Abstract
Objective:
Many children and adolescents are assessed for potential psychological and behavioral problems through the parent-completed Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) questionnaires. However, because these assessments are based on individual reports, they are subject to disagreement. This study considered multiple family factors and aspects of mothers’ mental health in discrepancies between mothers’ and youths’ ratings on the CBCL and YSR.
Method:
This study involved 926 mothers and their adolescent children (48.7% female children, mean age = 14.4 years) who completed the CBCL and YSR questionnaires, respectively.
Results:
Mothers who experienced more severe mental health problems reported more internalizing symptoms of their adolescent relative to the adolescent’s ratings.
Conclusion:
Findings indicate that mothers’ poor mental health is related to their reports of more frequent psychological problems in their adolescents. To verify the accuracy of maternal reports, additional raters and additional methods, such as behavioral observation and clinical interview, would be helpful.
Keywords: Achenbach Child Behavior Checklist, Achenbach Youth Self-Report, adolescent behavioral problems, mother-adolescent discrepancies, maternal mental health
The prevalence of mood disorders among US adolescents is increasing. Among youth aged 12 to 17 years, rates of a major depressive episode over the past year increased by 52% from 2009 to 2017.1 At the same time, the prevalence of attention-deficit/hyperactivity disorder is on the rise, increasing from 6.1% in 1997 to 10.2% in 2016.2 As these problems are increasingly reported in children and adolescents, early detection and accurate diagnoses become ever more important.
The Child Behavior Checklist (CBCL) and Youth Self-Report (YSR) are 2 of the Achenbach System of Empirically Based Assessment school-age instruments used to identify social and behavior problems in children and adolescents.3 The surveys are widely used in schools, pediatric clinics, mental health clinics, and research studies.4 The CBCL and YSR involve parents and children rating the child’s behaviors and social competencies. The measures are intended to be used as a first step in assessing the overall status of a child’s behavior and indicate whether intervention is needed.4
The CBCL and YSR are based on individual reports—the CBCL is solely a parent’s impression of their child, and the YSR is the adolescent’s self-perception. Because of the individual report nature of the CBCL and YSR, there is the potential for mothers and adolescents to be discrepant. Many of the items on the CBCL and YSR are nearly identical and thus can be readily compared. Identifying factors that relate to mothers’ and youths’ reports on their respective questionnaires could aid in understanding discrepancies and why such discrepancies occur, which could lead to better interpretation of results. Clinically, understanding mother-rated CBCL and adolescent-rated YSR discrepancies could be important in evaluating how CBCL and YSR scores guide treatment approaches and influence measures of treatment effectiveness and in determining whether large discrepancies indicate the presence of other problems in the home.5,6
Previously, it has been shown that maternal depression contributes to discrepancies between maternal and child psychosocial reports.7–12 It is suggested that maternal psychopathology influences maternal ratings of their children’s behavioral and emotional problems through the depression-distortion hypothesis, in which mothers with more severe depression hold more negative schemas of their children and their children’s behavior. These schemas lead mothers to report higher rates of problem behaviors in their children.11 In the current study, we evaluated the association between maternal depression and several additional aspects of mothers’ mental health and mother-adolescent discrepancy on their CBCL-YSR ratings. We also examined how multiple family factors, such as parent education, maternal intelligence quotient, and family size, as well as adolescent sex and age, are related to CBCL-YSR discrepancies. The current study adds to the literature by analyzing a large sample of Chilean mothers and adolescents. In addition, many mothers in the current sample had moderate-to-severe depressive symptomatology.13 This is important because most previous studies have involved samples of mothers with significantly lower rates of depressive symptoms.7,9,10
METHODS
