Construct validity of the five-factor Strengths and Difficulties Questionnaire (SDQ) in pre-, early, and late adolescence

Disrupted inter-brain synchronization in the prefrontal cortex between adolescents and young adults with gaming disorders during the real-world cooperating video games

BACKGROUND

Gaming disorder (GD) and hazardous gaming (HG) have a high incidence among adolescents and young adults and have caused various negative consequences. Interpersonal interaction deficits are closely related to GD and HG, however, the underlying brain mechanisms are still unclear.

METHODS

The current study recruited 46 healthy subjects and 32 subjects with GD/HG. Gaming time and frequency, gaming disorder risks, life events, strengths, and difficulties were measured with scales. Subjects were randomly paired into 12 HC-HC dyads, 15 GD/HG-HC dyads, and 7 GD/HG-GD/HG dyads and in pairs completed a real-world cooperating video game - "Tied Together" with functional near-infrared spectroscopy hyperscanning recording in the prefrontal cortex. The inter-brain synchronization in each region of the PFC between dyads was calculated by wavelet to transform coherence to measure brain-to-brain synchronization.

RESULTS

We found subjects with GD/HG reported higher risks of gaming. The highest IBS in the left dorsolateral prefrontal cortex significantly decreased in the GD/HG-HC and GD/HG-GD/HG dyads compared with healthy controls. A decreasing highest IBS of the left dlPFC was related to a decreasing level of peer problems.

LIMITATIONS

We declare limitations of age gaps of samples, undistinguishing GD from HG, use of sub-samples, and the broad concept of interpersonal interaction.

CONCLUSIONS

The current study found a decreased highest IBS in the left dlPFC among adolescents and young adults with gaming diseases. It may provide new prevention and treatment insights into gaming disorders targeting disrupted interpersonal interaction.

Poverty trajectories and child and mother well-being outcomes in Ireland: findings from an Irish prospective cohort

BACKGROUND

Poverty is associated with poor outcomes, yet exposure to distinct poverty trajectories in early childhood is not well understood.

OBJECTIVE

To understand the prevalence of different trajectories of household poverty and their association with mid-childhood and mother indicators of physical health and psychopathology in Ireland.

METHODS

We used a nationally representative, prospective cohort (Growing Up in Ireland-Infant Cohort). Household poverty included lowest third income decile, subjective poverty and material deprivation when children were aged 9 months, and 3, 5, 9 years. We used group-based multitrajectory cluster modelling to classify trajectories of poverty. Using multivariable logistic regression, adjusted with separate child and mother confounders, we assessed the association of poverty trajectories from 9 months to 9 years with child outcomes (overweight, any longstanding illness and psychopathology) at age 9 years and the same poverty trajectories over the same 9-year period with mother outcomes (overweight, any longstanding illness and depression).

RESULTS

Of 11 134 participants, 4 trajectories were identified: never in poverty (43.1%), material/subjective>monetary poverty (16.1%), monetary>material poverty (25.6%) and persistent poverty (15.2%). Children in persistent poverty compared with those in never in poverty experienced higher odds of being overweight at 9 years (adjusted OR (aOR) 1.70, 95% CI 1.34, 2.16), having a longstanding illness (aOR 1.51, 95% CI 1.20, 1.91), and psychopathology (aOR 2.06, 95% CI 1.42, 2.99). The outcomes for primary parents (99.7% were mothers) were as follows: having higher odds of being overweight (aOR 1.49, 95% CI 1.16, 1.92), having a longstanding illness (aOR 2.13, 95% CI 1.63, 2.79), and depression (aOR 3.54, 95% CI 2.54, 4.94).

CONCLUSIONS

Any poverty trajectory was associated with poorer psychopathology and physical well-being in late childhood for children and their mothers in Ireland.

Evaluation of a community-based brief intervention service for youth in crisis with suicidal ideation or self-harm

AIM

To evaluate the implementation of a mixed virtual and in-person brief intervention for young people, aged 12-25 years, presenting to a large urban mental health service in crisis with suicidal ideation and/or self-harm.

METHODS

A pragmatic, real-world evaluation was conducted on the Youth Brief Intervention Service between June 2021 (inception) and October 2022. Service users were offered four sessions over an approximate one-month period. Sessions focused on distress tolerance, safety plans and support systems. Implementation outcomes related to service uptake, retention, fidelity of the model and service user experience. Effectiveness outcomes were measured pre-post and included mental health-related hospital service utilization (primary outcome), functioning, mental health status, self-harm, suicidal ideation and quality of life.

RESULTS

Of the 136 young people referred to the Youth Brief Intervention Service, 99 were accepted with 17 disengaging before the first session. Eighty percent of people who commenced, completed the package of care. Young persons' and parent/carers experience of service was high (97% and 88%, respectively). Mental health-related emergency department presentations and inpatient days decreased from 3 months pre-intake to 3 months post-intake (42 vs. 7 presentations, X2 = 25.3, p < .001; 11 vs. 0 inpatient days, X2 = 9.1, p = .01). There were significant improvements in mental health status, days engaging in self-harm, general health and functioning and quality of life.

CONCLUSIONS

The Youth Brief Intervention Service is feasible, acceptable, subjectively beneficial and coincided with less mental health-related emergency department presentations and inpatient days, and improved mental health status and behaviour.

Developmental trajectories of conduct problems and time-varying peer problems: the Bergen child study

BACKGROUND

While it is increasingly acknowledged that conduct problems and peer problems often co-occur in development, less is known about the ways in which peer problems may alter the developmental course of conduct problems for distinct subgroups.

METHODS

Using data from a large population-based study in Norway (the Bergen Child Study/youth@hordaland; 47.4% males), we estimated group-based trajectories of conduct problems and the presence of time-varying peer problems on the developmental progression of conduct problems between seven and 19 years of age. Risk factors for group membership were also examined.

RESULTS

A 3-group model of conduct problems best fit the data (non-engagers, low-engagers, moderate-stable). The presence of peer problems increased the estimated level of conduct problems for both the low-engagers and moderate-stable groups across adolescence. No differences in conduct problems were observed when peer problems were present in childhood or preadolescence for these two groups, nor for the non-engagers group at any point. Being male, having lower perceived economic wellbeing, and lower levels of parental education predicted group membership for the moderate-stable group, whilst lower paternal education predicted membership for the low-engagers group.

CONCLUSIONS

Support for developmental 'turning points' was found, suggesting that adolescence is a particularly salient time for those with conduct problems. In particular, the presence of peer problems can increase observed conduct problems at this stage in development.

Household energy poverty and trajectories of emotional and behavioural difficulties in children and adolescents: findings from two prospective cohort studies

PURPOSE

The aim of this study is to examine the association between household energy poverty (EP) and trajectories of emotional and behavioural difficulties during childhood.

METHODS

The Growing up in Ireland study is two nationally representative prospective cohorts of children. The Infant Cohort (n = 11,134) were recruited at age 9 months (9 m) and followed up at 3, 5, 7 and 9 years (y). The Child Cohort (n = 8,538) were recruited at age 9 y and followed up at 13 y and 17/18 y. EP was a composite of two relative measures of EP. Emotional and behavioural difficulties were repeatedly measured using the strengths and difficulties questionnaire (SDQ). Linear spline multilevel models were used, adjusted for confounders to examine the association between (1) EP (9 m or 3 y) and trajectories of emotional and behavioural difficulties from 3 to 9 y in the Infant Cohort and (2) EP at 9 y and the same trajectories from 9 to 18 y in the Child Cohort.

RESULTS

In adjusted analyses, EP at 9 m or 3 y of age was associated with higher total difficulties score at 3 y (0.66, 95% CI 0.41, 0.91) and 5 y (0.77, 95% CI 0.48, 1.05) but not at 7 y or 9 y. EP at 9 y was associated with higher total difficulties score at 9 y (1.73, 95% CI 1.28, 2.18), with this difference reducing over time leading to 0.68 (95% CI 0.19, 1.17) at 17/18 y.

