglou, & Stogiannidou (2001) examined the correspondence between Teacher and Parent ratings on the SDQ in a sample of
Greek children. Difficulties scores according to Teacher Report are related to school achievement, and according to Parent Report are related to family
dysfunction.

NORDIC COUNTRIES
A review article on the use of the SDQ in Nordic countries (Obel, Heiervang, Odriguez, Heyerdahl, Smedje, Sourander, et al., 2004) suggested that the distributions of the SDQ are similar across countries and suggested collaboration in developing norms for Nordic countries. The authors described
the use of the SDQ in Sweden, Finland, Norway, Denmark, and Iceland, detailing studies in each of these countries that had used the SDQ.

FINNISH
1. Koskelainen, Sourander, & Kaljonen (2000) reported on the psychometrics of the Parent, Teacher, and Child SDQ in a sample of Finnish children aged 7-15 (n=735). They reported on the internal consistency for all three reporters as ranging from alpha=.63-.86. Teachers had the best internal consistency (M=.79) compared to Parents and Child (.67 and .65, respectively). Inter-rater reliability (correlations) ranged from .28-.40 for Child and Parents, .28-.38 for Child and Teachers, and .29-.45 for Parents and Teachers. The validity was supported through strong correlations with the CBCL and Youth Self-Report. For example, the Total CBCL and Parent SDQ were correlated at r=.75 and the Total Child
Self-Report SDQ and YSR Total were correlated at .71.

HOLLAND
van Widenfelt, Goedhart, Treffers, & Goodman (2003) described translation and
back-translation procedures for all versions (Parent, Child, Teacher) into Dutch.
They reported on internal consistencies and means for all three versions as well
as correlations among reporters. The Teacher report had good internal
consistencies (.74-.89). They found good evidence of concurrent validity as SDQ
scales correlated with the Children’s Depression Inventory, Revised Children’s
Manifest Anxiety Scale, CBCL, and YSR.

GERMANY
1. Klasen, Woerner, Rothenberger, & Goodman (2003) described the psychometric properties of the German SDQ Parent, Teacher, and Self-Report.
These data are summarized from the abstract, as the article is in German. They reported that factor analysis replicated the original scale structure. The SDQ was correlated with the German version of the CBCL, as expected. They suggested that the German version is as useful and valid as the English version.
2. Becker, Woerner, Hasselhorn, Banaschewski, & Rothenberger (2004) examined the validity of the SDQ (Parent and Teacher reports) in a German
clinical sample. They report internal consistencies: Parent (.72-.81) and Teacher (.75-.83).

All correlations between SDQ subscales and corresponding CBCL/TRF scales were significant (p<.001). For example: SDQ Total difficulties and TRF Total Problems (r=.87), SDQ Emotional Problems and TRF Internalizing Problems (r=.80), SDQ Conduct Problems and TRF Externalizing (r=.86), SDQ
Hyperactivity/Inattention and TRF Attention Problems (r=.80), SDQ Prosocial Behavior and TRF Social Problems =-.19. Factor analysis of Teacher SDQs resulted in a 5-factor solution accounting for 57.9% of the variance, with a high degree of concordance between what was found and the original SDQ scales. ROC analysis was used to examine the discriminative validity of the SDQ and CBCL/TRF with respect to diagnosis.
SDQ Parent, SDQ Teacher, CBCL, and TRF were equally able to differentiate between patients with a clinical diagnosis and those without. The SDQ Parent and SDQ Teacher were better at predicting children with ADHD than were the Attention Problems Scale of the CBCL or TRF. The Internalizing CBCL Scale was better at detecting children with emotional disorders than was the Emotional Problems Scale of the SDQ.

CONGO
In a study of 1,187 children aged 7-9 from Kinshasha, Democratic Republic of Congo, the French version of the SDQ was completed by teachers. Principal components with a varimax rotations, suggested the presence of a 5-factor model accounting for 44% of the variance. Factors were similar to that found in the British sample. Children in the study scored higher than British mean scores. The internal consistency was acceptable (.66-.81), excepting the Peer Problems Scale (alpha=.35). Children who scored above the 90th percentile on the Total Difficulties Score were at significantly higher risk for low school performance. Similar results were reported for the 5 SDQ scales, with the highest risk for the Hyperactivity Scale (Kashala, Elgen, Sommerfelt, & Tylleskar, 2005).

