Parent-child agreement in prepubertal depression: findings with a modified assessment method.
OBJECTIVE
Lack of or low parent-child (P-C) agreement is a well-documented problem in child psychopathology assessment. This study proposed to improve this agreement by using a modified assessment approach.


METHODS
Ninety-three depressed prepubertal children, aged 6 to 12 years, and their mothers underwent an assessment procedure that combined multiple assessment measures given separately to child and mother (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode [K-SADS-P], Children's Depression Inventory, and traditional psychiatric interviews), confrontation of either and/or both informants with intra- and interinformant discrepancies, and senior clinician's "best estimate" clinical judgment to solve discrepant ratings. Correlational statistics (r, kappa, and z) were used to compare child's with mother's ratings on 20 K-SADS-P depressive symptoms.


RESULTS
The major hypothesis, that using our assessment procedure, P-C agreement would be significant and moderately high (r and kappa = .40 or higher), was confirmed. The second hypothesis on dissociation of P-C agreement on behavioral versus ideational symptoms was partially confirmed; the third hypothesis on adverse effects of maternal "depression" on P-C agreement was not confirmed.


CONCLUSIONS
Our assessment method has potential clinical application in enhancing diagnostic reliability of childhood depression assessment.
Nguyen
N
N
Department of Psychiatry and Behavioral Sciences, Oklahoma University Health Sciences Center (OUHSC), College of Medicine, Oklahoma City.
Whittlesey
S
S
Scimeca
K
K
DiGiacomo
D
D
Bui
B
B
Parsons
O
O
Scarborough
A
A
Paddock
D
D
D000328:Adult; D002648:Child; D016241:Child of Impaired Parents; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009034:Mother-Child Relations; D015999:Multivariate Analysis; D015588:Observer Variation; D011569:Psychiatric Status Rating Scales