CONCLUSIONS

Our study demonstrates a potential association between early life EP and emotional and behavioural difficulties that may be transient and attenuate over time during childhood. Further studies are required to replicate these findings and to better understand if these associations are causal.

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

Aim

The Strengths and Difficulties Questionnaire self-report (SDQ-SR) is a valid instrument for detection of emotional and behavioral problems. The aim of this study was to compare the psychometric properties of the SDQ-SR for low and higher educated adolescents, and to explore its suitability.

Methods

We included 426 adolescents. We compared internal consistency for low-educated, i.e., at maximum pre-vocational secondary education, and higher educated adolescents and assessed whether the five-factor structure of the SDQ holds across educational levels. We also interviewed 24 low-educated adolescents, and 17 professionals.

Results

On most SDQ subscales the low-educated adolescents had more problematic mean scores than the higher educated adolescents. Findings on the invariance factor analyses were inconsistent, with some measures showing a bad fit of the five factor model, and this occurring relatively more for the low-educated adolescents. Professionals and adolescents reported that the SDQ included difficult wordings.

Discussion

Our findings imply that the scale structure of the SDQ-SR is slightly poorer for low educated adolescents. Given this caveat, psychometric properties of the SDQ-SR are generally sufficient for use, regardless of educational level.

Prospective associations between adolescent risky substance use and school dropout and the role of externalising and internalising problems

Background: The aim of the present study was to assess to what extent risky substance use (RSU) acts as an important risk factor for school dropout from upper secondary school in a prospective study of Norwegian adolescents, and how externalising and internalising mental health problems influenced this association. Methods: We used data from a large population-based survey (the youth@hordaland-survey), which included adolescents aged 16-19 years. The predictor variables were self-reported RSU. The survey was linked with prospective data from the Norwegian Education Database, following the adolescents to 21-23 years of age. The outcome variable was registry-based school dropout within five years after starting upper secondary school. The analyses were adjusted for sex, age, socioeconomic status, and externalising and internalising problems. Results: After adjustment for sociodemographic variables, all indicators of RSU were prospectively associated with school dropout (adjusted odds ratios 1.26-2.25; all p values <.01). While internalising problems only slightly changed these estimates, the associations were substantially attenuated by externalising problems. Still, all measures of RSU, except frequent alcohol intoxication, remained positively associated with school dropout in the fully adjusted models. For the youngest students, all associations between RSU and school dropout were significant. Conclusions: Adolescent RSU is a strong predictor for school dropout, and externalising problems explained a considerable proportion of this effect. Prevention efforts to reduce student substance could improve academic outcomes among upper secondary school students, and such efforts may benefit from also targeting co-occurring externalising problems.

Mental health problems and suicidal behavior from adolescence to young adulthood in college: linking two population-based studies

It is well established that mental health problems are highly recurrent and persistent from childhood to adolescence, but less is known to what extent mental health problems also persist from adolescence into young adulthood. The aim of the current study was therefore to examine the chronicity and risk of mental health problems and suicidality from adolescence to young adulthood. Data stem from two Norwegian population-based studies conducted 6 years apart; the youth@hordaland study from 2012 (age 16-19) and the SHoT2018 study (age 22-25). These two data sources were linked to produce a longitudinal sample of 1257 individuals. A wide range of self-reported mental health and suicidality instruments (used both continuously and categorically) were analyzed using log-link binomial regression analysis, adjusting for age, sex, parental education, and financial problems. We found that high levels of mental health problems in late adolescence were a significant risk factor for reporting poor mental health 6 years later. Internalizing and externalizing problems in adolescence were associated with a 2.8-fold and 1.9-fold increased risk, respectively, of reporting a mental disorder 6 years later. Similarly, self-harm in adolescence was associated with a 2.1-fold increased risk of suicidal thoughts 6 years later. The magnitudes of the adjusted risk ratios were generally similar across the various mental health and suicidality measures used at the two assessment points. Adjustment for confounders did not, or only slightly, attenuate the risk ratios, and all associations remained statistically significant in the adjusted analyses. This longitudinal study provides new evidence of the chronicity of mental health problems and suicidality from adolescence to adulthood in Norway. The results emphasize the importance of early identification and timely interventions to reduce the prevalence and impact of mental health problems and suicidality.

Social experiences and youth psychopathology during the COVID-19 pandemic: A longitudinal study

The early stages of the COVID-19 pandemic and associated stay-at-home orders resulted in a stark reduction in daily social interactions for children and adolescents. Given that peer relationships are especially important during this developmental stage, it is crucial to understand the impact of the COVID-19 pandemic on social behavior and risk for psychopathology in children and adolescents. In a longitudinal sample (N=224) of children (7-10y) and adolescents (13-15y) assessed at three strategic time points (before the pandemic, during the initial stay-at-home order period, and six months later after the initial stay-at-home order period was lifted), we examine whether certain social factors protect against increases in stress-related psychopathology during the pandemic, controlling for pre-pandemic symptoms. Youth who reported less in-person and digital socialization, greater social isolation, and less social support had worsened psychopathology during the pandemic. Greater social isolation and decreased digital socialization during the pandemic were associated with greater risk for psychopathology after experiencing pandemic-related stressors. In addition, children, but not adolescents, who maintained some in-person socialization were less likely to develop internalizing symptoms following exposure to pandemic-related stressors. We identify social factors that promote well-being and resilience in youth during this societal event.

Secondary outcomes of enhanced cognitive behavioral therapy (eCBT) for children and adolescents with obsessive-compulsive disorder

Background

Obsessive-compulsive disorder (OCD) is a debilitating mental health condition usually presenting with a high degree of comorbid symptoms in the majority of cases. Although face-to-face cognitive-behavioral therapy (CBT) is considered the therapeutic golden standard for pediatric OCD, its accessibility, availability, and consistency in delivery are still limited. To address some of these challenges, an enhanced CBT (eCBT) package was created and introduced. This study explored eCBT's broad-based impact on OCD-related comorbid symptoms, functional impairment, quality of life and family accommodation among youth with OCD.

Methods

This open trial involved 25 pediatric patients with OCD (7-17 years), assessed between January 2018 to February 2020. All patients received eCBT for 14 weeks. Secondary outcomes were assessed at baseline, post-treatment, and 3-, 6-, and 12-month follow-up co-occurring symptoms were evaluated using the Strengths and Difficulties Questionnaire (SDQ), Screen for Child Anxiety-Related Emotional Disorders (SCARED), and Mood and Feelings Questionnaire (MFQ). Quality of life was measured using the KINDL-R, functional impairment through the Child Obsessive-Compulsive Impact Scale Revised (COIS-R), and family accommodation by the Family Accommodation Scale (FAS). Linear mixed-effects models were applied to analyze treatment effects.

Results

Results indicated a significant decrease in OCD-related comorbid symptoms post-treatment, with SDQ mean reduce of 3.73 (SE = 1.10, child) and 4.14 (SE = 1.19, parent), SCARED mean reduce of 10.45 (SE = 2.52, child) and 8.40 (SE = 2.82, parent), MFQ mean reduce of 3.23 (SE = 1.11, child) and 2.69 (SE = 1.18, parent). Family accommodation declined with clinician scored FAS mean reduction of 13.25 (SE = 2.31). Quality-of-Life improved significantly post-treatment, with KINDL mean increase of 8.15 (SE = 2.87, children), and 10.54 (SE = 3.07, parents). These positive improvements were further amplified at the 3-month follow-up and remained consistent at the 12-month follow-up.

