Parent-adolescent disagreement regarding psychopathology in adolescents from the general population as a risk factor for adverse outcome

A Discrepancy in the Reports on Life Events Between Parents and Their Depressed Children Is Associated with Lower Responsiveness to SSRI Treatment

Introduction: Exposure to a range of stressful life events (SLE) is implicated in youth psychopathology. Previous studies point to a discrepancy between parents'/children's reports regarding stressful life events. No study systematically assessed the correlation between such discrepancies and psychopathology in depressed youth. This study was designed to assess parent-youth discrepancies regarding stressful life events and its association with severity of psychopathology at baseline and response to selective serotonin reuptake inhibitor (SSRI) treatment in depressed youth. Methods: Reports regarding stressful life events were assessed in children/adolescents suffering from depressive/anxiety disorders using the life events checklist (LEC), a self-report questionnaire measuring the impact of negative life events (NLE) and positive life events (PLE), as reported by the children and their parents. The severity of depression/anxiety disorders and response to antidepressant treatment were evaluated and correlated with both measures of LEC. Results: Participants were 96 parent-child dyads (39 boys, 57 girls) aged 6-18 years (mean = 13.90 years, SD = 2.41). Parents reported more NLE and higher severity of NLE events than their children (number of NLE: 7.51 ± 4.17 vs. 6.04 ± 5.32; Cumulative severity of NLE: 24.95 ± 14.83 vs. 17.24 ± 12.94). Discrepancy in PLE, but not NLE, was associated with more severe psychopathology and reduced response to treatment. Discussion: Discrepancy in informant reports regarding life events in depressed/anxious youth, especially regarding PLE, is associated with more severe psychopathology and reduced response to pharmacotherapy. It is essential to use multiple reporters in assessing stressful life events in children.

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.

The General Psychopathology 'p' Factor in Adolescence: Multi-Informant Assessment and Computerized Adaptive Testing

Accumulating evidence supports the presence of a general psychopathology dimension, the p factor ('p'). Despite growing interest in the p factor, questions remain about how p is assessed. Although multi-informant assessment of psychopathology is commonplace in clinical research and practice with children and adolescents, almost no research has taken a multi-informant approach to studying youth p or has examined the degree of concordance between parent and youth reports. Further, estimating p requires assessment of a large number of symptoms, resulting in high reporter burden that may not be feasible in many clinical and research settings. In the present study, we used bifactor multidimensional item response theory models to estimate parent- and adolescent-reported p in a large community sample of youth (11-17 years) and parents (N = 5,060 dyads). We examined agreement between parent and youth p scores and associations with assessor-rated youth global functioning. We also applied computerized adaptive testing (CAT) simulations to parent and youth reports to determine whether adaptive testing substantially alters agreement on p or associations with youth global functioning. Parent-youth agreement on p was moderate (r =.44) and both reports were negatively associated with youth global functioning. Notably, 7 out of 10 of the highest loading items were common across reporters. CAT reduced the average number of items administered by 57%. Agreement between CAT-derived p scores was similar to the full form (r =.40) and CAT scores were negatively correlated with youth functioning. These novel results highlight the promise and potential clinical utility of a multi-informant p factor approach.

The effect of parent-adolescent discrepancies in reports of familial dysfunction and depression on suicidal ideation in adolescents

INTRODUCTION

Parents and adolescents are often discrepant in their reports of adolescent psychosocial factors. Few studies have addressed parent-adolescent discrepancies in subjective ratings of familial dysfunction and depression as longitudinal predictor variables, and none have done so in a treatment setting for adolescents with acute suicidality. This study examined how parent-adolescent discrepancies in familial dysfunction and depression impact adolescent treatment response in an intensive outpatient program for suicidality.

METHODS

Adolescents (N = 315) were assessed at treatment entry and exit for familial dysfunction, depression, and suicidal ideation. Parents received parallel assessments of familial dysfunction and adolescent depression at each time point. A polynomial regression was conducted to determine whether parent-adolescent discrepancies in reports of familial dysfunction and depression at entry related to the treatment outcome of adolescent-reported depression and suicide ideation at exit.

RESULTS

Significant discrepancies were present with on average adolescents reporting more depression and familial dysfunction than parents. Entry discrepancy in familial dysfunction (but not depression) predicted suicide ideation at exit.

CONCLUSIONS

Our results suggest that parent-adolescent discrepancies in perception of familial dysfunction is a risk factor for poor outcomes in suicidal youth and might be a fruitful target in treatment programs.

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.

Cross-informant ratings on emotional and behavioral problems in Nepali adolescents: A comparison of adolescents' self-reports with parents' and teachers' reports

BACKGROUND

Studies on cross-informant agreement on adolescents' emotional and behavioral problems (EBPs) are sparse in low- and middle-income countries. This study aimed to assess parent-adolescent and teacher-adolescent agreement on EBPs and associated factors in Nepal.

METHODS

This cross-sectional survey included 1904 school-going adolescents aged 11-18, enrolled in government and private schools located in sixteen districts of Nepal. The Nepali versions of the Youth Self Report, Child Behavior Checklist, and Teacher's Report Form were administered to assess EBPs reported by adolescents, their parents, and teachers, respectively. Repeated measures analysis of variance (ANOVA) was done to assess mean differences in problem scores. Pearson's correlation was used to assess cross-informant agreement. Linear regression analysis was used to explore factors associated with cross-informant discrepancies in EBPs.

RESULTS

Adolescents reported significantly more problems than their parents and teachers. Mean Total Problem scores for the 90 common items in the adolescents' self-reports, parent reports, and teacher reports were 34.5 (standard deviation [SD]: 21.4), 24.1 (SD = 19.2), and 20.2 (SD = 17.5) respectively. Parent-adolescent agreement on Total Problems was moderate, whereas teacher-adolescent agreement was low. The parent-adolescent agreement was moderate to low for the two broadband scales and all syndrome scales, whereas the teacher-adolescent agreement was low for all scales. Female gender and ethnic minority status impacted both parent-adolescent and teacher-adolescent discrepancies. Family stress/conflicts impacted parent-adolescent discrepancies, while academic performance impacted teacher-adolescent discrepancies.

CONCLUSIONS

Nepali adolescents reported more EBPs than their parents and teachers. The agreement between adolescents' self-reports and reports by their parents and teachers was moderate to low. Gender, caste/ethnicity, family stress/conflicts, and academic performance were associated with cross-informant discrepancies. It is crucial to collect information from different sources, consider context-specific needs, and discern factors influencing cross-informant discrepancies to accurately assess adolescents' EBPs and develop personalized approaches to treatment planning.

Data-Informed Communication: How Measurement-Based Care Can Optimize Child Psychotherapy

Measurement-based care (MBC) research and practice, including clinical workflows and systems to support MBC, are grounded in adult-serving mental health systems. MBC research evidence is building in child and adolescent services, but MBC practice is inherently more complex due to identified client age, the family system and the need to involve multiple reporters. This paper seeks to address a gap in the literature by providing practical guidance for youth-serving clinicians implementing MBC with children and their families. We focus on MBC as a data-informed, client-centered communication process, and present three key strategies to enhance usual care child and adolescent psychotherapy via developmentally-appropriate MBC. These strategies include (1) go beyond standardized measures; (2) lean into discrepancies; and (3) get curious together. Case-based examples drawn from various child-serving settings illustrate these key strategies of MBC in child psychotherapy.

