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

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, infor...

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Bibliographic Details
Published in:PloS one Vol. 14; no. 6; p. e0218518
Main Authors: Hall, Charlotte L., Guo, Boliang, Valentine, Althea Z., Groom, Madeline J., Daley, David, Sayal, Kapil, Hollis, Chris
Format: Journal Article
Language:English
Published: United States Public Library of Science 19.06.2019
Public Library of Science (PLoS)
Subjects:
Adolescent
Algorithms
Analysis
Attention Deficit Disorder with Hyperactivity - diagnosis
Attention deficit hyperactivity disorder
Biology and Life Sciences
Child
Child & adolescent mental health
Childhood mental disorders
Children
Children & youth
Clinical trials
Diagnostic Self Evaluation
Diagnostic systems
Female
Health
Health problems
Humans
Hyperactivity
Impulsive behavior
Informers
Invariance
Male
Medical diagnosis
Medical research
Medicine
Medicine and Health Sciences
Mental disorders
Mental health
Parents
People and Places
Population
Psychiatry
Quantitative psychology
Questionnaires
Ratings
Research and Analysis Methods
Signs and symptoms
Social Sciences
Studies
Surveys and Questionnaires - standards
Teachers
Validity
United Kingdom > UK
ISSN:1932-6203, 1932-6203
Online Access:Get full text
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Summary: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. 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. 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. 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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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0218518