Conclusion

A significant reduction was observed in all secondary outcomes employed and OCD-related functional impairments from baseline to post-treatment, which was maintained through 12-month follow-up. These results imply that after receiving eCBT, children and adolescents experienced substantial decrease in the negative impacts of OCD-related symptoms on their daily life, including home, school, and social interactions.

Co-Occurring Anxiety in Youth with Tic Disorders: A Review

Objective: To review the current state of the literature regarding anxiety symptoms and anxiety disorders in chronic tic disorder (CTD). Results: We conducted a literature search on anxiety and tic disorders. Anxiety symptoms and anxiety disorders are common in youth with CTD, with ∼30%-50% of youth with CTD having at least one co-occurring anxiety disorder. Tics often improve by young adulthood but anxiety symptoms tend to persist, or worsen, over time. Anxiety and tics are closely related, but the exact nature of their relationship is poorly understood. We discuss some potential ways in which anxiety and tics are linked with an emphasis on the underlying brain circuitry involved. The relationship between anxiety and tics may be related to the premonitory urge. In addition, stress hormones may link anxiety and tics. Individuals with CTD have greater activation of their hypothalamic-pituitary-adrenal system in response to acute stress. We also review the impact of anxiety on youth with CTD and approaches to management of anxiety in youth. Conclusions: Anxiety is common in youth with CTD, is associated with more severe CTD, and can adversely affect a child's function. Thus, it is important to identify anxiety disorders in CTD and manage them appropriately.

Construct-related validity of the strengths and difficulties questionnaires with three and five dimensions: A multitrait-multimethod analysis

The Strengths and Difficulties Questionnaire (SDQ) is one of the most broadly used questionnaires to evaluate children's psychological adjustment, however its internal structure has been a target of ongoing controversy. Recent studies suggested a three-factor structure of the SDQ, however data is still scarce. The present study used the Multitrait-Multimethod analysis to examine SDQ construct related-validity with three and five dimensions, provided by children, their parents and teachers. A total of 415 participants were recruited from a Portuguese community sample. Both SDQ versions presented good convergence-related validity, with higher values for the five version. Findings from this study suggest that the SDQ with three dimensions could be more suitable as a screening measure of children's psychological adjustment in a community low-risk sample. Nevertheless, the SDQ still needs further psychometric improvements in order to properly collect information from multi-source samples about the prevalence of children's psychological adjustment.

Examining the measurement precision of behavior problems among a sample of primarily rural youth on juvenile probation and their parents

Accurate and timely intervention in the justice system is particularly critical in rural communities, given documented barriers to accessible, evidence-based services for youth. As youth in the juvenile justice system have a high prevalence of behavioral health needs, accurate assessment of those needs is a critical first step in linking youth to appropriate care. The goal of the current study is to examine the reliability of a brief assessment (the Brief Problem Checklist [BPC]) among a sample of 222 justice-involved youth and their caregivers who primarily reside in rural communities in the United States. Using a series of reliability analyses and tests of agreement, we examined whether youth and caregiver BPC produces reliable scales, the strength of the convergence among each of the BPC scales, and youth and caregiver agreement on the BPC scales. Findings support the reliability of the BPC, but not inter-rater reliability. Poor agreement between youth and caregiver reports exists for both youth internalizing and externalizing problems. Additionally, the BPC was significantly related to several theoretically relevant constructs, including treatment, substance use disorder severity, and family history of substance use. These findings lend merit to discussions about the need for more research on the reliability and validity of assessment instruments before their widespread use in guiding youth- and agency case planning decisions, along with informing conclusions about program effectiveness.

Psychopathic traits in the interpersonal context: Is the effect of psychopathic traits on prosocial behavior mediated by peer problems?

Psychopathic traits are often investigated within the individual, while most traits come to expression within the interpersonal context. Low social communion might even be an important overlooked core feature of psychopathy. This raises the question how psychopathic (i.e., Grandiose-Manipulative, Callous-Unemotional, and Irresponsible-Impulsive) traits affect the tendency to show prosocial behavior, and whether peer problems explain this relationship. Besides, the effects of gender on these subrelations are explored. In total, 541 community adolescents and emerging adults (26.4 % men; 16-25 years old, M_age = 21.7, SD_age = 2.50) completed questionnaires, measuring psychopathic traits, prosocial behavior, and peer problems. The relationship between psychopathic traits and prosocial behavior was investigated with three separate moderated mediation regression analyses (for Grandiose-Manipulative, Callous-Unemotional, and Impulsive-Irresponsible traits separately) including peer problems as mediator and gender as moderator. Significant direct negative effects of Grandiose-Manipulative and Callous-Unemotional traits on prosocial behavior were found, though not for Impulsive-Irresponsible traits. Peer problems did not mediate this relation and gender was no moderator. The significant moderation effect indicated that only for women a significant direct positive effect of Callous-Unemotional traits on peer problems was found, but not for men nor other psychopathic traits. More gender differences were found with men (vs. women) scoring significantly higher on all three psychopathic traits and lower on prosocial behavior. Implications of psychopathic traits within the interpersonal context are discussed and future research could further investigate how this relationship can be explained, for example by including different types of measures and other potential mediators (e.g., empathy).

Corrigendum: Structural validity of the Norwegian version of the Strengths and Difficulties Questionnaire in children aged 3-6 years

[This corrects the article DOI: 10.3389/fpsyg.2022.1024918.].

Deaf and hard-of-hearing children and adolescents' mental health, Quality of Life and communication

Mental health problems and lower Quality of Life (QoL) are more common in deaf and hard-of-hearing - (D)HH - children than in typically hearing (TH) children. Communication has been repeatedly linked to both mental health and QoL. The aims of this study were to compare mental health and QoL between signing deaf and hard-of-hearing (DHH), hard-of-hearing (HH) and TH children and to study associations between mental health/QoL and severity of hearing loss and communication. 106 children and adolescents (mean age 11;8; SD = 3.42), 59 of them DHH and 47 HH, and their parents reported child mental health and QoL outcomes. Parents also provided information about their children's communication, hearing loss and education while their children's cognitive ability was assessed. Although (D)HH and their parents rated their mental health similar to their TH peers, about twice as many (D)HH children rated themselves in the clinical range. However, (D)HH children rated their QoL as similar to their TH peers, while their parents rated it significantly lower. Associations between communicative competence, parent-reported mental health and QoL were found, whereas severity of hearing loss based on parent-report had no significant association with either mental health or QoL. These results are in line with other studies and emphasise the need to follow up on (D)HH children's mental health, QoL and communication.

Longitudinal Associations between Peer and Family Relationships, Emotional Symptoms, and Regional Brain Volume across Adolescence

The period of adolescence brings with it a dynamic interaction between social context and behaviour, structural brain development, and anxiety and depressive symptoms. The rate of volumetric change in the ventromedial prefrontal cortex (vmPFC) and amygdala have been implicated in socioemotional development in adolescence; typically, there is thinning of grey matter volume (GMV) in the vmPFC and growth in the amygdala during this time. The directionality of the associations between social, emotional, and neuroanatomical factors has yet to be untangled, such as the degree to which social variables impact regional brain development, and vice versa. To add, the differences between sexes are still up for debate. In this study, longitudinal associations between peer problems, family support, socioeconomic stress, emotional symptoms, amygdala volume, and vmPFC GMV were investigated for both sexes using latent change score models. Data from a multi-site European study at baseline (mean (SD) age = 14.40 (0.38) years; % female = 53.19) and follow-up 2 (mean (SD) age = 18.90 (0.69) years, % female = 53.19) were used. Results revealed that peer problems did not predict emotional symptoms, rather they changed together over time. For males only, there was positive correlated change between vmPFC GMV, peer problems and emotional symptoms, indicating that slower vmPFC GMV thinning was associated with poorer social and emotional functioning. Additionally, greater family support at age 14 years was associated with slower growth of amygdala volume between ages 14 and 19 years for males; previous research has related slower amygdala growth to resilience to mental health disorders. The findings have extended understanding of mutual social, emotional and brain development, and avenues to protect mental health.

