Introduction to the Special Issue: Discrepancies in Adolescent-Parent Perceptions of the Family and Adolescent Adjustment

The Prospective Predictive Power of Parent-Reported Personality Traits and Facets in First-Onset Depression in Adolescent Girls

Certain personality traits and facets are well-known risk factors that predict first-onset depression during adolescence. However, prior research predominantly relied on self-reported data, which has limitations as a source of personality information. Reports from close informants have the potential to increase the predictive power of personality on first-onsets of depression in adolescents. With easy access to adolescents' behaviors across settings and time, parents may provide important additional information about their children's personality. The same personality trait(s) and facet(s) rated by selves (mean age 14.4 years old) and biological parents at baseline were used to prospectively predict depression onsets among 442 adolescent girls during a 72-month follow-up. First, bivariate logistic regression was used to examine whether parent-reported personality measures predicted adolescent girls' depression onsets; then multivariate logistic regression was used to test whether parent reports provided additional predictive power above and beyond self-reports of same trait or facet. Parent-reported personality traits and facets predicted adolescents' depression onsets, similar to findings using self-reported data. After controlling for the corresponding self-report measures, parent-reported higher openness (at the trait level) and higher depressivity (at the facet-level) incrementally predicted first-onset of depression in the sample. Findings demonstrated additional variance contributed by parent-reported personality measures and validated a multi-informant approach in using personality to prospectively predict onsets of depression in adolescent girls.

Attachment Problems and Mentalizing Capacity Relate to Parent-Child Informant Discrepancies in Female Adolescents with Borderline Personality Disorder

Parent-child informant discrepancies on psychopathology provide important knowledge on the parent-child relationship and the child's mental health, but mechanisms underlying parent-child informant discrepancies are largely unknown. Therefore, we investigated the relationship between attachment problems and mentalizing capacity and parent-child informant discrepancies on borderline personality disorder (BPD) severity, internalizing, and externalizing pathology in a clinical sample of 91 adolescent girls with BPD and their parents. Results showed that more attachment problems to parents and peers were related to adolescents reporting more severe BPD than parents. Adolescents who described more internalizing symptoms relative to parents, reported more parental attachment problems, but enhanced peer attachment, suggesting those adolescents who do not feel recognized by their parents might turn to their friends. When parents rated adolescents higher on externalizing behaviors, the adolescent reported more attachment problems to parents and lower mentalizing capacity, indicating that this sub-group of adolescents may reflect less about how their behavior affects others.

Discrepancies in perceived family resilience between adolescents with chronic illness and parents: using response surface analysis to examine the relationship with adolescents' psychological adjustment

BACKGROUND

This study aimed to explore discrepancies in adolescents with chronic illness and their parents' perceptions of family resilience, as well as the relationship between these differences and the psychological adjustment of adolescents with chronic illness.

METHODS

A cross-sectional study was conducted. A total of 264 dyads of parents (77.7% mothers, mean age 41.60 years, SD = 6.17) and adolescents (48.5% girls, mean age 12.68 years, SD = 2.11) with chronic illness were recruited through convenience sampling from three children's hospitals in Wenzhou, Hangzhou, and Shanghai, China between June 2022 and May 2023. The Chinese version of the Family Resilience Scale and the Psychological Adjustment Scale, which are commonly used measures with good reliability and validity, were employed to assess family resilience and psychological adaption, respectively. The data were analyzed using polynomial regression and response surface analysis.

RESULTS

Adolescents with chronic illness reported higher family resilience than their parents (t=-2.80, p < 0.05). The correlations between family resilience and adolescents' psychological adjustment reported by the adolescents (r = 0.45-0.48) were higher than parents (r = 0.18-0.23). In the line of congruence, there were positive linear (a1 = 1.09-1.60, p < 0.001) and curvilinear (a2=-1.38∼-0.72, p < 0.05) associations between convergent family resilience and adolescents' psychological adjustment. In the line of incongruence, when adolescents reported lower family resilience than parents, adolescents had a lower level of psychological adjustment (a3=-1.02∼-0.45, p < 0.05). Adolescents' sociability decreased when the perceived family resilience of parent-adolescent dyads converged (a4 = 1.36, p < 0.01).

CONCLUSION

The findings highlighted the importance of considering the discrepancies and congruence of family resilience in the parent-child dyads when developing interventions to improve the psychological adjustment of adolescents with chronic illness. Interventions aimed at strengthening family communication to foster the convergence of perceptions of family resilience in parent-adolescent dyads were warranted.

Discrepancies in Parent-Child Perception of Parental Control and Associations with Children's Anxiety: The Buffering Effect of Parent-Child Closeness

Previous research has predominantly relied on single-informant reports to establish the association between parental control and children's anxiety. However, there remains ambiguity regarding the extent to which discrepancies in parent-child reports of parental control are related to children anxiety. This study examined parent-child perceived discrepancies in parental control and their association with children's anxiety, along with the moderated effect of parent-child closeness through cross-sectional and prospective analysis. The sample consisted of 790 children (Mage = 11.34, SD = 6.73, 45.60% for girls), with 741 father-child dyads and 760 mother-child dyads included. Data were analyzed using polynomial regressions with response surface analysis. The results indicated that children tended to perceive higher levels of parental psychological control and lower levels of behavioral control compared to their parents' perceptions. In the cross-sectional analysis, a significant association between greater incongruence in psychological/behavioral control and higher levels of children's anxiety at T1 was observed exclusively in father-child dyads. In prospective analysis, for both father-child and mother-child dyads, congruence in higher levels of psychological control was associated with higher levels of children's anxiety at T2, while congruence in higher levels of behavioral control was associated with lower levels of children's anxiety at T2. Additionally, greater incongruence in psychological/behavioral control was linked to higher levels of children's anxiety at T2. Furthermore, mother-child closeness emerged as a significant moderator such that perceived incongruence in psychological/behavioral control could not affect children's anxiety at T2 in the high mother-child closeness condition. These findings highlight the significance of considering parent-child congruence and incongruence when examining the impact of parental control on children's anxiety.

The Association between Discrepancies in Parental Emotional Expressivity, Adolescent Loneliness and Depression: A Multi-Informant Study Using Response Surface Analysis

Incongruent perceptions of parental emotional expressivity between parents and adolescents may signify relational challenges, potentially impacting adolescents' socioemotional adjustment. Direct evidence is still lacking and father-adolescent discrepancies are overlooked. This study employed a multi-informant design to investigate whether both mother-adolescent and father-adolescent discrepancies in perceptions of parental expressivity are related to adolescents' mental well-being, specifically focusing on loneliness and depression. Analyzing data from 681 families (mean age of adolescents = 15.5 years old, 51.2% girls, 40% only-children) in China revealed that adolescents tended to perceive paternal and maternal emotional expressivity more negatively than their parents, particularly fathers. Polynomial regression and response surface analysis showed significant links between parent-adolescent congruence and incongruence and adolescent loneliness. (In)Congruence between adolescents and mothers or fathers predicted later adolescent depression, mediated by adolescent loneliness and varied by the dimension of emotional expressivity. These findings provide insights into the roles of mothers' and fathers' emotional expressivity in shaping children's mental well-being during adolescence.