Youth Top Problems in an Acute Psychiatric Sample: Describing Consumer-Nominated Treatment Needs in an Adolescent Partial Hospital Setting

Given the wide range of diagnostic presentations treated in partial hospital programs, finding efficient ways to identify and measure progress on the chief concerns of consumers in these settings is important. The current study uses a self-administered version of the Top Problems Assessment to describe treatment targets identified by youth and their caregivers presenting for care at an adolescent partial hospital setting. Caregiver-youth agreement on these chief concerns upon admission and predictors of agreement were explored. About one-third (34.65%) of caregiver-youth pairs did not match on any target problems. Although anxiety and depression were the most commonly cited top problems in this sample, caregivers and youth exhibited disagreement on these domains. Treatment teams in acute care settings such as a partial hospital program can benefit from careful assessment surrounding the initial goals of treatment as youth and their caregivers may not agree on the referral problems upon entering a program.

Effectiveness of psychodynamic treatment: Comparing trajectories of internalizing and externalizing psychopathology of adolescents in treatment, healthy and physically ill adolescents

Effectiveness of psychodynamic therapy for adolescents in reducing internalizing and externalizing psychopathology was determined by comparing treated adolescents (86 sessions) with the normative developmental progression in two groups without treatment: healthy and diabetic adolescents. In a three-wave longitudinal study, n = 531 adolescents (n = 303 patients, n = 119 healthy, n = 109 diabetics) and their mothers filled out psychopathology questionnaires (Youth Self-Report and Child Behavior Checklist). Latent growth curve modeling and multilevel modeling were used to analyze and compare within-person symptoms changes across groups. Analyses showed a significant reduction over the course of treatment for internalizing (Cohen's d = .90-.92) and externalizing (d = .58-.72) symptoms, also when the developmental progression of both control groups was accounted for (d = .48-.76). Mothers reported lower levels than their children in internalizing symptoms (p ≤ .01) while this discrepancy increased over time for treated adolescents (p = .02). Results established the effectiveness of psychodynamic treatment for adolescents both with externalizing and internalizing symptoms in comparison with growth and change in nonclinical samples. Cross-informant differences and age-specific trajectories require attention in psychotherapy treatment and research.

Correlates of Informant Discrepancies in Self-Harm Among Youth Involved in Child Protective Services

Youth involved with child protective services (CPS) are at elevated risk for engaging in self-harm. Participation in interventions or treatments that may reduce youths' self-harm behaviors often depends on the accurate reporting of their self-injurious behaviors. However, informants often disagree on the presence or severity of self-harm engagement, making the identification of youth in need of treatment more challenging. The current study aims to characterize discrepancies between youth and caregiver reports of children's self-harm among a sample of youth with a history of CPS involvement, and to identify factors (e.g., demographics, youth and caregiver psychological impairments, aspects of the caregiving environment) associated with these discrepancies. Participants (N = 258) were drawn from a large, nationally representative sample of youth under the age of 18 (mean age = 13.8) and their caregivers who were investigated by CPS. Multinomial logistic regressions were used to examine correlates of discrepancies in caregiver and youth reports of youth self-harm. Results indicated that 10% of caregiver-child dyads agreed on children's engagement in self-harm. In 33% of cases, only the child reported self-harm and in 57% of cases, only the caregiver reported youth self-harm. Being a biological caregiver, child female sex, higher levels of internalizing symptoms; higher post-traumatic stress disorder (PTSD) symptoms; and greater caregiver alcohol use was associated with a lower likelihood of caregivers reporting self-harm only. Older child age; lower externalizing symptoms; higher PTSD symptoms, and greater levels of caregiver emotional security and structure were linked to lower odds of children reporting self-harm only. These results underscore important factors to consider when assessing self-harm among youth involved with CPS and have potential implications for practice guidelines in this population.

Mother-Adolescent Agreement Concerning Peer Victimization:Predictors and Relation to Coping

The current study analyzed adolescent, maternal, and family factors associated with mother-adolescent agreement on reports of verbal, relational, and physical forms of peer victimization. It also assessed the relationship between mother-adolescent agreement and adolescents' coping response to peer victimization. The sample consisted of 783 adolescents (337 male, 446 female) between the ages 13-15 and their mothers. Consistent with previous research, results showed mother-adolescent agreement to be low, with kappa coefficients ranging from .15 to .30 on items measuring adolescent peer victimization. A multinomial logistic regression analysis indicated that adolescent factors (age, gender, depression symptomology), maternal factors (depression symptomology, history of victimization), and family cohesion were significantly related to mother-adolescent agreement on reports of peer victimization. Lastly, mother-adolescent agreement on reports of adolescent peer victimization was associated with adolescents' increased use of adult support seeking and problem-solving and decreased use of passive-coping, distancing, and revenge-seeking as a coping response to peer victimization.

Discordance between Adolescents and Parents in Functional Somatic Symptom Reports: Sex Differences and Future Symptom Prevalence

Functional somatic symptoms, i.e., physical complaints that cannot be sufficiently explained by an objectifiable biomedical abnormality, become increasingly more prevalent in girls than in boys during adolescence. Both parents and adolescents report more functional somatic symptoms in girls, but their reports correspond only limitedly. It remains unknown whether parent-adolescent discordance contributes to the higher symptom prevalence in girls. This study investigated parent-adolescent discordance in reported functional somatic symptoms throughout adolescence, examined the longitudinal association of parent-adolescent discordance with symptom prevalence in early adulthood and focused on sex differences in these processes. Participants included 2229 adolescents (50.7% female) from four assessments (age 11 to 22 years) of the TRAILS population cohort. Parents and adolescents reported significantly more symptoms in girls than in boys during adolescence. Variance analyses showed that throughout adolescence, parents reported fewer symptoms than girls self-reported and more than boys self-reported. Regression analyses using standardized difference scores showed that lower parent-report than self-report was positively associated with symptom prevalence in early adulthood. Polynomial regression analyses revealed no significant interaction between parent-reported and adolescent self-reported symptoms. Associations did not differ between boys and girls. The findings show that lower parent-reported than self-reported symptoms predict future symptom prevalence in both sexes, but this discordance was more observed in girls. The higher functional somatic symptom prevalence in girls might be partly explained by parental underestimation of symptoms.

Parental psychosocial factors predicting adolescents' psychological adjustment during the surging and remission periods of COVID-19 in China: A longitudinal study

BACKGROUND

Parents play a critical role in adolescents' psychological adjustment, especially in stress response. Few studies have investigated parental impact on adolescents' psychological adjustment in the pandemic. The longitudinal study examined how parental psychosocial factors at the surging period of the pandemic (T1) in China predicted adolescents' anxiety and depression concurrently and at the remission periods three (T2) and six months (T3) later.