In this study, 926 adolescents (48.7% female children, mean age = 14.4 years, SD = 1.5) and their mothers (mean age = 40.7 years, SD = 6.1) were evaluated as part of an adolescent follow-up of a longitudinal, ongoing study in Santiago, Chile. The original study recruited mothers and infants from 1991 to 1996 in community clinics in Santiago to participate in either a preventive trial of iron deficiency anemia or, for those infants who had iron deficiency anemia at enrollment, a neuro-maturation study.14 A total of 1,790 infants were enrolled and were invited to participaS1te in follow-up evaluations that occurred approximately every 5 years in childhood and into adolescence. Psychologists at the University of Chile administered all questionnaires by reading them aloud for each mother and adolescent separately and recording the answers. The study was approved by the authors’ institutional review boards in the United States [University of Michigan (HUM00043770) and University of California, San Diego (#121649)] and Chile (the Institute of Nutrition and Food Technology at the University of Chile). At all study time points, signed informed consent was obtained from parents for both their and their child’s participation, and adolescents provided informed assent for their participation. All study procedures were in accord with the Code of Ethics of the World Medical Association.15
Measures
Child Behavior Checklist and Youth Self-Report
The Child Behavior Checklist (CBCL) is a 112-item inventory that was administered to mothers regarding their adolescent’s behavior.3 The Youth Self-Report (YSR) is also a 112-item inventory,3 which was completed by adolescents at the same visit when their mother completed the CBCL. All items on the CBCL and YSR have response options of 0 (not true), 1 (somewhat or sometimes true), and 2 (very true or often true). The CBCL and YSR items can be summed into 8 syndrome subscales3: attention problems (9 items), withdrawn-depressed (8 items), anxious-depressed (13 items), somatic complaints (11 items), aggression (18 items), social problems (11 items), thought problems (15 items), and rule breaking (17 items).
These aggregate scores can then be summed into 3 broadband scales of internalizing behavior problems (sum of withdrawn-depressed, anxious-depressed, and somatic complaints), externalizing behavior problems (sum of aggression and rule breaking), and total behavioral problems. However, not all items between the CBCL and YSR are identical; thus, to minimize false sources of discrepancy in analysis, only identical items, in both content and number, were included in analyses in this study and included 6 of the 8 syndrome scales. The Spanish versions of both the CBCL and YSR, provided by Achenbach System of Empirically Based Assessment, were used in this study.
Mothers’ Mental Health
Mothers completed the Center for Epidemiological Studies—Depression Scale (CES-D) to assess the presence and severity of depressive symptoms. The CES-D was administered at the same visit as the CBCL. The CES-D is a 20-item scale that asks about the frequency of feelings of depressed mood, with scores ranging from 0 (not at all or less than 1 day last week) to 3 (5–7 days last week).16 Items are summed for a total score, ranging from 0 and 60, with a score <16 indicating no-to-mild depressive symptoms, scores between 16 and 23 indicating moderate depressive symptoms, and scores ≥24 indicating severe depressive symptomology.16 Psychologists at the University of Chile administered the CES-D to mothers. The Brief Symptom Inventory (BSI) was also administered to mothers at the same time as the CBCL. The BSI is a 53-item inventory that assesses the extent to which mental problems have bothered the respondent, with scores ranging from 1 (not at all) to 5 (extremely).17 Items can be grouped into aggregate problem scores including somatization (6 items), obsession compulsion (6 items), interpersonal sensitivity (i.e., feelings of inadequacy or discomfort in interpersonal interactions; 4 items), anxiety (6 items), and global symptom severity (4 items).
Family Factors
The following family factors were assessed as part of the original infancy study: maternal age, number of children in the home, maternal intelligence quotient (IQ), and mothers’ and fathers’ years of education. Maternal IQ was assessed using an abbreviated Wechsler Adult Intelligence Scale, third edition.18 The abbreviated scale provides a full-scale IQ score. Maternal and paternal levels of education and the number of children in the home were assessed by maternal report.
