Childhood anxiety disorders: Parent-child (dis)agreement using a structured interview for the DSM-IV

Objective: To evaluate parent-child agreement for diagnosis of childhood anxiety disorders using a DSM-IV-based structured interview in an anxiety-clinic-referred sample and to explore the role of age and gender on agreement. Method: Forty-five children (ages 7-14 years) and their parents completed independent structured diagnostic interviews conducted by separate diagnosticians. Agreement between parent- and child-report on childhood anxiety disorder diagnoses was determined. Results: Levels of parent-child agreement were poor for the major childhood anxiety disorders presenting either as principal diagnosis or presence anywhere in the clinical picture. No significant differences were found for age or gender. However, somewhat greater agreement was found in older children for the principal diagnosis of specific phobia, and in females for the principal diagnosis of social phobia. Agreement was found to be greater between parents and children when each reported at least one principal anxiety diagnosis. Conclusions: When separate diagnosticians are used, there is limited agreement between parents and children for the DSM-IV anxiety disorders. Appropriately integrating the discrepant reports in reaching a diagnosis remains a methodological issue. Implications for treatment and future research are discussed.