Parent-child educational aspiration congruence and adolescents' internalizing problems: The moderating effect of SES

Previous studies have found that adolescents and their parents may hold discrepant views about educational aspirations. However, little is known about how these discrepancies affect adolescents' internalizing problems and the moderating effect of SES on the relation between (in)congruence of parent-child educational aspirations and adolescents' internalizing problems. Therefore, this study explored the relation between (in)congruence of parent-child educational aspirations and adolescents' internalizing problems, and further tested the moderating role of SES. Based on two-wave survey data collected from a nationally representative sample of 8194 parent-child dyads in China (51.3 % boys, mean age = 13.58 years), multilevel polynomial regression and response surface analysis were performed to investigate the hypotheses. The results found that (1) internalizing problems were minimal when the two educational aspiration variables were congruent, (2) internalizing problems were the highest when the discrepancy between child educational and parental educational aspirations was largest, and (3) SES moderated the relation between (in)congruence in educational aspirations and adolescents' internalizing problems. The study's results not only comprehensively and intuitively reveal the influence of parents' and children's educational aspirations on adolescents' internalizing problems, but also provide targeted guidance and suggestions regarding parenting practices for families from diverse SES backgrounds.

Parent-Child Discrepancies in Perceived Parental Control and Their Associations with Children's Prosocial Behaviors in Early Adolescence within Chinese Families

How parent-child discrepancies in perceived parental control associate with children's prosocial behaviors remains unknown. This study examined this issue in 578 Chinese children (297 girls, Mage = 10.85, SDage = 0.72) and their mothers and fathers. Parents and children reported parental psychological and behavioral control, and children reported their prosocial behaviors. The latent difference scores modeling showed that compared to parents' perceptions, children's higher perceptions of guilt induction were related to more public prosocial behaviors; higher perceptions of love withdrawal were linked to fewer altruistic, compliant, emotional, and dire prosocial behaviors; and higher reporting of solicitation was associated with more general prosocial behaviors. The findings revealed the association between parent-child discrepancies and early adolescents' prosocial behaviors, supporting both the discrepancy-maladaptive hypotheses and the discrepancy-adaptive hypotheses within Chinese families.

Examining profiles of convergence and divergence in reports of parental warmth: Links to adolescent developmental problems

Parental warmth during the transition from childhood to adolescence is a key protective factor against a host of adolescent problems, including substance use, maladjustment, and diminished well-being. Moreover, adolescents and parents often disagree in their perceptions of parenting quality, and these discrepancies may confer risk for problem outcomes. The current study applies latent profile analysis to a sample of 687 mother-father-6th grade adolescent triads to identify patterns of adolescent-parent convergence and divergence in perceptions of parental warmth. Five profiles were identified, and associations with adolescent positive well-being, substance use, and maladjustment outcomes in 9th grade were assessed. Patterns of divergence in which adolescents had a pronounced negative perception of parental warmth compared to parents, as well as those wherein pronounced divergence was present in only one adolescent-parent dyad, were associated with diminished positive well-being compared to adolescents who had more positive perceptions of warmth than parents. Having more negative perceptions of warmth compared to parents was also associated with elevated risk for alcohol and marijuana initiation, but only when the divergence was pronounced rather than more moderate. These findings add nuance to findings from previous between-family investigations of informant discrepancies, calling for further family-centered methods for investigating multiple perspectives.

Interplay of Adolescents' and Parents' Mindsets of Socioeconomic Status on Adolescents' Stress-Related Outcomes

The reciprocity and variation of values and beliefs are dynamic features of the parent-child relationship. Parents and adolescents may hold congruent or incongruent views regarding the malleability of socioeconomic status (mindset of SES), potentially influencing adolescents' psychological and physiological stress outcomes, as reflected in stress perceptions and the hypothalamic-pituitary-adrenal (HPA) axis functioning. The current study investigated how patterns of parent-adolescent congruence and incongruence in mindset of SES were associated with adolescents' perceived stress and diurnal cortisol patterns four months later. A total of 253 adolescents (Mage = 12.60, 46.2% girls) and their parents (Mage = 40.09 years, 59.5% mothers) participated in this study. Polynomial regression analyses and response surface analyses showed that adolescents perceived lower levels of stress when they themselves or their parents reported a stronger growth mindset of SES. Additionally, adolescents with a stronger growth mindset of SES also exhibited a steeper diurnal cortisol slope. Moreover, parents' mindset significantly interacted with adolescents' mindset to influence adolescents' diurnal cortisol patterns such that when adolescents hold weaker growth mindset of SES, those with higher parental growth mindsets had significantly higher cortisol awakening response and steeper diurnal cortisol slope. Furthermore, adolescents who showed incongruence with their parents but had averagely stronger growth mindsets of SES reported a significantly steeper diurnal cortisol slope than those who had averagely weaker growth mindsets with their parents. The findings point to the beneficial impacts of the growth mindset of SES on stress-related outcomes among adolescents, as well as the significance of considering both parents' and adolescents' mindsets when exploring these associations.

Parent-adolescent discrepancies in positive parenting and adolescent problem behaviors in Chinese families

Based on the discrepancy-maladaptive hypothesis and general strain theory, in this study, we examined two key aspects: first, the mediating role of self-control in the relationship between parent-adolescent discrepancies in positive parenting and adolescent internalizing and externalizing problems, and second, variations in problem behavior among subgroups with different parent-adolescent dyads reporting patterns. The participants were 349 intact Chinese families, with parents as the primary caregivers and teenagers aged 15-18 years who are attending secondary vocational schools. The results revealed that adolescents generally perceived lower levels of caring and behavioral control than parents. Compared to behavioral control, discrepancies in perceived levels of caring had more significant predicting levels of internalizing and externalizing problems, and the relationship between discrepancies of caring and internalizing and externalizing problems was mediated by self-control. Latent profile analysis revealed three parent-adolescent responding patterns (subgroups); compared to the other subgroups, only the subgroup characterized by adolescents perceiving lower caring and behavioral control than parents exhibited higher levels of internalizing and externalizing problems. The findings of this study provide insights on how parent-adolescent discrepancies may lead to adolescent problem behaviors and highlight the importance of self-control as a mediating mechanism.

Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study

BACKGROUND

This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents' cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers.

METHODS

The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children's Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews.

RESULTS

Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents' and mothers' perspectives as associated with adolescents' MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility.

CONCLUSIONS

This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence.

Economic hardship and adolescent behavioral outcomes: Within- and between-family associations

Understanding how youth perceive household economic hardship and how it relates to their behavior is vital given associations between hardship and behavioral development. Yet, most studies ignore youth's own perceptions of economic hardship, instead relying solely on caregiver reports. Moreover, the literature has tended to treat economic hardship as a stable force over time, rather than a volatile one that varies month-to-month. This study addressed extant limitations by collecting monthly measures of economic hardship, specifically caregiver- and youth-reported material deprivation and youth-reported financial stress, and youth internalizing and externalizing problems from 104 youth-caregiver dyads (youth: 14-16 years, 55% female, 37% Black, 43% White) over nine months. We examined month-to-month variability of these constructs and how youth-reports of material deprivation and financial stress predicted their behavior problems, controlling for caregiver-reports of material deprivation. We found that hardship measures varied month-to-month (ICCs = 0.69-0.73), and youth-reported material deprivation positively predicted internalizing when examining both within- and between-individual variability (β = .19-.47). Youth-reported financial stress positively predicted within-individual variation in externalizing (β = .18), while youth reports of material deprivation predicted externalizing when looking between families (β = .41). Caregiver-reported material deprivation was unrelated to youth behavior when accounting for youth perceptions of economic hardship.

