Journal of Clinical and Diagnostic Research. 2018 Jul, Vol-12(7): VM01-VM03 1 1 DOI: 10.7860/JCDR/2018/34087.11840 Short Communication Psychiatry/Mental Health Section Cross Cultural Adaptation, into Gujarati, of the English version, Strengths and Difficulties Questionnaire JAGDISH VARMA 1 , SANDHYA NAIR 2 , JAISHREE GANJIWALE 3 , SOMASHEKHAR NIMBALKA 4 , NIKHIL KHAROD 5 Keywords: Adolescent health, Child psychiatry, Child psychology, School health ABSTRACT Introduction: Adolescent mental health is a neglected entity today which needs to be addressed at the earliest. Several mental health screening questionnaires and tools are available for the same. Aim: To translate and validate self-report version of Strengths and Difficulties Questionnaire (SDQ), (11-17 years) into Gujarati (language). Materials and Methods: Cross-sectional study was conducted in two bilingual higher secondary schools from Anand district, Gujarat. A total of 30 students with 15 students (11-17 years) from Gujarati and English medium schools each belonged to 8 th and 9 th grades who were fluent in both Gujarati and English were selected. Scale performance was measured as normal/borderline/ abnormal based on the scores of the 25 items of SDQ. Linguistic equivalence, conceptual equivalence, scale equivalence and reliability of both versions of the SDQ were compared. Ethical clearance from the Ethics Committee was obtained and permission was sought from the heads of the schools. Results: Linguistic equivalence between the two versions was assessed using mean-difference scores for each item. 7 out of 25 items had mean difference score more than set standard 0.166. Items 9 and 10 had significantly different mean difference. Spearman's rank correlation coefficients showed good conceptual agreement between item and its corresponding subscale score in both, except item 7, 12 and 23 for Gujarati and item 12 for English version. Difference between pair of correlation coefficient was comparable for all except items 7,8 and 10. Concordance rate between classifications by 2 scales was good for Emotional (92.8%), Conduct (92.8%) and Pro-social behaviour subscale (96%) and fair for Hyperactivity and Peer problems subscale (67.8%). Total score concordance rate was 92.8%. Conclusion: Gujarati version of SDQ (11-17 years) has acceptable linguistic and conceptual equivalence and found to be a valid and reliable measure. Items 9 and 10 were rephrased after analysis. INTRODUCTION Strengths and difficulties questionnaire is a screening questionnaire for 11-17 years old children that survey their mental health symptoms and positive attitudes [1]. It addresses negative and positive behavioural attributes of children and adolescents and can be completed by parents or teachers or as a self-report by adolescents of age 11 or older. SDQ is widely used and has been translated, validated in several countries and also in different languages within India [2-5]. The aim of the present study was to translate and validate the SDQ in Gujarati (language) and use the self-report version of the same in a Gujarati speaking adolescent population for epidemiological study of mental health problems. MATERIALS AND METHODS Study type and setting: A total of 30 students from 8 th and 9 th grade (15 from a Gujarati medium school and 15 from English medium school) with equal number of boys and girls were randomly selected from the two schools. They were fluent in Gujarati and English. Study Tool: Strengths and difficulties questionnaire consists of 25 items distributed across five dimensions; emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems and prosocial behaviour. Items are scored on a 3-point Likert's scale with 0=not true, 1=somewhat true, and 2=certainly true with higher scores indicating larger problems. Higher scores for prosocial behaviour, indicates more positive behaviour and hence, is a protective factor. Subscale scores can be computed by summing scores on relevant items (after recoding reversed items; range 0-10). Items from the first four problem areas (excluding prosocial behaviour) are summed up to generate a total difficulties score (0-40). Procedure: Self-report version of SDQ was translated into Gujarati using back-translation translation process. Discrepancies were resolved and changes made after discussion. Translated version was then administered to the students. One week later the same students were administered English version of SDQ and scores were compared. SDQ total was categorised as normal for SDQ score upto 15 and 'borderline or abnormal' for all higher scores (16- 40). Ethical clearance was obtained prior to the study and assent was taken from the study participants. STATISTICAL ANALYSIS Linguistic equivalence, the extent to which the translation is a literal one was compared by assessing the mean difference in scores for the 25 items of the Gujarati and English version [6]. For a 0-1 scale acceptable mean difference was set at ±0.166. Conceptual equivalence, referred to as cultural equivalence, defined as having an analogous meaning and relevance of the constructs in the two cultures [7] was assessed by Spearman’s rank-order correlation coefficients for each item and its corresponding subscale score [7,8]. A correlation of 0.3 or more indicated that a particular item is consistent with the content of the overall scale [8]. Spearman’s rank-order correlation coefficients between each item of the two versions and p-values for the difference between the pair of correlation coefficients were also assessed. Scale equivalence, the extent to which the Gujarati and English versions of SDQ categorised, child as having either an abnormal or borderline score was determined by comparing the concordance