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Assessing the factor structure of the Spanish language parent Strengths and Difficulties Questionnaire (SDQ) in Honduras.

ABSTRACT: With worldwide prevalence rates between 10% and 20%, mental illness in children and adolescents is an issue for which culturally sensitive screening tools are needed. The Strengths & Difficulties Questionnaire (SDQ) is a commonly used measure that has been translated into numerous languages, although some research suggests issues with cross-cultural validity. Only four other studies have tested the Spanish-language SDQ in Latin America. In this study, we aimed to help fill this gap by assessing the factor structure of the parent or teacher version of the Spanish-language SDQ (for children ages 4-17) with 967 parent or other caregiver respondents of primary school-aged children (ages 4 to 17) in the Department of Intibucá, Honduras. When unable to find a good fitting factor model previously identified in the literature, we conducted split sample exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), along with measurement invariance testing with the best fitting EFA-extracted model based on gender for caregiver respondent and child gender. Results showed that while many EFA models had a good fit, CFI and TLI was < .90 for all extracted models when confirmed in the second sample with CFA. We then modified the best fitting extracted three-factor, 24-item model, which dropped item 15, by allowing select item residuals to correlate, increasing CFI and TLI to > .90 for female child gender. This modified three-factor model was partially invariant for configural and scalar models between child genders. Configural and scalar models would not converge for adult genders. Of note, metric models were not produced in Mplus related to items' cross-loading on more than one factor. These findings suggest that the SDQ Spanish language parent or teacher version may not perform optimally cross-culturally in this area of Honduras. Future research should confirm these findings with other Honduran populations.

SUBMITTER: Harry ML

PROVIDER: S-EPMC6438563 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Assessing the factor structure of the Spanish language parent Strengths and Difficulties Questionnaire (SDQ) in Honduras.

Harry Melissa L ML Acevedo José J Crea Thomas M TM

PloS one 20190328 3

With worldwide prevalence rates between 10% and 20%, mental illness in children and adolescents is an issue for which culturally sensitive screening tools are needed. The Strengths & Difficulties Questionnaire (SDQ) is a commonly used measure that has been translated into numerous languages, although some research suggests issues with cross-cultural validity. Only four other studies have tested the Spanish-language SDQ in Latin America. In this study, we aimed to help fill this gap by assessing ...[more]

PMID: 30921369

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Project description:BackgroundThe Strengths and Difficulties Questionnaire (SDQ) is widely used to screen for psychosocial problems among adolescents. As the severity of such problems is known to be related to age and gender, screening could be improved by interpreting SDQ scale scores with age-specific and perhaps gender-specific norms. Up to now, such norms are lacking. The aim of the current study is to present gender-specific and joint normative data per year of age for the Dutch self-reported and parent-reported SDQ versions for use among 12- to 17-year-old adolescents.MethodsThe norm groups for the self-reported and parent-reported SDQ versions consisted of 993 adolescents and 736 parents, respectively, from the general Dutch population. Per SDQ version, both gender-specific norms and joint norms (percentiles and cutoffs) per year of age were calculated through regression-based norming (Rigby in J Roy Stat Soc Ser C 54:507, 2005). Additionally, these norms were compared to the widely used British norms that are neither age-specific nor gender-specific.ResultsBy design, gender-specific 'abnormal' cutoffs (i.e., cutoffs aimed at identifying max. 10% of the most extremely scoring males and max. 10% of the most extremely scoring females) resulted in about equal percentages of 'abnormal' scoring male and female adolescents per SDQ scale. In contrast, joint 'abnormal' cutoffs (i.e., cutoffs aimed at identifying max. 10% of the most extremely scoring adolescents) resulted in relatively more male (7.6 to 13.6%, depending on age) than female (3.3 to 8.9%, depending on age) adolescents as scoring 'abnormal' on scales measuring externalizing behavior (self-reported and parent-reported SDQ versions), and relatively more female (3.9 to 14.3%, depending on age) than male (1.8 to 6.9%, depending on age) adolescents as scoring 'abnormal' on scales measuring internalizing behavior (self-reported SDQ version). In both types of norms, minor age effects were present. Among Dutch adolescents, the British norms yielded detection rates much lower than the expected 10%.ConclusionsOur findings indicate that detection rates depend on the reference group that is used (British or Dutch general adolescent population; specific gender group or not). The normative data in this paper facilitate the comparison of an adolescent's scores to different reference groups, and allow for cross-country/cultural comparisons of adolescents' psychosocial behavior.

