Informant Discrepancies in Assessing Child Dysfunction Relate to Dysfunction Within Mother-Child Interactions

Development and initial validation of the health-related quality of life pictorial inventory for children (HEALTH-PIC)

PURPOSE

This 3-study paper aimed to develop and validate a self-reported Health-Related Quality of Life Pictorial Inventory for Early Childhood Children (HEALTH-PIC). The scale was designed to overcome existing barriers of parent-proxy response styles such as observation bias and offer an alternative to age-suited literary questionnaires to assess self-reported health-related quality of life, including physical health, emotional health, social health and school health in early childhood.

METHODS

Each study targeted a specific aspect of scale development, employing distinct samples to refine and validate the inventory. Study 1 involved item development/revision, which utilized a panel of 10 experts (Meanage = 34.8, SD = 4.9) and 25 parents (Meanage = 38.9; SD = 4.1) via the Delphi method to revise the scale and establish agreement. Study 2 is a cross-sectional study that invited a sample of 22 primary school students (Meanage = 6.18, SD = 0.39) and 20 kindergarten students (Meanage = 4.55, SD = 0.50) to establish face validity amongst primary respondents. Finally, Study 3 is a cross-sectional study that invited 342 parent and child (Meanage = 6.30, SD = 1.31) dyads to complete the HEALTH-PIC and reference health-related quality of life (HRQoL) questionnaires to establish the questionnaire's factorial, concurrent, discriminant and criterion validity in addition to internal consistency.

RESULTS

Scale items in Study 1 were developed alongside experts and parents with a strong theoretical and statistical support calculated using Aiken's agreement (Aiken's V p < 0.05), ensuring that the items were clear, accurate and applicable for children. In Study 2, we ensured that primary respondents of different ages were able to accurately identify the pictorial images (Aiken's V p < 0.05) and complete the questionnaire when the scripted instructions were read aloud. In Study 3, structural equation modelling of the HEALTH-PIC demonstrated a robust factor structure (CFI and TLI > 0.99; RMSEA and SRMR ≤ 0.08), concurrent validity, discriminant validity, criterion validity and an acceptable level of internal consistency (i.e., Cronbach's α = 0.60-0.66).

CONCLUSION

The findings of the three studies provide preliminary evidence to support the content validity and construct validity of the HEALTH-PIC. This novel pictorial scale not only provides a reliable and valid assessment of the multidimensional aspects of health-related quality of life among children but can also overcome existing barriers of parent-proxy or age-suited questionnaires.

Further validation of the Parent-Reported ADHD Symptom Infrequency Scale (PRASIS) in parents of children with oppositional defiant disorder and anxiety

This study aimed to validate a novel parent-report measure of ADHD symptom inflation, the Parent-Reported ADHD Symptom Infrequency Scale (PRASIS), in a clinical sample. The PRASIS is composed of an Infrequency subscale and an ADHD subscale. Online participants were assigned to one of three groups: mothers of children with diagnosed ADHD (n = 110), mothers of children with diagnosed ODD and/or anxiety (n = 116), and mothers of children without ADHD, ODD, or anxiety. The third group was then randomized to either receive instructions to complete the questionnaire honestly (controls, n = 164) or to complete the questionnaire as if they were trying to convince a provider that their child has ADHD (simulators, n = 141). Results indicated good to excellent internal consistency (INF α = .83, ADHD Total α = .93); strong convergent validity of the PRASIS ADHD scale with the ADHD Rating Scale-5 (r(529) = .85, p < .001); excellent group discrimination of the PRASIS Infrequency scale and the PRASIS ADHD scale (η2 = 0.38-0.42); and specificity of 86.7, sensitivity of 67.4%, and an AUC of .86 for the Infrequency scale. Overall, these outcomes supported the utility of the PRASIS in samples including mothers of children with psychiatric diagnoses of ODD and/or anxiety.

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

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

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.

Are We Thinking about the Same Disorder? A Trifactor Model Approach to Understand Parents' and Their Adolescents' Reports of Borderline Personality Pathology

Multiple informant assessment is the norm when evaluating borderline personality pathology (BPP) in adolescence, especially by including reports from both parents and adolescents. However, these reports tend to be discrepant, and it is unclear how to integrate. The current study used a trifactor model to isolate sources of variance in parents' and adolescents' reports of BPP due to their shared and unique perspectives in a sample of 652 inpatient adolescents (63% female; Mage = 15.31, SD = 1.45) and their parents (81% mothers). Consensus/agreement was characterized by the externalizing features of BPP whereas idiosyncratic views of adolescent BPP covered the full latent BPP construct, suggesting that simple aggregation of parent and adolescent reports is inappropriate. Measurement invariance suggested that unique perspectives were characterized by slightly different operationalizations of BPP and response biases for specific features of BPP. Attachment security and parents' interpersonal problems predicted shared and unique perspectives differently for female and male adolescents. Lastly, we found that shared and unique perspectives differentially predicted interview based BPP, length of stay, and adolescent mentalizing. In sum, findings replicate previous evidence of parent-child informant discrepancy in youth psychopathology, broadly, and provide insights specific to BPP. Discussion includes practical recommendations for assessment and interpretation of BPP assessment.

Romantic relationship satisfaction and coparenting quality in families with children previously diagnosed with developmental delay

Children with developmental delay (DD) are at increased risk for behavioral difficulties. Past research has indicated that behavioral problems can interact with other parental difficulties in families of children with DD. To date, no research has explored the moderating role of marital satisfaction in the relationship between child behavioral difficulties and coparenting quality in families of children with DD. The purpose of this study was to undertake such an examination in a sample of 56 families with school-aged children previously identified with DD. To test the hypothesis that marital satisfaction moderates the relation between child behavior problems and coparenting disagreement, a hierarchical multiple regression analysis was conducted for mothers and fathers, respectively. Results demonstrated child problem behaviors predicted coparenting problems for fathers only, and that child problem behaviors interacted with marital satisfaction to predict coparenting difficulties for fathers but not mothers. Findings suggest that marital satisfaction may attenuate the effects of behavior problems on the coparenting relationship for fathers. Study implications and future directions are discussed.

