Comparing the German versions of the Strengths and Difficulties Questionnaire (SDQ-Deu) and the Child Behavior Checklist

 The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioural screening questionnaire that can be completed in about 5 minutes by the parents and teachers of 4–16 year olds. The scores of the English version correlate well with those of the considerably longer Child Behavior Checklist (CBCL). The present study compares the German versions of the questionnaires. Both SDQ and CBCL were completed by the parents of 273 children drawn from psychiatric clinics (N = 163) and from a community sample (N = 110). The children from the community sample also filled in the SDQ self-report and the Youth Self Report (YSR). The children from the clinic sample received an ICD-10 diagnosis if applicable. Scores from the parent and self-rated SDQ and CBCL/YSR were highly correlated and equally able to distinguish between the community and clinic samples, with the SDQ showing significantly better results regarding the total scores. They were also equally able to distinguish between disorders within the clinic sample, the only significant difference being that the SDQ was better able to differentiate between children with and without hyperactivity-inattention. The study shows that like the English originals, the SDQ-Deu and the German CBCL are equally valid for most clinical and research purposes. Accepted: 22 February 2000     

German version of the Strength and Difficulties Questionnaire (SDQ-German)--overview and evaluation of initial validation and normative results

The Strengths and Difficulties Questionnaire (SDQ) is a short behavioural screening questionnaire which can be completed in about five minutes by parents and teachers of 4- to 16-year-olds or as self-report by 11- to 16-year-olds. The English original has already been fully evaluated and is widely used in research and clinical practice. The instrument was translated into German in 1997, and several evaluative studies have since been completed. The present paper gives an overview of this novel instrument and summarizes the normative and validation studies to date. A normative study on a field sample of 930 children demonstrated that the distributions of raw scores in the German parent SDQ closely resemble those found in the English version, while a factor analysis of the German data yielded a pattern of loadings which convincingly replicated the original scale structure. Initial validation studies showed that the parent-, teacher-, and self-completed SDQ-Deu correlates well with the considerably longer German versions of the Child Behavior Checklist (CBCL) and respective teacher and self-report derivatives (TRF, YSR). Both parent-rated instruments are equally able to distinguish between a community and a clinic sample, and between subgroups with and without specified categories of disorders within a clinic sample. After discussing possible uses of the SDQ-Deu as well as similarities and differences to other scales, we conclude that the German SDQ is just as useful and valid an instrument for many clinical and research purposes as the English original.     

Screening for psychopathology in child welfare: the Strengths and Difficulties Questionnaire (SDQ) compared with the Achenbach System of Empirically Based Assessment (ASEBA)

Whilst children in child welfare suffer more psychopathology than their community peers, only a small percentage of them actually receive mental health care. Previous literature suggested that all children entering child welfare should be screened. This study evaluated whether the Strengths and Difficulties Questionnaire (SDQ) could be used for this purpose. The extended version of the SDQ and the Achenbach System of Empirically Based Assessment (ASEBA) questionnaire were administered to parents and caregivers of 292 children in child welfare. Children older than 11 years also completed the SDQ self-report and the Youth Self Report (YSR). Furthermore, the child’s history of service use was recorded and informants were asked if the actual care was sufficient. Inter-informant correlations for the scores from the SDQ and ASEBA were high and comparable or favoured the use of the SDQ (for parents and caregivers). Internal consistency was satisfactory to good. For all informants, high correlations were found between SDQ and ASEBA. Despite high scores on the SDQ, only 29% of the children had received mental health care. Service use was only correlated with the parent SDQ and the CBCL and TRF. Additional help, as requested by 21% of the parents and 37% of the caregivers, correlated moderately with the SDQ and ASEBA scores. Compared to the total difficulties score, the impact supplement is a better predictor of service use and the informant’s request for additional help. This study illustrates that the Dutch version of the SDQ, similar to the English and German versions, has equal validity as the Dutch ASEBA for screening children. Caution is warranted when the SDQ is the only source of information for referrals to specialized care.     

Psychometric properties of the strengths and difficulties questionnaire.

OBJECTIVE: To describe the psychometric properties of the Strengths and Difficulties Questionnaire (SDQ), a brief measure of the prosocial behavior and psychopathology of 3-16-year-olds that can be completed by parents, teachers, or youths. METHOD: A nationwide epidemiological sample of 10,438 British 5-15-year-olds obtained SDQs from 96% of parents, 70% of teachers, and 91% of 11-15-year-olds. Blind to the SDQ findings, all subjects were also assigned DSM-IVdiagnoses based on a clinical review of detailed interview measures. RESULTS: The predicted five-factor structure (emotional, conduct, hyperactivity-inattention, peer, prosocial) was confirmed. Internalizing and externalizing scales were relatively "uncontaminated" by one another. Reliability was generally satisfactory, whether judged by internal consistency (mean Cronbach a: .73), cross-informant correlation (mean: 0.34), or retest stability after 4 to 6 months (mean: 0.62). SDQ scores above the 90th percentile predicted a 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). CONCLUSION: The reliability and validity of the SDQ make it a useful brief measure of the adjustment and psychopathology of children and adolescents.     

