Cross-Cultural Comparison of the Strengths and Difficulties Self-Report Questionnaire in 12 Asian and European Countries

Andre Sourander; Minja Westerlund; Hitoshi Kaneko; Emmi Heinonen; Anat Brunstein Klomek; Say How Ong; Sturla Fossum; Gerasimos Kolaitis; Sigita Lesinskiene; Liping Li; Mai Huong Nguyen; Samir Kumar Praharaj; Tjhin Wiguna; Zahra Zamani; Sonja Gilbert; EACMHS Study Group

doi:10.1016/j.jaac.2024.10.002

Cross-Cultural Comparison of the Strengths and Difficulties Self-Report Questionnaire in 12 Asian and European Countries

J Am Acad Child Adolesc Psychiatry. 2024 Oct 9:S0890-8567(24)01938-5. doi: 10.1016/j.jaac.2024.10.002. Online ahead of print.

Authors

Affiliations

¹ INVEST Research Flagship and Turku University Hospital, Turku, Finland. Electronic address: andsou@utu.fi.
² INVEST Research Flagship and University of Turku, Turku, Finland.
³ Nagoya University, Nagoya, Japan.
⁴ Reichman University, Herzlyia, Israel.
⁵ Institute of Mental Health, Singapore.
⁶ UiT The Arctic University of Norway, Tromsø, Norway.
⁷ School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
⁸ Vilnius University, Vilnius, Lithuania.
⁹ Shantou University, School of Public Health, Shantou, China.
¹⁰ Vietnam National Children's Hospital, Hanoi, Vietnam.
¹¹ Kasturba Medical College, Manipal and Manipal Academy of Higher Education, Manipal, Karnataka, India.
¹² Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
¹³ Tehran University of Medical Sciences, Tehran, Iran.

PMID: 39393767
DOI: 10.1016/j.jaac.2024.10.002

Abstract

Objective: The self-report Strengths and Difficulties Questionnaire (SDQ) is widely used globally; hence, the validity of the intergroup comparisons is essential. This study examined the structure of the self-report SDQ in a large multinational adolescent sample, tested its measurement invariance across genders and countries, and compared youth mental health in 12 European and Asian countries.

Method: This study is part of the Eurasian Child Mental Health Study (EACMHS), a cross-cultural research study of child and adolescent well-being and mental health in 12 Asian and European countries. The sample (N = 26,306) came from a cross-sectional school-based survey of adolescents. Confirmatory factor analysis was used to assess a common measurement model for the self-report SDQ and the measurement invariance of the model across gender and country.

Results: Fit indices in the total sample, in each gender, and in each of the 12 countries separately supported the use of the first-order 3-factor model (without the reverse-coded items) as a common measurement model for the self-report SDQ. Measurement invariance analyses provided good support for configural, metric, and scalar invariance across gender; however, metric invariance across countries was not supported. There were significant gender main effects for all SDQ subscales except for hyperactivity/inattention. Culture had significant main effects and moderated the magnitude of gender differences in all subscales.

Conclusion: The present findings support the use of the correlated 3-factor model comprising the positive dimension of prosocial behavior and 2 broad groupings of internalizing and externalizing problems, without the reverse-coded problem items, as a common measurement model for the self-report SDQ internationally.

Keywords: Adolescent mental health; Cross-cultural research; Factor structure; Measurement invariance; Strengths and Difficulties Questionnaire (SDQ).