Reliability and Construct Validity of the Self-Report Version of Strengths and Difficulties Questionnaire in Children and Adolescents With Cerebral Palsy

IF 1.8 4区医学 Q2 PEDIATRICS

Child Care Health and Development Pub Date : 2025-06-09 DOI:10.1111/cch.70114

Hasan Bingöl, Dilan Demirtaş Karaoba

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引用次数: 0

Abstract

Background

Children and adolescents with childhood-onset physical disabilities, including cerebral palsy (CP), face a significantly higher risk of developing mental health disorders due to factors such as reduced physical activity, participation limitations, sleep disturbances, pain, social isolation, rejection, bullying and victimization. Therefore, identifying mental health problems in this population is crucial for promoting their mental health and psychosocial well-being. This study aimed to investigate the reliability and construct validity of the self-report Strengths and Difficulties Questionnaire (SDQ) in children and adolescents with CP.

Methods

The study included 120 children and adolescents with CP (mean age = 14.13 ± 2.2 years), representing the full spectrum of CP subtypes. Internal consistency was assessed using McDonald's omega (ω). Test–retest reliability was assessed using intraclass correlation coefficients (ICC) to estimate the level of consistency in scores for 50 children and adolescents who completed the SDQ again after 14 days. Three types of construct validity were assessed: factorial, convergent and known-group validity. Factorial validity was assessed based on the model fit of structural equation model-based confirmatory factor analysis (CFA). For CFA, the following fit indices were considered acceptable: a Root Mean Square Error of Approximation (RMSEA) < 0.08, a Goodness of Fit Index (GFI) ≥ 0.95 and a Standardized Root Mean Square Residual (SRMR) ≤ 0.08. Convergent validity was assessed by estimating correlations between the SDQ and Cerebral Palsy Quality of Life (CP QOL) scores using Pearson correlation coefficient (r).

Results

Internal consistency and test–retest reliability of both SDQ Total Difficulties Scale and SDQ Prosocial subscale were found to be acceptable (ω: 0.73–0.85; ICCs: 0.77–0.96). The SDQ's factor structure showed good fit (Total Difficulties Scale: RMSEA = 0.03, GFI = 0.95 and SRMR = 0.037; SDQ Prosocial: RMSEA = 0.025, GFI = 0.97 and SRMR = 0.066). Acceptable correlations between SDQ and CP-QOL scores (r = 0.53–0.93) supported convergent validity. Known-groups validity was confirmed, with children with CP showing significantly different SDQ scores compared to their TD peers (p < 0.05).

Conclusion

Our findings provide evidence of adequate internal consistency reliability, test–retest reliability and construct validity for scores on the SDQ for children and adolescents with CP.

Trial Registration: ClinicalTrials.gov identifier: NCT06527508.

Key Messages

This is the first study investigating the measurement properties of the self-report SDQ in children and adolescents with CP
This study yielded satisfactory evidence for the factorial validity, convergent validity and known-group validity of the self-report SDQ, supporting its suitability as a tool for assessing the mental health status of children and adolescents CP aged 11–17 years.
All items in the self-report SDQ were found to effectively measure the intended construct-mental health-demonstrating item homogeneity and supporting internal consistency
The satisfactory agreement between SDQ scores obtained over a two-week interval demonstrated the instrument's temporal stability, indicating strong test–retest reliability.

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脑瘫儿童及青少年优势与困难问卷自述版的信度与构效度

背景患有儿童期身体残疾（包括脑瘫）的儿童和青少年，由于身体活动减少、参与受限、睡眠障碍、疼痛、社会孤立、排斥、欺凌和受害等因素，患精神健康障碍的风险要高得多。因此，确定这一人群的心理健康问题对于促进他们的心理健康和社会心理健康至关重要。本研究旨在探讨儿童和青少年CP自我报告优势与困难问卷（SDQ）的信度和结构效度。方法纳入120例儿童和青少年CP（平均年龄= 14.13±2.2岁），代表了CP的全谱亚型。内部一致性用麦当劳的ω (ω)来评估。使用类内相关系数（ICC）评估重测信度，以估计50名儿童和青少年在14天后再次完成SDQ的分数一致性水平。评估三种构念效度：因子效度、收敛效度和已知组效度。基于结构方程模型的验证性因子分析（CFA）模型拟合评估因子效度。对于CFA，以下拟合指标被认为是可接受的：近似均方根误差（RMSEA） & 0.08，拟合优度指数(GFI)≥0.95，标准化均方根残差(SRMR)≤0.08。通过使用Pearson相关系数(r)估计SDQ与脑瘫生活质量（CP QOL）评分之间的相关性来评估收敛效度。结果SDQ总困难量表和SDQ亲社会分量表的内部一致性和重测信度均可接受(ω: 0.73-0.85；可以:0.77 - -0.96)。SDQ因子结构拟合良好(总困难量表：RMSEA = 0.03, GFI = 0.95, SRMR = 0.037；SDQ亲社会：RMSEA = 0.025, GFI = 0.97, SRMR = 0.066)。SDQ和CP-QOL评分之间可接受的相关性（r = 0.53-0.93）支持收敛效度。已知组效度得到证实，CP患儿的SDQ得分与TD患儿相比有显著差异（p < 0.05）。结论我们的研究结果为儿童和青少年CP的SDQ评分提供了足够的内部一致性信度、重测信度和结构效度的证据。试验注册：ClinicalTrials.gov识别码：NCT06527508。本研究首次探讨了儿童和青少年CP自我报告SDQ的测量特性。本研究对自我报告SDQ的析因效度、收敛效度和已知组效度提供了令人满意的证据。支持其作为评估11-17岁CP儿童和青少年心理健康状况的工具的适用性。自我报告SDQ的所有项目都能有效地测量预期的建构-心理健康状况——显示了项目的同质性和支持内部一致性。在两周的间隔内获得的SDQ分数之间的令人满意的一致性表明了该工具的时间稳定性，表明了较强的重测信度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child Care Health and Development 医学-小儿科

CiteScore

3.40

自引率

5.30%

发文量

136

审稿时长

4-8 weeks

期刊介绍： Child: care, health and development is an international, peer-reviewed journal which publishes papers dealing with all aspects of the health and development of children and young people. We aim to attract quantitative and qualitative research papers relevant to people from all disciplines working in child health. We welcome studies which examine the effects of social and environmental factors on health and development as well as those dealing with clinical issues, the organization of services and health policy. We particularly encourage the submission of studies related to those who are disadvantaged by physical, developmental, emotional and social problems. The journal also aims to collate important research findings and to provide a forum for discussion of global child health issues.