Skip to main content

Advertisement

SpringerLink
Log in

Psychometric validation of the child health questionnaire (CHQ) in a sample of children and adolescents with attention-deficit/hyperactivity disorder

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Measuring health-related quality of life (HRQL) in children with attention-deficit/hyperactivity disorder (ADHD) in clinical trials can complement efficacy measures, offering a complete picture of the impact of disease and treatment on overall well-being. The purpose of the current study was to psychometrically validate a multidimensional, generic HRQL instrument completed by parents of children with ADHD. A total of 921 children and adolescents with ADHD participated in a clinical study of atomoxetine. Subjects’ parents completed the 50-item Child Health Questionnaire-Parent Version (CHQ-PF50) at baseline and week 10. ADHD symptoms and behavioral problems were assessed using parent and clinician rating scales. Internal consistency reliability at baseline was 0.88 for the CHQ-PF50 Psychosocial Summary Score, ranging from 0.53 to 0.91 for subscale scores. Construct validity was supported by statistically significant correlations between CHQ-PF50 psychosocial scores and parent and clinician symptom ratings. Several methods were used to determine clinically meaningful differences in patient outcomes: inter- and intra-patient mean CHQ-PF50 change scores were tested and standard error of measurement (SEM) and effect sizes were calculated. Study results indicate the CHQ-PF50 is reliable, valid, and responsive to change in ADHD symptoms, suggesting it may provide a means of assessing HRQL outcomes associated with treatments for ADHD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ADHD:

attention-deficit/hyperactivity disorder

ADHD-RS:

attention-deficit/hyperactivity disorder rating scale-IV

ANCOVA:

analysis of covariance

ANOVA:

analysis of variance

CGI-ADHD-I:

clinical global impressions-ADHD-improvement

CGI-ADHD-S:

clinical global impressions-ADHD-Severity

CHQ:

Child Health Questionnaire

CHQ-PF28:

28-item Child Health Questionnaire-Parent Version

CHQ-PF50:

50-item Child Health Questionnaire-Parent Version

CPRS:

Conners’ parent rating scale-revised: short form

DSM-IV:

diagnostic and statistical manual of mental disorders,fourth edition

HRQL:

health-related quality of life

K-SADS-PL:

Kiddie schedule for affective disorders and schizophrenia-present and lifetime version

SD:

standard deviation

SEM:

standard error of measurement

References

  • InstitutionalAuthorNameAmerican Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders EditionNumber4 American Psychiatric Press Washington, DC

    Google Scholar 

  • RA Barkley (1998) Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. EditionNumber2 Guilford Press New York

    Google Scholar 

  • RD Hinshaw SM Melnick (1995) ArticleTitlePeer relationship in boys with attention deficit hyperactivity disorder with and without comorbid aggression. Dev Psychopathol 7 627–647

    Google Scholar 

  • EJ Mash C Johnston (1982) ArticleTitleSibling interactions of hyperactive and normal children and their relationship to reports of maternal stress and self-esteem. J Clin Child Psychol 12 91–99

    Google Scholar 

  • CK Whalen B Henker S Dotemoto (1980) ArticleTitleMethylphenidate and hyperactivity: Effects on teacher behaviors. Science 208 IssueID4449 1280–1282

    Google Scholar 

  • RA Barkley M Fischer C Edelbrock et al. (1991) ArticleTitleThe adolescent outcome of hyperactive children diagnosed by research criteria–III. Mother–child interactions, family conflicts and maternal psychopathology. J Child Psychol Psychiatry 32 IssueID2 233–255

    Google Scholar 

  • Pastor PN, Reuben CA. Attention deficit disorder and learning disability: United States, 1997–1998. National Center for Health Statistics. Vital Health Stat 2002; 10(206).

