Comparing Three Short Questionnaires to Detect Psychosocial Dysfunction Among Primary School Children: a Randomized Method

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2009 Dec 29

PMID 20035636

Citations 22

Authors

Antonius G C Vogels

Matty R Crone

Femke Hoekstra

Sijmen A Reijneveld

Affiliations

Soon will be listed here.

Abstract

Background: Good questionnaires are essential to support the early identification of children with psychosocial dysfunction in community based settings. Our aim was to assess which of three short questionnaires was most suitable for this identification among school-aged children

Methods: A community-based sample of 2,066 parents of children aged 7-12 years (85% of those eligible) filled out the Child Behavior Checklist (CBCL) and - randomly determined - one of three questionnaires to be compared: the Strengths and Difficulties Questionnaire with Impact Supplement (SDQ), the Pediatric Symptom Checklist (PSC) and the PSYBOBA, a Dutch-origin questionnaire. Preventive Child Healthcare professionals assessed children's psychosocial functioning during routine health examinations. We assessed the scale structure (by means of Structural Equation Modelling), validity (correlation coefficients, sensitivity and specificity) and usability (ratings by parents and professionals) of each questionnaire and the degree to which they could improve the identification based only on clinical assessment (logistic regression).

Results: For the three questionnaires, Cronbach's alphas varied between 0.80 and 0.89. Sensitivities for a clinical CBCL at a cut off point with specificity = 0.90 varied between 0.78 and 0.86 for the three questionnaires. Areas under the Receiver Operating Curve, using the CBCL as criterion, varied between 0.93 and 0.96. No differences were statistically significant. All three questionnaires added information to the clinical assessment. Odds ratios (95% confidence intervals) for added information were PSC: 29.3 (14.4-59.8), SDQ: 55.0 (23.1-131.2) and PSYBOBA: 68.5 (28.3-165.6). Parents preferred the SDQ and PSYBOBA. Preventive Child Health Care professionals preferred the SDQ.

Conclusions: This randomized comparison of three questionnaires shows that each of the three questionnaires can improve the detection of psychosocial dysfunction among children substantially.

Citing Articles

A study on the applicability of the Strengths and Difficulties Questionnaire among low- and higher-educated adolescents.

Theunissen M, de Wolff M, Eekhout I, van Vulpen C, Reijneveld S Front Psychol. 2024; 15:1289158.

PMID: 38375115 PMC: 10875965. DOI: 10.3389/fpsyg.2024.1289158.

Computerized adaptive testing to screen pre-school children for emotional and behavioral problems.

Theunissen M, Eekhout I, Reijneveld S Eur J Pediatr. 2024; 183(4):1777-1787.

PMID: 38252308 DOI: 10.1007/s00431-023-05414-1.

Relationship between cognitive ability and emotional problems in the context of poverty: a Nigerian adolescent twin study.

Hur Y Eur Child Adolesc Psychiatry. 2023; 33(4):1103-1111.

PMID: 37237243 DOI: 10.1007/s00787-023-02230-8.

Supporting Adolescents with Mental Health Problems in Secondary Education: Feasibility of a Supported Education Intervention.

Beukema L, Hofstra J, Reijneveld S, de Winter A, Korevaar E Int J Environ Res Public Health. 2022; 19(11).

PMID: 35682337 PMC: 9180216. DOI: 10.3390/ijerph19116754.

Investigating the use of support in secondary school: the role of self-reliance and stigma towards help-seeking.

Beukema L, de Winter A, Korevaar E, Hofstra J, Reijneveld S J Ment Health. 2022; 33(2):227-235.

PMID: 35502838 PMC: 11147454. DOI: 10.1080/09638237.2022.2069720.

References

Kelleher K, McInerny T, Gardner W, Childs G, Wasserman R . Increasing identification of psychosocial problems: 1979-1996. Pediatrics. 2000; 105(6):1313-21. DOI: 10.1542/peds.105.6.1313. View

Jellinek M, Evans N, Knight R . Use of a behavior checklist on a pediatric inpatient unit. J Pediatr. 1979; 94(1):156-8. DOI: 10.1016/s0022-3476(79)80386-8. View

Jellinek M, Murphy J, Burns B . Brief psychosocial screening in outpatient pediatric practice. J Pediatr. 1986; 109(2):371-8. DOI: 10.1016/s0022-3476(86)80408-5. View

Brugman E, Reijneveld S, Verhulst F, Verloove-Vanhorick S . Identification and management of psychosocial problems by preventive child health care. Arch Pediatr Adolesc Med. 2001; 155(4):462-9. DOI: 10.1001/archpedi.155.4.462. View

