Araya, R (2018) Mental health among children and ado

19 Pages·2017·5.54 MB·English

RESEARCHARTICLE
Mental health among children and
adolescents: Construct validity, reliability, and
parent-adolescent agreement on the
‘Strengths and Difficulties Questionnaire’ in
Chile
JorgeGaete1,2*,JesusMontero-Marin3,DanielaValenzuela4,CristianA.Rojas-Barahona5,
a1111111111
EsterbinaOlivares6,RicardoAraya7
a1111111111
a1111111111 1 DepartmentofPublicHealthandEpidemiology,FacultyofMedicine,UniversidaddelosAndes,Santiago,
a1111111111 Chile,2 DepartmentofPopulationHealth,LondonSchoolofHygieneandTropicalMedicine,London,United
a1111111111 Kingdom,3 PrimaryCarePreventionandHealthPromotionResearchNetwork(RedIAPP),Centrode
Investigacio´nBiome´dicaenReddeSaludMental,CIBERSAM,Zaragoza,Spain,4 SchoolofPsychology,
UniversidaddelosAndes,Santiago,Chile,5 FacultyofEducation,PontificiaUniversidadCato´licadeChile,
Santiago,Chile,6 SchoolofNursing(CampusSanFelipe),UniversidaddeValpara´ıso,SanFelipe,Chile,
7 CentreforGlobalMentalHealthandPrimaryCareResearch,HealthServiceandPopulationResearch
Department,InstituteofPsychiatry,Psychology,andNeuroscience,King’sCollegeLondon,London,United
OPENACCESS Kingdom
Citation:GaeteJ,Montero-MarinJ,ValenzuelaD,
*[email protected]
Rojas-BarahonaCA,OlivaresE,ArayaR(2018)
Mentalhealthamongchildrenandadolescents:
Constructvalidity,reliability,andparent-adolescent
Abstract
agreementonthe‘StrengthsandDifficulties
Questionnaire’inChile.PLoSONE13(2):
e0191809.https://doi.org/10.1371/journal. TheStrengthsandDifficultiesQuestionnaire(SDQ)isascreeningtoolusedtomeasure
pone.0191809 psychologicalfunctioningamongchildrenandadolescents.Ithasbeenextensivelyused
Editor:AndreaMartinuzzi,IRCCSE.Medea,ITALY worldwide,butitspsychometricproperties,suchasinternalstructureandreliability,seemto
varyacrosscountries.Thisisthefirststudyexploringtheconstructvalidityandreliabilityof
Received:March16,2017
theSpanishversionofSDQamongearlyadolescents(self-reported)andtheirparentsin
Accepted:January11,2018
LatinAmerica.Atotalof1,284earlyadolescents(9–15years)andtheirparentsanswered
Published:February5,2018
theSDQ.Wealsocollecteddemographicvariables.Aconfirmatoryfactoranalysiswascon-
Copyright:©2018Gaeteetal.Thisisanopen ductedtoassessthelatentstructureoftheSDQ.Wealsousedthemultitrait-multimethod
accessarticledistributedunderthetermsofthe
analysistoseparatethetruevarianceontheconstructsfromvarianceresultingfrommea-
CreativeCommonsAttributionLicense,which
surementmethods(self-reportvs.parentreport),andevaluatedtheagreementbetween
permitsunrestricteduse,distribution,and
reproductioninanymedium,providedtheoriginal adolescentsandtheirparents.Wefoundthattheoriginalfive-factormodelwasagoodsolu-
authorandsourcearecredited. tionandtheresultingsub-scaleshadgoodinternalconsistency.Wealsofoundthattheself-
DataAvailabilityStatement:Dataarefromthe reportedandparentalversionsofSDQprovidedifferentinformation,whicharecomplemen-
AKA-EDU/15andFONIS-EVS-13I0100studies taryandprovideabetterpictureoftheemotional,social,andconductproblemsofadoles-
whosePrincipalInvestigatormaybecontactedat
cents.WehaveaddedevidencefortheconstructvalidityandreliabilityoftheSpanishself-
[email protected]
reportedandparentalSDQversionsinaChileansample.
providedrestrictionstosharethedatapublicly
becauseitcontainssensitiveinformationregarding
mentalhealthofchildrenandadolescents.For
furtherinformationregardingrestrictionstoshare
thedatapublicly,pleasecontactthePresidentof
theCommitteeofEthicsofUniversidaddelos
Andes,JoaquinGarcia-Huidobro:[email protected].
