Abstract
Objective: Youth self-report data using the YOQ-30 has not been specifically examined for use in routine outcome monitoring systems. This study used the YOQ-30 self-report in three endeavors: (1) modeling change trajectories in a large, naturalistic outpatient sample, (2) creating and testing an empirical alert system for deterioration, and (3) exploring the role of informant agreement, both descriptively and in a change trajectory model. Method: The sample consisted of 21,098 adolescents ages 12-17 receiving outpatient mental health care who used the OQ Measures system. Multilevel individual change trajectory models estimated symptom change over time. An alert system was developed on one half of the sample to flag deterioration risk and tested on the other half of the sample. These alerts were used to estimate sensitivity, specificity, and overall accuracy. Exploratory analyses examined patterns of agreement between youth and caregiver reports using intraclass correlation coefficients (ICC) and tested whether agreement predicted change over time. Results: Growth models showed strong fit and aligned with previous research: distress decreased across sessions, and gender, age, and session frequency were significant predictors. The alert system demonstrated good performance (sensitivity = .70, specificity = .72, accuracy = .71), matching most benchmarks from previous YOQ research. Informant agreement was moderate (ICC = .38), and varied by age, youth gender, and caregiver gender. Higher agreement predicted both higher initial distress and greater improvement over time. Conclusions: The YOQ-30 self-report offers a meaningful way to track change and detect early risk in youth psychotherapy. Alert system performance mirrored earlier work that used the YOQ caregiver report or mixed samples. Informant agreement emerged as a significant predictor of change and may represent a promising addition to future early warning systems.
Degree
PhD
College and Department
Family, Home, and Social Sciences; Psychology
Rights
https://lib.byu.edu/about/copyright/
BYU ScholarsArchive Citation
Paxton, Tate M., "Routine Outcome Monitoring With the Youth Outcome Questionnaire-30.2 Self-Report: Creating and Testing an Empirical Alert System and Exploring Informant Discrepancy Patterns" (2025). Theses and Dissertations. 10944.
https://scholarsarchive.byu.edu/etd/10944
Date Submitted
2025-08-08
Document Type
Dissertation
Permanent Link
https://apps.lib.byu.edu/arks/ark:/34234/q2c6e2db8c
Keywords
youth psychotherapy, self-report, routine outcome monitoring, informant agreement, YOQ-30
Language
english