Skip to main content
SpringerLink
Log in

All Anxiety is not Created Equal: Correlates of Parent/Youth Agreement Vary Across Subtypes of Anxiety

  • Published:
Journal of Psychopathology and Behavioral Assessment Aims and scope Submit manuscript

Abstract

Research has examined patterns and correlates of parent/youth informant discrepancies in the reporting of youth anxiety. However, little work has examined whether it is better to conceptualize patterns and correlates of informant disagreement across anxiety broadly, or more useful to consider disagreement on specific symptom clusters. Using data from the Child Adolescent/Anxiety Multimodal Study (CAMS; N = 488; Walkup et al. The New England Journal of Medicine, 359(26), 2753-2766. doi:10.1056/NEJMoa0804633, 2008), the current study applied the most recent recommended analytic strategies to study informant discrepancies and examined differences in the magnitude and patterns of disagreement for: (a) broadband anxiety symptoms, versus (b) symptoms of specific anxiety diagnoses (or anxiety subtypes; e.g., separation, social anxiety). Correlates of informant discrepancies were also examined. Results indicated that there was variability in agreement across anxiety subtypes, with parent/youth agreement higher on separation anxiety and school refusal symptoms relative to other domains. Parental psychopathology was associated with disagreement on broadband anxiety symptoms, such that parental psychopathology was highest when parents reported higher symptoms than their children; however, this finding was largely driven by a relationship between parental psychopathology and disagreement on separation anxiety symptoms. Age was associated with disagreement on total and separation anxiety symptoms. Gender was not associated with disagreement. Clinical implications are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Achenbach, T. M. (2011). Commentary: definitely more than measurement error: but how should we understand and deal with informant discrepancies? Journal of Clinical Child and Adolescent Psychology, 40(1), 80–86. doi:10.1080/15374416.2011.533416.

    Article  PubMed  Google Scholar 

  • Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101(2), 213–232. doi:10.1037/0033-2909.101.2.213.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington: Author.

    Book  Google Scholar 

  • Berg-Nielsen, T., Vika, A. A., & Dahl, A. A. (2003). When adolescents disagree with their mothers: CBCL-YSR discrepancies related to maternal depression and adolescent self-esteem. Child: Care, Health and Development, 29(3), 207–213. doi:10.1046/j.1365-2214.2003.00332.x.

    Google Scholar 

  • Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. (1997). The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 545–553. doi:10.1097/00004583-199704000-00018.

    Article  PubMed  Google Scholar 

  • Birmaher, B., Brent, D. A., Chiappetta, L., Bridge, J., Monga, S., & Baugher, M. (1999). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a replication study. Journal of the American Academy of Child and Adolescent Psychiatry, 38(10), 1230–1236. doi:10.1097/00004583-199910000-00011.

    Article  PubMed  Google Scholar 

  • Boyle, M. H., Offord, D. R., Racine, Y. A., Szatmari, P., Sanford, M., & Fleming, J. E. (1997). Adequacy of interviews vs checklists for classifying childhood psychiatric disorder based on parent reports. Archives of General Psychiatry, 54(9), 793–799. doi:10.1001/archpsyc.1997.01830210029003.

    Article  PubMed  Google Scholar 

  • Brown, T. A., & Barlow, D. H. (2005). Dimensional versus categorical classification of mental disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and beyond: comment on the special section. Journal of Abnormal Psychology, 114(4), 551. doi:10.1037/0021-843X.114.4.551.

    Article  PubMed  Google Scholar 

  • Brown-Jacobsen, A. M., Wallace, D. P., & Whiteside, S. P. (2011). Multimethod, multi-informant agreement, and positive predictive value in the identification of child anxiety disorders using the SCAS and ADIS-C. Assessment, 18(3), 382–392. doi:10.1177/1073191110375792.

    Article  PubMed  Google Scholar 

  • Carlston, D. L., & Ogles, B. M. (2009). Age, gender, and ethnicity effects on parent–child discrepancy using identical item measures. Journal of Child and Family Studies, 18(2), 125–135. doi:10.1007/s10826-008-9213-2.

    Article  Google Scholar 

  • Choudhury, M. S., Pimentel, S. S., & Kendall, P. C. (2003). Childhood anxiety disorders: parent–child (dis)agreement using a structured interview for the DSM-IV. Journal of the American Academy of Child and Adolescent Psychiatry, 42(8), 957–964. doi:10.1097/01.CHI.0000046898.27264.A2.