  • RA Barkley GJ DuPaul MB McMurray (1990) ArticleTitleComprehensive evaluating of attention deficit disorder with and without hyperactivity as defined by research criteria. J Consult Clin Psychol 58 IssueID6 775–789

    Google Scholar 

  • G Weiss LT Hechtman (1993) Hyperactive Children Grown Up. EditionNumber2 Guilford Press New York

    Google Scholar 

  • D Michelson D Faries J Wernicke et al. (2001) ArticleTitleAtomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: A randomized, placebo-controlled, dose–response study. Pediatrics 108 IssueID5 E83 Occurrence Handle11694667

    PubMed  Google Scholar 

  • NK Leidy DA Revicki B Geneste (1999) ArticleTitleRecommendations for evalutating the validity of life claims for labeling and promotion. Value Health 2 IssueID2 113–127

    Google Scholar 

  • DL Patrick YP Chiang (2000) ArticleTitleMeasurement of health outcomes in treatment effectiveness evaluations: Conceptual and methodological challenges. Med Care 38 IssueID9 Suppl II14–II25

    Google Scholar 

  • C Eiser R Morse (2001) ArticleTitleQuality-of-life measures in chronic diseases of childhood. Health Technol Assess 5 IssueID4 1–157

    Google Scholar 

  • EW Gerharz C Eiser CR Woodhouse (2003) ArticleTitleCurrent approaches to assessing the quality of life in children and adolescents. BJU Int 91 IssueID2 150–154

    Google Scholar 

  • JM Landgraf L Abetz (1996) Measuring health outcomes in pediatric populations: Issues in psychometrics and application. B Spilker (Eds) Quality of Life and Pharmacoeconomics in Clinical Trials. EditionNumber2 Lippincott-Raven Philadelphia

    Google Scholar 

  • DL Patrick P Erickson (1993) Health Status and Health Policy: Quality of Life in Health Care Evaluation and Resource Allocation. Oxford University Press New York

    Google Scholar 

  • DA Revicki D Osoba D Fairclough et al. (2000) ArticleTitleRecommendations on health-related quality of life research to support labeling and promotional claims in the United States. Qual Life Res 9 IssueID8 887–900 Occurrence Handle10.1023/A:1008996223999

    Article  Google Scholar 

  • JM Landgraf L Abetz JE Ware (1999) The CHQ User’s Manual. HealthAct Boston

    Google Scholar 

  • J DeVeaugh-Geiss CK Conners EH Sarkis et al. (2002) ArticleTitleGW320659 for the treatment of attention-deficit/hyperactivity disorder in children. J Am Acad Child Adolesc Psychiatry 41 IssueID8 914–920 Occurrence Handle10.1097/00004583-200208000-00009 Occurrence Handle12162627

    Article  PubMed  Google Scholar 

  • JM Landgraf E Maunsell KN Speechley et al. (1998) ArticleTitleCanadian–French, German, and UK versions of the child health questionnaire: Methodology and preliminary item scaling results. Qual Life Res 7 IssueID5 433–445

    Google Scholar 

  • E Waters L Salmon M Wake et al. (2000) ArticleTitleThe child health questionnaire in Australia: Reliability, validity and population means. Aust N Z J Public Health 24 IssueID2 207–210

    Google Scholar 

  • E Waters L Salmon M Wake (2000) ArticleTitleThe parent-form child health questionnaire in Australia: Comparison of reliability, validity, structure, and norms. J Pediatr Psychol 25 IssueID6 381–391

    Google Scholar 

  • N Ruperto A Ravelli A Pistorio et al. (2001) ArticleTitleCross-cultural adaptation and psychometric evaluation of the childhood health assessment questionnaire (CHAQ) and the child health questionnaire (CHQ) in 32 countries. Review of the general methodology. Clin Exp Rheumatol 19 IssueID4 Suppl 23 S1–S9

    Google Scholar 

  • Guy E (ed), ECDEU Assessment Manual for Psychopharmacology. Revised ed. Rockville, MD: National Institute of Mental Health, 1976. ed. No. 217–222.

  • JK Ghuman GS Ginsburg G Subramaniam et al. (2001) ArticleTitlePsychostimulants in preschool children with attention-deficit/hyperactivity disorder: Clinical evidence from a developmental disorders institution. J Am Acad Child Adolesc Psychiatry 40 IssueID5 516–524

    Google Scholar 

  • PD Riggs SL Leon SK Mikulich et al. (1998) ArticleTitleAn open trial of bupropion for ADHD in adolescents with substance use disorders and conduct disorder. J Am Acad Child Adolesc Psychiatry 37 IssueID12 1271–1278 Occurrence Handle10.1097/00004583-199812000-00010 Occurrence Handle1:STN:280:DyaK1M%2Fmtl2ltw%3D%3D Occurrence Handle9847499

    Article  CAS  PubMed  Google Scholar 

  • CK Conners CD Casat CT Gualtieri et al. (1996) ArticleTitleBupropion hydrochloride in attention deficit disorder with hyperactivity. J Am Acad Child Adolesc Psychiatry 35 IssueID10 1314–1321