PLOSONE|https://doi.org/10.1371/journal.pone.0191809 February5,2018 1/18
ValidityandreliabilityoftheSDQforadolescentsinChile
Funding:Thisworkwassupportedby:1.Joint Introduction
project—NewLearningEnvironmentsand
Mentalhealthisanimportantproblemworldwide,andChileisnoexception.Ingeneral,the
Technologies—AKA-EDU/15,AcademyofFinland
(http://www.aka.fi/en)andCONICYT,Chile(http:// maincauseofyearslostbecauseofdisabilityamongthepopulationaged10–24yearsoldis
www.conicyt.cl)toJG;2.ChileanNationalGrantfor neuropsychiatricdisorder(45%)[1].Mentalhealthproblemshaveanimportanteffect,not
ResearchandDevelopmentinHealth—FONIS- onlyonthelivesoftheaffectedindividuals,butalsoonthepeoplearoundthem(family,
EVS-13I0100,CONICYT,Chile(http://www.conicyt.
school,peers).Mostofthepsychiatricproblemsweseeinadultlifestartduringchildhoodor
cl)toJG.Thefundershadnoroleinstudydesign,
adolescence[2].RecentreportsshowthattheprevalenceofpsychiatricdisordersamongChil-
datacollectionandanalysis,decisiontopublish,or
eanadolescentsreaches16.5%–18.2%[3,4],butonlyaminorityofaffectedadolescentsmake
preparationofthemanuscript.
contactwiththespecializedservicestheyrequire.
Competinginterests:Theauthorshavedeclared
Detectingmentalhealthproblemsearlyincreasesthechancesofreducedburdenandfuture
thatnocompetinginterestsexist.
complications[5].Inrecentyears,interestindevelopinginstrumentstodetecttheseemotional
andbehaviouraldisordershasbeenincreasing.Moreover,theWorldHealthOrganizationhas
repetitivelyadvocatedusingscreeningtoolsinprimarycaresettingsandschools[6–8].These
instrumentsshouldbevalidandreliableforassessingmentalhealthamongadolescents,but
shouldalsobeshort,simple,andculturallyadapted/tested.
Themostwidelyusedscreeningtestsfordetectingpsychologicalandbehaviouralproblems
amongyoungpeoplearetheChildBehaviorChecklist(CBCL),thePediatricSymptoms
Checklist(PSC),andtheStrengthsandDifficultiesQuestionnaire(SDQ).TheCBCLconsists
of113questionsonspecificproblematicbehaviourstobeansweredbytheparentsorsurro-
gatesofschool-agedchildrenbetween6and18yearsold.Theitemscanbeorganizedinto
threemainscales(totalproblems,internalizingproblems,andexternalizingproblems)and
eightsubscales(withdrawn,somaticcomplaints,anxious/depressed,socialproblems,thought
problems,attentionproblems,delinquentbehaviour,andaggressivebehaviour)[9,10].The
PSCconsistsof35questionsaboutarangeofemotionalandbehaviouralproblemsreported
byparentsofchildrenandadolescentsbetween4and18yearsold[11,12].Theseitemscanbe
organizedintothreesub-scales:attentionproblems,internalizingproblems,andexternalizing
problems.TheSDQconsistsof25itemsaboutanumberofemotionalandbehaviouralprob-
lemsexperiencedbychildrenagedbetween4and16years.Ithasfivesubscales[13]:emotional
symptoms,conductproblems,hyperactivity/attentionproblems,peerproblems,andpro-
socialbehaviour.Thefirstfoursub-scalescanbecombinedintoatotaldifficultiessub-scale,
whilethelastisconsideredthestrengthssub-scale.Ithasthreeversions,tobeanswered,
respectively,byparents/caregivers,byteachers,andbythesubjectsthemselvesifover11years
old;however,theself-reportedversionhasalsobeenusedinyoungerchildren(8–13yearsold)
withgoodpsychometricresults[14].TheSDQoffersseveraladvantagesovertheotherinstru-
ments:1)itisabriefinstrument,andthuslessburdensome;2)itprovidesinformationfrom
threedifferentsourcesusingasimilaritemstructure,allowingcomparisonofresultsanda
morecomprehensiveoverallassessmentofchildrenandadolescents’mentalstatus;and3)it
assessbothstrengthsanddifficultiesatthesametime.
