Strengths and Difficulties Questionnaire-Parent Report

Submitted by mholliday on Thu, 09/20/2012 - 10:37

Overview

Acronym: 
SDQ-Parent
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 ; sdq@youthinmind.net

Cost: 
Free
Copyrighted: 
Yes
Measure Description: 

The SDQ is a widely and internationally used brief behavioral screening 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
Psychosocial Functioning
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: 
Parent/Caregiver
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 SymptomsMay worry 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

Other Training to Interpret: 
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/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.

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

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).

Many studies across different populations and countries (e.g., Muris, Meesters, & van den Berg, 2003) have found significant differences in scores based on age and/or gender, supporting the use of different norms for gender and age groups.

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 correlation0.520.750.72
Internal ConsistencyAcceptableCronbach's Alpha0.570.850.71
Inter-raterAcceptablePearson correlation0.30.480.39
References for Reliability: 

The internal consistency and inter-rater reliability (Parent x 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. Test-retest reliability for impact scores over a 3-4 week period were reported by Goodman
(1999) using intraclass correlations:
Impact Rating (.63), Impact Score (.54), Burden (.44)
INTERNAL CONSISTENCY
Total (.82), Emotional Symptoms (.67), Conduct Problems (.63), Hyperactivity/Inattention
(.77), Peer Problems (.57), Prosocial Behavior (.65), Impact (.85)

INTERRATER 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)

Parent x Child:
Total Difficulties (.48), Emotional Symptoms (.37), Conduct Problems (.44),
Hyperactivity/Inattention (.41), Peer Problems (.40), Prosocial Behavior (.30), Impact (.30)


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
On a subset of 120 families over a 2-week period, Parent Report reliabilities were as follows:
Total Difficulties (.73), Emotional Symptoms (.73), Conduct Problems (.52),
Hyperactivity/Inattention (.85), Peer Problems (.74), Prosocial (.75)

INTERNAL CONSISTENCY (alpha for Parent reports)
Total Difficulties (.73), Emotional Symptoms (.71), Conduct Problems (.67),
Hyperactivity/Inattention (.80), Peer Problems (.75), Prosocial (.70)

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 x Teacher:
Total Difficulties (.46), Emotional Symptoms (.31), Conduct Problems (.34),
Hyperactivity/Inattention (.46), Peer Problems (.39), Prosocial (.30)

Parent x Child
Total Difficulties (.38), Emotional Symptoms (.32), Conduct Problems (.37),
Hyperactivity/Inattention (.46), Peer Problems (.34), Prosocial (.34)

3. Hawes & Dadds (2004) examined the psychometrics of the SDQ Parent Report in a sample of 1,359 Australian children aged 4-9.

TEST-RETEST STABILITY (1-year period)
Total Difficulties (.77), Emotional Symptoms (.71), Conduct Problems (.65),
Hyperactivity/Inattention (.77), Peer Problems (.61), Prosocial (.64), Impact (.63)

INTERNAL CONSISTENCY (alpha)
Total Difficulties (.82), Emotional Symptoms (.66), Conduct Problems (.66),
Hyperactivity/Inattention (.80), Peer Problems (.59), Prosocial (.70), Impact (.79)

OTHER RELIABILITY STUDIES
1. In a large U.S. sample (see Notes under “Norms for Details About the Sample”), the SDQ was found to have the following internal consistency:
Total Difficulties (.83), Impairment Scores (.80), 4 subscales (.63-.77), Peer Problems (.46) (Bourdon, Goodman, Rae, Simpson, & Koretz, 2005)

2. In a sample of British parents recruited from 10 London primary schools, Edmunds,
Garratt, Haines, & Blair (2005) report the internal consistency of the SDQ Parent Report as follows:
Conduct Problems (.64), Emotional Symptoms (.65), Hyperactivity (.74), Peer Problems (.33), Prosocial (.73), and Total (.80)

3. McDermott (2005) report internal consistency as .91 for the total sample of 222 children aged 8-18 who attended a school that had been in a “wildfire affected” area. Internal consistency for different grade levels was as follows: primary school, grades 3-6 (.91); junior high, grades 7-9 (.88); senior high, grades 10-12 (.89).