KENYA
The Parent and Teacher SDQs have been used with a Kenyan, Luo-speaking sample to examine the relation between stress and behavior in children
orphaned because of AIDS.

TREATMENT OUTCOME
1. Mathai, Anderson, & Bourne (2003) found significant declines on SDQ Teacher total following 6 months of treatment. Gavida-Payne, Littlefield,
Hallgren, Jenkins, & Coventry (2003) also reported significant change in an inpatient sample.

USE WITH TRAUMA-EXPOSED POPULATIONS

REFUGEE CHILDREN
The SDQ-Teacher Report has been used in multiple studies of refugee children from war-affected countries, many of whom had experienced traumatic events.
1. Fazel & Stein (2003) found that refugee children scored significantly higher than ethnic minority children did on Total and Emotional scores. Significantly more refugee children than did ethnic minority children were classified as psychiatric cases (SDQ Total>=14 and Impact >=2).

2. Refugee children participating in school-based treatment programs showed decreases in problems on the SDQ as reported by teachers during a randomized
control pilot of a CBT program (Ehntholt, Smith, & Yule, 2005; O’Shea, Hodges,
Down, & Bramley, 2000).

MALTREATED CHILDREN
In a study of maltreatment among Palestinian youth in the Gaza Strip, youth who were maltreated scored higher on many SDQ scales (Self and Teacher reports) than did non-maltreatment youth. Teacher-rated SDQ scores were predicted by coping strategies of blaming oneself and refusing to believe what happened (Thabet, Tischler, & Vostanis, 2004).

Criterion Validity: 
Not KnownNot FoundNonclinical SamplesClinical SamplesDiverse Samples
Predictive Validity:YesYesYes
References for Criterion Validity: 

Multiple studies have examined the predictive validity of the SDQ. Some of these studies are summarized below.

1. Goodman (2001) reported on the predictive validity of the SDQ in predicting independently diagnosed DSM-IV diagnoses. Statistics are reported separately by scale and by diagnosis. For total SDQ Teacher scales and any DSM-IV diagnosis: Specificity (95%), Sensitivity (43%), Negative Predictive Value (94%), Positive Predictive Value 44%. These data are reported in the above table.

A computerized algorithm has also been developed to predict child psychiatric diagnosis using SDQ Symptom and Impact scores from multiple informants (Parents, Teachers, and Children). The algorithm yields scores of Unlikely, Possible, or Probable for 4 categories of disorder: 1) Conduct Disorder, 2) Emotional Disorders, 3) Hyperactivity Disorders, and 4) Any Psychiatric Disorders.

A number of studies have examined the predictive validity of this algorithm in terms of its ability to screen for children with psychiatric disorders (e.g.,
Goodman, Ford, Simmons, Gatward, & Meltzer, 2000).

1. Using this algorithm, Goodman, Renfrew, & Mullick (2000) found that agreement between SDQ prediction and independent clinical diagnosis was
highly significant (Kendall’s tau-b = .49-.73).

When the scores were dichotomized (only “probably” counted as positive), across disorders (Conduct, Emotional, and Hyperactivity) and samples (London & Dhaka_____), they reported Sensitivity (.81%-90%), Specificity (47%-84%), Positive Predictive Power (35%-86%), and Negative Predictive Power (.83%- 98%). They reported that “the algorithm is good at detecting disorder . . . but at the expense of being over-inclusive.”

2. Goodman, Ford, Corbin, & Meltzer (2004) present Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value using the algorithm to predict psychiatric status in foster children. Using multiple informants they reported the following data: Sensitivity=84.8%, Specificity=80.1%, Positive Predictive Value=74.2%, Negative Predictive Value=88.7%.

For a private household sample: Sensitivity=63.3%, Specificity=94.6%, Positive Predictive Value=52.7%, Negative Predictive Value=96.4%.

