Multiple Informants and Behavior Problem Trajectories
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Assessing Trajectories of Child and Adolescent Behavior Problems
Based on Multiple Informant Data
Manfred van Dulmen, Julie Morales, & Jennifer Roberts
University of Minnesota Twin Cities
Institute of Child Development
Paper presented at the biennial meetings of the Society for Research on Child Development
(April 25th 2003, Tampa). Funding from the National Institutes of Mental Health (R01MH40864)
to Byron Egeland supported this study. Direct correspondence regarding this paper to Manfred
van Dulmen, University of Minnesota, Institute of Child Development, 51 East River Road
Minneapolis MN 55455 [email: vandu001@umn.edu]
RUNNING HEAD: Multiple Informants and Behavior Problem Trajectories
Multiple Informants and Behavior Problem Trajectories
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Abstract
The current paper investigated whether trajectories of child and adolescent behavior
problems differ by informant. Using data from an ongoing longitudinal study of risk and
adaptation, child behavior checklist data from kindergarten, grade 1, and age 16 were analyzed
using growth curve modeling. Results of the analyses show that based on mother reports of child
behavior problems, internalizing and externalizing behavior problems decline from kindergarten
to age 16, whereas based on teacher reports of child behavior problems, internalizing and
externalizing behavior problems increase from kindergarten to age 16. Preliminary results further
show, however, that externalizing behavior problems intercepts and slopes based on mother and
teacher reports are non-independent and are each uniquely predictive of age 17.5
psychopathology symptom scores derived from the KSADS diagnostic interview.
The results of this paper suggest that, even though trajectories of child behavior problems
as operationalized separately by mother and teacher data are non-independent, they each also
have a unique course and are distinctively associated with future psychopathology symptoms.
Thus, we recommend that researchers operationalize behavior problems as informant-specific
constructs not only with regard to level but also with regard to change in behavior problems.
Furthermore, we recommend that researchers take consideration of the large variation that exists
among the reports from a particular type of informant.
Keywords: Multiple Informants, Behavior Problems, Growth Curve Modeling
Multiple Informants and Behavior Problem Trajectories
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Assessing Trajectories of Child and Adolescent Behavior Problems
Based on Multiple Informant Data
Research on the development of child and adolescent behavior problems often relies on
information derived from multiple informants. In addition to self reports, information on the
child’s functioning is often derived from parents and teachers. Although there is a growing body
of research investigating who is the ‘optimal’ informant and/or how data from multiple
informants can be integrated, little attention has been paid to how the trajectories of child
behavior derived from multiple informants may differ.
The purpose of this paper is to investigate the trajectories of child behavior problems
based on data from multiple informants. With new statistical procedures and an interest in the
longitudinal development of children, the role of trajectories in the study of behavior problems is
an area of emerging interest. Most of this research, however, has relied on information from a
single informant, such as the teacher or parent, or has simply combined information from
multiple sources without regard to what the implications are of using one informant over the
other, or averaging scores from multiple informants, to assess trajectories of behavior problems.
Addressing issues of developmental continuity of behavior problems across childhood
and adolescence has been a concern for both clinicians and researchers. The ability to
distinguish manifest problem behaviors that have the same underlying meaning over multiple
developmental periods enables the examination of patterns of specific problem behaviors that
may be associated with greater or lesser risk for later psychopathology. Distinguishing these
patterns or trajectories is important because it may allow changes differentially associated with
particular concomitants to be identified. This is relevant to the present research because if
information from different informants leads to the identification of different trajectories then the
Multiple Informants and Behavior Problem Trajectories
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validity of the premise of having identified actual changes is called into question, as the different
trajectories may reflect changes in the informant’s perspective rather than reflecting actual
behavioral change.
Optimal Informants.
