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.
Overview
SDQ-Child
Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A Research Note. Journal of Child Psychology and Psychiatry, 38(5), 581-586.
Administration
Symptom Scales: 3-point rating: 0 = Not True, 1 = Somewhat True, 2 = Certainly True
| Domains | Scale | Sample Items |
|---|---|---|
| Total Difficulties | Conduct Problems | I am often accused of lying or cheating. |
| Inattention- Hyperactivity | I am restless, I cannot stay still for long. | |
| Emotional Symptoms | I worry a lot. | |
| Peer Problems | Other children or young people pick on me or bully me. | |
| Prosocial | I try to be nice to other pople. I care about their feelings. |
Training
The SDQ is designed to be administered by researchers, clinicians, and educators. Specific data on training needed to administer and interpret is not provided.
Parallel or Alternate 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.
The computerized version was more highly correlated with parent report and had a better test-retest reliability (r=.83, 40 children tested after 6 weeks) than the paper report did, although the difference between the computerized report and paper report was not statistically significant. Children who used the computerized form were more likely to report that the questionnaire was easy to complete. The computerized version appeared to discriminate between clinic and community samples (Truman et al., 2003).
Psychometrics
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).
While there are no cutoffs, scores at or above the 90th percentile are used to predict psychiatric disorder.
| Type: | Rating | Statistics | Min | Max | Avg |
|---|---|---|---|---|---|
| Test-Retest | Acceptable | Pearson correlation | 0.66 | 0.82 | 0.71 |
| Internal Consistency | Acceptable | Cronbach's Alpha | 0.41 | 0.81 | 0.66 |
| Inter-rater | Acceptable | Pearson correlation (parent-child) | 0.3 | 0.48 | 0.3 |
RELIABILITY The internal consistency and inter-rater reliability (Parent s Child) 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) Goodman (2001) reported the following data: Total (.80), Emotional Symptoms (.66), Conduct Problems (.60), Hyperactivity/Inattention (.67), Peer Problems (.41), Prosocial Behavior (.66), Impact (.81)' 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 Child: Total Difficulties (.48), Emotional Symptoms (.37), Conduct Problems (.44), Hyperactivity/Inattention (.41), Peer Problems (.40), Prosocial Behavior (.30), Impact (.30) 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: subset of 120 families over a 2-week period. Good test-retest reliability was reported for children aged 11-17 and children aged 7-11. There were no differences between older and younger children except for the peer problems scale, with younger children being less consistent in their responses. Total Difficulties (.72), Emotional Symptoms (.68), Conduct Problems (.66), Hyperactivity/Inattention (.82), Peer Problems (.67), Prosocial (.69) INTERNAL CONSISTENCY (alpha) Similar internal consistencies were reported for children aged 11-17 and children aged 7-11. CHILDREN AGED 11-17 Total Difficulties (.70), Emotional Symptoms (.65), Conduct Problems (.64), Hyperactivity/Inattention (.75), Peer Problems (.59), Prosocial (.66) CHILDREN AGED 7-11 Total Difficulties (.72), Emotional Symptoms (.68), Conduct Problems (.66), Hyperactivity/Inattention (.73), Peer Problems (.55), Prosocial (.62) ALL CHILDREN Total Difficulties (.71), Emotional Symptoms (.67), Conduct Problems (.65), Hyperactivity/Inattention (.74), Peer Problems (.58), Prosocial (.64) 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). Analyses examining differences between older (aged 11-17) and younger children (aged 7-11) showed that older children’s reports are more consistent with parents’ reports, but there are no differences between older and younger children’s reports with teachers. PARENT-CHILD Total Difficulties (.38), Emotional Symptoms (.32), Conduct Problems (.37), Hyperactivity/Inattention (.46), Peer Problems (.34), Prosocial (.34) TEACHER-CHILD Total Difficulties (.36), Emotional Symptoms (.24), Conduct Problems (.39), Hyperactivity/Inattention (.44), Peer Problems (.35), Prosocial (.29)
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.
| Validity Type | Not known | Not found | Nonclincal Samples | Clinical Samples | Diverse Samples |
|---|---|---|---|---|---|
| Convergent/Concurrent | Yes | Yes | Yes | ||
| Discriminant | Yes | Yes | Yes | ||
| Sensitive to Change | Yes | Yes | |||
| Intervention Effects | Yes | Yes | |||
| Sensitive to Theoretically Distinct Groups | Yes | Yes | Yes |
Only studies that administered the SDQ Child Self-Report version were included in the summary below. Given the large number of studies, 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 among categories.
