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Measuring children's emotional and behavioural problems: are SDQ parent reports from native and immigrant parents comparable?

ABSTRACT: Background:The number of immigrants worldwide is growing and migration might be a risk factor for the mental health of children. A reliable instrument is needed to measure immigrants' childrens mental health. The aim of the study was to test the measurement invariance of the parent version of the Strengths and Difficulties Questionnaire (SDQ) between German native, Turkish origin and Russian origin immigrant parents in Germany. The SDQ is one of the most frequently used screening instruments for mental health disorders in children. Methods:Differential Item Functioning (DIF) was tested in samples matched by socio-economic status, age and gender of the child. A logistic regression/item response theory hybrid method and a multiple indicators- multiple causes model (MIMIC) was used to test for DIF. Multi Group Confirmatory Factor analysis (MGCFA) was used to test for configural invariance. Parent reports of 10610 German native, 534 Russian origin and 668 Turkish origin parents of children aged 3-17 years were analysed. Results:DIF items were found in both groups and with both methods. We did not find an adequate fit of the original five factor model of the SDQ for the Turkish origin group, but for the Russian origin group. An analysis of functional equivalence indicated that the SDQ is equally useful for the screening of mental health disorders in all three groups. Conclusion:Using the SDQ in order to compare the parent reports of native and immigrant parents should be done cautiously. Thus, the use of the SDQ in epidemiological studies and for prevention planning is questionable. However, the SDQ turns out to be a valid instrument for screening purposes in parents of native and immigrant children.

SUBMITTER: Runge RA

PROVIDER: S-EPMC6882192 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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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.

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Measuring children's emotional and behavioural problems: are SDQ parent reports from native and immigrant parents comparable?

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