Statistical Analyses
The CBCL and YSR items were summed into the 6 syndrome subscales and the 3 broadband scales described above. Difference scores were computed between the identical scales of mother-ratings on the CBCL and adolescent-ratings on the YSR by subtracting summed adolescent ratings from summed maternal ratings, only along identical items between the scales. Initial analyses describe this difference score as a mean value, with higher values indicating that the mother rated the youth’s behavior symptom as more frequent than the adolescent. Subsequent analyses involved the absolute values of the difference scores for each scale, with larger values indicating greater discrepancy.
Correlations were then computed between (absolute value) difference scores and family and maternal mental health factors to determine which familial factors were associated with increasing discrepancy. In addition, partial correlations were computed between CBCL and YSR scores (separately) and each measured aspect of maternal mental health, although relevant family factors were controlled (i.e., adolescent age, adolescent sex, maternal age, maternal education, paternal education, number of children, and maternal IQ). These correlations illustrate whether maternal mental health relates to mothers’ ratings, youths’ ratings, or both.
Generalized linear regressions were also conducted using 6 different models to explain the magnitude of (absolute value) discrepancies. The 6 models included family factors, family factors + total CES-D score, and family factors + each BSI scale score (e.g., family factors + somatization and family factors + obsession-compulsion).
All p values for correlations and regressions were Bonferroni-corrected to account for multiple computations.
RESULTS
Descriptive Characteristics of Sample
On average, adolescents were 48.7% female and 14.4 years old (SD = 1.5, range = 12–17) at assessment, whereas mothers were 26.4 years old (SD = 6.1, range = 16–46) at assessment. Mothers had an average education of 9.5 years (SD = 2.8, range = 1–17), whereas fathers had an average of 9.8 years (SD = 2.8, range = 0–19), and average maternal intelligence quotient was 84 (SD = 9.5, range = 52–110). On average, there were 2.1 children in each family (SD = 1.2, range = 0–12). These factors were not correlated with mother or youth ratings.
Discrepancies
Table 1 shows the percentage of mother-adolescent pairs who had complete agreement per each symptoms scale and the range of mother-adolescent discrepancy per each symptom scale. Positive mean ratings (far-right column) indicate that the mother rated the behavior symptom as more frequent than their adolescent, and negative mean scores indicate that the adolescent rated that particular symptom as more frequent than their mother. On average, mothers rated their child as having more internalizing problems, somatic complaints, withdrawn-depressed symptoms, and anxious-depressed symptoms than adolescents’ self-ratings. By contrast, most adolescents rated themselves as having more problems with attention, externalizing, aggression, and rule breaking as compared with their mothers. However, there were large ranges in the difference scores for all measures, indicating wide discrepancies between mothers’ and adolescents’ ratings.
Table 1.
Percent Agreement and Mean, SDs, and Ranges of Discrepancies
| Mother > Youth (%) | Youth > Mother (%) | Discrepancy | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| 0–1 | 1–2 | 2+ | 0–1 | 1–2 | 2+ | ||||||
| Scale (No. of Items) | Complete Agreement (%) | SD | SD | SD | SD | SD | SD | Mean | SD | Min | Max |
| Attention (9) | 10.6 | 23.8 | 12.6 | 3.0 | 28.5 | 15.0 | 6.5 | −0.22 | 3.76 | −14 | 11 |
| Internalizing (31) | 4.6 | 29.5 | 14.5 | 3.0 | 29.6 | 9.0 | 9.8 | 1.10 | 8.88 | −29 | 34 |
| Withdrawn-depressed (8) | 10.4 | 28.9 | 17.2 | 3.8 | 26.2 | 9.7 | 3.8 | 0.79 | 3.62 | −9 | 15 |
| Anxious-depressed (13) | 9.0 | 27.2 | 13.2 | 2.4 | 29.4 | 13.1 | 5.8 | 0.03 | 4.62 | −15 | 17 |
| Somatic complaints (10) | 13.7 | 30.2 | 9.8 | 3.3 | 29.0 | 8.2 | 5.6 | 0.27 | 3.22 | −11 | 12 |
| Externalizing (32) | 4.8 | 23.5 | 6.9 | 1.9 | 37.0 | 17.7 | 8.1 | −2.33 | 8.58 | −30 | 36 |
| Aggression (17) | 6.5 | 26.8 | 8.4 | 2.4 | 37.4 | 13.2 | 5.4 | −0.72 | 6.16 | −18 | 24 |
| Rule breaking (15) | 11.3 | 17.6 | 4.1 | 1.3 | 36.6 | 18.7 | 10.4 | −1.60 | 3.38 | −13 | 19 |
Positive mean ratings (far-right column) indicate that mothers rated the behavior symptom as more frequent than their adolescent, and negative mean scores indicate that the adolescent rated that particular symptom as more frequent than their mother.
