Abstract
BACKGROUND: The COVID-19 pandemic disrupted adolescents' daily routines and access to support, with rural areas facing compounded risks due to limited digital infrastructure and scarce mental health services. This study examined differences between adolescents' self-reports and parents' reports of emotional disorders among high school students from rural Dobrogea, Romania. METHODS: A cross-sectional study carried out (February 2022-February 2024) including 300 participants: 150 adolescents (99 girls, 51 boys; 15-18 years) and one parent for each adolescent (120 mothers, 30 fathers). Parents completed the Adolescent Symptom Inventory-4 (ASI-4) and adolescents completed the Adolescent Psychopathology Scale-Short Form (APS-SF). Descriptive statistics and non-parametric Wilcoxon signed-rank tests compared responses; multiple regressions examined the extent to which parental ratings predicted adolescent self-ratings. RESULTS: Systematic informant discrepancies emerged for both externalizing and internalizing domains. Parents reported higher levels of conduct disorder (M = 56.94, SD = 29.87 vs. M = 50.65, SD = 10.03) and oppositional defiant disorder (M = 53.21, SD = 13.43 vs. M = 44.23, SD = 10.70), whereas adolescents reported more major depressive symptoms (M = 47.74, SD = 12.16 vs. M = 42.00, SD = 3.05). Parents also rated generalized anxiety as more severe (M = 59.10, SD = 14.78 vs. M = 46.42, SD = 12.99). Wilcoxon tests indicated significant median differences for conduct disorder (z = 2.865, p = 0.004), generalized anxiety (z = -2.397, p = 0.017), and major depressive disorder (z = 9.392, p < 0.001), but not for oppositional defiant disorder (z = 1.259, p = 0.208). Regression models showed that parental ratings significantly predicted adolescent self-ratings for externalizing and internalizing symptoms (e.g., oppositional defiant disorder (ODD) model R² = .547; generalized anxiety disorder (GAD) model R² = .603; major depressive disorder (MDD) model R² = .529), with cross-domain influences suggesting interdependence between externalizing and internalizing manifestations. CONCLUSIONS: Adolescents and parents in rural Dobrogea diverge in their perceptions of emotional difficulties following the COVID-19 pandemic, with parents tending to overestimate externalizing and anxiety symptoms and adolescents endorsing more depressive symptomatology. Findings underscore the need for multi-informant assessment and context-specific, school-connected mental health services in rural settings.