The authors suggested that the SDQ predictive algorithm works best when data are completed by caregivers and teachers. Caregivers and teachers
provide data of similar predictive value. When data from an adult informant are already being used, self-report data appears to contribute little additional information.

3. Mathai, Anderson, & Bourne (2004), using SDQ Parent and Teacher reports, reported Sensitivity for SDQ predictions of diagnoses versus clinicians’
diagnoses as follows: Probable Diagnosis:
Emotional Disorder (36%), Hyperactivity Disorder (44%),
Conduct Disorder (93%).
Possible and Probable Diagnosis (81%), Hyperactivity Disorders 93%),
Conduct Disorders (100%).

4. Goodman, Ford, Simmons, Gatward, & Meltzer (2003) report a Sensitivity of 63.3% and Specificity of 94.6% using muti-informant SDQ data to identify individuals with a psychiatric diagnosis.

Sensitivity Rate Score: 
0.43
Specificity Rate Score: 
0.95
Positive Predictive Power: 
0.44
Negative Predictive Power: 
0.94
Overall Psychometric Limitations: 

The SDQ has been extensively researched with different age groups, different informants, diverse cultural groups, and with various translations. Research indicates strong psychometric properties as well as research and clinical utility. As noted by Goodman, Renfrew, & Mullick (2000) the SDQ algorithm for predicting child psychiatric diagnosis is good at detecting disorder but is overly inclusive.

Translation Quality

Language(s) Other Than English: 
Language:TranslatedBack TranslatedReliableGood PsychometricsSimilar Factor StructureNorms AvailableMeasure Developed for this Group
1.YesYesYesYesNo
2.YesYesYesYesYesNo
3.YesYesYesYesYesNo
4.YesYesYesYesNo
5.YesYesYesYesYesNo
6.YesYesYesYesNo
7.YesYesYesYesNo
8.YesYesYesYesNo
9.YesYesNo
10.YesYesNo

Population Information

Population Used For Measure Development: 

Psychometrics for the SDQ were originally examined in a sample of 346 parent respondents and 185 teacher respondents. Children, aged 4-16, were recruited from two London child psychiatric clinics or a children’s dental hospital in London.

Psychiatric Sample: M=9.8 years; 63% male, 37% female
Dental Sample: M=10.8 years; 53% male, 47% female.
No other demographic information was available (Goodman, 1997).

Measure has demonstrated evidence of reliability and validity in which populations?: 
Physical Abuse
Traumatic Loss (Death)
War/Combat
Immigration Related Trauma
Other
Use with Diverse Populations: 
Population Type: Measure Used with Members of this GroupMembers of this Group Studied in Peer-Reviewed JournalsReliableGood PsychometricsNorms AvailableMeasure Developed for this Group
1. Developmental disabilityYesYesYesYesNo
2. DisabilitiesNo
3. Lower socio-economic statusYesYesYesYes
4. Rural populationsYesYesYesYes

Pros & Cons/References

Pros: 

1. The SDQ has been extensively researched in a wide variety of settings.
2. The SDQ appears to be a very useful tool for screening of mental health problems.
3. Multiple comparable informant versions are available (Parent, Child Self-Report, Teacher).
4. It is brief (much shorter than comparable measures).
5. It is easy to administer and score.
6. The subscales and items correspond to major categories and criteria of current classification systems (Rothenberger & Woerner, 2004).
7. The measure is easily available in more than 40 languages at www.sdqinfo.com.
8. May be good for cross-cultural studies because it is short and available in multiple languages (Rothenberger & Woerner, 2004).
 

Cons: 


1. While no cons are indicated for use of the SDQ as a screening tool, further research is necessary to examine it as a tool for guiding treatment and for examining outcome resulting from treatment.
2. The SDQ emotional subscale may have some weaknesses in terms of its ability to detect specific disorders that are not the focus of the measure’s attention such as specific phobias, panic disorders, separation anxiety, and eating disorders (Goodman et al., 2000; Quinton & Murray, 2002).
3. Neither naturalistic nor interventional longitudinal studies have repeatedly administered the SDQ (Rothenberger & Woerner, 2004).
4. For trauma-exposed children, it should be noted that there are no specific scales focusing on trauma symptomatology. However, it should be noted that few measures have undergone such rigorous testing of their factors’ structure, with numerous factor analyses conducted in different countries and cultural groups.
 

