Objective: Most screening instruments for externalizing disorders have been developed and validated in Western children. We developed and validated a brief screening instrument for predicting externalizing disorders in native Dutch children as well as in non-Dutch immigrant children, using predictors that can be easily obtained from teachers. Method: Teachers completed the Strengths and Difficulties Questionnaire for an ethnic diverse sample of 2,185 children ages 6 to 10 years. In a stratified subsample, 254 children and their parents were additionally interviewed regarding psychiatric disorders and sociodemographic data. In this group, stepwise logistic regression was used to derive a score from sex and all items of the Hyperactivity and Conduct Problems Scale of the Strengths and Difficulties Questionnaire, for predicting a best-estimate diagnosis of any externalizing disorder. The accuracy of the score was compared between native Dutch and non-Dutch immigrant children. Results: Ninety-one cases of externalizing disorders were identified. An externalizing disorder could be predicted by the items restless, obeys, lies, and concentrates. Sex and ethnicity did not contribute to a prediction of an externalizing disorder. The area under the receiver operating characteristic was 0.84 (95% confidence interval 0.79Y0.89), indicating good discriminatory power with no substantial differences between native Dutch and non-Dutch immigrant children. Conclusions: Externalizing disorders in both native Dutch and non- Dutch immigrant children can be predicted with a scoring rule, based on only four items that can be easily assessed by teachers. Before this internally validated prediction tool can be implemented, external validation in another sample is necessary.

Additional Metadata
Keywords ethnicity, externalizing disorders, prediction, sex
Persistent URL dx.doi.org/10.1097/CHI.0b013e318160c5c7, hdl.handle.net/1765/12203
Citation
Zwirs, B.W.C., Burger, H., Schulpen, T.W.J., & Buitelaar, J.K.. (2008). Developing a Brief Cross-Culturally Validated Screening Tool for Externalizing Disorders in Children. American Academy of Child and Adolescent Psychiatry. Journal, 47(3), 309–316. doi:10.1097/CHI.0b013e318160c5c7