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Parent-youth informant disagreement: Implications for youth anxiety treatment.

ABSTRACT: Greater parent-youth disagreement on youth symptomatology is associated with a host of factors (e.g., parental psychopathology, family functioning) that might impede treatment. Parent-youth disagreement may represent an indicator of treatment prognosis. Using data from the Child/Adolescent Anxiety Multimodal Study, this study used polynomial regression and longitudinal growth modeling to examine whether parent-youth agreement prior to and throughout treatment predicted treatment outcomes (anxiety severity, youth functioning, responder status, and diagnostic remission, rated by an independent evaluator). When parents reported more symptoms than youth prior to treatment, youth were less likely to be diagnosis-free post-treatment; this was only true if the youth received cognitive-behavioral therapy (CBT) alone, not if youth received medication, combination, or placebo treatment. Increasing concordance between parents and youth over the course of treatment was associated with better treatment outcomes across all outcome measures ( ps?

SUBMITTER: Becker-Haimes EM

PROVIDER: S-EPMC5988273 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Parent-youth informant disagreement: Implications for youth anxiety treatment.

Becker-Haimes Emily M EM Jensen-Doss Amanda A Birmaher Boris B Kendall Philip C PC Ginsburg Golda S GS

Clinical child psychology and psychiatry 20170213 1

Greater parent-youth disagreement on youth symptomatology is associated with a host of factors (e.g., parental psychopathology, family functioning) that might impede treatment. Parent-youth disagreement may represent an indicator of treatment prognosis. Using data from the Child/Adolescent Anxiety Multimodal Study, this study used polynomial regression and longitudinal growth modeling to examine whether parent-youth agreement prior to and throughout treatment predicted treatment outcomes (anxiet ...[more]

PMID: 28191794

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Project description:Parent-adolescent conflict can be intense, yet parents and adolescents do not always agree on the intensity of conflict. Conflict intensity tends to change during adolescence and is thought to be an indicator of how the parent-adolescent relationship transforms. However, parents and adolescents might differently perceive change in conflict intensity, resulting in changing discrepancies in conflict intensity throughout adolescence. Also, personality characteristics of parents and adolescents might affect the extent to which there are discrepancies in perceptions of conflict intensity. This multi-informant longitudinal study investigated a) the trajectories of parent-adolescent conflict intensity, b) the trajectories of informant discrepancies, and c) the prediction of these trajectories by parental and adolescent personality. Dutch adolescents (N?=?497, 43.1% female, Mage?=?13.03 at T1), their mothers, and their fathers reported on parent-adolescent conflict intensity and personality for six years. Latent Growth Curve Modeling and Latent Congruence Modeling revealed curvilinear changes in conflict intensity, as well as in discrepancies thereof. Two cycles of discrepancies emerged. First, in early-to-middle-adolescence discrepancies in perceptions of parents and adolescents increased, reflecting that adolescents' perceived conflict intensity increased. Second, in middle-to-late-adolescence, father-adolescent discrepancies increased further, reflecting that fathers' perceptions of conflict decreased. Resilient adolescents, mothers, and fathers reported lower levels of conflict intensity than Undercontrollers and Overcontrollers, but personality was not associated with the rate of change in conflict intensity. Finally, undercontrolling fathers and overcontrolling adolescents showed higher father-adolescent discrepancies. This study showed that parents and adolescents differentially perceive conflict intensity and that in the adolescent-father relationship, the extent of the differences depends on adolescent and father personality.

Project description:ObjectiveRandomized clinical trials of augmentation strategies for youth with treatment-resistant anxiety disorders do not exist. This report presents findings from an efficacy trial of attention bias modification treatment (ABMT) as an augment for this population compared with attention control training (ACT).MethodSixty-four youths (34 boys; mean age 11.7 years) who continued to meet for anxiety diagnoses after completing cognitive-behavioral therapy were randomized to ABMT or ACT. ABMT and ACT consisted of dot-probe attention training trials presenting angry and neutral faces; probes appeared in the location of neutral faces on 100% of trials in ABMT and 50% of trials in ACT. Independent evaluators, youths, and parents completed ratings of youth anxiety severity, and youths completed measures of attention bias to threat and attention control at pretreatment, post-treatment, and 2-month follow-up.ResultsThe 2 arms showed significant decreases in anxiety severity, with no differences between arms. Specifically, across informants, anxiety severity was significantly decreased at post-treatment and decreases were maintained at follow-up. Primary anxiety disorder diagnostic recovery combined across arms was 50% at post-treatment and 58% at follow-up. Attention control, but not attention bias to threat, was significantly improved at post-treatment in the 2 arms.ConclusionThis is the first study to show anxiety can be decreased in youth who did not respond to cognitive-behaviorial therapy, and that the anxiety-decreasing effect is found using these 2 attention training contingency schedules. These findings and increases in attention control in the 2 arms raise intriguing questions about mechanisms of decreasing anxiety in treatment-resistant youth with attention training that require further research.Clinical trial registration informationAttention Bias Modification Training for Child Anxiety CBT Nonresponders; https://clinicaltrials.gov/; NCT01819311.

Dataset Information

Parent-youth informant disagreement: Implications for youth anxiety treatment.

Publications

Parent-youth informant disagreement: Implications for youth anxiety treatment.

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