Alphas for the subscales were as follows: Emotional Symptoms (.79), Conduct Problems (.70), Hyperactivity/Inattention (.82), Prosocial Behavior (.76), with scales shown to be reliable across grades, excepting the Peer Relationships Subscale (Total Sample (.54), Range across grades (.20-.62).

4. 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 selectedbecause they reflect key symptoms for a DSM-IV diagnosis of ADHD or ICD-10 diagnosis of
hyperkinesis.

Construct Validity: 
Validity TypeNot knownNot foundNonclincal SamplesClinical SamplesDiverse Samples
Convergent/ConcurrentYesYesYes
DiscriminantYesYesYes
Sensitive to ChangeYesYes
Intervention EffectsYesYes
Sensitive to Theoretically Distinct GroupsYesYesYes
References for Construct Validity: 

Only studies that administered the SDQ Parent-Report 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 Parent 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., Button, Scourfield, Martin, Purcell, & McGuffin, 2005; Kuntsi, Rijsdijk, Ronald, Asherson, & Plomin, 2005; Saudino, Ronald, & Plomin, 2005; Scourfield, Martin, Eley, McGuffin, & Cherny, 2004; Scourfield, Van den Bree, Martin, & McGuffin, 2004).

CORRELATIONS WITH OTHER MEASURES/OUTCOMES
The Parent Report on SDQ was found to correlate significantly with Parent Report on the Rutter (Rutter Total Deviance and SDQ Total Difficulties: r=.88; Goodman, 1997).

Multiple studies (including those cited below under “USE IN OTHER COUNTRIES”) have examined the relation between the SDQ and Child Behavior
Checklist (CBCL). Goodman & Scott (1999) studied the predictive validity of SDQ and CBCL using ROC curves. Both measures discriminated well between high- and low-risk samples, with no significant differences between the measures in terms of predictive validity, assessed using area under the curve.

They found high correlations between the CBCL and SDQ: Total (r=.87),
Externalizing to Conduct (r=.84), Hyperactivity/Inattention (r=.71),
Internalizing/Emotional (r=.74), and Social/Peer (r=.59).

They also examined correlations between these measures and the Parent Account of Child Symptoms, a semi-structured interview about a child’s
emotional and behavioral symptoms. The measures correlated similarly, except that the SDQ Hyperactivity Scale correlated significantly better with the Interview scale than with the CBCL Inattention scale.

1. Parent SDQ scores were significantly correlated with teacher’s ratings of Anxiety, Aggression, and Hyperactivity/Inattention in the expected direction and with ratings of symptom severity of clinician made Axis I diagnoses (Hawes & Dadds, 2004).

2. 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).

3. Indicators of risk, assessed by high SDQ symptom scores, parents’ perception of definite or severe difficulties, or high symptoms plus impairment
were related to service contact/use in a large American nationwide sample (Bourdon et al., 2005).

4. McDermott (2005) reported a week correlation between the SDQ Total and PTSD-RI (r=.22, p<.01) in a sample of children who attended a school in a “wildfire affected” area. Exposure to threat from the fire was related to SDQ scores, particularly on the Total and Emotional scales.

5. The Burden scale from the impact supplement has been found to correlate significantly (r=.74) with the Parent Burden Interview (Goodman, 1999).

DISCRIMINANT VALIDITY
1. The SDQ (Parent Report) has been found to discriminate between groups of children. ROC analyses showed that the SDQ and Rutter questionnaires have equivalent predictive validity, with respect to their ability to discriminate between psychiatric and dental clinic samples (Goodman, 1997).

2. Another study found that compared to non-institutionalized children, institutionalized children scored higher on the SDQ total score and all problem subscales and lower on Prosocial Behavior (Muris & Maas, 2004).

