New evidence of factor structure and measurement invariance of the SDQ across five European nations

Understanding the relationship between gender and mental health in adolescence: the Gender Adherence Index (GAI)

Half of all mental health disorders appear during adolescence, although it is still far from clear how they relate to gender (not sex) criteria. This study aims both to analyse the relationship between gender and adolescent mental health and to propose an index: the Gender Adherence Index (GAI). We used cross-sectional, secondary data from 3888 adolescents (aged 13-19) from the FRESC Health Survey on Adolescence in Barcelona. We analysed the interaction among sex, age and socio-economic status with several mental health indices. Additionally, we computed a Gender Adherence Index (GAI) to transcend the information-poor binary sex label, and thus assess to what extent mental health can be predicted by the gender expression of adolescents irrespective of their biological sex. We found that older age and lower economic status have a greater impact on the emotional distress of girls, who reported lower self-perceived mental health than boys. Nevertheless, girls obtained higher scores regarding their prosocial behaviour, which is protective against mental health problems. The GAI was retained in all statistical models stressing it as a relevant metric to explain the variability of adolescent emotional distress. Young people who showed adherence to normative femininity in their lifestyles showed higher prosocial behaviour but did not tend to present more emotional distress. Despite its limitations, this is a novel attempt to explore the relationship between gender expression and mental health. Better defined indices of gender adherence could help us to improve our predictive capacity of mental health disorders during adolescence.

Investigating the factorial structure and measurement invariance of the parent-reported strengths and difficulties questionnaire at 11 years of age from the UK Millennium Cohort Study

The strengths and difficulties questionnaire (SDQ) consist of five sub-scales that have been used to measure internalising and externalising symptoms in children, typically by combining sum scores of two sub-scales each, and pro-social behaviours. However, the different possible factorial structures that represent these symptoms have not been formally tested in a nationally representative sample of UK children. In addition, it is necessary to assess whether the SDQ is interpreted similarly across subgroups of the population. Exploratory and confirmatory factor analysis were used to test three competing structures for the parent-reported SDQ collected at age 11, the start of adolescence, in the UK Millennium Cohort Study (n = 11,519), and measurement invariance was assessed according to sex and a measure of deprivation of the area in which households lived. Internal consistency using ordinal alpha, internal convergent validity and external discriminant validity using average variance explained (AVE), and predictive validity were assessed. A five-factor model and a model with two second-order factors for internalising and externalising symptoms had better model fit than a three-factor model. For both structures, invariance was demonstrated across sex and area-level deprivation. AVE scores for the five-factor model indicated that peer and emotional problems factors were measuring a similar construct, as were the hyperactivity and conduct factors. In the second-order model, AVE scores indicated internalising and externalising symptoms were distinct constructs. A second-order model with two factors for internalising and externalising symptoms is appropriate for use in a cohort of UK children born in 2001/02, and our finding of invariance across sex and area-level deprivation indicate that the SDQ can be used in analysis investigating differences in symptoms across subgroups of the population.

Self-reported and parent-reported mental health in children from low-income families in Agder, Norway: results from baseline measurements of New Patterns project participants

BACKGROUND

Poverty may pose risks to child and adolescent mental health, but few studies have reported on this association among children and adolescents in low-income families in Norway.

METHODS

Based on a sample participating in an intervention for low-income families in Norway, we report data from the survey administered at the start of the intervention. Mental health problems were measured using the Strengths and Difficulties Questionnaire (SDQ; self-report (SR) n = 148; parent/proxy-report (PR) n = 153, mean age = 10.8). Demographic and family characteristics were obtained from parent reported data. Results are presented by gender and migration background. Regression analysis was used to investigate the relative contribution of background factors to mental health symptoms. The distribution of scores is compared to UK norms.

RESULTS

Participants reported relatively high scores on the Strengths and Difficulties Questionnaire (SDQ) Total Difficulties Scale (parent/proxy-report, PR mean=10.7; self-report, SR mean=10.1). Participants with non-immigrant backgrounds scored considerably higher on the Total Difficulties Scale (PR mean difference=2.9; SR 5.3) and on most other domains measured with the SDQ compared with their peers with immigration backgrounds. Participants generally scored higher than or equal to UK norms.

CONCLUSION

Participants in the current study had many symptoms of mental health problems, with large differences between those with and without a migrant background. Interventions for low-income families should be based on detailed knowledge about differences in family risks, resources and needs.

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.

Mental health among unaccompanied refugee minors after settling in Norway: A matched cross-sectional study

Aims: To describe the mental health of unaccompanied refugee minors (URMs) settled in Norway and compare their responses to an age- and sex-matched sample of Norwegian young people. Methods: The data were from the Pathways to Independence study of URMs aged 15-20 years (n = 81; 82.7% male; response rate 80%) conducted in 2018-2019 in the Bergen municipality, Norway. The data from the URMs were linked to an age- and sex-matched group of young people from the Norwegian youth@hordaland study conducted in 2012 (n = 324). Mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ). Results: URMs were more likely to agree with most items pertaining to emotional problems, peer problems and prosocial subscales than Norwegian young people. Few differences were found for items on the conduct problems and hyperactivity-inattention problems scales. Poor psychometric properties, including weak factor loadings and low internal consistency, were detected for the SDQ subscales among URMs, except for the emotional problems subscale, indicating that the originally proposed five-factor model fitted the data poorly. Conclusions: URMs appear to have moderately more emotional problems than Norwegian young people. They are more likely to report being alone, getting along better with adults than with their peers and being bullied, but also report being more helpful and sharing with others. Studies with larger samples of URMs should determine the most appropriate factor structure of the SDQ when administered to URM samples.

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.

Sleep disturbance has the largest impact on children's behavior and emotions

OBJECTIVE

Children's behavior and emotions are affected by sleep disturbances, the parent-child relationship, media viewing time, and the social status of parents and caregivers. We conducted a questionnaire survey to identify the factors that have the greatest impact on children's behavior and emotions and how these factors relate to each other.

