Codes and Frequencies
Description
For sample children age 4 to 17, WELLBEHAVED reports parents' responses to a question about whether, during the past 6 months, the child was "generally well-behaved, usually does what adults request."
The interviewer began this part of the survey by stating, "I am going to read a list of items that describe children. For each item, please tell me if it has been not true, somewhat true, [or] certainly true for [sample child] during the past 6 months," and handed the respondent a flashcard listing the three acceptable responses.
The Field Representative's Manuals for 2001 and 2003 forward provided directions on how interviewers should respond if parents indicated that the child was taking medication:
As discussed in more detail in below, WELLBEHAVED was intended to be a measure of the child's "conduct problems." This question was part of the Strengths and Difficulties Questionnaire Extended (SDQ-EX), which, according to the 2001 and 2003 forward Field Representative's Manuals, was included "to monitor emotional and behavioral problems in children and the impact that these problems have on children's lives."
In 2002, 2005-2007, and 2010-2018, a brief version of the Strengths and Difficulties Questionnaire, consisting of just six items, including WELLBEHAVED, was included in the sample child section of the NHIS. The elements of, and the interpretation of results from, the abbreviated version of the SDQ-EX in are discussed toward the bottom of this variable description, directly before the section devoted to comparability issues.
Strengths and Difficulties Questionnaire Extended
WELLBEHAVED is part of a set of 33 questions from the Strengths and Difficulties Questionnaire Extended (SDQ-EX) developed by Dr. Robert Goodman, Institute of Psychiatry, London, England.
As the Appendix on SDQ in the 2001 and 2003-2004 Codebook of the NHIS public use files explains:
- emotional symptoms;
- conduct problems;
- hyperactive behavior;
- peer relationships;
- prosocial behavior.
The survey forms for 2001 and 2003-2004 acknowledged the debt to Dr. Goodman, as follows:
This information was included for legal reasons and was not shared with survey respondents. More information on the SDQ is available at www.sdqinfo.org.
As noted in the Appendix on SDQ in the 2001 and 2003-2004 Codebooks, WELLBEHAVED is an element of the 5-item subscale dealing with conduct problems.
The other elements of this subscale are:
- Often loses temper, past 6 months (BADTEMPER)
- Often fights or bullies kids, past 6 months (BULLIES)
- Often lies or cheats, past 6 months (LIECHEAT)
- Steals from home, school, or elsewhere, past 6 months (STEALS)
Valid responses for these questions were "not true," "somewhat true," and "certainly true." A response of "not true" for BADTEMPER, BULLIES, LIECHEAT, and STEALS (code 0 in IPUMS NHIS) implies the lowest level of conduct problems; a response of "certainly true" for these variables (code 2 in IPUMS NHIS) implies the highest level of conduct problems; and a response of "somewhat true" for these variables (code 1 in IPUMS NHIS) implies an intermediate level of conduct problems. A response of "not true" for WELLBEHAVED (code 2 in IPUMS NHIS) implies the highest level of conduct problems; a response of "certainly true" for this variable (code 0 in IPUMS NHIS) implies the lowest level of conduct problems; and a response of "somewhat true" for this variable (code 1 in IPUMS NHIS) implies an intermediate level of conduct problems. Researchers may choose to use a single variable from this set, but they can also sum the scores across the 5 variables. Summing these elements yields a total score for conduct problems ranging from 0 (the lowest level) to 10 (the highest level).
Summing the values for these variables yields valid totals only if the analyst excludes not in universe cases (persons other than sample children age 4-17, code 6 in IPUMS NHIS) and cases with missing information (codes 7, 8, and 9 in IPUMS NHIS).
