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Co-Development of Internalizing and Externalizing Problems in Mid-to-Late Childhood: A Cross-Lagged and Random Intercept Cross-Lagged Analysis
Gao Jiahui, Zhao Xinyu, Qiao Xiaoguang, Xing Xiaopei
Journal of Psychological Science ›› 2026, Vol. 49 ›› Issue (2) : 328-339.
PDF(1011 KB)
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Co-Development of Internalizing and Externalizing Problems in Mid-to-Late Childhood: A Cross-Lagged and Random Intercept Cross-Lagged Analysis
In recent years, the incidence of children's mental health problems has been on the rise, with an emerging trend of affecting younger ages. In light of this, mental health education has been elevated to a strategic priority at the national level. Behavioral problems, as key indicators for assessing children's mental health, have consistently received more attention from researchers and educators. Two types of behavioral problems are prevalent among children and adolescents: internalizing and externalizing problems. Although internalizing and externalizing problems are mutually independent and manifest with different symptoms, they are closely related and often co-develop in childhood and adolescence. Researchers have proposed that the dynamic reciprocal relations between internalizing and externalizing problems may lead to the co-development between the two constructs over time. For instance, the failure model holds that externalizing problem may result in peer rejection and a lack of social support, which may increase failure experiences in social interactions with important others, eventually leading to an increased risk for internalizing symptoms. In contrast, the acting out model states that children who show internalizing problems may “acted out” their negative feelings and emotions by displaying externalizing behaviors. Most relevant studies have tested the reciprocal relations between internalizing and externalizing problems. However, research failed to reach a consensus regarding the direction of the reciprocal effects between internalizing and externalizing problems. One possible reason for the inconsistent findings may be that studies examining these relations utilized the cross-lagged panel model (CLPM). CLPM has been criticized for failing to separate between-person variation from within-person variation. Between-person variation reflects that on average, whether children who perform high levels of externalizing problems also perform more symptoms of internalizing problems, and vice versa. In contrarst, within-person variation reflects whether the changes from one’s own mean level of externalizing problems during the one assessment period would predict the changes from one’s own mean level of internalizing problems during the next assessment period, and vice versa. In this regard, random intercept cross-lagged panel model (RI-CLPM) splits the variance of each variable into stable between-person variation and within-person variation. It is thus necessary to use RI-CLPM to provide a more appropriate test of the existing theories and studies. In addition, a comparison of the results from the CLPM and the RI-CLPM helps to reveal more refined reciprocal relations between internalizing and externalizing problems. Additionally, considering that the late elementary school period is an important transitional phase in children's development, the physiological, social, and psychological changes that children face during this time may exacerbate their internalizing and externalizing problems. However, most existing studies on behavioral problems have mainly focused on adolescent sample, with limited studies exploring these reciprocal relations beyond the mid-to-late childhood.
Using a longitudinal sample consists of 511 elementary school students (T1: Mage = 9.8 ±.78, 48.2% boys) in Grades 3 to 4 from Shandong Province, and conducting a four-wave longitudinal design (six-month apart), the current study aimed to reveal the dynamic reciprocal relations between internalizing and externalizing problems by comparing the CLPM and RI-CLPM. The CLPM results indicated that internalizing problems significantly predicted externalizing problems at the subsequent time point. However, the predictive effect of externalizing problems on internalizing problems was not significant. The RI-CLPM results revealed a significant correlation between the random intercepts of internalizing and externalizing problems. At the within-person level, changes in internalizing problems positively predicted subsequent changes in externalizing problems across four time points, whereas the reverse is not valid.
The findings emphasize the importance of early identification and intervention for internalizing problems in children’s mental health work. Considering the relatively stable predictive relationship between internalizing and externalizing problems, the manifestation of externalizing behaviors in children may signify that underlying internalizing symptoms have persisted for an extended period. Therefore, recognizing externalizing behaviors could serve as a pivotal opportunity to detect concealed internalizing problems in children, thereby aiding in the mitigation or prevention of such problems.