3. Children diagnosed with an externalizing disorder have also been found to score higher on SDQ Peer Problems, Hyperactivity/Inattention, and Conduct Problem and lower on Prosocial Behaviors than did nonanxious and nonclinical groups. The anxious children scored higher than the nonclinical group did (Lyneham & Rapee, 2005).

4. A study of 40 preschool children classified as “hard to manage” based on maternal SDQ scores and 40 comparison children (mean age=52 months), showed that these children differed on observational data gathered from interactions with peers. The “hard to manage” group showed higher rates of Antisocial Behavior and Negative Emotions, and lower rates of Empathic/Prosocial responses (Hughes, White, Sharpen, & Dunn, 2000).

5. Examination of the validity of the Impact Supplement showed that Perceived Difficulties, Impact Score, and Burden ratings (Parent, Teacher, and Child) were significantly different for community versus clinic samples. Impact scores were better at discriminating between clinic and community samples than were Symptom scores (Goodman, 1999).

TREATMENT OUTCOME
Multiple studies have used the Parent SDQ as an outcome measure, with the SDQ showing sensitivity, at least on some scales, to change in studies of children with behavioral problems (e.g., Anderson, Vostanis, & O’Reilly, 2005; Callaghan, Young, Pace, & Vostanis, 2004; Costin, Lichte, Hill-Smith, Vance, & Luk, 2004; Mathai, Anderson, & Bourne, 2003).

1. In a small sample of Chinese Cantonese-speaking parents in Sydney, Australia, significant changes were found on the SDQ Prosocial Behavior
postintervention (Crisante & Ng, 2003).

2. Comparable change was also found on the on the SDQ and the CBCL for an evaluation of a parenting program with Irish families (Behan, Fizpatrick, Sharry, Carr, & Waldron, 2001).

3. Significant change has also been found for inpatient samples (e.g., Gavida- Payne, Littlefield, Hallgren, Jenkins, & Coventry, 2003).

4. Mathai et al. (2003) also found significant change using the Impact Supplement with significant reduction in parents’ perception of Overall
Difficulties, Level of Burden Placed by the Child on the Family, and Impact scores.

5. While the majority of these studies have been conducted using pre- to posttest comparisons, the SDQ Parent Report also appears to be sensitive to change in randomized trials. For example, a study of Cantonese-speaking parents randomly assigned to the Triple P Parenting Program or a wait list group showed significant effects on SDQ Conduct Problem, Hyperactivity, Peer Problems, and Emotional Symptoms (Leung, Sanders, Leung, Mak, & Lau, 2003).

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 Australia (Hawes & Dadds, 2004), Germany (Becker, Woerner, Hasselhorn, Banaschewski, and Rothenberger, 2004; Woerner, Becker, &
Rothenberger, 2004), Sweden (Smedje, Broman, Hetta, & von Knorring, 1999), and the Netherlands (Muris, Meesters, & van den Berg, 2003) reported a similar factor structure as that reported by Goodman (2001).

3. However, studies in Gaza (Thabet, Stretch, & Vostanis, 2000) and the United States (Dicky & Wayne, 2004) suggest that the factor structure proposed by Goodman (2001) has a somewhat variable and questionable fit.

4. Dickey & Wayne (2004) examined the factor structure of the SDQ Parent Report using data from 9,577 American children aged 4-17. Principal
components analysis suggested a 5-factor solution.

The first 3 factors (Hyperactivity/Inattention, Emotional Symptoms, and Prosocial Problems) consisted of items that were intended to fit those domains, but the conduct problems and peer problems did not factor as hoped for.

An Exploratory Factor analysis using eigen values>1 and a promax rotation, suggested a 3-factor solution, titled Prosocial Problems, Externalization
Problems, And Internalization Problems. A Confirmatory Factor analysis provided support for the 3-factor model.

The authors suggested that for American children the 3-factor model may be more appropriate than were the 5 factors found typically in British samples.

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 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.
1. For example, the SDQ was used to screen for prevalence of psychopathology in a sample of 448 Russian children. Prevalence rates were generally higher for the Russian sample than for the comparison British sample (Goodman, Slobodskaya, & Knyazev, 2005).