    Article  PubMed  Google Scholar 

  • Comer, J. S., & Kendall, P. C. (2004). A symptom-level examination of parent–child agreement in the diagnosis of anxious youths. Journal of the American Academy of Child and Adolescent Psychiatry, 43(7), 878–886. doi:10.1097/01.chi.0000125092.35109.c5.

    Article  PubMed  Google Scholar 

  • Compton, S. N., Walkup, J. T., Albano, A., Piacentini, J. C., Birmaher, B., Sherrill, J. T., & March, J. S. (2010). Child/Adolescent Anxiety Multimodal Study (CAMS): rationale, design, and methods. Child and Adolescent Psychiatry and Mental Health, 4. doi:10.1186/1753-2000-4-1.

  • Costello, E., Egger, H. L., & Angold, A. (2005). The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. Child and Adolescent Psychiatric Clinics of North America, 14(4), 631–648. doi:10.1016/j.chc.2005.06.00.

    Article  PubMed  Google Scholar 

  • Costello, E. J., Egger, H. L., Copeland, W., Erkanli, A., & Angold, A. (2011). The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. In W. K. Silverman & A. P. Field (Eds.), Anxiety disorders in children and adolescents (pp. 56–75). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Cuthbert, B. N. (2014). The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry, 13(1), 28–35. doi:10.1002/wps.20087.

    Article  PubMed  PubMed Central  Google Scholar 

  • De Los Reyes, A. (2011). Introduction to the special section: More than measurement error: discovering meaning behind informant discrepancies in clinical assessments of children and adolescents. Journal of Clinical Child and Adolescent Psychology, 40(1), 1–9. doi:10.1080/15374416.2011.533405.

    Article  PubMed  Google Scholar 

  • De Los Reyes, A., & Kazdin, A. E. (2004). Measuring informant discrepancies in clinical child research. Psychological Assessment, 16(3), 330–334. doi:10.1037/1040-3590.16.3.330.

    Article  PubMed  Google Scholar 

  • De Los Reyes, A., & Kazdin, A. E. (2005). Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychological Bulletin, 131(4), 483–509. doi:10.1037/0033-2909.131.4.483.

    Article  PubMed  Google Scholar 

  • De Los Reyes, A., & Kazdin, A. E. (2006). Conceptualizing changes in behavior in intervention research: the range of possible changes model. Psychological Review, 113(3), 554–583. doi:10.1037/0033-295X.113.3.554.

    Article  PubMed  PubMed Central  Google Scholar 

  • De Los Reyes, A., Youngstrom, E. A., Pabón, S. C., Youngstrom, J. K., Feeny, N. C., & Findling, R. L. (2011). Internal consistency and associated characteristics of informant discrepancies in clinic referred youths age 11 to 17 years. Journal of Clinical Child & Adolescent Psychology, 40(1), 36–53. doi:10.1080/15374416.2011.533402.

    Article  Google Scholar 

  • De Los Reyes, A., Thomas, S. A., Goodman, K. L., & Kundey, S. M. (2013). Principles underlying the use of multiple informants’ reports. Annual Review of Clinical Psychology, 9, 123–149. doi:10.1146/annurev-clinpsy-050212-185617.

    Article  PubMed  Google Scholar 

  • De Los Reyes, A., Augenstein, T. M., Wang, M., Thomas, S. A., Drabick, D. A., Burgers, D. E., & Rabinowitz, J. (2015). The validity of the multi-informant approach to assessing child and adolescent mental health. Psychological Bulletin, 141(4), 858–900. doi:10.1037/a0038498.

    Article  PubMed  PubMed Central  Google Scholar 

  • Derogatis, L. R., & Melisaratos, N. (1983). The brief symptom inventory: an introductory report. Psychological Medicine, 13(3), 595–605. doi:10.1017/S0033291700048017.

    Article  PubMed  Google Scholar 

  • Dirks, M. A., Weersing, V. R., Warnick, E., Gonzalez, A., Alton, M., Dauser, C., & Woolston, J. (2013). Parent and youth report of youth anxiety: evidence for measurement invariance. The Journal of Child Psychology and Psychiatry. Advance Online Publication. doi: 10.1111/jcpp.12159

  • Edelbrock, C., Costello, A. J., Dulcan, M. K., Conover, N. C., & Kala, R. (1986). Parent‐child agreement on child psychiatric symptoms assessed via structured interview. Journal of Child Psychology and Psychiatry, 27(2), 181–190. doi:10.1111/j.1469-7610.1986.tb02329.x.