Anotherimportantconsiderationwhenselectinganinstrumentistheavailabilityofstudies
exploringitsvalidityandreliabilityinapopulationofthetargetage.Forinstance,inChile,
thereisastandardizedversionoftheCBCLforchildrenbetween6and11yearsold[15].Itis
worthmentioningthatthiscountry-specificversionisnotbasedontheupdatedgeneralver-
sionavailabletoday.AChileanversionofthenewCBCLhasbeenvalidated,butforapopula-
tionof1½to5-year-oldchildren[16].ThePSChasalsobeenvalidatedinChile,ina
populationofsocioeconomicallyvulnerablestudentsinthefirstgradeofprimaryschool(aged
6years)[17].TheChileanversionofthePSCconsistsof33itemsandhasbeenextensively
usedforschool-agedpre-adolescentstudents(under12yearsold)[18–21].However,valida-
tionstudiesforadolescentsarelacking.Finally,thepsychometricpropertiesoftheSDQhave
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ValidityandreliabilityoftheSDQforadolescentsinChile
beenevaluatedinChilefortheparent-answeredversionforchildrenbetween4and11years
old.Therefore,tothebestofourknowledge,nostudieshaveexploredtheconstructvalidity,
reliability,anddegreeofagreementbetweentheSDQself-reportandtheparentalreportfor
Chileanadolescents.Additionally,weknowofnoSDQstudiesforadolescentsfromSpanish-
speaking,Latin-Americancountries.
ThepsychometricpropertiesoftheSDQself-reportandparentalformatshavebeenwell
establishedforadolescentsinseveralcountries,suchastheUnitedKingdom[22],Germany
[23,24],Netherlands[25],Nordiccountries[26],Russia[27],Australia[28],Austria[29],
India[27],Yemen[27,30],Bangladesh[27,31],China[32,33],Brazil[27],andotherEuro-
peancountries[34].Theonlystudiesexploringtheconstructvalidityandreliabilityofthe
SpanishversionoftheyoungandparentalformatsofthisinstrumentcamefromSpain[35,
36].
Studieshaveconfirmedthefivetheoreticaldimensionsintheadolescentself-reportedver-
sionandintheparentalversionofthequestionnaire,usingexploratoryandconfirmatoryfac-
toranalyses[37,38].However,otherstudieshavefailedtoreplicatetheoriginallypostulated
five-factorsolution[39–42].Additionally,theyhaveproposedathree-factorsolution[41],
combiningtheconductandhyperactivity/attentionproblemsasan‘externalizing’dimension
andtheemotionalandpeerproblemsasan‘internalizing’dimension,whilekeepingthepro-
socialsub-scaleasaseparatefactor[43].Furthermore,despiteevidencethatthefive-factor
modelfitswellacrossgenderandethnicgroupsforyoungchildren[44],astudygathering
informationfromfiveEuropeancountriesfoundthatthenumberoffactorscouldbecountry-
dependentinthecaseofadolescents[40],andaNorwegianstudyfoundthatfactorloadings
weredifferentbetweenpre-adolescentsandadolescents[45].Regardingreliability,somestud-
ieshaveshownadequateinternalconsistency[46–49],whileothershavereportedlowvalues
forsomesub-scales,especiallyforconductandpeerproblems[50].
ForadolescentsinSpanish-speakingcountriesinLatinAmerica,wehavefoundnostudies
exploringtheconstructvalidityoftheSDQbymeansofconfirmatoryfactoranalysis(CFA),
usingparentalandself-reporteddata.Asmentionedearlier,wefoundonlytwostudiesusing
theSDQinChile,oneexploringthepsychometricpropertiesoftheparentalreportsonchil-
drenbetweentheagesof4and11[51],andonepresentingtheresultsofcomparingthescores
betweenearly-adolescentAymara[anindigenousSouthAmericannation]andnon-Aymara
students,usingtheself-reported,parental,andteacherversions[52].
