Parent-adolescent agreement on psychosis risk symptoms

Despite practice guidelines recommending caregiver inclusion for assessment of mental health problems in adolescents, clinical high-risk (CHR) assessment tools that target attenuated psychosis symptoms rely solely on self-report. As many individuals in the clinical high-risk phase are expected to be adolescents, and programs of CHR research routinely recruit participants as young as twelve, parent input regarding adolescents' symptoms and functioning may help to inform clinical conceptualizations. No assessment tool targeting CHR symptoms has been developed for this purpose. We created a caregiver-report version of the 12-item Prime Screen-Revised and administered the measure to caregivers of 52 youth ages 12-19 referred by mental health providers for CHR study participation. Youth completed the Prime Screen-Revised as well as the Structured Interview for Psychosis Risk Syndromes (SIPS). Caregiver responses demonstrated poor agreement with youth ratings on Prime Screen-Revised (r=.09), but moderate agreement with clinician ratings (r=.41). The addition of caregiver screening data to youth self-report scores significantly improved a linear regression predicting clinician ratings. Using a threshold of four or more endorsements, the combined use of parent and adolescent responses accurately classified 75% of respondents with regard to SIPS-determined CHR status. Findings suggest that involving caregivers may help to improve the specificity of CHR screening and assessment procedures.