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Adolescent Desire for Cosmetic Surgery: Associations with Bullying and Psychological Functioning
Abstract and Figures
Background:
Adolescent bullying may be a key driver of interest in cosmetic surgery. This study examined the extent of such interest and whether any effect was sex-specific, and examined psychological functioning as a potential mechanism through which bullying involvement may lead to a wish for cosmetic surgery.
Methods:
A two-stage design was used. In the first stage, 2782 adolescents (aged 11 to 16 years) were screened for bullying involvement using self-reports and peer nominations. In the second stage, 752 adolescents who were bullies, victims, bully-victims, or uninvolved in bullying reported their desire for cosmetic surgery. Psychological functioning was constructed as a composite of self-esteem and emotional problems (assessed at stage 1) and body-esteem scores (assessed at stage 2).
Results:
Adolescents involved in bullying in any role were significantly more interested in cosmetic surgery than uninvolved adolescents. Desire for cosmetic surgery was greatest in adolescents who were bullied (victims and bully-victims) and girls. Desire for cosmetic surgery was highest in girls, but sex did not interact with bullying role. Being victimized by peers resulted in poor psychological functioning, which increased desire for cosmetic surgery. In contrast, desire for cosmetic surgery in bullies was not related to psychological functioning, which was in the normal range.
Conclusions:
Bullying victimization is related to poor psychological functioning, and both are related to a greater desire for cosmetic surgery in adolescents. Cosmetic surgeons should screen candidates for psychological vulnerability and may want to include a short screening questionnaire for a history of peer victimization.
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... The types of bullying include physical (e.g., hitting, pushing, and kicking), verbal (e.g., name-calling and teasing), relational (e.g., social exclusion and spreading rumors), and cyber (e.g., e-mail, instant messaging on personal computers, or text messaging on cell phones) (29). One prior study reported that bullying may lead to victims opting for cosmetic surgery later in life (30). ...
... Although there are numerous studies [e.g., Ref. (35)] on body image dissatisfaction and BDD, researchers have seldom focused on healing childhood psychological trauma by undergoing cosmetic procedures. A previous study revealed that childhood bullying victims are at an increased risk of undergoing cosmetic surgery in adulthood (30). The findings reported victims experiencing an extreme desire to undergo cosmetic surgery and, consequently, demonstrated significant improvements in depression and anxiety. ...
... Research has highlighted numerous factors that may affect the likelihood of undergoing cosmetic surgery, such as religiousness, low self-esteem (45), age, gender, and vicarious experience of cosmetic surgery through family or friends (46). As mentioned above, previous studies have shown that bullying (30) and child neglect (27) may increase the predisposition toward undergoing cosmetic surgery later in life. In this study, interviewees A and C reported their experiences of verbal bullying during primary and secondary school. ...
... Several studies found that weight-based bullying was a significant predictor of difficulties in regulating eating behavior (Agras et al. 2007;Sweetingham and Waller 2008;Copeland et al. 2015;Lee et al. 2017). Though appearancebased teasing seems to be most strongly related to a subsequent desire to alter body size or shape, there is emerging evidence that other types of peer victimization, like overt and relational victimization, are also related to disordered eating behavior (Lee and Vaillancourt 2018). ...
... Though appearancebased teasing seems to be most strongly related to a subsequent desire to alter body size or shape, there is emerging evidence that other types of peer victimization, like overt and relational victimization, are also related to disordered eating behavior (Lee and Vaillancourt 2018). Regardless of actual weight, experiencing direct, relational, or cyber victimization by peers leads to a preoccupation with losing weight (Lee et al. 2017) and increased restrained eating (Farrow and Fox 2011) among adolescents. A longitudinal study spanning 16 years found that targets of peer teasing, physical attacks, and threats were at increased risk of anorexic and bulimic symptoms (Copeland et al. 2015). ...
