Informant Discrepancies in Clinical Reports of Youths and Interviewers' Impressions of the Reliability of Informants

Abstract

Objective: In this study the authors examined whether discrepancies between parent and youth reports of the youth's emotional and behavioral functioning are related to interviewers' reliability ratings of parents and youths. Methods: In a consecutive case series analysis of 328 parents and youths aged 11-17 years, parents and youths provided reports of youth emotional and behavioral functioning and participated in structured clinical interviews. At the conclusion of the interviews, interviewers rated the reliability of informants. Interviewers rated youths' clinical severity and parents and youths provided information on youth demographics. Nominal logistic regressions tested patterns of discrepancies between parent and youth reports (i.e., which informant consistently reported greater degrees of youth emotional and behavioral concerns than the other) as predictors of interviewers' ratings of the reliability of parents and youths. All analyses controlled for variance explained by youth demographics and youth severity. Results: When parents reported greater degrees of youth emotional and behavioral concerns than youths self-reported, interviewers were likely to rate the youth as an unreliable informant, and were unlikely to rate the youth as an unreliable informant when parents reported less concerns than youths self-reported. However, interviewers' ratings of parents' reliability did not relate to the discrepancies between reports, regardless of which informant reported greater degrees of youth concerns. Conclusions: Prior research indicates that informant discrepancies potentially reveal important information of youths' emotional and behavioral concerns, such as the settings in which youths express these concerns. Yet, when parents and youths disagree in their clinical reports of the youth's functioning, this relates to whether a clinical interviewer views the youth as a reliable informant of their own functioning. To increase the cost-effectiveness and clinical utility of multi-informant clinical evaluations, practitioners and researchers should anticipate informant discrepancies and predict what they may represent before conducting clinical evaluations.

Examining the Rule of Thumb of Not Using Multilevel Modeling: The “Design Effect Smaller Than Two” Rule

“…In another study on victimization and bullying among 73 children among 46 classrooms and 18 schools (Bonnet, Goossens, & Schuengel, 2011), the authors reasoned that as the average number of children in a classroom was 1.6, the design effect must be smaller than 2, and they chose the single-level regression analysis rather than the multilevel model. From our literature review in PsycINFO and ERIC, we found many similar studies in the field of education using this rule as a justification for not using multilevel models for multilevel/clustered data (e.g., Bouman et al, 2012;De Los Reyes et al, 2011;Deng et al, 2006;Hong & You, 2012;Linnenbrink-Garcia, Rogat, & Koskey, 2011;Ly, Zhou, Chu, & Chen, 2012;Von Grünigen, Kochenderfer-Ladd, Perren, & Alsaker, 2012;Wong et al, 2006). This rule was also commonly used in other research areas such as psychology (e.g., Corte & Zucker, 2008;Wagner, Christ, Pettigrew, Stellmacher, & Wolf, 2006), business (Qureshi & Fang, 2011), and medical science (Fuentes, Hart-Johnson, & Green, 2007).…”

Cognitive-Behavioral Therapy for Anxiety in Children With High-Functioning Autism: A Meta-analysis

“…60 Regarding the discrepancy between parent and child reports of anxiety, it is noteworthy that cross-informant disagreements are a norm rather than the exception in assessment of child psychopathology. 61,62 It is possible that children do not perceive their anxiety symptoms as being as troublesome as their parents do, which would attenuate the change in child self-report from pretreatment to posttreatment. Thus, parent ratings commonly reveal greater levels of anxiety in children with ASD than child selfreports.…”

Can We Use Convergence Between Caregiver Reports of Adolescent Mental Health to Index Severity of Adolescent Mental Health Concerns?

“…Thus, one cannot simply take reports from an adolescent's caregivers, compute their scores, and then choose a single caregiver's report at random to use in research or clinical work, assuming that conclusions drawn from one report will mirror those from the other. Consequently, researchers and practitioners alike often encounter a great deal of uncertainty making decisions when multiple informants' reports yield distinct conclusions (e.g., De Los Reyes et al 2011d;Hawley and Weisz 2003;Yeh and Weisz 2001).…”