Parents' perception of adolescents' difficulties and impact of problems in different castes and ethnic groups in Nepal. Do they converge with the frequencies of symptoms reported on the child behavior checklist (CBCL)?

Background: Parents' perceptions of their children's behavior are culturally determined and may differ across cultures. The present study aimed to investigate parents' perceptions of adolescents' difficulties and the impact of problems in different cultural contexts in Nepal, and to explore the extent to which they align with child symptoms measured on a problem rating scale.

Methods: This study was conducted with parents of school-going adolescents in sixteen districts of Nepal. The Nepali version of the Strengths and Difficulties Questionnaire (SDQ)-Impact Supplement was used to assess parents' perception of difficulties and the impact of problems, and the Child Behavior Checklist/6-18 (CBCL) was used as a symptom rating scale. We employed a mixed model approach for data analysis to address the hierarchical structure of our data.

Results: Parents' perceptions of difficulties and the impact of problems did not differ between the Hindu "high caste", the Hindu "low caste" and the indigenous/ethnic minority group. In contrast, the effect of caste/ethnicity was significant for parent ratings on the CBCL Total Problems as the "low caste" parents reported higher mean scores than parents from the indigenous/ethnic minorities group. Parents' perception of difficulties and the impact of problems were moderately associated with their reports on the CBCL Total Problems. There was no moderating effect of caste/ethnicity on any of these associations.

Conclusion: Although cross-cultural differences emerged in parents' ratings of symptoms, no differences emerged in their perception of difficulties and the impact of problems. Moderate associations between the CBCL Total Problems and perceived difficulties and the impact of problems suggest that clinicians should consider using supplement measurements in their assessment of child behavior problems. However, further studies are required to confirm our findings.