A school-based physical activity intervention on psychosocial health outcomes among 11- and 12-year-olds - HOPP-project

The purpose was to investigate the effect of a school-based physical activity (PA)-intervention among 11- and 12-year-olds (6th- and 7th graders) across 4 years. Seven primary schools in Horten municipality in Norway received 45 min daily extra PA as part of the curriculum. The intervention started in 2015 with follow-up in 2016-2019. The effect was measured after 1-4 years of participation, among the same children (6th to 7th grade) and among new children starting in 6th grade. Two control schools received no additional PA beyond the regular PA at school. The Self-reported Strength and Difficulties Questionnaire (SDQ-S) focusing on internalizing and externalizing difficulties were administrated. A statistical model for repeated measurements was used and adjusted for parents' educational level, sex, age, and waist-to-height ratio (WHtR). The significance level was p ≤ 0.01. In total, 1221 children completed the SDQ-S. SDQ-S scores were stable, and difficulties were relatively low. The control group had significantly lower SDQ-S scores than the intervention group at start, indicating fewer difficulties. The adjusted effect within the intervention schools showed a borderline significant increase in total difficulty scores between 2018 and 2019 (mean difference: 1.02, 95% CI: -1.82, -0.23, p ≤ 0.01). Educational level showed a weak negative correlation with total difficulty score (r = -0.1). No significant change was reported within the control schools. Few psychosocial health problems among 11- and 12-year-olds were detected. The borderline increase in total difficulty score that was seen for the intervention schools, is believed to be of limited clinical relevance.

Validation of the Arabic Version of Strengths and Difficulties Questionnaire in Early Childhood Education in Qatar

This study examined the validity of the Arabic version of the Strengths and Difficulties Questionnaire (SQD, teacher version) among a sample of young children in Qatar. Teachers rated 502 children aged four to five years from public preschools using the SDQ teacher version. The factor structure of the SDQ was analyzed using exploratory and confirmatory factor analyses. I calculated Cronbach's alpha coefficient and item-total correlations to determine the reliability of the five subscales and overall SDQ. The findings showed acceptable reliability, with the exception of the Peer Problems Scale. Common fit statistics-including the comparative fit index, non-normed fit index, and goodness-of-fit index-were used for the confirmatory factor analysis. In general, satisfactory psychometric characteristics were observed for the preschool SDQ, suggesting that the questionnaire could be administered to preschool-age children in Qatar.

The social correlates to callous-unemotional traits in a sample of high school students

Callous-Unemotional (CU) traits are strongly related to early-onset and severe levels of conduct problems. However, much less research has focused on their association with potential problems in adolescents' social relationships. Further, it is important to determine if CU traits explain variance in important social variables, independent of conduct problems or general personality dimensions related to sociability, like agreeableness. In the current study, we examined the association of CU traits with a range of social variables in a community sample of Italian adolescents (N = 563; 460 girls; mean age = 15.80, SD = 1.50). Measures for the social variables included assessment of peer rejection, adolescents' prosocial behaviors, satisfaction in peer relationships, and feelings of connection with school and classmates. We also obtained self-report ratings of CU traits, conduct problems (CP) and agreeableness. Analyses showed that CU traits were significantly associated with all the social variables. After controlling for CP and agreeableness, CU traits were still positively associated with ratings of peer rejection and negatively associated with prosocial behavior and satisfaction in relationships with peers. However, the negative associations with feelings of connection to school and peers were no longer significant. These findings provide further support for the clinical usefulness of CU traits and further evidence for potential targets of intervention, particularly focused on the adolescent's relational skills.

Factor structure of the parent-rated strengths and difficulties questionnaire in a sample of Canadian children from military families

The Strengths and Difficulties Questionnaire is a 25-item screening tool designed to measure the emotional and behavioral well-being of children. It includes five subscales including Emotional Symptoms, Conduct Problems, Peer Problems, Hyperactivity-Inattention and Prosocial Behavior. While the Strengths and Difficulties Questionnaire has been studied extensively on a global scale, it has not yet been evaluated among Canadian children from military families. This study used data collected from spouses and partners of Canadian Armed Forces members who completed a questionnaire assessing their quality of life, including the Strengths and Difficulties Questionnaire for respondents with children aged 3-16 years (N = 651). Using two independent randomized samples drawn from the overall group of respondents, the factorial structure was studied using exploratory factor analysis (n = 323) and confirmatory factor analysis (n = 328). Results of this study provide evidence for the factorial validity of the parent-rated Strengths and Difficulties Questionnaire for a sample of children from military families. Specifically, the exploratory factor analysis and confirmatory factor analysis supported the original proposed five-factor solution (CFI = 0.84; TLI = 0.82; SRMR = 0.073; RMSEA = 0.065) with good internal reliability of the Total Difficulties Scale and subscales. Overall, the results of this study were found to align with past research findings on the Strengths and Difficulties Questionnaire and support the future utility of this tool in assessing the well-being of Canadian children from military families.

Structural validity of the Norwegian version of the Strengths and Difficulties Questionnaire in children aged 3-6 years

Introduction

This study examined the structural validity of the teacher-report Strength and Difficulties Questionnaire (SDQ) in Norwegian preschoolers aged 3-6 years. We tested the original five-factor structure, the five-factor structure with two broader second-order factors, and a three-factor structure, all suggested in the literature. Since the positively worded items in SDQ have been shown to introduce noise, we also examined all three structures with a positive construal method factor for these items.

Methods

Preschool teachers from 43 preschools completed the SDQ questionnaire for 1,142 children [48% girls, mean age 4.3 (SD 0.9) years]. Confirmatory factor analyses were used to estimate and compare the six models. Measurement invariance was tested across sex (multi-group approach) and age (multiple-indicator multiple-cause approach).

Results

The original five-factor structure of SDQ was supported, where the model fit improved when including a method factor for positively worded items. Both models showed scalar invariance across sex and age. The second-order and the three-factor structures were not supported.

Conclusion

We recommend using the original five-factor structure when using SDQ for both clinical and research purposes in young children and adding a method factor when using structural equation modeling.

Co-occurrence, stability and manifestation of child and adolescent mental health problems: a latent transition analysis

Background

Complex constellations of socio-emotional and behavioural problems (i.e., mental health problems) in childhood and adolescence are common and heighten the risk for subsequent personality, anxiety and mood disorders in adulthood. Aims of this study included the examination of patterns of mental health problems (e.g., externalizing-internalizing co-occurrence) and their transitions to reported mental disorders by using a longitudinal person-centered approach (latent class and latent transition analysis).

Methods

The sample consisted of 1255 children and adolescents (51.7% female, mean age = 12.3 years, age range 8–26 years) from three time points of the comprehensive mental health and wellbeing BELLA study. Children and their parents completed the German SDQ (Strength and Difficulties Questionnaire, Goodman, 1997) and reported on diagnoses of ADHD, depression, and anxiety.

Results

Latent class analysis identified a normative class, an emotional problem class, and a multiple problem class. According to latent transition analysis, the majority of the sample (91.6%) did not change latent class membership over time; 14.7% of individuals showed a persistent pattern of mental health problems. Diagnoses of mental disorders were more likely to be reported by individuals in the emotional problem or multiple problem class.

Conclusions

Results highlight the need for early prevention of mental health problems to avoid accumulation and manifestation in the transition to adolescence and young adulthood.

