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Identifying Patterns of Emotional and Behavioural Problems in Preschool children: Facilitating Early Detection
Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Mental health problems often debut in early childhood and may last throughout adulthood, thereby making early detection and intervention especially important. The overarching aim of the present thesis was to identify patterns of emotional and behavioural problems indicating mental health problems in preschool children. To facilitate the detection of such problems early on, one available screening instrument Strengths and Difficulties Questionnaire (SDQ), was validated. The development and interaction of externalising problems in preschool children were studied over time. Functioning and behaviour and their relations to protective and risk indicators in both environmental and personal characteristics were explored. The long-term goal was to increase knowledge about early identification of emotional and behavioural problems in preschool children in order to facilitate early intervention.

In Study I (n=690), the subscales Hyperactivity and Conduct Problems were shown to be valid for children in the age group 1–3 years. A reasonable level of validity was found for the age group 4–5 years when using the original SDQ four-factor solution. The preschool teachers considered most of the SDQ items relevant and possible to rate. Based on the results of Study II (n=815), a score of ≥12 on the SDQ Total Problems Scale is recommended as a cut-off for Swedish preschool children. There were significant differences between boys and girls on all subscales except for the Emotional subscale. The Swedish norms for SDQ are to a large extent similar to findings from other European countries. Study III (n=195) showed that preschool children’s conduct problems decrease over time. Children exhibiting more initial hyperactivity (at year 1) have less reduction in conduct problems over time, i.e. the more hyperactivity early in life, the more conduct problems at year 3. In Study IV (n=197), children high in engagement and social interaction function well over time, even in the presence of hyperactivity, while children with low engagement and interaction alone or in combination with hyperactivity and conduct problems continue to have problems. Stability was related to the existence of a larger number of protective or risk indicators respectively.

Taken together, this thesis has shown that the SDQ can be used to identify preschool children at risk of developing mental health problems later in life.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2018. , p. 126
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1655
National Category
Pediatrics Psychiatry
Identifiers
URN: urn:nbn:se:liu:diva-153581DOI: 10.3384/diss.diva-153581ISBN: 9789176851647 (print)OAI: oai:DiVA.org:liu-153581DiVA, id: diva2:1273264
Public defence
2019-01-11, Belladonnasalen, Campus US, Linköping, 13:00
Opponent
Supervisors
Note

Korrigeringar är gjorda i den elektroniska versionen utifrån publicerad erratalistaThe corrections in the published errata list are implemented in the electronic version.

Available from: 2018-12-20 Created: 2018-12-20 Last updated: 2019-09-30Bibliographically approved
List of papers
1. The Strengths and Difficulties Questionnaire (SDQ) for preschool childrena Swedish validation
Open this publication in new window or tab >>The Strengths and Difficulties Questionnaire (SDQ) for preschool childrena Swedish validation
2016 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, no 8, p. 567-574Article in journal (Refereed) Published
Abstract [en]

Background: In Sweden, 80-90% of children aged 1-5 years attend preschool, and that environment is well suited to identify behaviours that may be signs of mental health problems. The Strengths and Difficulties Questionnaire (SDQ) is a well-known short and structured instrument measuring child behaviours that indicate mental health problems well suited for preschool use.Aim: To investigate whether SDQ is a reliable and valid instrument for identifying behavioural problems in children aged 1-3 years and 4-5 years in a Swedish population, as rated by preschool teachers.Methods: Preschools situated in different sized municipalities in Sweden participated. The preschool teacher rated each individual child. Concurrent validity was tested using the Child-Teacher Report Form (C-TRF) and Child Engagement Questionnaire (CEQ). Exploratory factor analysis was conducted for age groups, 1-3 years and 4-5 years.Results: The preschool teachers considered most of the SDQ items relevant and possible to rate. For the children aged 1-3 years, the subscales Hyperactivity (Cronbach alpha=0.84, split half=0.73) and Conduct (Cronbach alpha=0.76, split half=0.80) were considered to be valid. For the age group 4-5 years, the whole original SDQ scale, 4-factor solution was used and showed reasonable validity (Cronbach alpha=0.83, split half=0.87).Conclusion: SDQ can be used in a preschool setting by preschool teachers as a valid instrument for identifying externalizing behavioural problems (hyperactivity and conduct problems) in young children.Clinical implications: SDQ could be used to identify preschool children at high-risk for mental health problems later in life.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2016
Keywords
Mental health; preschool children; psychometrics; screening; strengths and difficulties questionnaire
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-132330 (URN)10.1080/08039488.2016.1184309 (DOI)000384530700003 ()27241951 (PubMedID)
Note

