(PS4-12) Examining Parent-adolescent Agreement on the SCARED in African American Families

Social Anxiety Disorder (SAD) has a high prevalence rate in youth with 9.1% of meeting diagnostic criteria. The Screen for Child Anxiety and Related Emotional Disorders (SCARED; Birmaher et al., 1999) is one of the most widely used questionnaires for assessing anxiety disorders in youth. The SCARED includes identical child and parent forms that measure a range of anxiety symptoms, including social anxiety. The social anxiety subscale has been found to have low parent-child agreement with parents often reporting fewer symptoms about their children (van Doorn et al., 2018). This is problematic, as parents are instrumental in recognizing their children’s difficulties and play a “gatekeeper” role in accessing mental health services for their children (Stiffman et al., 2004). Previous research has pointed towards a “threshold theory” in which parents and children have differential thresholds for what they consider “problematic behaviors” and ethnic minority parent-child dyads have been found to experience more discordance than White parent-child dyads (Roberts et al., 2005). These findings underscore the importance of examining race and parent-child agreement in reporting symptomatology especially because ethnic minority youth are less likely to receive treatment. While there is ample literature on low agreement in White samples, the literature regarding parent-child agreement in African American families is limited. Additionally, given lower agreement has been found in ethnic minority parent-child dyads, it is crucial to determine the more reliable informant for diagnosing SAD. Thus, the present study aims to evaluate agreement between African American caregiver and adolescent reports of adolescent’s social anxiety symptoms and relate caregiver and adolescent reports to ratings on a gold standard semi-structured diagnostic interview to assess which informant is better at assessing symptoms in adolescents.

Participants will include African American caregiver-adolescent dyads that participated in a treatment study of a culturally-responsive school-based intervention for SAD. Caregivers and adolescents completed the SCARED SAD subscales of the parent (SCARED-P) and child (SCARED-C) scales. Additionally, both caregivers and adolescents were administered the Anxiety Disorders Interview Schedule IV (ADIS-IV; Silverman & Albano, 2004) to assess for a SAD diagnosis and clinician severity rating (CSR). Pearson correlations will be conducted to assess the overlap between caregiver and adolescent ratings of adolescent’s social anxiety symptoms. Following recommendations of Shanock et al. (2010) a score will be considered discrepant when the standardized score of the SCARED-C is half a standard deviation above or below the standardized score of the SCARED-P. To determine the best informant of anxiety symptoms in adolescents, regression analyses will be conducted using caregiver-report and adolescent-report ratings as predictors and CSR on the ADIS-IV as criterion. 

Findings will provide a novel examination of the potential parent-adolescent discrepancies in reporting social anxiety symptoms on the SCARED and its significance in assessing SAD diagnosis in African American teens.