METHODS

Middle and high school students and their parents from three schools in Shanghai, China, completed online surveys on March 10, 2020 (T1), June 16, 2020 (T2), and Sep 25, 2020 (T3). Adolescents' anxiety/depression levels were assessed by matching self- and parent-reports at T1, T2, T3, and parents reported their psychological state (emotion and psychopathology), pandemic response (appraisal and coping), and perceived social support (PSS) at T1.

RESULTS

Parental positive/negative emotions, anxiety, depression, control-appraisal, forward- and trauma-focus coping style and PSS were all significantly related to their children's anxiety/depression at T1. All factors, except coping style, predicted adolescents' anxiety/depression at T2 and T3, even after controlling for T1 adjustment levels. Parental positive emotion and depression had the strongest impact on adolescents' adjustment.

LIMITATIONS

Some participants didn't complete the surveys at later time points, and the participants were only recruited in Shanghai.

CONCLUSIONS

The study found that parents' psychosocial factors played a pivotal role on adolescents' psychological adjustment during COVID-19, highlighting the need to provide help to parents who were suffering from potential psychological distress.

Characterizing Youth-Caregiver Concordance and Discrepancies in Psychopathology Symptoms in a US Community Sample

Evidence shows that reports of psychopathology symptoms by youth and their caregiver informants differ. To quantify youth-caregiver discrepancies in psychopathology symptoms and factors associated with such discrepancies, we investigated differences in how youth and their caregivers rated psychopathology symptoms. The sample (N = 5094) was extracted from the Philadelphia Neurodevelopmental Cohort, a community-based sample of youth and included participants ages 11-17 years old with both youth and caregiver reported symptom scores. Across psychopathology symptoms, youth-caregiver concordance was poor to fair (Cohens kappa for symptom items ranged between 0.03-0.41). Psychosis symptoms had the lowest concordance-Cohen's kappa ranged from 0.03 to 0.17 across psychosis symptoms. Discrepancies between youth and caregiver symptom reports were greater than average for Black youth and for youth of low socioeconomic status; discrepancies were also higher than average in youth with any psychiatric disorder when compared to typically developing youth. Network analysis of difference scores obtained by subtracting youth symptom scores from caregiver reported symptom scores showed that network connectivity (i.e., correlated difference scores) was sparsest for psychosis spectrum compared to other psychiatric disorders. Using a large sample, we show that youth and their caregiver informants tend to report psychopathology symptoms differently. Youth-caregiver discrepancies were the most pronounced for Black youth and youth of low socio-economic status. Race and socioeconomic status contribute to significant differences in how youth and their caregivers report such symptoms and are important factors that should be accounted for to facilitate accurate mental health symptom assessment and evaluation.

Long-term neuropsychological and behavioral outcome of mild and moderate hypoxic ischemic encephalopathy

BACKGROUND

Outcomes for infants who survive mild-moderate hypoxic ischemic encephalopathy (HIE) into adolescence is relatively uncharted.

AIMS

We examined neuropsychological and behavioral outcomes in adolescents with mild and moderate HIE, using both parent and self - informants, and including healthy peers and nearest age siblings as controls.

PARTICIPANTS

23 adolescents with a history of mild-moderate HIE (M age = 14.45 years, SD = 1.03; 14 boys and 9 girls) were recruited from an original cohort of 53. A group of their nearest - age siblings (n = 13), and healthy peers (n = 14) were recruited as controls.

OUTCOME MEASURES

A number of neuropsychological sub-tests, taken from the WISC-V.UK, Children's Memory Scale, NEPSY, WIAT-III.UK, Rey Complex Figure Copy Test and British Picture Vocabulary Scale were administered. Behavioral adjustment was assessed using the Strengths and Difficulties Questionnaire and the competence subscales of the Child Behavior Checklist.

RESULTS

No differences in neuropsychological and behavioral outcomes were observed between mild and moderate HIE cohorts. Together they had significantly lower scores on tests of attention/executive functioning, verbal reasoning and sensory-motor ability compared to healthy peers, with moderate to large effect sizes. Remedial provision at school was greater in the HIE group. Parents reported elevated levels of peer problems in the HIE group compared to both siblings and healthy peers. Reduced competencies were also observed.

CONCLUSIONS

We found evidence that both mild and moderate survivors of HIE experience neuropsychological, school and peer relationship problems in adolescence.

Informant Discrepancies in Child Maltreatment Reporting: A Systematic Review

Potential informants on child maltreatment include the youth who has experienced the alleged maltreatment, and the youth's caregivers, social workers and case files. When multiple informants are compared, they often disagree about whether or not a youth has experienced maltreatment. Such determinations are critical as endorsement-or lack of endorsement-of maltreatment can have significant consequences on the child's safety, future living arrangements and referral for treatment and services. The current study provides a systematic review of the literature on informant discrepancies in child maltreatment. Three databases-PsychINFO, Web of Science, and PubMed-were used to identify studies for the review and 13 articles met inclusion criteria. Results showed that more youth tend to report physical, sexual and emotional abuse than seen in case files. By contrast, more case files include neglect than reported by youth. Implications and future directions are discussed.

Parent-Child Agreement on the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)

OBJECTIVE

Multiple informants are often used in the assessment of child psychopathology; however, parent-child agreement is low in child psychiatry. The objective of this exploratory study was to assess informant agreement on the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a clinical sample of children with mental disorders and their parents, and to examine health and demographic factors associated with agreement.

METHOD

MINI-KID results were analyzed for 88 parent-child dyads. Children were between 8-17 years old and were receiving in- or outpatient services for at least one mental disorder at a pediatric hospital. Kappas were calculated to assess parent-child agreement and logistic regression models were used to identify factors associated with agreement.

RESULTS

Agreement was low to moderate (κ=0.19-0.41) across the MINI-KID modules. Household income was associated with agreement for major depression, generalized anxiety, and attention-deficit hyperactivity disorder. Recruitment setting and parent psychological distress were associated with agreement for generalized anxiety and separation anxiety, respectively. Age, sex, and child disability/impairment were not associated with agreement.

CONCLUSIONS

Parent-child agreement on the MINI-KID was low to moderate, and few factors were associated with agreement. These initial findings reaffirm the need for multiple informants when assessing psychopathology in children and can be used by health professionals to facilitate parent-child discussions in clinical settings in child psychiatry.