Due to the fact that reports among informants generally correlate only at low to moderate
levels (Achenbach et al., 1987; Duhig et al., 2000), several authors have suggested that
information from various informants needs to be treated as “informant specific” (Offord, Boyle,
Raicne, Szatmari, Fleming et al., 1996), and that one informant may be a better informant at one
particular age whereas a different informant may be a better informant at a different age. For
example, several studies have found that teacher reports are prospectively and retrospectively
more strongly related to mental health referral during childhood and early adolescence than
parental reports on the child’s behavior problems (Stanger & Lewis, 1993; Verhulst, Koot, & van
der Ende, 1994). These findings suggest that teachers may be better informants on the child’s
functioning during childhood than parents. During adolescence, however, parents may be better
informants than teachers, especially because during this period most teachers typically spend less
time with the children than during childhood. In addition, agreement between parents on child
behavior problems is higher during adolescence than during childhood (Duhig et al., 2000)
whereas agreement between parents and teachers is generally higher during childhood than
during adolescence (Achenbach et al., 1987). These latter findings suggest that parents and
teachers have more discrepant views of the child’s functioning during adolescence than during
childhood and that during adolescence mothers and fathers are developing, as compared to
childhood, a view more similar to teachers. For the study of trajectories, the parent-teacher
discrepancies would suggest that the reports from parents and teachers on child behavior
Multiple Informants and Behavior Problem Trajectories
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problems would lead to similar starting points (i.e. intercepts) but different trajectories (i.e.
slopes) from childhood into adolescence.
Discrepant Multiple Informant Reports: Analyzing change. Prior research has thus investigated
whether data from multiple informants should be combined or analyzed separately, and how to
understand discrepancies in reports between multiple informants. This body of research has,
however, been limited to analyzing the level of behavior problems at a particular age. The
current paper extends this body of research by investigating whether the change in behavior
problems from childhood to adolescence is informant-specific.
Methods
Participants. Participants for this study were drawn from the Minnesota Parent-Child
Project, an ongoing 26-year longitudinal study of developmental adaptation in a high-risk urban
sample of young mothers and their first-born children (Egeland & Brunnquell, 1979).
Primiparous mothers, aged 12-34, were recruited for the study (originally n=267) while seeking
prenatal care from the Minneapolis Public Health Clinic from 1975 to 1977. When the
participants were 24 months of age, 212 families remained in the sample with attrition being due
primarily to residential mobility. Since age two, 88% of the participants have been retained.
Participants were considered at high-risk due to a variety of factors including the majority of
mother's pregnancies being unplanned, being unmarried, being of low socioeconomic status and
low educational attainment at time of delivery, and experiencing a high degree of instability and
life stress.
The participants in this study have been seen at 25 different time-points over a 23-year
period. The population utilized for this research was a subsample of 187 participants for whom
data on at least two time-points on the relevant measures were available. The ethnic breakdown
Multiple Informants and Behavior Problem Trajectories
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of the participants at age 16 was 66% Caucasian, 12% African-American, 17% mixed race, 2 %
non-white, and 4% other. At age 16, 55% of the participants were male and 45% were female.
Child behavior checklist. The Child Behavior Checklist (CBCL; Achenbach, 1991a)
measures adolescent problem behaviors and is administered to parents. For this study,
kindergarten, grade 1 and age 16 data from the Child Behavior Checklist were used because the
Teacher Report Form was also administered during kindergarten, grade 1 and at age 16.
The total problem scale of the Child Behavior Checklist consists of 113 items such as
‘defiant’, ‘easily frustrated’, and ‘unhappy, sad or depressed’, that are scored on eight subscales
(withdrawn, somatic complaints, anxious/depressed, social problems, thought problems,
attention problems, delinquent behavior, and aggressive behavior) that make up the internalizing
and externalizing scales. The internalizing scale consists of the following sub-scales: withdrawn,
somatic complaints, and anxious/depressed subscales. The externalizing scale consists of the
sub-scales delinquent behavior and aggressive behavior subscales. One-week test-retest
reliability for the externalizing and internalizing scales ranges from .87 to .95 (Pearson
correlation) (Achenbach, 1991a).
