Short Mood and Feelings Questionnaire – Child self-report (SMFQ-C)

The Short Mood and Feelings Questionnaire (SMFQ; Angold et al.,1995) is a 13-item self-report questionnaire designed to measure core depressive symptomology in children and adolescents aged 6- 17 years old. More specifically, it assesses the presence of affective and cognitive symptoms of depression that have been experienced in the past 2 weeks. Items are rated on a 3-point Likert scale (not true = 0; sometimes true = 1; not true = 2). Example items include ‘I felt miserable or unhappy’ and ‘I cried a lot’. Scores are calculated by summing the point values on each item response. Total SMFQ scores range from 0 – 26. There are no prescribed cut points for the SMFQ. Instead, it is advised that the user utilise their discretion and clinical judgement to assess scores on a case by case basis (Angold & Costello, 1987). However, it has been suggested that higher scores, such as those over 12, suggest greater severity in depressive symptoms and may indicate the presence of depression (Wood, Kroll, Moore & Harrington, 1995). The SMFQ has also been shown to a useful measurement of clinical remission (Wood, Kroll, Moore & Harrington, 1995).

The SMFQ is a unidimensional factor structure with 13 items loading from .36 to .78 (Angold et al. 1995; Kuo, Vander Stoep & Stewart, 2005). It emerged from the original 33- item MFQ developed by Angold, Costello, Pickles and Winder (1987), which was based off the DMS-III-R and ICD-10 diagnostic criteria for depressive disorders. The shortened 13- item version is characterised by the cognitive and affective items from the original MFQ item pool, however it also includes tiredness, restlessness and poor concentration (Angold & Costello, 1995). The high correlations between the MFQ and the shortened SMFQ indicates that little information was lost when more than half of the original items where removed. The SMFQ correlates moderately highly with the depression scales on the Child Depression Inventory (CDI) and the Diagnostic Interview Schedule for Children indicating good criterion validity. Furthermore, good discriminate validity is demonstrated though clear distinctions between psychiatric and paediatric, depressed and non-depressed, populations. Internal reliability is high (Cronbach’s alpha = 0.85), with 60% sensitivity and 85% specificity with a cut off score of 8 or more (Angold & Costello, 1995). In addition, one-year rank order stability coefficients ranged from .28 to .48 (Messer, 1995).

The SMFQ has shown to be a valid and reliable measurement of cognitive and affective depressive symptomology in children and adolescents aged between 6 and 17 years old. Whilst it is inexpensive and brief to administer, score and interpret, there are some notable limitations to its application. Firstly, it is inappropriate to use the SMFQ as a diagnostic tool for depression. It is unable to distinguish between children and adolescents with depression only, from those with anxiety only, comorbid anxiety, or comorbid conduct disorder (Kent, Vostanis, Feehan, 1997). As such, its uses should be strictly limited to screening the presence and severity of depression, as an indication of progress and remission during treatment, and in research. Secondly, its uses are restricted to children and adolescence between the ages of 6 and 17. Finally, the accuracy of self-reporting may be compromised by reading and comprehensive abilities, mood at time of administration and the child’s ability to accurately identify and report their feelings. Children’s understanding and attributions of the symptoms measured in the SMFQ may become more refined with age, leading us to rationalize that age may decrease error associated with self-reporting, thus clinicians may need to take greater care in administration and interpretation of the SMFQ in younger children (Messer, 1995).

The English version of the SMFQ has been translated into 3 languages including Arabic, Spanish and Norwegian. However, psychometric evaluations on these translated versions are somewhat limited. The SMFQ is freely available to the public and can be accessed through multiple online sources, such as the website for the Centre for Developmental Epidemiology at Duke University. At present, the MFQ suite is comprised of six different versions; adult self-report, child self-report and parent report of child. Each is available in 13 and 33 item versions. This is important to note as it has been suggested that while child-self reports discriminate depression status better than parent reports, using both makes for a more accurate evaluation than either does alone (Angold & Costello, 1995). However, it is essential to consider a combination of sources when assessing any clinically significant presentations of depression, such as multiple self and/or observer rating scales, interviews with parents, caregivers and teachers, and other sources to assist in building a sound clinical picture to inform differential diagnoses and inform appropriate interventions.

References

Angold, A., Costello, E.J., Messer, S.C., Pickles, A., Winder, F., & Silver, D. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescence. International Journal of Methods in Psychiatric Research, 5, 237- 249.

Angold, A., Costello, E. J., Pickles, A., & Winder, F. (1987). The development of a questionnaire for use in epidemiological studies of depression in children and adolescents. London: Medical Research Council Child Psychiatry Unit.

Kent, L., Vostanis, P., & Feehan, C. (1997). Detection of major and minor depression in children and adolescents: Evaluation of the Mood and Feelings Questionnaire. Journal of Child Psychology and Psychiatry, 38(5), 565- 573.

Kuo, E.S., Vander Stoep, A., & Stewart, D.G. (2005). Using the Short Mood and Feelings Questionnaire to detect depression in detained adults. Assessment, 12(4), 374- 383.

Messer, S.C., Angold, A., Costello, J., Loeber, R., Van Kammen, W., & Stouthamer-Lober, M. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescence: Factor composition and structure across development. International Journal of Methods in Psychiatric Research, 5, 251- 262.

Wood, A., Kroll, L., Moore, A., & Harrington, R. (1995). Properties of the Mood & Feelings Questionnaire in adolescent psychiatric outpatients: A research note. Journal of Child Psychology and Psychiatry, 36(2), 327-334.