The parent-reported ADHD symptom infrequency scale (PRASIS): a parent report measure of ADHD symptom exaggeration

The present article outlines the development of the parent-reported ADHD symptom infrequency scale (PRASIS), a novel stand-alone questionnaire designed to discriminate between parents exaggerating ratings of ADHD symptoms of their child from parents more accurately reporting symptoms. The PRASIS includes an Infrequency scale (INF) to measure infrequently reported symptoms of ADHD and a clinical scale to measure Diagnostic and Statistical Manual of Mental Disorders-5^th Edition (DSM-5) defined ADHD symptoms (ADHD Total). An initial list of infrequency and clinical items was revised over the course of three studies, each conducted on a different sample of participants (n₁ = 154, n₂ = 203, n₃ = 167) recruited via CloudResearch and consisting of mothers of children 4-12 years old. Analyses on the final version of the measure demonstrated good to excellent internal consistency (INF α = .87 , ADHD Total α = .94) and high convergent validity of the PRASIS ADHD Total scores with ADHD Rating Scale-5 Total scores (r = .87, p < .001). Omnibus ANOVA comparisons demonstrated excellent group discrimination of both the PRASIS Infrequency scale and the PRASIS ADHD scale (Cohen's f = 0.81-0-90). Specificity was above the minimum requirement set a priori (≥.80) and resulting sensitivity was similar or higher than other non-ADHD measures in the symptom validity literature. Specificity and sensitivity are reported for multiple cutoff scores, and positive predictive values (PPV) and negative predictive values (NPV) are presented for several base rates.

Children’s Mental Health: Discrepancy between Child Self-Reporting and Parental Reporting

(1) Background: Discrepancies between children’s self-reports and their parents’ reports on mental health indicators are associated with measurement errors or informant bias. However, they are a valuable tool in understanding the course of child psychopathology. This study aims to determine the level of discrepancies between parents’ perceptions and children’s self-reports in mental health indicators in Northern Chile. (2) Methods: A System of Evaluation of Children and Adolescents self-report (Sistema de Evaluación de Niños y Adolescentes, SENA) was responded to by 408 students between 8 and 13 years old and their parents. (3) Results: Children reported a significantly higher frequency of emotional problems, defiant behavior, and executive functions as compared to their parents’ responses. (4) Conclusions: There is a disjunction between the report of parents and children, which could originate in poor family communication.

Readability of Commonly Used Quality of Life Outcome Measures for Youth Self-Report

Self-report measures are central in capturing young people’s perspectives on mental health concerns and treatment outcomes. For children and adolescents to complete such measures meaningfully and independently, the reading difficulty must match their reading ability. Prior research suggests a frequent mismatch for mental health symptom measures. Similar analyses are lacking for measures of Quality of Life (QoL). We analysed the readability of 13 commonly used QoL self-report measures for children and adolescents aged 6 to 18 years by computing five readability formulas and a mean reading age across formulas. Across measures, the mean reading age for item sets was 10.7 years (SD = 1.2). For almost two-thirds of the questionnaires, the required reading age exceeded the minimum age of the target group by at least one year, with an average discrepancy of 3.0 years (SD = 1.2). Questionnaires with matching reading ages primarily targeted adolescents. Our study suggests a frequent mismatch between the reading difficulty of QoL self-report measures for pre-adolescent children and this group’s expected reading ability. Such discrepancies risk undermining the validity of measurement, especially where children also have learning or attention difficulties. Readability should be critically considered in measure development, as one aspect of the content validity of self-report measures for youth.

Screen Time as a Mechanism Through Which Cumulative Risk is Related to Child Socioemotional and Developmental Outcomes in Early Childhood

Socio-demographic risks are associated with higher child screen time and higher screen time is associated with poor socioemotional and developmental health. Existing studies have not examined children's screen time as a mechanism through which distal risks may be associated with child outcomes. In the current study, we examined whether two proximal factors, screen time and parenting quality, mediate the relation between distal cumulative risk and child outcomes. Participants (N = 1992) were drawn from a birth cohort of mothers and their children (81% white; 46% female). Mothers reported on cumulative risk factors (maternal income, education, depression, stress, marital status, housing instability, unemployment, and maternal history of childhood adversity) during the prenatal period. Parenting quality (ineffective/hostile, positive interactions) and children's screen time (hours/week) were assessed when children were three years of age. Child socioemotional (internalizing and externalizing problems) and developmental (achievement of developmental milestones) outcomes were measured at five years of age. Path analysis revealed indirect effects from cumulative risk to internalizing symptoms and achievement of developmental milestones via screen time. Indirect effects were observed from cumulative risk to internalizing and externalizing behavior via hostile parenting behavior. Over and above the effects of parenting, screen time may be a factor that links structural forms of social disadvantage during the prenatal period to child socioemotional and developmental outcomes. Due to modest effect sizes of screen time, it remains the case that child socioemotional and developmental health should be conceptualized within the context of distal cumulative risk factors such as caregiver psychological and material resources.

The impact of COVID-19 on stress, anxiety, and coping in youth with and without autism and their parents

In the wake of COVID-19, the world has become a more uncertain environment-a breeding ground for stress and anxiety, especially for individuals with autism spectrum disorder (ASD). The study examined stress, anxiety, and coping in a data-driven, real-time assessment of 122 youth with and without ASD and their parents at the height of the COVID-19 shutdown and three-months later. Standardized measures were administered to ascertain stress and coping explicitly related to the pandemic (RSQ COVID-19-Child [self-report], Adult [self-report from the guardian of youth], Parent [report about child]) and anxiety (STAI-C, STAI-A). Multivariate, univariate analyses of variance and hierarchical regression were used. ASD youth endorsed more Trait anxiety and response to specific stressors (e.g., virus). Caregivers of youth with ASD (Adults) self-reported higher anxiety, yet scores were elevated for both groups. Adults of youth with ASD reported more stress, especially related to the virus, access to healthcare, and concern for the future. In the TD group, youth and adults used more Primary and Secondary Control Coping whereas ASD youth and adults used more Disengagement Coping. Adult stress was the primary predictor of parent perception of child stress as well as Child self-reported stress. While the ASD group was consistently high compared to the TD group, there were no significant changes over time for stress or anxiety. Results reveal striking differences in youth with ASD and their parents regarding stress, anxiety, and coping. Findings highlight the need for essential support, access to services, and strategies to enhance psychological and emotional well-being. LAY SUMMARY: This study examined stress, anxiety, and coping related to the COVID-19 pandemic in 61 youth with autism spectrum disorder (ASD) and 61 youth with typical development (TD) and their parents. Results showed that ASD youth reported more anxiety and stress. Adults of youth with ASD indicated higher self-reported anxiety and stress than adults of TD youth. TD youth and their parents reported using more adaptive coping strategies. Findings highlight the need for strategies to enhance psychological and emotional well-being.

Discrepancies in Parent Perceptions of Child Vulnerability in Youth With Spina Bifida

OBJECTIVE

This study aimed to describe informant discrepancies between mother and father reports of child vulnerability in youth with spina bifida (SB) and examine variables that were associated with these discrepancies.

