The authors have declared that no competing interests exist.
The majority of studies on parent-child discrepancies in the assessment of adolescent emotional and behavioral problems have been conducted in Western countries. It is believed that parent-adolescent agreement would be higher in societies with a strong culture of familism. We examined whether parent-adolescent discrepancies in the rating of adolescent emotional and behavioral problems are related to parental and family factors in Taiwan. Participants included 1,421 child-parent pairs of 7th-grade students from 12 middle schools in Northern Taiwan and their parents. We calculated Pearson’s correlation coefficients to assess the relationship between parental (Child Behavior Checklist, CBCL) and adolescent (Youth Self Report, YSR) report of emotional/behavioral problem syndromes. Regression models were used to assess parent-adolescent differences in relation to parental psychopathology and family factors. We found that parent-adolescent agreement was moderate (
Disagreement between self and parental report of adolescent psychopathology is common [
The most commonly proposed factor contributing to the observed parent-child discrepancy is the type of disorder being observed; there are indications that agreement between child and parental reporting is stronger with respect to externalizing than internalizing symptoms [
Apart from the overtness of the children’s symptoms, family factors such as parental level of psychopathology, parental socioeconomic status (SES), family structure, and family conflicts are also related to informant discrepancies [
Some researchers have hypothesized that parent-child discrepancies may be smaller in societies where cultural values promote familism and collectivism, such as those with Confucian traditions in East Asia [
To provide further information to this area of research, we used school-based survey data from 1,412 students aged 12–13 in Taiwan and assessed the degree of agreement between child and parental reports of adolescent emotional and behavioral problems. In addition, we explored whether family characteristics, including parental psychopathology, family structure, family SES, and maternal bonding, were associated with disagreement in parent-adolescent reporting of emotional and behavioral symptoms.
Participants were recruited from 6 of the 73 junior high schools in Taipei City, and 6 of the 66 in New Taipei City in 2003. The Taipei City and New Taipei City school districts were each categorized into three groups based on SES and neighborhood location. Two schools were randomly selected from each group using simple randomization procedure. All the students in the 36 selected classes were recruited to generate an eligible population of 1,518 students aged 12 to 13 years. All the parents of the recruited students were invited to complete a parental questionnaire. Approximately 67% of the parental questionnaire was filled in by mothers, and 33% was reported by fathers. The parents of 91 students did not turn in the questionnaire. We further excluded those who did not provide complete data on our outcome measures. The final sample size used in the current analysis was 1,412 parent-adolescent pairs. This study was approved by the Research Ethics Committee of the National Taiwan University Hospital, Taipei, Taiwan (Approval ID, 9100002328).
The Chinese Versions of the Child Behavioral Checklist (CBCL) reported by the parental participants, and the Youth Self-Report (YSR) reported by the adolescents were used to assess adolescent emotional/behavioral problem syndromes. The CBCL is a parental questionnaire used to measure the parental perception of children and adolescents aged 4 to 18 [
The reliability and validity of the Chinese versions of the YSR and CBCL have been demonstrated previously in Taiwan [
The CHQ is a 12-item self-reporting questionnaire modified from the General Health Questionnaire [
Family structure was assessed by parental marital status (married vs. not currently married) and sibship size (single, two, and three or more). Family SES was measured by paternal educational attainment. A recent study from Taiwan has shown that paternal educational attainment is more sensitive than the maternal educational attainment in predicting mental health outcomes [
This instrument was administered to adolescents to report their perceived bonding with their mothers. The PBI is a 25-item instrument (rated on a four-point Likert scale from 1 [very likely] to 4 [very unlikely]) measuring parenting styles during the child’s first 16 years, using two principal dimensions—care (12 items) and protection (13 items). Higher scores on the care subscale reflect affection and warmth; lower scores indicate rejection or indifference. Higher scores on the protection scale indicate greater parental authoritarian control and overprotectiveness. The reliability and validity of the Chinese version of the PBI have been demonstrated elsewhere [
We controlled for adolescent gender and parental age (paternal age >50 vs. < = 50; maternal age > 45 vs. < = 45).
We compared the eight emotional/behavioral problem syndromes and the internalizing and externalizing problems assessed by parental report of the CBCL and the adolescent report of the YSR. Pearson’s correlation coefficients (
Mixed-model ANOVAs were used to test for mean differences between the corresponding original scores of the CBCL and YSR subscales. We used the Bonferroni correction to decrease the possibility of false positives due to multiple comparisons. The significance level was set at 0.0028 (i.e. 0.05/18 = 0.0028).
Multiple linear regression analyses were used to assess whether parental and family factors were related to differences in parental-adolescent agreement (YSR score minus CBCL score was treated as our dependent variable).
