Screening for the attention deficit hyperactivity disorder phenotype using the strength and difficulties questionnaire

  • Anne Karin UllebøEmail author
  • Maj-Britt Posserud
  • Einar Heiervang
  • Christopher Gillberg
  • Carsten Obel
Original Contribution


The strengths and difficulties questionnaire (SDQ) is a broad-band child mental health instrument, which has been reported to be a good screener for the ADHD phenotype. Questionnaires containing the SDQ and the 18 SNAP-IV items corresponding to the DSM-IV ADHD symptoms were completed by parents and teachers for 66% (N = 6,233) of all 7- to 9-year-olds in the city of Bergen, Norway, 2002. Screening properties of the five-item SDQ hyperactivity–inattention subscale for the DSM-IV ADHD phenotype were examined. Using the DSM-IV ADHD phenotype based on both informants as the gold standard (5.2% of the sample), the receiver operating characteristics (ROC) analyses demonstrated an area under the curve of 0.91 (95% CI: 0.90–0.92) for parent and 0.95 (95% CI: 0.94–0.95) for teacher SDQ hyperactivity–inattention subscale ratings. The SDQ hyperactivity–inattention predictive algorithm identified 74% of those with the ADHD combined subtype as possible or probable cases, but only 22% of those with the inattentive subtype. The 5-item long SDQ hyperactivity–inattention subscale is a shorter substitute for the 18-item ADHD symptom list. The SDQ predictive algorithm had an acceptable sensitivity for the ADHD combined subtype, but low sensitivity for the ADHD inattentive and the ADHD hyperactive subtypes.


Strength and difficulties questionnaire (SDQ) Attention-deficit hyperactivity disorder (ADHD) Screening Children 



We are grateful to the children, parents and teachers for their participation in the study. We extend our thanks to Astri J. Lundervold and Jim Stevenson for comments on the manuscript and to Stein Atle Lie for statistical support. This study was supported by the Norwegian Research Council and the Centre for Child and Adolescent Mental Health, Unifob Health, Bergen.

Conflict of interest

Einar Heiervang is the director and owner of Careahead, which provides teaching and supervision to clinics on the use of the SDQ. The other authors of this manuscript declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Anne Karin Ullebø
    • 1
    Email author
  • Maj-Britt Posserud
    • 1
  • Einar Heiervang
    • 1
  • Christopher Gillberg
    • 1
  • Carsten Obel
    • 1
  1. 1.Unifob Health DepartmentRBUP VestBergenNorway

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