Integrating multi-informant reports of youth mental health: A construct validation test of Kraemer and colleagues' (2003) Satellite Model

Advancing equity in access to school mental health through multiple informant decision-making

There has been a substantial increase in the number of students with mental health needs, yet significant discrepancies exist in access to timely intervention. Traditional gatekeeping to intervention has been the provenance of single information sources. Multi-informant decision-making is a promising mechanism to improve equitable access. However, critical advancements are necessary to improve decision-making relating to (a) who is identified, (b) what type of need is determined, (c) the type of intervention necessary, and (d) where or under what circumstances to implement the intervention. We review critical components of effective mental health decision-making, contributors to inequities in school mental health services, and offer future directions for research and practice to increase equitable student outcomes.

Systematic Integration of Multi-Informant Externalizing Ratings in Clinical Settings

Best practice clinical assessment of externalizing problems often necessitates collection of information from parents, youth themselves, and teachers. The present study tested the predictive validity of a psychometrically-driven scoring procedure to integrate multi-informant, dimensional ratings of externalizing problems. Participants were 2264 clinic-referred youth ages 6-18. Parents, teachers, and youth completed questionnaire ratings of externalizing problems (hyperactivity-inattention, conduct problems, and oppositionality-defiance) prior to an initial clinical appointment. The predictive validity of simple (highest informant rating; and all informant ratings separately) and more complex (latent S-1 bifactor model with specific informant factors; and moderated nonlinear factor analysis accounting for child age and sex) methods of informant integration was tested in predicting impairment, comorbidity, and number of clinical encounters. A simple model, in which all informant ratings were included, showed the best predictive validity across outcomes, performing as well or better than the use of the highest informant ratings or more complex latent variable models. The addition of child age and sex as moderators in the factor model did not improve predictive validity. Each informant (parent, teacher, and youth) contributes important information to the prediction of clinically-relevant outcomes. There is insufficient evidence at present to suggest that complex latent variable models should be favored over simpler models that preserve each informant's ratings.

Bivalent fears of evaluation: A developmentally-informed, multi-informant, and multi-modal examination of associations with safety behaviors

Fears of negative (FNE) and positive (FPE) evaluation and safety behaviors feature prominently in cognitive-behavioral models of social anxiety. However, we have a poor understanding of their associations, particularly given evidence that they both vary in form and function. This study aimed to identify the factor structure of safety behaviors and explore their differential associations with FNE and FPE. We addressed these aims across samples that varied in developmental stage, informant, and assessment modality. We collected self-reported data from college students (n = 349; Mage = 19.42) and adolescent-parent dyads (n = 134; Mage_adolescents = 14.49, Mage_parents = 45.01); parents also completed an ecologically-valid evaluation task. We confirmed a two-factor structure of safety behaviors (i.e., avoidance and impression management) that fit the data well for college students, adolescents, and parents' self-report, but not for parents' report about adolescents. Associations between avoidance and impression management and FNE/FPE were significant within-informants but not between-informants. For parents, in-the-moment arousal following receipt of negative, but not positive, feedback was associated with avoidance and impression management. Findings have implications for integrated measurement of FNE, FPE, and safety behaviors, as well as treatments that target social anxiety through each of these domains.

The Proposed Specifiers for Conduct Disorder - Parent (PSCD-P): Convergent Validity, Incremental Validity, and Reactions to Unfamiliar Peer Confederates

Youth who experience psychopathy display multiple impairments across interpersonal (grandiose-manipulative [GM]), affective (callous-unemotional [CU]), lifestyle (daring-impulsive [DI]), and potentially antisocial and behavioral features. Recently, it has been acknowledged that the inclusion of psychopathic features can offer valuable information in relation to the etiology of Conduct Disorder (CD). Yet, prior work largely focuses on the affective component of psychopathy, namely CU. This focus creates uncertainty in the literature on the incremental value of a multicomponent approach to understanding CD-linked domains. Consequently, researchers developed the Proposed Specifiers for Conduct Disorder (PSCD; Salekin & Hare, 2016) as a multicomponent approach to assess GM, CU, and DI features in combination with CD symptoms. The notion of considering the wider set of psychopathic features for CD specification requires testing whether multiple personality dimensions predict domain-relevant criterion outcomes above-and-beyond a CU-based approach. Thus, we tested the psychometric properties of parents' reports on the PSCD (PSCD-P) in a mixed clinical/community sample of 134 adolescents (M_age = 14.49, 66.4% female). Confirmatory factor analyses resulted in a 19-item PSCD-P displaying acceptable reliability estimates and a bifactor solution consisting of GM, CU, DI, and CD factors. Findings supported the incremental validity of scores taken from the PSCD-P across multiple criterion variables, including (a) an established survey measure of parent-adolescent conflict; and (b) trained independent observers' ratings of adolescents' behavioral reactions to laboratory controlled tasks designed to simulate social interactions with unfamiliar peers. These findings have important implications for future research on the PSCD and links to adolescents' interpersonal functioning.

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.

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).