Parental Concordance Research Articles

Agreement between parent and child report of quality of life in children with attention‐deficit/hyperactivity disorder

There is little information in the research literature of agreement between parent and child in reports of child quality of life (QOL) for a sample of children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The aim of our study was to determine whether parent and child concordance is greater for physical domains of QOL than for psychosocial domains; whether parents rate their child's QOL better or poorer than their child's ratings; and whether concordance is related to demographic, socioeconomic or clinical factors. The study was a questionnaire survey of children aged 10-17 referred to the ADHD clinic and diagnosed with ADHD in the province of British Columbia (Canada) between November 2001 and October 2002 and their parent. Fifty-eight children diagnosed with ADHD and their parents completed our study questionnaire. The main outcome measure was the Child Health Questionnaire, which permitted comparisons on eight QOL domains and one single item. Intraclass correlation coefficients were moderate for five domains (range from 0.40 to 0.51), and good for three domains (range from 0.60 to 0.75). Children rated their QOL significantly better than their parents in four areas and poorer in one. Standardized Response Means indicated clinically important differences in mean scores for Behaviour and Self-esteem. Compared with population norms, across most domains, children with ADHD reported comparable health. Discrepancies between parent-child ratings were related to the presence of a comorbid oppositional/defiant disorder, a psychosocial stressor and increased ADHD symptoms. Although self-report is an important means of eliciting QOL data, in children with ADHD, given the discrepancies in this study between parent and child report, measuring both perspectives seems appropriate.

When adolescents disagree with others about their symptoms: Differences in attachment organization as an explanation of discrepancies between adolescent, parent, and peer reports of behavior problems

This study examined whether attachment theory could be used to shed light on the often high degree of discordance between self- and observer ratings of behavioral functioning and symptomatology. Interview-based assessments of attachment organization, using the Adult Attachment Interview, were examined as predictors of the lack of agreement between self- and other reports of behavioral and emotional problems among 176 moderately at-risk adolescents. Lack of agreement was measured in terms of concordance of adolescent and parent or close friend report on equivalent measures of behavioral and emotional adjustment. Insecure-dismissing attachment was linked to less agreement in absolute terms between self- and mother reports of externalizing symptoms, and between adolescent and close friend reports of behavioral conduct. Insecure-preoccupied attachment was associated with higher levels of adolescent reporting of internalizing and externalizing symptoms relative to parent reports of adolescent symptomatology. The findings suggest that attachment organization may be one factor that accounts for individual differences in the degree of discordance between self- and other reports of symptoms in adolescence.

Multiple Informant Agreement and the Anxiety Disorders Interview Schedule for Parents and Children

To examine concordance of child, parent, and consensus agreement on the Anxiety Disorders Interview Schedule, Child and Parent versions (ADIS-C/P), for an outpatient sample of children and adolescents and to explore moderators of those relations. Child characteristics (age, gender, social desirability), a family environment variable (conflict), and type of diagnoses (internalizing, externalizing) were systematically examined. These relations were examined in 165 children and adolescents referred to a psychological clinic by family practitioners, pediatricians, schools, and mental health professionals. Participants were individually administered the ADIS-C or ADIS-P by separate clinicians, and consensus diagnoses were determined in a clinical conference. Agreements between child-parent, child-consensus, and parent-consensus were determined. Poor levels of agreement were found among our informants, especially between child and parent and to some extent between child and consensus. Agreement was higher between parent and consensus, suggesting that our clinicians tended to favor parent input over child input. Although the effects were complex, characteristics of the child, family, and type of diagnosis moderated or qualified these findings. Although discrepancies exist among our informants, our overall findings suggest important information is obtained from each informant and, when combined with certain modifying characteristics, may lead to diagnostic and treatment decisions.

Parental alcohol use disorders and alcohol use and disorders in offspring: a community study.

We examined the association between parental alcohol use disorders and patterns of alcohol consumption and DSM-IV alcohol use disorders in their offspring in a community-based sample of young adults. Data are based on baseline and 4-year follow-up data of 2427 respondents aged 14-24 at baseline. Alcohol use and disorders in respondents were assessed using the Munich-Composite-international-Diagnostic-Interview with DSM-IV algorithms. Diagnostic information about parents was collected by family history information from the respondents, and by direct interview with one parent (cohort aged 14 to 17 years only). Although the association between maternal and paternal alcohol use disorders and non-problematical drinking in offspring was minimal, there was a strong effect for the transition to hazardous use and for alcohol abuse and dependence; the effect of parental concordance for transition into hazardous use was particularly striking. Maternal history was associated with a higher probability of progression from occasional to regular use, whereas paternal history was associated with progression from regular to hazardous use. Parental alcoholism increased the risk for first onset of hazardous use and alcohol dependence between the ages of 14-17, and for an earlier onset of the alcohol outcomes in offspring. The impact of parental alcohol use disorders was comparable for male and female offspring. Parental alcoholism predicts escalation of alcohol use, development of alcohol use disorders and onset of alcohol outcomes in offspring.