Teacher report form. The Teacher Report Form (TRF, Achenbach, 1991b) is
administered to the teacher and follows the same structure as the Child Behavior Checklist.
Twenty-five CBCL items that are difficult for teachers to rate (e.g. nightmares) are replaced on
the TRF by items that the teacher has specific knowledge about (e.g. disrupts class discipline)
(Achenbach & McConaughy, 1997). One-week test-retest reliability on the externalizing and
internalizing scales ranges from .82 to .92 (Pearson Correlation). Items on the TRF have shown
to distinguish children referred to services for behavioral and emotional problems from other
children (Achenbach, 1991b).
Multiple Informants and Behavior Problem Trajectories
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K-SADS. The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS;
Puig-Antich and Chambers, 1978) was used to assess symptoms of mental health disorder at age
17. The total number of symptoms within the domains of affective disorders, behavioral
disorders and anxiety disorders were calculated to give affective, behavioral, and anxiety
symptom scores. In the domain of affective disorders, symptoms were scored from the following
syndromes: major depressive disorder (single episode), dysthymia, mania, and cyclothymia. In
the domain of behavioral disorders, symptoms were scored from attention-deficit hyperactivity
disorder, oppositional defiant disorder, and conduct disorder. In the domain of anxiety disorders,
symptoms were scored for the following syndromes: avoidant disorder, schizoid disorder,
overanxious disorder, panic disorder, separation anxiety, phobia, obsessive-compulsive disorder,
and post-traumatic stress disorder. Because some symptoms are considered in the diagnosis of
more than one syndrome, a scoring language was written that would ensure that symptoms
would not be double-counted. For example, if a participant reported depressed mood for both the
diagnosis of major depressive disorder and dysthymia, depressed mood was only counted once.
Each symptom was scored 0/1, where a ‘1’ was given if the behavior was mild/moderate
or severe/extreme. A score of ‘0’ was given if the symptom did not occur at all or if it was only
slightly present. Scoring the symptoms in this manner reflects the K-SADS scoring manual
where a symptom is considered to be present only if it is either mild/moderate or severe/extreme.
A summary score was created for three domains of psychopathology: behavior disorders,
affective disorders, and anxiety disorders. Scores for each domain did not meet requirements for
univariate normality, as indicated by skewness > 2 and kurtosis > 7 (Curran, West, & Finch,
1996), and thus a natural log transformation was applied.
Multiple Informants and Behavior Problem Trajectories
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Analysis Plan. We first investigated the group level of behavior problems as compared to
standardized norms for the CBCL and TRF within each time-point. Next, agreement between
informants at each time point was examined by calculating zero-order correlations.
Following these descriptive analyses, growth curve modeling was conducted in PRELIS
2 (Jöreskog, Sörbom, du Toit, & du Toit, 2001). Growth curve modeling (aka multilevel
modeling, hierarchical linear modeling) allows examination of individual patterns across time.
This procedure assumes that the series of data points collected for each individual may be
represented by a growth model (e.g. such as linear change, Rogosa, 1988; Willett & Sayer,
1994). In the present paper, this procedure provides trajectories of externalizing and
internalizing symptoms across time as rated by different informants. These trajectories are
represented by estimated intercept and slope values. The intercept indicates the symptom score
in kindergarten and the slope value indicates the rate of change. Growth curve modeling
enhances within-time comparisons and within-time correlations between informants by
connecting ratings across time. For example, the individual trajectories of externalizing scores
from kindergarten to age 16 as rated by parents may be compared to those rated by teachers.
Instead of simply comparing the three pairs of mean values or the three correlations at
kindergarten, first grade, and age 16, the intercepts and slopes representing the course of
externalizing scores across time may be compared. If there is sufficient variation of the intercept
and slope terms, they may be correlated as well.