Longitudinal coupling of emotional wellbeing in parent-adolescent dyads: Evaluating the role of daily life positive affect socialization processes

This study evaluated the role of bidirectional micro- and macro- level positive affect-related processes in the longitudinal coupling of depressive symptoms in parent-adolescent dyads. Using a measurement-burst design, including dyadic experience sampling methods (ESM) and monthly follow-ups over one year, this work investigated associations between (1) parental depressive symptoms and anhedonia and parental daily-life enhancing and dampening responses to youth positive affect; (2) parental daily-life enhancing and dampening and trajectories of youth positive affect, negative affect, and depressive symptoms across one year; and (3) youth developmental trajectories and prospective parental daily-life enhancing and dampening, and parental depressive symptoms and anhedonia at one-year follow-up. Participants included 146 early adolescents (52.1% girls, 47.9% boys; Mage[SD] = 12.71[.86]) and 139 parents (78.7% mothers; Mage[SD] = 44.11[5.08]). Parental enhancing and dampening were measured using a dyadic ESM procedure at baseline and 12-months. Youth completed monthtly questionnaires assessing depressive symptoms and trait positive and negative affect across 12 months. Parents reported on depressive symptoms and anhedonia at baseline and 12-months. Results showed that parental anhedonia negatively related to parental daily-life enhancing, and youths' perceptions of their parents' enhancing and dampening reciprocally related to youth emotional development across one year, with downstream implications for parents' own symptoms of depression.

(In)Congruence in Perceived Mother-child Cohesion and Informants' Depressive Symptoms: A Dyadic Response Surface Analysis

Mother-child cohesion, reflecting the emotional connection between mothers and children, is a protective factor for individuals' mental health. The Modified Operations Triad Model suggests that children and mothers hold either congruent or incongruent views of their perceived cohesion, which reflects family functioning and is an indication of future mental health outcomes for family members. Despite increasing research on the impact of (in)congruence in perceived family functioning on children's mental health, few studies concurrently address the mental health of both mothers and children, overlooking their interdependence. This longitudinal study with multi-informant reports explored the long-term and developmental effects of (in)congruence in perceived mother-child cohesion on informants' depressive symptoms. A total of 577 families participated at the first time point, comprising 577 children (52.34% girls, Mage = 10.11 years) and 577 mothers (Mage = 37.32 years). The Dyadic Response Surface Analysis revealed that mother-child congruence at high levels of cohesion (versus low levels) predicted fewer depressive symptoms in mothers and children after three and nine months, as well as decreased depressive symptoms over nine months. Children who reported higher levels of cohesion than their mothers experienced fewer depressive symptoms after three months. Mothers with higher levels of cohesion than their children reported fewer depressive symptoms after three months. The current findings emphasize the importance of identifying and resolving discrepancies in perceived mother-child cohesion between mothers and children to promote a healthy family environment.

Adolescent-Mother Agreements and Discrepancies in Reports of Helicopter Parenting: Associations with Perceived Conflict and Support

Adolescents' and parents' similar and/or divergent perceptions of parental behaviors may be associated with youth-parent relationship quality. This study examined adolescents' and mothers' perceptions of helicopter parenting, and whether (dis)agreements between these views were associated with perceived conflict and support. Participants were 349 late adolescents (MT1age = 18.20; 39.8% male) and their mothers (MT1age = 49.10) in Hong Kong who completed four assessments over one year. Results suggested that youth-mother agreements regarding helicopter parenting were positively associated with both conflict and support. Additionally, discrepancies between their reports were positively related to adolescent-reported conflict. These findings highlight the importance of examining multiple perspectives when studying helicopter parenting dynamics, and suggest both positive and negative aspects of these practices in Chinese families.

Biological sensitivity to adolescent-parent discrepancies in perceived parental warmth

Introduction

Parenting behaviors are formative to the psychological development of young people; however, parent and adolescent perceptions of parenting are only moderately correlated with each other. Whereas discrepant perceptions may represent a normative process of deindividuation from caregivers in some adolescents, in others a discrepancy might predict psychological maladjustment. The biological sensitivity to context model provides a framework from which individual differences in development can be estimated in adolescents whose perceptions of parenting diverge from those of their parents.

Methods

At baseline we obtained diurnal cortisol samples from US adolescents (M = 13.37 years of age, SD = 1.06) as well as parents' and adolescents' ratings of parental warmth; we obtained adolescent-reported symptoms of psychopathology at baseline and again at follow-up two years later (N = 108, 57.5% female). We estimated waking cortisol, cortisol awakening response, and daytime cortisol slopes using piecewise regression models.

Results

Lower adolescent than parent ratings of parental warmth predicted increased externalizing symptoms at follow-up. Higher waking cortisol and steeper cortisol awakening response and daytime slopes predicted increased internalizing symptoms at follow-up. Further, discrepant ratings of parental warmth interacted with cortisol awakening response and daytime slopes such that greater discrepancies predicted greater increases in externalizing symptoms in adolescents with steeper cortisol slopes.

Conclusions

These findings indicate that steeper changes in cortisol production throughout the day index a greater sensitivity to perceived parental warmth. Lower adolescent than parent ratings of parental warmth may represent dysfunction in the parental relationship rather than a normative process of deindividuation in adolescents with steeper diurnal cortisol slopes.

Prospective within-family bidirectional effects between parental emotion socialization practices and Chinese adolescents' psychosocial adjustment

Previous research indicates that parental emotion socialization (ES) practices play important roles in adolescents' social and emotional development. However, longitudinal studies testing bidirectional effects are relatively scarce. Additionally, most studies have focused on people from Western societies. In the current 3-year, multi-informant, longitudinal study of Chinese adolescents and their parents, we investigated prospective bidirectional effects between parental positive ES practices and adolescents' psychosocial adjustment (i.e., self-esteem and depressive symptoms). Adolescents (N = 710 at T1, 50% boys, Mage = 12.41, SD = 0.59) reported on parental positive ES practices and their own depressive symptoms and self-esteem when they were in 7th, 8th, and 9th grade. Mothers and fathers reported on their own use of positive ES practices at all three time points. We utilized a random intercept cross-lagged panel model to examine between- and within-family effects. Overall results showed robust effects of adolescent depressive symptoms on parental positive ES practices and bidirectional effects between parental ES and adolescent self-esteem. Effects differed by informants whether using adolescent-perceived data, or mother- or father-reported data. However, these child effects and bidirectional effects did not differ by adolescent sex. Our findings add to the understanding of parental ES and adolescent psychosocial adjustment.

Perceived Parenting Discrepancy Profiles, Feelings about Language Brokering, and Internalizing Symptoms among Mexican-origin Adolescents in Immigrant Families

While different patterns of perceived parenting discrepancy among mother-adolescent dyads have been shown to be associated with adolescent internalizing symptoms, little is known about the pathway underlying such associations, particularly among immigrant families. The current study considered one culturally salient form of mother-adolescent communication, language brokering (i.e., adolescents translating and interpreting between host and heritage languages for mothers), in order to investigate its mediating role based on two waves of longitudinal data on Mexican-origin immigrant families. Wave 1 included 604 adolescents (54% female; Mage = 12.92, SD = 0.92) and 595 mothers (Mage = 38.89, SD = 5.74); Wave 2 was collected one year later with data from 483 adolescents. Perceived parenting discrepancy patterns at Wave 1 were captured by three profiles based on the levels of both mothers' and adolescents' perceived positive parenting (i.e., Mother High, Adolescent High, and Both High). Compared to the other two profiles, adolescents who reported much lower positive parenting than mothers at Wave 1 (i.e., Mother High) experienced more negative feelings about brokering at Wave 2, relating to more anxiety. Being in the Mother High (vs. Both High) group was also directly related to more depressive symptoms one year later. This study highlights the importance of considering culturally salient forms of communication, such as language brokering, when designing family-level interventions to reduce adolescents' internalizing symptoms by building agreement on high positive parenting among mother-adolescent dyads from immigrant families.

