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

Abstract

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.

Figure 1

Latent profiles of standardized difference scores taken between caregiver and youth reports of youth behavior and emotional problems. The latent profiles included: Youth ≫ Caregiver = Youth Reports Much Greater on Average (n = 56); Youth > Caregiver = Youth Reports Slightly Greater on Average (n = 147); Caregiver > Youth = Caregiver Reports Slightly Greater on Average (n = 173); and Caregiver ≫ Youth = Caregiver Reports Much Greater on Average (n = 44). The eight points along the x-axis represent mean standardized difference scores across the eight syndrome scales of the Child Behavior Checklist (caregiver) and Youth Self-Report (youth report). We calculated these scores by independently standardizing caregiver and youth scores for each syndrome, and then subtracting youth scores on each syndrome scale from caregiver scores on the same syndrome scale. We structured the y-axis to conform to the properties of standardized difference scores (i.e., mean value of “0,” standard deviations of “1”).

Figure 2

Comparison of the four profiles of caregiver-youth agreement on ratings of youth mood, caregiver mood, family functioning, and youth impairment all scaled as “Percentage of Maximum Possible” (POMP) scores. The latent profiles included: Youth ≫ Caregiver = Youth Reports Much Greater on Average (n = 56); Youth > Caregiver = Youth Reports Slightly Greater on Average (n = 147); Caregiver > Youth = Caregiver Reports Slightly Greater on Average (n = 173); and Caregiver ≫ Youth = Caregiver Reports Much Greater on Average (n = 44). P-MDQ = Caregiver rating of youth manic symptoms on the Mood Disorder Questionnaire (MDQ); P-GBID = Caregiver rating of youth depressive symptoms on the Caregiver General Behavior Inventory (GBI); A-MDQ = Adolescent rating of own manic symptoms on MDQ; A-GBI-D = Adolescent ratings of own depressive symptoms on GBI; YMRS = Clinical interviewer ratings of youth manic symptoms on Young Mania Rating Scale; CDRS-R = Clinical interviewer ratings of youth depressive symptoms on Child Depression Rating Scale-Revised; P-MDQP = Caregiver ratings of own manic symptoms on MDQ; P-BDIP = Caregiver ratings of own depression on BDI; GFES = Clinical interviewer ratings of global family environment (reversed so that high scores show poorer functioning); FAD = caregiver ratings of family environment problems; CGI = Clinical Global Impressions rating by interviewer of youth impairment. * p < .001, two tailed; all other comparisons p > .05.