Table 2 shows the correlations between (absolute value) mother-adolescent discrepancy scores and various family factors and maternal mental health scores. A positive significant correlation indicates, for example, that as the family factor increases, the discrepancy between mothers’ and youths’ reports also increases, and a significant negative correlation indicates that, as the family factor increases, the discrepancy decreases. The results indicate that there were no significant correlations between family factors and Child Behavior Checklist (CBCL)-Youth Self-Report (YSR) discrepancies.
Table 2.
Pearson Correlation Coefficients Between CBCL-YSR Discrepancies and Family Factors and Maternal Mental Health
| Attention | Internalizing | Withdrawn-Depressed | Anxious-Depressed | Somatic | Externalizing | Aggression | Rule Breaking | |
|---|---|---|---|---|---|---|---|---|
| Family factors | ||||||||
| Adolescent age | 0.08 | −0.05 | 0.01 | −0.11 | 0.04 | 0.05 | 0.01 | 0.06 |
| Adolescent sex (female) | 0.02 | −0.08 | −0.03 | −0.11 | −0.04 | −0.02 | 0.00 | −0.01 |
| Maternal age | 0.08 | −0.05 | 0.01 | −0.11 | 0.04 | 0.05 | 0.01 | 0.06 |
| Maternal education | −0.05 | −0.07 | −0.10 | −0.05 | −0.05 | −0.02 | −0.05 | −0.02 |
| Paternal education | −0.01 | −0.07 | −0.06 | −0.08 | 0.01 | −0.03 | −0.06 | 0.02 |
| No. of children in home | 0.03 | 0.04 | 0.04 | 0.02 | 0.02 | 0.04 | 0.04 | 0.06 |
| Maternal IQ | 0.00 | 0.00 | −0.08 | −0.02 | 0.01 | −0.04 | −0.04 | −0.04 |
| Maternal mental health | ||||||||
| Total CES-D | 0.03 | 0.16* | 0.15* | 0.17* | 0.12* | 0.07 | 0.09 | 0.04 |
| Brief symptom inventory | ||||||||
| Somatization | 0.04 | 0.16* | 0.14* | 0.16* | 0.13* | −0.01 | 0.05 | −0.03 |
| Obsessive compulsive | 0.08 | 0.14* | 0.16* | 0.13* | 0.08 | 0.01 | 0.07 | −0.03 |
| Interpersonal sensitivity | 0.13* | 0.18* | 0.18* | 0.17* | 0.14* | 0.09 | 0.14* | 0.01 |
| Anxiety | 0.05 | 0.13* | 0.17* | 0.14* | 0.10 | 0.03 | 0.07 | 0.00 |
| Symptom severity | 0.05 | 0.15* | 0.15* | 0.14* | 0.08 | 0.01 | 0.06 | −0.03 |
Adolescent sex was coded as 1 = female and 0 = male. CBCL-YSR discrepancies were coded as absolute differences, with higher scores indicating greater absolute difference between mothers’ and youths’ reports.
p < 0.05. p values have been corrected according to the number of correlations computed. CBCL, Child Behavior Checklist; CES-D, Center for Epidemiological Studies—Depression Scale; IQ, intelligence quotient; YSR, Youth Self-Report.