The SDQ Child version, along with other SDQ versions have been used in many studies of conduct disorder and behavior problems (e.g., Taha et al., 2005) including twin studies examining genetic and environmental influences (e.g., Scourfield, Van den Bree, Martin, & McGuffin, 2004).
CORRELATIONS WITH OTHER MEASURES
1. The SDQ correlates with the Rutter (Goodman, 1997) and relates well with Teacher and Parent SDQ scores (Goodman, Meltzer, & Bailey, 2003).
2. In a study of bullying behavior (Woods & White, 2005), behavior problems in the clinical range on all SDQ scores were associated with clinical levels of over arousal, as assessed using the Arousal Predisposition Scale. Additional data are also summarized below under "USE IN OTHER COUNTRIES."
DISCRIMINANT VALIDITY
1. The measure differentiates between different groups of children. A number of studies show that the measure discriminated between clinic and community samples (e.g., Goodman et al., 2003).
2. Anxious children have been found to score higher than do nonclinical and externalizing groups on the Total and Emotional Symptoms Subscale, and externalizing children score higher than do anxious and nonclinical groups on Hyperactivity/Inattention. (Lyneham & Rapee, 2005).
FACTOR ANALYSIS
As described below, under “USE IN OTHER COUNTRIES” a number of factor analytic studies have been conducted with somewhat divergent results.
1. Goodman (2001) reported that, as hypothesized, a 5-factor solution was found for Parent, Teacher, and Child Self-Report using eigen values>1 to determine the number of factors.
2. Studies in Germany (Becker, Hagenberg, Roessner, Woerner, & Rothenberger, 2004) and the Netherlands (Muris, Meesters, & van den Berg,
2003) found a similar factor structure as that reported by Goodman using British samples.
3. However, factor analysis with Norwegian (Ronning, Handegaard, Sourander, & Morch, 2004), Finnish (Koskelainen, Sourander, & Vauras, 2001), and Arab (Gaza) children (Thabet, Stretch & Vostanis, 2004) suggest that the factor structure proposed by Goodman has a somewhat variable and questionable fit.
4. Koskelainen et al. (2001) proposed an alternate 3-factor structure (externalizing, internalizing, and prosocial).
TREATMENT OUTCOME
A number of studies have shown that at least some SDQ scales are sensitive to treatment effects using pre- to post-test comparison designs (e.g., inpatient: Gavida-Payne, Littlefield, Hallgren, Jenkins, & Coventry, 2003; outpatient: Callaghan, Young, Pace, & Vostanis, 2004).
1. For example, Callaghan et al. (2004) found that following 5 months of treatment the peer relationship problems score showed significant improvement.
2. In a small sample of child reports (n=8) Mathai, Anderson, & Bourne (2003) reported significant declines in total SDQ scores following treatment.
USE WITH YOUNGER CHILDREN
1. Muris, Meesters, Vincken, & Eijkelenboom (2004) examined the psychometrics of the SDQ self-report in a non-clinical sample of children aged 8-
13 years old. These data are reviewed separately because the measure was not developed for children under age 11. Overall, the results provide some support for the use of the Self- Report with younger children.
The authors reported questionable internal reliability for younger children aged 8-10: Conduct (.45); Peer Problems (.36); Emotional Symptoms (.56), and Prosocial behavior (.57). Children’s SDQ scores were, however, correlated with teacher SDQ scores, mean correlation=.28, and teacher scores on the externalizing scales of the Teacher Report Form.
Factor analysis suggested the presence of four factors: Emotional Symptoms, Prosocial Behavior, Hyperactivity/Inattention, and a mixed factor of Peer and Conduct Problems. Children identified by teachers as displaying behavior problems at school had higher Difficulty and lower Prosocial scores. SDQ scores appeared to be better at predicting behavior problems (teacher rating) than Youth Self-Report Scores (YSR). SDQ scores were found to correlate with YSR scores in the expected direction.