internalizing problem / externalizing problem / co-development / within-person / between-person / mid-to-late childhood
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发展级联(developmental cascades)近年来已成为发展心理学追踪研究中一种重要的理论视角。其基本观点是：人的发展过程是一个诸多发展特征不断产生级联效应的过程, 某个时间点上个体特征的发展状况会对该特征的后续发展产生影响, 并影响其他领域的发展, 进而影响到个体的整个发展进程。在发展级联的理论观点基础上形成的相关方法学模型, 为探究发展系统中多个因素之间的纵向关联提供了方法学依据与指导。本文介绍了发展级联的相关概念、理论基础、主要观点以及相关的方法学问题, 并对其在实证研究中的应用进行了展望。
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This study examined the stability of internalizing and externalizing problems from age 1.5 to 6 years, while taking into account developmental changes in the presentation of problems. The study comprised a population-based cohort of 7,206 children (50.4 % boys). At ages 1.5, 3, and 6 years, mothers reported on problem behavior using the Child Behavior Checklist/1.5-5 (CBCL/1.5-5). At each age we performed latent profile analysis on the CBCL/1.5-5 scales. Latent transition analysis (LTA) was applied to study the stability of problem behavior. Profiles of problem behavior varied across ages. At each age, 82-87 % of the children did not have problems whereas approximately 2 % showed a profile of co-occurring internalizing and externalizing problems. This profile was more severe (with higher scores) at 6 years than at earlier ages. A predominantly internalizing profile only emerged at 6 years, while a profile with externalizing problems and emotional reactivity was present at each age. LTA showed that, based on profiles at 1.5 and 3 years, it was difficult to predict the type of profile at 6 years. Children with a profile of co-occurring internalizing and externalizing problems early in life were most likely to show problem behavior at 6 years. This study shows that the presentation of problem behavior changes across the preschool period and that heterotypic continuity of problems is very common among preschoolers. Children with co-occurring internalizing and externalizing problems were most likely to show persisting problems. The use of evidence-based treatment for these young children may prevent psychiatric problems across the life course.
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Reciprocal feedback processes between experience and development are central to contemporary developmental theory. Autoregressive cross-lagged panel (ARCL) models represent a common analytic approach intended to test such dynamics. The authors demonstrate that—despite the ARCL model's intuitive appeal—it typically (a) fails to align with the theoretical processes that it is intended to test and (b) yields estimates that are difficult to interpret meaningfully. Specifically, using a Monte Carlo simulation and two empirical examples concerning the reciprocal relation between spanking and child aggression, it is shown that the cross-lagged estimates derived from the ARCL model reflect a weighted—and typically uninterpretable—amalgam of between- and within-person associations. The authors highlight one readily implemented respecification that better addresses these multiple levels of inference.
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This study used a three-wave longitudinal design to investigate developmental cascades among social competence and externalizing and internalizing behavioral adjustment in a normative sample of 117 children seen at 4, 10, and 14 years. Children, mothers, and teachers provided data. A series of nested path analysis models was used to determine the most parsimonious and plausible cascades across the three constructs over and above their covariation at each age and stability across age. Children with lower social competence at age 4 years exhibited more externalizing and internalizing behaviors at age 10 years and more externalizing behaviors at age 14 years. Children with lower social competence at age 4 years also exhibited more internalizing behaviors at age 10 years and more internalizing behaviors at age 14 years. Children who exhibited more internalizing behaviors at age 4 years exhibited more internalizing behaviors at age 10 years and more externalizing behaviors at age 14 years. These cascades among social competence and behavioral adjustment obtained independent of child intelligence and maternal education and social desirability of responding.
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Associations among internalizing, externalizing, and social competence were examined in a longitudinal cohort (N = 205) of 8- to 12-year-old children reassessed after 7, 10, and 20 years. Theoretically informed nested structural equation models tested interconnections among broad multi-informant constructs across four developmental periods. Follow-up analyses examined gender invariance, measurement and age effects, and putative common causes. Key model comparisons indicated robust negative paths from social competence to internalizing problems from childhood to adolescence and from emerging adulthood to young adulthood. Social competence and externalizing problems showed strong initial associations in childhood but no longitudinal cross-domain paths. Using a developmental psychopathology framework, results are discussed in relation to cascade and transactional effects and the interplay between competence and symptoms over time.