The correlations shown at the bottom of Table 2, however, indicate that maternal mental health factors were consistently related to discrepancies concerning adolescents’ internalizing symptoms. That is, more frequent maternal depressive symptoms were related to greater discrepancies concerning youths’ total internalizing, withdrawn-depressed, anxious-depressed, and somatic problems. In addition, every maternal mental health issue as measured on the Brief Symptom Inventory (BSI) was related to greater discrepancies in ratings of youths’ total internalizing, withdrawn-depressed, and anxious-depressed symptoms. Mothers’ somatization and interpersonal problems also related to greater discrepancies in ratings of adolescents’ somatic complaints, and mothers’ greater interpersonal issues related to higher rating discrepancy of youths’ aggressive and attention problems. None of the mental health issues assessed on the BSI related to rating discrepancy of youths’ externalizing or rule-breaking behaviors.
Table 3 shows the partial correlations between maternal mental health symptom scores and mothers’ CBCL ratings and, separately, adolescents’ YSR ratings, controlling for relevant maternal and family factors (listed in Table 2). More frequent maternal mental health problems were consistently related to higher ratings on both the YSR and CBCL. It is noteworthy that mothers’ self-ratings of mental health tended to be more closely associated with mothers’ ratings on the CBCL than with adolescents’ ratings on the YSR.
Table 3.
Pearson Partial Correlation Coefficients Between CBCL and YSR Scores and Various Aspects of Maternal Mental Health, Controlling for Maternal and Family Background Factors
| Attention | Internalizing | Withdrawn-Depressed | Anxious-Depressed | Somatic | Externalizing | Aggression | Rule Breaking | |
|---|---|---|---|---|---|---|---|---|
| YSR | ||||||||
| CES-D (total) | 0.14* | 0.14* | 0.13* | 0.12* | 0.10 | 0.15* | 0.14* | 0.11* |
| Brief symptom inventory | ||||||||
| Somatization | 0.14* | 0.13* | 0.13* | 0.10 | 0.10 | 0.10 | 0.10 | 0.07 |
| Obsessive compulsive | 0.12* | 0.13* | 0.13* | 0.11 | 0.10 | 0.09 | 0.09 | 0.06 |
| Interpersonal sensitivity | 0.16* | 0.13* | 0.10 | 0.10 | 0.10 | 0.09 | 0.09 | 0.05 |
| Anxiety | 0.17* | 0.15* | 0.13* | 0.13* | 0.10 | 0.14* | 0.13* | 0.10 |
| Symptom severity | 0.13* | 0.13* | 0.10 | 0.10 | 0.09 | 0.09 | 0.10 | 0.06 |
| CBCL | ||||||||
| CES-D (total) | 0.29* | 0.40* | 0.28* | 0.37* | 0.29* | 0.29* | 0.30* | 0.21* |
| Brief symptom inventory | ||||||||
| Somatization | 0.33* | 0.28* | 0.26* | 0.38* | 0.34* | 0.41* | 0.29* | 0.21* |
| Obsessive compulsive | 0.35* | 0.41* | 0.29* | 0.39* | 0.29* | 0.32* | 0.32* | 0.23* |
| Interpersonal sensitivity | 0.32* | 0.38* | 0.27* | 0.38* | 0.25* | 0.34* | 0.33* | 0.26* |
| Anxiety | 0.37* | 0.44* | 0.30* | 0.42* | 0.31* | 0.34* | 0.35* | 0.24* |
| Symptom severity | 0.30* | 0.29* | 0.29* | 0.37* | 0.27* | 0.39* | 0.31* | 0.19* |
Correlations controlled for all family factors listed in Table 2.
p < 0.05. p values have been corrected according to the number of correlations computed. CBCL, Child Behavior Checklist; CES-D, Center for Epidemiological Studies—Depression Scale; YSR, Youth Self-Report.