USE WITH DIVERSE SAMPLES
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. The measure has been used with many different ethnic groups within England, including immigrant and refugee children (e.g., Leavey, 2004). For
example, in a multiethnic group of 26,23 adolescents in East London (included 690 Bangladeshi, 250 Indian, 184 Pakistani, 166 black Carribean, 279 Black African, 121 Black British 191 mixed ethnicity, 581 White UK, and 161 White other youth), Bangladeshi youth who were more culturally integrated were found to have fewer mental health problems as assessed by the SDQ (Bhui, Stansfeld, Head, Haines, Hillier, Taylor, et al., 2005).
3. The measure has been used in samples of Indian and White British children, with results showing different connections between symptoms and father’s involvement based on ethnicity (Flouri, 2005).
4. The SDQ was used in a large (n=2,790) study of ethnically diverse children aged 11-14 to examine whether ethnic differences in the prevalence of
psychological distress are associated with deprivation (Stansfeld, Haines, Head, Bhui, Viner, Taylor, et al., 2004).
USE IN OTHER COUNTRIES (EXCEPT BRITAIN)
The SDQ has been used in many countries to examine rates of psychopathology (e.g., Ireland: Lynch, Mills, Daly, & Fitzpatrick, 2004). Studies have also examined the psychometrics of the measure in different countries. Many of these studies are detailed below.
1. Woerner et al. (2004) report on the use of the SDQ overseas (beyond Europe) in Brazil, Canada, the Middle East, Asia, and Australia. They suggest that the data provides support for the psychometric properties of the measure.
BRAZIL
The SDQ (Parent, Teacher, and Child versions) were used in a 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).
AUSTRALIA
The SDQ is part of the health department in Queensland Australia’s standardized assessment procedure, which is routinely administered at intake
and discharge at child and youth mental health facilities throughout the state (Harnett, Loxton, Sadler, Hides, & Baldwin, 2005).
BANGLADESH
Mullick & Goodman (2001) examined the psychometrics of a Bangla version (translated and backtranslated) 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, Emotional Problems, and Hyperactivity/Inattention. 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
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).
SOUTHERN EUROPE
Marzocchi et al. (2004) described the use of the SDQ in southern European countries (Italy, Spain, Portugal, Croatia, France).
Spanish
The Spanish version of the SDQ has been used in a number of studies. García, Goodman, Mazaira, Torres, Rodríguez-Sacristán, Hervas & Fuentes (2000) reported on the initial psychometrics comparing the SDQ with the CBCL and Child Behavior Questionnaire. The original article cannot be obtained, so it is unclear as to which version of the SDQ they used.
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.
NORWAY
1. Oppedal, Roysamb, & Heyerdahl (2005) analyzed data from 1,295 10th-rade immigrants in Norway. The sample included children who had immigrated from recent conflict zones. In this sample, they reported the following internal consistencies for the SDQ-Self-Report version: Total Score (.72), Emotional Problems (.69), Conduct Problems (.46), Hyperactivity Problems (.53), Peer problems (.44). They reported differences on SDQ scores by generation, ethnicity, and gender.
2. Ronning, Handegaard, Sourander, & Morch (2004) examined the psychometrics of the SDQ self-report version in a sample of 4,167 Norwegian
children aged 11-16. They reported internal consistencies (58-.67). Confirmatory factor analysis suggested that the factor structure proposed by
Goodman had a somewhat variable and questionable fit. The authors suggested that it “might be worth reformulating some items” at least in the Norwegian version and making modifications to improve the measure’s psychometric strength.
3. In a sample of 4,130 Norwegian 6th-10th graders self-perceived harassment was found to be related to SDQ symptoms (Ronning et al. 2004).
FINLAND
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 alpha=.63-.86.
Teachers had the best internal consistency (M=.79) compared to parents and children (.67 and .65, respectively).
Inter-rater reliability (correlations): .28-.40 for children and parents, .28-.38 for children and teachers, and .29-.45 for parents and teachers. The validity was supported through correlations with 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.
