534 - Caregiver-Adolescent Discordance In Reporting Exposures To ACEs and Resilience

Poster Number: 534
Publication Number: 534.423

Esther C. Kibakaya, The Children's Hospital at Montefiore, Bronx, NY, United States; Suzette Oyeku, The Children's Hospital at Montefiore, Bronx, NY, United States; Sylvia W. Lim, The Children's Hospital at Montefiore, Bronx, NY, United States

Background: Adverse Childhood Experiences (ACEs) are associated with negative mental health outcomes. Studies show parents underreport an adolescent’s exposures. Accurate knowledge of ACEs exposure will allow appropriate allocation of resources for treatment and prevention. Improving resilience is a potential target for innovative interventions targeting ACEs.

Objective: Compare frequency and inter-rater reliability of caregiver vs. self-reported ACEs and resilience factors in adolescents with mental health diagnoses.

Design/Methods: Adolescents 12-17 years old with ICD-10 diagnoses of depression, anxiety, ADHD and/or behavioral/conduct disorder were identified using EMR. A cross-sectional study was conducted using an anonymous self-administered paper, online or telephone survey of eligible caregiver and adolescents dyads. ACEs were assessed using The Center for Youth Wellness (CYW) ACEs Questionnaire categorized as No/Low(0-3) vs High (4 or more). Resilience factors were assessed using The Revised Child and Youth Resilience Measure 28, characterized as Low (less or equal to the sample median) vs High (more than the sample median). Resilience was further divided into: 1) personal resilience (individual characteristics) 2) relational resilience (caregiver relationship) and 3) contextual resilience (spiritual, educational, cultural characteristics). Demographic variables and reported adolescent mental health diagnoses were recorded. Chi square analyses were conducted to assess the association of reported diagnosis of depression (no vs yes) or anxiety (no vs yes) with demographic characteristics, ACEs (No/Low vs High) and Resilience Factors (Low vs High). Agreement and Cohen’s Kappa were utilized to assess inter-rater reliability of caregiver vs. adolescent reported ACEs, resilience, diagnosis of depression and anxiety.

Results: We recruited 70 participants: 42 caregivers and 28 adolescents, more parents than adolescents completed the survey (Table 1). Adolescent sex was associated with reported diagnoses of depression (Table 2). Moderate to high agreement exists between parent and adolescent reports of ACEs, resilience, diagnosis of depression and anxiety; however there was minimal to moderate inter-rater reliability (Table 3). Caregivers report fewer ACEs and higher resilience compared to adolescents while Adolescents report higher diagnoses of anxiety than caregivers (Table 3).Conclusion(s): Discordance exists between caregiver and adolescent  reported ACEs and resilience factors, which suggests surveying both groups may be preferred practice. Future research to explore why these discrepancies exist is needed.
Kibakaya_ECaroline_ CV 122021.pdf
Table 2: Association of Demographic Characteristics With Reported Diagnosis of Depression And Anxiety