Klasen H, Woerner W, Rothenberger A, Goodman R . [German version of the Strength and Difficulties Questionnaire (SDQ-German)--overview and evaluation of initial validation and normative results]. Prax Kinderpsychol Kinderpsychiatr. 2003; 52(7):491-502. View

Vogels T, Reijneveld S, Brugman E, den Hollander-Gijsman M, Verhulst F, Verloove-Vanhorick S . Detecting psychosocial problems among 5-6-year-old children in preventive Child Health Care: the validity of a short questionnaire used in an assessment procedure for detecting psychosocial problems among children. Eur J Public Health. 2004; 13(4):353-60. DOI: 10.1093/eurpub/13.4.353. View

Verhulst F, van der Ende J . Factors associated with child mental health service use in the community. J Am Acad Child Adolesc Psychiatry. 1997; 36(7):901-9. DOI: 10.1097/00004583-199707000-00011. View

Wildman B, Kinsman A, Logue E, Dickey D, Smucker W . Presentation and management of childhood psychosocial problems. J Fam Pract. 1997; 44(1):77-84. View

Mullick M, Goodman R . Questionnaire screening for mental health problems in Bangladeshi children: a preliminary study. Soc Psychiatry Psychiatr Epidemiol. 2001; 36(2):94-9. DOI: 10.1007/s001270050295. View

10.

Goodman R, Renfrew D, Mullick M . Predicting type of psychiatric disorder from Strengths and Difficulties Questionnaire (SDQ) scores in child mental health clinics in London and Dhaka. Eur Child Adolesc Psychiatry. 2000; 9(2):129-34. DOI: 10.1007/s007870050008. View

11.

Jutte D, Burgos A, Mendoza F, Blasey Ford C, Huffman L . Use of the Pediatric Symptom Checklist in a low-income, Mexican American population. Arch Pediatr Adolesc Med. 2003; 157(12):1169-76. DOI: 10.1001/archpedi.157.12.1169. View

12.

Jellinek M, Murphy J . Screening for psychosocial disorders in pediatric practice. Am J Dis Child. 1988; 142(11):1153-7. DOI: 10.1001/archpedi.1988.02150110031013. View

13.

Reijneveld S, Vogels A, Hoekstra F, Crone M . Use of the Pediatric Symptom Checklist for the detection of psychosocial problems in preventive child healthcare. BMC Public Health. 2006; 6:197. PMC: 1550396. DOI: 10.1186/1471-2458-6-197. View

14.

Malmberg M, Rydell A, Smedje H . Validity of the Swedish version of the Strengths and Difficulties Questionnaire (SDQ-Swe). Nord J Psychiatry. 2003; 57(5):357-63. DOI: 10.1080/08039480310002697. View

15.

Verhulst F, Koot H, van der Ende J . Differential predictive value of parents' and teachers' reports of children's problem behaviors: a longitudinal study. J Abnorm Child Psychol. 1994; 22(5):531-46. DOI: 10.1007/BF02168936. View

16.

Bengi-Arslan L, Verhulst F, Crijnen A . Prevalence and determinants of minor psychiatric disorder in Turkish immigrants living in The Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2002; 37(3):118-24. DOI: 10.1007/s001270200003. View

17.

Reijneveld S, Vogels A, Brugman E, van Ede J, Verhulst F, Verloove-Vanhorick S . Early detection of psychosocial problems in adolescents: how useful is the Dutch short indicative questionnaire (KIVPA)?. Eur J Public Health. 2003; 13(2):152-9. DOI: 10.1093/eurpub/13.2.152. View

18.

Muris P, Meesters C, van den Berg F . The Strengths and Difficulties Questionnaire (SDQ)--further evidence for its reliability and validity in a community sample of Dutch children and adolescents. Eur Child Adolesc Psychiatry. 2003; 12(1):1-8. DOI: 10.1007/s00787-003-0298-2. View

19.

Jellinek M, Murphy J, Little M, Pagano M, Comer D, Kelleher K . Use of the Pediatric Symptom Checklist to screen for psychosocial problems in pediatric primary care: a national feasibility study. Arch Pediatr Adolesc Med. 1999; 153(3):254-60. PMC: 3905751. DOI: 10.1001/archpedi.153.3.254. View

20.

Crone M, Vogels A, Hoekstra F, Treffers P, Reijneveld S . A comparison of four scoring methods based on the parent-rated Strengths and Difficulties Questionnaire as used in the Dutch preventive child health care system. BMC Public Health. 2008; 8:106. PMC: 2359742. DOI: 10.1186/1471-2458-8-106. View