Correspondence between adolescent and informant reports of substance use: Findings from the Philadelphia Neurodevelopmental Cohort

Abstract

Inclusion of collateral informant reports is common in adolescent psychopathology research and clinical assessment, yet few studies have examined agreement on ratings of adolescent substance use or factors that may be associated with reporter agreement. The present study aimed to extend prior work on the correspondence between adolescent and informant reports of adolescent substance use with data from a large (n=5,214), diverse, community-based sample of youth aged 11–17 (mean age=14.53, SD=1.98; 52% female). Specifically, we examined: (a) agreement between adolescent and collateral informant reports of adolescent use of alcohol, marijuana, cocaine, inhalants, and stimulants and (b) potential correlates of reporter agreement. Agreement ranged from low (κ=.007, p=.053) for inhalant use to moderate (κ=.414, p<.001) for marijuana use. Disagreements were mainly driven by collateral underestimation of adolescent substance use. Older adolescent age was associated with poorer agreement across all substances (Odds Ratios [ORs] ≤ .80, ps<.05) except inhalants (OR=1.28, p<.001). Reporter agreement on alcohol and marijuana use was lower for male than female adolescents (ORs≤.85, ps<.05). Adolescent psychopathology was associated with poorer agreement on all substances (ORs≤.62, ps<.01). For alcohol and marijuana, past year frequency of use was associated with better reporter agreement (ORs≥1.54, ps<.001). For marijuana, older age at first use was related to poorer agreement (OR=.81, p=.01). Our results suggest that collateral reports of adolescent substance use may be ineffective proxies for adolescent self-reports in community samples, particularly for low base rate substances. Findings also highlight important factors to consider when collecting substance use information from multiple informants.

Developmental relations between alcohol expectancies and social norms in predicting alcohol onset.

“…Our measure of alcohol use was based on a single self-report item; although self-reported measures of alcohol consumption have been shown to be valid in adolescents (Donovan, 2004; Smith et al, 1995), and particularly so with web-based data collection (Turner et al, 1998), there is still potential for self-report bias. While other assessment methods (e.g., parent report) would add to the richness of our data, other investigations have shown that underestimation of child alcohol use is common and severe (Jones et al, 2017), and it’s unclear how such discrepancies would be resolved in this study. Also related to measurement, although we distinguished between norms held by general peers versus close friends, the scale assessing close friends’ norms included both descriptive and injunctive norms, where the scale assessing peer norms assessed only descriptive norms.…”

Gender differences in the association between conduct disorder and risky sexual behavior

“…However, given recent evidence for the validity of self-report data (Chan, 2009), our extensive focus on protecting confidentiality as part of our procedures, and the fact that rates of AOD use in the sample match national norms (Johnston et al, 2013), we do not believe this issue affected our results. Moreover, research has suggested that parents report lower estimates of participation in risky behavior than their children, including sexual activity, AOD use, and antisocial behaviors (Jones et al, 2017; Stanton et al, 2000; Yang et al, 2006). Therefore, we believe that basing our analyses on youth-reported data yields a more accurate estimate of the true prevalence of these behaviors.…”

Diagnostic accuracy of Achenbach scales in detecting youths’ substance use disorders.

“…Prior studies show inconsistent findings with regard to reporting accuracy across informants in reporting substance use. Some research has found kappas as low as .01-.48 between collateral report and self-report (Jones et al, 2017), which hover in the range of typical parent-youth agreement about behavioral problems in general (De Los Reyes et al, 2015). Some interpret this as suggesting either one or the other perspective may not be accurate, and others advocate treating endorsement by either party as indicating a problem (De Los Reyes et al, 2015).…”