Adolescents', parents', and teachers' distress over adolescents' behavior

This study evaluated adolescents', parents', and teachers' self-reported distress and wishes to change adolescents' emotional/behavioral problems in a sample of clinically referred adolescents. Parents reported being bothered more than adolescents or teachers by adolescents' internalizing behavior. Both parents and teachers rated adolescents' externalizing behavior as more bothersome than did adolescents. Adolescents were significantly less likely to want to change their behavior than were parents or teachers. In addition, adolescents were significantly more likely to want to change their internalizing problems than their externalizing problems. For all three informants, being bothered by adolescents' behaviors was strongly associated with a desire to change the behaviors. Clinical implications of these findings are discussed.The authors wish to thank John Iriye and Alisa Waldman for their invaluable help as research assistants.     

Accuracy of Informants: Do Parents Think That Mother Knows Best?

A total of 200 mothers and fathers provided their opinions as to the accuracy of mothers, fathers, teachers, children's peers, and children themselves as informants of children's emotional/behavioral problems. The results showed that mothers and fathers had very similar patterns of perceptions of accuracy, although fathers' ratings showed less differentiation between informants than did mothers' ratings. Patterns were very similar for reports on children and adolescents. Overall, mothers were perceived to be more accurate in reporting internalizing problems; mothers and teachers (and fathers to a lesser extent) were perceived to be more accurate in reporting externalizing problems; mothers, fathers, and teachers were seen as more accurate in reporting children's adaptive behaviors, and mothers, fathers, and children were seen as more accurate in reporting family problems. The results are discussed in the context of multiple informants of children's and adolescents' emotional/behavioral problems.     

Agreement of informants on emotional and behavioral problems from childhood to adulthood

Agreement among informants' ratings of children's and adults' internalizing and externalizing problems is moderate. Each informant contributes unique information about an individual's problems. Thus, it has been advocated to obtain ratings from multiple sources in child psychiatry, whereas adult psychiatry relies mostly on self-reports. Longitudinal studies repeatedly assessing children's psychiatric problems from childhood into adulthood and including reports from multiple informants could serve as benchmarks for studies including only selected time points or informants. We examined the development of agreement among informants' ratings of internalizing and externalizing problems using self-, parent, teacher, and partner reports in a longitudinal study with 7 assessment waves spanning an interval of 24 years and covering an age range of 4 to 40 years. The number of informant pairs is 12,059, who rated 1,875 individuals. The results revealed that correlations among informant ratings of internalizing and externalizing problems depend more on the informant pair than on problem type or age group. Second, differences among informants rating internalizing problems typically become larger when individuals get older. Third, when rating themselves, individuals typically report higher scores than do parents, teachers, or partners. These results were consistent for internalizing and externalizing problems and across age groups. The findings indicate that like in child psychiatry, assessment in adult psychiatry may benefit from a shift to multiple informant reports, as different informants' ratings may contain more information than if informants completely agree.     

Parent and Teacher Agreement of Behavior Problems in Youth Diagnosed With and Without Autism Spectrum Disorders

The prevalence and severity of behavioral problems in youth with autism spectrum disorders (ASD) may be context dependent leading to discrepant informants’ reports and complicating case conceptualizations and treatment goals. This study examines the inter-rater agreement of parents and teachers on behavioral problems of 58 youth with ASD and 42 youth without an ASD diagnosis. Parents and teachers of 26 youth with ASD (M?=?4.08, SD?=?1.02) and 21 youth with non-ASD diagnoses (M?=?4.38, SD?=?0.80), ages 2–5 years, and 32 youth with ASD (M?=?7.47, SD?=?1.44), and 21 youth with non-ASD diagnoses (M?=?7.71, SD?=?1.23), ages 6–10, completed the Child Behavior Checklist and Teacher Report Form. Compared to youth with a non-ASD diagnosis (ages 2–5 years), youth with ASD also had poor to moderate agreement across subscales with the exception of comparable substantial agreement on Externalizing Behavior (ICC?=?0.73 and ICC?=?0.63, respectively) and Aggressive Behavior subscales (ICC?=?0.72 and ICC?=?0.69, respectively). Compared to youth with a non-ASD diagnosis (ages 6–10 years), youth with ASD similarly had poor agreement across subscales with the exception of moderate agreement on Anxious/Depressed subscale (ICC?=?0.41 and ICC?=?0.06, respectively). These results suggest that the severity and prevalence of behavior problems in youth may depend on the context and reporter of the symptoms.     