METHODS

A parental questionnaire survey was performed at a public elementary school. The questionnaire comprised questions on the family environment (e.g., family structure, media and game exposure, after-school lessons, and caregiver's work schedule) and physical information, the Strengths and Difficulties Questionnaire (SDQ), the Children's Sleep Habits Questionnaire (CSHQ), and the Pittsburgh Sleep Quality Index (PSQI) for parents' sleep condition. A path diagram was drawn to hypothesize the complex interrelationships among factors, and structural equation modeling was used to estimate the path coefficients.

RESULT

We identified several factors that significantly affected the SDQ score. The CSHQ total score had the largest impact, followed by after-school lessons, single-mother families, and children's sex. In addition, several indirect pathways that led to the CSHQ score (i.e., a pathway from time spent watching television to CSHQ score via children's bedtime and a pathway from single-mother family to CSHQ score via PSQI total score) significantly affected the SDQ score.

CONCLUSION

Children's sleep habits that were influenced by several environmental factors had the greatest impact on children's behavior and emotions, which suggested that children's behavioral problems can be improved by interventions focused on sleep habits, such as sleep hygiene instructions.

Stress-symptoms and well-being in children and adolescents: factor structure, measurement invariance, and validity of English, French, German, Russian, Spanish, and Ukrainian language versions of the SSKJ scales

Objective

The present cross-cultural study examined the factor structure, measurement invariance, and convergent validity of the Stress-Symptom and Well-Being Scales from the Stress and Coping Questionnaire for Children and Adolescents (SSKJ), originally in German, across gender and for five newly developed language versions: English, French, Russian, Spanish, and Ukrainian.

Design

Children and adolescents (N = 5,227) from Germany, France, Russia, the Dominican Republic, Ukraine, and several English-speaking countries participated in the survey study.

Main outcome measures

The SSKJ Stress-Symptom and Well-Being Scales capture stress symptomatology and well-being with five subscales: Somatic Symptoms, Anger, Sadness, Anxiety, and Well-Being. The Strengths and Difficulties Questionnaire (SDQ) was used for validation.

Results

The factorial structure (five factors) was confirmed. In multi-group comparisons, confirmatory factor analyses showed partial metric invariance across the different languages. Regarding gender, results showed scalar invariance for all languages, except for Spanish. Gender differences were shown with girls scoring higher on somatic symptoms, sadness, anxiety (German-, French-, Russian-speaking samples), anger (French), and well-being (German, Ukrainian). Correlations with indicators of mental health and behavioral problems demonstrated convergent validity.

Conclusion

The SSKJ Stress-Symptom and Well-Being Scales showed psychometric evidence for equivalence across the different languages and gender. Thus, this instrument is a useful tool for cross-cultural research in children and adolescents.

A Longitudinal and Gender Invariance Analysis of the Strengths and Difficulties Questionnaire Across Ages 3, 5, 7, 11, 14, and 17 in a Large U.K.-Representative Sample

Developmental invariance is important for making valid inferences about child development from longitudinal data; however, it is rarely tested. We evaluated developmental and gender invariance for one of the most widely used measures of child mental health: the parent-reported Strengths and Difficulties Questionnaire (SDQ). Using data from the large U.K. population-representative Millennium Cohort Study (N = 10,207; with data at ages 3, 5, 7, 11, 14, and 17 years), we tested configural, metric, scalar, and residual invariance in emotional problems, conduct problems, hyperactivity/inattention, prosociality, and peer problems. We found that the SDQ showed poor fit at age 3 in both males and females and at age 17 in males; however, it fit reasonably well and its scores were measurement invariant up to the residual level across gender at ages 5, 7, 11, and 14 years. Scores were also longitudinally measurement invariant across this age range up to the partial residual level. Results suggest that the parent-reported SDQ can be used to estimate developmental trajectories of emotional problems, conduct problems, hyperactivity/inattention, prosociality, and peer problems and their gender differences across the age range 5 to 14 years using a latent model. Developmental differences outside of this range may; however, partly reflect measurement differences.

The IMAGEN study: a decade of imaging genetics in adolescents

Imaging genetics offers the possibility of detecting associations between genotype and brain structure as well as function, with effect sizes potentially exceeding correlations between genotype and behavior. However, study results are often limited due to small sample sizes and methodological differences, thus reducing the reliability of findings. The IMAGEN cohort with 2000 young adolescents assessed from the age of 14 onwards tries to eliminate some of these limitations by offering a longitudinal approach and sufficient sample size for analyzing gene-environment interactions on brain structure and function. Here, we give a systematic review of IMAGEN publications since the start of the consortium. We then focus on the specific phenotype 'drug use' to illustrate the potential of the IMAGEN approach. We describe findings with respect to frontocortical, limbic and striatal brain volume, functional activation elicited by reward anticipation, behavioral inhibition, and affective faces, and their respective associations with drug intake. In addition to describing its strengths, we also discuss limitations of the IMAGEN study. Because of the longitudinal design and related attrition, analyses are underpowered for (epi-) genome-wide approaches due to the limited sample size. Estimating the generalizability of results requires replications in independent samples. However, such densely phenotyped longitudinal studies are still rare and alternative internal cross-validation methods (e.g., leave-one out, split-half) are also warranted. In conclusion, the IMAGEN cohort is a unique, very well characterized longitudinal sample, which helped to elucidate neurobiological mechanisms involved in complex behavior and offers the possibility to further disentangle genotype × phenotype interactions.

Emotional and behavioural difficulties and prosocial behaviour in adolescents: A latent profile analysis

INTRODUCTION

The purpose of this study was to identify homogenous subgroups of adolescents with emotional and behavioural difficulties using latent profile analysis. The relationship between the latent profile classes and socio-emotional and school adjustment was also analysed.

MATERIALS AND METHODS

A total of 1,506 students, 667 men (44.3%) were selected by random cluster sampling. The mean age was 16.15 years (SD=1.36). The instruments used were the Strengths and Difficulties Questionnaire, the Personal Wellbeing Index-School Version, The 10-item Positive and Negative Affect Schedule for Children, the Prodromal Questionnaire Brief, the Paykel Suicide Scale, the Cyberbullying-Brief Questionnaire, the Penn Matrix Reasoning Test, and the school performance assessment.