    Article  PubMed  Google Scholar 

  • Ginsburg, G. S., Kendall, P. C., Sakolsky, D., Compton, S. N., Piacentini, J., Albano, A., & March, J. (2011). Remission after acute treatment in children and adolescents with anxiety disorders: findings from the CAMS. Journal of Consulting and Clinical Psychology, 79(6), 806–813. doi:10.1037/a0025933.

    Article  PubMed  PubMed Central  Google Scholar 

  • Grills, A. E., & Ollendick, T. H. (2002). Issues in parent–child agreement: the case of structured diagnostic interviews. Clinical Child and Family Psychology Review, 5(1), 57–83. doi:10.1023/A:1014573708569.

    Article  PubMed  Google Scholar 

  • Grills, A. E., & Ollendick, T. H. (2003). Multiple informant agreement and the anxiety disorders interview schedule for parents and children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(1), 30–40. doi:10.1097/00004583-200301000-00008.

    Article  PubMed  Google Scholar 

  • Hale, W., Raaijmakers, Q., Muris, P., & Meeus, W. (2005). Psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the general adolescent population. Journal of the American Academy of Child and Adolescent Psychiatry, 44(3), 283–290. doi:10.1097/00004583-200503000-00013.

    Article  PubMed  Google Scholar 

  • Jensen‐Doss, A. (2011). Practice involves more than treatment: how can evidence‐based assessment catch up to evidence‐based treatment? Clinical Psychology: Science and Practice, 18(2), 173–177. doi:10.1111/j.1468-2850.2011.01248.x.

    Google Scholar 

  • Jensen-Doss, A., & Hawley, K. M. (2010). Understanding barriers to evidence-based assessment: clinician attitudes toward standardized assessment tools. Journal of Clinical Child & Adolescent Psychology, 39(6), 885–896. doi:10.1080/15374416.2010.517169.

    Article  Google Scholar 

  • Jones, J. D., Lebowitz, E. R., Marin, C. E., & Stark, K. D. (2015). Family accommodation mediates the association between anxiety symptoms in mothers and children. Journal of Child & Adolescent Mental Health, 27(1), 41–51. doi:10.2989/17280583.2015.1007866.

    Article  Google Scholar 

  • Kendall, P. C., Compton, S. N., Walkup, J. T., Birmaher, B., Albano, A., Sherrill, J., & Piacentini, J. (2010). Clinical characteristics of anxiety disordered youth. Journal of Anxiety Disorders, 24(3), 360–365. doi:10.1016/j.janxdis.2010.01.009.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602. doi:10.1001/archpsyc.62.6.593.

    Article  PubMed  Google Scholar 

  • Kolko, D. J., & Kazdin, A. E. (1993). Emotional/behavioral problems in clinic and nonclinic children: correspondence among child, parent and teacher reports. Journal of Child Psychology and Psychiatry, 34(6), 991–1006. doi:10.1111/j.1469-7610.1993.tb01103.x.

    Article  PubMed  Google Scholar 

  • Laird, R. D., & De Los Reyes, A. (2013). Testing informant discrepancies as predictors of early adolescent psychopathology: why difference scores cannot tell you what you want to know and how polynomial regression may. Journal of Abnormal Child Psychology, 41(1), 1–14. doi:10.1007/s10802-012-9659-y.

    Article  PubMed  Google Scholar 

  • Lambert, M. J., & Shimokawa, K. (2011). Collecting client feedback. Psychotherapy, 48(1), 72. doi:10.1037/a0022238.

    Article  PubMed  Google Scholar 

  • Lebowitz, E. R., Woolston, J., Bar‐Haim, Y., Calvocoressi, L., Dauser, C., Warnick, E., & Leckman, J. F. (2013). Family accommodation in pediatric anxiety disorders. Depression and Anxiety, 30(1), 47–54. doi:10.1002/da.21998.

    Article  PubMed  Google Scholar 

  • Müller, J. M., Achtergarde, S., & Furniss, T. (2011). The influence of maternal psychopathology on ratings of child psychiatric symptoms: an SEM analysis on cross-informant agreement. European Child & Adolescent Psychiatry, 20(5), 241–252. doi:10.1007/s00787-011-0168-2.

    Article  Google Scholar 

  • Niditch, L. A., & Varela, R. E. (2011). Mother–child disagreement in reports of child anxiety: effects of child age and maternal anxiety. Journal of Anxiety Disorders, 25(3), 450–455. doi:10.1016/j.janxdis.2010.11.009.

    Article  PubMed  Google Scholar 

  • Pereira, A. I., Muris, P., Barros, L., Goes, R., Marques, T., & Russo, V. (2015). Agreement and discrepancy between mother and child in the evaluation of children’s anxiety symptoms and anxiety life interference. European Child & Adolescent Psychiatry, 24(5), 327–337. doi:10.1007/s00787-014-0583-2.