Assessment of Psychological Distress and Peer Relations among Trans Adolescents-An Examination of the Use of Gender Norms and Parent-Child Congruence of the YSR-R/CBCL-R among a Treatment-Seeking Sample

Among trans adolescents, increased psychological distress is reported in the literature. The goal of this study was to examine psychological distress, associated peer relations and parent report congruence among the treatment-seeking sample of the Gender Identity Special Consultation (GISC) for youth at the Charité Berlin. Further, differences between the instruments' binary gender norms were investigated. Retrospectively, we analyzed clinical data derived from the GISC. By initial interviews and using the Youth Self-Report and Child Behavior Checklist, n = 50 trans adolescents aged 12-18 years (M = 15.5) were examined for psychological problems and peer relations. Congruence between self and parent report was analyzed by correlations. Half of the sample reported suicidality, self-harm and bullying. Trans adolescents showed significantly higher internalizing and total problems than the German norm population. The congruence between self and parent report proved to be moderate to high. The level of congruence and poor peer relations were identified as predictors of internalizing problems. Significant differences between the female vs. male gender norms emerged regarding mean scores and the number of clinically significant cases. Data provide valuable implications for intervention on a peer and family level. There are limitations to the suitability of questionnaires that use binary gender norms, and further research on adequate instruments and assessment is needed.

Mother-Adolescent Discrepancies in Ratings of Adolescents' Adjustment: Associations with Maternal Mental Health and Family Factors

OBJECTIVE

Many children and adolescents are assessed for potential psychological and behavioral problems through the parent-completed Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) questionnaires. However, because these assessments are based on individual reports, they are subject to disagreement. This study considered multiple family factors and aspects of mothers' mental health in discrepancies between mothers' and youths' ratings on the CBCL and YSR.

METHOD

This study involved 926 mothers and their adolescent children (48.7% female children, mean age = 14.4 years) who completed the CBCL and YSR questionnaires, respectively.

RESULTS

Mothers who experienced more severe mental health problems reported more internalizing symptoms of their adolescent relative to the adolescent's ratings.

CONCLUSION

Findings indicate that mothers' poor mental health is related to their reports of more frequent psychological problems in their adolescents. To verify the accuracy of maternal reports, additional raters and additional methods, such as behavioral observation and clinical interview, would be helpful.

Discrepancies in adolescent-mother dyads' reports of core depression symptoms: Association with adolescents' help-seeking in school and their somatic complaints

OBJECTIVE

Parents of adolescents with mental problems do not always recognize the symptoms in their children, particularly regarding depression, and therefore do not seek professional help. Adolescents themselves tend to seek help from school personnel for their emotional or social difficulties. In contrast, adolescents do report somatic complaints and parents are likely to seek help for these problems. The current study explored whether the divergence between maternal and child reports of depression symptoms is associated with child's help-seeking in school and patterns of somatic complaints.

METHOD

A sample of 9th grade students (N = 693; 56% girls; mean age = 15.1) and their mothers representing the Muslim and Druze populations in northern Israel were interviewed simultaneously and independently. Maternal reports were classified either as underestimating, matching, or overestimating their own child self-report of three core symptoms of depression (depressed mood, anhedonia, and irritability). Adolescents reported whether they had consulted school staff and were classified into clusters based on self-reported somatic complaints.

RESULTS

Maternal misidentification of their child's depression symptoms was associated with increased help-seeking in school, particularly by boys if depressed mood or irritability were misidentified and particularly by girls if anhedonia was misidentified. Hierarchical cluster analysis indicated that the number and severity of somatic complaints was higher among adolescents whose depression symptoms were not identified, regardless of gender.

CONCLUSION

Mental health professionals, educators and parents should be aware that adolescents may attempt to communicate their emotional difficulties through somatic complaints and by seeking help in school.

Exploring parent-child agreement on reports of exposure to community violence: Utilizing a latent profile approach

Exposure to community violence (ECV) has a number of implications for children including poor mental health functioning, impaired cognition, memory, learning, and school performance (Edlynn et al, 2008 Am. J. Orthopsychiat., 78, 249-258; Gardner et al., 1996, J. Consult. Clin. Psychol., 64, 602-609). Discrepancies in child and parent reports of the child's ECV may exacerbate these adverse effects (Hill & Jones, 1997 J. Natl Med. Assoc., 89, 270-276). This study aimed to categorize dyads based on the agreement in reports of ECV. Furthermore, this study aimed to identify ethnic differences within these groups in addition to mental health issues. Four profiles, based on average exposure to violence, emerged: Low exposure (LE), moderate exposure, high exposure, and severe exposure. Ethnic differences among these profiles indicate ethnic minorities are less likely to belong to the LE profile and more likely to represent the other profiles. There were differences among profiles based on mental health functioning.

Insight and Satisfaction with Life Among Adolescents with Mental Disorders: Assessing Associations with Self-Stigma and Parental Insight

Objective:

The purpose of the current study was to assess the associations of illness perception-related variables with satisfaction with life (SwL) among adolescents with mental disorders.

Methods:

Insight into mental disorder (SAI-E), Internalized stigma of mental illness (ISMI) and Multidimensional Students’ Life Satisfaction Scale (MSLSS) were administrated to 30 adolescent patients. Adapted version for parents of the SAI-E was also administrated to 37 of their parents.

Results:

Significant positive correlations were found between insight into the illness, self-stigma and parental insight. Insight and self-stigma were significantly negatively related to the total score of SwL and few of its dimensions while parental insight was significantly associated only with the SwL dimensions of school and self. Regression models revealed main negative effects of insight and self-stigma on SwL and no interaction effect.

Conclusions:

The possible independent contribution of insight and self-stigma to SwL should be addressed in interventions designed for family and adolescents coping with mental illness. Special attention should be given to the possible negative implications that insight possesses. In lack of support of the moderation role of self-stigma, reported in studies among adults with mental illness, future studies should trace other variables in order to further understand the insight paradox among adolescents.

Prevalence and Family-Related Factors Associated With Suicidal Ideation, Suicide Attempts, and Self-injury in Children Aged 9 to 10 Years

IMPORTANCE

Although suicide is a leading cause of death for children in the United States, and the rate of suicide in childhood has steadily increased, little is known about suicidal ideation and behaviors in children.

OBJECTIVE

To assess the overall prevalence of suicidal ideation, suicide attempts, and nonsuicidal self-injury, as well as family-related factors associated with suicidality and self-injury among preadolescent children.

DESIGN, SETTING, AND PARTICIPANTS

Cross-sectional study using retrospective analysis of the baseline sample from the Adolescent Brain Cognitive Development (ABCD) study. This multicenter investigation used an epidemiologically informed school-based recruitment strategy, with consideration of the demographic composition of the 21 ABCD sites and the United States as a whole. The sample included children aged 9 to 10 years and their caregivers.

MAIN OUTCOMES AND MEASURES

Lifetime suicidal ideation, suicide attempts, and nonsuicidal self-injury as reported by children and their caregivers in a computerized version of the Kiddie Schedule for Affective Disorders and Schizophrenia.

