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DIFFRIEND
Child's difficulties interfere with friendships

Codes and Frequencies



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Description

For sample children age 4 to 17, whose parents said they had difficulties with emotions, concentration, behavior, or being able to get along with other people (EMODIFF), and whose difficulties had lasted 1 month or longer (DIFMOS), DIFFRIEND reports responses to the follow-up question, "Do the difficulties interfere with your child's everyday life in the following areas . . . Friendships?" Interviewers handed respondents a flashcard listing acceptable responses: "Not at all," "A little," "A medium amount," "A great deal."

As discussed in more detail below, DIFFRIEND was part of the Strengths and Difficulties Questionnaire Extended (SDQ-EX) which, according to the 2001 and 2003-2004 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." More specifically, in these years, DIFFRIEND was part of a section of the SDQ-EX which the NHIS Survey Descriptions for 2001 forward describe as "extended questions that provide information on the duration of a child's problem and the impact that problem has on the child and his/her family."

Interviewers also asked whether difficulties interfered with other aspects of the child's everyday life.

 

Specifically, the other areas asked about were home life (DIFHOME), classroom learning (DIFLEARN), and leisure (DIFLEISURE). Other questions collected information about whether the difficulties upset or distressed the child (DIFUPSET) and burdened the child's family (DIFBURDEN).

Strengths and Difficulties Questionnaire Extended

DIFFRIEND 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:

The parent respondent version of the SDQ was added as a mental health supplement for children ages 4-17 as part of a collaborative agreement between NCHS and the National Institute of Mental Health (NIMH). The first part of the SDQ consists of 25 scale items . . . These items can be divided into five subscales measuring the following psychological attributes or dimensions:
  • emotional symptoms;
  • conduct problems;
  • hyperactive behavior;
  • peer relationships;
  • prosocial behavior.

DIFFRIEND was an element in the second part of the SDQ, which the same source describes as follows:

The second part of the SDQ, the extended questions . . . obtains additional information about the duration and impact of symptoms, which can be useful for determining psychiatric caseness.


More information on the SDQ-EX is available at www.sdqinfo.com. This source describes the second section of the SDQ-EX, which includes DIFFRIEND, as the "Impact Supplement."

Calculating a Score for the SDQ-EX Impact Supplement 

In the 2001 and 2003-2004 NHIS, if parents said (in EMODIFF) that the child had minor, definite, or severe difficulties with emotions, concentration, behavior, or getting along with others, they were asked how long the difficulties had been present (DIFMOS). If the reported duration of these difficulties was one month or longer, interviewers asked further follow-up questions that were the basis of the following variables:

  • Difficulties upset or distress child (DIFUPSET)
  • Child's difficulties interfere with home life (DIFHOME)
  • Child's difficulties interfere with friendships (DIFFRIEND)
  • Child's difficulties interfere with classroom learning (DIFLEARN)
  • Child's difficulties interfere with leisure activities (DIFLEISURE)

DIFUPSET was based on the question, "Do the difficulties upset or distress your child?" The remaining four variables were based on query, "Do the difficulties interfere with your child's everyday life in the following areas: Home life? Friendships? Classroom learning? Leisure activities?"

The Scoring Guide at the www.sdqinfo.com website provides guidance on how responses for these five variables "can be summed to generate an impact score that ranges from 0 to 10 for the parent-completed version." Under these guidelines, the responses "not at all" and "a little" are given a score of 0; a response of "a medium amount" is given a score of 1; and a response of "a great deal" is given a score of 2. For each of these variables, a score of 0 implies the least impact from the child's difficulty, and a score of 2 implies the greatest impact from the child's difficulty. If the scores for these five variables are summed, the total ranges from 0 to 10, with 0 implying the least impact from the child's difficulties and 10 implying the greatest impact from the child's difficulties.

If parents responded "no" to the opening question about whether the child had difficulties with emotions, concentration, behavior, or getting along with others (EMODIFF), none of these five questions were asked. In such cases, when parents "are not asked to complete the questions on resultant distress or impairment," the Scoring Guide states, "the impact score is automatically scored zero." The same is true when, in DIFMOS, parents reported that difficulty in these areas lasted less than 1 month (and thereby avoided these follow-up questions on "resultant distress or impairment").

The five variables that can be summed to create a total "impact score" receive codes in IPUMS NHIS that facilitate this scoring process. Responses that should receive a score of 0 in the scoring process--namely, "not at all" or "a little"--receive a code of 0 in the first digit. In addition, sample children with no reported difficulties (in EMODIFF) or with difficulties lasting "less than one month" (code 1 in DIFMOS) also receive a code of 0 in the first digit in these five variables. (The three different categories, "No difficulty for greater than or equal to 1 month," "not at all," and "a little" can still be distinguished from each other by the respective values of 0, 1, and 2 in the second digit.) The response "a medium amount," which should receive a score of 1, receives a code of 1 in the first digit (and a code of 0 in the second digit). The response "a great deal," which should receive a score of 2, receives a code of 2 in the first digit (and a code of 0 in the second digit). Cases which should be excluded from this summing of scores--that is, not in universe cases and cases with a response of "unknown"--all receive a code of 9 in the first digit (with the second digit distinguishing between those not in the variable universe and unknowns.)

Put succinctly, to calculate an "impact score" for the child's difficulties, researchers should 1) exclude cases beginning with a code of 9; 2) group together other categories that share a common first digit; 3) sum the scores across the five variables, using only the first digit of the codes for each variable. The result will range from 0 to 10.

The Scoring Guide at www.sdqinfo.com provides the following guideline for interpreting these results:

Although the impact scores can be used as continuous variables, it is sometimes convenient to classify them as normal, borderline, or abnormal: a total impact score of 2 or more is abnormal; a score of 1 is borderline; and a score of 0 is normal.

Individual Elements of the SDQ-EX Impact Supplement

Some researchers may prefer to use only some of the "impact" variables (DIFUPSET, DIFHOME, DIFFRIEND, DIFLEARN, and DIFLEISURE) discussed in the previous section, or to avoid combining their values in a single "impact score."

 

The same is true for EMODIFF (which reports whether the child had difficulties with emotions, concentration, behavior, or getting along with others) and DIFMOS (which reports the duration of such difficulties, if present). DIFBURDEN (which reports parents' answers to the question, "Do the difficulties put a burden on you or the family as a whole?") focuses on the effect of difficulties on family members other than the child. DIFBURDEN is thus excluded from the calculation of an "impact score" for the child, described in the previous section.

In the abbreviated version of the SDQ, which was part of the NHIS in 2002 and 2005 forward, EMODIFF was the only element of the "impact supplement" from the SDQ-EX included in the survey.

Comparability

This variable is completely comparable over time.

Universe

  • 2001; 2003; 2004: Sample children age 4 to 17 who had a known response for whether they had difficulties with emotions, concentration, or behavior and had a known response for how many months their difficulties were present.

Availability

  • 2001, 2003-2004

Weights