    Article  Google Scholar 

  • Preacher, K. J., Curran, P. J., & Bauer, D. J. (2006). Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics, 31(4), 437–448. doi:10.3102/10769986031004437.

    Article  Google Scholar 

  • Richter, M. A. (2014). Is anxiety best conceived as a unitary condition? The benefits of lumping compared with splitting. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie, 59(6), 291.

    PubMed  PubMed Central  Google Scholar 

  • Salbach-Andrae, H., Klinkowski, N., Lenz, K., & Lehmkuhl, U. (2009). Agreement between youth-reported and parent-reported psychopathology in a referred sample. European Child & Adolescent Psychiatry, 18(3), 136–143.

    Article  Google Scholar 

  • Seiffge-Krenke, I., & Kollmar, F. (1998). Discrepancies between mothers’ and fathers’ perceptions of sons’ and daughters’ problem behaviour: a longitudinal analysis of parent–adolescent agreement on internalising and externalising problem behaviour. Journal of Child Psychology and Psychiatry, 39(05), 687–697.

    Article  PubMed  Google Scholar 

  • Smith, S. R. (2007). Making sense of multiple informants in child and adolescent psychopathology: a guide for clinicians. Journal of Psychoeducational Assessment, 25(2), 139–149. doi:10.1177/0734282906296233.

    Article  Google Scholar 

  • Southam-Gerow, M. A., Kendall, P. C., & Weersing, V. (2001). Examining outcome variability: correlates of treatment response in a child and adolescent anxiety clinic. Journal of Clinical Child Psychology, 30(3), 422–436. doi:10.1207/S15374424JCCP3003_13.

    Article  PubMed  Google Scholar 

  • Stevanovic, D., Jancic, J., Topalovic, M., & Tadic, I. (2012). Agreement between children and parents when reporting anxiety and depressive symptoms in pediatric epilepsy. Epilepsy & Behavior, 25(2), 141–144. doi:10.1016/j.yebeh.2012.07.017.

    Article  Google Scholar 

  • Treutler, C. M., & Epkins, C. C. (2003). Are discrepancies among child, mother, and father reports on children’s behavior related to parents’ psychological symptoms and aspects of parent–child relationships? Journal of Abnormal Child Psychology, 31(1), 13–27. doi:10.1023/A:1021765114434.

    Article  PubMed  Google Scholar 

  • Walkup, J. T., Albano, A., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., & Kendall, P. C. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. The New England Journal of Medicine, 359(26), 2753–2766. doi:10.1056/NEJMoa0804633.

    Article  PubMed  PubMed Central  Google Scholar 

  • Weems, C. F., Feaster, D. J., Horigian, V. E., & Robbins, M. S. (2011). Parent and child agreement on anxiety disorder symptoms using the DISC predictive scales. Assessment, 18(2), 213–216. doi:10.1177/1073191110389278.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported the National Institute of Mental Health grants U01MH64089, U01MH64107, U01MH64003, U01MH63747, U01MH064092, and U01MH64088 awarded to the PIs of the Child/Adolescent Anxiety Multimodal Study, and NIMH grant F31 MH102852-01A1 awarded to the first author; ClinicalTrials.gov Number NCT00052078.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Emily M. Becker & Amanda Jensen-Doss

  2. Department of Psychology, Temple University, Philadelphia, PA, USA

    Philip C. Kendall

  3. Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Boris Birmaher

  4. Department of Psychiatry, University of Connecticut Health Center, 65 Kane Street, West Hartford, CT, 06119, USA

    Golda S. Ginsburg

Authors
  1. Emily M. Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amanda Jensen-Doss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Philip C. Kendall
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Boris Birmaher
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Golda S. Ginsburg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Golda S. Ginsburg.

Ethics declarations

Conflict of Interest

Authors Becker, Jensen-Doss, and Ginsburg have nothing to disclose. Author Birmaher receives royalties from Random House and APA publishing and consults with Janssen Pharmaceuticals. Author Kendall receives royalties from the sale of materials related to the treatment of anxiety in youth.

Experiment Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Becker, E.M., Jensen-Doss, A., Kendall, P.C. et al. All Anxiety is not Created Equal: Correlates of Parent/Youth Agreement Vary Across Subtypes of Anxiety. J Psychopathol Behav Assess 38, 528–537 (2016). https://doi.org/10.1007/s10862-016-9544-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10862-016-9544-z

Keywords

Search

Navigation