METHODS

Ninety-two parent dyads, with a child with SB (ages 8-15 years), were recruited as a part of a longitudinal study. Mothers and fathers completed questionnaires assessing parental perception of child vulnerability (PPCV), as well as medical and demographic information, behavioral aspects of the couple relationship, parenting stress, mental health of the parent, and child behavioral adjustment. The degree to which there was a parenting alliance was assessed with observational data. Mother-father discrepancies were calculated at the item level.

RESULTS

Findings revealed that greater father mental health symptoms, parenting stress, and child behavior problems were associated with "father high and mother low" discrepancies in PPCV. There were also lower scores on observed parenting alliance when there were higher rates of "father high and mother low" discrepancies in PPCV.

CONCLUSIONS

For families of youth with SB, discrepancies in PPCV where fathers perceive high vulnerability and mothers perceive low vulnerability may be a "red flag" for the presence of other parental and child adjustment difficulties. Findings are discussed in terms of the Attribution Bias Context Model and underscore the importance of including fathers in research on families who have children with chronic health conditions.

Using Evaluative Criteria to Review Youth Anxiety Measures, Part II: Parent-Report

This Evidence Base Update of parent-report measures of youth anxiety symptoms is a companion piece to our update on youth self-report anxiety symptom measures (Etkin et al., 2021). We rate the psychometric properties of the parent-report measures as Adequate, Good, or Excellent using criteria developed by Hunsley and Mash (2008) and Youngstrom et al. (2017). Our review reveals that the evidence base for parent-report measures is considerably less developed compared with the evidence base for youth self-report measures. Nevertheless, several measures, the parent-report Screen for Child Anxiety-Related Emotional Disorders, Multidimensional Anxiety Scale for Children, and Spence Children's Anxiety Scale, were found to have Good to Excellent psychometric properties. We conclude our review with suggestions about which parent-report youth anxiety measures are best suited to perform different assessment functions and directions for additional research to expand and strengthen the evidence base.

Übereinstimmung zwischen Eltern und Kind zur kindlichen Psychopathologie und deren Bedeutung für den Therapieerfolg

<b><i>Hintergrund:</i></b> Symptome psychischer Störungen werden von Kindern und Jugendlichen häufig anders als von den Eltern eingeschätzt. Als Einflussfaktoren für diese Urteilsdiskrepanzen im externalisierenden und internalisierenden Symptombereich werden kindliches Geschlecht und Alter untersucht. Zudem wird der prädiktive Wert der Diskrepanz für den wahrgenommenen Therapieerfolg analysiert. <b><i>Methode:</i></b> Kinder und Jugendliche (<i>n</i> = 271, 10–21 Jahre) in ambulanter Psychotherapie sowie Eltern gaben Auskunft über den Youth Self Report (YSR) und die Child Behavioral Checklist (CBCL). <b><i>Ergebnisse:</i></b> Neben einer grundsätzlich guten Übereinstimmung zwischen Eltern und Kind berichten Eltern über mehr psychische Symptome als die davon betroffenen Kinder. Mit zunehmendem Alter steigt die von den Kindern selbstberichtete externalisierende Symptomatik an. Mädchen geben mehr internalisierende Symptome als Jungen an. Ein hoher elterlicher Baselinewert (prä-Therapie) zur kindlichen externalisierenden Symptomatik sagt einen höheren Elternbericht nach Abschluss der Psychotherapie des Kindes vorher. Kinder berichten nach der Psychotherapie mehr Symptome, wenn Uneinigkeit zwischen Eltern und Kindern bezüglich der internalisierenden Symptomatik prä-Therapie besteht sowie eine hohe kindberichtete externalisierende bzw. elternberichtete internalisierende Symptomatik berichtet wird. <b><i>Schlussfolgerung:</i></b> Insgesamt zeigen sich einzelne Faktoren prädiktiv für die Symptomatik post-Therapie, jedoch die Eltern-Kind Urteilsdiskrepanz nur in geringem Maß. Beeinflussende Faktoren wie Alter und Geschlecht sollten in zukünftigen Studien standardmäßig aufgenommen werden.

Comparing Parent and Child Self-report Measures of the State-Trait Anxiety Inventory in Children and Adolescents with a Chronic Health Condition

Anxiety symptoms in children and adolescents with a chronic health condition have been estimated as high as 40% lifetime prevalence. Clinicians often rely on parent/caregiver information to supplement or substitute child self-report related to pediatric physical and mental health. We developed a caregiver proxy version (STAI-P) for the State-Trait Anxiety Inventory (STAI) State Anxiety Scale that was compared with a child self-report version in 201 parent-child dyads to evaluate its utility in measuring state anxiety in chronically ill youth. For patients aged 7-12, self-reports of state anxiety were moderately associated with parent distress and health provider-reported functional status, but negatively associated with parent STAI-P scores. For patients aged 13-17, self-reports of state anxiety were significantly associated with STAI-P scores, parent distress, and health provider-reported functional status. The STAI-P parent version may be a useful tool in identifying and addressing anxiety symptoms in youth living with a chronic health condition.

Discrepancies between parent and child ratings of anxiety in children with autism spectrum disorder

Co-occurring anxiety is common in children with autism spectrum disorder (ASD). However, inconsistencies across parent and child reports of anxiety may complicate the assessment of anxiety in this population. The present study examined parent and child anxiety ratings in children with ASD with and without anxiety disorders and tested the association between parent-child anxiety rating discrepancy and ASD symptom severity. Participants included children aged 8-16 years in three diagnostic groups: ASD with co-occurring anxiety disorders (ASD + Anxiety; n = 34), ASD without co-occurring anxiety disorders (ASD; n = 18), and typically developing healthy controls (TD; n = 50). Parents and children completed ratings of child anxiety using the Multidimensional Anxiety Rating Scale. Patterns of parent and child anxiety ratings differed among the three groups, with parent ratings exceeding child ratings only in the ASD + Anxiety group. Parents reported higher levels of child anxiety in the ASD + Anxiety versus ASD group, whereas children reported comparable levels of anxiety in the two groups. Among children with ASD, ASD symptom severity was positively associated with the degree to which parent ratings exceeded child ratings. Results suggest that children with ASD and co-occurring anxiety disorders endorse some anxiety symptoms but may underreport overall levels of anxiety. In addition, ASD symptom severity might increase discrepancies in parent-child anxiety ratings. These findings suggest a unique and valuable role of child anxiety ratings and suggest that both parent and child anxiety ratings should be considered in light of children's ASD symptom severity and used to guide further assessment. Autism Res 2020, 13: 93-103. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Children with autism spectrum disorder (ASD) commonly experience anxiety; yet, their perceptions of their anxiety might differ from their parents' perceptions. This study found that, while children with ASD and anxiety disorders acknowledge some anxiety, their parents report them as having higher levels of anxiety. Also, child and parent perceptions of anxiety may differ more for children with more severe ASD symptoms. How these findings may guide research and clinical practice is discussed.

