(PS7-51) The impact of parent- and youth-report discrepancy on family processes: Cohesion, conflict, and accommodation.

Abstract Text: Research suggests significant relationships between youth anxiety and family processes like family cohesion, conflict, and accommodation (Wang et al., 2014). Less is known about the impact of youth-parent discrepancies in reporting on predicting family processes. Early studies suggest that families in environments with less cohesion and more conflict are likelier to display discrepancy in reports of children's emotional problems. Furthermore, straightforward relations are established between family accommodation and report discrepancy, specifically with adolescents reporting lower levels of anxiety than parents (Hamblin et al., 2016). This study will fill continued gaps by exploring: 1) if parent reporting low anxiety and child reporting high anxiety predicts low family cohesion or 2) if parent reporting high anxiety and child reporting low anxiety predicts high conflict and/or high accommodation.

A total of 265 youth ages 9-17 (Mage = 13.01, SD = 2.5; 56.1% female) and their primary caregivers completed symptom and family functioning measures in the context of a RCT treating youth anxiety and depression. Youth anxiety symptoms were assessed using youth- and caregiver-reported Revised Child Anxiety and Depression Scale (RCADS; Chorpita et al., 2000). Cohesion and conflict were assessed using parent-reported Family Environment Scale (FES; Moos & Moos, 2009). Accommodation was assessed using parent-reported Family Accommodation Scale - Anxiety (FAS-A; Lebowitz et al., 2013). A series of hierarchical regressions were utilized to predict family process from parent-youth discrepancy (interaction effect of parent-youth RCADS scores), with youth age and sex entered as covariates.

Results suggest that discrepancies in parent and child anxiety ratings did not predict parent-reported cohesion (p=.14) or conflict (p=.42). However, discrepancies in parent and child anxiety ratings did predict parent-reported accommodation (Child-rated anxiety, β = 0.10 (0.036), t=2.73, p=.007; Parent-rated anxiety, β=.38 (.040), t = 9.61, p< .001; Child x Parent anxiety, β = -.003 (.001), t = -3.31, p=.001.) When children rate low anxiety and parents rate high anxiety, parent-reported accommodation is higher. When children and parents both rate high anxiety, parent-reported accommodation is lower. Child sex and age were not significant predictors of cohesion, conflict, or accommodation.

This has several potential clinical implications. One reporting discrepancy suggests that parents observe high youth anxiety while the youth do not. In these cases, the parent tends to use greater accommodation; perhaps the parent is applying accommodation instinctively based on their own assessment. The impact could be that the youth feels accommodated and less anxious due to parent actions. When both parent and youth report high youth anxiety, parents use less accommodation. Perhaps the parent feels less compelled to accommodate given the youth’s greater insight. Future research should explore these relationships in longitudinal and experimental frameworks to replicate their occurrence. Overall, findings imply that parent and child observations of anxiety are related to parent accommodation which deserves more investigation.