Some authors have argued for the use of raw scores when conducting growth curve
modeling because results from examining change in standardized scores over time could reflect
differences in the standardization rather than the true change (Karney & Bradbury, 1995).
Others, however, have defended the use of t-scores for research purposes (Truetler & Epkins,
Multiple Informants and Behavior Problem Trajectories
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2003). In the present study, t-scores were used to allow comparison between informants and also
because t-scores take important gender and age norms into consideration (Truetler & Epkins,
2003).
Results
-------------------------------Insert Figure 1 and Figure 2 about here
-------------------------------Compared to the normed t-scores on the CBC, the scores for the sample under study were
somewhat higher than expected (mean=50). T-scores ranged from 51.34 (mother-age 16
internalizing) to 59.69 (mother-kindergarten externalizing).
-----------------------------Insert Table 1 about here
------------------------------The cross-informant correlations during kindergarten, grade 1, and age 16 were low
(Table 1) and ranged from .10 (mother-age 16 internalizing and teacher-grade 1 internalizing) to
.31 (mother-age 16 externalizing and teacher-age 16 externalizing as well as mother-grade 1
externalizing and teacher-grade 1 externalizing). Within-informant correlations were generally
lower for teachers than for mothers. Across time, within-informant correlations for teachers
ranged from .00 (grade 1 internalizing behavior problems and age 16 internalizing behavior
problems) to .49 (kindergarten externalizing behavior problems and grade 1 externalizing
behavior problems). Within-informant correlations for mothers ranged from .43 (kindergarten
externalizing behavior problems with age 16 externalizing behavior problems) to .58
(kindergarten externalizing behavior problems with grade 1 externalizing behavior problems).
Multiple Informants and Behavior Problem Trajectories
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-----------------------Insert Figure 3 about here
------------------------Latent growth curve modeling was conducted in PRELIS to analyze the trajectories of
child behavior problems separately for internalizing and externalizing behavior problems (see
Figure 3). Missing data was handled using expectation-maximization (EM; Dempster, Laird, &
Rubin, 1977) with full-information maximum likelihood.
Intercepts derived from the growth curve analyses ranged from 51.42 (teacher
internalizing behavior problems) to 59.20 (mother externalizing behavior problems). There was
significant variation among individuals for intercepts derived from the growth curve analyses for
both mother reports (internalizing, τ = 45.08, t>1.96; externalizing, τ=39.00, t>1.96) and teacher
reports (internalizing, τ=45.08, t>1.96; externalizing, τ=49.59, t>1.96).
Mother reports of internalizing (-.47, t>1.96) and externalizing (-.35, t>1.96) behavior
problems decreased from kindergarten to age 16 whereas teacher reports of internalizing (.23,
t>1.96) and externalizing (.17, t>1.96) behavior problems increased from kindergarten to age 16.
There was significant variation among individuals for slopes derived from the data using the
mother as an informant of internalizing (τ = .25, t>1.96) and externalizing (τ =.25, t>1.96)
behavior problems, but no significant variation when teacher data was used. This suggests that
maternal data are associated with more variation among individuals in the change of behavior
problems over time than are teacher data.
------------------------Insert Figure 4 about here
-------------------------
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We further investigated the interrelationship between intercept and slope values for
externalizing behavior problems1 (see Figure 4). More specifically, we were interested in
investigating whether maternal and teacher data were non-independent. Results showed that for
teacher data, the intercept for externalizing behavior problems was negatively related to the slope
for externalizing behavior problems (-.65, t=5.15) whereas for maternal data, the intercept for
externalizing behavior problems was positively related to the slope for externalizing behavior
problems (.21, t=.87) but this relationship was not statistically significant. These findings
suggests that based on teacher reports, the higher the level of externalizing behavior problems
during kindergarten, the more the level of externalizing behavior problems decreased from
kindergarten to age 16. The variance components of the intercepts were associated at statistically
significant levels (.55, t=4.39) as well as the variance components of the slopes (.42, t=2.00).