The role of inflammatory markers and cortisol in the association between early social cognition abilities and later internalising or externalising problems: Evidence from a UK birth cohort

OBJECTIVE

Deficits in social cognition are associated with internalising (emotional and peer problems) and externalising (conduct problems and hyperactivity/inattention) symptoms in youth. It has been suggested that stress may be one of the mechanisms underlying these associations. However, no empirical studies have investigated if physiological stress can explain the prospective associations between social cognition deficits and internalising and externalising symptoms in the general youth population. This study addressed this question and focused on two indicators of physiological stress, dysregulated diurnal cortisol patterns and systemic inflammation.

METHOD

Participants were 714 individuals from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population-based birth cohort. Bayesian structural equation modelling was used to investigate a) the associations of social cognition abilities at ages 8, 11, and 14 years with internalising and externalising problems at age 17 years and b) the potential mediating effects of cortisol parameters at age 15 years and inflammatory markers [interleukin 6 (IL-6) and C-reactive protein (CRP)] at ages 9 and 16 years.

RESULTS

We found that social cognition difficulties were associated with later internalising and externalising problems. Flattened diurnal cortisol slope was associated with hyperactivity/inattention problems two years later. Lower morning cortisol partially mediated the direct association between social communication deficits at 8 years and hyperactivity/inattention and conduct problems at 17 years, even after adjustments for inflammation and confounders (for hyperactivity/inattention: indirect effect = 0.07, 95% CI [0.00, 0.18], p = .042; for conduct problems: indirect effect = 0.04, 95% CI [0.00, 0.11], p = .040). We did not find a significant association between systemic inflammation and social cognition difficulties, internalising problems, or externalising problems.

CONCLUSION

Our findings suggest that part of the effect of social communication difficulties in childhood on externalising problems in adolescence was mediated by lower morning cortisol. Hence, our study indicates that the hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis may be one of the physiological mechanisms linking some social cognition deficits to externalising problems.

The relationship between adolescents' externalizing and internalizing symptoms and brain development over a period of three years

BACKGROUND

Adolescence is a crucial period for both brain maturation and the emergence of mental health disorders. Associations between brain morphology and internalizing/externalizing symptomatology have been identified in clinical or at-risk samples, but age-related developmental differences were rarely considered. The current study investigated the longitudinal relationship between internalizing/externalizing symptoms and brain development in the absence of psychiatric disorders during early and late adolescence.

METHODS

98 healthy adolescents within two cohorts (younger: 9 years, older: 12 years) participated in annual assessments for three years; a clinical assessment measuring their externalizing and internalizing symptoms (SDQ) and an MRI assessment measuring their brain volume and white matter microstructure, including fractional anisotropy (FA), mean diffusivity (MD) and average path length.

RESULTS

Linear mixed effect models and cross-lagged panel models showed that larger subcortical gray matter volume predicted more externalizing symptoms in older adolescents whereas decreases of subcortical gray matter volume predicted more externalizing symptoms for younger adolescents. Additionally, longer average white matter path length predicted more externalizing symptoms for older adolescents, while decreases in cerebral white matter volume were predictive of more externalizing symptoms for younger adolescents. There were no predictive effects for internalizing symptoms, FA or MD.

CONCLUSIONS

Delays in subcortical brain maturation, in both early and late adolescence, are associated with increases in externalizing behavior which indicates a higher risk for psychopathology and warrants further investigations.

Spanish normative data of the Strengths and Difficulties Questionnaire in a community-based sample of adolescents

Background/Objective: The Strengths and Difficulties Questionnaire self-report (SDQ-S) has been extensively used to assess mental health problems among children and adolescents. However, previous research has identified substantial age and country variation on its psychometric properties. The aim of this study was three-fold: i) to evaluate internal structure and measurement invariance of the Spanish version of the SDQ; ii) to analyze age and gender-specific effects on the SDQ subscales; and iii) to provide Spanish normative data for the entire age range of adolescence. Method: Data were derived from two representative samples of adolescents aged 14 to 19 years old, selected by stratified random cluster sampling years (N = 3378). Results: The reliability of the Total difficulties score was satisfactory, but some subscales showed lower levels of internal consistency. Confirmatory factor analysis supported the original five-factor model. Finally, results revealed that SDQ scores were influenced by the gender and the age of participants; thus, the normative banding scores and cut-off values were provided accordingly. Conclusions: This study validates the Spanish SDQ-S for the entire age range of adolescence. However, more cross-country and cross-age research is needed to better understand the inconsistent findings on SDQ reliability.

Validation of brief screening instruments for internalizing and externalizing disorders in Mozambican adolescents

BACKGROUND

Mental disorders are the leading cause of disability for youth worldwide. However, there is a dearth of validated, brief instruments to assess mental health in low- and middle-income countries (LMIC). We aimed to facilitate identification of mental disorders in LMIC contexts by adapting and validating measures of internalizing and externalizing disorders for adolescents in Mozambique, an LMIC in southeastern Africa.

METHODS

We selected instruments with good support for validity in high-income and other LMIC settings: the Patient Health Questionnaire Adolescent (PHQ-A), Generalized Anxiety Disorders 7 (GAD-7), and Strengths and Difficulties Questionnaire (SDQ). Instruments were adapted by local and international mental health specialists followed by cognitive interviews (n = 48) with Mozambican adolescents. We administered the instruments along with the Miniature International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)to 485 adolescents aged 12-19 years attending two secondary schools in Maputo City, Mozambique. One week later, we re-administered instruments to a randomly selected sample of 49 adolescents.

RESULTS

Participants were 66.2% (n = 321) female and the average age was 15.9 (S.D = 1.7).Internal consistency (alpha = 0.80, PHQ-A; 0.84, GAD-7; 0.80, SDQ) and test-retest reliabilty (ICC = 0.74, PHQ-A; 0.70, GAD-7; 0.77, SDQ) were acceptabe for the PHQ-A, GAD-7, and the full SDQ. The SDQ internalizing subscale showed poor test-retest reliability (ICC = 0.63) and the SDQ externalizing subscale showed poor internal consistency (alpha = 0.65). All instruments demonstrated good sensitivity and specificity (> 0.70). Youden's index identified optimal cutoff scores of 8 for the PHQ-A, 5 for the GAD-7, 10 for the SDQ internalizing and 9 for the SDQ externalizing subscales, though a range of scores provided acceptable sensitivity and specificity.

CONCLUSIONS

Our data supports reliability and validity of the PHQ-A, GAD-7, and SDQ instruments for rapidly assessing mental health problems in Mozambican adolescents. Use of these tools in other contexts with limited specialists may asist with expanding mental health assessment. Specific instrument and cutoff selection should be based on screening goals, treatment resources, and program objectives.

Emotion regulation among Chinese and German children and adolescents: a binational comparative study

Emotion regulation has been a central research topic in developmental psychology and psychopathology for several decades. Habitual use of adaptive (e.g., cognitive reappraisal) or maladaptive strategies (e.g., expressive suppression) may influence psychosocial adjustment in children and adolescents. Despite consensus on the influence of culture on emotion regulation, little is known about cultural differences in emotion regulation in children and adolescents. In this study, the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) was used and tested for its measurement invariance between Chinese and German children and adolescents. Cultural similarities and differences in the use of cognitive reappraisal and expressive suppression were examined, as well as the associations of these strategies with behavior problems and prosocial behavior. The sample consisted of 765 Chinese and 431 German students (Mage = 12.46 years, SD = 1.12). Multi-group confirmatory factor analysis revealed partial scalar measurement invariance of the ERQ-CA. A latent mean comparison showed more frequent use of both strategies in Chinese compared to German students. The results of the multi-group structural equation model showed similar patterns of relationships between emotion regulation strategies and youth behavior across groups. Cognitive reappraisal was associated with fewer behavior problems and more prosocial behavior, whereas expressive suppression was related to more behavior problems. In summary, the current findings indicate that the ERQ-CA allows comparisons of emotion regulation between Chinese and German children and adolescents. Furthermore, the relevance of the cultural context for emotion regulation and the promotion of adaptive regulation strategies is highlighted.

