ABSTRACTThis study examines discrepancies between adolescent and caregiver reports of youth internalizing symptoms in families presenting for an initial eating disorder assessment. Initial diagnostic assessments of 49 adolescent-caregiver dyads seeking treatment at an urban pediatric hospital eating disorder clinic were utilized to examine differences between youth and caregiver reports of youth anxiety and depression symptoms. Caregivers reported significantly higher scores of major depression and generalized anxiety than adolescents (p=.000). Caregivers of youth with more severe ED symptoms exhibited more congruence with youth’s own reports of their depression and anxiety. Our results suggest that agreement within families regarding comorbid psychological concerns may be beneficial in promoting treatment uptake for those who desire a reduction in depression and anxiety symptoms, regardless of motivation to change eating behaviors.