RESULTS

A total of 11 814 children aged 9 to 10 years (47.8% girls; 52.0% white) and their caregivers were included. After poststratification sociodemographic weighting, the approximate prevalence rates were 6.4% (95% CI, 5.7%-7.3%) for lifetime history of passive suicidal ideation; 4.4% (95% CI, 3.9%-5.0%) for nonspecific active suicidal ideation; 2.4% (95% CI, 2.1%-2.7%) for active ideation with method, intent, or plan; 1.3% (95% CI, 1.0%-1.6%) for suicide attempts; and 9.1% (95% CI, 8.1-10.3) for nonsuicidal self-injury. After covarying by sex, family history, internalizing and externalizing problems, and relevant psychosocial variables, high family conflict was significantly associated with suicidal ideation (odds ratio [OR], 1.12; 95% CI, 1.07-1.16) and nonsuicidal self-injury (OR, 1.09; 95% CI, 1.05-1.14), and low parental monitoring was significantly associated with ideation (OR, 0.97; 95% CI, 0.95-0.98), attempts (OR, 0.91; 95% CI, 0.86-0.97), and nonsuicidal self-injury (OR, 0.95; 95% CI, 0.93-0.98); these findings were consistent after internal replication. Most of children's reports of suicidality and self-injury were either unknown or not reported by their caregivers.

CONCLUSIONS AND RELEVANCE

This study demonstrates the association of family factors, including high family conflict and low parental monitoring, with suicidality and self-injury in children. Future research and ongoing prevention and intervention efforts may benefit from the examination of family factors.

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

Previous studies have found discrepancies between parent and child reports of parental favoritism. Some studies have also found that these discrepancies have unique effects on children's psychosocial adjustment. Nonetheless, much is still unknown about discrepancies between parent-reports and child-reports of parental favoritism and how they are associated with children's development. The current study examines discrepancies in multi-informant reports on parental favoritism in relation to children's internalizing and externalizing problems. The sample consisted of 556 mother-child dyads and 554 father-child dyads (46% boys, M_age = 12.52 years, SD_age = 1.18). Polynomial regression analyses and response surface analyses were used to disentangle the effects of parent-child discrepancies in perceived parental favoritism. The results indicate that children reported higher parental favoritism than their parents. And the highest internalizing and externalizing problems occurred when both the mother and the child reported high maternal favoritism, and when both the father and the child report high paternal favoritism. Therefore, these findings partly support the assumptions based on the operations triad model. The findings also highlight the importance of the discrepancy between child- and parent-reports on parental favoritism in the development of children's internalizing and externalizing problems.

An mHealth approach to extend a brief intervention for adolescent alcohol use and suicidal behavior: Qualitative analyses of adolescent and parent feedback

Mobile health (mHealth) tools that supplement inpatient psychiatric care can maintain and enhance intervention effects following hospitalization. Adolescents hospitalized following a suicidal event represent a vulnerable population who could greatly benefit from such an mHealth intervention. In specific, suicidal adolescents who drink alcohol are in need of robust interventions that address the bidirectional relationship between alcohol use and suicidal thoughts and behaviors, because it puts them at especially high risk for suicide upon discharge. The purpose of this study was to conduct qualitative interviews to gather feedback to improve a brief alcohol intervention provided to suicidal adolescents during psychiatric hospitalization, and to develop a mHealth tool to extend care after discharge. Participants, eight adolescents and their parents, identified the need for a smartphone application to deliver intervention content to adolescents and parents during the post-hospitalization period. Adolescents sought support in meeting alcohol- and mood-related goals, while parents desired general resources as well as tips for conversations with their adolescent about mood and alcohol use.

Agreement and Discrepancy on Emotional and Behavioral Problems Between Caregivers and HIV-Infected Children and Adolescents From Uganda

Background: HIV-infected children and adolescents (CA-HIV) face significant mental health challenges related to a broad range of biological and psychosocial factors. Data are scarce on the agreement and discrepancy between caregivers and CA-HIV regarding emotional and behavioral problems (EBPs) in CA-HIV. Objectives: We determined agreement between self- versus caregiver- reported EBPs and describe factors associated with informant discrepancy among caregiver-youth dyads who participated in the "Mental health among HIV-infected CHildren and Adolescents in KAmpala and Masaka, Uganda" (CHAKA) study. Methods: In a cross-sectional sample, caregiver-reported EBPs were assessed with the Child and Adolescent Symptom Inventory-5 (CASI-5), and self-reported problems were evaluated with the Youth Inventory-4 (YI-4) in 469 adolescents aged 12-17 years and the Child Inventory-4 (CI-4) in 493 children aged 8-11 years. Adolescents were questioned about experiences of HIV stigma. Caregiver psychological distress was assessed with the Self-Reporting Questionnaire (SRQ-20). Linear regression models were applied to identify variables associated with discrepancy scores. Results: Self-reported emotional problems (EPs) were present in 28.8% of adolescents and 36.9% of children, and 14.5% of adolescents self-reported behavioral problems (BPs). There was only a modest correlation (r ≤ 0.29) between caregiver- and CA-HIV-reported EBPs, with caregivers reporting more EPs whereas adolescents reported more BPs. Informant discrepancy between adolescents and caregivers for BPs was associated with adolescent age and caregiver's employment and HIV status. Among adolescents, EP discrepancy scores were associated with adolescent's WHO HIV clinical stage, caregiver level of education, and caregivers caring for other children. Among children, EP discrepancy scores were associated with child and caregiver age, caregiver level of education, and caregiver self-rated health status. HIV stigma and caregiver psychological distress were also associated with discrepancy, such that adolescents who experienced HIV stigma rated their EPs as more severe than their caregivers did and caregivers with increased psychological distress rated EBPs as more severe than CA-HIV self-rated. Conclusions: EBPs are frequently endorsed by CA-HIV, and agreement between informants is modest. Informant discrepancy is related to unique psychosocial and HIV-related factors. Multi-informant reports enhance the evaluation of CA-HIV and informant discrepancies can provide additional insights into the mental health of CA-HIV.

The Clinical Relevance of Divergence in Adolescent-Parent Reports of Adolescent Depression and Anxiety

This study examines associations between adolescent problem behaviors and adolescent-parent disagreement in ratings of adolescent depression and anxiety symptoms. Adolescent-parent dyads (N = 463; mean age = 12.68 years; 48.5% female; 78.2% White and 21.8% non-White) reported on adolescent depression and anxiety using parallel scales from the Youth Self Report (Achenbach et al., J Emot Behav Disord 10:194-203, 2002) and the Child Behavior Checklist (Achenbach and Rescorla, The manual for the ASEBA school-age forms & profiles, University of Vermont, Research Center for Children, Youth, and Families, Burlington, 2001) across four waves. Generalized estimating equations were used to examine the relationship between discrepancy scores and adolescent behavioral outcomes: incidence of adolescent past-year substance use (alcohol use, binge drinking, marijuana use, and nonmedical use of controlled medications), delinquency, self-harm behavior, and aggression. Findings showed that larger adolescent-parent divergence scores of depression were associated with higher odds of marijuana use, non-medical use of controlled medications, alcohol use, binge drinking, in-school delinquency, illegal behavior, self-harm behavior, and clinically significant levels of aggressive behavior. Results further revealed that larger divergence scores on anxiety were associated with higher odds of in-school delinquency, illegal behavior, self-harm behavior, and clinically significant levels of aggressive behavior. Adolescent-parent reporting discrepancy on adolescent's depression and anxiety symptoms may be indicative of adolescent's social, emotional, and behavioral problems, and the disagreement may signal further need for assessment of the adolescent.

