The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms.

<h4>Background</h4>The Strengths and Difficulties Questionnaire (SDQ) is widely used to assess child and adolescent mental health problems. However, the factor structure of the SDQ is subject to debate and there is limited evidence investigating measurement equivalence invariance (ME/I)...

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Main Authors: Charlotte L Hall, Boliang Guo, Althea Z Valentine, Madeline J Groom, David Daley, Kapil Sayal, Chris Hollis
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0218518
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author Charlotte L Hall
Boliang Guo
Althea Z Valentine
Madeline J Groom
David Daley
Kapil Sayal
Chris Hollis
author_facet Charlotte L Hall
Boliang Guo
Althea Z Valentine
Madeline J Groom
David Daley
Kapil Sayal
Chris Hollis
author_sort Charlotte L Hall
collection DOAJ
description <h4>Background</h4>The Strengths and Difficulties Questionnaire (SDQ) is widely used to assess child and adolescent mental health problems. However, the factor structure of the SDQ is subject to debate and there is limited evidence investigating measurement equivalence invariance (ME/I) between treatment groups, informants, and across time.<h4>Method</h4>A randomised controlled trial (RCT) recruited 250 participants (6-17 years) who had been referred for an attention deficit hyperactivity disorder (ADHD) assessment. Participants and their clinician either received or did not receive a QbTest report (computer task measuring attention, impulsivity and activity). Parents and teachers completed the SDQ at baseline and 6-months later. This study aimed to understand the factor structure of the SDQ in a clinic referred ADHD sample, and validate the scale as a screening/diagnostic aide and as a measure of treatment outcome both in clinical and research settings. Exploratory Structural Equation Modelling (ESEM) was performed to examine the factor structure, and ME/I was assessed between treatment groups, informants, and time points. The criterion validity of the SDQ predictive algorithm for ADHD was compared with clinician and research diagnoses using logistic regression and tests of diagnostic accuracy.<h4>Results</h4>A 5-factor structure provided the best fit with strong factorial invariance between treatment groups and across time points, but not across informants (parent and teacher ratings). SDQ ratings of 'probable' hyperactivity disorder were good predictors of clinical (OR = 10.20, 95%CI 2.18-48.71,p = 0.003) and research diagnoses of ADHD (OR = 6.82, 95%CI 1.95-23.84,p = 0.003), and research diagnoses of Hyperkinetic disorder (OR = 4.02, 95%CI 1.13-14.25,p = 0.031). Further examination of the SDQ hyperactivity 'probable' rating showed good specificity (84.5%-74.5%) but poor sensitivity (45.0-42.5%) for ADHD.<h4>Conclusion</h4>The findings indicate the SDQ is a valid outcome measure for use in RCTs and clinical settings. However, care should be taken when using the SDQ predictive algorithm to screen for ADHD in clinically referred samples.
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spelling doaj.art-325c191e09944fd39e7f5ecf6cc8c51f2022-12-21T19:13:36ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01146e021851810.1371/journal.pone.0218518The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms.Charlotte L HallBoliang GuoAlthea Z ValentineMadeline J GroomDavid DaleyKapil SayalChris Hollis<h4>Background</h4>The Strengths and Difficulties Questionnaire (SDQ) is widely used to assess child and adolescent mental health problems. However, the factor structure of the SDQ is subject to debate and there is limited evidence investigating measurement equivalence invariance (ME/I) between treatment groups, informants, and across time.<h4>Method</h4>A randomised controlled trial (RCT) recruited 250 participants (6-17 years) who had been referred for an attention deficit hyperactivity disorder (ADHD) assessment. Participants and their clinician either received or did not receive a QbTest report (computer task measuring attention, impulsivity and activity). Parents and teachers completed the SDQ at baseline and 6-months later. This study aimed to understand the factor structure of the SDQ in a clinic referred ADHD sample, and validate the scale as a screening/diagnostic aide and as a measure of treatment outcome both in clinical and research settings. Exploratory Structural Equation Modelling (ESEM) was performed to examine the factor structure, and ME/I was assessed between treatment groups, informants, and time points. The criterion validity of the SDQ predictive algorithm for ADHD was compared with clinician and research diagnoses using logistic regression and tests of diagnostic accuracy.<h4>Results</h4>A 5-factor structure provided the best fit with strong factorial invariance between treatment groups and across time points, but not across informants (parent and teacher ratings). SDQ ratings of 'probable' hyperactivity disorder were good predictors of clinical (OR = 10.20, 95%CI 2.18-48.71,p = 0.003) and research diagnoses of ADHD (OR = 6.82, 95%CI 1.95-23.84,p = 0.003), and research diagnoses of Hyperkinetic disorder (OR = 4.02, 95%CI 1.13-14.25,p = 0.031). Further examination of the SDQ hyperactivity 'probable' rating showed good specificity (84.5%-74.5%) but poor sensitivity (45.0-42.5%) for ADHD.<h4>Conclusion</h4>The findings indicate the SDQ is a valid outcome measure for use in RCTs and clinical settings. However, care should be taken when using the SDQ predictive algorithm to screen for ADHD in clinically referred samples.https://doi.org/10.1371/journal.pone.0218518
spellingShingle Charlotte L Hall
Boliang Guo
Althea Z Valentine
Madeline J Groom
David Daley
Kapil Sayal
Chris Hollis
The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms.
PLoS ONE
title The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms.
title_full The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms.
title_fullStr The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms.
title_full_unstemmed The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms.
title_short The validity of the Strengths and Difficulties Questionnaire (SDQ) for children with ADHD symptoms.
title_sort validity of the strengths and difficulties questionnaire sdq for children with adhd symptoms
url https://doi.org/10.1371/journal.pone.0218518
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