Therefore,weseeaknowledgegapconcerningtheperformanceoftheSDQinSpanish-
speaking,Latin-Americancountries,specifically,itsconstructvalidityandreliabilityforado-
lescentpopulations.Theaimsofthepresentstudyare:i)toevaluatecompetingmodelsofthe
latentstructureoftheSDQ,usingconfirmatoryfactoranalysis;ii)toexplorethereliabilityof
theresultingsub-scaleshavingthebestfit;iii)tocomparethedegreeofagreementbetween
adolescentself-reportsandparentalreports,andtheirrespectiveexplanatorypower;iv)topro-
videnormativedatafortheSDQadolescentandparentalversions.
Methods
Participants
Forthepurposesofthisstudy,weusedSDQdatafromtwoseparatestudiesinsimilar,school-
agedpopulations.Thefirststudy(Study1)isbeingconductedinavulnerableurbanpopula-
tioninSanFelipe,asmallcitynorthofSantiago.Thisisanongoinglongitudinalstudyexplor-
ingthefactorsassociatedwiththedevelopmentofhealth-promotingbehavioursinearly
adolescents.Aspartofthebaselineassessment,weadministeredtheSDQtothestudents(10
to15yearsold)andtheparents.Somepreliminaryresultsofthecross-sectionalanalysishave
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ValidityandreliabilityoftheSDQforadolescentsinChile
beenpublished[53].Thesecondstudy(Study2)gathereddatafromstudents9to15yearsold,
aimingtotestthevalidityoftheSDQandoftheChilean-adaptedversionoftheOlweusBully/
VictimQuestionnaireRevised.Thispreliminaryvalidationstudyispartofalarger,ongoing
researchcalled‘TheKiVaantibullyingprograminprimaryschoolsinChile,withandwithout
thedigitalgamecomponent,arandomizedcontrolledtrial’[54].Wedecidedtopresenthere
analyticalresultsfrombothstudiesbecauseStudy1gatheredinformationfromlow-income
families,whileStudy2gatheredinformationfromlow-,middle-,andhigh-incomefamilies,
allowingthelattersetofresultstobemorerepresentativeoftheadolescentChileanpopulation
asawhole.
Procedureandethics
InStudy1,weinvitedallurban,municipal,state-fundedprimaryschoolsinSanFelipe
(n=10)toparticipateafterobtainingauthorizationfromschoolboardauthorities.Allten
schoolsagreedtoparticipate.Weinformedtheparentsormaincaregiversaboutthestudyand
askedthemtosignandinformedconsenttoallowtheirchildrentoparticipate.Atotalof1,035
parentswerecontacted,682consentedandansweredtheparentalquestionnaire.Onthedayof
theassessment,560studentsassentedtoparticipateandansweredthequestionnaire(10did
notassent,and112wereabsentthatday).Atotalof488parent-childdyadsprovidedcomplete
data.InStudy2,weinvitedfiveschoolstoparticipate.Atotalof1,945parentsormaincaregiv-
erswerecontacted,and1,068consentedandansweredtheparentversionoftheSDQques-
tionnaire.Onthedayoftheassessment,913studentsassentedtoparticipateandansweredthe
questionnaire(50didnotassent,and105wereabsentthatday).Atotalof796parent-child
dyadsprovidedcompletedata.SeeFig1:Flowchart.Inbothstudies,theparentalSDQques-
tionnairewasansweredbythemaincaregiver,whichmostofthetimewasthemother.Other
maincaregiverswerethefatherorothersignificantfamilymembersuchasgrandmother.
BothstudieshadbeenapprovedbytheEthicsCommitteeoftheUniversidaddelosAndes.
Writteninformedconsentwasobtainedfromparentsandwritteninformedassentfromado-
lescents.Thestudyposednorisks.
Measures
Socio-demographicvariables. Sex(0=male;1=female),age(years)andsocio-economic
status(0=low-incomefamilies;1=middle-income;2=high-incomefamilies)werecollected.
Thesocioeconomicstatuswasbasedonthecriteriaofthe2009NationalSystemfortheMea-
surementofEducationQuality,whichgathersinformationfromparentsormaincaregivers
abouttheirhouseholdincome,anditwascollectedfromtheMinistryofEducation.