Perceived need and barriers to adolescent mental health care: agreement between adolescents and their parents

AIMS

Mental disorders cause high burden in adolescents, but adolescents often underutilise potentially beneficial treatments. Perceived need for and barriers to care may influence whether adolescents utilise services and which treatments they receive. Adolescents and parents are stakeholders in adolescent mental health care, but their perceptions regarding need for and barriers to care might differ. Understanding patterns of adolescent-parent agreement might help identify gaps in adolescent mental health care.

METHODS

A nationally representative sample of Australian adolescents aged 13-17 and their parents (N = 2310), recruited between 2013-2014, were asked about perceived need for four types of adolescent mental health care (counselling, medication, information and skill training) and barriers to care. Perceived need was categorised as fully met, partially met, unmet, or no need. Cohen's kappa was used to assess adolescent-parent agreement. Multinomial logistic regressions were used to model variables associated with patterns of agreement.

RESULTS

Almost half (46.5% (s.e. = 1.21)) of either adolescents or parents reported a perceived need for any type of care. For both groups, perceived need was greatest for counselling and lowest for medication. Identified needs were fully met for a third of adolescents. Adolescent-parent agreement on perceived need was fair (kappa = 0.25 (s.e. = 0.01)), but poor regarding the extent to which needs were met (kappa = -0.10 (s.e. = 0.02)). The lack of parental knowledge about adolescents' feelings was positively associated with adolescent-parent agreement that needs were partially met or unmet and disagreement about perceived need, compared to agreement that needs were fully met (relative risk ratio (RRR) = 1.91 (95% CI = 1.19-3.04) to RRR = 4.69 (95% CI = 2.38-9.28)). Having a probable disorder was positively associated with adolescent-parent agreement that needs were partially met or unmet (RRR = 2.86 (95% CI = 1.46-5.61)), and negatively with adolescent-parent disagreement on perceived need (RRR = 0.50 (95% CI = 0.30-0.82)). Adolescents reported most frequently attitudinal barriers to care (e.g. self-reliance: 55.1% (s.e. = 2.39)); parents most frequently reported that their child refused help (38.7% (s.e. = 2.69)). Adolescent-parent agreement was poor for attitudinal (kappa = -0.03 (s.e. = 0.06)) and slight for structural barriers (kappa = 0.02 (s.e. = 0.09)).

CONCLUSIONS

There are gaps in the extent to which adolescent mental health care is meeting the needs of adolescents and their parents. It seems important to align adolescents' and parents' needs at the beginning and throughout treatment and to improve communication between adolescents and their parents. Both might provide opportunities to increase the likelihood that needs will be fully met. Campaigns directed towards adolescents and parents need to address different barriers to care. For adolescents, attitudinal barriers such as stigma and mental health literacy require attention.

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.

Method effects of the relation between family history of alcoholism and parent reports of offspring impulsive behavior

There is an extensive, albeit inconsistent, literature on the relation between parental alcoholism and offspring impulsive behavior. The reasons for this inconsistency are likely multiple but it seems probable that method effects due to different methodological approaches might explain some of the inconsistencies. Offspring behavior is typically assessed based on informant reports. However, no specific method has been demonstrated as optimal for analyzing informant reports, and conclusions may differ depending on the method used. The present study compared findings derived from a multi-informant method proposed by Bauer et al. (2013) to other structural equation models. Participants came from Wave 7 of the Alcohol, Health and Behavior study and included mother and father reports of offspring impulsive behavior on the Health and Behavior Questionnaire (Armstrong, Goldstein, & the MacArthur Working Group on Outcome Assessment, 2003). There were 368 offspring (50% female, age range 3-17 years, meanage = 6.78, SDage = 3.07) from 205 families. The multi-informant model and the single-reporter models each provided a good fit of the data; however, findings differed based on the approach employed. Specifically, the mother-only report model found that offspring with a family history of alcoholism (FHA) were more impulsive compared to offspring without a FHA; no effect of FHA was found in the other single-reporter models. Ratings of offspring impulsive behavior were higher on the father perspective factor suggesting alcoholic fathers were biased in their reports. These findings highlight the relation between FHA and impulsive behavior varies depending on the analytic method used.

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.

Understanding parent-teacher agreement of the Strengths and Difficulties Questionnaire (SDQ): Comparison across seven European countries

Assessments of child psychopathology are often derived from parental and teacher reports, yet there is substantial disagreement. This study utilized data from 7 European countries to examine parent-teacher agreement and possible explanatory factors for parent-teacher disagreement such as child and family characteristics, parenting dimensions, and maternal distress were explored. Parent-teacher agreement of the Strengths and Difficulties Questionnaire were assessed using a cross-sectional survey of 4,894 school aged children 6-11 from the School Children Mental Health Europe Project. Parent-teacher agreement was low to moderate (Pearson correlation ranging from .24 (Prosocial) to .48 (Hyperactivity) for the 5 subscales across 7 countries); kappa coefficient ranged from .01 (Turkey) to .44 (Italy) for internalizing problems and .19(Romania) to .44(Italy) for externalizing problems. Child's gender and age, mother's employment status, single parent home, number of children in household, and selected parenting dimension were found to be explanatory of informant disagreement. This study not only serves to advance our understanding of parent-teacher agreement of the Strengths and Difficulties Questionnaire in 7 European countries but provides a novel approach to examining the factors that contribute to informant disagreement.

The Broader Autism Phenotype in Mothers is Associated with Increased Discordance Between Maternal-Reported and Clinician-Observed Instruments that Measure Child Autism Spectrum Disorder

Autism spectrum disorder (ASD) diagnosis relies on parent-reported and clinician-observed instruments. Sometimes, results between these instruments disagree. The broader autism phenotype (BAP) in parent-reporters may be associated with discordance. Study to Explore Early Development data (N = 712) were used to address whether mothers with BAP and children with ASD or non-ASD developmental disabilities were more likely than mothers without BAP to 'over-' or 'under-report' child ASD on ASD screeners or interviews compared with clinician observation or overall impression. Maternal BAP was associated with a child meeting thresholds on a maternal-reported screener or maternal interview when clinician ASD instruments or impressions did not (risk ratios: 1.30 to 2.85). Evidence suggests acknowledging and accounting for reporting discordances may be important when diagnosing ASD.

