The relevance of informant discrepancies for the assessment of adolescent personality pathology

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.

A developmental approach to youth maladaptive personality traits: Variable- versus person-centered change in the transition from childhood to adolescence

Increasing evidence shows that personality pathology starts to develop from (late) childhood onwards. The current study extends previous research by examining maladaptive personality change using both a variable-centered approach (i.e., mean-level changes) and a person-centered approach (i.e., latent profile transitions). Data were used from a 3-wave longitudinal study on Dutch youth (at T1: N = 492, mean age = 10.1). Maladaptive personality traits (i.e., Emotional Instability, Disagreeableness, Introversion, and Compulsivity) were assessed yearly using the Dimensional Personality Symptom Item Pool (DIPSI). A Factor of Curves model indicated presence of a higher-order developmental factor, reflecting low initial levels and small decreases over time, which explained change in all DIPSI traits. Latent profile analyses revealed three quantitatively different maladaptive personality trait profiles. Latent Transition Analysis demonstrated substantial stability in profiles over time. Small groups showed a transition toward another (often more adaptive) profile. Although a person-centered approach may have some merit when aiming to detect high-risk subgroups, the current results suggest that a variable-centered approach—and a Factor of Curves model capturing shared underlying developmental processes in particular—is favorable over a person-centered approach.

Whose Outcomes Come Out? Patterns of Caregiver- and Youth-reported Outcomes Based on Caregiver-youth Baseline Discrepancies

OBJECTIVE

Discrepancies between caregiver and youth reports of emotional and behavioral symptoms are well-documented, with cross-informant correlations often falling in the low to moderate range. Studies have shown that caregiver-youth (dis)agreement in reporting of youth symptoms is related to treatment outcomes. However, commonly used methods for exploring reporter discrepancies (e.g., difference scores) are limited by their inability to assess discrepancies across multiple symptom domains simultaneously, and thus these previous findings do not explore multiple patterns of (dis)agreement.

METHOD

We used latent profile analysis (LPA) to identify subgroups of clinically referred youths based on patterns of caregiver- and youth-reported internalizing and externalizing symptoms for 174 caregiver-youth dyads. Longitudinal multilevel models were used to examine changes in weekly caregiver- and youth-reported internalizing symptoms, externalizing symptoms, and top problems for identified subgroups.

RESULTS

The LPA identified four latent subgroups: (a) Caregiver Internalizing (9%), (b) Caregiver Internalizing-Externalizing (45%), (c) Youth Internalizing (7%), and (d) Caregiver-Youth Internalizing-Externalizing (39%). Clinical outcomes varied across informants and subgroups. Significant improvements in caregiver- and youth-reported outcome measures were documented within the Caregiver Internalizing, Caregiver Internalizing-Externalizing, and Caregiver-Youth Internalizing-Externalizing subgroups. However, only youth-reported improvements were detected in the Youth Internalizing subgroup. The results show differences in treatment outcomes across caregiver-youth informant subgroups.

CONCLUSIONS

These findings suggest how youth and caregiver baseline data could provide guidance for clinicians in interpreting discrepant reporting and its relevance to change during treatment.

Relational Aggression and Narcissistic Traits: How Youth Personality Pathology Informs Aggressive Behavior

Low agreeableness features centrally in personality profiles of Cluster B personality disorder (PD) diagnoses, and it has been associated with relational aggression (RAgg; intentionally damaging others' social relationships). Researchers have hypothesized that RAgg may be a potential developmental precursor for Cluster B PDs. However, a dimensional approach to personality dysfunction is preferable to the categorical system found in the current diagnostic manual. To build a bridge between two disjointed literatures (categorical PDs and RAgg), the aim of this project is to detail how RAgg in youth is situated in the trait space represented by disagreeableness in a dimensional model of personality pathology. Caregivers of 911 youth (ages 6-18) reported on youth's RAgg and disagreeableness. We found that RAgg was most strongly related to three facets: Narcissistic traits, Hyperexpressive traits, and Dominance-Egocentrism traits. Overall, these findings provide support for RAgg as an early manifestation of personality pathology, particularly for narcissistic traits.

The assessment of personality disorder: methodological, developmental, and contextual considerations

The reliable and valid assessment of personality disorders (PDs) faces several challenges in different domains. In particular, the variety of methods, settings, and informants relevant for PD assessment raises questions about best practices. Additionally, issues surrounding assessment across the lifespan, including youth and the elderly, further complicate PD assessment. We review these issues here and point toward future directions in PD assessment, with an emphasis on the utility of dimensional PD assessment.

Integrating developmental aspects in current thinking about personality pathology

The current review outlines some recent highlights from the developmental literature on personality pathology with regard to its conceptualization, development, assessment and clinical utility. Notable parallels with adult evidence are described, but also unique and age-specific issues are discussed. Finally, suggestions for future research that may stimulate a life-span and integrative perspective on personality pathology from childhood onwards are proposed.

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

Researchers commonly rely on adolescents' and parents' reports to assess family functioning (e.g., conflict, parental monitoring, parenting practices, relationship quality). Recent work indicates that these reports may vary as to whether they converge or diverge in estimates of family functioning. Further, patterns of converging or diverging reports may yield important information about adolescent adjustment and family functioning. This work is part of a larger literature seeking to understand and interpret multi-informant assessments of psychological phenomena, namely mental health. In fact, recent innovations in conceptualizing, measuring, and analyzing multi-informant mental health assessments might meaningfully inform efforts to understand multi-informant assessments of family functioning. Therefore, in this Special Issue we address three aims. First, we provide a guiding framework for using and interpreting multi-informant assessments of family functioning, informed by recent theoretical work focused on using and interpreting multi-informant mental health assessments. Second, we report research on adolescents' and parents' reports of family functioning that leverages the latest methods for measuring and analyzing patterns of convergence and divergence between informants' reports. Third, we report research on measurement invariance and its role in interpreting adolescents' and parents' reports of family functioning. Research and theory reported in this Special Issue have important implications for improving our understanding of the links between multi-informant assessments of family functioning and adolescent adjustment.

Discrepancies Between Perceptions of the Parent-Adolescent Relationship and Early Adolescent Depressive Symptoms: An Illustration of Polynomial Regression Analysis

Adolescence is a critical period for the development of depressive symptoms. Lower quality of the parent-adolescent relationship has been consistently associated with higher adolescent depressive symptoms, but discrepancies in perceptions of parents and adolescents regarding the quality of their relationship may be particularly important to consider. In the present study, we therefore examined how discrepancies in parents' and adolescents' perceptions of the parent-adolescent relationship were associated with early adolescent depressive symptoms, both concurrently and longitudinally over a 1-year period. Our sample consisted of 497 Dutch adolescents (57 % boys, M age = 13.03 years), residing in the western and central regions of the Netherlands, and their mothers and fathers, who all completed several questionnaires on two occasions with a 1-year interval. Adolescents reported on depressive symptoms and all informants reported on levels of negative interaction in the parent-adolescent relationship. Results from polynomial regression analyses including interaction terms between informants' perceptions, which have recently been proposed as more valid tests of hypotheses involving informant discrepancies than difference scores, suggested the highest adolescent depressive symptoms when both the mother and the adolescent reported high negative interaction, and when the adolescent reported high but the father reported low negative interaction. This pattern of findings underscores the need for a more sophisticated methodology such as polynomial regression analysis including tests of moderation, rather than the use of difference scores, which can adequately address both congruence and discrepancies in perceptions of adolescents and mothers/fathers of the parent-adolescent relationship in detail. Such an analysis can contribute to a more comprehensive understanding of risk factors for early adolescent depressive symptoms.