Assessing caregiver-adolescent agreement on internalizing symptoms as a predictor of treatment outcomes: A response surface approach.

Abstract

Objective: Discrepancies between caregiver and adolescent reports of youth psychopathology are common. Although they may complicate clinical assessment and treatment planning, their association with psychotherapy outcomes in routine clinical care remains insufficiently understood. We examined whether baseline agreement between caregiver and adolescent reports of internalizing symptoms predicted post-treatment outcomes.

Method: Data were drawn from 1,648 caregiver-adolescent dyads receiving outpatient treatment in Germany (57.6% female adolescents; 85.8% medium/high socioeconomic status). Adolescents completed the Youth Self-Report and caregivers the Child Behaviour Checklist. Polynomial regression with multilevel response surface analyses examined whether baseline agreement and discrepancy predicted treatment satisfaction, psychosocial functioning, and internalizing symptoms. Exploratory analyses tested moderation by adolescent sex, family socioeconomic status, and family psychiatric history.

Results: Baseline caregiver-adolescent agreement showed small associations with specific treatment outcomes. Higher agreement was associated with slightly higher treatment satisfaction (marginal R² =  .022) and better psychosocial functioning (marginal R² = .040) but was unrelated to internalizing symptoms.

Conclusions: Baseline caregiver-adolescent agreement was not associated with post-treatment internalizing symptom levels. Interpretation of these null findings should consider the potential influence of shared method bias, as the same informants contributed to predictor and outcome assessments. Agreement may serve as a modest marker of selected therapist-rated treatment outcomes.