2. 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.

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).

AUSTRALIA
1. The SDQ has been used in multiple studies of Australian children. Principal components analysis of 1,359 Australian children aged 4-9, with an oblimin rotation suggested the presence of 5 factors, consistent with that found by Goodman (2001) (Hawes & Dadds, 2004). Analyses showed that for boys, Hyperactivity accounted for most of the total variance (22.4%) while for girls, Prosocial Problems accounted for the most variance (19.7%).

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).

BANGLADESH
1. 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,
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.

SOUTHERN EUROPEAN COUNTRIES
1. 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)Obel 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.

Swedish
1. Smedje, Broman, Hetta, & von Knorring (1999) reported on the psychometrics of the Swedish SDQ. Internal consistency for the total scale was
.76, with alphas ranging from .51-.75 for subscales. Principal Components analysis suggested the presence of 5 factors based on eigen values>1 and interpretability. The authors provide means and cutoff scores.

2. The Swedish SDQ has also been found to differentiate between clinical and community samples, and showed good Sensitivity and Specificity (Malmberg, Rydell, & Smedge, 2003).

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 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.

Dutch
1. The psychometrics of the Dutch version of the SDQ has been reported on in at least two studies (Muris, Meesters, & van den Berg, 2003; van Widenfelt, Goedhart, Treffers, & Goodman, 2003). Muris et al. (2003) examined the psychometrics of the SDQ (Parent and Child versions) in a sample of 562 children aged 9 to 15 (M=12.3).

Factor analysis of the Parent SDQ suggested a 5-factor solution accounting for 47.6% of the variance, with all items loading on the intended factor and only 1 item having a substantial secondary loading.

TEST-RETEST RELIABILITY (average 2-month intraclass correlation):
Total Difficulties (.88); Emotional Symptoms (.76); Conduct Problems (.89);
Hyperactivity/Inattention (.84); Peer Problems (.91); Prosocial Behavior (.75)

INTERNAL CONSISTENCY (alpha):
Total Difficulties (.80); Emotional Symptoms (.70); Conduct Problems (.55);
Hyperactivity/Inattention (.78); Peer Problems (.66); Prosocial Behavior (.68)

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 Parent SDQ correlated significantly with the CBCL, Child Depression Inventory (CDI), Revised Children’s Manifest Anxiety Scale (RCMAS), and
ADHD Questionnaire (ADHDQ), as expected. Specific correlations are reported in the article.

Germany
1. Woerner, Becker, & Rothenberger (2004) reported on psychometrics of the German SDQ Parent Report version. They report on normative data gathered from 930 children aged 6-16. SDQ scores differentiated between the community sample and a clinical sample.

2. The factor structure also appears to be similar to what has been proposed by Goodman (2001) in English samples, and the SDQ scores correlate with scores on the CBCL and Youth Self-Report, as would be expected (Klasen et al., 2000; Klasen, Woerner, Rothenberger, & Goodman, 2003).

3. Additional data on the validity of the German SDQ are presented in Woerner
et al. (2002).

4. 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 ranging from .72-.81 for the Parent and .75-.83 for the Teacher.

All correlations between SDQ subscales and corresponding CBCL/TRF scales were significant (p<.001). For example: SDQ Total Difficulties and CBCL Total Problems (r=.83), SDQ Emotional Problems and CBCL Internalizing Problems (r=.77), SDQ Conduct Problems and CBCL Externalizing (r=.82), SDQ Hyperactivity/Inattention and CBCL Attention Problems (r=.75), SDQ Prosocial Behavior and CBCL Social Problems =-.22.

Factor analysis combining additional Parent reports (Total Sample=1,686) resulted in a 5-factor solution explaining 53.9% of the variance matching the intended scale structure. 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 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.

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.

USE WITH TRAUMA-EXPOSED SAMPLES
The SDQ has also been used in numerous studies of children in the British
foster care system who have most likely experienced traumas.