Comparison of Mothers', Fathers', and Teachers' Reports on Problem Behavior in 5- to 6-Year-Old Children

Evidence exists that there is low agreement between multiple informants reporting on children's and adolescents' behavior problems. Few studies, however, focus on agreement between informants in specific age groups. This study examined correspondence and disagreement between mother, father, and teacher reports of problem behavior by analyzing CBCL and TRF data of 2 nonclinical samples of 5- to 6-year-old preschool children (N = 424). Findings indicated that interrater agreement was low to moderate. This was shown by the intercorrelations, the explained variance in regression analyses and the little overlap in the number of children rated as behaviorally disturbed by all 3 informants. Agreement between mother and father reports was highest, whereas agreement between mother and teacher reports was lowest. Disagreement between informants was highest for internalizing problems. Potential explanations for the lack of agreement are discussed. Guidelines are formulated to refine assessment and optimize clinical decision-making processes.     

Parent Informants for Child Personality: Agreement,Discrepancies, and Clinical Utility

A long-standing issue in child clinical research is the integration of various informants, but this topic has not been comprehensively applied to the domain of child personality. Mothers and fathers rated their children (N = 346) on personality traits and behavioral problems. Mother–father agreement was highest for Conscientiousness and lowest for Neuroticism and Agreeableness. Each parent's ratings added incremental variance in predicting behavioral problems, and mother–father discrepancy predicted internalizing problems. These results suggest that both parents should be used as informants in child personality assessment and discrepancies might reflect meaningful variance with clinical utility.     

Lateralized brain injury and behavior problems in children

This study investigated the types of behavior problems found in children with lateralized brain lesions. Children referred for neuropsychological assessment were assigned to dominant (DH) or nondominant (NDH) groups on the basis of history of neurological disease or injury, findings on neurological examination, functional and structural laboratory findings, and neuropsychological assessment. Over two-thirds fell into the clinical range of behavior problems by parental report on the Achenbach Child Behavior Checklist. Degrees of pathology were nearly equal. DH children showed more externalizing than internalizing symptomatology. NDH children showed more internalizing than externalizing behavior problems. Results are discussed in terms of symptom formation based on lateralization of lesion.     

Assessment of incarcerated juvenile delinquents: Agreement across raters and approaches to psychopathology

The purpose of the current study was to examine the agreement across three informants (youth, teacher, caretaker) when rating behaviors of incarcerated juvenile delinquents. Furthermore, the agreement between a dimensional approach (Child Behavior Checklist) and a categorical approach (DSM-III-R) of assessing behavior was examined. Fifty-two delinquent youth were assessed with a structured interview. In addition, the youth, teacher, and caretaker completed the Child Behavior Checklist (CBCL). The results indicated significant correlations across the teacher and caretaker for externalizing types of problems. The youth report form of the CBCL did not correspond to either adult informant. However, the ratings by the teacher and caretaker were related to externalizing types of problems, primarily hyperactivity/inattention, derived from the structured interview with the delinquent. The results suggest that, in the psychological assessment of incarcerated juvenile delinquents, agreement across informants is dependent on multiple factors, including type of behavior assessed and the approach utilized in assessment.This work was supported, in part, by the Juvenile Justice Coordinating Council of Georgia, the Office of Juvenile Justice and Delinquency Prevention, and the University of Georgia's Institute for Behavioral Research.     

Do Mothers and Fathers Assess their Children's Behavioral Problems in the Same Way as do their Children? An IRT Investigation on the Strengths and Difficulties Questionnaire

This study investigated the equivalence of different types of informants, such as children (or early adolescents) and parents, in evaluating child externalizing and internalizing problems. We applied a polytomous item response theory (IRT) model for the Strengths and Difficulties Questionnaire (SDQ). We obtained responses to three subscales—Conduct Problems, Hyperactivity/Inattention, and Emotional Symptoms—from 541 elementary school students aged 10–12 years, fathers for 233 students, mothers for 275 students, and the homeroom teachers for 524 students. Expected values on the individual item calculated by the discrimination and threshold parameters were compared among students, fathers, and mothers as an investigation of differential item functioning (DIF) or differential informant functioning. Assessing either externalizing or internalizing problems were mostly equivalent between fathers and mothers, and most items for externalizing problems functioned equally between students and parents, whereas items for internalizing problems showed DIF between them. IRT also yielded that the intervals of response categories varied across items, particularly for the conduct problems items “fight” and “steal,” and positively worded items showed an extremely low threshold.     

