青少年临床报告中的信息提供者差异以及访谈者对信息提供者可靠性的印象。
Informant discrepancies in clinical reports of youths and interviewers' impressions of the reliability of informants.
作者信息
De Los Reyes Andres, Youngstrom Eric A, Swan Anna J, Youngstrom Jennifer K, Feeny Norah C, Findling Robert L
机构信息
Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland at College Park, College Park, Maryland 20742, USA.
出版信息
J Child Adolesc Psychopharmacol. 2011 Oct;21(5):417-24. doi: 10.1089/cap.2011.0011.
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.
目的
在本研究中，作者探讨了父母与青少年关于青少年情绪和行为功能的报告之间的差异是否与访谈者对父母和青少年的可靠性评级相关。
方法
在对328名11至17岁的父母和青少年进行的连续病例系列分析中，父母和青少年提供了青少年情绪和行为功能的报告，并参与了结构化临床访谈。访谈结束时，访谈者对提供信息者的可靠性进行了评级。访谈者对青少年的临床严重程度进行了评级，父母和青少年提供了有关青少年人口统计学的信息。名义逻辑回归测试了父母与青少年报告之间的差异模式（即，哪一方提供信息者始终报告的青少年情绪和行为问题程度比另一方更高），以此作为访谈者对父母和青少年可靠性评级的预测指标。所有分析均控制了青少年人口统计学和青少年严重程度所解释的方差。
结果
当父母报告的青少年情绪和行为问题程度高于青少年自我报告时，访谈者可能会将青少年评为不可靠的提供信息者；而当父母报告的问题程度低于青少年自我报告时，访谈者不太可能将青少年评为不可靠的提供信息者。然而，无论哪一方提供信息者报告的青少年问题程度更高，访谈者对父母可靠性的评级都与报告之间的差异无关。
结论
先前的研究表明，提供信息者之间的差异可能揭示了青少年情绪和行为问题的重要信息，例如青少年表达这些问题的情境。然而，当父母和青少年在关于青少年功能的临床报告中存在分歧时，这与临床访谈者是否将青少年视为其自身功能的可靠提供信息者有关。为了提高多提供信息者临床评估的成本效益和临床实用性，从业者和研究人员应在进行临床评估之前预测提供信息者之间的差异，并预测它们可能代表的含义。
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