1. The SDQ has been used in a number of studies examining the effects of traffic accidents (e.g., Bryant, Mayou, Wiggs, Ehlers, & Stores, 2004 ). Bryant et al. (2004) reported that those children who were found to be in the abnormal or borderline range on the Emotional Symptoms Scale were more likely to have Acute Stress Disorder. Emotional symptoms were also associated with PTSD at 3-month follow-up but not at 6 months. At 6 months, Abnormal and Borderline scores on Conduct and Prosocial Behavior were more likely to have PTSD.

2. The SDQ was used to screen children who had experienced a wildfire (McDermott, Lee, Judd, & Gibbon, 2005). Internal consistency was .91 for the
Total sample of 222 children aged 8-18 who attended a school that had been in a “wildfire affected” area.

Internal consistency for different grade levels was as follows: primary school, grades 3-6 (.86); junior high, grades 7-9 (.78); senior high, grades 10-12 (.82). There was a small correlation between SDQ scores and scores on the PTSD Reaction Index (r=.22, p<.01).

The authors suggested that “the SDQ is not on its own a suitable measure for identifying trauma-related symptoms and should not be used in isolation to identify postdisaster trauma in children and adolescents” (p. 141).

3. 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, and 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)
4. 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).

5. The SDQ was used in a treatment outcome study of Spanish-speaking mothers and children exposed to domestic violence (Martín & Pérez, 2002). The original article could not be obtained for review.

6. The SDQ was used in a study of homeless children, some of whom had experienced domestic violence and others of whom had experienced neighborhood violence, with results showing high psychiatric comorbidity for both groups (Vostanis, Tischler, Cumella, & Bellerby, 2001).

7. The SDQ was used in a study of Greek children exposed to the Athens earthquake in September 1999 (Kolaitis, 2003). The authors found no significant differences between earthquake exposed and non-exposed children, although they did find differences between immigrant and non-immigrant children. It should be noted that earthquake-exposed children did differ from non-exposed children on the Child’s Report of Depression (CDI) and Anxiety (SCARED).

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

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 and any DSM-IV diagnosis: Specificity was 94%, Sensitivity 47%, Negative Predictive Value 96%, Positive Predictive Value 46%.
These data are reported in the above table.

The SDQ has also been found to be related to important clinical outcomes. For
example, initial severity rates on the SDQ were found to be predictive of later
referral to a child mental health specialist (Sayal, 2004).

A computerized algorithm has 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, 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. In a large-scale sample of British youth (n=10,438), scores above the 90th percentile on Parent-, Teacher-, and Self-Report versions were associated with substantially raised probability of independently diagnosed psychiatric disorders (mean odds ratio: 15.7 for Parent scales, 15.2 for Teacher scales, 6.2 for Youth scales) (Goodman, 2001). Parent SDQ scores above the 90th percentile predicted a 15-fold increase in the likelihood of any independently diagnosed psychiatric disorder (assessed using the Development and Well-Being Assessment).

2. 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.

3. Using this algorithm, Goodman, Renfrew, & Mullick (2000) found 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=7%-84%, Positive Predictive Power=35%-86%, Negative Predictive Power=.83%-98%. They reported that “the algorithm is good at detecting disorder . . . but at the expense of being over-inclusive.”

4. 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 parents and teachers. Parents 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.

5. Mathai et al. (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: Emotional Disorder (81%), Hyperactivity
Disorder (93%), Conduct Disorder (100%)

Sensitivity Rate Score: 
0.47
Specificity Rate Score: 
0.94
Positive Predictive Power: 
0.46
Negative Predictive Power: 
0.96
Overall Psychometric Limitations: 

NOT A CON: 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.

NOT A CON: Goodman & Scott (1999) noted that the SDQ and CBCL are comparable in many ways but that the SDQ may be a more useful measure of inattention and hyperactivity. Given its brevity it may also be a more useful screening measure. The CBCL, however, as they mentioned, covers a broader range of problems, making it perhaps more suitable for clinical assessments or studies that require a broad coverage of childhood psychopathology.

