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Since its development, the Strengths and Difficulties Questionnaire (SDQ) has been widely used in both research and practice. The SDQ screens for positive and negative psychological attributes. This review aims to provide an overview of the psychometric properties of the SDQ for 4- to 12-year-olds. Results from 48 studies (N = 131,223) on reliability and validity of the parent and teacher SDQ are summarized quantitatively and descriptively. Internal consistency, test-retest reliability, and inter-rater agreement are satisfactory for the parent and teacher versions. At subscale level, the reliability of the teacher version seemed stronger compared to that of the parent version. Concerning validity, 15 out of 18 studies confirmed the five-factor structure. Correlations with other measures of psychopathology as well as the screening ability of the SDQ are sufficient. This review shows that the psychometric properties of the SDQ are strong, particularly for the teacher version. For practice, this implies that the use of the SDQ as a screening instrument should be continued. Longitudinal research studies should investigate predictive validity. For both practice and research, we emphasize the use of a multi-informant approach.

In various countries preventive support groups are offered to children of mentally ill and/or addicted parents to reduce the risk that they will develop problems themselves. This study assessed the effectiveness of Dutch support groups for children aged 8–12 years old in terms of reducing negative cognitions; improving social support, competence, and parent–child interaction (direct intervention goals); and reducing emotional and behavioural problems (ultimate intervention aim). Children from 254 families were randomly assigned to the intervention or a control condition. Parents and children completed questionnaires at baseline and 3 and 6 months later. Emotional and behavioural problems of intervention group children were also assessed 1 year after the start. Univariate analyses of variance showed that children in the intervention group experienced a greater decrease in negative cognitions and sought more social support, immediately after participation and 3 months later, as compared to control group children. They also remained stable in their feelings of social acceptance (competence aspect) immediately after the intervention, whereas these feelings declined in control group children. The intervention and control groups both improved over time in terms of cognitions, competence, parent–child interaction and emotional and behavioural problem scores. Additional improvement in terms of problem scores was found in the intervention group 1 year after baseline. Further enhancement of effectiveness requires re-consideration of the support group goals; it should be studied whether the goals reflect the most important and influential risk and protective factors for this specific population. Besides, effects should be studied over a longer period.

Although the detrimental influence of parenting stress on child problem behavior is well established, it remains unknown how these constructs affect each other over time. In accordance with a transactional model, this study investigates how the development of internalizing and externalizing problems is related to the development of parenting stress in children aged 4–9. Mothers of 1582 children participated in three one-year interval data waves. Internalizing and externalizing problems as well as parenting stress were assessed by maternal self-report. Interrelated development of parenting with internalizing and externalizing problems was examined using Latent Growth Modeling. Directionality of effects was further investigated by using cross-lagged models. Parenting stress and externalizing problems showed a decrease over time, whereas internalizing problems remained stable. Initial levels of parenting stress were related to initial levels of both internalizing and externalizing problems. Decreases in parenting stress were related to larger decreases in externalizing problems and to the (stable) course of internalizing problems. Some evidence for reciprocity was found such that externalizing problems were associated with parenting stress and vice versa over time, specifically for boys. Our findings support the transactional model in explaining psychopathology.

Background The children of parents with a mental illness (COPMI) are at increased risk for developing costly psychiatric disorders because of multiple risk factors which threaten parenting quality and thereby child development. Preventive basic care management (PBCM) is an intervention aimed at reducing risk factors and addressing the needs of COPMI-families in different domains. The intervention may lead to financial consequences in the healthcare sector and in other sectors, also known as inter-sectoral costs and benefits (ICBs). The objective of this study was to assess the cost-effectiveness of PBCM from three perspectives: a narrow healthcare perspective, a social care perspective (including childcare costs) and a broad societal perspective (including all ICBs). Methods Effects on parenting quality (as measured by the HOME) and costs during an 18-month period were studied in in a randomized controlled trial. Families received PBCM ( n  = 49) or care as usual (CAU) ( n  = 50). For all three perspectives, incremental cost-effectiveness ratios (ICERs) were calculated. Stochastic uncertainty in the data was dealt with using non-parametric bootstraps. Sensitivity analyses included calculating ICERs excluding cost outliers, and making an adjustment for baseline cost differences. Results Parenting quality improved in the PBCM group and declined in the CAU group, and PBCM was shown to be more costly than CAU. ICERs differ from 461 Euros (healthcare perspective) to 215 Euros (social care perspective) to 175 Euros (societal perspective) per one point improvement on the HOME T-score. The results of the sensitivity analyses, based on complete cases and excluding cost outliers, support the finding that the ICER is lower when adopting a broader perspective. The subgroup analysis and the analysis with baseline adjustments resulted in higher ICERs. Conclusions This study is the first economic evaluation of family-focused preventive basic care management for COPMI in psychiatric and family services. The effects of the chosen perspective on determining the cost-effectiveness of PBCM underscore the importance of economic studies of interdepartmental policies. Future studies focusing on the cost-effectiveness of programs like PBCM in other sites and studies with more power are encouraged as this may improve the quality of information used in supporting decision making. Trial registration NTR2569 , date of registration 2010-10-12.