The SDQ Scoring Guide provides guidelines for interpreting subscale scores (with Not in Universe and unknown cases excluded) for the SDQ-EX. For "Parent Completed" results (as in the NHIS), the guide suggests a three-band or four-band approach for interpreting the summed score for "Conduct Problems." Under the original three-band categorization, the summed Conduct Problems score can be identified as normal, borderline, or abnormal: a score of 0-2 is normal; a score of 3 is borderline; and a score of 4-10 is abnormal. Under the newer four-band categorization, the summed score can be identified as close to average, slightly raised, high, or very high: a score of 0-2 is close to average; a score of 3 is slightly raised; a score of 4-5 is high; and a score of 6-10 is very high.
The SDQ-EX includes 5 subscales for measuring different aspects of child mental health. The five subscales (i.e., emotional symptoms, conduct problems, hyperactivity behavior, peer relationships, and prosocial behavior) can be scored separately to look at specific psychological characteristics (as described above, for the "conduct problems" subscale). Alternatively, items in four of the five subscales (emotional symptoms, conduct problems, hyperactivity behavior, and peer relationships) can be added for an overall score from 0 to 40.
Variables from the SDQ-EX receive codes in IPUMS NHIS that facilitate this scoring process. More specifically, the response that corresponds to the lowest likelihood of a psychological problem is coded as 0 in IPUMS NHIS; the response that corresponds to the highest likelihood of a psychological problem is coded 2 in IPUMS NHIS; and the response that corresponds to an intermediate level likelihood of a psychological problem is coded 1 in IPUMS NHIS.
This coding strategy to facilitate scoring means that a given parental response of "not true" or "certainly true" may be sometimes coded as 0 and sometimes coded as 2. (Responses of "somewhat true" are always coded 1.) For example, the question, "During the past 6 months, has [child] often complained of headaches, stomach aches, or sickness?" presupposes that "not true" (coded 0 in IPUMS NHIS) implies less emotional symptomology than a response of "certainly true" (coded 2 in IPUMS NHIS). However, with the question, "During the past 6 months, has [child had] at least one good friend?," a response of "not true" implies poorer peer relationships than a response of "certainly true." In the latter case (for the variable HASFRIEND), responses of "not true" are coded 2 in IPUMS NHIS, and responses of "certainly true" are coded 0 in IPUMS NHIS.
Once analysts exclude not in universe cases (persons who are not sample children age 4-17, IPUMS NHIS code 6) and cases with missing information (IPUMS NHIS codes 7, 8, and 9), they may sum the values for the following SDQ-EX variables for an overall score of 0 (least likely to have psychological problems) to 40 (most likely to have psychological problems). In addition to the 5 variables (including WELLBEHAVED) used to measure "Conduct Problems," as described in the previous section, the variables whose values may summed are:
- Complains of headaches/stomach-aches or sickness, past 6 months (STOMACHE)
- Often seems worried, past 6 months (WORRIED)
- Often unhappy, depressed, or tearful, past 6 months (UNHAPPY)
- Nervous or clingy in new situations, past 6 months (CLINGY)
- Many fears or easily scared, past 6 months (FEARFUL)
- Restless or overactive, past 6 months (OVERACTIVE)
- Constantly fidgeting, past 6 months (FIDGETY)
- Easily distracted, past 6 months (DISTRACTED)
- Thinks before acting, past 6 months (THINKSFIRST)
- Good attention span and finishes tasks, past 6 months (GOODATTEN)
- Prefers to be alone, past 6 months (SOLITARY)
- Had at least 1 good friend, past 6 months (HASFRIEND)
- Liked by other kids, past 6 months (KIDSLIKE)
- Was picked on or bullied, past 6 months (PICKEDON)
- Gets along better with adults than kids, past 6 months (GETALONGAD)
In 2002, 2005-2007, and 2010-2018, six items from the SDQ-EX were included in the sample child section of the NHIS, again with the permission of Dr. Robert Goodman. According to Appendix V of the NHIS Survey Description Document for 2002 and 2005, the abbreviated SDQ, "constructed to save time and space in the questionnaire, was added for children of ages 4-17 as a part of a collaborative agreement between NCHS and the National Institute of Mental Health (NIMH) of the National Institutes of Health (NIH)."