As noted by Goodman et al. (2000), the SDQ algorithm for predicting child psychiatric diagnosisis 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. SpanishYesYesYesYesYesYesNo
2. FrenchYesYesYesYesYesYesNo
3. GermanYesYesYesYesYesYesNo
4. DutchYesYesYesYesYesYesNo
5. FinnishYesYesYesYesYesNo
6. SwedishYesYesYesYesYesNo
7. Portuguese (Brazil)YesYesYesYesNo
8. NorwegianYesYesYesNo
9. Bangla/BangladeshYesYesYesNo
10. GreekYesYesYesYesNo

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
Sexual Abuse
Medical Trauma
Natural Disaster
Domestic Violence
Community Violence
Traumatic Loss (Death)
War/Combat
Neglect
Accidents
Immigration Related Trauma
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 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).
 

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. 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.

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” anywhere revealed that the measure has been referenced in 329 peer-reviewed journal articles. 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. Anderson, L., Vostanis, P., & O'Reilly, M. (2005). Three-year follow-up of a family support service cohort of children with behavioural problems and their parents. Child: Care, Health and Development, 31(4), 469-477.

3. 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.

4. 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.

5. Behan, J., Fitzpatrick, C., Sharry, J., Carr, A., & Waldron, B. (2001). Evaluation of the parenting plus programme. Irish Journal of Psychology, 22(3-4), 238-256.

6. 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.

7. Bourdon, K. H., Goodman, R., Rae, D. S., Simpson, G., & Koretz, D. S. (2005). The Strengths and Difficulties Questionnaire: U.S. normative data and psychometric properties. Journal of the American Academy of Child & Adolescent Psychiatry, 44(6), 557-564.

8. Bryant, B., Mayou, R., Wiggs, L., Ehlers, A., & Stores, G. (2004). Psychological consequences of road traffic accidents for children and their mothers. Psychological Medicine, 34(2), 335-346.

9. Button, T. M. M., Scourfield, J., Martin, N., Purcell, S., & McGuffin, P. (2005). Family dysfunction interacts with genes in the causation of antisocial symptoms. Behavior Genetics, 35(2), 115-120.

10. 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.

11. 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.

12. Costin, J., Lichte, C., Hill-Smith, A., Vance, A., & Luk, E. (2004). Parent group treatments for children with oppositional defiant disorder. AeJAMH (Australian e-Journal for the Advancement of Mental Health), 3(1).


13. Crisante, L., & Ng, S. (2003). Implementation and process issues in using group triple P with Chinese parents: Preliminary findings. AeJAMH (Australian e-Journal for the Advancement of Mental Health), 2(3).

14. 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.

15. Dickey, W. C., & Blumberg, S. J. (2004). Revisiting the factor structure of the Strengths and Difficulties Questionnaire: United States, 2001. Journal of the American Academy of Child & Adolescent Psychiatry, 43(9), 1159-1167.

16. Edmunds, S., Garratt, A., Haines, L., & Blair, M. (2005). Child health assessment at school entry (CHASE) project: Evaluation in 10 London primary schools. Child: Care, Health & Development, 31(2), 143-154.

17. 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.

18. 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.

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

20. 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.

21. 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.

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

23. 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.

24. 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.

25. 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.

26. 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.

27. 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.

28. 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.

29. 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.

30. 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.

31. 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.

32. Goodman, R., Slobodskaya, H., & Knyazev, G. (2005). Russian child mental health: A cross-sectional study of prevalence and risk factors. European Child & Adolescent Psychiatry, 14(1), 28-33.

33. Hawes, D. J., & Dadds, M. R. (2004). Australian data and psychometric properties of the Strengths and Difficulties Questionnaire. Australian & New Zealand Journal of Psychiatry, 38(8), 644-651.

34. Hughes, C., White, A., Sharpen, J., & Dunn, J. (2000). Antisocial, angry, and unsympathetic: "hard-to-manage" preschoolers' peer problems and possible cognitive influences. Journal of Child Psychology & Psychiatry, 41(2), 169-179.