Table 4 shows the regression results when family factors and maternal mental health symptoms were considered simultaneously. These results indicate that mothers’ greater interpersonal problems (β = 0.13) were significantly associated with high discrepancy in mother-adolescent ratings of adolescents’ attention problems. These standardized effect estimates were larger than those for the family factors (β range −0.06 to 0.06). All the maternal mental health problem scores (β range 0.12–0.17) had statistically significant associations with mother-adolescent rating discrepancy of the adolescent’s internalizing problems. The effect estimates for maternal mental health problem scores (0.12–0.17) were 1.5 to 2 times greater in magnitude than those estimated for the family factors (β range −0.08 to 0.03). Finally, none of the family or maternal mental health variables were significantly associated with mother-adolescent discrepancy for the adolescents’ externalizing behaviors. Maternal interpersonal problems (β 50.08), Center for Epidemiological Studies—Depression Scale score (β = 0.06), and maternal age (β = 0.07) had similar effect sizes, although these estimates did not reach statistical significance.
Table 4.
Standardized Regression Coefficients of Maternal and Family Factors Associated with CBCL-YSR Difference Scores
| CBCL-YSR Discrepancies | |||
|---|---|---|---|
| Attention | Internalizing | Externalizing | |
| β | β | β | |
| Family factors | |||
| Adolescent age | 0.08 | −0.06 | 0.05 |
| Adolescent sex (female) | −0.03 | −0.08 | 0.02 |
| Maternal age | 0.06 | 0.02 | 0.07 |
| Maternal education | −0.06 | −0.07 | 0.01 |
| Paternal education | 0.01 | −0.04 | −0.02 |
| Number of children | −0.02 | 0.01 | 0.00 |
| Maternal IQ | 0.02 | 0.03 | −0.05 |
| Maternal mental health | |||
| Total CES-D | 0.04 | 0.14* | 0.06 |
| Brief symptom inventory | |||
| Somatization | 0.03 | 0.15* | −0.02 |
| Obsessive-compulsive | 0.07 | 0.13* | 0.00 |
| Interpersonal sensitivity | 0.13* | 0.17* | 0.08 |
| Anxiety | 0.05 | 0.12* | 0.02 |
| Symptom severity | 0.04 | 0.14* | −0.01 |
Adolescent sex was coded as 1 = female and 0 = male. CBCL-YSR discrepancies were coded as absolute differences, with higher scores indicating greater absolute difference between mothers’ and youths’ reports.
p < 0.05. p values have been corrected according to the number of correlations computed. CBCL, Child Behavior Checklist; CES-D, Center for Epidemiological Studies—Depression Scale; IQ, intelligence quotient; YSR, Youth Self-Report.
DISCUSSION
This study identified several maternal mental health factors that were associated with mother-adolescent discrepancy of the adolescents’ problem behaviors. In our sample, maternal mental health problems were associated with greater Child Behavior Checklist (CBCL)-Youth Self-Report (YSR) discrepancy. These findings were robust across a broad array of maternal mental health factors, including not only mothers’ anxiety and depression but also mothers’ somatization, obsession compulsion, interpersonal problems, and global symptom severity. These aspects of maternal mental health contributed more consistently to mother-adolescent discrepancy than did any of the assessed family factors, which is consistent with the previous literature.7–9
Comparing the absolute discrepancies to the findings of the individual CBCL and YSR scores allowed us to see which respondents were increasing or decreasing their problem ratings as certain maternal mental health factors increased and whether these changes contributed to an overall absolute discrepancy. Mother-adolescent discrepancies associated with maternal mental health problems seemed more strongly related to mother ratings on the CBCL than youth ratings on the YSR. This would be expected given shared reporter effects.19 It has been shown previously that poor maternal mental health does, indeed, affect her children’s mental well-being, putting them at higher risk for developing mental health complications,20–22 especially in female patients.23 Our results were consistent with previous findings because more frequent maternal mental health symptoms were associated with higher adolescent ratings of their own psychosocial problems. However, our findings also show that maternal CBCL ratings were higher than adolescent self-ratings, given more severe maternal mental health problems.
