Validity of the SDQ as a Preventive Child Health Care instrument to identify psychosocial problems in children of 13 years and older as compared to the KIVPA

Psychosocial problems in adolescents are highly prevalent. A good and early
detection increases the change of an effective treatment and the adolescent's
healthy development. Research has shown that current identification of
psychosocial problems by Dutch Preventive Child Health Care needs to be
improved.

Recently, the SDQ was chosen as standard instrument for children in the age
between 7 to 12 years. The SDQ was found to be reliable, valid, and
practically usefull for these age groups. In this study we examine whether the
SDQ is also a reliable and valid instrument in older age groups (13 years and
older).

For adolescents professional Health Care workers in the Netherlands do not use
any standard instruments for the detection of problems, or they used the
so-called KIVPA (a Dutch questionnaire to detect psychosocial problems in
adolescents). Replacing the KIVPA with the SDQ offers some advantages: using
the SDQ professional Health Care workers can assess and compare the child's
emotional and behavioral problems at different ages; the SDQ can broadly be
used in different informants such as adolescents, parents, and teachers; and
the implementation of this instrument in the Dutch Health Care will be
facilitated. The SDQ is is however, not validated for this age group. Moreover,
sensitivity and specificity of the KIVPA is neither optimal.

This project aims at evaluating the reliability, validity, and the practical
relevance of the SDQ Self Report compared to KIVPA (a Dutch questionnaire to
detect psychosocial problems in adolescents).

The study findings may support the Dutch policy for the use of standard
instruments for the identification of psychosocial problems at early age.
Furthermore, in this study we examine whether the Parent Format and the Teacher
Format of the SDQ, the additional impact questions in the SDQ, and the
subscales can improve the detection of psychosocial problems in adolescents.

The study design has three phases:
1) PREPARATION
In this phase we want to include Preventive Child Health Care Organisations
(Jeugdgezondheid) ) in the Netherlands in the study. In addition, the
questionnaires can be developed in this phase and will be sent to all
participating organisations.
Finally, each organisation will participate in a training session about the
study procedures.

The following questionnaires will be developed:
- Adolescent and Parent questionnaires to determine background information, as
well as the SDQ, KIVPA, and the YSR/CBCL.
- Non respons questionnaire for the professional.
- Questionnaire for the professional to assess his or her personal evaluation
of the psychosocial problems in a individual child, as well as some background
information on the child's family.
- Teacher version of the SDQ
- a multilingual version of the adolescent questionnaire to be used by those
adolescents who can not read the Dutch language.

2) DATA COLLECTION
The PHC professionals send adolescents and their parents a letter asking them
to cooperate in the study, together with a regular health check invitation.
When parents and adolescents are willing to participate, they fill in the SDQ,
the KIVPA, and the YSR/ CBCL.
Questionnaires are put in closed enveloppes, given to the PCH professional who
will send them to TNO. With parents' permission, teachers will be asked whether
he or she perceives the adolescent as having problems, and if so, they answer
the SDQ Teacher Form for that adolescent, for max. 5 of their pupils.

If adolescents are not able to read a Dutch questionnaire, they can answer a
multilangual verson during the regular consultation.

3) ANALYIS AND REPORTING
Using Structural Equation Modeling we want to test the scale structure of the
SDQ and the KIVPA.

Area under curve, sensitivity and the specificity of the SDQ and the KIVPA will
be assessed using the YSR total problem score as a criterium. Prevalence of
elevated scores in the normal population will be compared to scores in a (poli)
clinical sample.

Finally, using logistic regresion analyses we want to determine wheter the SDQ
Parent Format and the SDQ Teacher Form the additional impact questions in the
SDQ, and the subscales can improve the detection of problems in adolescents.

The study findings will be presented in a symposium for Preventive Child Health
Care professionals. Additionally, the study findings will be described in a
report, as well as a peer reviewed scientific publication.

The study takes place in the context of the regular health examination at the
age of 13 years and older. For the purpose of this study, adolescents and
their parents are asked to fill in written questionnaires. This will take about
15 - 20 minutes of their time and implies no risk.