Project description:BackgroundThe Strengths and Difficulties Questionnaire (SDQ) is widely used to assess child and adolescent mental health problems. However, the factor structure of the SDQ is subject to debate and there is limited evidence investigating measurement equivalence invariance (ME/I) between treatment groups, informants, and across time.MethodA randomised controlled trial (RCT) recruited 250 participants (6-17 years) who had been referred for an attention deficit hyperactivity disorder (ADHD) assessment. Participants and their clinician either received or did not receive a QbTest report (computer task measuring attention, impulsivity and activity). Parents and teachers completed the SDQ at baseline and 6-months later. This study aimed to understand the factor structure of the SDQ in a clinic referred ADHD sample, and validate the scale as a screening/diagnostic aide and as a measure of treatment outcome both in clinical and research settings. Exploratory Structural Equation Modelling (ESEM) was performed to examine the factor structure, and ME/I was assessed between treatment groups, informants, and time points. The criterion validity of the SDQ predictive algorithm for ADHD was compared with clinician and research diagnoses using logistic regression and tests of diagnostic accuracy.ResultsA 5-factor structure provided the best fit with strong factorial invariance between treatment groups and across time points, but not across informants (parent and teacher ratings). SDQ ratings of 'probable' hyperactivity disorder were good predictors of clinical (OR = 10.20, 95%CI 2.18-48.71,p = 0.003) and research diagnoses of ADHD (OR = 6.82, 95%CI 1.95-23.84,p = 0.003), and research diagnoses of Hyperkinetic disorder (OR = 4.02, 95%CI 1.13-14.25,p = 0.031). Further examination of the SDQ hyperactivity 'probable' rating showed good specificity (84.5%-74.5%) but poor sensitivity (45.0-42.5%) for ADHD.ConclusionThe findings indicate the SDQ is a valid outcome measure for use in RCTs and clinical settings. However, care should be taken when using the SDQ predictive algorithm to screen for ADHD in clinically referred samples.

Project description:BackgroundChild and adolescent mental health problems are urgent health issues in low- and middle-income countries. To promote child and adolescent mental health services, simple validated screening tools are helpful. In Mongolia, the Strengths and Difficulties Questionnaire (SDQ), an internationally used child and adolescent mental health screening tool for children aged 4-17, was translated but not yet validated. To use the questionnaire appropriately, validation is necessary.MethodsChildren at 4th year at elementary school (community sample) and children visited psychiatric outpatient service (clinical sample) were recruited and their parental version of the SDQ was compared. The discriminating ability of the parental version of the SDQ was examined using Receiver Operating Characteristics (ROC) analysis on the SDQ total difficulties score. The area under the ROC curve (AUC) was used as a measure. Cut-off score was determined by normative banding that categorizes children with the highest 10% score range as abnormal and the second highest 10% as borderline following the original method; this cut-off score was compared with the cut-off score candidates with good balance between sensitivity and specificity using ROC analysis.ResultsWe included 2301 children in the community sample, and 429 children in the clinical sample. Mean age was 9.7 years (SD 0.4, range 8.3-12.0) among the community sample and 10.4 years (SD 3.8, range 4.0-17.8) among the clinical sample. The mean total difficulties score was 12.9 (SD 4.8) among the community sample and 20.4 (SD 6.2) among the clinical sample. A total of 88.8% of the community sample and 98.8% of the clinical sample answered the SDQ. Using ROC analysis, the AUC was 0.82 (95% confident interval 0.80-0.85), which meant moderate discriminating ability. Using normative banding, the borderline cut-off score was 16/17 and abnormal cut-off score was 19/20. For cut-off scores of 16/17 and 19/20, sensitivity was 71.9 and 53.8% and specificity was 78.5 and 90.5%, respectively. The cut-off score candidates by ROC analysis were 16/17 and 17/18.ConclusionsThe parental version of the SDQ had moderate discriminating ability among Mongolian school-age children. For the screening of mental health problems among community children, cut-off score of 16/17 is recommended.

Project description:The Strengths and Difficulties Questionnaire (SDQ) is widely used as an international standardised instrument measuring child behaviour. The primary aim of our study was to examine whether behavioral symptoms measured by SDQ were elevated among children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) relative to the rest of the population, and to examine the predictive value of the SDQ for outcome of parent-reported clinical diagnosis of ASD/ADHD. A secondary aim was to examine the extent of overlap in symptoms between children diagnosed with these two disorders, as measured by the SDQ subscales. A cross-sectional secondary analysis of data from the Millennium Birth Cohort (n?=?19,519), was conducted. Data were weighted to be representative of the UK population as a whole. ADHD or ASD identified by a medical doctor or health professional were reported by parents in 2008 and this was the case definition of diagnosis; (ADHD n?=?173, ASD n?=?209, excluding twins and triplets). Study children's ages ranged from 6.3-8.2 years; (mean 7.2 years). Logistic regression was used to examine the association between the parent-reported clinical diagnosis of ASD/ADHD and teacher and parent-reported SDQ subscales. All SDQ subscales were strongly associated with both ASD and ADHD. There was substantial co-occurrence of behavioral difficulties between children diagnosed with ASD and those diagnosed with ADHD. After adjustment for other subscales, the final model for ADHD, contained hyperactivity/inattention and impact symptoms only and had a sensitivity of 91% and specificity of 90%; (AUC)?=?0.94 (95% CI, 0.90-0.97). The final model for ASD was composed of all subscales except the 'peer problems' scales, indicating of the complexity of behavioural difficulties that may accompany ASD. A threshold of 0.03 produced model sensitivity and specificity of 79% and 93% respectively; AUC?=?0.90 (95% CI, 0.86-0.95). The results support changes to DSM-5 removing exclusivity clauses.

Dataset Information

Assessing the factor structure of the Spanish language parent Strengths and Difficulties Questionnaire (SDQ) in Honduras.

Publications

Assessing the factor structure of the Spanish language parent Strengths and Difficulties Questionnaire (SDQ) in Honduras.

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