35. 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.

36. 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.

37. Kolaitis, G., Kotsopoulos, J., Tsiantis, J., Haritaki, S., Rigizou, F., Zacharaki, L., et al. (2003). Posttraumatic stress reactions among children following the Athens earthquake of September 1999. European Child & Adolescent Psychiatry, 12(6), 273-280.

38 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.

39. Kuntsi, J., Rijsdijk, F., Ronald, A., Asherson, P., & Plomin, R. (2005). Genetic influences on the stability of attention-deficit/hyperactivity disorder symptoms from early to middle childhood. Biological Psychiatry, 57(6), 647-654.

40. Leung, C., Sanders, M. R., Leung, S., Mak, R., & Lau, J. (2003). An outcome evaluation of the implementation of the Triple P-Positive Parenting Program in Hong Kong. Family Process, 42(4), 531-544.

41. 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.


42. 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.

43. 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.

44. Malmberg, M., Rydell, A., & Smedje, H. (2003). Validity of the Swedish version of the Strengths and Difficulties Questionnaire (SDQ-Swe). Nordic Journal of Psychiatry, 57(5), 357-363.

45. Martín Rodríguez, A., & Pérez San Gregorio, M. Á. (2002). Implementation of psychological training to mothers of children exposed to domestic violence/Aplicación de un programa de intervención psicológica para madres de niños expuestos a violencia conyugal. Analisis y Modificacion de Conducta, 28(120), 503-521.

46. 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.

47. 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.

48. 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.

49. McDermott, B. M., Lee, E. M., Judd, M., & Gibbon, P. (2005). Posttraumatic stress disorder and general psychopathology in children and adolescents following a wildfire disaster. Canadian Journal of Psychiatry, 50(3), 137-143.

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

51. 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.

52. 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.

53. 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.

54. 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.

55. 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.

56. 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.

57. 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.

58. 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.

59. 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.

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

61. 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.

62. Sayal, K. (2004). The role of parental burden in child mental health service use: Longitudinal study. Journal of the American Academy of Child & Adolescent Psychiatry, 43(11), 1328-1333.

63. Scourfield, J., Martin, N., Eley, T. C., McGuffin, P., & Cherny, S. (2004). The genetic relationship between social cognition and conduct problems. Behavior Genetics, 34(4), 377-383.

64. 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.

65. Smedje, H., Broman, J. E., Hetta, J., & von Knorring, A. L. (1999). Psychometric properties of a Swedish version of the "Strengths and Difficulties Questionnaire." European Child & Adolescent Psychiatry, 8(2), 63-70.

66. 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.

67. 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.

68. 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.

69. Vostanis, P., Tischler, V., Cumella, S., & Bellerby, T. (2001). Mental health problems and social supports among homeless mothers and children victims of domestic and community violence. International Journal of Social Psychiatry, 47(4), 30-40.

70. 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.

71. Waldron, B., Sharry, J., Fitzpatrick, C., Behan, J., & Carr, A. (2002). Measuring children's emotional and behavioural problems: Comparing the Child Behaviour Checklist and the Strengths and Difficulties Questionnaire. Irish Journal of Psychology, 23(1-2), 18-26.

72. Woerner, W., Becker, A., Friedrich, C., Klasen, H., Goodman, R., & Rothenberger, A. (2002). Normative data and evaluation of the German parent-rated Strengths and Difficulties Questionnaire (SDQ): Results of a representative field study/Normierung und evaluation der deutschen elternversion des Strengths and Difficulties Questionnaire (SDQ): Ergegnisse einer repräsentativen felderhebung. Zeitschrift für Kinder- und
Jugendpsychiatrie und Psychotherapie, 30(2), 105-112.

73. 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.
Editor of Review: 
Chandra Ghosh Ippen, Ph.D., Madhur Kulkarni, M.S.
Last Updated: 
Wed, 01/29/2014
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