    Google Scholar 

  • TE Wilens J Biederman AM Abrantes et al. (1996) ArticleTitleA naturalistic assessment of protriptyline for attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 35 IssueID11 1485–1490

    Google Scholar 

  • GJ DuPaul TJ Power AD Anastopoulos et al. (1998) ADHD Rating Scale-IV: Checklists, Norms, and Clinical Interpretations. Guilford Press New York

    Google Scholar 

  • C Kadesjo B Kadesjo B Hagglof et al. (2001) ArticleTitleADHD in Swedish 3- to 7-year-old children. J Am Acad Child Adolesc Psychiatry 40 IssueID9 1021–1028

    Google Scholar 

  • CJ Kratochvil JH Heiligenstein R Dittmann et al. (2002) ArticleTitleAtomoxetine and methylphenidate treatment in children with ADHD: A prospective, randomized, open-label trial. J Am Acad Child Adolesc Psychiatry 41 IssueID7 776–784

    Google Scholar 

  • P Magnusson J Smari H Gretarsdottir et al. (1999) ArticleTitleAttention-deficit/hyperactivity symptoms in Icelandic schoolchildren: Assessment with the attention deficit/hyperactivity rating scale-IV. Scand J Psychol 40 IssueID4 301–306

    Google Scholar 

  • JB Prince TE Wilens J Biederman et al. (2000) ArticleTitleA controlled study of nortriptyline in children and adolescents with attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol 10 IssueID3 193–204 Occurrence Handle10.1089/10445460050167304 Occurrence Handle1:STN:280:DC%2BD3crgtlymuw%3D%3D Occurrence Handle11052409

    Article  CAS  PubMed  Google Scholar 

  • TA Rugino TC Copley (2001) ArticleTitleEffects of modafinil in children with attention-deficit/hyperactivity disorder: an open-label study. J Am Acad Child Adolesc Psychiatry 40 IssueID2 230–235

    Google Scholar 

  • L Scahill PB Chappell YS Kim et al. (2001) ArticleTitleA placebo-controlled study of guanfacine in the treatment of children with tic disorders and attention deficit hyperactivity disorder. Am J Psychiatry 158 IssueID7 1067–1074 Occurrence Handle10.1176/appi.ajp.158.7.1067 Occurrence Handle1:STN:280:DC%2BD3MznsVegtQ%3D%3D Occurrence Handle11431228

    Article  CAS  PubMed  Google Scholar 

  • InstitutionalAuthorNameAmerican Psychiatric Association. (2000) Diagnostic and Statistical Manual of Mental Disorders. EditionNumber4 American Psychiatric Press Washington, DC

    Google Scholar 

  • DA Revicki AM Rentz D Dubois et al. (2003) ArticleTitleDevelopment and validation of a patient-assessed gastroparesis symptom severity measure: The gastroparesis cardinal symptom index. Aliment Pharmacol Ther 18 141–150 Occurrence Handle10.1046/j.1365-2036.2003.01612.x

    Article  Google Scholar 

  • KS Coyne I Wiklund J Schmier et al. (2001) ArticleTitleDevelopment and validation of a disease-specific treatment satisfaction questionnaire for gastro-oesophageal reflux disease. Aliment Pharmacol Ther 18 907–915

    Google Scholar 

  • JB Spies K Coyne N Guaou Guaou et al. (2002) ArticleTitleThe UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata. Obstet Gynecol 99 IssueID2 290–300

    Google Scholar 

  • GH Guyatt D Osoba AW Wu et al. (2002) ArticleTitleMethods to explain the clinical significance of health status measures. Mayo Clin Proc 77 IssueID4 371–383

    Google Scholar 

  • RD Crosby RL Kolotkin GR Williams (2003) ArticleTitleDefining clinically meaningful change in health-related quality of life. J Clin Epidemiol 56 IssueID5 395–407

    Google Scholar 

  • MA Sprangers CM Moinpour TJ Moynihan et al. (2002) ArticleTitleAssessing meaningful change in quality of life over time: A users’ guide for clinicians. Mayo Clin Proc 77 IssueID6 561–571

    Google Scholar 

  • LE Kazis JJ Anderson RF Meenan (1989) ArticleTitleEffect sizes for interpreting changes in health status. Med Care 27 IssueID3 Suppl S178–S189

