Early predictors of parent- and self-reported perceived global psychological difficulties among adolescents: a prospective cohort study from age 3 to age 15.

AIMS: To study predictors at age 3 and at age 12 for parent and self-reported perceived global psychological difficulties at age 15.

METHOD: A representative birth cohort was prospectively followed from early childhood to age 15. Ratings of children's behavioral and emotional problems were collected at age 3 (Child Behavior Check List 2/3) and at age 12 (Child Behavior Check List 4-16, Youth Self Report). Mothers and fathers separately completed a questionnaire on their own well-being, health and mental distress when the child was 12. At the same time-point, family functioning was measured with the Family Assessment device. Outcome variables included both parent and self-reports of children's perceived psychological difficulties at age 15.

RESULTS: At age 15, of the 707 children with both parent and self-reports on perceived difficulties available, 10% had more perceived difficulties than peers of the same age in parent or self-reports. There was a significant increase in perceived difficulties from age 12 to age 15 in self-reports but not in parent reports. The parent-child agreement on difficulties at both time-points was very low (proportion of agreement 0.12-0.17). At age 3, externalizing problems, especially aggressiveness, predicted parent reports of child's difficulties at 15 years of age in univariate analysis. At age 12, parent-reported child's externalizing symptoms and perceived difficulties, poor social competence in self-reports, and mothers' reports of her own poor well-being, independently predicted parents' reporting of their child's perceived difficulties at age 15. Self-reports of internalizing problems and mother's own reports of her depressiveness when the child was 12 independently predicted the 15-year old's self-reported difficulties. Furthermore, in univariate analysis, poor family functioning at age 12 predicted perceived difficulties in parent and self-reports.

CONCLUSIONS: Both parent and self-reports of a child's difficulties are the outcome of an accumulation of the child's psychopathology, parental distress, and family dysfunction. The results emphasize the importance of early detection of children at risk of negative developmental pathways. In clinical practice and in prevention interventions, it is important to take into account the child's individual psychopathology, parental distress, and family dysfunction.