Parent-Child Discrepancy on Children's Body Weight Perception: The Role of Attachment Security

The discrepancies between parents and their children on the description of the behavior and representations of their children have been shown in various studies. Other researchers have reported the parents' difficulty in correctly identifying the weight status of their children. The purpose of our study was to investigate the parent's attributional accuracy on their children's body weight perception in relation to the children attachment security. It was hypothesized that insecure children's parents have a greater discrepancy with their children compared to secure children with their parents. The research participants were 217 children, aged between 5 and 11 years of both genders, and their parents. The attachment pattern was measured by the SAT of Klagsbrun and Bowlby, with the Italian version of Attili. The children were also shown a set of figure body-drawings with which to measure the perception of their weight status. Parents answered a questionnaire to find out the parental attribution of their children's perception. The results show that the body weight perception of insecure children's parents have a greater discrepancy with their children's body weight perception compared with parentally secure children. In particular, parents of insecure children tend to underestimate the perception of their children. This result is most evident in disorganized children. In addition, the perception of insecure children's parents show a greater correlation with children's actual weight rather than with their children's perception. These results suggest that the discrepancies on the perception of children's body weight between parents and children may be influenced by the poor parental attunement to their children's internal states, which characterizes the insecure parent-child attachment relationship.

BIS/BAS Scale in Primary School Children: Parent-Child Agreement and Longitudinal Stability

The current study provided psychometric information on the parent and child version of the Behavioural Inhibition System (BIS)/Behavioural Approach System (BAS) scale. Parent-child agreement was evaluated (N = 217, 7.5 to 14 years, 50% boys). Moreover, absolute and rank order stability of mother-reported BIS/BAS scores over a 2-year period were assessed (N = 207, 5.5 to 11 years at baseline, 49% boys). Only full measurement invariant (sub-)scales were considered in the parent-child agreement and longitudinal stability assessment. Parent and child ratings were found to be measurement invariant but discrepant on BAS Drive and BAS Reward Responsiveness. In younger children, child ratings on BAS Drive tended to be higher than parent ratings, whereas in older children, child ratings tended to be lower than parent ratings. Further, the discrepancy between the BAS Drive ratings of fathers and children was higher than the discrepancy between the BAS Drive ratings of mothers and children. Finally, the study results suggested 2-year absolute and rank order stability of the measurement-invariant, mother-reported BIS and BAS Drive scores in children aged 5.5 to 11 years at baseline.

Parent-child discrepancies in the report of adolescent emotional and behavioral problems in Taiwan

The majority of studies on parent-child discrepancies in the assessment of adolescent emotional and behavioral problems have been conducted in Western countries. It is believed that parent-adolescent agreement would be higher in societies with a strong culture of familism. We examined whether parent-adolescent discrepancies in the rating of adolescent emotional and behavioral problems are related to parental and family factors in Taiwan. Participants included 1,421 child-parent pairs of 7^th-grade students from 12 middle schools in Northern Taiwan and their parents. We calculated Pearson’s correlation coefficients to assess the relationship between parental (Child Behavior Checklist, CBCL) and adolescent (Youth Self Report, YSR) report of emotional/behavioral problem syndromes. Regression models were used to assess parent-adolescent differences in relation to parental psychopathology and family factors. We found that parent-adolescent agreement was moderate (r = 0.37). Adolescents reported higher symptom scores than their parents (Mean Total Problem Score: CBCL: 20.79, YSR: 33.14). Parental psychopathology was related to higher parental ratings and better informant agreement. Parents with higher socioeconomic status (SES) tended to report lower scores for adolescent problem syndromes, resulting in higher levels of disagreement. Greater maternal care was related to higher parent-adolescent agreement. Based on our study findings, we conclude that familism values do not seem to improve parent-child agreement in the assessment of adolescent problem syndromes. The finding that higher SES was related to increased discrepancies speaks to the need to explore the culture-specific mechanisms giving rise to informant discrepancies.

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.

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.

A Social Domain Approach to Informant Discrepancies in Parental Solicitation and Family Rules

An extensive body of research has explored the effects of parental monitoring on adolescent outcomes, but studies consistently find substantial discrepancies between parent and adolescent reports of different monitoring behaviors. Little research has examined whether parents and adolescents are more or less discrepant when reporting on parents' rules or solicitation for different adolescent problem and health risk behaviors and few studies have explored potential explanatory variables to explicate individual variability in parent-adolescent discrepant reporting. To address this gap in the literature, the current study examined discrepancies in mother-adolescent reports of family rules and solicitation across five distinct adolescent behaviors: personal behaviors and four different risk behaviors (alcohol-related, cyber, over- and under-eating). Participants were 143 mother-adolescent dyads (Adolescent M age  = 14.42, SD = 1.73, range = 12-18, 81 % white, 60 % female). Mean-level discrepancies between maternal and adolescent reports significantly differed by category of adolescent behavior and also varied as a function of reported parental monitoring behavior (rules vs. solicitation). Discrepancies in mother-adolescent reports of behavior-specific rules and solicitation were positively associated with discrepancies in mother and adolescent judgments of the harmfulness of the activities. The results demonstrate that discrepancies in mother-adolescent reports of family process differ by category of adolescent behavior and may be undergirded by differences in mother and adolescent informational assumptions about the potential harm involved with different activities.

Incremental Validity and Informant Effect from a Multi-Method Perspective: Assessing Relations between Parental Acceptance and Children's Behavioral Problems

This study examines the relationships between perceived parental acceptance and children's behavioral problems (externalizing and internalizing) from a multi-informant perspective. Using mothers, fathers, and children as sources of information, we explore the informant effect and incremental validity. The sample was composed of 681 participants (227 children, 227 fathers, and 227 mothers). Children's (40% boys) ages ranged from 9 to 17 years (M = 12.52, SD = 1.81). Parents and children completed both the Parental Acceptance Rejection/Control Questionnaire (PARQ/Control) and the check list of the Achenbach System of Empirically Based Assessment (ASEBA). Statistical analyses were based on the correlated uniqueness multitrait-multimethod matrix (model MTMM) by structural equations and different hierarchical regression analyses. Results showed a significant informant effect and a different incremental validity related to which combination of sources was considered. A multi-informant perspective rather than a single one increased the predictive value. Our results suggest that mother-father or child-father combinations seem to be the best way to optimize the multi-informant method in order to predict children's behavioral problems based on perceived parental acceptance.

Comparing Multi-Informant Assessment Measures of Parental Monitoring and Their Links with Adolescent Delinquent Behavior

OBJECTIVE

Parents' poor monitoring of adolescents' whereabouts and activities is commonly linked to adolescents' increased engagement in delinquent behaviors. Yet, different domains of parental monitoring (parental monitoring behaviors vs. parental knowledge) and reports from multiple informants (parent vs. adolescent) may vary in their links to delinquent behavior.

DESIGN

Seventy-four parental caregivers and 74 adolescents completed survey measures of parental monitoring and knowledge, and adolescents completed self-report surveys of delinquent behavior.