Background Childhood internalizing and externalizing problems are closely related and often co-occur. Directional models have been employed to test how these problems are related, while few studies have tested a third variables model. Objective This study investigates whether internalizing and externalizing problems are reciprocally or unidirectionally related, whether these relations can be explained by third variables, and how these relations are associated with onset and stability. Methods A community sample of 1,434 children aged 5.08 ( SD  = 1.25) and their mothers participated in two 1-year interval data waves. Internalizing and externalizing problems were examined with the Strengths and Difficulties Questionnaire. Results Using latent cross-lagged modeling, externalizing problems were found not be related to subsequent internalizing problems, or vice versa. These results were also found when controlling for inadequate parenting, parenting stress, maternal health and social preference. When taking problem level into account, externalizing problems were related to stability of clinical level internalizing problems, even when controlling for third variables inadequate parenting, parenting stress, maternal mental health and social preference. Conclusions Strong autoregressive paths for internalizing and externalizing problems were found. Internalizing and externalizing problems do not seem to influence each other over time in the community sample. When investigating relations among internalizing and externalizing problems, it seems to be important to take problem level into account.

Background Children of parents with a mental illness or substance use disorder (COPMI) have an increased risk of developing social-emotional problems themselves. Fear of stigmatisation or unawareness of problems prevents children and parents from understanding each other. Little is known about COPMI with mild intellectual disabilities (ID), except that they have a high risk of developing social-emotional problems and require additional support. In this study, we introduce a program for this group, the effectiveness of which we will study using a quasi-experimental design based on matching. The program ‘You are okay’ consists of a support group for children and an online educational program for parents. The goal of the program is to increase children and parents’ perceived competence with an aim to prevent social-emotional problems in children. Methods/Design Children between ten and twenty years old with mild ID (IQ between 50 and 85) and at least one of their parents with a mental illness will be included in the study. The children will receive part time treatment or residential care from an institute for children with mild ID and behavioural problems. Participants will be assigned to the intervention or the control group. The study has a quasi-experimental design. The children in the intervention group will join a support group, and their parents will be offered an online educational program. Children in the control group will receive care as usual, and their parents will have no extra offer. Assessments will be conducted at baseline, post-test, and follow up (6 months). Children, parents, and social workers will fill out the questionnaires. Discussion The ‘You are okay’ program is expected to increase children and parents’ perceived competence, which can prevent (further) social-emotional problem development. Because the mental illness of parents can be related to the behavioural problems of their children, it is important that children and parents understand each other. When talking about the mental illness of parents becomes standard in children’s treatment, stigmatisation and the fear for stigmatisation can decrease. Trial registration Dutch Trial Register NTR4845 . Registered 9 October 2014.

The goal of the present study was to examine the combined and unique ability of different aspects of family functioning to predict involvement in antisocial behavior in a large nonclinical (community) sample of adolescents. Distinction was made between global (e.g., family socio‐economic status), distal (dispositional characteristics of parents), contextual (family characteristics), and proximal (parent‐child interaction) factors that operate within families. Results show that proximal factors were significant predictors of antisocial behavior, independent of their shared variance with other factors. Consistent with the hypothesized mediational model, the effects of distal and contextual factors appear to be mostly indirect: after their association with proximal factors was taken into account, these factors were no longer significantly related to antisocial behavior. The implications of these findings for planning of developmentally appropriate interventions for ado‐lesents and their families are discussed.

Previous research has established that cognitive theory-based depression prevention programs aiming change in negative cognitive style in early adolescents do not have strong effects in universal settings. Although theories suggest that a negative cognitive style precedes depressive symptoms, empirical findings are mixed. We hypothesized that negative cognitive style may not predict depressive symptoms in adolescents with normative depressive symptoms. Depressive symptoms, negative cognitive style and dependent negative life events were assessed in young adolescents ( N  = 1343; mean age = 13.4 years, SD  = 0.77; 52.3 % girls) at four time points over an 18-month period. Using a cross-lagged panel design, results revealed that depressive symptoms predicted a negative cognitive style but not vice versa. However, when including dependent negative life events as a variable, depressive symptoms did not prospect a negative cognitive style consistently. When dependent negative life events were used as a time-varying covariate, depressive symptoms and a negative cognitive style were not related. We concluded that negative cognitive style is not predictive of depressive symptoms in a community sample of young adolescents. Moreover, the findings suggest that longitudinal relationships between depressive symptoms and a negative cognitive style are not meaningful when dependent negative life events are not considered.

A randomized controlled trail was conducted to examine the effectiveness of a depression and anxiety prevention program ‘Een Sprong Vooruit’ (A Leap Forward) among adolescent girls with a high familial risk (N = 142). The results showed neither effects of the prevention program directly after the intervention, nor at 6 or 12 months follow-up on depression and anxiety symptoms. Further, latent growth curve modeling (LGCM) was used to examine whether the growth functions for the intervention and the control condition were different. The slope representing the change in depression symptoms was not significantly different between the intervention and the control condition. For anxiety symptoms, the difference between slopes was also not significant. Based on these results, we suggested that these high-risk adolescent girls might benefit more from a more intensive prevention program.

Although separation anxiety is prevalent in young children, it remains unclear whether and how maternal separation anxiety is related to separation anxiety in children. This study examined associations between maternal separation anxiety and separation anxiety in children, and the potential effect psychologically controlling parenting. Mothers (N = 269) and children (N = 287) recruited for a community sample participated in two 1-year interval data-waves. Children were aged five-eight and were interviewed using an age-appropriate method for obtaining self-reports of separation anxiety and perceptions of dependency-oriented psychologically controlling parenting. Mothers reported on their feelings of separation anxiety regarding their child via a questionnaire. We found that maternal separation anxiety was positively related to separation anxiety in children within, but not over time. We did not find psychologically controlling parenting to mediate this association. Studying other factors than parenting may be an important avenue for future research in explaining separation anxiety in children.