Quality of life and emotional vulnerability in a national cohort of adolescents living with Fontan circulation

INTRODUCTION

To investigate quality of life and mental health after Fontan completion, we aimed to characterise outcomes in a representative group of adolescent patients. The study was part of the pre-transition clinical work-up in adolescents with Fontan-type palliation of univentricular CHD. The programme covers the entire paediatric Fontan patient population in Norway.

METHODS

Our cross-sectional study included 42 adolescents with Fontan circulation aged 15-18. We recruited a control group of 29 healthy peers. Quality of life was measured by the Pediatric Quality of Life Inventory Questionnaire, while mental health was assessed with the Strength and Difficulties Questionnaire.

RESULTS

Fontan patients scored lower than healthy controls on the Pediatric Quality of Life Inventory total (p = 0.004), the physical (p < 0.001) and social (p = 0.001) functioning subscale, and the Strength and Difficulties Questionnaire subscale of emotional symptoms (p = 0.035). Compared to two of the healthy teens (7%), seven patients (16%) in the Fontan group scored as having impaired mental health (p = 0.224). The female/male ratio for individuals with impaired health was 7:2 (p = 0.003).

CONCLUSIONS

Compared to healthy controls, adolescents after Fontan-type palliation in Norway have good health-related quality of life and mental health, despite having slightly lower score than healthy individuals, mainly in physical domains and school functioning. Compared to healthy controls and healthy teenagers, these adolescents have somewhat more emotional problems, and compared to male patients, female patients more often have impaired mental health.

The association between paternal depression and adolescent internalising problems: A test of parenting style as a mediating pathway

Whilst there is a large evidence base demonstrating the impact of maternal depression on the development of adolescent internalising problems, less is known about the association between paternal depression and adolescent internalising problems, and the mechanisms through which risk is conferred. This study examined the association between paternal depression and adolescent internalising problems, investigating parenting style as a pathway through which this association may be mediated. Participants included 4048 families taking part in the Growing Up in Ireland child cohort study. Self-report measures of paternal depression were completed when the study child was aged 9. Adolescents assessed paternal demandingness, responsiveness and autonomy granting at the age of 13. Adolescent internalising symptoms were measured at the age of 17/18 by the primary caregiver. A parallel multiple mediator model was used to test the total and specific indirect effects of the three parenting styles, whilst controlling for covariates and other mediators in the model. A direct effect of paternal depression on adolescent internalising problems was found (B = .051, 95% CI: 0.020, 0.083). However, no support for mediation via any of the paternal parenting styles (i.e., responsiveness, demandingness, or autonomy-granting) were found. These findings build on an emerging evidence-base demonstrating a specific direct association between paternal depression and adolescent internalising problems, and suggest that interventions ought to also target fathers suffering from depression to help reduce the risk of adolescent internalising problems.

Alcohol and Nicotine Use among Adolescents: An Observational Study in a Sicilian Cohort of High School Students

In recent years, the mode of alcoholic intake known as binge drinking (BD) has become a common practice, especially among adolescents who, due to socio-environmental motives, tend to reach a rapid state of drunkenness. This drunkeness leads to alterations in brain areas responsible for executive functions and cognitive processes, as well as to the genesis of factors that predispose to lasting addiction. Likewise, nicotine leads to a comparable degree of addiction. On this basis, the aim of this research was to evaluate, on a cohort of 349 high school students (15−17 years old) in the province of Palermo, the following: (I) the drinking model of alcoholic beverages; (II) the use of nicotine and the degree of dependence; (III) the correlation between the consumption of alcoholic beverages and the use of nicotine. We employed the AUDIT-C test and the Fagerström test, two valid and standard instruments, in order to assess alcohol and nicotine use, respectively. Statistical analysis of the data showed that male and female students consumed alcohol prominently in a BD mode (77.2%, audit score (AS) 3.497, confidence interval (CI) 3.206−3.788; 69.6%, AS 2.793, CI 2.412−3.274) and nicotine (41.5%, Fagerström score (FS) 3.882, CI 3.519−4.245; 28%, FS 3.286, CI 2.547−4.024). Furthermore, a positive correlation between alcohol consumption and nicotine use was found for male (r = 0.6798, p < 0.0001) and female (r = 0.6572, p < 0.0001) students. This study provided further insights into the use of legal substances of abuse in adolescents, evidencing the obvious need for the promotion of specific school educational programs aimed at the wellbeing of youth populations.

Internalizing problems, externalizing problems, and prosocial behavior - three dimensions of the strengths and difficulties questionnaire (SDQ): A study among South African adolescents

This study aimed to examine the factor structure of the Strengths and Difficulties Questionnaire Self-Report version (SDQ-S), its psychometric properties and measurement invariance by gender and language spoken at home, among secondary school students in Western Cape, South Africa. A sample of 3,542 adolescents in Grade 8 (Mean age = 13.7 years) completed the SDQ-S in a three-language questionnaire (Afrikaans, English and isiXhosa). The data were collected from 42 secondary schools in Cape Town, South Africa. Confirmatory factor analyses with the WLSMV estimator with adjustment for cluster effects (schools) were applied. The SDQ-S was originally developed to cover five domains: four "difficulty" domains (hyperactivity/inattention, emotional, conduct, and peer) and one "strengths" domain (prosocial behavior). When the five factors were tested on the data for the current study, poor fit was obtained. After excluding four items, a three-factor solution with no cross-loadings and no correlated error terms obtained acceptable fit. The results are consistent with previous studies. Strong measurement invariance across genders and language spoken at home was confirmed. In studies of community samples, the use of the SDQ-S scale as an instrument with a three-factor dimension (internalizing, externalizing and prosocial) may be more appropriate than using the original five-factor model.

The factor structure of the Strength and Difficulties Questionnaire in a national sample of Swedish adolescents: Comparing 3 and 5-factor models

The Strength and Difficulties Questionnaire (SDQ) is one of the most common screening instruments for emotional and behavioral problems in children and adolescents. Although exploratory factor analyses support the originally proposed 5-factor structure of SDQ as well as a 3-factor model, the evidence from confirmatory factor analyses is more mixed. Some of the difficulties items in SDQ are positively worded and it has been proposed that this leads to method effects, i.e. these items share variance that is due to the method used rather than to a substantive construct. Also, there seems to be minor factors in some subscales. This study tests a series of 3- and 5- factor models pertaining to the factor structure of SDQ, also considering method effects and minor factors. The sample consists of a nationally representative cohort of Swedish adolescents born in 2001 (n = 5549). Results show a relatively better fit of the 5-factor model compared with the 3-factor model although neither of these had a satisfactory fit. Model fit was improved when specifying cross-loadings of the positively worded difficulties items on the prosocial scale as well as minor factors on the hyperactivity scale. Although no model provided a completely satisfactory fit to the data, the results show that the 5-factor model performs better than the 3-factor model and has an acceptable fit. We conclude that for the purposes of epidemiological research, SDQ has acceptable factorial validity, provided that researchers consider method effects and minor factors.

Covid-19, social restrictions, and mental distress among young people: a UK longitudinal, population-based study

BACKGROUND

Adolescence is a critical period for social and emotional development. We sought to examine the impacts of Covid-19 and related social restrictions and school closures on adolescent mental health, particularly among disadvantaged, marginalised, and vulnerable groups.

