Self- and parent assessment of mental health: disagreement on externalizing and internalizing behaviour in young refugees from the Middle East.

Self- and parent assessment of mental health problems yield a limited degree of cross-informant agreement in adolescent populations. Working with data from 122 refugee children, adolescents and young adults from the Middle East, the aims of this study were to analyse levels of agreement and disagreement between self- and parent ratings of externalizing and internalizing behaviour and to identify predictors for the differences between the two sets of ratings. Parents and children were interviewed separately using structured questionnaires. Mental health was assessed using the Achenbach System of Empirically-based Assessment. Self- and parent-rated scale scores correlated moderately. The mean score differences between self- and parent-rated internalizing and externalizing behaviour were 2.0 and 2.7, p < 0.005, respectively. A larger mean difference was found among boys concerning externalizing behaviour and among girls concerning internalizing behaviour. Individual (age, and sex) family (father's health situation) and ethnic background predicted this difference. This could indicate that parent ratings and children's self-ratings are two, qualitatively different constructs and not just a result of expected inter-observer disagreement. When assessing young refugees for possible treatment, this difference needs to be understood and taken into consideration.