When to Use Broader Internalising and Externalising Subscales Instead of the Hypothesised Five Subscales on the Strengths and Difficulties Questionnaire (SDQ): Data from British Parents,Teachers and Children

The Strengths and Difficulties Questionnaire (SDQ) is a widely used child mental health questionnaire with five hypothesised subscales. There is theoretical and preliminary empirical support for combining the SDQ’s hypothesised emotional and peer subscales into an ‘internalizing’ subscale and the hypothesised behavioral and hyperactivity subscales into an ‘externalizing’ subscale (alongside the fifth prosocial subscale). We examine this using parent, teacher and youth SDQ data from a representative sample of 5–16 year olds in Britain (N = 18,222). Factor analyses generally supported second-order internalizing and externalizing factors, and the internalizing and externalizing subscales showed good convergent and discriminant validity across informants and with respect to clinical disorder. By contrast, discriminant validity was poorer between the emotional and peer subscales and between the behavioral, hyperactivity and prosocial subscales. This applied particularly to children with low scores on those subscales. We conclude that there are advantages to using the broader internalizing and externalizing SDQ subscales for analyses in low-risk samples, while retaining all five subscales when screening for disorder.     

多主体评定青少年外化问题行为的一致性问题

以529名城乡初一学生为被试进行短期追踪研究,考察了青少年自我、同伴和教师三种主体对学校情境中的青少年外化问题行为评定的一致性问题。采用相关分析、多质多法分析、验证性因素分析和检出率分析对三种主体的评定结果进行了分析比较。结果显示,青少年自我、同伴和教师对外化问题行为的评定只存在中低程度的一致性;通过同伴评定测得的四种外化问题行为群之间的相关性高于通过教师评定和自我报告测得的结果,而自我报告测得的四种外化问题行为群之间的相关性最低。不同报告主体对青少年外化问题行为评定的跨时间稳定性存在差异,同伴评定的稳定性最高,其次为教师评定,青少年自我报告的稳定性最低。通过同伴评定测得的结果对多主体评定的解释率高于教师评定和自我报告的结果,自我报告的结果对多主体评定的解释率最低。三种主体所检出的不同形式的外化问题行为的人数比例没有呈现出规律性的差异,只有通过同伴评定检出的不同形式的外化问题行为者的人数比例随着检出标准的提高而减小     

Comparing Four Methods of Integrating Parent and Teacher Symptom Ratings of Attention-deficit/hyperactivity Disorder (ADHD)

Although parents and teachers are valid informants in the assessment of childhood attention-deficit/hyperactivity disorder (ADHD), there is relatively little systematic research on how these ratings should be optimally combined. We compared four methods of ADHD assessment to determine how well they identified impaired children: (1) parent only, (2) teacher only, (3) parent or teacher (‘or rule’), and (4) parent and teacher (‘and rule’). We obtained parent and teacher ratings of ADHD from the Disruptive Behavior Disorder Rating Scale on 232 5- to 10-year-old children (69% male; 47% Caucasian) with (n = 121) and without (n = 111) ADHD. We used receiver operating characteristic curves (ROC) and seemingly unrelated regression analyses (SUR) to evaluate how accurately each method identified categorically- and dimensionally-defined measures of functional impairment. Parent ratings of ADHD optimally identified globally impaired children based on categorical and dimensional measures. However, teacher ratings of ADHD most accurately identified children who were negatively regarded by peers using categorical, but not dimensional, measures. No ADHD assessment method effectively identified children with academic difficulties. Although multiple informants are valuable in the assessment of ADHD, no single method was consistently superior in identifying impaired children across domains. We consider alternative assessment strategies in ADHD as well as other potential factors that may contribute to modest agreement among informants.     

