The validity of the multi-informant approach to assessing child and adolescent mental health.

Abstract

Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for “best practices” in using and interpreting multi-informant assessments in clinical work and research. This paper has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns.

Cross-Cultural Perspectives on Parent–Adolescent Discrepancies: Existing Findings and Future Directions

“…However, the mean r for Externalizing of .55 was larger than that reported for population samples (.46). This Externalizing [ Internalizing r effect for clinical samples is consistent with Achenbach et al (1987) and De Los Reyes et al (2015), both of which included many studies with clinical samples. Cross-informant rs varied less across societies in the seven clinical samples (.42-.55) than in the 25 population samples (.17-.58).…”

“…Despite using 341 studies not analyzed in the 1987 review and employing somewhat different statistical procedures, De Los Reyes et al (2015) found essentially the same mean r of .28 between different kinds of informants observed by Achenbach et al (1987). Furthermore, they replicated the previous finding of better agreement for externalizing than internalizing problems, as well as the finding that mother-father agreement was better than agreement between informants who play different roles with the child (e.g., parent vs. teacher, parent vs. adolescent, etc.).…”

“…If the Achenbach et al (1987) meta-analysis served as the opening chapter in a 25-year research effort focused on the ubiquity of cross-informant discrepancy, the ways it can be measured, and the factors contributing to it, one might argue that the final chapter is the De Los Reyes et al (2015) meta-analysis of 341 studies dealing with adolescent mental health published since the Achenbach review. As De Los Reyes and colleagues note, a major purpose of their review was to determine if the Achenbach et al (1987) findings had ''stood the test of time.''…”

Introduction to the Special Issue: Discrepancies in Adolescent–Parent Perceptions of the Family and Adolescent Adjustment

“…For adults, selfreports and clinician ratings may be the most often used sources, although over the last decade, researchers have increasingly leveraged reports from collateral informants, such as significant others of the adults being assessed (e.g., spouses, caregivers in the case of elderly adults; Achenbach 2006). Over 50 years of work across hundreds of investigations of informants' reports of children, adolescents, and adults indicates that mean cross-informant correspondence hovers in the low-to-moderate range (e.g., Pearson r's in the .20 s-.40 s; Achenbach et al 1987Achenbach et al , 2005De Los Reyes et al 2015b). However, correspondence does not remain uniform across informants.…”

“…Using this approach, researchers gather reports from those involved in family interactions (e.g., parents and adolescents). Multiple informants' reports may also be augmented by data from other sources, such as independent observers' ratings of family interactions (e.g., level of warmth or hostility displayed within a laboratory-based family discussion task; De Los Reyes et al 2015b), or direct assessments of physiological processes as they manifest within relevant contexts (e.g., elevations in arousal or decreased physiological flexibility displayed during computer-based tasks, unstructured home observations, periods of social stress, or a resting period; Aldao and De Los Reyes 2015;De Los Reyes et al 2015a;De Los Reyes and Aldao 2015;Cohen et al 2015;Franklin et al 2015;Leitzke et al 2015;McLaughlin et al 2015;Youngstrom and De Los Reyes 2015). Further, a key focus of this approach involves collecting assessments of psychosocial outcomes commonly linked to family functioning, such as adolescent psychosocial functioning, which may also leverage multi-informant, multi-method measurement approaches (e.g., reports of adolescents' mental health from adolescents, parents, teachers, clinicians, and independent observers).…”