RESULTS

A total of 7.7% of adolescents obtained risk scores for mental health difficulties. We identified 3 mental health subgroups named: Low risk, Externalizing, and Internalizing. These 3 latent classes demonstrated a differential pattern in terms of socio-emotional adjustment and academic performance.

CONCLUSIONS

To identify and validate risk groups of youths for emotional and behavioural problems allows implementing measures to promote emotional well-being and prevent mental health problems. Future studies should continue to analyse young people with emotional and behavioural problems longitudinally and to incorporate new forms of assessment and intervention.

Turning Back to Treatment: The Effect of Attendance and Symptom Outcomes on Subsequent Service Use

This study explored whether post-treatment symptom severity moderated the association between session attendance during an initial treatment episode and subsequent mental health service use. Data on attendance, symptom severity, and service use were gathered from an effectiveness trial testing a modular treatment for youth anxiety, depression, disruptive behavior, and traumatic stress. Multilevel logistic regression analyses showed a significant interaction between attendance and post-treatment symptom severity on subsequent service use, such that attendance significantly predicted subsequent service use when post-treatment symptom severity was in the normal range. Implications regarding the influence of treatment engagement on future help-seeking are discussed.

Strengths Against Psychopathology in Adolescents: Ratifying the Robust Buffer Role of Trait Emotional Intelligence

The aim of this study was to unravel the interrelated effects of trait emotional intelligence (Trait EI), mindfulness, and irrational beliefs on adolescent mental health. A random sample of students from three secondary schools in Spain and eight secondary schools in Portugal was recruited. We conducted four-step hierarchical regression analyses. We also conducted regression analyses to examine the role of mindfulness skills and catastrophizing as mediators of the link between emotional intelligence and psychosocial problems. Finally, the SPSS PROCESS computing tool was used to perform conditional process analysis (model 6). A total of 1370 adolescents from Spain (n = 591) and Portugal (n = 779) participated in this study (mean age = 14.97, SD = 1.50; range = 12-18). The mediation analyses confirmed that adolescent mental health was determined by Trait EI directly, and by mindfulness skills and catastrophizing thoughts in an indirect way. Together, the four variables explained 44% of psychopathology, with EI being the most powerful predictor, which ratify the robust buffer role and incremental validity of Trait EI against youth mental health. The identified pathways provide keys for emotional education interventions aimed at promoting adolescent mental health.

Measurement Invariance of Psychotic-Like Symptoms as Measured With the Prodromal Questionnaire, Brief Version (PQ-B) in Adolescent and Adult Population Samples

Valid measurement of group differences in self-reported psychotic-like experiences (PLEs) requires knowing any group-specific measurement properties of the instruments. We investigated the measurement invariance of the 21-item Prodromal Questionnaire-Brief (PQ-B) questionnaire across gender, ethnic minority/majority status, and presence of depressive symptoms in two different US non-clinical undergraduate samples (N = 1,099). For each item, endorsement of the experience and the associated distress were combined for analysis. A unidimensional model of the PQ-B fit the data well. Across genders, the PQ-B showed configural and metric, but not full scalar invariance; there were statistically significant differences in eight thresholds of six items, most being higher endorsement thresholds for self-identified females. Partial scalar invariance was also found for ethnic status, with five thresholds of three items being higher for the minority participants. For depressive symptomatology, defined as the top quintile by the Beck Depression Inventory-II, partial scalar invariance required dropping one item, after which there were statistically significant differences only in two response thresholds. Overall, a wide range of PLE questionnaire items were found to be robust to gender and ethnicity effects, strengthening confidence in found group differences in PLEs. Although full scalar invariance could not be ascertained for any of the group comparisons, the few found scalar differences across groups were small, with minimal impact on group PLE estimates. However, since PLEs are easily conceptually entangled with depression symptoms, similar items should be considered for exclusion if separable constructs are the target of investigation.

Social Emotional Health Survey-Secondary (SEHS-S): A Universal Screening Measure of Social-Emotional Strengths for Spanish-Speaking Adolescents

The Social Emotional Health Survey-Secondary (SEHS-S), which is a measure of core psychological assets based on a higher-order model of Covitality, is comprised of 36 items and four latent traits (with three measured subscales): belief in self (self-efficacy, self-awareness, and persistence), belief in others (school support, family coherence, and peer support), emotional competence (emotional regulation, behavioral self-control, and empathy), and engaged living (gratitude, zest, and optimism). Previous international studies have supported the psychometric properties of the SEHS-S. The present study extended this research by examining the psychometric properties of a Spanish-language adaptation with a sample of 1042 Spanish adolescents (M_age = 14.49, SD = 1.65.). Confirmatory factor analyses replicated the original factorial structure, with hierarchical omega between 0.66–0.93, with 0.94 for the total score. Factorial invariance across genders revealed small latent mean differences. A path model evaluated concurrent validity, which revealed a significant association between Covitality and bidimensional mental health (psychological distress and well-being). Specifically, correlational analyses showed a negative association with internalizing/externalizing symptoms, and positive associations with subjective well-being, health-related quality of life, and prosocial behaviors. This study provides an example of a culturally relevant adaptation of an international tool to measure student strengths, which is critical to planning school programming and policy.

Universal screening in middle and high schools: Who falls through the cracks?