Comparing adolescent and parent reports of externalizing problems: A longitudinal population-based study

Adolescent and parent reports of adolescent mental health problems often correlate poorly, and understanding this discrepancy has clinical importance. Yet contextual factors have only been inconsistently explained. At the 14- and 17-year follow-ups of the Western Australian Pregnancy Cohort (Raine) Study, 1,596 parent-child dyads completed the parent-reported Child Behaviour Checklist (CBCL) and the adolescent-rated Youth Self-Report (YSR). Maternal, family, adolescent, and parent factors were examined as potential predictors of discrepancies. When adolescent YSR scores were in the clinical range but parents' CBCL ratings were not, adolescents were more likely to report alcohol intoxication in the last 6 months, illicit drug use, low school motivation, and depression. When parents reported externalizing behaviour in the clinical range but adolescents did not, the characteristics associated with this were a younger maternal age, receiving social security benefit, stress related to parenting, depression, and poor family functioning. These new results will inform clinical management and research with adolescents who present with behavioural disorders. Statement of contribution What is already known on this subject? We know that adolescent and parent reports of adolescent mental health problems often correlate poorly, but little is known about which contextual factors lead to disagreement. Understanding the factors that influence agreement is clinically relevant for predicting and identifying externalizing behavioural disorders. This is a large-scale study with the ability to assess the impact of numerous psychosocial factors on instrument disagreement. What the present study adds We found that substance use, depression and low school motivation impacted on discrepancy in externalizing behaviour scores for 14-year-old male adolescents and their parents. Parental depression, stress, low family income, and family dysfunction also led to a higher likelihood of discrepancy in scores.

Mother-father-adolescent triadic concordance and discordance on home environment factors and adolescent disordered eating behaviors

INTRODUCTION

This study utilizes triadic data to examine the association between mother-father-adolescent concordance (agreement) and discordance (disagreement) on home environment factors (i.e., parental encouragement of dieting, family functioning) and adolescent unhealthy weight control behaviors and binge eating.

METHOD

A subsample of adolescent-mother-father triads (n = 833; adolescents ages 10-22) from two coordinated population-based studies (EAT 2010 and F-EAT) were used. Poisson regression analysis was used to estimate the relative risks of each eating disordered behavior.

RESULTS

Triads were more concordant (range 9-42%) than discordant (range 4-24%). Triadic agreement that parents did not encourage dieting was associated with a lower risk of adolescent eating disordered behaviors in some triadic combinations. Additionally, triadic concordance on high family functioning was also associated with a lower risk of adolescent eating disordered behaviors among some triadic combinations.

DISCUSSION

Results suggest that triadic concordance on healthy home environment factors is associated with fewer adolescent disordered eating behaviors in some triads. Family based interventions may want to consider focusing on strategies to help move mother-father-adolescent triads closer on seeing the home environment more similarly. Future research is needed on triadic concordance/discordance and disordered eating behaviors to confirm study results and to inform the development of family based interventions. (PsycINFO Database Record

Parent-Adolescent Concordance in Borderline Pathology and why it Matters

The aims of the current study were to: 1) identify patterns of agreement between parent-adolescent dyads on reports of adolescent borderline personality features utilizing latent class analysis (LCA) and 2) examine the clinical implications of class membership for indices of psychiatric severity and internal psychological resources. The sample included 643 adolescent inpatients. Borderline personality features were assessed by both adolescents and parents using the Borderline Personality Features Scale - Child (BPFS-C; Crick et al. 2005) and Borderline Personality Features Scale - Parent (BPFS-P; Sharp et al. 2010), respectively. Following recommended statistical approaches for evaluating rater concordance, LCA was utilized to identify distinct classes of parent-adolescent dyads based on concordance/discrepancy in BPFS reports. The subsequent classes were then related to outcome measures of psychiatric severity and internal psychological resources (emotion regulation and experiential acceptance). LCA identified 3 classes of parent-adolescent dyads: 2 convergent classes demonstrating BPFS-P and BPFS-C agreement at a moderate and high level and a divergent class consisting of dyads reporting clinically significant scores on the BPFS-P but clinically negligible BPFS-C scores. Both convergent classes evidenced higher rates of psychiatric severity and lower access to internal resources. The current study is the first to use LCA to examine the relation between informant concordance on reports of DSM-based adolescent borderline pathology in a clinical sample. The significance of the discrepancies within and between classes is discussed with relation to psychosocial outcomes, the diagnosis of borderline personality disorder and implications for what it means when parents and adolescents disagree.

The Clinical Significance of Informant Agreement in Externalizing Behavior from Age 3 to 14

The objective of the current study was to test to what extent agreement between preschool teachers (using a questionnaire-based assessment) and clinicians (using a clinician-rated behavioral task) with regard to externalizing problems in early childhood was predictive of parent reports of children's externalizing behavior trajectory from age 3 to age 14. The prospective longitudinal study was conducted over five waves with 111 clinically referred children aged 3-5 years in wave 1. Analyses were conducted using a multilevel modeling framework. The results of the conditional model testing the association of informant agreement with behavioral trajectories show that the greater the number of informants reporting a high level of behavioral problems in early childhood, the more the trajectory increases until adolescence. The results stress the importance of multi-informant assessment not only for methodological reasons but in order to target at-risk children.

Caregiver-Adolescent Disagreement on the Mental Health of Youth in Foster Care: The Moderating Role of the Caregiver Relationship

It is not uncommon for caregivers and adolescents to provide different perspectives of adolescents' mental health symptoms; however, few studies have examined these discrepancies, especially between foster parents and adolescents in the child welfare system. The goal of this study was to investigate the levels of disagreement on adolescent mental health symptoms among caregivers and adolescents in foster care, to examine factors associated with caregiver-adolescent discrepancies, and the potential moderating role of caregiver-child closeness on the link between the length of time the youth lived with caregivers and discrepancies regarding adolescent mental health symptoms. These research questions were examined using two measures of adolescent-caregiver disagreement, intraclass correlations and discrepancy scores, using data from a nationally representative study of youth involved with the child welfare system. Analyses of 183 adolescent-caregiver dyads revealed caregiver-adolescent disagreement on adolescents' internalizing and externalizing symptoms, with caregivers reporting higher levels of adolescents' problems on average. Adolescent gender, type of maltreatment experienced, and placement type were associated with caregiver-adolescent discrepancies. Results also indicated that closeness with caregivers significantly moderated the relationship between the length of time adolescents lived with their caregivers and discrepancies on adolescent externalizing symptoms.

