On the relevance of the reference period in youth mental health outcome questionnaires

Abstract

For the empirical test of the effectiveness of mental health treatment and for the monitoring of outcomes in practice settings the youth mental health field relies heavily on outcome measures that are based on self-report by the youth and proxy reports by caregivers and clinicians. In this dissertation I argue that we need to better understand the response process in the context of youths and caregivers completing these types of questionnaires to ensure that scores obtained with these questionnaires are interpreted accurately. I report the results of a secondary analysis of data that were obtained as part of randomized experiment. Youths and their caregivers were randomly assigned to either complete a version of the Symptom and Function Severity Scale (SFSS) that included a two-week reference period or a longer reference period (3 and 6 months). Based on a review of the relevant literature, I hypothesized that there would be no meaningful differences between the groups, which was not confirmed by the results. Significant differences at the group level were found in regard to the level of severity as rated by this scale. On average, both youths and caregivers seem to rate severity higher if a longer reference period is used. These differences are further explored in regard to differences by item and respondent characteristics. Implications of the findings for the mental health field and directions for future research are discussed.