These findings suggest that teacher and mother reports on externalizing behavior problems are
non-independent both with regard to initial starting level as well as change over time.
Finally, we investigated whether teacher and mother intercepts and slopes would
differentially predict psychopathology at age 17.5 as indicated by symptom scores derived from
the KSADS diagnostic interview. Preliminary results showed that the intercepts and slopes based
on mother and teacher data each uniquely predict age 17.5 psychopathology.
Discussion
These results suggest that data from different informants leads to identification of
different trajectories of behavior problems over time. One possible explanation is that mothers
become more accurate in reporting the level of their child’s behavior problems over time, due to
increased knowledge of the child, whereas teachers in elementary school are better informants of
1
At this point we still have some concerns about the reliability of the internalizing slope values as the reliability of
this particular slope was low. Therefore analyses investigating the relationship among slopes/intercepts, as well as
their relationship with psychopathology symptoms, was only investigated for externalizing behavior problems.
Multiple Informants and Behavior Problem Trajectories
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the child’s behavior problems than teachers in high school because they are spending more time
with the child during elementary school than during adolescence.
It should be noted though that Child Behavior Checklist normalized t-scores were used
and thus these findings contradict our expectations. That is, because our teacher reports do not
rely on the information from the same individual across time (i.e. different teachers reported at
different grades) we expected that teacher reports would lead to more variation than maternal
reports.
This study has important implications for investigators using multiple informant data in
longitudinal research. Some researchers have suggested that multiple informant data need not to
be averaged (Offord, Boyle, Racine, Szatmari, Fleming, et al., 1996; Kuo, Mohler, Raudenbusch,
& Earls, 2000) whereas others have attempted to develop statistical decision rules to assist
scholars in deciding how to best aggregate multiple informant data (Loeber, Green, Lahey, &
Stouthamer-Loeber, 1989; Piacentini, Cohen, & Cohen, 1992; Baillargeon, Boulerice, Tremblay,
Zoccolillo, Vitaro, & Kohen, 2001). The findings from this study add to the body of research that
suggests that reports from multiple informants should be treated separately and not simply
combined because different informant reports show unique trajectories of behavior problems,
even though trajectories of child behavior problems based on mother and teacher reports are nonindependent.
This study is limited in three important ways. The participants in this study were derived
from a longitudinal study that follows a high-risk sample due to poverty. The findings from this
study can therefore not be generalized beyond this type of population. Second, we only included
mothers in our sample and were not able to investigate how father reports differ from teacher
reports with regard to both intercept and change in child behavior problems. This is an important
Multiple Informants and Behavior Problem Trajectories
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point because other studies have shown that father and mother reports are systematically
different (e.g. Truetler & Epkins, 2003) and that they differ from teacher reports in important
ways (Duhig et al., 1999). Third, the slope and intercept values in this paper are based on data
from only three time-points that are systematically unbalanced. It remains the question whether
the slopes derived in the analyses presented in this paper would have differed had more timepoints been included.
Future research should incorporate analyses of variation among different informants
when examining trajectories of behavior problems across developmental stages. The analyses in
the current study have shown that there is significant variation, not only between informants, but
also within a particular type of informant as to how (s)he perceives a child’s behavior problems.
We have shown that the assumption that the perspective on a child’s functioning is similar within
a particular informant is erroneous and would neglect important variation among the reports of a
particular informant.