Parental Concordance and Comorbidity for Psychiatric Disorder and Associate Risks for Current Psychiatric Symptoms and Disorders in a Community Sample of Juvenile Twins

In this report we characterize associations between parental psychiatric disorders and children's psychiatric symptoms and disorders using a population-based sample of 850 twin families. Juvenile twins are aged 8-17 years and are personally interviewed about their current history of DSM-III-R conduct, depression, oppositional-defiant, overanxious, and separation anxiety disorders using the CAPA-C. Mothers and fathers of twins are personally interviewed about their lifetime history of DSM-III-R alcoholism, antisocial personality disorder, generalized anxiety disorder, major depression, panic disorder/agoraphobia, social phobia, and simple phobia using a modified version of the SCID and the DIS. Generalized least squares and logistic regression are used to identify the juvenile symptoms and disorders that are significantly associated with parental psychiatric histories. The specificity of these associations is subsequently explored in a subset of families with maternal plus parental psychiatric histories with a prevalence > 1%. Parental depression that is not comorbid or associated with a different spousal disorder is associated with a significantly elevated level of depression and overanxious disorder symptoms and a significantly increased risk for overanxious disorder. Risks are higher for both symptomatic domains in association with maternal than paternal depression, and highest in association with maternal plus paternal depression. Risks for otherjuvenile symptoms and disorders index the comorbid and spousal histories with which parental depression is commonly associated. Paternal alcoholism that is not comorbid or associated with a maternal disorder is not significantly associated with current psychiatric symptoms or disorders in offspring. Risks for oppositional-defiant or conduct symptoms/disorders in the offspring of alcoholic parents index parental comorbidity and/or other spousal histories.

Parental Concordance and Comorbidity for Psychiatric Disorder and Associate Risks for Current Psychiatric Symptoms and Disorders in a Community Sample of Juvenile Twins

Parental Concordance and Comorbidity for Psychiatric Disorder and Associate Risks for Current Psychiatric Symptoms and Disorders in a Community Sample of Juvenile Twins

Parental non-concordance with occlusion therapy

BACKGROUND/AIMSNon-concordance has often been reported as a major contributor to the failure of occlusion therapy for amblyopia. In other fields of medicine the extent of a patient's understanding in areas...

Influence of Parental Concordance for Psychiatric Disorders on Psychopathology in Offspring

To examine the influence of parental mating types for substance abuse and anxiety/affective disorders on the risk of psychopathology among child and adolescent offspring. Emotional and behavioral disorders were assessed in offspring, aged 7 to 17 years, of male and female parents who served as probands from a family study of comorbidity of substance abuse and anxiety disorders. The findings indicated that (1) patterns of psychopathology among offspring were similar for mothers and fathers; (2) spouse concordance for psychopathology was greater among parents with substance abuse than among those with anxiety, particularly among female substance abusers; (3) there was a direct relationship between the number of affected parents and the magnitude of psychopathology in children, particularly with respect to the anxiety disorders; and (4) by contrast, rates of conduct disorder were elevated only among offspring of dually affected parents, irrespective of the specific parental disorders. These findings underscore the importance of the contribution of both mothers and fathers, particularly those with concordance for psychiatric disorders, to the development of psychopathology in offspring.

P3. The impact of physician and parent conformance with practice parameters on outcomes of pediatric gastroenteritis

Focusing on the outcome “clinical dehydration,” we compared children who received oral rehydration therapy (ORT) before an outpatient visit with children who did not. We also studied the relationship between physician advice for ORT and whether patients returned for follow-up with continued illness or dehydration. Three groups of children were studied: (1) 523 patients seen by 88 pediatric practitioner members of an office-based research network of the American Academy of Pediatrics (AAP); (2) 618 children treated at Charity Hospital’s Pediatric Emergency Room in New Orleans; and (3) 298 children treated at one of three rural practice sites in Louisiana. The results indicate that children whose parents poorly comply with ORT practice parameters of the AAP are more likely to be dehydrated at time of presentation. Parent concordance with AAP practice parameters was in the range of 77% to 87% for nondehydrated patients but substantially lower for patients found to be dehydrated at the initial visit (29% to 48%). Children whose physicians complied with AAP practice medications at the initial visit were less likely to return for further office follow-up with persistence of gastroenteritis or dehydration. Compliance with AAP practice parameters for ORT did not have a significant effect. These results support the clinical validity of the AAP practice parameters.

Parental concordance for affective disorders: psychopathology in offspring

This paper examines the effects of parental concordance for affective disorders and psychopathology among the 219 offspring of probands with major depression and normal controls. The lifetime prevalence of psychiatric disorders was significantly higher among the spouses of depressed probands as compared to those of normal controls. The spouses of 37% of the normals and 69% of the depressed probands met criteria for a diagnosis of major depression, an anxiety disorder, or alcoholism. Parental concordance for diagnoses, particularly for anxiety disorders, substantially increased the risk of major depression and anxiety disorders in their children. Moreover, the marital relationship, some aspects of family adjustment and severity of current symptoms were significantly worse among the couples who exhibited diagnostic concordance for anxiety, alcoholism and / or depression. The major implication of these findings is that the diagnostic status of both parents should be considered in the design and analysis of studies of children. The findings of the present study also underscore the importance of assessment of comorbid disorders in parents and offspring. Although the original study design focused on the risk of depression in children of parents in treatment for major depression, stronger transmissibility was found for anxiety disorders plus depression than for major depression alone. However, the exclusion criteria of a lifetime history of mania or hypomania led to an extremely low proportion of probands with pure major depression without concomitant anxiety disorders. These findings confirm the results of previous studies which have demonstrated a strong degree of overlap between affective and anxiety syndromes. The increased risk of anxiety disorders in the offspring of parents who had sought treatment for non-bipolar major depression suggests that anxiety may constitute an early form of expression of affective disorders. Confirmation of the finding of age-dependent expression of anxiety and depression in prospective longitudinal studies of children is indicated.

Parental concordance on child rearing and the interactive emphases of parents: Sex-differentiated relationships during the preschool years.

Parental concordance on child rearing and the interactive emphases of parents: Sex-differentiated relationships during the preschool years.

Parental concordance on child rearing and the interactive emphases of parents: Sex-differentiated relationships during the preschool years.

Parental concordance on child rearing and the interactive emphases of parents: Sex-differentiated relationships during the preschool years.