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

J Am Acad Child Adolesc Psychiatry. 2024 Oct 8: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, China.
⁶ UiT The Arctic University of Norway, Tromsø, Norway.
⁷ National and Kapodistrian University of Athens and Aghia Sophia Children's Hospital, 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 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 SDQ is widely used globally, hence, the validity of the inter-group comparisons is essential. We 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 a cross-cultural research on child and adolescent wellbeing and mental health in 12 Asian and European countries EACMHS. The sample (N = 26,306) came from a cross-sectional school-based survey of adolescents. We used confirmatory factor analysis 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 each of the 12 countries separately supported the use of the first order three-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 findings support the use of the correlated three-factor model comprising the positive dimension of prosocial behavior and two 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: Strengths and difficulties questionnaire (SDQ); adolescent mental health; cross-cultural research; factor structure; measurement invariance.