Author Comments : 

The author read the review and indicated he was pleased with it. His feedback was integrated into the review.
 

References: 

A PsychInfo search (8/05) of “Strengths and Difficulties Questionnaire” or SDQ” anywhere revealed that the measure has been referenced in 329 peer-reviewed journal articles.

Note: Because it was not possible to conduct a search that identified which specific version of the SDQ (Parent, Teacher, Child Self-Report) was used, this number represents the total for all SDQ versions.

However, the articles cited below (for the most part) included the Parent version. The number is most likely an underestimate, given that the SDQ is internationally used and citations in foreign journals may not all be included in PsychInfo.

1. Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: Implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101, 213- 232.

2. Becker, A., Hagenberg, N., Roessner, V., Woerner, W., & Rothenberger, A. (2004).
Evaluation of the self-reported SDQ in a clinical setting: Do self-reports tell us more than
ratings by adult informants? European Child & Adolescent Psychiatry, 13(Suppl2), 17-24.

3. 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(Suppl2), 11-16.

4. Bibou-Nakou, I., Kiosseoglou, G., & Stogiannidou, A. (2001). Strengths and difficulties of
school-aged children in the family and school context. Psychology: The Journal of the
Hellenic Psychological Society, 8(4), 506-525.

5. Calam, R., Gregg, L., & Goodman, R. (2005). Psychological adjustment and asthma in
children and adolescents: The UK nationwide mental health survey. Psychosomatic
Medicine, 67(1), 105-110.

6. Cury, C.R. & Golfeto, J.H. (2003). Strengths and difficulties questionnaire (SDQ): a study
of school children in Ribeirão Preto. Rev. Bras. Psiquiatr, 25(3), 139-145.

7. Ehntholt, K. A., Smith, P. A., & Yule, W. (2005). School-based cognitive-behavioural
therapy group intervention for refugee children who have experienced war-related trauma.
Clinical Child Psychology & Psychiatry, 10(2), 235-250.

8. Emerson, E. (2005). Use of the Strengths and Difficulties Questionnaire to assess the
mental health needs of children and adolescents with intellectual disabilities. Journal of
Intellectual & Developmental Disability, 30(1), 14-23.

9. Emerson, E. (2003). Prevalence of psychiatric disorders in children and adolescents with
and without intellectual disability. Journal of Intellectual Disability Research, 47(1), 51-58.
10. Fazel, M., & Stein, A. (2003). Mental health of refugee children: Comparative study.
British Medical Journal, 327(7407), 134.

11. Fombonne, E., Simmons, H., Ford, T., Meltzer, H., & Goodman, R. (2003). Prevalence
of pervasive developmental disorders in the British nationwide survey of child mental heath.
International Review of Psychiatry, 15(1-2), 158-165.

12. García Cortázar, P., Mazaira, J. A., & Goodman, R. (2000). The initial validation study
of the Gallego version of the Strengths and Difficulties Questionnaire (SDQ)/Validación
inicial de la versión gallega del cuestionario de capacidades y dificultades (SDQ). Revista
de Psiquiatria Infanto-Juvenil, No 2, 95-100.

13. Gavidia-Payne, S., Littlefield, L., Hallgren, M., Jenkins, P., & Coventry, N. (2003).
Outcome evaluation of a statewide child inpatient mental health unit. Australian & New
Zealand Journal of Psychiatry, 37(2), 204-211.

14. Goodman, R. (2001). Psychometric properties of the Strengths and Difficulties
Questionnaire. Journal of the American Academy of Child & Adolescent Psychiatry, 40(11),
1337-1345.

15. 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 & Psychiatry, 40(5), 791-799.

