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Gepubliceerd in: Research on Child and Adolescent Psychopathology 10/2019

02-04-2019

Parent-Youth Divergence (and Convergence) in Reports of Youth Internalizing Problems in Psychiatric Inpatient Care

Auteurs: Bridget A. Makol, Andres De Los Reyes, Rick S. Ostrander, Elizabeth K. Reynolds

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 10/2019

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Abstract

When compared to one another, multiple informants’ reports of adolescent internalizing problems often reveal low convergence. This creates challenges in the delivery of clinical services, particularly for severe outcomes linked to internalizing problems, namely suicidal thoughts and behaviors. Clinicians would benefit from methods that facilitate interpretation of multi-informant reports, particularly in inpatient settings typified by high-cost care and high-stakes decision-making. 765 adolescent inpatients (70.3% female; Mage = 14.7) and their parents completed measures of adolescent internalizing problems. We obtained baseline clinical and treatment characteristics from electronic medical records. Latent class analysis revealed four reporting patterns: Parent-Adolescent Low (LL; 49.0%), Parent Low-Adolescent High (PL-AH; 11.5%), Parent High-Adolescent Low (PH-AL; 21.8%), Parent-Adolescent High (HH; 17.6%). Relative to the LL class, adolescents in the PH-AL and PL-AH classes were more likely to be admitted with suicidality. In terms of treatment characteristics and relative to the LL class, HH and PH-AL adolescents were more likely to receive standing antipsychotics, PH-AL adolescents were more likely to be in seclusion, and HH adolescents had longer hospital stays. At discharge and relative to the LL class, HH, PH-AL, and PL-AH adolescents were more likely to receive an anxiety disorder diagnosis. Further, HH, PH-AL, and PL-AH adolescents were more likely to receive partial hospitalization or care in another restrictive environment after inpatient treatment, relative to the LL class. This naturalistic study informs clinical decision-making by aiding our understanding of how multi-informant reports facilitate interpretations of adolescents’ clinical presentations as well as predictions about treatment characteristics.
Voetnoten
1
Specifically, girls were more likely than boys to exhibit suicidality at admission, receive a depressive disorder diagnosis, and receive standing antipsychotics during treatment. European American participants were more likely to be diagnosed with an anxiety disorder and African American participants were less likely to be diagnosed with an anxiety disorder.
 
2
When controlling for the number of externalizing diagnoses (i.e., ADHD, SUDs, Conduct Disorder [CD], Oppositional Defiant Disorder [ODD], Disruptive Behavior Disorder [DBD]) adolescents met criteria for, the same pattern of findings emerged including all significant associations between LCA classes and baseline clinical characteristics.
 
3
When controlling for the number of externalizing diagnoses (i.e., ADHD, SUDs, CD, ODD, DBD) adolescents met criteria for, the same pattern of findings emerged including all significant associations between LCA classes and treatment characteristics.
 
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Metagegevens
Titel
Parent-Youth Divergence (and Convergence) in Reports of Youth Internalizing Problems in Psychiatric Inpatient Care
Auteurs
Bridget A. Makol
Andres De Los Reyes
Rick S. Ostrander
Elizabeth K. Reynolds
Publicatiedatum
02-04-2019
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 10/2019
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-019-00540-7