Despite theoretical support for the conceptualization of emotion dysregulation as a pathway linking peer victimization to psychopathology, there is a dearth of empirical support for this association. Hence, the present study aims to investigate if emotion dysregulation acts as a mechanism linking peer victimization to social anxiety and comorbid disordered eating symptoms and behavior. Data was collected from 411 undergraduates from a technical institute in India, using self-report instruments. Mediation analyses showed that online victimization exerted its influence on social anxiety and disordered eating through a lack of emotional awareness. These findings may have important clinical implications for preventive interventions that seek to reduce the prevalence of psychopathology among youth confronting peer-related stressors.
... Bullying can also yield advantages in intrasexual competition with rivals, as adversaries may withdraw from competition due to intimidation or the infliction of harm, or lose status relative to the perpetrator through social exclusion or derogation that damages their reputation (Campbell, 2013;Vaillancourt, 2013). Indeed, victims of bullying have been found to have reduced odds of dating over time , as well as significantly more interest in cosmetic surgery and weight loss compared to individuals who are not victimized, suggesting that bullying is effective at making potential competitors feel less attractive or sexually desirable (Lee et al., 2017a(Lee et al., , 2017b. Taken together, it seems that bullying works to bolster the perpetrator and tear down competitors in the pursuit of reproductive success (i.e., the propagation of genetic material). ...
Bullying is a serious behavior that negatively impacts the lives of tens of millions of adolescents across the world every year. The ubiquity of bullying, and its stubborn resistance toward intervention effects, led us to propose in 2012 that adolescent bullying might be an evolutionary adaptation. In the intervening years, a substantial amount of research has arisen to address this question. Therefore, the goal of this review is to consider whether evidence continues to support an evolutionary perspective that bullying is an adaptation that remains adaptive for some individuals in favorable contexts. In addition, we consider new ideas related to this hypothesis , explore how an evolutionary theory of bullying intersects with other influential perspectives, including ecological and social learning theories, and discuss applied implications for interventions. Our review of the evidence published since our 2012 paper provides very consistent and strong support for the hypothesis that adolescent bullying is, at least in part, an evolutionary adaptation that is currently adaptive regarding at least five evolutionarily relevant functions (the Five "Rs"): Reputation, Resources, deteRrence, Recreation, and Reproduction. We note that bullying is a facultative adaptation that is conditionally adaptive, subject to cost-benefit analyses. Finally, we discuss how an evolutionary theory of bullying frequently complements alternative theories of adolescent bullying rather than conflicting or competing with them. An interdisciplinary approach to bullying that includes evolutionary theory is thus likely to afford stronger options for both research and prevention efforts.
... In line with previous studies (e.g., Lee et al., 2017) students were assigned to bullying-related roles by standardizing their peer-ratings for bullying, victimization and defending. The overall mean and SD across both wave 1 and wave 2 were used to ensure that students with the same value at both wave 1 and wave 2 were assigned to the same student group. ...
School bullying is a serious problem worldwide, but little is known about how teacher interventions influence the adoption of bullying-related student roles. This study surveyed 750 early adolescents (50.5% female; average age: 12.9 years, SD = 0.4) from 39 classrooms in two waves, six months apart. Peer ratings of classmates were used to categorize students to five different bullying-related roles (criterion: >1 SD): bully, victim, bully-victim, defender, and non-participant. Student ratings of teachers were used to obtain class-level measures of teacher interventions: non-intervention, disciplinary sanctions, group discussion, and mediation/victim support. Controlling for student- and class-level background variables, two multilevel multinomial logistic regression analyses were computed to predict students’ bullying-related roles at wave 2. In the static model, predictors were teacher interventions at wave 1, and in the dynamic model, predictors were teacher intervention changes across time. The static model showed that disciplinary sanctions reduced the likelihood of being a bully or victim, and group discussion raised the likelihood of being a defender. Mediation/victim support raised the likelihood of being a bully. The dynamic model complemented these results by indicating that increases in group discussion across time raised the likelihood of being a defender, whereas increases in non-intervention across time raised the likelihood of being a victim and reduced the likelihood of being a defender. These results show that teacher interventions have distinct effects on students’ adoption of bullying-related roles and could help to better target intervention strategies. The findings carry practical implications for the professional training of prospective and current teachers.
