The predictive validity of the Strengths and Difficulties Questionnaire for child attention-deficit/hyperactivity disorder

Abstract

We need accurate screening measures for attention-deficit/hyperactivity disorder (ADHD) to ensure that children with the disorder are referred for assessment without raising concern for children with normal behaviour. The Strengths and Difficulties Questionnaire (SDQ) provides hyperactivity-inattention (HI), conduct, emotional and peer problem subscales and impact scores that may be used for screening. The aim of the study was to investigate the predictive validity of the Danish version of the parent SDQ HI subscale at the child age of 7 years for subsequent clinically diagnosed ADHD (age 8-15 years). Participants were part of the Danish National Birth Cohort (N = 51,096), and children with ADHD were identified through the Danish National Health registries (n = 943). Receiver operating characteristic analysis showed that the screening accuracy for the HI scores was good (area under the curve = .84). With Cox multivariate regression analysis, we found that SDQ HI subscale scores ≥ 7 with impact gave a nearly 14-fold [hazard ratio (HR) = 13.59] increased risk for ADHD, while conduct and emotional problems indicated low risk (HRs of 1.62 and 1.67, respectively). For the HI subscale to be a sensitive measure for ADHD, a low cutoff (4) was needed, but gave many false screening positives (PPV = .02). Although the diagnostic accuracy of the parent version of the SDQ HI subscale for predicting ADHD was good, our results question the feasibility of screening the general child population for ADHD with only the parent SDQ HI subscale.

Elevated Gestational IL-13 During Fetal Development Is Associated With Hyperactivity and Inattention in Eight-Year-Old Children

“…Five subscores were defined based on five out of the 25 items and corresponded to the following behavioral categories; “hyperactivity/inattention,” “emotional symptoms,” “conduct problems,” “peer relationship problems,” and “prosocial behavior” as developed by Goodman et al (31). The hyperactivity/inattention subscale is a valid predictor of clinically diagnosed ADHD (32) and is composed of five items (“Restless, overactive, cannot stay still for long”; “Constantly fidgeting or squirming”; “Easily distracted, concentration wanders”; “Thinks things out before acting”; and “Sees tasks through to the end, good attention span”) addressing the three core symptoms of ADHD diagnosis criteria according to the Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition (DSM-IV—American Psychiatric Association, 1994), namely inattention and hyperactivity/impulsiveness behavior (26).…”

Early Life Exposure to Perfluoroalkyl Substances (PFAS) and ADHD: A Meta-Analysis of Nine European Population-Based Studies

“…The SDQ-hyperactivity/Inattention questionnaire is composed of five items (total scores obtainable ranges: 0-10). A score ≥7 points was used to classify children with abnormal hyperactivity/inattention (Goodman 1997) and suspected ADHD (Overgaard et al 2019). Finally, the ADHD-DSM-IV questionnaire consists of 18 symptoms categorized into two separate groups: inattention (9 symptoms) and hyperactivity/ impulsivity (9 symptoms).…”

Prenatal maternal infections and children's socioemotional outcomes

“…Studies have further shown that the SDQ has good predictive validity, for diagnoses of ADHD [29,30] and other mental disorders [22,23,31]. The pre-school version of the scale, which we use in the current study, has previously been validated in the MCS [21].…”