2. Koskelainen, Sourander, & Vauras (2001) conducted a factor analysis using data from 1,458 Finnish youth. They forced a 5-factor solution and reported that the first 3 factors were structured in accordance with the original SDQ. The remaining factors were somewhat problematic. A second factor analysis with the number of factors unspecified, suggested the presence of 3 factors. They reported internal consistency for the 5 scales as .53-.71. Mean scores and cutoffs are provided.
GERMANY
The psychometrics of the German version of the SDQ have been detailed in a number of published studies.
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, Hagenberg, Roessner, Woerner, & Rothenberger (2004) reported the following internal consistencies for the SDQ German version: Total
Difficulties (.78), Emotional (.77), Conduct Problems (.58), Hyperactivity/Inattention (.65), Peer Problems (.65), Prosocial Behavior (.78). Principal components analysis with a German sample suggested a 5-factor solution explaining 51.4% of the variance, with high concordance with the
original SDQ scales (Becker et al., 2004).
The authors also reported correlations between Child and Parent SDQ scores for each scale and for Child and Teacher SDQ scores. Correlations were all significant and moderate for parents and children (.30-.57), and teachers and children (.27-.50). The authors compared the predictive power of the SDQ with the CBCL in terms of detecting psychiatric diagnosis. The child self report was reportedly as effective as the Youth Self-Report or CBCL.
Netherlands
The psychometrics of the Dutch version of the SDQ have been reported on in at least two studies (Muris, Meesters, & van den Berg, 2003; van Widenfelt, Goedhart, Treffers, & Goodman, 2003).
1. Muris, et al. (2003) examined the psychometrics of the SDQ (Parent and Child versions) in a sample of Dutch 562 children aged 9 to 15 (M=12.3). Factor analysis of the Child Self-Report data suggested a 5-factor solution accounting for 43.9% of the variance, with the majority of items (all but 4) loading on their hypothesized factors. They also reported the following data:
TEST-RETEST RELIABILITY (average 2-month intraclass correlation): Total Difficulties (.87), Emotional Symptoms (.76), Conduct Problems (.66),
Hyperactivity/Inattention (.88), Peer Problems (.83), Prosocial Behavior (.59)
INTERNAL CONSISTENCY (alpha):
Total Difficulties (.78), Emotional Symptoms (.71), Conduct Problems (.45), Hyperactivity/Inattention (.72), Peer Problems (.54), Prosocial Behavior (.62) INTERRATER RELIABIITY (correlations between Parent and Child reports): Total Difficulties (.46), Emotional Symptoms (.43), Conduct Problems (.31), Hyperactivity/Inattention (.42), Peer Problems (.43), Prosocial Behavior (.21)
VALIDITY
The Child Self-Report SDQ correlated significantly with the Youth Self-Report (YSR), Children’s Depression Inventory (CDI), Revised Children’s Manifest
Anxiety Scale (RCMAS), and ADHD Questionnaire (ADHDQ), as expected. All correlations are reported in the article.
USE WITH TRAUMA-EXPOSED POPULATIONS
General Trauma
Correlations between Parent and Child reports on the SDQ were examined in both an At-Risk Norwegian sample and a community sample (Waaktaar, Borge, Christie, & Torgersen, 2005). The At-Risk sample included children, many of whom had experienced traumas including death of a parent or sibling, war exposure, refugee experiences.
Correlations for the At-Risk sample:
Total Problems (.43), Disruptive Difficulties (.52), Emotional Difficulties (.22),
Prosocial Behavior (.19)
Correlations for the community sample:
Youth-Mother: Total Problems (.30), Disruptive Difficulties (.34), Emotional
Difficulties (.30), Prosocial Behavior (.16)
Youth-Father: Total Problems (.33), Disruptive Difficulties (.37), Emotional
Difficulties (.21), Prosocial Behavior (.16).
MALTREATED CHILDREN
1. 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-maltreated youth.
2. Emotional Problems scores were predicted by a coping strategy of “trying to feel better by eating, drinking, smoking, using drugs, or medication (Thabet, Tischler, & Vostanis, 2004).