RESULTS

We observed low-to-moderate magnitudes of correspondence between parent- and adolescent-reports of parental monitoring behaviors and parental knowledge. Adolescent self-reported delinquent behavior related to parent and adolescent reports of parental monitoring behaviors and parental knowledge, with adolescents who self-reported engagement in delinquent behaviors evidencing lower levels of parental knowledge and higher levels of poor monitoring compared to adolescents who did not self-report engagement in delinquent behaviors. Adolescent self-reported engagement in delinquent behaviors evidenced stronger links to parental monitoring when based on adolescent reports of monitoring (relative to parent reports), whereas stronger links held between adolescent self-reported delinquent behavior and parental knowledge when based on parent reports of knowledge (relative to adolescent reports).

CONCLUSIONS

Links between monitoring and adolescents' delinquent behavior vary by the kind of monitoring measure completed as well as the informant completing the measure. These findings inform measurement selection in research and clinical assessments of parental monitoring and adolescent delinquent behavior.

Why Mothers and Young Children Agree or Disagree in Their Reports of the Child's Problem Behavior

This study examined multiple determinants of discrepancies between mother and child reports of problem behavior. In 5,414 6-year-olds, child problem behavior was assessed by self-report using the Berkeley Puppet Interview and by maternal report using the Child Behavior Checklist. Patterns in mother-child reports were modeled using latent profile analysis. Four profiles, differing in problem level, and the direction and magnitude of mother-child discrepancies, were identified: one profile representing agreement (46%), another representing slight discrepancies (30%), and two representing higher problem levels and more discrepancies. In the latter two profiles either children (11%) or mothers (13%) reported more problems. Compared to the first profile, the second was predominantly characterized by a positive family environment, the third by child cognitive difficulties, and the fourth by harsh discipline and poor family functioning. Knowledge about specific child/family characteristics that contribute to mother-child discrepancies can help to interpret informants' reports and to make diagnostic decisions.

Adolescent Callous-Unemotional Traits and Parental Knowledge as Predictors of Unprotected Sex Among Youth

Risky sexual behavior among adolescents is common and results in many negative consequences. The present study investigated longitudinal predictors of adolescents' likelihood of engaging in unprotected sexual intercourse. Parental knowledge, or the extent to which parents know about their children's activities, whereabouts, and friendships, is a robust predictor of youth risk behavior, including risky sexual behavior. However, parenting practices are typically less potent as predictors of subsequent behavior among youth with high levels of callous-unemotional (CU) traits. We conducted three logistic regression models, each of which examined parental knowledge in a different way (through child report, parent report, and a discrepancy score), allowing us to examine parental knowledge, CU traits, and their interaction as predictors of adolescents' subsequent engagement in sex without a condom. Results indicated that adolescents who perceived their parents to possess greater knowledge were less likely to engage in unprotected sex. Higher parent report of parental knowledge was also related to decreased likelihood of engaging in unprotected sex, but only for adolescents with high levels of CU traits. In addition, greater discrepancy between parent and adolescent reports of parental knowledge was related to increased likelihood of engaging in unprotected sex, but only for adolescents with low levels of CU traits. Results highlight the importance of considering both parent and adolescent perceptions of parental knowledge and have important implications for prevention and intervention efforts.

Maternal borderline personality disorder symptoms and convergence between observed and reported infant negative emotional expressions

To date, the influence of maternal borderline personality disorder (BPD) on perceptions of infants' emotional expressions has not been examined. This study investigated the relation of maternal BPD symptoms to discrepancies between mother-reported and observed infant expressions of fear and anger. Emotional expressions in response to fear- and anger-eliciting stimuli were observed among 101 12- to 23-month-old infants of mothers with a range of BPD symptoms. Mothers also reported on their infants' past-month fear and anger expressions. Findings from polynomial regression analyses revealed that maternal BPD symptoms (particularly BPD interpersonal symptoms) are associated with greater convergence of mother-reported and observed infant anger expressions. Furthermore, although maternal BPD symptoms were not related to discrepancies between mother-reported and observed infant fear, findings did reveal a relation between maternal BPD symptoms and observed infant fear expressions, such that maternal BPD symptoms related to both low and high (vs. moderate) levels of fear expressions in the laboratory. Moreover, BPD behavioral symptoms in particular were associated with greater convergence of mother-reported and observed infant fear expressions. Overall, findings contribute to the literature on the impact of maternal BPD on parenting and infant outcomes, and highlight the relevance of maternal BPD symptoms to discrepancies between perceived and observed infant negative emotional expressions.

Economic Hardship, Parent Positive Communication and Mental Health in Urban Adolescents Seeking Outpatient Psychiatric Care

Economic hardship and poor parenting behaviors are associated with increased risk for mental health problems in community adolescents. However, less is known about the impact of socioeconomic status (SES) and parenting behaviors on youth at elevated risk for mental health problems, such as teens seeking outpatient psychiatric care. This study examined whether family SES and parent positive communication were directly and indirectly associated with mental health symptoms six months later in urban teens seeking outpatient treatment, after accounting for baseline levels of symptoms. At baseline, adolescent participants (N = 346; 42% female; 61% African-American) ages 12 to 19 years old (M = 14.9; SD = 1.8) and their primary caregivers reported on SES and teen internalizing and externalizing symptoms and engaged in a videotaped discussion of a real-life conflict to assess parent positive communication. At 6-month follow-up, 81% (N = 279) of families were retained and teens and caregivers again reported internalizing and externalizing symptoms. Structural Equation Modeling (SEM) was used to test the hypothesized models with a sample of 338, using the full information likelihood method to adjust for missing data. For parent-reported externalizing symptoms, SEM revealed support for the indirect association of SES with follow-up externalizing symptoms via parent positive communication and externalizing symptoms at baseline. For parent reported internalizing symptoms, there was a direct association between SES and follow-up internalizing symptoms, but not an indirect effect via parent positive communication. Youth-reported symptoms were not associated with SES nor with parent positive communication. Current findings extend prior research on adolescent mental health in a diverse sample of urban youth seeking outpatient psychiatric care. These families may benefit from interventions that directly target SES-related difficulties and parent positive communication.

Mothers' and Fathers' Negative Responsibility Attributions and Perceptions of Children's Problem Behavior

Parents' negative responsibility attributions about their child's misbehavior are related to a perception that the child has more behavior problems. The current study used a dyadic framework to explore how mothers' and fathers' attributions relate to their own perceptions and to their partner's perceptions of the child's externalizing problems. Participants included 102 couples interviewed when children were 7 years old. Results confirmed that mothers reported more externalizing behavior problems in their children than did fathers, and fathers of boys reported more child behavior problems than fathers of girls. Dyadic analyses suggested that parents' negative responsibility attributions of the child's behavior were associated with greater perceptions of child externalizing problems on behalf of parents and their partners.