Application of a Multitrait-Multimethod Matrix to Social,Emotional, and Behavioral Screening

The authors' purpose was to evaluate the multiple-gate Preschool Behavior Screening System (PBSS) for identifying children's social, emotional, and behavioral (SEB) difficulties. The sample included 122 triads of preschool children between 3 and 5 years old and their parents and teachers. The teacher and parent samples were predominantly women and European American with a substantial African American representation. The design involved numerous indicators of the reliability of scores and the validity of ensuing inferences. Scores from the Behavior Assessment System for Children, Second Edition were used as criterion measures for scores from the PBSS. The PBSS scores were found reliable across scales with Cronbach's alpha values ranging from.85 to.97. Agreement between teachers and parents was consistent with findings from previous research. Analyzed within a Multitrait-Multimethod Matrix, correlational evidence supported inferences about externalizing difficulties, prosocial behavior, and total problems, as well as internalizing difficulties to a lesser degree. Receiver-operating characteristic curve analyses supported the PBSS across a range of scales and cut scores. Findings support the use of the PBSS as one method for identifying preschool children who may be at risk for SEB difficulties and underscore the importance of using multiple informants in the assessment of SEB difficulties.     

Strengths-Based Assessment of Children with SED: Consistency of Reporting by Teachers and Parents

Parents and teachers rated the strengths of a group of 20 children diagnosed as having serious emotional disturbance. The degree of consistency between different informants' reports was examined to determine whether certain items and scales on the Behavioral and Emotional Rating Scale (BERS) were more appropriately answered by different sources or in different situations, and whether there were method effects associated with each group. A repeated measures ANOVA and correlations between the informants on each subscale demonstrated significant convergent and discriminant validity as well as possible assessment biases. Results also supported the need for developing separate norms for different informants.     

Moderators of informant agreement in the assessment of adolescent psychopathology: extension to a forensic sample

A well-documented finding in developmental psychopathology research is that different informants often provide discrepant ratings of a youth's internalizing and externalizing problems. The current study examines youth- and parent-based moderators (i.e., youth age, gender, and IQ; type of psychopathology; offense category; psychopathic traits; parental education, income, and stress) of informant discrepancies in a sample of young offenders and compares the utility of youth and caregiver reports against relevant clinical outcomes. Results indicate that gender moderated the discrepancy between informant reports of somatic complaints, while parenting stress moderated the discrepancies across reports of internalizing and externalizing psychopathology. Variables unique to the forensic context (e.g., offense category) were found to moderate cross-informant discrepancies in reports of internalizing and externalizing psychopathology. Further, youth self-reports of internalizing symptoms predicted a clinician-generated diagnosis of a mood disorder, while caregiver reports of aggressive behaviors predicted the presence of an externalizing diagnosis. Results highlight the importance of assessing informant agreement in the context of forensic assessment and raise questions surrounding the optimal use of informant data in this setting.     

The Student Guided Functional Assessment Interview: An Analysis of Student and Teacher Agreement

Functional assessment strategies are used to guide the treatment of problem behavior with individuals who have severe disabilities. Also, researchers have extended functional assessment applications to individuals with emotional and behavioral disabilities. One such extension is the use of students as informants in the functional assessment process. The present study assessed an interview tool designed to elicit information directly from students regarding their problem behaviors. We examined agreement between students and their teachers. Results showed high agreement on the causes and functions of problem behavior with mixed agreement on support plan recommendations.     

Maternal Sensitivity: a Resilience Factor against Internalizing Symptoms in Early Adolescents Born Very Preterm?

Compared with full-terms, preterm individuals are more at risk from infancy to adulthood for developing internalizing symptoms. Early maternal interactive behavior, especially maternal sensitivity, has been found to be a resilience factor in the developmental outcome of preterm children. The present longitudinal study aimed at examining whether early interactive parenting behaviors have a long term impact on the internalizing symptoms of preterm-born young adolescents. A total sample of 36 very preterm and 22 full-term children participated in an 11-year follow-up study. Maternal interactive behavior was assessed during a mother–infant interaction when the infant was 18 months old. At 11 years, internalizing symptoms were assessed with the Child Behavior Checklist (CBCL). Hierarchical regression analyses revealed that the interaction between groups (preterm/full-term) and maternal sensitivity at 18 months significantly explained CBCL internalizing symptoms at 11 years (β = ?0.526; p < 0.05). Specifically, although prematurity was related to internalizing problems, preterm children with higher maternal sensitivity did not differ from their full-term-born peers on the CBCL internalizing problems domain. These results suggest that maternal sensitivity is a long-term resilience factor preventing the development of internalizing problems at early adolescence in very preterm individuals.     