... Chronic bullying was associated with both decreasing body self-concept and social self-concept from childhood to adulthood, but only when child-reported data were used at 13 years of age. The risk of chronic bullying on body self-concept is consistent with previous findings which showed reduced body satisfaction and increased desire for cosmetic surgery in adolescents who were bullied (Carbone-Lopez, Esbensen, & Brick, 2010;Lee, Guy, Dale, & Wolke, 2017). Chronic bullying was also the strongest predictor of having decreasing social self-concept from childhood to adulthood, consistent with findings that victims of bullying often have lower social status and are more isolated by peers who may be reluctant to associate with them for fear of losing their own social position (Guy, Lee, & Wolke, 2019). ...
Self-concept refers to individuals’ perceptions of themselves in specific domains and is closely related with their overall self-esteem. Lower self-esteem has been reported in those born preterm (<37 weeks gestation), but the development of self-concept has not been studied in this population. This study investigates whether differences in trajectories of domain-specific self-concepts are explained by premature birth or other risk factors, using the Bavarian Longitudinal Study ( N = 460), a population-based study of very preterm (VP; <32 weeks gestation)/very low birth weight (VLBW; <1500 g) cohort and term-born controls. Trajectories of body and social self-concept from 6 to 26 years of age were estimated using latent class growth analysis. Regression models examined the effects of VP/VLBW and other individual, social, and family factors. Two trajectories – one stable and one decreasing – were identified for both self-concepts. VP/VLBW birth was associated with decreasing self-concept in both domains, although the effect of VP/VLBW on social self-concept was weakened in the adjusted analysis. Furthermore, mediated pathways were found from VP/VLBW to decreasing social self-concept via chronic bullying (β = 0.05, 95% CI [0.002, 0.12]) and motor impairments (β = 0.04, 95% CI [0.01, 0.07]), suggesting that negative self-concept in the VP/VLBW population is partially modifiable through improving peer relationships and motor impairments in childhood.
... It usually begins in adolescence and has been shown that childhood neglect; emotional, physical, or sexual abuse; and bullying lead to a higher incidence of BDD in adolescents and young adults, which leads them to seek cosmetic surgery. [16,17] It may not be apparent initially in the first consultation, and clues to a possible diagnosis include frequent mirror checking, excessive grooming, skin picking, acne excoree, frequently changing clothes, always comparing with others, and believing that others are constantly observing their defects. [15] A study observed that 94.3% of adolescents reported moderate, severe, or extreme distress due to BDD; 80.6% had a history of suicidal ideation; and 44.4% had attempted suicide. ...
Teenagers between 13 and 19 years are increasingly seeking cosmetic procedures. They are suffering from anxiety, depression, and low self-esteem as a result of an obsession with body image and celebrity culture, fueled by social networking sites. Teenagers seek cosmetic procedures most commonly for traumatic scars, acne and acne scars, pigmentary abnormalities, hypertrichosis, hirsutism, and tattoo removal. They demand plastic surgery for nose deformities, breast asymmetry, ear abnormalities, and congenital deformities. The physical, emotional, psychological, social, ethical, and legal aspects must be considered while counseling adolescents. Not every teenager seeking cosmetic surgery is well suited for a procedure, and teens must demonstrate emotional maturity and an understanding of the limitations of these procedures and the risks involved. There should be a 3-month cooling-off period, followed by another consultation, which should be done in the presence of a parent. Only very essential surgery should be performed, giving realistic expectations on the outcome of procedures, as they rely too much on physical appearance to gain confidence. A psychiatric evaluation is essential to rule out body dysmorphic disorders in those repeatedly seeking treatment for minor defects. Sometimes, procedures are necessary to avoid social withdrawal and loss of self-esteem. Proper informed consent should be taken, explaining the benefits, limitations, and risks involved. Ideally, teenagers should not receive cosmetic or surgical procedures unless there are compelling medical or psychological reasons to do so. A successful aesthetic procedure in a mature teenager can have a positive influence, whereas surgery on an immature, psychologically unstable adolescent can have an adverse impact. This review discusses what is safe and what can wait, still there is limited evidence. There is a strong need for guidelines for the use of cosmetic surgery on children and teenagers.
