Assessment of Behavioral and Emotional Problems in Children

The SDQ is, as mentioned, a brief screening instrument for behavioral and emotional problems in children and adolescents. The SDQ items were initially selected on the basis of relevant concepts as well as factor analysis [32 (link)]. A parent and a teacher form of the SDQ are available for children aged 3–16 years, and a youth report form is available for the age span 11–16 years. The SDQ symptom scales contain 25 items divided into five subscales, namely Emotional Symptoms, Conduct Problems, Hyperactivity-Inattention, Peer Problems, and Prosocial Behavior. A 3-point Likert-type scale is employed to indicate how each attribute applies to the target child (0 = not true, 1 = somewhat true, 2 = certainly true). Some of the items are reversed. A high score on the Prosocial Behavior subscale reflects strength, while high scores on the other four SDQ subscales reflect difficulties. All subscales but Prosocial Behaviors are also summed together to generate the Total Difficulties score. The SDQ also includes an impact scale to score to what extent the child has a problem with emotions, concentration, or with how to get on with other people. The SDQ also contains four questions about chronicity, distress, social impairment, and possible burden to others. The scoring algorithms allow the subscale scores to be prorated if at least three of the five subscale items are complete (http://www.sdqinfo.org). Factor analytic studies have shown mixed results across countries. The five psychological dimensions of the SDQ have been confirmed in studies, among others in Sweden [21 (link)], UK [32 (link)], and Germany [33 (link)]. Exploratory factor analysis of the US NHIS data, has however found that the best-fitting factor solution involved only three dimensions. Those were externalizing, internalizing, and a prosocial dimension [22 (link)].
The Disruptive Behavior Disorders (DBD) rating scale [7 (link)] can be responded to by parents or teachers. The DBD covers the DSM-IV-based symptoms [34 ] for all three disruptive behavior disorders: Attention Deficit/Hyperactivity Disorder (ADHD: 18 items), Oppositional Defiant Disorder (ODD: 8 items) and Conduct Disorder (CD: 15 items). Each item is rated on a 4-point Likert-type scale (0 = not at all, 1 = just a little, 2 = pretty much, and 3 = very much). The DBD rating scale includes 45 items. After the revision of the DSM-III-R to DSM-IV [34 ,35 ], three items are no longer coded in the scoring (item 10, 14 and 21). Item 5 (Often initiates physical fights with other members of his or her household) does not correspond to any criteria in either the DSM-III-R or the DSM-IV, and is not coded. The responses on the DBD can be summarized using “symptom count” or “composite scores”. For the present study, composite scores were calculated by adding the items within each subscale [7 (link)]. The internal consistency (polychoric ordinal alpha: Please see Statistical analysis) of the subscales of the DBD varied between .97 and .99. When the internal consistency was calculated for boys versus girls, mothers versus fathers or the Internet versus paper-and-pencil, very small differences emerged, and the range was still within the upper limits (.94 to .99).