StrengthsandDifficultiesQuestionnaire(SDQ)[55–57]. Thisquestionnairehas25
items,dividedintofivesubscales:emotionalsymptoms,conductproblems,hyperactivity-inat-
tentionproblems,peerproblems,andpro-socialbehaviour.Thesefivesubscalescanbeorga-
nizedintotwomajorsub-scales:strengths(pro-socialbehaviour)anddifficulties(theother
foursubscales).Eachitemusesathree-pointordinalformattobeansweredwithoneofthefol-
lowing:0=nottrue;1=somewhattrue;and2=certainlytrue.Fiveoftheitemsarenegatively
wordedintheoriginal(i.e.isobedient,thinksbeforeacting,hasgoodattention,hasgood
friends,isgenerallyliked).Therefore,forcompatibilityincombiningsubscalesintomajorsub-
scales,theirscoreswerereversed.Themeanscoreforeachsubscalewasthencalculated(range
0–10).Allscoresforthedifficultiessubscaleswereaddeduptoatotaldifficultiesscore(range:
0–40).Thescoresonthepro-socialsubscalewereanalysedindependently(range:0–10).The
SDQhasbeentranslatedintomorethan50languages[10].WeusedtheauthorizedSpanish
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ValidityandreliabilityoftheSDQforadolescentsinChile
Fig1.Flowchart.
https://doi.org/10.1371/journal.pone.0191809.g001
versionandthescoringalgorithmsproposedbyitsauthor(formoreinformationsee:sdqinfo.
com).
Dataanalysis
Forthepurposesofthisarticle,onlyresponderswithvalidanswersonall25itemswere
includedintheanalyses.
Firstly,wesummarizedthesocio-demographicvariablesandbasicpsychometriccharacter-
isticsoftheitemsusingdescriptivestatistics,includingmeans,standarddeviations(SD),and,
whennecessary,frequenciesandpercentages.Weusedastructuralequationmodelling
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ValidityandreliabilityoftheSDQforadolescentsinChile
approachtoCFA,toassessthestructureoftheproposedfive-factorandthree-factormodels
fortheSDQ,inself-reportsaswellasinparentalreports.MultivariateMardia’scoefficients
[58]andpolychoricmatriceswerecalculatedtoevaluatethedistributionoftheitems.We
ensuredtheadequacyofthematricesbyassessmentofthedeterminant,bytheKMOindex,
andbyBarlett’stest[59].Wealsocalculatedtheinternalconsistencyofeachfactorbyusing
McDonald’sOmega(ω),whichcanbeinterpretedasthesquareofthecorrelationbetweenthe
scalescoreandthelatentvariablecommontoalltheindicators[60].TheOmegaindex
assumesacongenericmodel,whichmeansthatfactorloadingsareallowedtovary,anditalso
takesintoaccounttheitem-specificmeasurementerror.Thus,itprovidesamorerealisticesti-
mateoftruereliabilitythanclassicalCronbach’sAlphavalues,beingthatbothcanbeinter-
pretedusingthesamethresholdcut-offpoints.
Weusedtheunweightedleastsquares(ULS)methodforfactorextraction,inviewofits
robustness[61].Specifically,TheULSmethoddoesnotprovideinferentialestimationsbased
ontheχ2distribution(andthereforedoesnotprovidep-values),butitdoesnotrequireany
distributionalassumption;itisrobustandusuallyconvergesbecauseofitscomputationaleffi-
ciency;ittendstoprovidelessbiasedestimatesofthetrueparametervaluesthanotherproce-
dures;anditshowsgoodperformancewhenworkingwithpolychoricmatrices[62–65].Froma
generalperspective,weusedweusedthefitindicesthattheULSreportssuchasthegoodness-
of-fitindex(GFI),theadjustedgoodness-of-fitindex(AGFI),thenormed-fitindex(NFI),and
theroot-mean-squareofthestandardizedresiduals(RSMR).GFIandAGFIrefertothe
explainedvarianceofthemodel,andvalues>0.90areconsideredacceptable[66].TheNFI
measurestheproportionalreductionintheadjustmentfunctionwhengoingfromnulltothe
proposedmodelandisconsideredacceptablewhen>0.90[67].TheRSMRisthestandardized
differencebetweentheobservedandthepredictedcovariance,indicatingagoodfitforvalues
<0.08[68].Fromananalyticalperspective,standardizedsaturationsandtheexplainedvariance
wereconsidered.WealsousedaCFAapproachtoMTMManalysis[69].Thisapproachpermits
separationofthetruevarianceontheconstructsfromvarianceresultingfrommeasurement
methods(self-reportvs.parentalreport).Thelogicisthatself-reportandparentalmeasuresof
thesameconstructshouldbehighlycorrelated,butthatmeasuresofdifferentconstructsshould
havelowcorrelations.Wecalculatedsquaredfactorloadingstoestimatetheexplainedvariance
inthesub-scalesresultingfromtheunderlyingtraitandthereportingmethod.Theunexplained
variancewastermeduniqueness.Weperformedthesameanalysesaccordingtoage((cid:20)11vs
>11)andsocioeconomicstatus(LowvsMiddle/Highincome)toassesspotentialdifferences.