In the brief version of the questionnaire used in the 2002, 2005-2007, and 2010-2018 NHIS, one or two items were chosen from each of the 4 subscales making up the Strengths and Difficulties Questionnaire Extended (SDQ-EX). WELLBEHAVED was selected from the "conduct problems" subscale and, according to Appendix V, "correlates 0.69" with the full "SDQ conduct score." WORRIED (Has many worries or often seems worried) was selected from the "emotional symptoms" subscale and, according to Appendix V, "correlates 0.71" with the full "SDQ emotion score." UNHAPPY (Often unhappy, depressed, or tearful, past 6 months) was also selected from the "emotional symptoms" subscale and, according to Appendix V, "correlates 0.64" with the full "SDQ emotion score." GETALONGAD (Gets along better with adults than kids, past 6 months) was selected from the "peer relationships" subscale and, according to Appendix V, "correlates 0.69" with the full "SDQ peer problems score." GOODATTEN (Good attention span and finishes tasks, past 6 months) was selected from the "hyperactivity behavior" subscale and, according to Appendix V, "correlates 0.72" with the full "SDQ hyperactivity-inattention score."
As with the SDQ-EX, variables from the brief version of the SDQ receive codes in IPUMS NHIS that allow researchers to add codes across items for a meaningful overall score. More specifically, the response that corresponds to the lowest likelihood of a psychological problem is coded as 0 in IPUMS NHIS; the response that corresponds to the highest likelihood of a psychological problem is coded 2 in IPUMS NHIS; and the response that corresponds to an intermediate level likelihood of a psychological problem is coded 1 in IPUMS NHIS.
Once analysts exclude not in universe cases (persons who are not sample children age 4-17, IPUMS NHIS code 6) and cases with missing information (IPUMS NHIS codes 7, 8, and 9), they may sum the values for the aforementioned six SDQ variables for an overall score of 0 (least likely to have psychological problems) to 10 (most likely to have psychological problems). According to Appendix V in 2002 and 2005 forward, "all values are summed to produce a total score. A total score from 1 to 5 correlates 0.84 with the full [long] SDQ total difficulties score."
Comparability
With the exception of the NHIS questionnaire redesign introduced in 2019, WELLBEHAVED is completely comparable over time. As mentioned above, this variable is an element of both the extended version of the SDQ, which was fielded for sample children in the NHIS in 2001, 2003, 2004, and 2019 forward, and an element of the short version of SDQ, which was fielded for sample children in 2002, 2005-2007, and 2010-2018.
Other Variables on Child Mental Health
From 1997-2000, the NHIS used questions from the Child Behavioral Checklist (CBCL) developed by Dr. Thomas Achenbach to measure children's emotional and behavioral problems. For 2001 forward, the NHIS retained the CBCL questions for children age 2-3, but replaced the CBCL survey with the Strengths and Difficulties Questionnaire (SDQ) for older children.
For the most part, the public use files of the NHIS data include only summary recodes for the CBCL questions, calculated separately for male and female children age 2-3 (MTODMHI, FTODMHI), for male and female children age 4-11 (MKIDMHI, FKIDMHI), and for male and female children age 12 to 17 (MTEENMHI, FTEENMHI). The one exception to this generalization is that variables from the CBCL relating to whether the child had been unhappy or depressed in recent months (TODDEPRES, KIDDEPRES, TEENDEPRES) appear in the NHIS public files.
The NHIS questionnaire was substantially redesigned in 2019 to introduce a different data collection structure and new content. For more information on changes in terminology, universes, and data collection methods beginning in 2019, please see the user note.
Universe
- 2001-2007: Sample children age 4 to 17.
- 2010-2018: Sample children age 4 to 17.
- 2019 2022: Sample children age 4 to 17.
Availability
- 2001-2007, 2010-2019, 2022
Weights
- 2001-2007, 2010-2019, 2022 : SAMPWEIGHT