Child self-report and parent ratings for the Strengths and Difficulties Questionnaire: Norms and agreement in a Swedish random population sample

Abstract

Background: The Strengths and Difficulties Questionnaire (SDQ) measures behavioral problems among children and adolescents. Prior research in Sweden has included child self-report or parent ratings from community or population data. Objective: To provide child-reported and parent-rated SDQ norms for 11-to 16-year-olds, as well as data on child-parent agreement and parental sociodemographic correlates: education, employment status, and quality of life. Method: A random population sample with 600 children aged 11 to 16 years, 100 per age group, and one of their parents (N=1200) yielded a sampling pool of 1158 participants and a 34.8% response rate, including 175 child-parent pairs and 27 and 26 child/parent singletons. Responses to child and parent versions of the extended SDQ were analyzed by child gender and age. Child-parent agreement was evaluated using the Prevalence-and Bias-Adjusted Kappa and Bland-Altman plots. Results: Older children reported greater difficulties compared with younger children, while girls reported a higher negative impact of difficulties on daily life in comparison to boys. Child-parent item-by-item agreement was fair to slight on 15 of the 25 SDQ items, perfect to moderate on 9 items, and less than chance on 1 item, but generally high regarding dichotomous assignment to the "raised difficulties" or "normal" groups, based on subscales and the total SDQ score. Greater difficulties for children were reported by parents born outside Sweden, parents of children born outside Sweden, parents lacking regular employment, and parents with lower education or lower quality of life. In relation to other child-parent pairs, parents born outside Sweden perceived greater difficulties for their children compared with the children's own ratings. Parents with better physical health and social relationships rated their children as having fewer difficulties compared with the rates reported by children. Conclusions: Gender differences contrasted with prior Swedish studies showing higher ratings for boys on hyperactivity and total difficulties and for girls on emotional symptoms. However, findings on increased difficulties with age concurred with prior studies. Research on children's mental health should be widely and systematically conducted at regular intervals and encompasses large, representative samples in order to inform national public health and health-care policy regarding measures to support children and enhance their mental health.

Behavioral and Emotional Problems among Adolescent Students

“…Also, lack of recreational facilities and closed communities especially in rural Upper Egypt could play a role that increases the impact of the difficulties. This is in the same line with Liu et al, (4) who reported that females reported a higher negative impact of difficulties. On the contrary, Mowafy et al, (7) reported that there was higher significant impact of difficulties among students who had a working mother.…”

“…However, epidemiological data on adolescent mental health problems in developing and Arab countries are limited. (4)(5) Adolescents' mental health problems are wide range of emotional and behavioral problems that range from minor difficulties to more severe ones that fulfill diagnostic criteria of a psychiatric classification. (3) They include depression, anxiety, adjustment, conduct, eating disorders and others.…”

Epidemiologija problema mentalnog zdravlja u mladih s područja Osijeka, korištenjem upitnika snaga i teškoća (SDQ)

“…Results from different subscales demonstrated that girls are more often affected by emotional problems, as well that they are better in social skills which is similar to other studies. On the other side, boys are more prone to peer relationship problems and have more conduct problems and that is also already recognized in the literature [4,[21][22][23]. In our study we found girls to have more hyperactivity/inattention problems, which is opposite to findings from other studies [21,23].…”

Mental Health and Behavioral Screening in Pediatric Type 1 Diabetes

“…Normative data available from the SDQ in the United States are limited to parent-reported SDQs, whereas the SDQs in this study were patient-reported. However, previous studies have shown relatively high parent-child agreement on SDQ measures, and the comparison between parent-and patient-reported SDQ measures was felt to be appropriate (20)(21)(22). Insufficient power due to small sample size likely limited our ability to detect differences in scores and detect relationships between SDQ scores and patient characteristics such as duration of disease.…”