Caregiver Engagement in Outpatient Treatment for Adolescents in Community Settings: Construct and Predictive Validity of Family Therapy Techniques

Caregiver engagement and participation in community-based outpatient treatment services for adolescents is generally poor, which is problematic given the integral role of caregivers prescribed by evidence-based treatments across orientations. The current study explores the psychometric and predictive properties of a set of caregiver engagement techniques distilled from family therapy, used by community clinicians in routine care. It highlights relational engagement interventions and adds to growing work distilling core elements of family therapy. The study examined caregiver engagement techniques observed in 320 recorded sessions and outcome data from 152 cases treated by 45 therapists participating in one of three randomized trials investigating delivery of family therapy for adolescent behavior problems in community settings. Construct and predictive validity of caregiver engagement coding items were analyzed to understand the degree to which they cohered as a single factor and predicted outcomes in predictable ways. Results demonstrated item reliability and construct validity of a Caregiver Engagement Techniques factor. Greater use of these techniques was associated with decreased adolescent substance use. Unexpected results suggested greater use of techniques was associated with worsening internalizing symptoms and family cohesion per youth-report only. Post-hoc analyses revealed additional complexities in the association between engagement techniques and outcomes. Caregiver engagement practices tested in the current study represent a unified treatment factor that may contribute to positive therapeutic outcomes for adolescents in some clinical domains. Further research is needed to understand predictive effects.

Longitudinal Association between Maternal Autonomy Support and Controlling Parenting and Adolescents' Depressive Symptoms

Most studies on autonomy support and controlling parenting rely on children's perceptions, despite the limitations of this approach. This study investigated congruency between autonomy support and controlling parenting reported by mothers and adolescents and their association with adolescents' depressive symptoms via basic psychological needs satisfaction. Participants included 408 Japanese mother-adolescent (M_age = 13.73, SD = 0.90, 52% female) pairs who completed a questionnaire at two time points four months apart. Results demonstrated low to moderate levels of mother-adolescent agreement. Cross-lagged regression models revealed that mothers' reported autonomy support positively predicted adolescents' basic psychological needs satisfactions, which was negatively associated with depressive symptoms. The independent roles of parenting reported by mothers and adolescents for adolescents' well-being were discussed.

Parent-Child Discrepancies in Perceived Parental Emotion Socialization: Associations with Children's Internalizing and Externalizing Problems in Chinese Families

Parental emotion socialization is highly associated with children's internalizing and externalizing problems. However, research on parent-child discrepancies in parental emotion socialization perceptions and their relationship with children's developmental outcomes remains limited. This study explores the relationship between parent-child discrepancies in their reports of parental emotion socialization and children's internalizing/externalizing problems in Chinese families. The participants were 390 children (55% girls, M_age = 11.70 years, SD_age = 1.17) and their primary caregivers (68% mother, M_age = 39.52 years, SD_age = 5.23). A latent profile analysis identified three profiles of parent-child discrepancies in supportive parental emotion socialization and four profiles in non-supportive parental emotion socialization. Children with more negative perceptions of parental emotion socialization than their parents exhibited the most internalizing and externalizing problems. The parent-child perception difference of the supportive dimension connected to internalizing and externalizing problems, while the perception difference of the non-supportive dimension connected only to internalizing problems. These findings advocate for the conceptualization of perceptions of parent-child discrepancies within family dynamics, which may predict children's developmental outcomes.

Family Functioning in Hispanic Parents of Adolescents: Who Benefits Most from a Family-Based HIV and Substance Use Preventive Intervention?

To understand which families are likely to benefit most from resource-intensive family-based, evidence-based interventions (EBIs), we must examine the key, modifiable determinant of family functioning. The purpose of this study was to (1) identify whether there are subgroups of Hispanic parents that differ meaningfully based on their family functioning at baseline, (2) test whether the Familias Unidas preventive intervention was differentially effective across the baseline family functioning subgroups, and (3) understand the mechanisms of intervention effectiveness within each baseline family functioning subgroup. On a pooled data set of 4 completed efficacy and effectiveness trials of Familias Unidas (n = 1445 low-income, Hispanic immigrant origin, parents and their adolescent between the ages of 12-17), we conducted a series of secondary data analyses. Latent profile analyses revealed four significantly different profiles: (1) low family functioning (n = 210, 14.55%), (2) low-to-moderate family functioning (n = 554, 38.39%), (3) moderate-to-high family functioning (n = 490, 33.96%), and (4) high family functioning (n = 189, 13.10%). A structural equation modeling approach found there were significant differences in intervention effectiveness between the subgroups. The low family functioning subgroup experienced gains in family functioning, and in turn, lower levels of adolescent substance use, internalizing, and externalizing symptoms. The high family functioning subgroup showed significant direct effects of the intervention on adolescent substance use, internalizing, and externalizing symptoms, but no indirect effects through improvements in family functioning. Implications for screening, targeting, and adapting interventions are discussed.

Mother-Adolescent Perceived Parenting Profiles and Mexican-origin Adolescents' Academic Performance

Mothers and adolescents often perceive parenting differently, but it is unclear how different profiles of mother-adolescent perceived parenting and developmental transitions of such profiles would influence adolescent academic performance longitudinally. The current study adopted a three-wave dataset of 604 Mexican-origin adolescents (54% female; Mwave1.age = 12.92 years) and 595 mothers. Adolescents who agreed on high levels of positive parenting with their mothers in early adolescence (i.e., the Both High group) and stayed in the Both High group demonstrated the best academic performance in late adolescence. However, adolescents who changed from the Both High group in early adolescence and ended with discrepancies in perceived parenting or an agreement on low positive parenting with mothers in late adolescence had the worst academic performance. The findings suggest the plasticity of mother-adolescent relationships during adolescence, which can be an intervention target to improve Mexican-origin adolescent academic performance.

The Operations Triad Model and Youth Mental Health Assessments: Catalyzing a Paradigm Shift in Measurement Validation

Researchers strategically assess youth mental health by soliciting reports from multiple informants. Typically, these informants (e.g., parents, teachers, youth themselves) vary in the social contexts where they observe youth. Decades of research reveal that the most common data conditions produced with this approach consist of discrepancies across informants' reports (i.e., informant discrepancies). Researchers should arguably treat these informant discrepancies as domain-relevant information: data relevant to understanding youth mental health domains (e.g., anxiety, depression, aggression). Yet, historically, in youth mental health research as in many other research areas, one set of paradigms has guided interpretations of informant discrepancies: Converging Operations and the Multi-Trait Multi-Method Matrix (MTMM). These paradigms (a) emphasize shared or common variance observed in multivariate data, and (b) inspire research practices that treat unique variance (i.e., informant discrepancies) as measurement confounds, namely random error and/or rater biases. Several yearsw ago, the Operations Triad Model emerged to address a conceptual problem that Converging Operations does not address: Some informant discrepancies might reflect measurement confounds, whereas others reflect domain-relevant information. However, addressing this problem requires more than a conceptual paradigm shift beyond Converging Operations. This problem necessitates a paradigm shift in measurement validation. We advance a paradigm (Classifying Observations Necessitates Theory, Epistemology, and Testing [CONTEXT]) that addresses problems with using the MTMM in youth mental health research. CONTEXT optimizes measurement validity by guiding researchers to leverage (a) informants that produce domain-relevant informant discrepancies, (b) analytic procedures that retain domain-relevant informant discrepancies, and (c) study designs that facilitate detecting domain-relevant informant discrepancies.