Discrepancies between parent and adolescent beliefs about daily life topics and performance on an emotion recognition task

Parents and children and adolescents commonly disagree in their perceptions of a variety of behaviors, including the family relationship and environment, and child and adolescent psychopathology. To this end, numerous studies have examined to what extent increased discrepant perceptions-particularly with regard to perceptions of the family relationship and environment-predict increased child and adolescent psychopathology. Parents' and children and adolescents' abilities to decode and identify others' emotions (i.e., emotion recognition) may play a role in the link between discrepant perceptions and child and adolescent psychopathology. We examined parents' and adolescents' emotion recognition abilities in relation to discrepancies between parent and adolescent perceptions of daily life topics. In a sample of 50 parents and adolescents ages 14-to-17 years (M = 15.4 years, 20 males, 54 % African-American), parents and adolescents were each administered a widely used performance-based measure of emotion recognition. Parents and adolescents were also administered a structured interview designed to directly assess each of their perceptions of the extent to which discrepancies existed in their beliefs about daily life topics (e.g., whether adolescents should complete their homework and carry out household chores). Interestingly, lower parent and adolescent emotion recognition performance significantly related to greater parent and adolescent perceived discrepant beliefs about daily life topics. We observed this relation whilst accounting for adolescent age and gender and levels of parent-adolescent conflict. These findings have important implications for understanding and using informant discrepancies in both basic developmental psychopathology research and applied research in clinic settings (e.g., discrepant views on therapeutic goals).

Discrepancies in mother and child perceptions of spina bifida medical responsibilities during the transition to adolescence: associations with family conflict and medical adherence

OBJECTIVE

This study investigated mother-child discrepancies over perceptions of who is responsible for spina bifida (SB) medical tasks in relation to family conflict and medical adherence.

METHOD

140 youth with SB and their mothers completed questionnaires regarding who is responsible for specific SB medical tasks, family conflict, and medical adherence. An observational measure was also used to assess family conflict.

RESULTS

Although children viewed themselves as more responsible for medical management than mothers did, mother-child discrepancies were not associated with family conflict or medical adherence. Interaction effects revealed that adherence was better when family conflict was low and when parents were responsible for medical tasks.

CONCLUSIONS

Parental involvement in SB medical care is essential for optimal medical adherence during adolescence. The presence of family conflict also plays an influential role on SB medical adherence. Future research should evaluate the relations between discrepancies, family conflict, and medical adherence across time.

Understanding parent-child social informant discrepancy in youth with high functioning autism spectrum disorders

We investigated discrepancies between parent- and self-reported social functioning among youth with autism spectrum disorders (ASD). Three distinct samples showed discrepancies indicating that parents viewed their children as performing one standard deviation below a standardization mean, while youth viewed themselves as comparably-skilled relative to peers. Discrepancies predicted lower parental self-efficacy, and lower youth-reported hostile attributions to peers, marginally-lower depression, and decreased post-treatment social anxiety. Discrepancies predicted outcomes better than parent- or youth-report alone. Informant discrepancies may provide valuable additional information regarding child psychopathology, parental perceptions of parenting stress, and youth treatment response. Findings support a model where abnormal self-perceptions in ASD stem from inflated imputation of subjective experiences to others, and provide direction for improving interventions for youth and parents.

Adolescent attachment security, family functioning, and suicide attempts

Theories of suicidal behavior suggest that the desire to die can arise from disruption of interpersonal relationships. Suicide research has typically studied this from the individual's perspective of the quality/frequency of their social interactions; however, the field of attachment may offer another perspective on understanding an individual's social patterns and suicide risk. This study examined attachment along with broader family functioning (family adaptability and cohesion) among 236 adolescent psychiatric inpatients with (n = 111) and without (n = 125) histories of suicide attempts. On average, adolescents were 14 years of age and Hispanic (69%). Compared to those without suicide attempts, adolescent attempters had lower self-reported maternal and paternal attachment and lower familial adaptability and cohesion. When comparing all three types of attachment simultaneously in the logistic regression model predicting suicide attempt status, paternal attachment was the only significant predictor. Suicide attempt group was also significantly predicted by self-rated Cohesion and Adaptability; neither of the parent ratings of family functioning were significant predictors. These findings are consistent with the predictions of the Interpersonal Theory of Suicide about social functioning and support the efforts to develop attachment-based interventions as a novel route towards suicide prevention.

Discrepancies between parent and adolescent beliefs about daily life topics and performance on an emotion recognition task

Parents and children and adolescents commonly disagree in their perceptions of a variety of behaviors, including the family relationship and environment, and child and adolescent psychopathology. To this end, numerous studies have examined to what extent increased discrepant perceptions-particularly with regard to perceptions of the family relationship and environment-predict increased child and adolescent psychopathology. Parents' and children and adolescents' abilities to decode and identify others' emotions (i.e., emotion recognition) may play a role in the link between discrepant perceptions and child and adolescent psychopathology. We examined parents' and adolescents' emotion recognition abilities in relation to discrepancies between parent and adolescent perceptions of daily life topics. In a sample of 50 parents and adolescents ages 14-to-17 years (M = 15.4 years, 20 males, 54 % African-American), parents and adolescents were each administered a widely used performance-based measure of emotion recognition. Parents and adolescents were also administered a structured interview designed to directly assess each of their perceptions of the extent to which discrepancies existed in their beliefs about daily life topics (e.g., whether adolescents should complete their homework and carry out household chores). Interestingly, lower parent and adolescent emotion recognition performance significantly related to greater parent and adolescent perceived discrepant beliefs about daily life topics. We observed this relation whilst accounting for adolescent age and gender and levels of parent-adolescent conflict. These findings have important implications for understanding and using informant discrepancies in both basic developmental psychopathology research and applied research in clinic settings (e.g., discrepant views on therapeutic goals).

Individuation of female adolescents: relations with adolescents' perceptions of maternal behavior and with adolescent-mother discrepancies in perceptions

The study examined how individuality and connectedness of female adolescents relate to their perceptions of maternal behavior and to adolescent-mother discrepancies in perceptions of maternal behavior. Seventy 16.5-year-old daughters and their mothers participated in the study. Individuality and connectedness of the daughters were assessed from observed daughter-mother interactions. The perceptions of daughters and mothers regarding maternal behavior were assessed using a video recall procedure. Daughters' negative perceptions of maternal behavior were associated with higher individuality. Daughter-mother discrepancies in perceptions of maternal behavior were related to lower connectedness of the daughters. Finally, daughters who showed high individuality at the expense of connectedness had more discrepancies in perceptions with their mothers compared to daughters that balanced between moderate-to-high individuality and connectedness. These findings underscore the importance of assessing daughters and mothers' perceptions of their interactions at the individual as well as the dyadic levels for understanding daughters' behavior during communication with their mothers.