We plan to extend these current analyses in two ways. First, we plan to investigate in
future analyses how multiple informant data are associated with different group trajectories. For
example, in the study of externalizing behavior problems, researchers have relied sometimes on
teacher reports only (Nagin & Tremblay, 1999) or have used different decision rules to combine
data from both parents and teachers (Fergusson, Lynskey, & Horwood, 1996; Moffitt & Caspi,
2001; Moffitt, Caspi, Harrington, & Milne, 2002). It is not clear whether different informants
predict the classification of individuals into various groups that describe change in externalizing
behavior problems. If this is the case, it will be important to distinguish how specifically each
type or combination of informants’ assessments affect the description of change. Second, we
further plan to investigate whether growth curves based on teacher and parent report are
Multiple Informants and Behavior Problem Trajectories
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differentially associated with psychopathology during adulthood. Specifically, we will address
whether teacher or parent reports are ‘better’ predictors of psychopathology prospectively.
Multiple Informants and Behavior Problem Trajectories
Page 15
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Multiple Informants and Behavior Problem Trajectories
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Figure 1.
Boxplots of mother and teacher reports of externalizing behavior problems (CBCL: mother report; TRF: teacher report)
100
113
90
148
148
206
160
80
113
70
60
50
40
30
20
N=
140
140
CBCL K: Externalizin
140
140
CBCL 1: Externalizin
TRF K: Externalizing
140
140
CBCL 16: Externalizi
TRF 1: Externalizing
TRF 16: Externalizin
Multiple Informants and Behavior Problem Trajectories
Page 19
Figure 2.
Boxplots of mother and teacher report on internalizing behavior problems (CBCL: mother report; TRF: teacher report)
90
261
179
113
80
81
70
60
50
40
30
20
N=
142
142
CBCL K: Internalizin
142
142
CBCL 1: Internalizin
TRF K: Internalizing
142
142
CBCL 16: Internalizi
TRF 1: Internalizing
YSR 16: Internalizin
Multiple Informants and Behavior Problem Trajectories
Page 20
Table 1.
Intercorrelations among teacher and mother report on behavior problems during kindergarten, grade 1, and age 16
1
2
3
4
5
6
7
8
9
10
11
1. Teacher internalizing (K)
1
2. Teacher externalizing (K)
.49*
1
3. Teacher internalizing (1)
.33*
.20*
1
4. Teacher externalizing (1)
.13
.49*
.55*
1
5. Teacher internalizing (16)
.10
.01
.00
.07
1
6. Teacher externalizing (16)
.05
.17*
.10
.24*
.39
1
7. Mother internalizing (K)
.12
-.08
.20*
.03
.08
.00
1
8. Mother externalizing (K)
.08
.12
.04
.14
.10
.16
.60*
1
9. Mother internalizing (1)
.32*
.16
.21*
.13
.09
.01
.58*
.43*
1
10. Mother externalizing (1)
.27*
.31*
.18*
.31*
.21*
.11
.30*
.51*
.59*
1
11. Mother internalizing (16)
.21*
.13
.13
.07
.10
.07
.46*
.39*
.52*
.31*
1
12. Mother externalizing (16)
.22*
.27*
.15
.26*
.20*
.31*
.27*
.43*
.32*
.42*
.66*
12
1
Multiple Informants and Behavior Problem Trajectories
Page 21
Figure 3.
Predicted trajectories of internalizing and externalizing behavior problems from childhood to adolescence (N=187)
60
58
56
TINT
TEXT
PINT
PEXT
54
52
50
48
46
K
1
2
3
4
5
6
7
8
9
10
Note: x-axis represents grade level.
TINT=Teacher report internalizing behavior problems; TEXT=Teacher report externalizing behavior problems; PINT=Mother report
internalizing behavior problems; PEXT=Mother report externalizing behavior problems
Multiple Informants and Behavior Problem Trajectories
Page 22
Figure 4. Growth curve analyses investigating interrelationship among intercept and slope values for mother and teacher reports on
child externalizing behavior problems (unstandardized parameter estimates).
.21 (t=.87)
Mother intercept
Mother slope
.42 (t=2.00)
.55 (t=5.26)
Teacher intercept
χ2 (14) =26.61, p=.02. RMSEA = .072
-.65 (t=5.15)
Teacher slope