Popp Lukka, Neuschwander Murielle, Mannstadt Sandra, In-Albon Tina, Schneider Silvia
Clinical Child and Adolescent Psychology, Department of Psychology, Ruhr-Universität Bochum Bochum, Germany.
Kinder- und Jugendpsychiatrische Klinik, Universitäre Psychiatrische Kliniken Basel, Switzerland.
Front Psychol. 2017 Mar 27;8:404. doi: 10.3389/fpsyg.2017.00404. eCollection 2017.
In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years ( = 10.94; = 2.22). Overall, parent-child agreement on the diagnostic category of anxiety disorder ( = 0.21; = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder ( = 0.24-0.52; = 0.19-0.43) and corresponding diagnostic criteria ( = 0.22-0.67; = 0.24-0.41) were low to moderate with the highest agreement on separation anxiety disorder ( > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family-especially maternal depression and low social support-lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement.
在临床结构化诊断访谈中，基于父母和孩子报告做出的诊断一致性较低至中等。本研究的目的是：（1）在当前和终生诊断类别层面，以及特别聚焦于诊断标准的诊断方面，检验父母与孩子在焦虑症诊断上的一致性；（2）识别与父母及孩子相关的诊断一致性预测因素。样本包括166对亲子，他们接受了儿童精神障碍结构化诊断访谈（儿童版精神疾病诊断访谈量表，施奈德等人，2009年）。孩子们（51.8%为女孩）年龄在7至18岁之间（平均年龄 = 10.94岁；标准差 = 2.22岁）。总体而言，父母与孩子在焦虑症诊断类别（卡帕值 = 0.21；标准差 = 0.22）、社交恐惧症、特定恐惧症和分离焦虑症的特定焦虑诊断（基础率 > 10%）（卡帕值 = 0.24 - 0.52；标准差 = 0.19 - 0.43）以及相应诊断标准（卡帕值 = 0.22 - 0.67；标准差 = 0.24 - 0.41）上的一致性较低至中等，其中分离焦虑症的一致性最高（卡帕值 > 0.43）。母亲抑郁程度较低，以及母亲和父亲报告的较高社会支持与较高的亲子一致性相关。母亲抑郁被认为是最强的预测因素。父母的能力感、父母焦虑、亲子互动量以及孩子的年龄和性别没有预测价值。与特定焦虑诊断和诊断焦虑类别相比，预计在焦虑标准层面亲子一致性会更高。家庭中的心理压力——尤其是母亲抑郁和低社会支持——会降低父母与孩子在焦虑症状上的一致性。与孩子及关系相关的变量（年龄、性别、父母与孩子互动的时间量）在预测低亲子一致性方面不起作用。