... 7,10,11 Because BDD involves distorted perception of body image, cosmetic "fixes" rarely produce the desired result, and it is generally acknowledged as a clear contraindication to cosmetic surgeries and procedures. 7,12 Patients with BDD are less likely to be satisfied with treatment outcomes and may even perceive a worsening in appearance after procedures, 13,14 opening the door for potential exacerbation of symptoms and retaliation against practitioners, from negative reviews and potential lawsuits for violation of informed consent to physical assaults. [13][14][15] The literature reports that 2% of plastic surgeons have been physically threatened by a patient with BDD, and 10% have received threats of violence and legal action. ...
Background
The incidence of body dysmorphic disorder in cosmetic dermatology is high. Even though treating patients with this disorder may worsen symptoms and is fraught with potential complications, screening is low, due in part to lack of knowledge of the disorder, as well as inadequate screening tools.
Objectives
To verify the probability of body dysmorphic disorder in a nonsurgical esthetic setting and determine the effect of a multiphasic screening protocol on mitigating poor outcomes in high‐risk patients.
Methods
A multiphasic screening protocol for body dysmorphic disorder was distributed to a total of eight esthetic clinics in the United States. Practitioners administered an anonymous, cryptic prescreening form to all new, incoming patients aged ≥ 18 to ≤ 65 years from June 1, 2019, through September 1, 2019, followed by a second, more extensive screening questionnaire. Patients with suspected or subclinical body dysmorphic disorder could be refused treatment.
Results
A total of 734 initial screenings were recorded over 16 weeks. Of these, 4.2% (31/734) proceeded to the secondary screening phase; 29% (9/31) subsequently screened positive for body dysmorphic disorder. Practitioners refused to treat 77.8% (7/9) of positive screenings. Two patients out of seven who tested positive underwent a third screening and were subsequently treated with positive outcomes.
Conclusions
Use of a cryptic screening protocol enables identification of individuals at risk for BDD and encourages open and continuous communication between patient and provider.
There is an established relationship between acceptance of cosmetic surgery and psychological factors, including body image. However, qualitative research among diverse cultural groups is needed to provide a more fine-grained understanding of the influences on women’s attitudes towards cosmetic surgery. In this study, 20 Chinese and 20 Dutch women aged 18-50 years (MChinese = 34.20; MDutch = 34.70) participated in one-on-one semi-structured interviews. Data were analyzed using reflexive thematic analysis. We identified three themes that captured the factors that women perceived to foster favorable attitudes towards cosmetic surgery: (a) sociocultural pressures (e.g., normalization of cosmetic surgery, appearance-focused peers); (b) intrapersonal characteristics (e.g., beauty-ideal internalization, social comparison); and (c) benefits of beauty (e.g., attracting men, socioeconomic benefits). Conversely, two themes captured the factors perceived to reduce favorable attitudes towards cosmetic surgery: (a) intrapersonal characteristics (e.g., unconditional body acceptance, self-confidence); and (b) external considerations (e.g., health risks, financial costs). Overall, Chinese and Dutch participants shared many similarities in their opinions about what might affect cosmetic surgery consideration. The most striking cross-cultural differences concerned perceived socioeconomic benefits of beauty (mainly Chinese women) and women’s conceptualization of body appreciation. This study may enable a more comprehensive understanding about the factors influencing Chinese and Dutch women’s attitudes towards cosmetic surgery, and the nuances in these relationships across these cultures.
Objective: Bullying perpetration has been proposed to be a strategic behavior used by adolescents to compete for social resources, yet the co-development of bullying perpetration and trait hypercompetitiveness is understudied. The joint developmental trajectories of self-rated bullying perpetration and parent-rated hypercompetitiveness were investigated in a sample of adolescents and childhood social, emotional, and physical predictors were explored.
Method: In a sample of 607 adolescents (Mage = 13.02 years in Grade 7 [SD = 0.38]; 54.4% girls; 76.4% White) self-rated bullying perpetration and parent-rated hypercompetitiveness were assessed across six years of development (Grades 7 to 12). Childhood (i.e., Grades 5 and 6) social, emotional, and physical predictors of trajectory group membership were also examined.