Navigating academic demands in middle and high school may be particularly challenging for youth experiencing emotional and behavioral difficulties, and screening practices are a necessary first step in identifying youth in need of services. The goal of this study was to inform efficient universal screening practices in secondary schools by comparing 3 common methods of screening, including self- and teacher report on the Strengths and Difficulties Questionnaire, and grade point average (GPA) to indicate moderate and high levels of risk. Participants were 2,350 secondary students (47% female; 94% non-Hispanic White) and their teachers in 1 socioeconomically diverse school district. Using the moderate-risk criteria, there was low agreement among methods, and almost half the sample (46%) was identified as at risk by at least 1 of the 3 methods, indicating that responding to the needs of students who cross this liberal cutoff may not be feasible given school resources. Using the high-risk criteria reduced the agreement among screening measures. Self-report identified the most students as high risk and was more sensitive to teacher-rated concerns than the converse. If students were uniquely identified by teacher report, teachers rated them at high levels of risk, and predominant concerns were related to conduct problems. GPA captured few students with self- or teacher-rated internalizing or externalizing difficulties. Implications for universal screening within secondary schools are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Measurement equivalence of the SDQ in Chinese Adolescents: A horizontal and longitudinal perspective

BACKGROUND

The Strengths and Difficulties Questionnaire (SDQ) is commonly used in research and clinical settings as a tool for the measurement of mental well-being. The current study evaluated the best-fit factor structure model of the Chinese version of the SDQ (SDQ-C) among Chinese adolescents and evaluated the measurement invariance of the SDQ-C across gender, age and time.

METHODS

Participants included 1,134 adolescents from Hunan Province and Hainan Province in China. A confirmatory factor analysis (CFA) was conducted to determine the structure of the SDQ-C on a large scale. Multigroup CFA(N = 1102, 48.5% male, 51.5% female, mean age = 16.2) were utilized to test the measurement invariance of the five subscales included in the SDQ-C, across gender, age and time.

RESULTS

The SDQ-C exhibited strong internal consistency (overall Cronbach's alpha coefficient = 0.927) and moderate test-retest reliability (Pearson's correlation coefficient = 0.719, over a 6-month interval). The CFA showed a valid five-factor model. Measurement invariance of the model across gender was fully supported. However, measurement invariance across age and time was limited.

LIMITATIONS

The participants were from Hunan Province and Hainan Province. It may be necessary to expand the sampled population to better represent the Chinese population.

CONCLUSIONS

Measurement equivalence of the SDQ-C across gender was established. Measurement equivalence across age and time was moderate. These findings suggest that the use of the SDQ-C in comparing samples across gender is valid but measurement across age and time may be limited.

Psychometric properties of the self-report version of the strengths and difficulties questionnaire in the Ecuadorian context: an evaluation of four models

Background

This study evaluates the psychometric properties of four models of the Strengths and Difficulties Questionnaire (SDQ) in a sample of 1470 children and adolescents from Biblián, Ecuador. The instrument has been used by researchers and students. However, there are not reports that show that the instrument is valid or reliable in the Ecuadorian context.

Methods

Reliability was evaluated through Cronbach’s Alpha, McDonald’s Omega, Intra-class Correlations and Greatest Lower Bound (GLB). Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) with polychoric correlation matrix and Diagonally Weighted Least Square (DWLS) estimator is performed in each model. Due to possible readability problems, CFA was performed in three age groups. Measurement invariance analysis across biological sex and two groups of age is carried out.

Results

CFA and reliability analysis revealed poor construct validity of the original version of SDQ. Three additional factor structures were tested. A version that includes a prosocial subscale, and ҅ internalizing ҆ subscale and an ҅ externalizing ҆ subscale has the best yet insufficient construct validity properties among the four models (CFI = .858, TLI = .844, RMSEA = .055, WRMR = 1.588). Cronbach’s Alpha for the subscales ranged from .44 to .71, McDonald’s Omega from .22 to .606, GLB from .612 to .693, and ICC from .385 to .63. Measurement invariance analysis found no evidence of invariance across sex groups and evidence of partial invariance across age groups.

Conclusions

The four tested models have questionable psychometric properties. Consequently, the use of the SDQ in the Ecuadorian context is not advisable. The three-factor first-order model of the SDQ that shows the best validity and reliability properties does not have undisputed psychometric properties. Comparisons across groups of age and/or sex using the SDQ should not be made.

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

Background

The Strengths and Difficulties Questionnaire (SDQ) is widely used to assess child and adolescent mental health problems. However, the factor structure of the SDQ is subject to debate and there is limited evidence investigating measurement equivalence invariance (ME/I) between treatment groups, informants, and across time.

Method

A randomised controlled trial (RCT) recruited 250 participants (6–17 years) who had been referred for an attention deficit hyperactivity disorder (ADHD) assessment. Participants and their clinician either received or did not receive a QbTest report (computer task measuring attention, impulsivity and activity). Parents and teachers completed the SDQ at baseline and 6-months later. This study aimed to understand the factor structure of the SDQ in a clinic referred ADHD sample, and validate the scale as a screening/diagnostic aide and as a measure of treatment outcome both in clinical and research settings. Exploratory Structural Equation Modelling (ESEM) was performed to examine the factor structure, and ME/I was assessed between treatment groups, informants, and time points. The criterion validity of the SDQ predictive algorithm for ADHD was compared with clinician and research diagnoses using logistic regression and tests of diagnostic accuracy.

Results

A 5-factor structure provided the best fit with strong factorial invariance between treatment groups and across time points, but not across informants (parent and teacher ratings). SDQ ratings of ‘probable’ hyperactivity disorder were good predictors of clinical (OR = 10.20, 95%CI 2.18–48.71,p = 0.003) and research diagnoses of ADHD (OR = 6.82, 95%CI 1.95–23.84,p = 0.003), and research diagnoses of Hyperkinetic disorder (OR = 4.02, 95%CI 1.13–14.25,p = 0.031). Further examination of the SDQ hyperactivity ‘probable’ rating showed good specificity (84.5%-74.5%) but poor sensitivity (45.0–42.5%) for ADHD.

Conclusion

The findings indicate the SDQ is a valid outcome measure for use in RCTs and clinical settings. However, care should be taken when using the SDQ predictive algorithm to screen for ADHD in clinically referred samples.

Revising the self-report strengths and difficulties questionnaire for cross-country comparisons of adolescent mental health problems: the SDQ-R

AIMS

The Strengths and Difficulties Questionnaire (SDQ) has been used in many epidemiological studies to assess adolescent mental health problems, but cross-country comparisons of the self-report SDQ are scarce and so far failed to find a good-fitting, common, invariant measurement model across countries. The present study aims to evaluate and establish a version of the self-report SDQ that allows for a valid cross-country comparison of adolescent self-reported mental health problems.

