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

Abstract

Clinical assessments of adolescent mental health often incorporate the perspectives of multiple caregivers (e.g., mothers and fathers). Caregiver reports tend to exhibit relatively high levels of correspondence versus other informant pairs such as caregivers and teachers. Yet, caregiver reports are not redundant with one another. Thus, researchers often apply strategies for integrating caregiver reports (e.g., composite score), assuming that greater convergence between caregivers on reports of high adolescent mental health concerns points to greater severity in such concerns. To our knowledge, this assumption has never been directly tested. We examined patterns of convergence and divergence between caregiver reports of adolescent mental health in a sample of 519 families from the National Institute of Child Health and Human Development’s Study of Early Child Care and Youth Development. Caregivers and adolescents completed reports of adolescent mental health, and independent coders rated levels of adolescent hostility displayed in separate caregiver–adolescent interactions (e.g., mother–adolescent vs. father–adolescent). We identified caregiver dyads that converged in their reports of relatively high levels of adolescent mental health concerns, as well as dyads that diverged in reports of such concerns. Relative to adolescents whose caregivers diverged in their reports of adolescent mental health, those adolescents with caregivers who converged on reports of relatively high adolescent mental health concerns both self-reported high levels of mental health concerns, and displayed greater levels of hostility within caregiver–adolescent interactions. Our findings have important implications for using convergence between caregiver reports of adolescent mental health concerns as an indicator of the severity of such concerns.