Abstract
Objectives
Mental health screening instruments are essential in population health research and clinical practice. The strengths and difficulties questionnaire (SDQ) self-report version has been widely used across the globe to screen for mental health problems in adolescent populations. This study aimed to explore the psychometric properties of the Latvian and Russian language versions of the SDQ in a representative sample of a general population of Latvian adolescents and establish the population-based normative scores.
Materials and methods
This analysis was based on data from the international Health Behaviour in School-aged Children study year 2017/2018 Latvian database. The sample comprised 2683 Latvian and 1321 Russian-speaking 11-, 13-, and 15-year-old adolescents.
Results
Significant language-based variance was observed in the mean scores of the externalising subscales of the SDQ, with Latvian-speaking adolescents reporting higher levels of conduct problems and hyperactivity. The reliability was satisfactory (ordinal alpha >0.7) only for the prosocial behaviour, emotional, internalising problems, and total difficulties subscales, while conduct, hyperactivity, peer, and externalising problems scales demonstrated lower internal consistency (ordinal alpha 0.5–0.7). Confirmatory factor analysis (CFA) did not support the hypothesised narrow-band five-factor or broad-band three-factor structure of the SDQ. The normative banding scores were calculated for both language variants.
Conclusions
This study suggests that the self-report SDQ must be used cautiously in Latvian adolescents because some SDQ subscales lack reliability. When used in population research, the internalising subscales seem more reliable than the externalising ones. More research is needed regarding the reliability of the SDQ in clinical adolescent populations.
Acknowledgements
The authors would like to thank all the adolescents who participated in this study.
Institutional review board statement
The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Riga Stradins University (protocol Nr.85/21.12.2017).
Informed consent statement
Informed consent was obtained from all subjects involved in the HBSC study. No informed consent was needed for the secondary analysis of the anonymised dataset.
Author contributions
N.B. and A.V. contributed to the conception and design of the study. R.K. did the statistical analysis of the data and drafted a part of the Methods and Results section. L.V. did the literature review and drafted the Introduction. N.B. interpreted the data and drafted the rest of the manuscript. E.R. and A.V. participated in the data interpretation and critically reviewed the manuscript. All authors read and agreed to the published version of the manuscript.
Notes on contributors
Ņikita Bezborodovs is a child psychiatrist and a PhD candidate at the Department of Psychiatry and Narcology, Faculty of Medicine, Riga Stradins University. His research focuses on child and adolescent mental health from a public health perspective. He is involved in developing and implementing mental health screening programs in Latvia.
Rūdolfs Krēgers is a PhD candidate at the Department of Mathematics, Faculty of Physics, Mathematics and Optometry, University of Latvia. His main research interests are in data science and mathematical modelling.
Lelde Vētra is a medical doctor and a trainee clinician in child psychiatry at the Child and Youth Mental Health Centre, Children’s Clinical University Hospital, Riga, Latvia. As part of her training, she participates in research projects on the mental health of help-seeking clinical adolescent populations.
Elmārs Rancāns is a Professor and the Head of the Department of Psychiatry and Narcology, Faculty of Medicine, Riga Stradins University. His current clinical and research interests are in the field of epidemiology and psychopharmacological treatment of affective disorders at the primary care and population level.
Anita Villeruša is a Professor at the Department of Public Health and Epidemiology, Faculty of Public Health and Social Welfare and Lead Researcher at the Institute of Public Health, Riga Stradins University. Her research interests are health behaviours in school-aged children and adults, as well as infant health and traumatism
Disclosure statement
The authors declare no conflict of interest.
Data availability statement
The datasets used and analysed during this study are available from the HBSC study group upon reasonable request.