Parent-Child Agreements And Disagreements in Perceptions of Adolescent General Functioning in Psychiatric Residential Care

Abstract

Abstract While much research exists on alignment between parent–child reporting on adolescent mental health symptoms, little exists on parent–child agreement in perceptions of general functioning, or the day-to-day ability to engage in adaptive activities, which may be a better measure for treatment progression and outcomes. Understanding these agreements or disagreements also has implications for assessment and treatment planning, especially in intensive settings like psychiatric residential care. We sought to explore parent–child agreement across six functional domains – family engagement, familial trust, school engagement, prosocial friendships, emotional regulation and future goals – using the Newport Functional Assessment in a sample of youth ( N = 321) admitted to psychiatric residential care. Both mothers and fathers consistently perceived lower adolescent functioning in every domain. There were some differences in disagreement based on adolescent age and gender. Interestingly, for some domains, higher parent–child disagreement was present for adolescents with lower insecure attachment to the target parent. Patients who felt they did not need to be in treatment disagreed more with mothers, but not fathers. Limitations and clinical implications are discussed. These findings underscore the importance of including both adolescent and parent perspectives of general functioning and how attachment dynamics and readiness for treatment may influence how adolescents assess their own functioning relative to their caregivers’ views.