Wecalculatedthe25th,50th,75th,and90thpercentilescoresforeachgeneratedsub-scale,
forthetotalsampleandforeachsex,forboththeadolescentandtheparentalSDQversions.
Wealsopresentthenormativedataforagegroups(cid:20)11and>11yearsold.
AllanalyseswereperformedusingSTATA-14,SPSS-19,andAmos-7.
Results
Thematerialsusedtoproducethefollowingresultswillbeavailableuponrequest,includinga
detailedlistofdocumentsandallthedatafilesneededinorderforreplication,aswellasevery
stepandthespecificsequencetheinterestedresearchersshouldtakeintoaccounttomakedata
available[70].Authorswillpostthereferredmaterialsinthegroup’swebsite,and/orwillbe
sendwhenaskedforthem[71].
Characteristicsofparticipants
Missingdatafromitemresponsesvariedfrom0.2%to1.0%.Thefinalnumberofrespondents
inchildrenandearlyadolescents(agerange:9–15years)andtheirparentswas1,284(54.0%,
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ValidityandreliabilityoftheSDQforadolescentsinChile
Table1. Descriptivefeaturesofparent-childdyadswithcompletedata.
Totalsample Study1 Study2
%(95%CI)/Mean(SD) %(95%CI)/Mean(SD) %(95%CI)/Mean(SD)
n=1284 n=488 n=796
Sex
Girls 46.0(43.3–48.8) 50.4(46.0–54.8) 56.2(52.7–59.6)
Boys 54.0(51.2–57.0) 49.6(45.2–54.0) 43.8(40.4–47.3)
Age 11.3(1.4) 11.5(1.2) 11.2(1.5)
Grade
Year4 13.6(11.8–15.5) - 21.9(19.1–24.9)
Year5 26.2(23.8–28.6) 34.2(30.1–38.6) 21.2(18.5–24.2)
Year6 24.1(21.8–26.5) 32.8(28.8–37.1) 18.7(16.2–21.6)
Year7 24.9(22.6–27.4) 33.0(28.9–37.3) 20.0(17.3–22.9)
Year8 11.3(9.7–13.1) - 18.2(15.7–21.1)
Socioeconomicstatus
Low 40.6(37.9–43.3) 100 4.1(3.0–5.8)
Medium 21.0(18.9–23.3) 33.9(30.7–37.3)
High 38.4(35.8–41.1) 61.9(58.5–65.3)
https://doi.org/10.1371/journal.pone.0191809.t001
female).Themeanagewas11.3years(SD=1.4).Studentsattended4th-(13.6%),5th-(26.2%),
6th-(24.1%),7th-(24.9%),and8th-(11.3%)yearprimaryschool.Ofthestudentsample,40.6%
camefromlow-incomefamilies,21.0%frommiddle-incomefamilies,and38.4%fromhigh-
incomefamilies.Table1showsthegeneralfeaturesofthewholesample,anddividedbystudy.
PsychometricsandconstructvalidityoftheSDQ
ThepolychoricmatrixoftheSDQitemsusingself-reportdatahadadeterminantof0.008,the
KMOtesthadavalueof0.87,Bartlett´stestgave6,167.30(df=300;p<0.001),andMardia’s
statisticwas48.24(p<0.001).Incontrast,thematrixoftheparental-reportSDQitemshada
determinantof0.001,aKMOvalueof0.87,aBartlett´stestof8,340.10(df=300;p<0.001),
andaMardia’sstatisticof82.07(p<0.001).
