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Childhood Anxiety Disorders: Parent–Child (Dis) Agreement Using a Structured Interview for the DSM-IV

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ABSTRACT

Objective

To evaluate parent–child agreement for diagnosis of childhood anxiety disorders using a DSM-IV-based structured interview in an anxiety-clinic-referred sample and to explore the role of age and gender on agreement.

Method

Forty-five children (ages 7–14 years) and their parents completed independent structured diagnostic interviews conducted by separate diagnosticians. Agreement between parent- and child-report on childhood anxiety disorder diagnoses was determined.

Results

Levels of parent–child agreement were poor for the major childhood anxiety disorders presenting either as principal diagnosis or presence anywhere in the clinical picture. No significant differences were found for age or gender. However, somewhat greater agreement was found in older children for the principal diagnosis of specific phobia, and in females for the principal diagnosis of social phobia. Agreement was found to be greater between parents and children when each reported at least one principal anxiety diagnosis.

Conclusions

When separate diagnosticians are used, there is limited agreement between parents and children for the DSM-IV anxiety disorders. Appropriately integrating the discrepant reports in reaching a diagnosis remains a methodological issue. Implications for treatment and future research are discussed.

Section snippets

Subjects

Participants were children (7–14 years of age) referred for treatment to the Child and Adolescent Anxiety Disorders Clinic at Temple University and their parents. Children and their parents completed the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions (ADIS-C/P) (Silverman and Albano, 1996) as part of the standard Child and Adolescent Disorders Clinic intake evaluation. Participants were included if the child received a DSM-IV principal social phobia, generalized

Sample

The sample (N = 45) included 26 males (57%) and 19 females (43%), ranging in age from 7 to 14 years, with a mean age of 10.48 years (SD 2.4 years). In all cases, both children and parents were interviewed. Thirty-nine children (86%) were white, two (4.4%) were black, two (4.4%) were Asian, and the two (4.4%) remaining were of “other” ethnic backgrounds. Table 1 provides frequencies and percentages of composite principal diagnoses for this sample.

Child Interview

Table 1 provides frequencies and percentages for

DISCUSSION

Results demonstrate that there is poor agreement between parents and children for the diagnosis of the major anxiety disorders using a DSM-IV based structured interview when separate interviewers are used. Agreement was found to be poor not only for principal anxiety diagnosis, but also for the presence of an anxiety disorder anywhere in the clinical picture. These results are consistent with previous studies of parent–child agreement for diagnosis of anxiety disorders (Edelbrock et al., 1986;

REFERENCES (35)

  • AM Albano et al.

    The Anxiety Disorders Interview Schedule for DSM-IV, Child Version: Clinician Manual

    (1996)
  • American Psychiatric Association

    Diagnostic and Statistical Manual of Mental Disorders

    (1987)
  • American Psychiatric Association

    Diagnostic and Statistical Manual of Mental Disorders

    (1994)
  • A Angold et al.

    Parent and child reports of depressive symptoms at children at low and high risk of depression

    J Child Psychol Psychiatry

    (1987)
  • DC Beidel et al.

    Shy Children, Phobic Adults

    (1998)
  • J Cohen

    A coefficient of agreement for nominal scales

    Educ Psychol Meas

    (1960)
  • PM DiBartolo et al.

    Crossinformant agreement in the assessment of social phobia in youth

    J Abnorm Child Psychol

    (1998)
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    This study was supported in part by NIMH research grants MH59087 and MH60653 .

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