Results: Using latent class growth analyses, the three expected joint trajectory groups of primary interest were found: (1) a pattern of moderate stable bullying perpetration and high increasing hypercompetitiveness (high-risk group), (2) a pattern of low decreasing bullying and high increasing hypercompetitiveness (hypercompetitive only group), and (3) a pattern of low decreasing bullying and low stable hypercompetitiveness (low-risk group). Adolescents reflecting the high-risk joint trajectory pattern were differentiated from adolescents reflecting the other two trajectory patterns by having more adverse childhood social, emotional, and physical predictors.
Conclusions: Findings indicate that bullying is a developmental and context-dependent behavior that can reflect trait hypercompetitiveness. Bullying prevention efforts should focus on reducing emphasis on outcompeting peers and instead facilitate a sense of self-acceptance, awareness, and accomplishment within prosocial school and family environments.
Our aim was to systematically review the prevalence of body dysmorphic disorder (BDD) in a variety of settings. Weighted prevalence estimate and 95% confidence intervals in each study were calculated. The weighted prevalence of BDD in adults in the community was estimated to be 1.9%; in adolescents 2.2%; in student populations 3.3%; in adult psychiatric inpatients 7.4%; in adolescent psychiatric inpatients 7.4%; in adult psychiatric outpatients 5.8%; in general cosmetic surgery 13.2%; in rhinoplasty surgery 20.1%; in orthognathic surgery 11.2%; in orthodontics/cosmetic dentistry settings 5.2%; in dermatology outpatients 11.3%; in cosmetic dermatology outpatients 9.2%; and in acne dermatology clinics 11.1%. Women outnumbered men in the majority of settings but not in cosmetic or dermatological settings. BDD is common in some psychiatric and cosmetic settings but is poorly identified.
Background:
Bullying victimization in childhood is associated with a broad array of serious mental health disturbances, including anxiety, depression, and suicidal ideation and behavior. The key goal of this study was to evaluate whether bullying victimization is a true environmental risk factor for psychiatric disturbance using data from 145 bully-discordant monozygotic (MZ) juvenile twin pairs from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and their follow-up into young adulthood.
Method:
Since MZ twins share an identical genotype and familial environment, a higher rate of psychiatric disturbance in a bullied MZ twin compared to their non-bullied MZ co-twin would be evidence of an environmental impact of bullying victimization. Environmental correlations between being bullied and the different psychiatric traits were estimated by fitting structural equation models to the full sample of MZ and DZ twins (N = 2824). Environmental associations were further explored using the longitudinal data on the bullying-discordant MZ twins.
Results:
Being bullied was associated with a wide range of psychiatric disorders in both children and young adults. The analysis of data on the MZ-discordant twins supports a genuine environmental impact of bullying victimization on childhood social anxiety [odds ratio (OR) 1.7], separation anxiety (OR 1.9), and young adult suicidal ideation (OR 1.3). There was a shared genetic influence on social anxiety and bullying victimization, consistent with social anxiety being both an antecedent and consequence of being bullied.
Conclusion:
Bullying victimization in childhood is a significant environmental trauma and should be included in any mental health assessment of children and young adults.
Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research.
Bullying is a common childhood experience with enduring psychosocial consequences. The aim of this study was to test whether bullying increases risk for eating disorder symptoms.
Ten waves of data on 1,420 participants between ages 9 and 25 were used from the prospective population-based Great Smoky Mountains Study. Structured interviews were used to assess bullying involvement and symptoms of anorexia nervosa and bulimia nervosa as well as associated features. Bullying involvement was categorized as not involved, bully only, victim only, or both bully and victim (bully-victims).