16. Goodman, R. (1994). A modified version of the Rutter Parent Questionnaire including
extra items on children's strengths: A research note. Journal of Child Psychology &
Psychiatry, 35(8), 1483-1494.

17. Goodman, R., Dos Santos, D.N., Nunes,, A.P., Miranda, D., Fleitlich-Bilyk, B., Almeida, N. (2005). The Ilha de Maré study: a survey of child mental health problems in a predominantly African-Brazilian rural community. Social Psychiatry and Psychiatric Epidemiology, 40(1), 11-17.

18. Goodman, R., Gledhill, J., & Ford, T. (2003). Child psychiatric disorder and relative age within school year: cross sectional survey of large population sample British Medical Journal, 327, 7413.

19. Goodman, R., Ford, T., Corbin, T., & Meltzer, H. (2004). Using the Strengths and Difficulties Questionnaire (SDQ) multi-informant algorithm to screen looked-after children for psychiatric disorders. European Child & Adolescent Psychiatry, 13(Suppl2), 25-31.

20. Goodman, R., Ford, T., Simmons, H., Gatward, R., & Meltzer, H. (2003). Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. International Review of Psychiatry, 15(1-2), 166-172.

21. 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. British Journal of Psychiatry, 177, 534-539.

22 Goodman, R., Renfrew, D., & Mullick, M. (2000). Predicting type of psychiatric disorder from Strengths and Difficulties Questionnaire (SDQ) scores in child mental health clinics in London and Dhaka. European Child & Adolescent Psychiatry, 9(2), 129-134.

23. Goodman, R., & Scott, S. (1999). Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: Is small beautiful? Journal of Abnormal Child Psychology, 27(1), 17-24.

24. Kashala, E., Elgen, I., Sommerfelt, K., & Tylleskar, T. (2005). Teacher ratings of mental health among school children in Kinshasa, Democratic Republic of Congo. European Child & Adolescent Psychiatry, 14(4), 208-215.

25. Klasen, H., Woerner, W., Rothenberger, A., Goodman, R. (2003). [German version of the Strength and Difficulties Questionnaire (SDQ-German)—overview and evaluation of initial validation and normative results]. Prax Kinderpsychol. K, 52(7), 491-502.

26. Koskelainen, M., Sourander, A., & Kaljonen, A. (2000). The Strengths and Difficulties Questionnaire among Finnish school-aged children and adolescents. European Child & Adolescent Psychiatry, 9, 277-284.

27. Lindsey, C., Frosh, S., Loewenthal, K., & Spitzer, E. (2003). Prevalence of emotional and behavioural disorders among strictly orthodox Jewish pre-school children in London. Clinical Child Psychology & Psychiatry, 8(4), 459-472.

28. Lyneham, H. J., & Rapee, R. M. (2005). Agreement between telephone and in-person delivery of a structured interview for anxiety disorders in children. Journal of the American Academy of Child & Adolescent Psychiatry, 44(3), 274-282.

29. Marzocchi, G. M., Capron, C., Di Pietro, M., Tauleria, E. D., Duyme, M., Frigerio, A., et al. (2004). The use of the Strengths and Difficulties Questionnaire (SDQ) in southern European countries. European Child & Adolescent Psychiatry, 13(Suppl2), 40-46.

30. Mathai, J., Anderson, P., & Bourne, A. (2004). Comparing psychiatric diagnoses generated by the Strengths and Difficulties Questionnaire with diagnoses made by clinicians. Australian & New Zealand Journal of Psychiatry, 38(8), 639-643.

31. Mathai, J., Anderson, P., & Bourne, A. (2003). Use of the Strengths and Difficulties Questionnaire as an outcome measure in a child and adolescent mental health service. Australasian Psychiatry, 11(3), 334-337.

32. Mellor, D. (2004). Furthering the use of the Strengths and Difficulties Questionnaire: Reliability with younger child respondents. Psychological Assessment, 16(4), 396-401.

33. Mullick, M. S. I., & Goodman, R. (2001). Questionnaire screening for mental health problems in Bangladeshi children: A preliminary study. Social Psychiatry & Psychiatric Epidemiology, 36(2), 94-99.

