Parent-child agreement regarding children's acute stress: the role of parent acute stress reactions.
OBJECTIVE
We examined parent-child agreement regarding child acute stress disorder (ASD) and the relationship between parent ASD symptoms and parent ratings of child ASD.


METHODS
Parent-child dyads (N = 219; child age 8-17 years) were assessed within 1 month of child injury. Parent-child agreement was examined regarding child ASD presence, severity, and specific symptoms. Relationships among parent ASD and parent- and child-reported child ASD were examined using regression analysis and generalized estimating equations (GEE).


RESULTS
Parent-child agreement was low for presence of child ASD (kappa = 0.22) and for individual symptoms. Parent and child ratings of child ASD severity were moderately correlated (r = 0.35). Parent ASD was independently associated with parent-rated child ASD, after accounting for child self-rating (beta =.65). Generalized estimating equations indicated that parents with ASD overestimated child ASD and parents without ASD underestimated child ASD, compared to the child's self-rating.


CONCLUSIONS
Parents' own responses to a potentially traumatic event appear to influence their assessment of child symptoms. Clinicians should obtain child self-report of ASD whenever possible and take parent symptoms into account when interpreting parent reports. Helping parents to assess a child's needs following a potentially traumatic event may be a relevant target for clinical attention.
Kassam-Adams
Nancy
N
Children's Hospital of Philadelphia, PA 19104, USA. nlkaphd@mail.med.upenn.edu
García-España
J Felipe
JF
Miller
Victoria A
VA
Winston
Flaura
F
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002648:Child; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015588:Observer Variation; D010287:Parent-Child Relations; D015995:Prevalence; D012720:Severity of Illness Index; D040701:Stress Disorders, Traumatic, Acute / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000523:psychology / Q000534:rehabilitation