Longitudinal Linkages Between Parent-Child Discrepancies in Reports on Parental Autonomy Support and Informants' Depressive Symptoms

Although parent-child discrepancies in reports of parenting are known to be associated with child depressive symptoms, the direction of causality is unknown. To address this knowledge gap, this study contributes to existing literature by examining longitudinal within-family linkages between parent-child discrepancies in their reports on autonomy support and depressive symptoms of children, while also assessing these linkages with parents' depressive symptoms. In addition, this study explored whether these linkages differ for father- versus mother-child discrepancies. Longitudinal data (six annual waves) of 497 adolescents (56.9% boys, M_age at T₁ = 13.03, SD = 0.46), their mothers (N = 495), and their fathers (N = 446) of the Dutch study Research on Adolescent Development and Relationships (RADAR) were used. Counter to expectations, the results of a Random Intercept Cross-Lagged Panel Model provided no evidence for within-family cross-lagged effects. Instead, stable differences between families explained linkages; in families where children reported on average higher levels of depressive symptoms, children also reported lower levels of autonomy support relative to their parents. There were no associations between parent-child discrepancies and parents' depressive symptoms. Thus, the findings suggest that depressive symptoms are neither a consequence, nor a predictor of parent-child discrepancies in adolescence. The hypotheses and analytical plan of this study were preregistered in a project on the Open Science Framework.

A Meta-Analysis on Differences and Associations between Alliance Ratings in Child and Adolescent Psychotherapy

OBJECTIVE

The alliance in child and adolescent psychotherapy is widely recognized as an important factor in therapy. Studies on the alliance have increasingly focused on assessment of the alliance as a dyadic construct, measuring both client and therapist alliance ratings. However, cross-informant reports of the alliance in child psychotherapy have not yet been subjected to meta-analysis. Therefore, the present meta-analysis aims to increase knowledge on the degree of convergence and divergence between child, parent, therapist, and observer alliance ratings in child and adolescent psychotherapy.

METHODS

A series of three-level meta-analyses of 78 studies was conducted to investigate differences and associations between child, parent, therapist, and observer alliance ratings in child and adolescent psychotherapy.

RESULTS

Findings indicated that children and parents in general rated the alliance more positively than their therapists (d = 0.35, d = 0.72, respectively), and that child-therapist and parent-therapist alliance ratings were moderately correlated (r = .32, r = .23, respectively). Associations between child and therapist ratings and observer ratings were moderate to large (r = .43, r = .53, respectively).

CONCLUSIONS

It can be concluded that children and parents generally report more positively on the alliance compared to their therapists, which is consistent with research on the alliance in adult populations. The small to moderate associations between alliance ratings indicate that individuals to some extent have a shared perspective on their alliance, and that the various perspectives on alliance should be acknowledged when dealing with children and parents in therapy. Implications for future research are discussed.

Introduction to the Special Issue. A Dozen Years of Demonstrating That Informant Discrepancies are More Than Measurement Error: Toward Guidelines for Integrating Data from Multi-Informant Assessments of Youth Mental Health

Validly characterizing youth mental health phenomena requires evidence-based approaches to assessment. An evidence-based assessment cannot rely on a "gold standard" instrument but rather, batteries of instruments. These batteries include multiple modalities of instrumentation (e.g., surveys, interviews, performance-based tasks, physiological readings, structured clinical observations). Among these instruments are those that require soliciting reports from multiple informants: People who provide psychometrically sound data about youth mental health (e.g., parents, teachers, youth themselves). The January 2011 issue of the Journal of Clinical Child and Adolescent Psychology (JCCAP) included a Special Section devoted to the most common outcome of multi-informant assessments of youth mental health, namely discrepancies across informants' reports (i.e., informant discrepancies). The 2011 JCCAP Special Section revolved around a critical question: Might informant discrepancies contain data relevant to understanding youth mental health (i.e., domain-relevant information)? This Special Issue is a "sequel" to the 2011 Special Section. Since 2011, an accumulating body of work indicates that informant discrepancies often contain domain-relevant information. Ultimately, we designed this Special Issue to lay the conceptual, methodological, and empirical foundations of guidelines for integrating multi-informant data when informant discrepancies contain domain-relevant information. In this introduction to the Special Issue, we briefly review the last 12 years of research and theory on informant discrepancies. This review highlights limitations inherent to the most commonly used strategies for integrating multi-informant data in youth mental health. We also describe contributions to the Special Issue, including articles about informant discrepancies that traverse multiple content areas (e.g., autism, implementation science, measurement validation, suicide).

Do You See What I See? Longitudinal Associations Between Mothers' and Adolescents' Perceptions of Their Relationship and Adolescent Internalizing Symptoms

This 6-year community study examined how discrepancies in mothers' and adolescents' perceptions of their relationship were longitudinally associated with adolescent internalizing symptoms, and vice versa. 497 adolescents (57% boys, M_{age T1} = 13.03, SD_age = 0.46) and their mothers reported in 6 annual waves on conflict and warmth in the mother-adolescent relationship and adolescents reported on their depressive and Generalized Anxiety Disorder (GAD) symptoms. Latent Congruence Models suggested that both adolescent depressive and GAD symptoms significantly predicted higher levels of conflict as well as stronger discrepancies in perceptions of conflict 1-year later. In turn, higher levels of conflict significantly predicted both adolescent depressive and GAD symptoms 1-year later. For warmth, lower levels significantly predicted adolescent depressive symptoms 1-year later. Concluding, these findings suggest (1) more systematic evidence for longitudinal associations between conflict than warmth in the mother-adolescent relationship and adolescent internalizing symptoms; (2) support for a transactional model, including support for both interpersonal scar or symptom-driven effects (concerning both levels of and mother-adolescent discrepancies in conflict) and interpersonal risk or relationship-driven effects (concerning levels of both conflict and warmth); (3) longitudinal effects from adolescent internalizing symptoms to mother-adolescent discrepancies, but not vice versa; and (4) strong consistency in patterns of findings across both adolescent depressive and GAD symptoms, with few differential longitudinal associations with aspects of mother-adolescent relationship quality. Thereby, this study provides a more nuanced understanding of the direction of effects between adolescent internalizing symptoms and both levels of and discrepancies in mothers' and adolescents' perceptions of their relationship.

A comparison of expressed emotion between mothers and their adolescent daughters with and without a history of nonsuicidal self-injury

BACKGROUND

Expressed Emotion refers to the extent to which close relatives express critical/hostile and/or emotionally overinvolved attitudes and feelings when speaking about a family member. High Expressed Emotion is a valuable predictor of clinical outcomes and is related to the presence of various mental disorders, including nonsuicidal self-injury (NSSI). Interpersonal factors have been shown to be relevant in initiating and in maintaining with NSSI, as interpersonal difficulties are often reported as triggers for emotional dysregulation. The parental role in the etiology and treatment of NSSI needs to be further investigated. This study assesses Expressed Emotion in adolescents who engage in NSSI and their mothers.

METHOD

We examined Expressed Emotion levels of mother-daughter dyads among adolescents who engage in NSSI, clinical controls (CCs), and nonclinical controls (NCs). The sample consisted of 70 female adolescents aged 12-20 years (M = 15.28 years, SD = 1.81; NSSI: n = 21, CC: n = 17, NC: n = 32) and 24 mothers aged 38-56 years (M = 46.47 years, SD = 4.61) using The Five-Minute Speech Sample (FMSS).

RESULTS

Adolescents who engage in NSSI exhibited significantly more covert criticism and critical tone toward their mothers than CCs (d = 0.65, d = 1.10) and NCs (d = 1.30, d = 1.10).

CONCLUSION

The findings highlight the importance of family-based interventions for the treatment of NSSI in order to enhance a positive relationship quality between parents and adolescents.