METHODS

Using the Health Behaviour in School-aged Children study, the measurement model and measurement invariance of the 20 items of the self-report SDQ measuring adolescent mental health problems were evaluated. Nationally representative samples of 11-, 13- and 15-year old adolescents (n = 33 233) from seven countries of different regions in Europe (Bulgaria, Germany, Greece, the Netherlands, Poland, Romania, Slovenia) were used.

RESULTS

In order to establish a good-fitting and common measurement model, the five reverse worded items of the self-report SDQ had to be removed. Using this revised version of the self-report SDQ, the SDQ-R, partial measurement invariance was established, indicating that latent factor means assessing conduct problems, emotional symptoms, peer relationships problems and hyperactivity-inattention problems could be validly compared across the countries in this study. Results showed that adolescents in Greece scored relatively low on almost all problem subscales, whereas adolescents in Poland scored relatively high on almost all problem subscales. Adolescents in the Netherlands reported the most divergent profile of mental health problems with the lowest levels of conduct problems, low levels of emotional symptoms and peer relationship problems, but the highest levels of hyperactivity-inattention problems.

CONCLUSIONS

With six factor loadings being non-invariant, partial measurement invariance was established, indicating that the 15-item SDQ-R could be used in our cross-country comparison of adolescent mental health problems. To move the field of internationally comparative research on adolescent mental health forward, studies should test the applicability of the SDQ-R in other countries in- and outside Europe, continue to develop the SDQ-R as a cross-country invariant measure of adolescent mental health, and examine explanations for the found country differences in adolescent mental health problems.

Assessing the factor structure of the Spanish language parent Strengths and Difficulties Questionnaire (SDQ) in Honduras

With worldwide prevalence rates between 10% and 20%, mental illness in children and adolescents is an issue for which culturally sensitive screening tools are needed. The Strengths & Difficulties Questionnaire (SDQ) is a commonly used measure that has been translated into numerous languages, although some research suggests issues with cross-cultural validity. Only four other studies have tested the Spanish-language SDQ in Latin America. In this study, we aimed to help fill this gap by assessing the factor structure of the parent or teacher version of the Spanish-language SDQ (for children ages 4–17) with 967 parent or other caregiver respondents of primary school-aged children (ages 4 to 17) in the Department of Intibucá, Honduras. When unable to find a good fitting factor model previously identified in the literature, we conducted split sample exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), along with measurement invariance testing with the best fitting EFA-extracted model based on gender for caregiver respondent and child gender. Results showed that while many EFA models had a good fit, CFI and TLI was < .90 for all extracted models when confirmed in the second sample with CFA. We then modified the best fitting extracted three-factor, 24-item model, which dropped item 15, by allowing select item residuals to correlate, increasing CFI and TLI to > .90 for female child gender. This modified three-factor model was partially invariant for configural and scalar models between child genders. Configural and scalar models would not converge for adult genders. Of note, metric models were not produced in Mplus related to items’ cross-loading on more than one factor. These findings suggest that the SDQ Spanish language parent or teacher version may not perform optimally cross-culturally in this area of Honduras. Future research should confirm these findings with other Honduran populations.

SDQ in the Hands of Fathers and Preschool Teachers-Psychometric Properties in a Non-clinical Sample of 3-5-Year-Olds

The Strengths and Difficulties Questionnaire (SDQ) is a well-established instrument for measuring social and behavioural problems among children, with good psychometric properties for older children, but less validity reports on pre-schoolers. In addition, there is a knowledge gap concerning fathers as informants. The present work is one of the few validity studies to include preschool teachers and the first on preschool children where fathers are included as separate informants. In this study, SDQs were collected from a large community sample (n = 17,752) of children aged 3-5, rated by mothers, fathers, and preschool teachers and analysed using confirmatory factor analysis. Our results revealed acceptable fit for all informant groups and measurement invariance across child gender, child age, and parental education level. Our findings suggest good construct validity of the SDQ for a non-clinical preschool population and imply that it may be used for assessing child behaviour problems from different informant perspectives.

Do learners with special education needs really feel included? Evidence from the Perception of Inclusion Questionnaire and Strengths and Difficulties Questionnaire

BACKGROUND

School inclusion is an important right of students in school systems around the world. However, many students with special education needs (SEN) have lower perceptions of inclusion despite attending inclusive schools.

AIMS

This study examined perceived levels of inclusion, academic self-concept and developmental problems in inclusive schools.

METHODS AND PROCEDURES

The Strengths and Difficulties Questionnaire and the Perception of Inclusion Questionnaire were administered at two measurement points (6th and 7th grade; n = 407, including 48 with SEN) at multiple inclusive schools. Responses were compared based on gender, grade level, and SEN. Factor structure and measurement invariance were evaluated.

OUTCOMES AND RESULTS

Factor structures of both questionnaires were confirmed. Academic self-concept and emotional inclusion were lower for learners with SEN. However, these effects shrank in grade 7. Similarly, academic self-concept increased between grade 6 and 7. Lastly, learners with SEN had a higher level of conduct problems.

CONCLUSIONS AND IMPLICATIONS

Both instruments remain suitable for use in comparisons in inclusive schools. Significant differences exist for learners with SEN in inclusive classrooms, although these differences may shrink over time. We recommend the continued use of the Perception of Inclusion Questionnaire for information about school inclusion and for learners with SEN.

Measuring adolescent mental health around the globe: psychometric properties of the self-report Strengths and Difficulties Questionnaire in South Africa, and comparison with UK, Australian and Chinese data

AIMS

This study evaluated the psychometric properties of the Strengths and Difficulties Questionnaire Self-Report (SDQ-S) in South African adolescents, and compared findings with data from the UK, Australia and China.

METHODS

A sample of 3451 South African adolescents in grade 8, the first year of secondary school (Mage = 13.7 years), completed the SDQ-S in Afrikaans, English or isiXhosa. Means, group differences and internal consistency were analysed using SPSS V22, and confirmatory factor analyses were conducted using MPlus V7.