34. Muris, P., & Maas, A. (2004). Strengths and difficulties as correlates of attachment style in institutionalized and non-institutionalized children with below-average intellectual abilities. Child Psychiatry & Human Development, 34(4), 317-328.

35. Muris, P., Meesters, C., Eijkelenboom, A., & Vincken, M. (2004). The self-report version of the Strengths and Difficulties Questionnaire: Its psychometric properties in 8- to 13-year old non-clinical children. British Journal of Clinical Psychology, 43(4), 437-448.

36. Muris, P., Meesters, C., Vincken, M., & Eijkelenboom, A. (2005). Reducing children's aggressive and oppositional behaviors in the schools: Preliminary results on the effectiveness of a social-cognitive group intervention program. Child & Family Behavior Therapy, 27(1), 17-32.

37. Obel, C., Heiervang, E., Rodriguez, A., Heyerdahl, S., Smedje, H., Sourander, A., et al. (2004). The Strengths and Difficulties Questionnaire in the Nordic countries. European Child & Adolescent Psychiatry, 13(Suppl2), 32-39.

38. Oburu, P. O. (2005). Caregiving stress and adjustment problems of Kenyan orphans raised by grandmothers. Infant & Child Development. Special Parenting Stress and Children's Development, 14(2), 199-210.

39. Oppedal, B., Roysamb, E., & Heyerdahl, S. (2005). Ethnic group, acculturation, and psychiatric problems in young immigrants. Journal of Child Psychology & Psychiatry, 46(6), 646-660.

40. O’Shea, B., Hodges, M., Down, B., & Bramley, J. (2000). A school-based mental health service for refugee children. Clinical Child Psychology and Psychiatry, 5, 189-201.

41. Quinton, D., & Murray, C. (2002). Assessing emotional and behavioral development in children looked after away from home. In H. Ward & W. Rose (Eds.). Approaches to needs assessment in children’s services (pp. 277-308). London: Jessica Kingsley.

42. Rothenberger, A., & Woerner, W. (2004). Strengths and Difficulties Questionnaire (SDQ)-evaluations and applications. European Child & Adolescent Psychiatry, 13(Suppl2), 1-2.

43. Saudino, K.J., Ronald, A., & Plomin, R. (2005). Rater effects in the etiology of behavior problems in 7-year-old twins: Parent ratings and ratings by same and different teachers. Journal of Abnormal Child Psychology, 33, 113-130.

44. Scourfield, J., Van den Bree, M., Martin, N., & McGuffin, P. (2004). Conduct problems in children and adolescents: A twin study. Archives of General Psychiatry, 61(5), 489-496.

45. Thabet, A.A., Stretch, D., & Vostanis, P. (2000). Child mental health problems in Arab children: Applications of the Strengths and Difficulties Questionnaire. International Journal of Social Psychiatry, 46, 266-280.

46. Thabet, A. A. M., Tischler, V., & Vostanis, P. (2004). Maltreatment and coping strategies among male adolescents living in the Gaza strip. Child Abuse & Neglect, 28(1), 77-91.

47. Truman, J., Robinson, K., Evans, A. L., Smith, D., Cunningham, L., Millward, R., et al. (2003). The Strengths and Difficulties Questionnaire: A pilot study of a new computer version of the self-report scale. European Child & Adolescent Psychiatry, 12(1), 9-14.

48. van Widenfelt, B. M., Goedhart, A. W., Treffers, P. D. A., & Goodman, R. (2003). Dutch version of the Strengths and Difficulties Questionnaire (SDQ). European Child & Adolescent Psychiatry, 12(6), 281-289.

49. Woerner, W., Becker, A., & Rothenberger, A. (2004). Normative data and scale properties of the German parent SDQ. European Child & Adolescent Psychiatry, 13(Suppl2), 3-10.

Developer of Review: 
Chandra Ghosh Ippen, Ph.D., Amie Alley, Ph.D.
Editor of Review: 
Chandra Ghosh Ippen, Ph.D., Madhur Kulkarni, M.S.
Last Updated: 
Wed, 01/29/2014
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