Are clinicians' assessments of improvements in children's functioning "global"?

In this study, the authors examined the relations among clinician ratings of treatment improvement and discrepancies between parent and blinded laboratory rater reports of child social functioning administered before and after treatment for social anxiety disorder. Participants included a clinic sample of 101 children (7-16 years old; M = 11.67, SD = 2.57; 51 girls, 81% Caucasian) receiving treatment as part of a two-site controlled trial. Overall, clinician ratings reflected lack of improvement when parents reported persistent (i.e., pre- to posttreament) social functioning deficits not reported by blinded raters. However, when blinded raters reported persistent social skill deficits not reported by parents, we did not observe the same effect on clinician ratings as we did when the direction of discrepant reports was reversed. We replicated these observations in a subset of participants (n = 81) providing parent and child pre-post reports of social anxiety symptoms. These findings have implications for the interpretations of clinical ratings as "primary outcome measures" within controlled trials.

Internal consistency and associated characteristics of informant discrepancies in clinic referred youths age 11 to 17 years

In this study, we examined the internal consistency of informant discrepancies in reports of youth behavior and emotional problems and their unique relations with youth, caregiver, and family characteristics. In a heterogeneous multisite clinic sample of 420 youths (ages 11-17 years), high internal consistency estimates were observed across measures of informant discrepancies. Further, latent profile analyses identified systematic patterns of discrepancies, characterized by their magnitude and direction (i.e., which informant reported greater youth problems). In addition, informant discrepancies systematically and uniquely related to informants' own perspectives of youth mood problems, and these relations remained significant after taking into account multiple informants' reports of informant characteristics widely known to relate to informant discrepancies. These findings call into question the prevailing view of informant discrepancies as indicative of unreliability and/or bias on the part of informants' reports of youths' behavior.

Discrepancies in perceptions of maternal aggression: implications for children of methadone-maintained mothers

Despite a long history of documenting discrepancies in parent and child reports of parental care and child psychopathology, it has only been in recent years that researchers have begun to consider these discrepancies as meaningful indicators of parent-child relationship quality and as predictors of long-term child adjustment. Discrepancies in perceptions of parenting may be particularly important for the children of mothers with a history of substance abuse who may be less aware of the impact of their behavior on their child and of their child's internalizing symptoms. This study examined associations between (a) mother-child discrepancies in reports of maternal aggression, and (b) mother and child reports of child internalizing and externalizing symptoms. Data collected from 99 mother-child dyads (with children 4-16 years of age) during the baseline phase of a randomized clinical trial testing a parenting intervention were used in this study. Measures included parent and child versions of the Parental Acceptance-Rejection Questionnaire and the Behavioral Assessment Scale for Children. Findings indicated that as children viewed their mothers as increasingly more aggressive than mothers viewed themselves, children reported more internalizing and externalizing symptoms but mothers only reported more child externalizing symptoms. Mother-child discrepancies in reports of parenting behavior have potentially meaningful implications for child emotional and behavioral problems.

The relations among measurements of informant discrepancies within a multisite trial of treatments for childhood social phobia

Discrepancies between informants' reports of children's behavior are robustly observed in clinical child research and have important implications for interpreting the outcomes of controlled treatment trials. However, little is known about the basic psychometric properties of these discrepancies. This study examined the relation between parent-child reporting discrepancies on measures of child social phobia symptoms, administered before and after treatment for social phobia. Participants included a clinic sample of 81 children (7-16 years old [M = 11.75, SD = 2.57]; 39 girls, 42 boys) and their parents receiving treatment as part of a multisite controlled trial. Pretreatment parent-child reporting discrepancies predicted parent-child discrepancies at posttreatment, and these relations were not better accounted for by the severity of the child's pretreatment primary diagnosis. Further, treatment responder status moderated this relation: Significant relations were identified for treatment non-responders and not for treatment responders. Overall, findings suggest that informant discrepancies can be reliably employed to measure individual differences over the course of controlled treatment trials. These data provide additional empirical support for recent work suggesting that informant discrepancies can meaningfully inform understanding of treatment response as well as variability in treatment outcomes.

The longitudinal consistency of mother-child reporting discrepancies of parental monitoring and their ability to predict child delinquent behaviors two years later

This study examined the longitudinal consistency of mother-child reporting discrepancies of parental monitoring and whether these discrepancies predict children's delinquent behaviors 2 years later. Participants included 335 mother/female-caregiver and child (46% boys, >90% African American; age range 9-16 years [M = 12.11, SD = 1.60]) dyads living in moderate-to-high violence areas. Mother-child discrepancies were internally consistent within multiple assessment points and across measures through a 2-year follow-up assessment. Further, mothers who at baseline consistently reported higher levels of parental monitoring relative to their child had children who reported greater levels of delinquent behaviors 2 years later, relative to mother-child dyads that did not evidence consistent discrepancies. This finding could not be accounted for by baseline levels of the child's delinquency, maternal and child emotional distress, or child demographic characteristics. This finding was not replicated when relying on the individual reports of parental monitoring to predict child delinquency, suggesting that mother-child reporting discrepancies provided information distinct from the absolute frequency of reports. Findings suggest that mother-child discrepancies in reports of parental monitoring can be employed as new individual differences measurements in developmental psychopathology research.

Linking informant discrepancies to observed variations in young children's disruptive behavior

Prior work has not tested the basic theoretical notion that informant discrepancies in reports of children's behavior exist, in part, because different informants observe children's behavior in different settings. We examined patterns of observed preschool disruptive behavior across varying social contexts in the laboratory and whether they related to parent-teacher rating discrepancies of disruptive behavior in a sample of 327 preschoolers. Observed disruptive behavior was assessed with a lab-based developmentally sensitive diagnostic observation paradigm that assesses disruptive behavior across three interactions with the child with parent and examiner. Latent class analysis identified four patterns of disruptive behavior: (a) low across parent and examiner contexts, (b) high with parent only, (c) high with examiner only, and (d) high with parent and examiner. Observed disruptive behavior specific to the parent and examiner contexts were uniquely related to parent-identified and teacher-identified disruptive behavior, respectively. Further, observed disruptive behavior across both parent and examiner contexts was associated with disruptive behavior as identified by both informants. Links between observed behavior and informant discrepancies were not explained by child impairment or observed problematic parenting. Findings provide the first laboratory-based support for the Attribution Bias Context Model (De Los Reyes and Kazdin Psychological Bulletin 131:483-509, 2005), which posits that informant discrepancies are indicative of cross-contextual variability in children's behavior and informants' perspectives on this behavior. These findings have important implications for clinical assessment, treatment outcomes, and developmental psychopathology research.