RESULTS

In the South African sample, significant gender differences were found for four of the five sub-scale means and for total difficulties, but gender differences of alpha scores were negligible. The internal consistency for the total difficulties, prosocial behaviour and emotional symptoms sub-scales were fair. UK cut-off values for caseness (set to identify the top 10% of scores in a UK sample) led to a higher proportion of South African adolescents classified in the 'abnormal' range on emotional and peer difficulties and a lower proportion classified in the 'abnormal' range for hyperactivity. South African cut-offs were therefore generated. The cross-country comparison with UK, Australian and Chinese data showed that South African adolescent boys and girls had the highest mean scores on total difficulties as well as on the subscales of emotional symptoms and conduct problems. In contrast, South African boys and girls had the lowest mean scores for hyperactivity/inattention. The UK boys and girls had the highest mean scores for hyperactivity/inattention, while the Australian sample had the highest scores for prosocial behaviours. The Chinese boys had the highest peer problem mean scores and Chinese boys and girls had the lowest means on prosocial behaviours. Confirmatory factor analyses showed significant item loadings with loadings higher than 0.40 for the emotional and prosocial behaviour sub-scales on the five-factor model, but not for all relevant items on the other three domains.

CONCLUSIONS

Findings support the potential usefulness of the SDQ-S in a South African setting, but suggest that the SDQ-S should not be used with UK cut-off values, and indicate the need for further validation and standardisation work in South African adolescents. We recommend that in-country cut-offs for 'caseness' should be used for clinical purposes in South Africa, that cross-country comparisons should be made with caution, and that further examination of naturalistic clusters and factors of the SDQ should be performed in culturally and contextually diverse settings.

Messinvarianz zwischen Eltern- und Jugendversion des Strengths and Difficulties Questionnaire (SDQ)?

Zusammenfassung. Die interne Struktur des Strengths and Difficulties Questionnaire (SDQ) ist kontrovers diskutiert worden. Das erste Ziel der vorliegenden Studie bestand daher in der Überprüfung der internen Struktur der SDQ Jugend- und Elternversion. Auf Basis der Daten der ersten Wiederholungsbefragung der Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland (KiGGS-Studie) wurde mittels konfirmatorischer Faktorenanalysen gezeigt, dass das Fünf-Faktoren-Modell eine gute Anpassungsgüte besitzt, wenn korrelierte Fehlervarianzen zwischen Items mit ähnlichem Inhalt zugelassen werden. Da Skalenmittelwerte aus der SDQ Jugend- und Elternversion häufig miteinander verglichen werden, wurde im zweiten Teil der Analyse geprüft, ob skalare Messinvarianz zwischen beiden SDQ-Versionen besteht. Die Ergebnisse der konfirmatorischen Multi-Gruppen-Faktorenanalysen zeigen, dass der SDQ bei Eltern und Jugendlichen die gleichen Konstrukte erfasst (konfigurale Messinvarianz). Skalare Messinvarianz liegt hingegen nur für 19 der 25 Items vor. Unterschiede in den latenten Skalenmittelwerten zwischen Jugendlichen und Eltern können daher entweder das Ergebnis von tatsächlichen Bewertungsunterschieden darstellen oder sie sind das Resultat der fehlenden skalaren Messinvarianz zwischen beiden SDQ-Versionen. Folglich sollten Unterschiede in den latenten Mittelwerten aus Eltern- und Selbstbeurteilungsversion für Jugendliche mit Vorsicht interpretiert werden.

Is Small Still Beautiful for the Strengths and Difficulties Questionnaire? Novel Findings Using Exploratory Structural Equation Modeling

During the present decade a large body of research has employed confirmatory factor analysis (CFA) to evaluate the factor structure of the Strengths and Difficulties Questionnaire (SDQ) across multiple languages and cultures. However, because CFA can produce strongly biased estimations when the population cross-loadings differ meaningfully from zero, it may not be the most appropriate framework to model the SDQ responses. With this in mind, the current study sought to assess the factorial structure of the SDQ using the more flexible exploratory structural equation modeling approach. Using a large-scale Spanish sample composed of 67,253 youths aged between 10 and 18 years (M = 14.16, SD = 1.07), the results showed that CFA provided a severely biased and overly optimistic assessment of the underlying structure of the SDQ. In contrast, exploratory structural equation modeling revealed a generally weak factorial structure, including questionable indicators with large cross-loadings, multiple error correlations, and significant wording variance. A subsequent Monte Carlo study showed that sample sizes greater than 4,000 would be needed to adequately recover the SDQ loading structure. The findings from this study prevent recommending the SDQ as a screening tool and suggest caution when interpreting previous results in the literature based on CFA modeling.

Normative Data of the Self-Report Version of the German Strengths and Difficulties Questionnaire in an Epidemiological Setting

OBJECTIVE

This study served to establish German norms for the Strengths and Difficulties Questionnaire self-report (SDQ-S) by using data from a representative epidemiological sample from the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS study). Although the German version of the SDQ has been widely used and normative data for the parent version (SDQ-P) exist, no German norms for the self-report version have been reported, so that practitioners had to rely on the available British norms. In addition, we investigated whether sex- and age-specific norms are necessary.

METHODS

At the baseline of the KiGGS study, SDQ-S ratings were collected from n = 6,726 children and adolescents between 11 and 17 years (n = 3,440 boys und n = 3,286 girls). We assessed the internal consistency and age/sex effects of the SDQ-S. Confirmatory factor analysis was conducted to assess the factor structure of the SDQ-S. Banding scores were developed to differentiate children and adolescents with levels of difficulties and categorized them as "normal," "borderline," and "abnormal." General as well as age- and sex-specific bandings were created for both total score and subscales of SDQ-S. In addition, the German norms of the SDQ-S were compared with those of the UK, Norway, and Thailand.