METHODS

We analysed four waves of data - 3 pre-Covid-19 (2016-2019) and 1 mid-Covid-19 (May-Aug 2020; n, 1074; 12-18 years old, >80% minority ethnic groups, 25% free school meals) from REACH (Resilience, Ethnicity, and AdolesCent Mental Health), an adolescent cohort based in inner-London, United Kingdom. Mental health was assessed using validated measures at each time point. We estimated temporal trends in mental distress and examined variations in changes in distress, pre- to mid-Covid-19, by social group, and by pre- and mid-pandemic risks.

RESULTS

We found no evidence of an overall increase in mental distress midpandemic (15.9%, 95% CI: 13.0, 19.4) compared with prepandemic (around 18%). However, there were variations in changes in mental distress by subgroups. There were modest variations by social group and by pre-Covid risks (e.g., a small increase in distress among girls (b [unstandardised beta coefficient] 0.42 [-0.19, 1.03]); a small decrease among boys (b - 0.59 [-1.37, 0.19]); p for interaction .007). The most notable variations were by midpandemic risks: that is, broadly, increases in distress among those reporting negative circumstances and impacts (e.g., in finances, housing, social support and relationships, and daily routines) and decreases in distress among those reporting positive impacts.

CONCLUSIONS

We found strong evidence that mental distress increased among young people who were most negatively impacted by Covid-19 and by related social restrictions during the first lockdown in the United Kingdom.

HIV-Related Stigma and Psychological Adjustment Among Perinatally HIV-Infected Youth in Cape Town, South Africa

The effect of chronic HIV-infection on psychological adjustment, including the impact of HIV-related stigma in perinatally HIV-infected (PHIV+) youth across Africa is largely unknown. This study examined psychological adjustment and HIV-related stigma using the Strengths and Difficulties Questionnaire (SDQ) and a 10-item stigma questionnaire in a cohort of PHIV+ youth in Cape Town, South Africa. The relationships between SDQ scores, elevated viral load, and suboptimal antiretroviral therapy (ART) adherence were also explored. Among 473 PHIV+ youth (aged 9-14 years, on ART > 6 months at enrollment), higher perceived HIV-related stigma was associated with higher scores across all adolescent and caregiver-reported SDQ difficulty subscales. Higher socioeconomic status (SES) was associated with lower scores on adolescent self- and caregiver-reported hyperactivity subscales. Higher adolescent-reported prosocial scores were associated with lower odds of self-reported suboptimal ART adherence, and higher caregiver-reported conduct scores were associated with higher odds of elevated viral load. No associations were observed between perceived HIV-related stigma and treatment outcomes. These findings highlight the potentially detrimental impact of perceived stigma on psychological adjustment in PHIV+ youth. The use of psychosocial metrics and interventions aimed at reducing illness related stigma in PHIV+ youth is also considered.

Normative data for the self-reported and parent-reported Strengths and Difficulties Questionnaire (SDQ) for ages 12-17

BACKGROUND

The Strengths and Difficulties Questionnaire (SDQ) is widely used to screen for psychosocial problems among adolescents. As the severity of such problems is known to be related to age and gender, screening could be improved by interpreting SDQ scale scores with age-specific and perhaps gender-specific norms. Up to now, such norms are lacking. The aim of the current study is to present gender-specific and joint normative data per year of age for the Dutch self-reported and parent-reported SDQ versions for use among 12- to 17-year-old adolescents.

METHODS

The norm groups for the self-reported and parent-reported SDQ versions consisted of 993 adolescents and 736 parents, respectively, from the general Dutch population. Per SDQ version, both gender-specific norms and joint norms (percentiles and cutoffs) per year of age were calculated through regression-based norming (Rigby in J Roy Stat Soc Ser C 54:507, 2005). Additionally, these norms were compared to the widely used British norms that are neither age-specific nor gender-specific.

RESULTS

By design, gender-specific 'abnormal' cutoffs (i.e., cutoffs aimed at identifying max. 10% of the most extremely scoring males and max. 10% of the most extremely scoring females) resulted in about equal percentages of 'abnormal' scoring male and female adolescents per SDQ scale. In contrast, joint 'abnormal' cutoffs (i.e., cutoffs aimed at identifying max. 10% of the most extremely scoring adolescents) resulted in relatively more male (7.6 to 13.6%, depending on age) than female (3.3 to 8.9%, depending on age) adolescents as scoring 'abnormal' on scales measuring externalizing behavior (self-reported and parent-reported SDQ versions), and relatively more female (3.9 to 14.3%, depending on age) than male (1.8 to 6.9%, depending on age) adolescents as scoring 'abnormal' on scales measuring internalizing behavior (self-reported SDQ version). In both types of norms, minor age effects were present. Among Dutch adolescents, the British norms yielded detection rates much lower than the expected 10%.

CONCLUSIONS

Our findings indicate that detection rates depend on the reference group that is used (British or Dutch general adolescent population; specific gender group or not). The normative data in this paper facilitate the comparison of an adolescent's scores to different reference groups, and allow for cross-country/cultural comparisons of adolescents' psychosocial behavior.

Trauma informed occupational therapy school practice with adolescents with social emotional and behavioural difficulties: findings of standardised measures

Abstract Introduction Although non-standardized qualitative and quantitative reports from 39 Irish students aged 12 to 14 years, with complex social and emotional needs and their 13 teachers had established benefits of ‘Movement Matters’, an occupational therapy designed participatory curriculum for learning self-regulation in mainstream schools (National Behaviour Support Service, 2015a), standardized measures were required for quality assurance by the Irish Government funded service. Objective The relevance of findings of standardized attitude measurements on the impacts of an occupation focused intervention with a discrete school population in areas of social disadvantage are discussed. Method Findings of the ‘Pupil Attitude to Self and School’ (PASS) (Granada Learning, 2021) and ‘Strengths and Difficulties Questionnaire’ (SDQ) (Youth in Mind, 2021), both well-established standardized measures of attitude and behaviours completed (pre and post intervention) by teachers, parents and students are presented. Results No statistically significant differences were found between the standardized pre and post intervention measures. However, findings indicate a disparity between how these students in complex environments experience school in comparison to large UK study populations. Conclusion This paper discusses the use of these standardized measures for capturing impacts of an occupation focused intervention in a school environment. It calls for an increased appreciation on outcomes measurement related to the intervention’s aim of providing experiences of meaningful participation and well-being. Further collaborative research on outcome measurement of participation of students in complex mainstream school environments is required.

Sibling, Peer, and Cyber Bullying Among Children and Adolescents: Co-occurrence and Implications for Their Adjustment

Bullying across the sibling, peer, and cyber context has consistently been associated with a range of long-term health and well-being consequences for children and adolescents. Although research examining different bullying forms simultaneously in the same study are emerging, it remains unclear to what extend sibling, peer, and cyber bullying co-occur and in what ways they are associated. Moreover, previous work has demonstrated that children and adolescents who experience multiple forms of victimization are at a particular risk of adverse outcomes. However, whether different constellations of co-occurring bullying forms have differential impacts has not yet been investigated sufficiently. The aim of the present study was to examine the frequencies of isolated and co-occurring sibling, peer, and cyber bullying as well as to explore their independent and cumulative relationships with child adjustment. This study was based on a sample of 329 children and adolescents aged between 9 and 15. Bullying experiences across the sibling, peer, and cyber context in the previous 6 months were assessed via self-report. Youth further reported on emotional problems, conduct problems, sleep problems, and academic achievement via an online questionnaire. Sibling, peer, and cyber bullying were uniquely associated with child outcomes. A cumulative relationship between bullying victimization across contexts and emotional problems, conduct problems, and sleep problems could be identified, while bullying perpetration across contexts was only linked to more conduct problems in a cumulative manner. The findings have important practical implications arguing for the adoption of a holistic approach toward bullying in prevention and intervention.