In the Eye of the Beholder? Parent-Observer Discrepancies in Parenting and Child Disruptive Behavior Assessments

This study examined parent-observer discrepancies in assessments of negative child behavior and negative parenting behavior to shed more light on correlates with these discrepancies. Specifically, we hypothesized that informant discrepancy between observers and parents on child behavior would be larger when parents reported high levels of negative parenting (and vice versa) because high levels of these behaviors might be indicators of negative perceiver bias or patterns of family dysfunctioning. Using restricted correlated trait-models, we analyzed cross-sectional observation (coded with the Dyadic Parent-Child Interaction Coding System) and survey data (Eyberg Child Behavior Inventory and Parenting Practices Interview) of 386 Dutch parent-child dyads with children aged 4-8 years (Mage = 6.21, SD = 1.33; 55.30% boys). Small associations between parent-reported and observed child and parenting behavior were found, indicating high discrepancy. In line with our hypothesis, this discrepancy was higher when parents self-reported more negative parenting or more negative child behavior. Parent-observer discrepancy on negative child behavior was also predicted by child gender. For boys parents reported higher levels of negative child behavior than were observed, but for girls parents reported lower levels of negative child behavior than were observed. These findings suggest that informant discrepancies between observers and parents might provide important information on underlying, problematic family functioning and may help to identify those families most in need of help.

Do Parent-Adolescent Discrepancies Predict Deviant Peer Affiliation and Subsequent Substance Use?

Recent evidence suggests parent-adolescent discrepancies regarding adolescent disclosure can provide insight into parent-child relations and adolescent adjustment. However, pathways linking discrepancies to adjustment are not well known. We tested a model linking parent-adolescent discrepancies in disclosure to adolescent substance use through affiliation with deviant peers. Using three annual waves of data from a community-based study (N = 357; 91% African American; 53% female; M_age = 13.13 years, SD = 1.62 years at baseline), findings revealed that adolescent-reported secrecy and deviant peer affiliation were positively associated with substance use one and two years later, respectively, but there was no evidence of mediation. The results highlight associations of adolescent secrecy and adjustment, and the role peers play in adolescent substance use behaviors.

Informant similarities, twin studies, and the assessment of externalizing behavior: A meta-analysis

The purpose of this study was to examine similarity within informant ratings of the externalizing behavior of monozygotic (MZ) and dizygotic (DZ) twin pairs. To do this, we conducted a meta-analysis of correlations within ratings completed by mothers, fathers, teachers, and youth. We retrieved n=204 correlations for MZ twins and n=267 correlations for DZ twins from n=54 studies containing n=55 samples. Results indicated that all four informants were significant negative predictors of within-informant correlations in their ratings of MZ, but not DZ twins. In the case of longitudinal studies and as the age of MZ twins increased, similarity within ratings by mothers was significantly greater than similarity within ratings by fathers. Among participant characteristics, we found that (a) age was a significant negative predictor of similarity within ratings for MZ twins; (b) race was a significant predictor of similarity within ratings for both MZ and DZ twins, but in the opposite direction; and (c) DZ opposite sex twins were a significant negative predictor of within-rating similarity. Among study characteristics for MZ twins, participant group and longitudinal study were significant negative predictors of within-rating similarity, and for both MZ and DZ twin pairs, non-independence in the data was a significant negative predictor of within-rating similarity. For DZ twins, multiple informants were significant positive predictors of within-rating similarity, and in longitudinal studies with DZ twins, similarity within ratings by mothers was significantly greater than similarity within ratings by fathers, and similarity within ratings by fathers was significantly less than similarity within ratings by teachers and youth. For both MZ and DZ twins, the following study characteristics were significant positive predictors of similarity within ratings: study group, number of time points, and multiple constructs. All four informants appeared equally skilled at predicting within-informant correlations for MZ (but not DZ) twins, with participant characteristics having different predictive effects for MZ compared to DZ twins, and study characteristics having comparable predictive effects for both twin types. Overall, these findings suggest effective discrimination on the part of four informants who rated the externalizing behavior of MZ and DZ twins.

Assessing for suicidal behavior in youth using the Achenbach System of Empirically Based Assessment

This study investigated the clinical utility of the Achenbach System of Empirically Based Assessment (ASEBA) for identifying youth at risk for suicide. Specifically, we investigated how well the Total Problems scores and the sum of two suicide-related items (#18 "Deliberately harms self or attempts suicide" and #91 "Talks about killing self") were able to distinguish youth with a history of suicidal behavior. Youth (N = 1117) aged 5-18 were recruited for two studies of mental illness. History of suicidal behavior was assessed by semi-structured interviews (K-SADS) with youth and caregivers. Youth, caregivers, and a primary teacher each completed the appropriate form (YSR, CBCL, and TRF, respectively) of the ASEBA. Areas under the curve (AUCs) from ROC analyses and diagnostic likelihood ratios (DLRs) were used to measure the ability of both Total Problems T scores, as well as the summed score of two suicide-related items, to identify youth with a history of suicidal behavior. The Suicide Items from the CBCL and YSR performed well (AUCs = 0.85 and 0.70, respectively). The TRF Suicide Items did not perform better than chance, AUC = 0.45. The AUCs for the Total Problems scores were poor-to-fair (0.33-0.65). The CBCL Suicide Items outperformed all other scores (ps = 0.04 to <0.0005). Combining the CBCL and YSR items did not lead to incremental improvement in prediction over the CBCL alone. The sum of two questions from a commonly used assessment tool can offer important information about a youth's risk for suicidal behavior. The low burden of this approach could facilitate wide-spread screening for suicide in an increasingly at-risk population.

Parent-youth informant disagreement: Implications for youth anxiety treatment

Greater parent-youth disagreement on youth symptomatology is associated with a host of factors (e.g., parental psychopathology, family functioning) that might impede treatment. Parent-youth disagreement may represent an indicator of treatment prognosis. Using data from the Child/Adolescent Anxiety Multimodal Study, this study used polynomial regression and longitudinal growth modeling to examine whether parent-youth agreement prior to and throughout treatment predicted treatment outcomes (anxiety severity, youth functioning, responder status, and diagnostic remission, rated by an independent evaluator). When parents reported more symptoms than youth prior to treatment, youth were less likely to be diagnosis-free post-treatment; this was only true if the youth received cognitive-behavioral therapy (CBT) alone, not if youth received medication, combination, or placebo treatment. Increasing concordance between parents and youth over the course of treatment was associated with better treatment outcomes across all outcome measures ( ps < .001). How parents and youth "co-report" appears to be an indicator of CBT outcome. Clinical implications and future directions are discussed.

Convergence in Reports of Adolescents' Psychopathology: A Focus on Disorganized Attachment and Reflective Functioning

Although convergence in parent-youth reports of adolescent psychopathology is critical for treatment planning, research documents a pervasive lack of agreement in ratings of adolescents' symptoms. Attachment insecurity (particularly disorganized attachment) and impoverished reflective functioning (RF) are 2 theoretically implicated predictors of low convergence that have not been examined in the literature. In a cross-sectional investigation of adolescents receiving inpatient psychiatric treatment, we examined whether disorganized attachment and low (adolescent and parent) RF were associated with patterns of convergence in adolescent internalizing and externalizing symptoms. Compared with organized adolescents, disorganized adolescents had lower parent-youth convergence in reports of their internalizing symptoms and higher convergence in reports of their externalizing symptoms; low adolescent self-focused RF was associated with low convergence in parent-adolescent reports of internalizing symptoms, whereas low adolescent global RF was associated with high convergence in parent-adolescent reports of externalizing symptoms. Among adolescents receiving inpatient psychiatric treatment, disorganized attachment and lower RF were associated with weaker internalizing symptom convergence and greater externalizing symptom convergence, which if replicated, could inform assessment strategies and treatment planning in this setting.