Funding Agencies|National Board of Health and Welfare (Socialstyrelsen)

Available from: 2016-11-12 Created: 2016-11-01 Last updated: 2018-12-20
2. Emotional and behavioural problems in Swedish preschool children rated by preschool teachers with the Strengths and Difficulties Questionnaire (SDQ)
Open this publication in new window or tab >>Emotional and behavioural problems in Swedish preschool children rated by preschool teachers with the Strengths and Difficulties Questionnaire (SDQ)
2017 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 17, no 110Article in journal (Refereed) Published
Abstract [en]

Background: There is a high risk that young children who show early signs of mental health problems develop symptoms in the same or overlapping areas some years later. The Strengths and Difficulties Questionnaire (SDQ) is widely used to screen externalizing and internalizing problems early in life. In Sweden 80-90% of all children aged 1-5 years go to preschool and preschool is thus an appropriate context for finding early signs of mental health problems among children. Methods: This study is part of a longitudinal project too investigate the frequency of emotional and behavioural problems for children between 1 and 5 years of age in Sweden. The SDQ including the impairment supplement questions were rated by preschool teachers too establish Swedish norms for SDQ in preschool children. Results: The sample involved 815 children with a mean age of 42 months (SD = 16, range 13-71 months). 195 children were followed longitudinally for three years. There were significant differences between boys and girls on all subscales except for the Emotional subscale. The prevalence of behavioural problems was similar to other that in European countries, except for Prosocial behaviour, which was rated lower, and Conduct problems, rated higher. Swedish children were estimated to have more problems in the preschool setting, scored by preschool teachers. The development of behaviour over time differed for the different subscales of SDQ. Conclusions: The teacher version of the SDQ, for 2-4 year-olds, can be used as a screening instrument to identify early signs of emotional distress/behavioural problems in young children. Preschool teachers seem to be able to identify children with problematic behaviour with the use of SDQ at an early age. The development of behaviour over time differs for the different subscales of SDQ. The Swedish norms for SDQ are to a large extent, similar to findings from other European countries.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Preschool children; Behaviour problems; Mental health; Emotional distress; Strengths and difficulties questionnaire; Screening - longitudinal study
National Category
Pediatrics
Identifiers
urn:nbn:se:liu:diva-137605 (URN)10.1186/s12887-017-0864-2 (DOI)000399640600001 ()28431506 (PubMedID)2-s2.0-85018515187 (Scopus ID)
Note

Funding Agencies|National Board of Health and Welfare (Socialstyrelsen); Sunnerdahls Handikappfond and the Futurum; Academy for Health and Care; Region Jonkoping County; Medical Research Council of Southeast Sweden [FORSS- 653271]

Available from: 2017-05-22 Created: 2017-05-22 Last updated: 2018-12-20Bibliographically approved
3. Hyperactivity precedes conduct problems in preschool children: a longitudinal study.
Open this publication in new window or tab >>Hyperactivity precedes conduct problems in preschool children: a longitudinal study.
Show others...
2018 (English)In: BJPsych Open, E-ISSN 2056-4724, Vol. 4, no 4, p. 186-191Article in journal (Refereed) Published
Abstract [en]

Background: Externalising problems are among the most common symptoms of mental health problems in preschool children.

Aims: To investigate the development of externalising problems in preschool children over time, and the way in which conduct problems are linked to hyperactivity problems.

Method: In this longitudinal study, 195 preschool children were included. Latent growth modelling of conduct problems was carried out, with gender and hyperactivity at year 1 as time-invariant predictors.

Results: Hyperactivity was a significant predictor for the intercept and slope of conduct problems. Children with more hyperactivity at year 1 had more conduct problems and a slower reduction in conduct problems. Gender was a significant predictor for the slope of conduct problems.

Conclusions: Children with more initial hyperactivity have less of a reduction in conduct problems over time. It is important to consider the role of hyperactivity in studies of the development of conduct problems.

Declaration of interest: None.

Place, publisher, year, edition, pages
Cambridges Institutes Press, 2018
National Category
Pediatrics Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:liu:diva-153582 (URN)10.1192/bjo.2018.20 (DOI)000436934800004 ()29989010 (PubMedID)
Available from: 2018-12-20 Created: 2018-12-20 Last updated: 2020-01-20

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