At-risk early adolescents profiles in the community: A cluster analysis using the strengths and difficulties questionnaire

Early adolescence, with its several changes and demands, represents a delicate period of life. Several studies highlighted that during early adolescence, emotional and behavioral problems tend to increase. Using a person-centered approach, the present study explored the emotional and behavioral functioning profiles in a sample of Italian preadolescent students. Participants were 2959 youths (1533 males and 1426 females; age 10-14 years); they completed the Strengths and Difficulties Questionnaire (SDQ) and the Inventory of Callous Unemotional traits (ICU). Findings revealed four different profiles: "no psychopathology" (41.5%), "low psychopathology with sub-threshold hyperactivity" (33%), "predominantly internalizing" (19%), and "predominantly externalizing" (6.5%). The two latter clusters are characterized by high levels of SDQ Total Score. The "predominantly internalizing" is distinguished by a higher prevalence of females, and the "predominantly externalizing" by a higher prevalence of males and higher CU traits. A person-oriented approach allowed for identifying subgroups of early adolescents who may significantly vary in their configuration of internalizing and externalizing problems. Such subgroups may reflect youths for whom the creation of prevention and intervention programs could be more tailored.

Greek Validation of the Factor Structure and Longitudinal Measurement Invariance of the Strengths and Difficulties Questionnaire-Self Report (SDQ-SR): Exploratory Structural Equation Modelling

The study examined the factor structure and longitudinal measurement invariance over three time points (1-year apart) of the Strengths and Difficulties Questionnaire-Self Report (SDQ-SR) for ratings provided by adolescents in Greece. It used exploratory structural equation modelling (ESEM) to achieve these two goals. At time point one, a total of 968 adolescents (males = 508, and females = 460) between 12 and 17.9 years completed the SDQ-SR. In relation to factor structure, ESEM tested the fit of one- to five-factor models. The findings were interpreted as indicating most support for the ESEM model with three factors (the factors being dysregulation, peer problems, and prosocial behaviour). This model showed support for configural invariance and full metric invariance across the three time points. Except for two thresholds, all other thresholds were also invariant across the three time points. Thus, there was good support for longitudinal measurement invariance. The implications of the findings for use of the SDQ-SR are discussed.

Exploratory Graph Analysis of the Strengths and Difficulties Questionnaire for Aboriginal and/or Torres Strait Islander Children

In Australia, one of the most frequently used measures for assessing social and emotional well-being (SEWB) of Aboriginal and/or Torres Strait Islander children is the Strengths and Difficulties Questionnaire (SDQ). Previous studies on state-level validations have indicated the problems associated with the original five-factor SDQ structure, especially in the dimension of Peer Problems. The aim of this study was to use a novel psychometric methodology, namely Exploratory Graph Analysis (EGA), to evaluate the dimensionality of caregiver-informant SDQ version 4-10 years at a national level in Australia. Data for this study were retrospectively collected from two independent longitudinal studies: the Longitudinal Study of Indigenous Children (LSIC) and South Australian Aboriginal Birth Cohort (SAABC). The caregiver-informed SDQ version 4-10 years was applied across several study waves, including more than 4,000 responses. To conduct EGA, Gaussian graphical models (GGMs) were estimated using the Least Absolute Shrinkage and Selection Operator. About 2,500 bootstrap samples were also employed to investigate dimensions and item stability. The findings indicated robust evidence against the construct validity of the original five-factor SDQ structure. Future studies should conduct a direct external validation of the findings with Aboriginal and/or Torres Strait Islander parents/carers and community groups to develop the guidelines for future use of the instrument among Aboriginal and/or Torres Strait Islander children in Australia.

Promoting youth mental health during the COVID-19 pandemic: A longitudinal study

The COVID-19 pandemic has introduced novel stressors into the lives of youth. Identifying factors that protect against the onset of psychopathology in the face of these stressors is critical. We examine a wide range of factors that may protect youth from developing psychopathology during the pandemic. We assessed pandemic-related stressors, internalizing and externalizing psychopathology, and potential protective factors by combining two longitudinal samples of children and adolescents (N = 224, 7-10 and 13-15 years) assessed prior to the pandemic, during the stay-at-home orders, and six months later. We evaluated how family behaviors during the stay-at-home orders were related to changes in psychopathology during the pandemic, identified factors that moderate the association of pandemic-related stressors with psychopathology, and determined whether associations varied by age. Internalizing and externalizing psychopathology increased substantially during the pandemic. Higher exposure to pandemic-related stressors was associated with increases in internalizing and externalizing symptoms early in the pandemic and six months later. Having a structured routine, less passive screen time, lower exposure to news media about the pandemic, and to a lesser extent more time in nature and getting adequate sleep were associated with reduced psychopathology. The association between pandemic-related stressors and psychopathology was reduced for youths with limited passive screen time and was absent for children, but not adolescents, with lower news media consumption related to the pandemic. We provide insight into simple, practical steps families can take to promote resilience against mental health problems in youth during the COVID-19 pandemic and protect against psychopathology following pandemic-related stressors.

Zusammenhänge zwischen dissozialen Verhaltensweisen und Stresserleben bei Jugendlichen

Zusammenfassung. Dissoziale Verhaltensweisen wie Wutanfälle, Lügen und Stehlen bis hin zu gewaltsamen Übergriffen gegenüber Peers, Lehrpersonen und Eltern stellen hohe Belastungen für die soziale Umwelt der Jugendlichen dar. Obwohl kognitiv-emotionale Stressverarbeitungsprozesse eine zentrale Bedeutung für die Erklärung von Verhaltensproblemen haben, analysiert bislang keine Studie systematisch das Stresserleben bei Jugendlichen mit dissozialem Verhalten in unterschiedlichen Lebensbereichen. Diese Studie geht der Fragestellung nach, inwiefern Jugendliche mit dissozialem Verhalten in verschiedenen Lebensbereichen (u. a. Eltern, Schule, Zukunftsplanung, Freizeit, Peerbeziehungen) Stress empfinden. Die Stichprobe umfasst N = 91 Jugendliche (Altersrange 12 – 16, 39 Mädchen), von denen N = 44 dissoziale Verhaltensweisen aufweisen. Verhaltensprobleme und Stresserleben wurden mittels standardisierter Instrumente erfasst. In hierarchischen Regressionsanalysen erklären dissoziale Verhaltensweisen bedeutsame Varianz des Stresserlebens. In Bezug auf die Zukunft (z. B. Angst vor Arbeitslosigkeit) sowie schulische Stressoren (z. B. Leistungsversagen) ist das Stresserleben dissozialer Jugendlicher erhöht, im Freizeitbereich sowie im Umgang mit Peers bestehen keine bedeutsamen Unterschiede zur Kontrollgruppe. Die Ergebnisse implizieren spezifische kognitiv-emotionale Stressverarbeitungsprozesse bei dissozialen Jugendlichen, deren mögliche Bedeutung für Verhaltensänderungen in schulischen und anderen pädagogischen Kontexten diskutiert wird.

Measuring Prosocial Behaviors: Psychometric Properties and Cross-National Validation of the Prosociality Scale in Five Countries

This research investigated the psychometric properties of the Prosociality Scale and its cross-cultural validation and generalizability across five different western and non-western countries (China, Chile, Italy, Spain, and the United States). The scale was designed to measure individual differences in a global tendency to behave in prosocial ways during late adolescence and adulthood. Study 1 was designed to identify the best factorial structure of the Prosociality Scale and Study 2 tested the model's equivalence across five countries (N = 1,630 young adults coming from China, Chile, Italy, Spain and the United States; general M _age = 21.34; SD = 3.34). Findings supported a bifactor model in which prosocial responding was characterized by a general latent factor (i.e., prosociality) and two other specific factors (prosocial actions and prosocial feelings). New evidence of construct validity of the Prosociality Scale was provided.