CHRONIC ILLNESS
1. Parent and Child SDQs were collected on a sample of 43 children with end stage renal disease. Means and SD are presented and compared to a
normative sample (Madden, Hastings, & Hoff, 2002).
| Not Known | Not Found | Nonclinical Samples | Clinical Samples | Diverse Samples | |
|---|---|---|---|---|---|
| Predictive Validity: | Yes | Yes | Yes |
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 scales (Youth Report only) 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; Goodman, Ford, Simmons, Gatward, & Meltzer, 2003).
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 ranging from .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.
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.
Translations
| Language: | Translated | Back Translated | Reliable | Good Psychometrics | Similar Factor Structure | Norms Available | Measure Developed for this Group |
|---|---|---|---|---|---|---|---|
| 1. Spanish | Yes | Yes | No | ||||
| 2. French | Yes | Yes | No | ||||
| 3. German | Yes | Yes | Yes | Yes | Yes | Yes | No |
| 4. Dutch | Yes | Yes | Yes | Yes | Yes | Yes | No |
| 5. Finnish | Yes | Yes | Yes | Yes | No | ||
| 6. Portuguese (Brazil) | Yes | Yes | Yes | Yes | No | ||
| 7. Bangla/Banglades | Yes | Yes | Yes | No | |||
| 8. Norwegian | Yes | Yes | Yes | Yes | No | Yes | No |
| 9. Finnish | Yes | Yes | Yes | Yes | No | Yes | No |
| 10. Arabic (Gaza) | Yes | Yes | No |
Population Information
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).
| Population Type: | Measure Used with Members of this Group | Members of this Group Studied in Peer-Reviewed Journals | Reliable | Good Psychometrics | Norms Available | Measure Developed for this Group |
|---|---|---|---|---|---|---|
| 1. Developmental disability | Yes | Yes | Yes | Yes | No | |
| 2. Disabilities | No | |||||
| 3. Lower socio-economic status | Yes | Yes | Yes | Yes | ||
| 4. Rural populations | Yes | Yes | Yes | Yes | ||
| 5. Below Average IQ | Yes | Yes | Yes | No |
Pros & Cons/References
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 SDQ Parent Report has been associated with service utilization outcomes.
7. The subscales and items correspond to major categories and criteria of current classification systems (Rothenberger & Woerner, 2004).
8. The measure is easily available in more than 40 languages at www.sdqinfo.com.
9. May be good for cross-cultural studies because it is short and available in multiple languages (Rothenberger & Woerner, 2004).
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. The correlation found between the SDQ and the PTSD Reaction Index is of small magnitude (r=.22), and the authors (McDermott et al., 2005) suggested that the SDQ should not be used on its own to screen for trauma-related symptoms.
5. Studies on the factor structure of the SDQ that have used Child Self-Reports have conflicting findings, with some studies replicating the original 5-factor structure and others suggesting other structures (e.g., 3 factors). 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.
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 Child 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. Bhui, K., Stansfeld, S., Head, J., Haines, M., Hillier, S., Taylor, S., et al. (2005). Cultural identity, acculturation, and mental health among adolescents in east London's multiethnic community. Journal of Epidemiology & Community Health, 59(4), 296-302.
4. 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.
5. Callaghan, J., Young, B., Pace, F., & Vostanis, P. (2004). Evaluation of a new mental health service for looked-after children. Clinical Child Psychology & Psychiatry, 9(1), 130-148.
6. 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.
7. 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.
8. Flouri, E. (2005). Father's involvement and psychological adjustment in Indian and White British secondary school-age children. Child & Adolescent Mental Health, 10(1), 32-39.
9. 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.
10. Goodman, R. (2001). Psychometric properties of the Strengths and Difficulties Questionnaire. Journal of the American Academy of Child & Adolescent Psychiatry, 40(11), 1337-1345.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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.
17. 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.
18. Goodman, R., Meltzer, H., & Bailey, V. (2003). The Strengths and Difficulties Questionnaire: A pilot study on the validity of the self-report version. International Review of Psychiatry, 15(1-2), 173-177.
19. 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.
20. 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.