Conceptual, methodological, and measurement factors that disqualify use of measurement invariance techniques to detect informant discrepancies in youth mental health assessments

On page 1 of his classic text, Millsap (2011) states, “Measurement invariance is built on the notion that a measuring device should function the same way across varied conditions, so long as those varied conditions are irrelevant [emphasis added] to the attribute being measured.” By construction, measurement invariance techniques require not only detecting varied conditions but also ruling out that these conditions inform our understanding of measured domains (i.e., conditions that do not contain domain-relevant information). In fact, measurement invariance techniques possess great utility when theory and research inform their application to specific, varied conditions (e.g., cultural, ethnic, or racial background of test respondents) that, if not detected, introduce measurement biases, and, thus, depress measurement validity (e.g., academic achievement and intelligence). Yet, we see emerging bodies of work where scholars have “put the cart before the horse” when it comes to measurement invariance, and they apply these techniques to varied conditions that, in fact, may reflect domain-relevant information. These bodies of work highlight a larger problem in measurement that likely cuts across many areas of scholarship. In one such area, youth mental health, researchers commonly encounter a set of conditions that nullify the use of measurement invariance, namely discrepancies between survey reports completed by multiple informants, such as parents, teachers, and youth themselves (i.e., informant discrepancies). In this paper, we provide an overview of conceptual, methodological, and measurement factors that should prevent researchers from applying measurement invariance techniques to detect informant discrepancies. Along the way, we cite evidence from the last 15 years indicating that informant discrepancies reflect domain-relevant information. We also apply this evidence to recent uses of measurement invariance techniques in youth mental health. Based on prior evidence, we highlight the implications of applying these techniques to multi-informant data, when the informant discrepancies observed within these data might reflect domain-relevant information. We close by calling for a moratorium on applying measurement invariance techniques to detect informant discrepancies in youth mental health assessments. In doing so, we describe how the state of the science would need to fundamentally “flip” to justify applying these techniques to detect informant discrepancies in this area of work.

Early Adolescent Social Anxiety: Differential Associations for Fathers' and Mothers' Psychologically Controlling and Autonomy-Supportive Parenting

Although psychologically controlling and autonomy-supportive parenting are important indicators of social anxiety during early adolescence, less research has explored distinct roles of father and mother parenting, especially in interdependent-oriented culture. This 3-year longitudinal study examined the reciprocal associations between such parenting and early adolescent social anxiety from multi-informants in the Chinese context. A sample of 1,140 Chinese early adolescents (51.1% boys; M_age = 10.50 years) and their parents participated at Wave 1. The results did not reveal reciprocal relations between fathers' reported parenting and social anxiety, but indicated paternal parenting effects from boys' perceptions of autonomy support to social anxiety, and child effects from social anxiety to girls' perceived psychological control. Maternal parenting effects were present for boys' perceptions of autonomy support and girls' perceptions of psychological control. The findings highlight the distinct roles of father and mother parenting across child gender and suggest differentiated relations of parenting to social anxiety during early adolescence in the Chinese context.

Links between shared and unique perspectives of parental psychological control and adolescent emotional problems: A dyadic daily diary study

Using month-long daily diary data collected between 2019 and 2020 among 99 dyads of Canadian parents (58.6% White, M_age  = 43.5, 69.7% female) and adolescents (51.5% White, M_age  = 14.6, 53.5% female) from middle to high socioeconomic status families, this study investigated parents' and adolescents' daily shared and unique perceptions of parental psychological control and adolescent emotional problems at within- and between-family level, and examined their cross-day associations. Multilevel multi-trait multi-method confirmatory factor analysis revealed both convergence and divergence across parent-adolescent perceptions at the within level, but no convergence at the between level. Dynamic structural equation modeling revealed cross-day associations across different perspectives of parenting and adolescent behaviors. Findings contribute novel knowledge to understanding parent-child daily interactions with a multi-informant approach.

Children's Attention and Self-Regulatory Behavior Before and During the COVID-19 Pandemic

OBJECTIVE

The goal of this study was to investigate changes in children's self-regulatory behavior before and during the COVID-19 pandemic.

METHOD

Participants were parents of children aged 4 to 13 years (n = 45, mean 7.5, SD: 2.6) who participated in the Baltimore Generations Study before the pandemic. They reported on their child's self-regulation (SR) using the Parent Observation of Child Adaptation. During the pandemic, they were recontacted to report on child SR, disruptions to family life (Coronavirus Impact Scale), and parenting stress (Parenting Stress Index). Prepandemic to pandemic changes in SR were compared with repeated measures analysis of variance.

RESULTS

There were significant decreases in child SR (poorer concentration, attention, task engagement and persistence, and greater impulsivity) prepandemic to pandemic. During the pandemic, parenting stress was correlated with lower child SR (r range = -0.52 to -0.34, p < 0.05). Pandemic-related family disruptions were associated with changes in children's impulsivity (F [1, 42] = 5.28, p = 0.03); children with 4 or more disruptions (67%) showed less ability to wait their turn during the pandemic compared with prepandemic (M [SD] = 3.34 [0.93] vs. 4.41 [1.21], t [28] = 3.93, p < 0.001). There was no change in SR for children with fewer than 4 disruptions.

CONCLUSION

Results highlight modest pandemic-associated decreases in child attention, task persistence, and task engagement alongside increases in impulsivity. We did not find evidence of broad or severe impacts; however, children whose families have been disproportionately affected by the pandemic may need focused support in school and at home to avoid widening prepandemic health and educational disparities.

External childcare and socio-behavioral development in Switzerland: Long-term relations from childhood into young adulthood

This study examined early external childcare in relation to development from age 7 to 20. A Swiss sample was used (N = 1,225; 52% male). Development included multi-informant-reported externalizing behavior, internalizing problems, prosocial behavior, delinquency, and substance use. Growth curve models revealed that, dependent on the informant, time in a daycare center was related to increased externalizing and internalizing problems until at least age 11. It was not related to delinquency. Roughly three days per week at a daycare mother or playgroup was related to increased externalizing behavior. External family care was associated with increased prosocial behavior. Finally, time in a daycare center was associated with fewer externalizing but more internalizing problems and substance use for children from vulnerable backgrounds. This relation with substance use lasted to age 20.

A Two-Way Street? Reciprocal Associations Between Parental Warmth and Hostility with Substance Use Among Justice-Involved Adolescents

Transactional developmental theories propose that poor parenting behaviors contribute to youth substance use, and youth substance use contributes to poor parenting behaviors. However, research aimed at testing these theories has not distinguished: (1) between- and within-person sources of variance; (2) maternal and paternal parenting behaviors; and (3) alcohol, marijuana, and other illicit drug use. This study addressed these limitations by investigating the reciprocal associations between maternal and paternal warmth and hostility with alcohol, marijuana, and other illicit drug use among justice-involved adolescents, an at-risk population for substance use. 1354 justice-involved adolescents (86.4% male; M_age = 16.04 [SD = 0.14], range = 14-17; 41.4% Black, 33.5% Hispanic, 20.2% White, 4.8% other race/ethnicity) completed self-reports assessing parental warmth, parental hostility, and substance use every six months for 36 months. Random-intercept structural equation models disaggregated between- and within-person associations. At the between-person level, maternal and paternal warmth were negatively associated with alcohol, marijuana, and other illicit drug use, whereas maternal and paternal hostility were positively associated with alcohol, marijuana, and other illicit drug use. At the within-person level, maternal and paternal warmth predicted decreases in marijuana and other illicit drug use, and paternal warmth predicted decreases in alcohol use six months later. Maternal hostility predicted increases in subsequent marijuana and other illicit drug use. Marijuana and other illicit drug use predicted decreases in subsequent paternal hostility. The results are partially consistent with transactional developmental models proposing recursive influences between parenting behaviors and youth substance use. Evocative effects were in the opposite direction than expected and specific to fathers, such that youth drug use was related to improvements in the father-youth relationship. The results support the potential utility of family-based interventions for substance use among justice-involved adolescents.