Prognostic value of parent–adolescent disagreement in a referred sample

Objective To investigate whether parent–adolescent disagreement regarding reports on adolescents’ psychopathology indicates a poor prognosis. Methods A total of 151 11- to 18-year-olds who had been assessed with the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) at referral to an outpatient psychiatry clinic were followed up. At follow-up, 4.3 years later, signs of poor outcome were assessed. Findings Discrepancies between CBCL and YSR scores predicted future disciplinary problems at school, police/judicial contacts, and drug use. Conclusions To determine the prognosis of psychopathology in adolescents who are referred to mental health services, discrepancies between parents and adolescents may be useful. Given the relatively large number of statistical comparisons (n=16) that was needed to obtain these results, future studies are needed to test if the results are robust across different settings.     

Agreement between youth-reported and parent-reported psychopathology in a referred sample

Objective  The study examined parent-youth agreement regarding reports on psychopathology among adolescents suffering from psychiatric disorders. Method  A total of 1,718 patients between the age of 11 and 18, as well as their parents, were assessed using the child behavior checklist (CBCL), and the youth self-report (YSR). Results  Poor to low agreement between parent- and adolescent-reported problem behavior on the internalizing scale, the total problem scale and moderate agreement concerning the externalizing scale of the CBCL and the YSR were found. Independent from the amount of psychiatric diagnoses, adolescents reported significantly less behavioral problems than their parents. Concerning externalizing problems, parent-youth disagreement was stronger for patients suffering from comorbid psychiatric disorders, than for adolescents displaying only one psychiatric disorder. Conclusion  In clinically referred children, parents are likely to emphasize the severity of the difficulties, whereas adolescents’ under-report symptoms.     

Denial of symptoms and psychopathology in adolescent anorexia nervosa

OBJECTIVE: To evaluate the psychopathological status and denial of symptoms in a sample of 38 consecutively admitted adolescents with anorexia nervosa (AN). METHOD: The Schedule for Affective Disorders and Schizophrenia for School-Aged Children was used to determine the categorical diagnosis of eating disorder. The anorexic adolescents completed the EAT-40 (Eating Attitude Test) and, on the basis of its score, the sample was dichotomized in a false-negative group (FNG) scoring under 30 and a positive group (PG) scoring over 30. We compared these two subgroups in terms of clinical variables (age of onset and admission, duration of illness prior to admission, diagnosis, BMI) and psychopathology assessed by the CBCL (Child Behaviour Checklist) and the YSR (Youth Self-Report). In order to evaluate the possible role of diagnosis and BMI on the EAT score we also dichotomized the sample with respect to the diagnosis (full vs. partial AN) and to the mean female BMI (< or = 15 vs. > 15). RESULTS: A significant difference was found in terms of duration of illness prior to admission, which was briefer in the FNG. Higher CBCL and YSR values were found in the PG with significant differences in terms of YSR internalizing symptoms. A large amount of significantly positive Pearson's correlations were found between the CBCL and YSR values in the FNG. No significant Pearson's correlations were found between EAT, BMI and diagnosis. CONCLUSIONS: The lower CBCL and YSR values in the FNG seem to point out a tendency of this group to deny anxiety and depression as well as an eating pathology; the longer duration of illness prior to admission in the PG seems to support the hypothesis that the PG may be considered to be not so much more disturbed as more aware of its eating attitudes and psychopathology. The nature of denial in anorexic adolescents is discussed.     

The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version

The self-report version of the Strengths and Difficulties Questionnaire (SDQ) was administered to two samples of 11-16 year olds: 83 young people in the community and 116 young people attending a mental health clinic. The questionnaire discriminated satisfactorily between the two samples. For example, the clinic mean for the total difficulties score was 1.4 standard deviations above the community mean, with clinic cases being over six times more likely to have a score in the abnormal range. The correlations between self-report SDQ scores and teacher--or parent rated SDQ scores--compared favourably with the average cross informant correlations in previous studies of a range of measures. The self-report SDQ appears promising and warrants further evaluation.     

The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version

The self-report version of the Strengths and Difficulties Questionnaire (SDQ) was administered to two samples of 11-16 year olds: 83 young people in the community and 116 young people attending a mental health clinic. The questionnaire discriminated satisfactorily between the two samples. For example, the clinic mean for the total difficulties score was 1.4 standard deviations above the community mean, with clinic cases being over six times more likely to have a score in the abnormal range. The correlations between self-report SDQ scores and teacher--or parent rated SDQ scores--compared favourably with the average cross informant correlations in previous studies of a range of measures. The self-report SDQ appears promising and warrants further evaluation.     

The German version of the "Screen for Child Anxiety Related Emotional Disorders" (SCARED): parent- and self report in a clinical sample

The psychometric properties and cross-informant agreement of the German version of the "Screen for Child Anxiety Related Emotional Disorders" (SCARED) were assessed in a clinical sample. 77 children and adolescents aged 11 to 18 years in outpatient psychotherapy and 66 parents filled out the SCARED and Youth Self Report (YSR) or Child Behavior Checklist (CBCL), respectively. In n = 57 cases both parent and self-report was available. The German SCARED is shown to have good convergent and divergent validity compared with YSR/CBCL scales. The total score discriminated between children with an anxiety disorder and children with another psychiatric disorder. Cross-informant agreement was moderate with children reporting more and more severe anxiety symptoms than their parents. In conclusion, both the parent and the child version of the German SCARED proved valid. In clinical settings the integration of data from both perspectives seems important.