Parental report | Adolescent report | r | Difference | t value | P value | |
---|---|---|---|---|---|---|
(CBCL) | (YSR) | |||||
Mean (SD) | Mean (SD) | Mean (95%CI) | ||||
Aggressive behaviors | 4.77 (4.70) | 7.03 (5.04) | 0.35 | -2.26(-2.55,-1.97) | -15.26 | < .0001 |
Anxious / Depressed | 3.20 (3.64) | 5.58 (4.69) | 0.34 | -2.38(-2.64,-2.13) | -18.37 | < .0001 |
Attention Problems | 4.20 (3.39) | 5.87 (3.38) | 0.37 | -1.68(-1.87,-1.48) | -16.62 | < .0001 |
Delinquent behavior | 1.35 (1.91) | 2.77 (2.46) | 0.33 | -1.42(-1.55,-1.29) | -20.79 | < .0001 |
Social Problems | 2.27 (2.17) | 3.01 (2.27) | 0.40 | -0.74(-0.87,-0.61) | -11.39 | < .0001 |
Somatic Complaints | 1.71 (2.33) | 3.15 (3.10) | 0.35 | -1.45(-1.61,-1.28) | -17.18 | < .0001 |
Thought Problems | 0.84 (1.26) | 1.82 (1.87) | 0.25 | -0.98(-1.08,-0.88) | -18.73 | < .0001 |
Withdrawn | 2.45 (2.41) | 3.89 (2.75) | 0.30 | -1.44(-1.60,-1.28) | -17.66 | < .0001 |
Total problems | 20.79(17.45) | 33.14(20.16) | 0.37 | -12.35(-13.46,-11.24) | -21.79 | < .0001 |
Internalizing problems | 7.35 (7.22) | 12.62 (9.17) | 0.36 | -5.27(-5.76,-4.78) | -21.01 | < .0001 |
Externalizing problems | 6.13 (6.23) | 9.80 (6.99) | 0.36 | -3.68(-4.07,-3.29) | -18.39 | < .0001 |
CBCL: Child Behavioral Checklist, YSR: Youth Self-Report
N(%) | Original score for Internalizing problems | Original score for Externalizing problems | |||||
---|---|---|---|---|---|---|---|
Parental report | Adolescent report | Parental report | Adolescent report | ||||
Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | ||||
< .0001 | < .0001 | ||||||
Male | 702(49.72) | 6.64(6.72) | 10.83(8.25) | 6.41(6.31) | 10.20(7.14) | ||
Female | 710(50.28) | 8.06(7.61) | 14.40(9.68) | 5.85(6.14) | 9.41(6.82) | ||
|
< .0001 | < .0001 | |||||
Paternal age >50 | 143(10.85) | 6.95(6.99) | 14.73(10.20) | 5.84(6.10) | 10.50(6.96) | ||
Paternal age < = 50 | 1175(89.15) | 7.37(7.22) | 12.30(8.96) | 6.08(6.21) | 9.66(6.93) | ||
|
< .0001 | < .0001 | |||||
Maternal age >45 | 265(19.73) | 7.17(7.43) | 14.61(9.69) | 6.26(6.62) | 10.62(6.79) | ||
Maternal age < = 45 | 1078(80.27) | 7.35(7.16) | 12.08(8.94) | 5.97(6.03) | 9.52(6.94) | ||
< .0001 | < .0001 | ||||||
Married | 1229(88.48) | 7.11(7.11) | 12.37(9.00) | 5.81(6.04) | 9.55(6.88) | ||
Not married | 160(11.52) | 9.14(7.73) | 14.26(10.20) | 8.32(6.98) | 11.47(7.69) | ||
< .0001 | < .0001 | ||||||
Single child | 124(8.88) | 7.80(7.32) | 12.65(9.73) | 6.80(6.83) | 10.45(7.90) | ||
Two | 692(49.57) | 7.00(6.83) | 11.88(9.04) | 5.68(5.88) | 9.46(6.97) | ||
Three or more | 580(41.55) | 7.67(7.61) | 13.42(9.10) | 6.47(6.43) | 10.00(6.76) | ||
< .0001 | < .0001 | ||||||
Some high school or lower | 319(24.26) | 8.64(7.49) | 13.43(9.50) | 7.46(6.73) | 10.29(7.44) | ||
High school graduate | 435(33.08) | 7.46(7.26) | 12.27(8.80) | 6.30(6.21) | 9.69(6.62) | ||
Some college | 255(19.39) | 7.13(7.58) | 12.38(9.05) | 5.52(5.61) | 9.85(7.09) | ||
College degree or higher | 306(23.27) | 5.85(6.04) | 12.18(9.25) | 4.47(5.52) | 9.11(6.83) | ||
< .0001 | < .0001 | ||||||
Yes (CHQ> = 4) | 226(16.12) | 11.09(8.26) | 14.73(10.40) | 8.33(6.78) | 11.19(7.89) | ||
No (CHQ<4) | 1176(83.88) | 6.64(6.78) | 12.18(8.83) | 5.69(6.03) | 9.48(6.74) | ||
|
< .0001 | < .0001 | |||||
High care |
703(49.79) | 6.66(6.47) | 11.16(8.57) | 5.23(5.49) | 8.43(6.43) | ||
Low care |
685(49.35) | 8.04(7.89) | 14.19(9.55) | 7.02(6.81) | 11.24(7.27) | ||
|
< .0001 | < .0001 | |||||
High overprotection |
683(48.37) | 7.34(6.97) | 12.78(9.35) | 6.06(5.93) | 9.79(6.98) | ||
Low overprotection |
700(50.61) | 7.41(7.52) | 12.54(9.06) | 6.23(6.57) | 9.84(7.05) |
# Mixed-model ANOVAs were used to test for mean differences between the corresponding original scores of the CBCL and YSR subscales.