We also found that the effects of maternal mental health symptoms were most consistently related to discrepancy scores for adolescents’ internalizing problems. Of the Achenbach System of Empirically Based Assessment broadband scales, internalizing problems are the most difficult to see physically, as compared to attention problems that may have multiple outward manifestations, including regular forgetting, poor planning and organization, and avoidance of tasks.24,25 Similarly, externalizing problems can be very visible, such as destroying property, violence, theft, and arson. Thus, self-report measures may be more valuable in identifying internalizing problems as opposed to reports by others. At the same time, our findings suggest that reports of internalizing problems may be most affected by symptoms of mothers’ poor mental health. Thus, mothers’ own mental health symptoms should be considered when attempting to identify youths’ behavioral and especially their emotional problems.
Finally, it is noteworthy that none of the family or maternal background variables related to discrepancy in youth-mother reports of youths’ problem behaviors. Thus, at least within the current sample, mothers’ age, education level, and intelligence quotient, for example, were unrelated to youth-mother disagreements about youths’ behaviors.
Limitations and Strengths
This study is limited by the fact that we did not have ratings by individuals other than the mother or youth, such as the father or a teacher, and did not have other related methods, such as behavioral observations or clinical interviews. Teacher ratings on the Achenbach Teacher Report Form are often used to augment parent reports and self-reports. Comparison of teacher ratings to maternal and adolescent ratings would afford a more comprehensive view of the adolescents’ problems and the relative impact of maternal mental health and family factors on the discrepancies among all 3 measures.26 In addition, our study did not involve clinical interviews, so we cannot determine whether mothers or adolescents made more accurate assessments.27,28 Because previous work suggests that both adolescent depressive symptoms and maternal depressive symptoms contribute to discrepancies, we cannot determine, without additional data, whether any under- or overreporting occurred.9
Our study is also limited by the cross-sectional nature of the data collected, which precluded an assessment of the temporal ordering or directionality between mothers’ and adolescents’ ratings and mothers’ mental health. It would be useful in future studies to take into account longitudinal mental health data of both mothers and adolescents to assess the directionality of the relations. This would clarify whether changes in maternal mental health are related to changes in discrepancy scores or whether larger discrepancies are related to increases in maternal mental health problems.
Regarding strengths, our study involved a relatively large sample and a wide span of variables assessed, both pertaining to the family and to maternal mental health. This allowed us to control for possible confounding family-background variables in both the correlation and linear regression analyses. Our sample also included mothers with relatively extensive mental health problems, allowing us to more fully elucidate the associations of mothers’ own mental health problems with ratings of their children’s socioemotional problems. In addition, this study had simultaneous assessments of mothers’ mental health, her CBCL ratings, and her adolescents’ YSR ratings. Thus, the ratings were not biased by time or events that could have occurred in between the various assessments. Finally, the current study adds to the literature by analyzing a large sample of Chilean mothers and adolescents, which is important, given previous findings indicating that the size of informant differences varies across societies.29
Clinical Implications.
In clinical settings where the CBCL and YSR are used to diagnose psychosocial problems in children and adolescents, clinicians may wish to consider family background characteristics and maternal mental health factors when evaluating mothers’ and youths’ reports. Specifically, mothers who experienced more severe mental health problems tended to report more internalizing symptoms of their adolescent relative to the adolescent’s own report. As a whole, the findings suggest that individual reports of their adolescents’ psychological problems, especially internalizing problems, may be susceptible to greater discrepancy given mothers’ poor mental health.
Acknowledgments
This research was supported by grants from the National Institutes of Health R01-HL-088530 (PI: S. Gahagan), R01-HD-033487 (PIs: S. Gahagan and B. Lozoff), R01-DA-021181 (PI: J. Delva), R03-HD-097295 (PI: P. East), and T32-HL-079891 (PI: M. Allison).
Footnotes
Disclosure: The authors declare no conflict of interest.
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