    Google Scholar 

  • G Guyatt S Walter G Norman (1987) ArticleTitleMeasuring change over time: Assessing the usefulness of evaluative instruments. J Chronic Dis 40 IssueID2 171–178

    Google Scholar 

  • KW Wyrwich NA Nienaber WM Tierney et al. (1999) ArticleTitleLinking clinical relevance and statistical significance in evaluating intra-individual changes in health-related quality of life. Med Care 37 IssueID5 469–478

    Google Scholar 

  • KW Wyrwich WM Tierney FD Wolinsky (1999) ArticleTitleFurther evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. J Clin Epidemiol 52 IssueID9 861–873

    Google Scholar 

  • JM Landgraf M Rich L Rappaport (2002) ArticleTitleMeasuring quality of life in children with attention-deficit/hyperactivity disorder and their families: Development and evaluation of a new tool. Arch Pediatr Adolesc Med 156 IssueID4 384–391

    Google Scholar 

  • JJ Garcia-Garcia E Gonzalez-Pascual J Pou-Fernandez et al. (2000) ArticleTitleDevelopment of a Spanish (Castillian) version of the childhood health assessment questionnaire. Measurement of health status in children with juvenile chronic arthritis. Clin Exp Rheumatol 18 IssueID1 95–102

    Google Scholar 

  • JC Nunnally IH Bernstein (1994) Psychometric Theory EditionNumber3 McGraw-Hill, Inc. New York

    Google Scholar 

  • RD Hays RT Anderson DA Revicki (1998) Assessing reliability and validity of measurement in clinical trials. MJ Staquet RD Hays PM Fayers (Eds) Quality of Life Assessment in Clinical Trials: Methods and Practice. Oxford University Press Oxford

    Google Scholar 

  • C Eiser R Morse (2001) ArticleTitleCan parents rate their child’s health-related quality of life? Results of a systematic review. Qual Life Res 10 IssueID4 347–357

    Google Scholar 

  • LS Matza AR Swensen EM Flood et al. (2004) ArticleTitleAssessment of health-related quality of life in children: Review of conceptual, methodological and regulatory issues. Value Health 7 IssueID1 79–92 Occurrence Handle10.1111/j.1524-4733.2004.71273.x

    Article  Google Scholar 

  • G Rebok A Riley C Forrest et al. (2001) ArticleTitleElementary school-aged children’s reports of their health: A cognitive interviewing study. Qual Life Res 10 IssueID1 59–70

    Google Scholar 

  • M Beneke W Rasmus (1992) ArticleTitle‘‘Clinical Global Impressions’’ (ECDEU): Some critical comments. Pharmacopsychiatry 25 IssueID4 171–176

    Google Scholar 

  • L Asmussen LM Olson EN Grant et al. (2000) ArticleTitleUse of the child health questionnaire in a sample of moderate and low-income inner-city children with asthma. Am J Respir Crit Care Med 162 IssueID4 Pt 1 1215–1221

    Google Scholar 

  • TM Palermo L Schwartz D Drotar et al. (2002) ArticleTitleParental report of health-related quality of life in children with sickle cell disease. J Behav Med 25 IssueID3 269–283

    Google Scholar 

  • O Chassany P Sagnier P Marquis et al. (2002) ArticleTitleFor the European regulatory issues on quality of life assessment group. Patient-reported outcomes: The example of health-related quality of life–A European guidance document for the improved integration of health-related quality of life assessment in the drug regulatory process. Drug Inform. J. 36 IssueID1 209–218

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Health Outcomes Research, MEDTAP International, 7101 Wisconsin Avenue, Suite 600, Bethesda, MD, USA, 20814

    Anne M. Rentz, Louis S. Matza & Dennis A. Revicki

  2. Eli Lilly and Company, Indianapolis, IN, USA

    Kristina Secnik & Andrine Swensen

Authors
  1. Anne M. Rentz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Louis S. Matza
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kristina Secnik
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrine Swensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dennis A. Revicki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anne M. Rentz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rentz, A.M., Matza, L.S., Secnik, K. et al. Psychometric validation of the child health questionnaire (CHQ) in a sample of children and adolescents with attention-deficit/hyperactivity disorder. Qual Life Res 14, 719–734 (2005). https://doi.org/10.1007/s11136-004-0832-9

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-004-0832-9

Keywords

Search

Navigation