Table2showsthattheCFAfitindicesfortheSDQwerewithinacceptablevaluesonlyin
thecaseofthefive-factormodel–whichinfactwasoriginallyproposedfromatheoretical
pointofview–andtheywerebetterthaninthecaseofthethree-factormodel,beingthatboth
thecorrespondingself-reportandparental-reportindiceswereadequateintheformer.
Table2. ConfirmatoryfactoranalysisoftheSDQ.
Models CMIN NPAR GFI AGFI NFI RMSR
Threefactors
Self-report 594.79 53 0.924 0.910 0.875 0.092
Parental 554.35 53 0.932 0.918 0.900 0.101
Fivefactors
Self-report 451.05 60 0.943 0.930 0.905 0.081
Parental 387.06 60 0.952 0.941 0.930 0.084
MTMM 704.06 41 0.997 0.988 0.993 0.026
Note:CMIN,Chi-squarestatistic,comparingthetestedmodelandtheindependencemodeltothesaturatedmodel;NPAR,numberofparametersinthemodel;GFI,
goodness-of-fitindex;AGFI,adjustedgoodness-of-fitindex;NFI,normed-fitindex;RMSR,rootmeansquareofthestandardizedresiduals;MTMM,multitrait-
multimethod.
https://doi.org/10.1371/journal.pone.0191809.t002
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ValidityandreliabilityoftheSDQforadolescentsinChile
Table3. DescriptiveandstandardizedfactorloadingsforSDQitems.
Self-report Parental-report
ω Mean SD ω Mean SD
Emotionalsymptoms 0.76 3.48 2.40 0.81 2.86 2.37
Somatic(3) 0.57 0.71 0.56 0.70
Worries(8) 0.90 0.75 0.52 0.66
Unhappy(13) 0.51 0.68 0.38 0.63
Clingy(16) 0.93 0.77 0.77 0.74
Fears(24) 0.58 0.71 0.63 0.72
Conductproblems 0.76 2.21 1.92 0.85 1.98 1.85
Tempers(5) 0.58 0.71 0.80 0.74
Obedient(7) 0.70 0.59 0.57 0.61
Fights(12) 0.33 0.59 0.25 0.52
Lies(18) 0.40 0.63 0.32 0.52
Steals(22) 0.20 0.50 0.04 0.26
Hyperactivity 0.77 3.91 2.39 0.85 3.69 2.56
Restless(2) 0.79 0.75 0.62 0.72
Fidgety(10) 0.78 0.76 0.61 0.72
Distractible(15) 0.92 0.75 0.93 0.77
Thinksbeforeacting(21) 0.69 0.63 0.77 0.61
Goodattention(25) 0.74 0.62 0.75 0.68
Peerproblems 0.65 2.30 1.93 0.76 1.95 1.84
Solitary(6) 0.40 0.65 0.46 0.68
Goodfriend(11) 0.31 0.63 0.20 0.46
Generallyliked(14) 0.51 0.60 0.31 0.52
Bullied(19) 0.42 0.65 0.33 0.55
Adults(23) 0.66 0.74 0.65 0.70
Pro-socialbehaviour 0.72 7.73 1.80 0.77 8.42 1.64
Considerate(1) 1.61 0.55 1.74 0.48
Shares(4) 1.51 0.60 1.68 0.53
Caring(9) 1.55 0.56 1.70 0.51
Kindtokids(17) 1.71 0.53 1.81 0.46
Oftenvolunteerstohelp(20) 1.36 0.64 1.50 0.59
Note:Valuesaremeans,standarddeviations(SD),andMcDonald’sOmega(ω).
https://doi.org/10.1371/journal.pone.0191809.t003
Table3showsthedescriptivestatisticsandMcDonald’sOmegavaluesfortheSDQitems
andfactors,andFig2theweightsandcorrelationsbetweenfactorsfortheCFAbothforself-
reportandparental-reportscores.Aswecansee,thevaluesandvariabilityofthe‘steal’item
arelowinself-reportscores(mean=0.20,SD=0.50),butespeciallysoinparental-report
scores(mean=0.04,SD=0.26).Thefactorialloadingsareadequate,althoughthe‘goodfriend’
itemisalowoutlierinthecaseofself-reportscores(w=0.25).Intermsofreliability,parental
reportsaremoreconsistentthanself-reports.McDonald’sOmegavaluesforself-reportsrange
from0.65(‘peerproblems’)to0.77(‘hyperactivity’)and,inthecaseofparentalreports,from
0.76(‘peerproblems’)to0.85(‘conductproblems’,and‘hyperactivity’).