Discrepant Parent-Adolescent Reports of Parenting Practices: Associations with Adolescent Internalizing and Externalizing Symptoms

Discrepancies in multi-informant reports of parenting practices represent a meaningful clinical construct that can be harnessed to predict adolescent mental health outcomes and shed light on the nature of parent-adolescent relationships. To date, however, no research has sought to examine discrepancies in perceptions of parenting practices among adolescents with histories of substance use disorders, a population for whom supportive parenting is a critical protective factor during the recovery process. This study examined parent-adolescent informant discrepancies of parenting practices and their associations with externalizing and internalizing symptomology among a sample of adolescents with substance use disorder histories. Data were analyzed from 294 adolescents (M adolescent age = 16 years; 45% female, 72% white) and their parents (87% female, 83% white) from a larger longitudinal study. Parenting practices of interest were positive parenting, inconsistent discipline, and poor monitoring. Polynomial regression analyses were used to test the discrepancy hypotheses. The results generally suggested null associations between single informant reports and internalizing and externalizing symptoms. Discrepancies were noted, however, in multi-informant reports of positive parenting, such that higher levels of adolescent-reported positive parenting were associated with higher levels of internalizing symptoms at high (but not low) levels of parent-reported positive parenting. Similarly, discrepancies were noted in multi-informant reports of poor monitoring, such that lower levels of adolescent-poor monitoring were associated with higher externalizing symptoms at low levels of parent-reported poor monitoring. The findings are discussed in terms of research and clinical implications of collecting and utilizing multi-informant data among clinical samples of adolescents with unique risk profiles.

Listening in: An Alternative Method for Measuring the Family Emotional Environment

The family emotional environment influences children's development of emotion regulation in various ways. Children's difficulties with effectively regulating emotions, in turn, can contribute to the development of psychopathology. However, the pathways that explain how environmental emotion-including overheard emotion among family members-influences children's development of healthy or problematic emotion regulation are unclear. In this article, we briefly discuss the most common methods (e.g., questionnaires, laboratory observations) used to assess emotion in the family. We consider the benefits and limitations of these methods and discuss the need for objective measurement of the family emotional environment. We include a description of the Electronically Activated Recorder (EAR), which provides unobtrusive, extended sampling of the emotional tone of family interaction in the home. We present preliminary evidence of its use with 7- and 8-year-old and their families during one day at home. The method reveals that objectively assessed parent-to-parent interactions that are negatively toned, but not parental self-report of conflict or expressivity, are associated with children's self-reported emotional reactions to hearing independently recorded clips of their mothers' voices during simulated angry interactions. The finding suggests unique contributions of objective, unobtrusive, extended measurement of the family emotional environment to understanding aspects of children's emotional development that may not be captured with other commonly used methods. We discuss future directions that explore how EAR may be used to further our knowledge of the pathways between environmental emotion as a risk factor that influences children's emotional functioning and their psychological well-being.

What if children with psychiatric problems disagree with their clinicians on the need for care? Factors explaining discordance and clinical directions

BACKGROUND

Children and adolescents in mental healthcare often perceive their care needs and necessary treatment differently from their clinicians. As such discordance between young patients and clinicians may obstruct treatment adherence and compromise treatment outcomes, it is important to understand the factors associated with it. We therefore investigated the factors associated with patient-clinician discordance with regard to care needs in various areas of functioning.

METHODS

A cross-sectional study involving 244 children/adolescents aged 6-18 participating with their clinicians in treatment at a specialized mental healthcare center. As a previous study conducted by our research group had found the greatest patient-clinician discordance in three CANSAS care needs-"mental health problems," "information regarding diagnosis and/or treatment," and "making and/or keeping friends"-we used univariable and multivariable statistics to investigate the factors associated with discordance regarding these three care needs.

RESULTS

patient-clinician discordance on the three CANSAS items was associated with child, parent, and family/social-context factors. Three variables were significant in each of the three final multivariable models: dangerous behavior towards self (child level); severity of psychiatric problems of the parent (parent level); and growing up in a single-parent household (family/social-context level).

CONCLUSIONS

To deliver treatment most effectively and to prevent drop-out, it is important during diagnostic assessment and treatment planning to address the patient's care needs at all three levels: child, parent and family/social context.

Multi-informant reports of depressive symptoms and suicidal ideation among adolescent inpatients

OBJECTIVE

Suicide is a leading cause of death among adolescents, and suicidal thoughts represent key predictors to suicidal behavior. Yet, suicidal thoughts can be challenging to accurately assess. Symptoms that commonly co-occur with suicidal thoughts, such as depressive symptoms, may provide valuable information for predicting these thoughts. Although clinicians commonly collect multi-informant reports about adolescent depressive symptoms, these reports often yield discrepant findings as individual predictors of adolescents' suicidal thoughts.

METHOD

We tested the ability of specific patterns of multi-informant reports to predict adolescents' suicidal thoughts. Ninety adolescent inpatients and their parents (i.e., "dyads") reported on adolescent depressive symptoms, and adolescents completed self-report assessments of suicidal thoughts at baseline and three-month follow-up.

RESULTS

Dyads displayed variability in reporting patterns, and these patterns uniquely predicted suicidal thoughts. Adolescents reporting elevated depressive symptoms displayed increased concurrent suicidal thoughts relative to adolescents reporting subthreshold depressive symptoms, regardless of parent report. Yet, only adolescents who reported elevated depressive symptoms and whose parents reported subthreshold adolescent depressive symptoms displayed increased future suicidal thoughts.

CONCLUSIONS

Identifying patterns of multiple informants' reports about adolescent depressive symptoms may improve the prediction of suicidal thoughts. These findings have important implications for assessing adolescents at risk for suicide.

Assessing practical implementation of modular psychotherapy for youth in community-based settings using benchmarking

Background

Achieving high quality outcomes in a community context requires the strategic coordination of many activities in a service system, involving families, clinicians, supervisors, and administrators. In modern implementation trials, the therapy itself is guided by a treatment manual; however, structured supports for other parts of the service system may remain less well-articulated (e.g., supervision, administrative policies for planning and review, information/feedback flow, resource availability). This implementation trial investigated how a psychosocial intervention performed when those non-therapy supports were not structured by a research team, but were instead provided as part of a scalable industrial implementation, testing whether outcomes achieved would meet benchmarks from published research trials.

Method

In this single-arm observational benchmarking study, a total of 59 community clinicians were trained in the Modular Approach to Therapy for Children (MATCH) treatment program. These clinicians delivered MATCH treatment to 166 youth ages 6 to 17 naturally presenting for psychotherapy services. Clinicians received substantially fewer supports from the treatment developers or research team than in the original MATCH trials and instead relied on explicit process management tools to facilitate implementation. Prior RCTs of MATCH were used to benchmark the results of the current initiative. Client improvement was assessed using the Top Problems Assessment and Brief Problem Monitor.

Results

Analysis of client symptom change indicated that youth experienced improvement equal to or better than the experimental condition in published research trials. Similarly, caregiver-reported outcomes were generally comparable to those in published trials.

