Validity of Strengths and Difficulties Questionnaires in measuring mental health symptoms in Chinese preschoolers

Abstract

<p>Introduction</p><p>Emotional and behavioral problems in preschoolers may develop into mental health problems and disorders in later childhood, and targeted early preventive interventions are warranted. The availability of culturally sensitive and locally validated scales is crucial to facilitate studies in mental health profile of children in early childhood. Strengths and Difficulties Questionnaires (SDQ 2-4) is a widely-used brief screening scale for such and is available free-of-charge yet its validity remains inconclusive. This study aims to assess the internal consistency of parent-report SDQ 2-4 in a sample of Chinese preschoolers.</p><p>Methods</p><p>During 1 January 2024 to 31 March 2024, 301 parents of children aged 2-4 completed an electronic survey on mental health of their preschool children using SDQ 2-4 in Hong Kong. Reliability of SDQ 2-4 was examined using Cronbach’s alpha and McDonald’s omega and its correlations with the use of childhood clinical developmental service were calculated for the total sample and that by gender. All analyses were conducted using R. Ethical approval was obtained.</p><p>Results</p><p>The sample description and the distribution of SDQ scores in the total sample and different gender are shown in Table 1. Boys scored significantly higher in the hyperactivity, externalizing and problem subscales and lower in the prosocial subscale. Reliability of SDQ 2-4 and correlations with the use of childhood clinical developmental service are shown in Table 2. Only the hyperactivity, prosocial, externalizing and problem subscales in boys and the prosocial, externalizing and problem subscales in girls reached acceptable level of inconsistency as determined by McDonald’s omega greater than 0.7. All subscales, except the prosocial subscale, had weak positive correlations (0.1-0.3) with the use of childhood clinical developmental service.</p><p>Conclusion</p><p>In a Chinese sample of preschoolers, only the prosocial, externalizing and problem subscales of SDQ 2-4 showed satisfactory internal consistency. Further studies are required to determine other measures of validity, such as criterion or predictive validity of SDQ 2-4 and to explore other assessment methods in Chinese preschoolers to improve our understanding of multidimensions of mental health in this group. </p>