21. Harnett, P. H., Loxton, N. J., Sadler, T., Hides, L., & Baldwin, A. (2005). The health of the nation outcome scales for children and adolescents in an adolescent in-patient sample. Australian & New Zealand Journal of Psychiatry, 39(3), 129-135.
22. Klasen, H., Woerner, W., Wolke, D., Meyer, R., Overmeyer, S., Kaschnitz, W., et al. (2000). Comparing the German versions of the Strengths and Difficulties Questionnaire (SDQ-deu) and the Child Behavior Checklist. European Child & Adolescent Psychiatry, 9(4), 271-276.
23. Koskelainen, M., Sourander, A., & Kaljonen, A. (2000). The Strengths and Difficulties Questionnaire among Finnish school-aged children and adolescents. European Child and Adolescent Psychiatry, 9, 277-284.
24. Koskelainen, M., Sourander, A., & Vauras, M. (2001). Self-reported strengths and difficulties in a community sample of Finnish adolescents. European Child & Adolescent Psychiatry, 10(3), 180-185.
25. Leavey, G., Hollins, K., King, M., Barnes, J., Papadopoulos, C., & Grayson, K. (2004). Psychological disorder amongst refugee and migrant schoolchildren in London. Social Psychiatry & Psychiatric Epidemiology, 39(3), 191-195.
26. Lynch, F., Mills, C., Daly, I., & Fitzpatrick, C. (2004). Challenging times: A study to detect Irish adolescents at risk of psychiatric disorders and suicidal ideation. Journal of Adolescence, 27(4), 441-451.
27. 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.
28. Madden, S. J., Hastings, R. P., & Hoff, W. V. (2002). Psychological adjustment in children with end stage renal disease: The impact of maternal stress and coping. Child: Care, Health & Development, 28(4), 323-330.
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. (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.
31. Mellor, D. (2004). Furthering the use of the Strengths and Difficulties Questionnaire: Reliability with younger child respondents. Psychological Assessment, 16(4), 396-401.
32. 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.
33. 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-yearold
non-clinical children. British Journal of Clinical Psychology, 43(4), 437-448.
34. Muris, P., Meesters, C., & van den Berg, F. (2003). The Strengths and Difficulties Questionnaire (SDQ): Further evidence for its reliability and validity in a community sample of Dutch children and adolescents. European Child & Adolescent Psychiatry, 12(1), 1-8.
35. 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.
36. 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.
37. 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.
38. 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.
39. Ronning, J. A., Handegaard, B. H., & Sourander, A. (2004). Self-perceived peer harassment in a community sample of Norwegian school children. Child Abuse & Neglect, 28(10), 1067-1079.
40. Ronning, J. A., Handegaard, B. H., Sourander, A., & Morch, W. (2004). The strengths and difficulties self-report questionnaire as a screening instrument in Norwegian community samples. European Child & Adolescent Psychiatry, 13(2), 73-82.
41. Rothenberger, A., & Woerner, W. (2004). Strengths and Difficulties Questionnaire (SDQ)-evaluations and applications. European Child & Adolescent Psychiatry, 13(Suppl2), 1-2.
42. 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.
43. Stansfeld, S. A., Haines, M. M., Head, J. A., Bhui, K., Viner, R., Taylor, S. J. C., et al. (2004). Ethnicity, social deprivation and psychological distress in adolescents: School-based epidemiological study in East London. British Journal of Psychiatry, 185(3), 233-238.
44. Taha, A. B., Baharuddin, R., Mazlan, M., Yaccob, J. B. M., Hamdan, S. K., & Hussin, Z. (2005). The family environment and family functioning of school-going adolescents with conduct problems. International Medical Journal, 12(1), 19-23.
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. Waaktaar, T., Borge, A. I. H., Christie, H. J., & Torgersen, S. (2005). Youth-parent consistencies on ratings of difficulties and prosocial behavior: Exploration of an at-risk sample. Scandinavian Journal of Psychology, 46(2), 179-188.
50. 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.
51. Woods, S., & White, E. (2005). The association between bullying behaviour, arousal levels and behaviour problems. Journal of Adolescence, 28(3), 381-395.
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