Within childhood/adolescence, victims of bullying were at increased risk for symptoms of anorexia nervosa and bulimia nervosa as well as associated features. These associations persisted after accounting for prior eating disorder symptom status as well as preexisting psychiatric status and family adversities. Bullies were at increased risk of symptoms of bulimia and associated features of eating disorders, and bully-victims had higher levels of anorexia symptoms. In terms of individual items, victims were at risk for binge eating, and bully-victims had more binge eating and use of vomiting as a compensatory behavior. There was little evidence in this sample that these effects differed by sex. Childhood bullying status was not associated with increased risk for persistent eating disorder symptoms into adulthood (ages 19, 21, and 25).
Bullying predicts eating disorder symptoms for both bullies and victims. Bullying involvement should be a part of risk assessment and treatment planning for children with eating problems. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015).
© 2015 Wiley Periodicals, Inc.
Bullying was investigated as a group process, a social phenomenon taking place in a school setting among 573 Finnish sixth-grade children (286 girls, 287 boys) aged 12–13 years. Different Participant Roles taken by individual children in the bullying process were examined and related to a) self-estimated behavior in bullying situations, b) social acceptance and social rejection, and c) belongingness to one of the five sociometric status groups (popular, rejected, neglected, controversial, and average). The Participant Roles assigned to the subject were Victim, Bully, Reinforcer of the bully, Assistant of the bully, Defender of the victim, and Outsider. There were significant sex differences in the distribution of Participant Roles. Boys were more frequently in the roles of Bully, Reinforcer and Assistant, while the most frequent roles of the girls were those of Defender and Outsider. The subjects were moderately well aware of their Participant Roles, although they underestimated their participation in active bullying behavior and emphasized that they acted as Defenders and Outsiders. The sociometric status of the children was found to be connected to their Participant Roles. © 1996 Wiley-Liss, Inc.
Background:
Body dysmorphic disorder may negatively affect self-perception of body shape and lead patients to seek cosmetic surgery. This study estimates the level of body dissatisfaction and prevalence of body dysmorphic disorder symptoms in candidates for three plastic surgical procedures.
Methods:
Three hundred patients of both sexes divided into three groups (abdominoplasty, n = 90; rhinoplasty, n =151; and rhytidectomy, n =59) were classified as having (n =51, n =79, and n =25, respectively) or not having (n =39, n =72, and n =34, respectively) body dysmorphic disorder symptoms, based on the Body Dysmorphic Disorder Examination, which was administered preoperatively.
Results:
Prevalence rates of body dysmorphic disorder symptoms in the abdominoplasty, rhinoplasty, and rhytidectomy groups were 57, 52, and 42 percent, respectively. Significant between-group differences were observed regarding age (p < 0.001), body mass index (p = 0.001), and onset of body dysmorphic disorder symptoms (p < 0.001). Within-group differences in body dysmorphic disorder severity were observed in the abdominoplasty (p < 0.001), rhinoplasty (p < 0.001), and rhytidectomy (p = 0.005) groups. Body dysmorphic disorder severity was significantly associated with degree of body dissatisfaction (mean Body Dysmorphic Disorder Examination total scores; p < 0.001), avoidance behaviors (p< 0.001), sexual abuse (p = 0.026), suicidal ideation (p < 0.001), and suicide attempt (p = 0.012).
Conclusions:
Abdominoplasty candidates showed the highest prevalence; rhytidectomy candidates exhibited the highest percentage of severe cases, and rhinoplasty candidates had the lowest percentage of severe cases.
Background Child psychiatric disorders are common and treatable, but often go undetected and therefore remain untreated.
Aims To assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community.
Method SDQ predictions and independent psychiatric diagnoses were compared in a community sample of 7984 5- to 15-year-olds from the 1999 British Child Mental Health Survey.
Results Multi-informant (parents, teachers, older children) SDQs identified individuals with a psychiatric diagnosis with a specificity of 94.6% (95% Cl 94.1-95.1%) and a sensitivity of 63.3% (59.7-66.9%). The questionnaires identified over 70% of individuals with conduct, hyperactivity, depressive and some anxiety disorders, but under 50% of individuals with specific phobias, separation anxiety and eating disorders. Sensitivity was substantially poorer with single-informant rather than multi-informant SDQs.
Conclusions Community screening programmes based on multi-informant SDQs could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments.