What is the problem, and who says

What is the problem, and who says?

In deciding how to evaluate the problems of their clients and patients, therapists inevitably rely largely on what they say about themselves in interviews, on questionnaires, and in standard psychological tests. But we don't always know ourselves, or see ourselves as others see us. And our feeling, thinking, and behavior change with the time, the place, the situation, and the company. So it's important to study how well reports agree or disagree when they come from different people in different settings.

It's easiest to get reports from others about children because adults usually bring them for evaluation and treatment. Meta-analyses (pooled statistical analyses) of many studies show that children's ratings of their own problems are correlated poorly with ratings by their parents and other adults in their lives. But the adults don't agree with one another, either — at least not when they encounter children in different contexts, such as home, school, therapy, or a research lab. Adults who play similar roles in the child's life — as parents, teachers, mental health workers, or research observers — are much more likely to agree about the nature of the child's problems, although even then their agreement is imperfect.

But maybe that is to be expected. Children are often not good at talking about themselves, and their state of constant change may make their problems difficult to pin down even for people who know them well. Researchers at the University of Vermont have tried to find out whether adults present a more stable target. They conducted a meta-analysis of more than 100 studies that evaluated how well different informants (for example, self versus husband, wife, or clinician) agreed about an individual adult's psychopathology.

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