Effective Mental Health Screening in Adolescents: Should We Collect Data from Youth, Parents or Both?

Abstract

Youth- and parent-rated screening measures derived from the Strengths and Difficulties Questionnaire (SDQ) and Development and Well-Being Assessment (DAWBA) were compared on their psychometric properties as predictors of caseness in adolescence (mean age 14). Successful screening was judged firstly against the likelihood of having an ICD-10 psychiatric diagnosis and secondly by the ability to discriminate between community (N = 252) and clinical (N = 86) samples (sample status). Both, SDQ and DAWBA measures adequately predicted the presence of an ICD-10 disorder as well as sample status. The hypothesis that there was an informant gradient was confirmed: youth self-reports were less discriminating than parent reports, whereas combined parent and youth reports were more discriminating—a finding replicated across a diversity of measures. When practical constraints only permit screening for caseness using either a parent or an adolescent informant, parents are the better source of information.Electronic supplementary materialThe online version of this article (doi:10.1007/s10578-016-0665-0) contains supplementary material, which is available to authorized users.

The contribution of parent and youth information to identify mental health disorders or problems in adolescents

“…According to hypothesis 4, our findings confirm results of previous studies based on clinical settings that adolescent self-report show limited value for assessing ADHD [46, 47], CD [48], and ODD [32, 49]. Although some studies have previously found higher correlations between parent and youth reports for externalizing disorders [5–7, 19] and that self-reports can discriminate youth referred for conduct disorder from normal controls [50], our findings show limited additional value resulting from including self-reports to detect externalizing mental health problems in both the community and clinical samples. In clinical settings, youth may minimize problems to gain favorable reports from their clinicians.…”

“…The current study adds to previous findings on the validity of multi-informant assessments of mental disorders in youth [5, 19]. Unlike earlier studies, the present investigation is based on internet-based instruments only.…”

“…For detecting any mental health problems, information from both informants can be useful [19]. In a community sample, parent and youth information uniquely and indispensably contributed to later signs of maladjustment (referral to mental health services, need for professional help, and presence of a disorder) [20].…”

Examining the predictive validity of behavior screeners across measures and respondents

“…Thus, elementary school teachers may have a more intimate knowledge of typical pattern of social emotional responding for a particular child. Furthermore, students in middle and high school may be better able to recall their own psychological experiences compared to younger children who may lack the cognitive ability to do this (Dowdy & Kim, 2012; Kuhn et al, 2017). However, while older children may have the cognitive ability to report on their experiences, adolescence is a transitional life phase and there is active debate on which informant is best for reporting this age group (Kuhn et al, 2017).…”

“…Furthermore, students in middle and high school may be better able to recall their own psychological experiences compared to younger children who may lack the cognitive ability to do this (Dowdy & Kim, 2012; Kuhn et al, 2017). However, while older children may have the cognitive ability to report on their experiences, adolescence is a transitional life phase and there is active debate on which informant is best for reporting this age group (Kuhn et al, 2017). Thus, this study extends the literature by investigating the relationship between student and teacher respondents' answers within a high school setting on the SDQ and SRSS‐IE.…”