RESULTS

The five-factor solution of the SDQ-S (including Emotional symptoms, Conduct problems, Hyperactivity/Inattention, Peer problems, and Prosocial behavior) provided a satisfactory fit to the data. Moderate internal consistencies (Cronbach's α) were observed for the scales Emotional symptoms, Hyperactivity/Inattention, and Total difficulties score, whereas insufficient internal consistency was found for the scales Peer problems and Conduct problems. However, using McDonald's ω as a more appropriate measure of homogeneity, internal consistencies were found to be satisfactory for all subscales and for Total difficulties. Normative banding scores were established conservatively to avoid producing too many false positives in the category "abnormal." In line with previous research, girls showed more emotional problems but fewer Peer problems than boys. German normative bandings of SDQ-S were similar to the original British bandings and those of other countries.

CONCLUSIONS

This study of the German SDQ-S in a large representative epidemiological sample presents evidence of partly moderate to good psychometric properties. It also supports the usefulness of SDQ-S as an effective and efficient instrument for child and adolescent mental health problems in Germany. German normative banding scores of SDQ-S established in this study were comparable with the original British norms as well as with those of other countries, so that SDQ-S can be recommended as a psychopathological broadband-screening tool.

Strengths and Difficulties Questionnaire: internal validity and reliability for New Zealand preschoolers

OBJECTIVES

This observational study examines the internal construct validity, internal consistency and cross-informant reliability of the Strengths and Difficulties Questionnaire (SDQ) in a New Zealand preschool population across four ethnicity strata (New Zealand European, Māori, Pasifika, Asian).

DESIGN

Rasch analysis was employed to examine internal validity on a subsample of 1000 children. Internal consistency (n=29 075) and cross-informant reliability (n=17 006) were examined using correlations, intraclass correlation coefficients and Cronbach's alpha on the sample available for such analyses.

SETTING AND PARTICIPANTS

Data were used from a national SDQ database provided by the funder, pertaining to New Zealand domiciled children aged 4 and 5 and scored by their parents and teachers.

RESULTS

The five subscales do not fit the Rasch model (as indicated by the overall fit statistics), contain items that are biased (differential item functioning (DIF)) by key variables, suffer from a floor and ceiling effect and have unacceptable internal consistency. After dealing with DIF, the Total Difficulty scale does fit the Rasch model and has good internal consistency. Parent/teacher inter-rater reliability was unacceptably low for all subscales.

CONCLUSION

The five SDQ subscales are not valid and not suitable for use in their own right in New Zealand. We have provided a conversion table for the Total Difficulty scale, which takes account of bias by ethnic group. Clinicians should use this conversion table in order to reconcile DIF by culture in final scores. It is advisable to use both parents and teachers' feedback when considering children's needs for referral of further assessment. Future work should examine whether validity is impacted by different language versions used in the same country.

Do They Rate in the Same Way?

Abstract. The internal structure of the Strengths and Difficulties Questionnaire (SDQ) has been widely discussed in the literature. The first purpose of this study was, therefore, to analyze the internal structure of the SDQ as completed by German parents and teachers. Parents and teachers of 1,135 children between the ages of 3 and 6 years in German daycare facilities were asked to complete the SDQ. Using confirmatory factor analysis (CFA), we found that the original five-factor model with added correlations between items with similar content and allowing cross-loads of reverse-worded items to the prosocial behavior factor is the model that fits the data the best. Additionally, we found significant mean differences between parents and teachers in four of the five SDQ subscales. Nevertheless, to compare the scores across both groups, it is necessary that the SDQ measures social-emotional and behavioral difficulties for both parents and teachers in the same way. Hence, the second purpose of this study was to test for measurement invariance of the SDQ across both groups. Using multigroup confirmatory factor analysis (MGCFA), we found that strict measurement invariance is tenable. Therefore, the observed means of the SDQ scores from parents and teachers are readily comparable and interpretable.

Mental health difficulties in children and adolescents: The study of the SDQ in the Spanish National Health Survey 2011-2012

The Strengths and Difficulties Questionnaire (SDQ) is a well-known measuring instrument widely used for the assessment of mental health in children and adolescents. Relatively few studies have analysed the factor structure, the measurement invariance, and the internal consistency, including the information function of the SDQ in its parent version. The study included a large sample (N = 3828) from the Spanish National Survey (2016 were male; 52.7%). Mean age was 9.13 (SD = 3.21) with ages ranging from 4 to 14. The level of internal consistency of the scores for the Total difficulties score was 0.84, ranging between 0.75 and 0.78 for the SDQ subscales. Results from the confirmatory factor analysis showed a five-factor model as the most appropriate. Nonetheless, the fit indices were inadequate and different modifications were needed. The hypothesis of measurement invariance of the SDQ scores across gender and educational level was supported. The present study allows us to affirm that the SDQ, parent's version form, appears to be an adequate tool for the screening of emotional and behavioural problems for children and adolescents. Future research should analyse the SDQ at cross-cultural level, incorporating novel psychometric frameworks and new mental health classifications.

Should Clinicians Split or Lump Psychiatric Symptoms? The Structure of Psychopathology in Two Large Pediatric Clinical Samples from England and Norway

It has been suggested that the structure of psychiatric phenomena can be reduced to a few symptom dimensions. These proposals, mainly based on epidemiological samples, may not apply to clinical populations. We tested the structure of psychiatric symptoms across two pediatric clinical samples from England (N = 8434) and Norway (N = 5866). Confirmatory factor analyses of the parent-reported Strengths and Difficulties Questionnaire (SDQ) evaluated the relative fit of several models, including a first-order model, a second-order model with the widely-established broad symptom dimensions of internalizing-externalizing, and two bi-factor models capturing a general psychopathology factor. Predictive value of the SDQ subscales for psychiatric disorders was examined. A first-order five-factor solution better fit the data. The expected SDQ subscale(s) related best to the corresponding psychiatric diagnosis. In pediatric clinical samples, a granular approach to psychiatric symptoms where several dimensions are considered seems to fit the data better than models based on lumping symptoms into internalizing/externalizing dimensions.