Inself-reportscores,thecorrelationsamongthefiveconstructsarestrongestbetween‘emo-
tionalsymptoms’and‘peerproblems’(r=0.78),whileinparentalreports,thestrongestcorre-
lationsarebetween‘conductproblems’and‘hyperactivity’(r=0.76).Thelowestcorrelations
inself-reportsarebetween‘pro-socialbehaviour’and‘emotionalsymptoms’(r=-0.06),while
PLOSONE|https://doi.org/10.1371/journal.pone.0191809 February5,2018 8/18
ValidityandreliabilityoftheSDQforadolescentsinChile
Fig2.CFAparametersoftheSDQforself-andparent-reports(n=1,284).
https://doi.org/10.1371/journal.pone.0191809.g002
thelowestcorrelationsinparentalreportsarebetween‘hyperactivity’and‘peerproblems’
(r=0.23).SeeFig2.
TraitandmethodcomponentsintheMTMMapproach
TheCFAapproachtoMTMMwithtwomethodfactorsandfivetraitfactorshasaverygood
fittothemodel(Table2).Fig2showstheCFAparametersfortheMTMMapproach,Fig3
showsthestructuralparametersfortheMTMMmodel,andTable4showsthetraitand
methodvariancecomponents.Aswecansee,thetraitvariancecomponentssuggestthatself-
reportstendtobemorediscriminatingon‘pro-socialbehaviour’(wheretheyarepractically
unaffectedbymethod)and‘conductproblems’.Ontheotherhand,parentalreportsseemto
beparticularlydiscriminatingonratingsfor‘peerproblems’(wheretheyaresubjecttolow
methodeffects)and‘emotionalsymptoms’.Thelargestuniquenessvalueinself-reportsisin
‘emotionalsymptoms’,whileinparentalreportsitisin‘pro-socialbehaviour’.Finally,we
foundmoderatelylowcorrelationsbetweenthemethods(r=0.38).
WehaveproducedadditionalresultsforCFAandMTMManalysesstratifiedbyage((cid:20)11
vs>11)andsocioeconomicstatus(LowvsMiddle/Highincome).Theseresultsareavailable
inS1File.
PLOSONE|https://doi.org/10.1371/journal.pone.0191809 February5,2018 9/18
ValidityandreliabilityoftheSDQforadolescentsinChile
Fig3.StructuralMTMMmodeloftheSDQforChileanadolescents(n=1,284)usingCFA.
https://doi.org/10.1371/journal.pone.0191809.g003
Normativedata. Regardingthepercentilesofthetotaldifficultiesscale,thevaluesare
similarbetweengirlsandboys,beinglowerforgirlswithadifferenceofonepoint.SeeTables
5and6forthetotalsample,Tables7and8forparticipantsaged(cid:20)11yearsold,andTables9
and10forparticipantsaged>11yearsold.Thepercentilesintheself-reportedSDQare
slightlylowerthanthoseintheparentalSDQ.
Table4. TraitandmethodvariancecomponentsfortheMTMManalysis.
Measuredvariables Trait Method Uniqueness
Self-report Emotionalsymptoms 0.10 0.41 0.49
Conductproblems 0.36 0.34 0.30
Hyperactivity 0.42 0.13 0.45
Peerproblems 0.21 0.33 0.46
Pro-socialbehaviour 0.55 0.01 0.44
Parental Emotionalsymptoms 0.45 0.30 0.25
Conductproblems 0.14 0.52 0.34
Hyperactivity 0.29 0.34 0.37
Peerproblems 0.49 0.10 0.41
Pro-socialbehaviour 0.10 0.12 0.78
https://doi.org/10.1371/journal.pone.0191809.t004
PLOSONE|https://doi.org/10.1371/journal.pone.0191809 February5,2018 10/18