The Role of Anxiety Control and Treatment Implications of Informant Agreement on Child PTSD Symptoms

The goal of this study is to examine parent and child agreement of child posttraumatic stress disorder (PTSD) symptoms pre- and posttreatment, as well as potential moderators of agreement including treatment responder status, child anxiety control, and parent self-reported PTSD symptoms. We examined child self-reported and parent-reported child PTSD symptoms from the Diagnostic Interview Schedule for Children. Of the 141 parent-child pairs, the mean age of children was 12.72 (SD = 3.40), 53% were female, and 54% were Black. A subsample of participants (n = 47) was assessed after completion of a cognitive behavioral therapy treatment for PTSD. Moderate levels of agreement were found at baseline, though Criterion D (increased arousal) symptoms had lower levels of agreement than the other symptom clusters. Symptom agreement was lower at posttreatment. Treatment responders had higher levels of baseline informant agreement than treatment nonresponders. Child perceived anxiety control significantly moderated informant agreement, such that pairs with children who had high levels of perceived control of their anxiety had lower PTSD symptom agreement where children reported lower symptoms relative to their parents. Contrary to expectations, parent self-reported PTSD did not moderate parent-child symptom agreement. Factors associated with higher parent-child agreement of child PTSD symptoms were being a PTSD treatment responder and children with lower perceived anxiety control. These findings have potential implications for determining those who may benefit from greater symptom monitoring over the course of intervention and potential alternative intervention approaches.

Anxious and Depressive Symptomatology Among Male Youth: The Joint and Interactive Contribution of Temperament and Executive Functioning

Few studies have investigated the combined effects of temperament and executive functioning (EF) on anxious and depressive symptomatology in youth. The current study is the first to investigate the joint and interactive contribution of mother- and youth self-reported affective dimensions of temperament and EF to the explanation of anxious and depressive symptomatology. Participants included 174 adolescent males (M _age = 13.6 ± 1.35). Results confirmed the joint and interactive contribution of temperament in the explanation of anxious and depressive symptomatology. Further, EF contributed to the explanation of anxious/depressive symptomatology via interaction with youth-, but not mother-reported, temperament; it was not a unique predictor. Results support the need to consider both affective dimensions of temperament and EF in etiological models of anxious and depressive symptomatology, which has implications for identifying at-risk youth and developing early intervention and targeted problem-specific prevention programs.

Validation of the Teacher’s Report Form for Teachers of Unaccompanied Refugee Minors

The psychometric properties of the Dutch Teacher’s Report Form (TRF) for teachers of Unaccompanied Refugee Minors (URM) were evaluated in this study. The teachers ( n = 486) that participated received a Dutch TRF to report on the mental health of the unaccompanied minor. Hierarchical confirmative factor analysis and individual confirmatory factor analyses support the a priori structure of the Dutch TRF. However, the Thought Problems subscale could not be verified in this study, suggesting that some of the problem behavior reported by teachers of URM differs from that of parent reports or that the item constellation of the Dutch TRF is different for teachers of URM. The total Internalizing and Externalizing scales show good internal consistency. The construct and concurrent validity of the Dutch TRF were found to be acceptable. The results suggest that the Dutch TRF is a reliable and valid instrument to assess emotional and behavior problems of URM.

Parent and Adolescent Agreement for Reports of Life Stressors

In this article, we investigated the extent and nature of informant discrepancies on parent- and adolescent self-report versions of a checklist measuring youth exposure to life stressors. Specifically, we examined (a) mean-level differences, relative consistency, and consensus for family-level and youth-specific stressors and (b) the utility of parent-youth discrepancies in accounting for variance in youth temperament and psychopathology. Participants were 106 parent-child dyads (47 male, 59 female; 90.6% mothers) aged 13 to 18 years old ( M = 16.01, SD = 1.29). The results revealed evidence for both congruence and divergence in parent and youth reports, particularly with respect to respondents' accounts of youth-specific stressors. Discrepancies for youth-specific stressors were associated with adolescents' negative affectivity, surgency, effortful control, and internalizing problems. Discrepancies for youth stressors may therefore reveal individual differences in emotionality and self-regulation, thus reflecting meaningful variance in adolescents' functioning.

Longitudinal Associations Between Parental Monitoring Discrepancy and Delinquency: An Application of the Latent Congruency Model

Studies have shown that discrepancies (relative concordance or discordance) between parent and adolescent ratings are predictive of problem behaviors; monitoring, in particular, has been consistently linked to them. The current study tested whether discrepancies in perceptions of maternal monitoring, rated by mothers and youth at age 12, foretold delinquency (rule breaking) at age 15, and whether parental closeness and conflict predicted higher discrepancies, and indirectly, higher delinquency. The final study sample used the NICHD longitudinal dataset with N = 966 youth (50.1 % female) and their mothers (80.1 % European American, 12.9 % African American, 7 % other ethnicity). The analytic approach consisted of an extension and application of the Latent Congruency Model (LCM) to estimate monitoring discrepancies as well as age 15 delinquency scores. Findings showed that age 12 monitoring discrepancy was predictive of age 15 delinquency for both boys and girls based on youth reports, but not for maternal reports. Age 11 closeness predicted age 12 monitoring discrepancy, which served as a mediator for its effect on age 15 adolescent-reported delinquency. Thus, based on the rigorous LCM analytic approach which seeks to minimize the effects by competing explanations and to maximize precision in providing robust estimates, rates of perceived discordance in parenting behaviors during early adolescence matter in understanding variability in adolescent delinquency during middle adolescence.

Psychosocial functioning in Dutch foster children: The relationship with child, family, and placement characteristics

Foster care is the preferred alternative for out-of-home care, but not necessarily beneficial for foster children's psychosocial functioning. This dilemma leaves researchers with a challenge to find out more about the factors related to foster children's social and emotional functioning. In a sample of 446 Dutch foster children we examined the extent to which three clusters of characteristics, those akin to the foster child, the foster family, or foster placement, were related to foster children's functioning at the time of research. Multivariate three-step hierarchical regression analyses were performed for three outcome variables: externalizing problems, internalizing problems, and prosocial behavior. We found that all three clusters of foster care characteristics were significantly related to foster children's functioning. Foster placement characteristics, in particular interventions aimed at foster children, explained the largest amount of variance in behavior problems. Children receiving interventions had more externalizing and internalizing problems. A possible explanation is that interventions are indicated for those foster children who are in the highest need of additional support. Prosocial behavior was particularly related to foster family characteristics. The results were mostly in line with international research. Careful screening and monitoring of the social and emotional functioning of foster children may help to identify problems at an early stage. In addition (preventive) support should be offered to those foster children and families who are in need of it.