Review of the strengths and difficulties questionnaire translated into languages spoken by children and adolescents of refugee background

The Strengths and Difficulties Questionnaire (SDQ), routinely used to screen for children's and adolescents' emotional and behavioural problems, has been translated into at least 80 languages. As children of refugee background are particularly vulnerable to mental health problems resulting from their refugee experiences, this review examines whether SDQs translated into languages spoken by major refugee groups are validated and culturally equivalent to the original SDQ and sensitive to change following interventions. No reviewed studies of translated SDQs reported on challenges in achieving conceptual and linguistic equivalence in translation. Factor analysis predominantly showed structural inequivalence with the original 5-factor model, suggesting translated SDQ subscales may measure different constructs. Predictive equivalence findings tended to show somewhat higher sensitivity for detecting disorder than the original SDQ's low sensitivity, and somewhat lower specificity. Outcome studies yielded equivocal results with refugee and immigrant groups. SDQ items do not detect the psychological sequelae of trauma; hence it is recommended that the SDQ be used with caution to screen refugee children, with a follow-up clinical interview for verification. Cross-cultural qualitative research is needed into parents' and adolescents' interpretation of translated SDQ items.

Suicidal ideation in a community-derived sample of Spanish adolescents

INTRODUCTION

Suicide is a current public health problem and among the main causes of mortality in adolescents and young adults. The main goal of this study was to analyse suicidal ideation in a representative sample of Spanish adolescents. Specifically, the prevalence rates of suicide ideation, the psychometric properties of the Paykel Suicide Scale (PSS) scores, and the socio-emotional adjustment of adolescents at risk for suicide were analysed.

MATERIAL AND METHODS

The sample consisted of 1,664 participants (M=16.12 years, SD=1.36, range 14-19 years), selected by stratified sampling by clusters. The instruments used were the PSS, the Strengths and Difficulties Questionnaire, the Personal Wellbeing Index-School Children, and the Oviedo Infrequency Scale.

RESULTS

The results showed that 4.1% of the sample indicated that they had tried to commit suicide in the previous year. Statistically significant differences were found according to gender but not according to age in the PSS mean scores. The analysis of the internal structure of the PSS showed that the one-dimensional model presented excellent goodness of fit indexes. This model showed measurement invariance across gender. The reliability of the scores, estimated with ordinal alpha, was 0.93. Participants who reported suicide ideation showed poorer mental health status and lower life satisfaction compared to the non-suicide ideation group.

CONCLUSIONS

Suicidal ideation is present during adolescence and is associated with poor subjective well-being and increased emotional and behavioural problems. PSS seems to show adequate psychometric behaviour to assess suicidal ideation in adolescents. These findings have clear implications, both in health and education systems, to improve the promotion of emotional well-being and prevention of psychological and psychiatric problems in this sector of the population.

Analysis of Predictive Factors on Minors' Mental Health According to the Spanish National Health Survey

Research on minors' mental health is an increasingly developing area. Given the increased prevalence of disorders, it seems necessary to analyze the factors that can affect poor mental health. This study analyzes the influence of occupational class, educational level, age, sex and perceived mental health of Spanish children, which is measured through the Strengths and Difficulties Questionnaire. The sample consists of 3599 minors between 4 and 14 years old, who were interviewed through the Spanish National Health Survey 2011. Our results indicating the significant (p < 0.05) relationship between mental health, occupational class (OR 0.533) and minors' health in the last year (OR 0.313) are shown. However, gender (OR 1.187) and educational level of Pre-School Education in relation to Secondary Education (OR 1.174) and Primary Education (OR 0.996) do not generate significant differences. In conclusion, we consider it necessary to design and implement public policies aimed at improving the care system for children who have had poor or regular health in the last year, and whose parents are positioned in the lowest part of the occupational scale.

Trauma Center Youth Violence Screening and Brief Interventions: A Multisite Pilot Feasibility Study

Every day, 16 American youths between the ages of 10 and 24 years are murdered; 84% of these fatalities involve a firearm. Nearly half of traumatic youth deaths result from violence-related injuries. In 2013, 580,250 youth suffered nonfatal, assault-related injuries, necessitating emergency department treatment. The aim of this multisite pilot study was to examine the process, feasibility, and challenges of violence brief interventions (VBIs). The participants were youth between 15 and 25 years of age, at 2 major Level 1 trauma centers (TCs; TC1, TC2) in the Southeastern United States. Eligible participants (N = 38; TC1: n = 20, TC2: n = 18) received at least 1 VBI during their hospital stay, which provided information about individual screening results and elicited patients' perspectives on violent and risky behaviors. More participants at TC2 than at TC1 completed 2 VBI sessions. Barriers to and support of implementation were identified at both sites, and factors for improving implementation were identified, including the need for staff support through clinical guidelines and coordinated prevention and outreach programs. Further research is needed to identify factors for successful implementation of VBIs in TCs.

The use of the SDQ with Chinese adolescents in the clinical context

This study investigated the psychometric properties of the Strengths and Difficulties Questionnaire when it was applied to a sample of 443 outpatients in China. Included in the sample were 88 adolescents diagnosed with depression, 96 with schizophrenia, 98 with generalized anxiety, 70 with OCD, and 91 with ADHD. Each patient and one of their parents completed the SDQ at intake. Confirmatory Factor Analyses provided limited support for the proposed five factor structure of the scale over other models. Internal reliabilities of the subscales for both self and parent report were weak, and inter-rater agreement between self- and parent-report was moderate. The specificity and sensitivity for the Total Difficulties scores were weak. Overall, these findings suggest that the use of the SDQ in clinical samples in China may be limited.

The Strengths and Difficulties Questionnaire (SDQ): Factor Structure and Gender Equivalence in Norwegian Adolescents

Although frequently used with older adolescents, few studies of the factor structure, internal consistency and gender equivalence of the SDQ exists for this age group, with inconsistent findings. In the present study, confirmatory factor analysis (CFA) was used to evaluate the five-factor structure of the SDQ in a population sample of 10,254 16-18 year-olds from the youth@hordaland study. Measurement invariance across gender was assessed using multigroup CFA. A modestly modified five-factor solution fitted the data acceptably, accounting for one cross loading and some local dependencies. Importantly, partial measurement non-invariance was identified, with differential item functioning in eight items, and higher correlations between emotional and conduct problems for boys compared to girls. Implications for use clinically and in research are discussed.