+ above mean,
++ mean or lower
Notes: missing values—Paternal age, N = 94; Maternal age, N = 69; Parental Marital status, N = 23; Sibship size, N = 16; Paternal educational attainment, N = 97; Parental psychopathology, N = 10; Care, N = 24; Overprotection, N = 29
Bonferroni correction was used to decrease the possibility of false positives. The significance level was set at 0.0028 (i.e. 0.05/18 = 0.0028).
Internalizing problems | Externalizing problems | |||||||
---|---|---|---|---|---|---|---|---|
Sex& age adjusted | Adjusting for family characteristics | Sex&age adjusted | Adjusting for family characteristics | |||||
Male | 1 | 1 | 1 | 1 | ||||
Female | 2.14 | < .0001 | 2.15 | < .0001 | -0.27 | 0.52 | -0.29 | 0.50 |
Paternal age < = 50 | 1 | 1 | 1 | 1 | ||||
Paternal age >50 | 1.48 | 0.12 | 1.42 | 0.15 | 0.51 | 0.50 | 0.41 | 0.61 |
Maternal age < = 45 | 1 | 1 | 1 | 1 | ||||
Maternal age >45 | 2.11 | 0.01 | 2.17 | 0.01 | 0.79 | 0.19 | 0.77 | 0.22 |
-0.46 | < .001 | -0.21 | 0.04 | |||||
Married | 1 | 1 | ||||||
Not married | -0.49 | 0.64 | -0.47 | 0.58 | ||||
Single child | 1 | 1 | ||||||
Two | -0.39 | 0.71 | -0.37 | 0.65 | ||||
Three or more | 0.94 | 0.38 | -0.07 | 0.93 | ||||
Some high school or lower | 1 | 1 | ||||||
High school graduate | 0.10 | 0.88 | 0.73 | 0.21 | ||||
Some college | 0.44 | 0.60 | 1.20 | 0.08 | ||||
College degree or higher | 1.97 | 0.02 | 1.95 | 0.003 | ||||
Care | -0.14 | < .001 | -0.08 | 0.02 | ||||
Over-protection | 0.00 | 0.93 | 0.02 | 0.55 |
We found the correlation between the parent and child reporting of adolescent emotional and behavioral problem syndromes to be moderate in Taiwan (
We hypothesized that in a Confucian society like Taiwan, the stronger tradition of familism and collectivism would result in greater parent-adolescent agreement. Our results, however, do not support this proposition. The correlation for the total scale was 0.37, and none of the correlation coefficients for any dimensional problem assessed was greater than 0.4. This figure was much lower than a study conducted in China (r = 0.6) [
Rescorla et al. also reported the correlation coefficients to be 0.53 in Korea, and 0.41 in Hong Kong; both were higher than the corresponding figure observed in the current study [
Consistent with previous research results, adolescents tended to report higher levels of problems than their parents in the general population sample, which was particularly evident for internalizing problems such as anxiety and depression [
In line with previous studies, our current results indicate that parental psychopathology may cause the parent to encode children’s behaviors with greater negative descriptors [
One important aim of this study was to explore the relationships between family characteristics and parent-child agreement. Very few previous studies have examined the impact of parental SES on informant discrepancies. One study reported no association between SES and parent-child discrepancy [
The association between greater maternal care and a lower level of disagreement in reporting was consistent with previous research. Previous studies, although few, have indicated that greater family cohesion [
We did not find a correlation between family structure (such as parental marital status and sibship size) and informant discrepancy when we controlled for all potential covariates. Previous studies on this association have been conflicting: one study showed that intact families and small family sizes were related to better consistency in parent-child reporting [
Even statistical consideration of several parent-child characteristics could not explain away informant disagreement in the family-oriented collective society of Taiwan. This resonates with the proposition of several researchers that disagreement among informants does not necessarily indicate unreliability in one or both informants; conversely, this may indicate that different informants contribute complementary information, and both are valid [
This is one of few large-scale studies (N = 1,412) which has attempted to look into parent-adolescent disagreement in reporting emotional and behavioral problem syndromes in a non-Western setting. The current investigation responds to the call of several previous researchers and provides valuable empirical information which can be used to compare cross-informant data across multiple cultures [
We found moderate agreement in the parent-child reporting of adolescent emotional and behavioral problem syndromes in Taiwan. Our findings refute the hypothesis that societies with strong familism/collectivism traditions have greater parent-child agreement. Cultural attitudes of adolescent problematic behaviors should be further examined to understand the connotations underlying the assessment of each informant so that we can better help children who are suffering from different sets of problems.
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