Caregiver self-reports and reporting of their preschoolers’ trauma exposure: Discordance across assessment methods.

Abstract

Nearly half of preschool-aged children from low-income families in the United States have been exposed to potentially traumatic events (PTEs), yet few are identified or receive trauma-focused mental health care. Given the critical need to accurately and efficiently identify PTE-exposed individuals, the current study examined discordant caregiver self-reporting of PTE exposure and caregiver reporting of child PTE exposure across two assessment methods: checklist and interview. Research has demonstrated significant cross-method discrepancies among adults reporting stressful life experiences, but examinations of caregiver reporting for their young children have not been conducted. Further, given their possible impact on reporting patterns, caregiver and child characteristics were examined in relation to discordant caregiver reporting by trauma type. Participants were 64 low-income, racially and ethnically diverse caregivers and their preschool-aged children from a Northeastern US city. Caregivers reported self and child PTE exposure via checklist and semi-structured interview. Cross-method discordance for caregiver and child exposure by trauma type ranged from 10.9% to 46.9% (Cohen’s kappa =.06-.70). Caregiver race and education were associated with discordant reporting, as were caregiver and child psychopathology. Lower levels of caregiver psychopathology were associated with discordant caregiver reporting of their own exposure, whereas higher levels were associated with discordant caregiver reporting of child exposure. Discordant caregiver reporting of PTE exposure varies by assessment format and trauma type and is differentially related to caregiver demographics and caregiver and child psychopathology. Associations between assessment methods, individual characteristics, and reporting should be considered when assessing PTE exposure to support service engagement and targeted treatment.

Caregiver Report of Children’s Exposure to Adverse Life Events: Concordance Between Questionnaire and Interview Approaches

“…These findings demonstrating concordance values that fall predominantly in the fair-to-moderate range for both overall endorsement and endorsement of characteristics of specific ALE types align with some of the general grouping patterns observed in prior studies on concordance between interview and questionnaire formats. For example, Glackin et al (2019) reported kappa values between interview and questionnaire formats for any type of ALE and indirect violence to be in the fair range, whereas exposure to noninterpersonal violence was in the poor range. The present data extend these prior findings by demonstrating this variability at the level of the individual type of ALE exposure.…”

“…Among these studies, two found strong, positive correlations between formats on the overall number of reported ALEs, suggesting reliability between formats (Allen et al, 2012;Wagner et al, 2006). Glackin et al (2019) found agreement between questionnaire versus interview methods to range between 10.9% and 45.3% for certain ALE groupings, with Cohen's kappa estimates reaching a max of .36.…”

“…For example, Allen et al (2012) exclusively inquired about short-term ALEs (less than 4 weeks) and excluded ALEs thought to be less common among socioeconomically healthy families (e.g., caregiver going to jail). Moreover, Wagner et al (2006) and Glackin et al (2019) did not assess for several types of interpersonal victimizations, such as injury after physical assault. The limited inventory of ALE types is problematic, as it may exclude certain ALEs known to be relatively common among children (e.g., family dysfunction related ALEs; Finkelhor et al, 2015) and, therefore, fail to identify a proportion of exposed children.…”

“…Counterbalancing administration is necessary when comparing methods to avoid priming effects (Peirce et al, 2009). Although Glackin et al (2019) did not use a confirmation procedure, the authors included different sets and types of ALEs between formats, forcing them to rely on broadened categories of ALEs when examining concordance.…”

Who Reports What? A Comparison of Child and Caregivers´ Reports of Child Trauma Exposure and Associations to Post-Traumatic Stress Symptoms and Functional Impairment in Child and Adolescent Mental Health Clinics

“…We did not measure caregiver and child reports of different trauma types across different assessment methods, nor did we have information about how the screening was conducted. A study comparing discordance among caregiver-child reports across assessment methods found that caregivers generally reported higher levels of self-exposure to PTEs as well as child PTEs via interview as compared to checklists, with the exception of higher report frequencies of both caregiver and child direct violence exposure through checklists than through interview (Glackin et al, 2019 ). Based on this, Glackin et al ( 2019 ) suggested that caregivers may feel more comfortable disclosing severe PTE exposure via checklists rather than through interviews.…”