Informant discrepancies in clinical reports of youths and interviewers' impressions of the reliability of informants

Objective: In this study the authors examined whether discrepancies between parent and youth reports of the youth's emotional and behavioral functioning are related to interviewers' reliability ratings of parents and youths. Methods: In a consecutive case series analysis of 328 parents and youths aged 11-17 years, parents and youths provided reports of youth emotional and behavioral functioning and participated in structured clinical interviews. At the conclusion of the interviews, interviewers rated the reliability of informants. Interviewers rated youths' clinical severity and parents and youths provided information on youth demographics. Nominal logistic regressions tested patterns of discrepancies between parent and youth reports (i.e., which informant consistently reported greater degrees of youth emotional and behavioral concerns than the other) as predictors of interviewers' ratings of the reliability of parents and youths. All analyses controlled for variance explained by youth demographics and youth severity. Results: When parents reported greater degrees of youth emotional and behavioral concerns than youths self-reported, interviewers were likely to rate the youth as an unreliable informant, and were unlikely to rate the youth as an unreliable informant when parents reported less concerns than youths self-reported. However, interviewers' ratings of parents' reliability did not relate to the discrepancies between reports, regardless of which informant reported greater degrees of youth concerns. Conclusions: Prior research indicates that informant discrepancies potentially reveal important information of youths' emotional and behavioral concerns, such as the settings in which youths express these concerns. Yet, when parents and youths disagree in their clinical reports of the youth's functioning, this relates to whether a clinical interviewer views the youth as a reliable informant of their own functioning. To increase the cost-effectiveness and clinical utility of multi-informant clinical evaluations, practitioners and researchers should anticipate informant discrepancies and predict what they may represent before conducting clinical evaluations.