This study examined parent–child agreement on psychopathology among children with chronic physical illness over 24 months and investigated whether parent psychological distress moderated associations between informant reports over time.
Data come from an ongoing longitudinal study of the mental health of children with chronic physical illness aged 2–16 years and their primary caregiving parent. Data were restricted to children 10 years of age and older (age-eligible to self-report), and analyses included parent–child dyads who completed baseline and 24-month assessments (n = 106). Child psychopathology was measured using the Emotional Behavioural Scales-Brief Version. Parent psychological distress was a composite of the Center for Epidemiological Studies Depression and Generalized Anxiety Disorder Scales. Kappa estimated agreement and product–term interactions in regression models were used to estimate whether parent psychological distress moderated associations between informant reports of child psychopathology.
Poor-to-moderate informant agreement was found at baseline, which improved to moderate at 24 months. Parent psychological distress moderated the associations between informant reports of behavior problems, β = 0.20 (0.05–0.36) at baseline, and for emotional, behavioral, and attentional problems at 24 months, β = 0.16–0.25. Among parents with elevated psychological distress, agreement with child reports was poor at baseline (intraclass correlation coefficient = 0.35–0.50), but improved to good at 24 months (intraclass correlation coefficient = 0.73–0.85).
There was no evidence that parents with elevated psychological distress negatively biased (overestimated) reports of psychopathology in their children with chronic physical illness. Findings are important when assessing psychopathology in integrated physical–mental health services.