(WITHDRAWN) Effect of Caregiver Depressive Symptoms on the Concordance between Caregiver and Youth Assessment of Youth Physical Health

Background and Purpose: Health professionals acknowledge that discordance exists between adolescent and their parent ratings of adolescent physical health. Parental depression has been found to moderate the discrepancies between adolescent and parent ratings of adolescent mental and behavioral health, but less is known about whether caregiver depression also moderates concordance between parent and adolescent rating of adolescent physical health. Health information from both the adolescent and their parent is needed for a complete picture of an adolescent’s health status. The objective of this study was to explore whether caregivers (birth parents, adoptive parents, relative caregivers, and unrelated caregivers) depressive symptoms moderated the concordance between their and their youth’s assessment of the youth’s physical health.

Methods: Participants included 224 youth with mean age of 18.0 years (SD =1.3) and their caregivers. Participants were part of a longitudinal study of adolescents in a large urban city in the Western U.S. Caregiver depressive symptoms were measured using the Brief Symptom Inventory. Youth physical health was measured by the presence of health symptoms over the last 30 days (including colds and pain), presence of illnesses over the past year (including respiratory, gastrointestinal, ear, nose, and throat, urinary, and skin infections), and a subjective rating of health status. Multiple-group models were run to test whether caregiver depression status moderated the concordance between youth and caregiver report of physical health outcomes. Models compared caregivers above the mean for depression in the sample (n=62) with caregivers below the mean for depression in this sample (n=128).

Results: There was a strong correlation between youth and caregiver report of the youth’s pain in the last 30 days and subjective physical health status in the caregiver group with low or no depressive symptoms (r (128) = .29, p =.04; r (128) = .59, p <.01), but no significant correlation between the two in the caregiver group with higher depressive symptoms (r (62) = -.27, p =.27; r (62) = -.14, p =.57). Although the types of caregivers varied, we did not find differences in caregiver depression moderation by the type of caregiver.

Conclusions and Implications: Higher caregiver depressive symptoms were associated with worse concordance between caregiver and youth assessment of the youth’s pain and subjective physical health status. These two health issues are less visible and more subjective than other symptoms and illnesses (e.g. urinary and gastrointestinal illnesses) and communication between caregiver and youth may be affected by the caregiver’s depressive symptoms. The youth might choose not to talk about their pain or how they feel health-wise with caregivers who have higher depressive symptoms. Or it could be that caregivers with higher depressive symptoms may not be as attuned to their youth’s health since they are dealing with their own mental health issues. Since both caregiver and youth assessments of a youth’s physical health provide the best clinical data, it may be helpful for health providers, including health social workers, to assess caregiver’s mental health status to provide a more complete picture.