Conclusions

Although results must be interpreted cautiously, they support the feasibility of using process management tools to facilitate the successful implementation of MATCH outside the context of a formal research or funded implementation trial. Further, these results illustrate the value of benchmarking as a method to evaluation industrial implementation efforts. Plain Language Summary: Randomized effectiveness trials are inclusive of clinicians and cases that are routinely encountered in community-based settings, while continuing to rely on the research team for both clinical and administrative guidance. As a result, the field still struggles to understand what might be needed to support sustainable implementation and how interventions will perform when brought to scale in community settings without those clinical trial supports. Alternative approaches are needed to delineate and provide the clinical and operational support needed for implementation and to efficiently evaluate how evidence-based treatments perform. Benchmarking findings in the community against findings of more rigorous clinical trials is one such approach. This paper offers two main contributions to the literature. First, it provides an example of how benchmarking is used to evaluate how the Modular Approach to Therapy for Children (MATCH) treatment program performed outside the context of a research trial. Second, this study demonstrates that MATCH produced comparable symptom improvements to those seen in the original research trials and describes the implementation strategies associated with this success. In particular, although clinicians in this study had less rigorous expert clinical supervision as compared with the original trials, clinicians were provided with process management tools to support implementation. This study highlights the importance of evaluating the performance of intervention programs when brought to scale in community-based settings. This study also provides support for the use of process management tools to assist providers in effective implementation.

Antecedents and Consequences of Discrepant Perceptions of Racial Socialization between Parents and Adolescents within Mexican-Origin Families

Parents and adolescents often have different views regarding parental racial socialization practices; however, studies documenting such discrepancies remain scarce. Using a person-centered approach, this study investigated patterns of parent-adolescent discrepant views on racial socialization (i.e., cultural socialization, bias coping, bias awareness) as well as antecedents and consequences of the discrepancy profiles. Participants were 604 adolescents (54% female, Mage = 12.41, Rangeage = 11-15) and their mothers and fathers. The results showed distinct discrepancy patterns and suggested that more maternal/paternal warmth was associated with profiles that have smaller discrepancies or profiles in which adolescents reported higher socialization than parents. Adolescents who reported higher or similar socialization as parents demonstrated better adjustment. Implications for interventions aimed at strengthening parent-child relationships and communication about race and culture are discussed.

Perceptions of Parenting in Daily Life: Adolescent-Parent Differences and Associations with Adolescent Affect

Adolescents can perceive parenting quite differently than parents themselves and these discrepancies may relate to adolescent well-being. The current study aimed to explore how adolescents and parents perceive daily parental warmth and criticism and whether these perceptions and discrepancies relate to adolescents' daily positive and negative affect. The sample consisted of 80 adolescents (M_age = 15.9; 63.8% girls) and 151 parents (M_age = 49.4; 52.3% women) who completed four ecological momentary assessments per day for 14 consecutive days. In addition to adolescents' perception, not parents' perception by itself, but the extent to which this perception differed or overlapped with adolescents' perception was related to adolescent affect. These findings highlight the importance of including combined adolescents' and parents' perspectives when studying dynamic parenting processes.

Parent-Child Discrepancies in Perceived Parent-Child Communication and Depressive Symptoms in Early Adolescents in China

Although recent studies demonstrated that parent-child discrepancies in the perceived family processes were associated with children's developmental outcomes, few studies have addressed this issue in different types of families in mainland China. The present study investigated that how discrepancies in parents' and adolescents' perceptions of parent-adolescent communication were associated with early adolescent depressive symptoms in a nationally representative sample (N = 15,377) with 7010 father-adolescent dyads (adolescents: Mage = 14.24 years, SD = 1.25 years; 5960 adolescents from two-parent families, 443 adolescents from single-father families) and 8367 mother-adolescent dyads (adolescents: Mage = 14.02 years, SD = 1.18 years; 6670 adolescents from two-parent families, 1362 adolescents from single-mother families) in China. Adolescent respondents completed a measure of depressive symptoms and all informants reported on the perceived levels of parent-adolescent communication. Results indicated that adolescents reported parent-child communication more negatively than did their parents. Father-adolescent discrepancies were also greater in intact families than non-intact families. Polynomial regression analyses indicated that while there was a significant interactive effect of father-reported and adolescent-reported father-adolescent communication in Chinese two-parent families, no significant interaction was found for mother-adolescent dyad. Besides, adolescent-reported mother-child communication interacted with mother-reported communication in Chinese single-mother families only. The findings clarify parent-adolescent discrepancies in parent-child communication in different types of families in China and they have theoretical and practical implications on the role of discrepancies in parents and adolescent children on perceived parent-adolescent communication in early adolescent depressive symptoms.

Linking Foster Family Characteristics and Mental Health Symptoms of Youth in Care

Youth in foster care are disproportionately at risk for developing internalizing and externalizing problems (Lawrence et al., 2006); however, a history of maltreatment prior to foster care placement does not automatically result in poor mental health outcomes. Among non-foster care youth, the quality of family interactions has been related to adjustment outcomes, such that low family cohesion and high family conflict is associated with poor mental health symptoms (Caples & Barrera, 2006). While little is known about these constructs in foster care placements, they may help explain the variance in internalizing and externalizing problems for youth in foster care. The present study aimed to examine whether characteristics of the foster care environment (i.e., conflict, cohesion) across various placement types (i.e., traditional foster homes, group-care settings) could help explain the link between previous maltreatment exposure and mental health problems. The sample included 178 youth in foster care (M _age  = 15.18, SD = 1.76) and their foster caregivers living in the Midwest. Youth participants completed self-report measures about prior maltreatment history, current family environment characteristics, and youth internalizing symptoms. Foster caregivers completed measures on current family environment and youth externalizing symptoms. Results indicated that caregiver report, but not youth report, of family cohesion was negatively associated with youth report of internalizing problems. When examining the indirect effects, youth report of family conflict partially accounted for the link between youth self-report of maltreatment and internalizing symptoms (B = 0.106, 95% CI = 0.026-0.186). Caregiver report of family conflict fully accounted for the association between youth self-report of maltreatment and caregiver report of youths' externalizing symptoms (B = 0.108, 95% CI = 0.005-0.211). Findings highlight the importance of utilizing multiple informants when measuring foster family environment and suggest that family conflict is particularly salient for the mental health of youth in foster care.

Improving Mental Health Services: A 50-Year Journey from Randomized Experiments to Artificial Intelligence and Precision Mental Health

This conceptual paper describes the current state of mental health services, identifies critical problems, and suggests how to solve them. I focus on the potential contributions of artificial intelligence and precision mental health to improving mental health services. Toward that end, I draw upon my own research, which has changed over the last half century, to highlight the need to transform the way we conduct mental health services research. I identify exemplars from the emerging literature on artificial intelligence and precision approaches to treatment in which there is an attempt to personalize or fit the treatment to the client in order to produce more effective interventions.

Family Functioning in Families Affected by Parental Mental Illness: Parent, Child, and Clinician Ratings

Family functioning is often impaired in families with a parent with mental illness and is linked to child mental health. This study aims to gain a better understanding of family functioning in affected families by comparing ratings among family members and by analyzing associations with clinician-rated family functioning. The cross-sectional sample comprised 210 families with ratings of 207 patients, 139 partners, and 100 children. Parents with a mental illness as well as their partners and children completed the German version of the Family Assessment Measure (FAM). Clinician ratings were obtained by the Global Assessment of Relational Functioning Scale (GARF). We conducted several mixed models to compare ratings of family functioning while accounting for family cluster. Family dysfunction was consistently elevated compared to a normative sample. On several domains, parents with a mental illness perceived family functioning to be worse compared to their partners and children. Partners and children did not differ in their perceptions of family functioning. Ratings of family members were moderately associated with clinician ratings. We discuss the importance of multi-informant assessment of family functioning and the implementation of family-based interventions for families with a parent with mental illness.