Evaluating anxiety and depression symptoms in children and adolescents with prior mild traumatic brain injury: Agreement between methods and respondents

Psychological functioning can be adversely impacted after a mild traumatic brain injury (mTBI) and may be a potential target for intervention. Despite the use of symptom ratings or structured diagnostic interview to assess long-term anxiety and depression symptoms in children and adolescents post-injury, no known studies have considered the agreement between different assessment methods and between respondents. The objectives of this study were to investigate the agreement between symptom ratings and structured diagnostic interview and between children and parents’ symptom reporting. Participants (N = 33; 9–18 years old) were recruited from the Emergency Department and assessed on average 22.8 months (SD = 5.6) after their mTBI. Anxiety and depression symptoms were evaluated via subscales of a questionnaire (Behavior Assessment System for Children) and parts of a computerized structured diagnostic interview (generalized anxiety disorder and major depressive episode; Diagnostic Interview Schedule for Children – C-DISC-IV) administered individually to children and their parents. Results showed that the inter-method agreement to identify high levels of anxiety and depression was moderate to perfect in children while it was lower in parents. Although a similar percentage of participants with elevated anxiety or depression were identified by both children and parents, the agreement between youth and parents was variable, ranging from poor to good for anxiety and poor to moderate for depression. These results highlight the importance of collecting youth and parents’ reports of anxiety and depression symptoms and considering potential discrepancies between informants’ answers.     

Behavioral Inhibition and Attentional Control in Adolescents: Robust Relationships with Anxiety and Depression

Behavioral inhibition (BI) has been associated with the development of internalizing disorders in children and adolescents. It has further been shown that attentional control (AC) is negatively associated with internalizing problems. The combination of high BI and low AC may particularly lead to elevated symptomatology of internalizing behavior. This study broadens existing knowledge by investigating the additive and interacting effects of BI and AC on the various DSM-IV based internalizing dimensions. A sample of non-clinical adolescents (N = 1806, age M = 13.6 years), completed the Behavioral Inhibition System/Behavioral Activation System Scales (BIS/BAS), the attentional control subscale of the Adult Temperament Questionnaire (ATQ) and the Revised Child Anxiety and Depression Scale (RCADS). As expected, BI was positively, and AC was negatively related to internalizing dimensions, with stronger associations of BI than of AC with anxiety symptoms, and a stronger association of AC than of BI with depressive symptoms. AC moderated the association between BI and all measured internalizing dimensions (i.e., symptoms of generalized anxiety disorder, social phobia, separation anxiety disorder, panic disorder, obsessive–compulsive disorder, and major depressive disorder). Since high AC may reduce the impact of high BI on the generation of internalizing symptoms, an intervention focused on changing AC may have potential for prevention and treatment of internalizing disorders.     

The Peer Informant: Characteristics Related to the Perceptions of Peer Behavior Problems

Victimization and rejection by peers leads to and exacerbates behavior problems in children and adolescents. Given the implications of problematic peer relations for adolescents who experience behavior problems, the present study examined factors that may be related to how adolescents perceive peers who exhibit such problems. Specifically, the present study examined the relationship of adolescent informants’ socioeconomic status, their prior exposure to psychological symptoms, their perceived social acceptance, and their own behavior problems to their perceptions of peers’ internalizing and externalizing behavior problems, their liking and disliking of peers who exhibit such problems, and their attributions for the etiology of such problems when portrayed by fictitious peers of the same age. In particular, adolescents were asked to rate a set of vignettes portraying internalizing and externalizing behavior problems that are seen commonly in peers and to complete a set of brief questionnaires. Results revealed that adolescents were able to perceive the presence of both internalizing and externalizing behavior problems in vignette characters. Additionally, vignette characters who did not exhibit behavior problems were most likely to be approached and liked, whereas those vignette characters who displayed externalizing behavior problems were more likely to be disliked and ignored. Finally, although adolescents endorsed both internal and external etiological factors, ratings were related to the sex of the depicted vignette character and the nature of the portrayed behavior problems. Overall, this study provided additional evidence that, although adolescents can serve as valuable informants, they also tended to be rejecting of peers who display behavior problems.