Self-reported mental health in school-aged children using the Dominic Interactive questionnaire in the French Enabee 2022 study

Enabee 2022 is a national cross-sectional study conducted in 399 French schools to assess children's mental health by incorporating their own perceptions of it. Specifically, we used the Dominic Interactive (DI), which consists of illustrated questions reflecting situations associated with symptoms of common disorders. We collected DI responses from 15,206 children (48.9% girls, with a mean age of 8.91 years and a standard deviation of 0.04) attending schools in metropolitan France. This large sample provided a unique opportunity to deepen our understanding of the psychometric properties of the DI and to assess the self-reported prevalence of mental health problems in children. To generate national estimates of children's mental health, we employed a probabilistic multistage, stratified, and balanced sampling design. Statistical analyses accounted for the study's sampling design, including nonresponse weight adjustments, strata, and the finite population correction factor. The Cronbach's alpha and McDonald's Omega values were acceptable (between 0.56 and 0.91) for all DI subscales assessing specific mental health disorders, and metric measurement invariance was observed across gender, school type, and grade levels. Based on the DI cut-off, we estimated that 28.7% of children reported at least one probable mental health disorder. Phobias and separation anxiety disorder were the most common probable disorders (9.4% and 10.7%, respectively). Integrating the DI allows for the consideration of children's own perspectives when assessing their mental health.