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Emotion expression is an important feature of healthy child development that has been found to show gender differences. However, there has been no empirical review of the literature on gender and facial, vocal, and behavioral expressions of different types of emotions in children. The present study constitutes a comprehensive meta-analytic review of gender differences and moderators of differences in emotion expression from infancy through adolescence. We analyzed 555 effect sizes from 166 studies with a total of 21,709 participants. Significant but very small gender differences were found overall, with girls showing more positive emotions (g = -.08) and internalizing emotions (e.g., sadness, anxiety, sympathy; g = -.10) than boys, and boys showing more externalizing emotions (e.g., anger; g =.09) than girls. Notably, gender differences were moderated by age, interpersonal context, and task valence, underscoring the importance of contextual factors in gender differences. Gender differences in positive emotions were more pronounced with increasing age, with girls showing more positive emotions than boys in middle childhood (g = -.20) and adolescence (g = -.28). Boys showed more externalizing emotions than girls at toddler/preschool age (g =.17) and middle childhood (g =.13) and fewer externalizing emotions than girls in adolescence (g = -.27). Gender differences were less pronounced with parents and were more pronounced with unfamiliar adults (for positive emotions) and with peers/when alone (for externalizing emotions). Our findings of gender differences in emotion expression in specific contexts have important implications for gender differences in children's healthy and maladaptive development.2013 APA, all rights reserved
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This study investigated the development of relational aggression (RA) in a sample of Chinese youth (N = 2,274, 52% boys) from fourth (M = 10.27 years) to ninth grade. Using latent class growth analysis, four trajectories were identified for both peer- and teacher-rated RA: a no aggression trajectory, a low-increasing trajectory, a moderate-decreasing trajectory, and a chronically high trajectory. Chronically high RA showed a chronicity effect on adolescent peer acceptance, rejection, and rule-breaking behaviors. Adolescents showed worse adjustment as RA increased, but they did not necessarily evidence significant improvement in adjustment even if their RA decreased. Findings reveal the maladaptive nature of RA and highlight the importance of considering cultural context in understanding RA.© 2018 Society for Research in Child Development.
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The co-occurrence of conduct problems (CP) and depressive symptoms (DS) is an important topic in developmental psychopathology; however, research in this area is still in its early stages. Using data from a school-based longitudinal sample of 2,453 adolescents with five waves from Grade 6 to 9, we examined the prevalence, etiology, and consequences of the co-occurrence of CP and DS. A person-centered approach, general growth mixture modeling, was applied to obtain CP and DS trajectory groups. The risk factors and consequences of the co-occurrence problem were examined using the trajectory groups. As hypothesized in a nonclinical sample, a small proportion of boys (8.8%) and girls (3.7%) reported to be high in both CP and DS over time. Among the adolescents with the highest level of CP, only 6.3% of the boys and 6.0% of the girls experienced the highest level of DS. However, among those with the highest level of DS trajectories, 42.9% of the boys and 10.2% of the girls reported the highest level of CP, indicating a gender-specific risk of the co-occurrence problem for depressed boys. Psychosocial and family factors were identified as vulnerable precursors to co-occurring CP and DS, a finding in line with the multiple domain risk model for CP and the transactional model for DS. The study also found that adolescents with the co-occurrence problem were more similar to those with "pure DS" than those with "pure CP" in academic adjustment at the ninth grade.
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The failure model posits that peer rejection and poor academic performance are dual pathways in the association between early aggressive behavior and subsequent depressive symptoms. We examined this model using an accelerated longitudinal design while also incorporating proactive and reactive aggression and gender moderation. Children in 1st, 3rd, and 5th grades (n = 912; ages 6-12; 48% female) were rated three times annually by their primary teachers on measures of proactive and reactive aggression, peer rejection, academic performance, and depressive symptoms. Using Bayesian cross-classified estimation to account for nested and planned-missing data, path models were estimated to examine whether early reactive aggression predicted subsequent peer rejection and academic performance, and whether these, in turn, predicted subsequent depressive symptoms. From 1st to 3rd grade, reactive aggression predicted peer rejection (not academic performance), proactive aggression predicted academic performance (not peer rejection), and academic performance and peer rejection both predicted depressive symptoms. From 3rd to 5th grade, however, neither peer rejection nor academic performance predicted subsequent depressive symptoms. Results were not moderated by gender. Overall, these findings provide mixed and limited support for the failure model among school-age children. Early reactive aggression may be a key risk factor for social problems, whereas proactive aggression may be linked to improved academic functioning. The "dual pathways" of peer rejection and academic performance may operate during early but not later elementary school. Limitations and implications are discussed.
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In a sample of 405 children assessed in kindergarten through the seventh grade, we determined the basic developmental trajectories of mother-reported and teacher-reported externalizing and internalizing behaviors using cross-domain latent growth modeling techniques. We also investigated the effects of race, socioeconomic level, gender, and sociometric peer-rejection status in kindergarten on these trajectories. The results indicated that, on average, the development of these behaviors was different depending upon the source of the data. We found evidence of the codevelopment of externalizing and internalizing behaviors within and across reporters. In addition, we found that African-American children had lower levels of externalizing behavior in kindergarten as reported by mothers than did European-American children but they had greater increases in these behaviors when reported by teachers. Children from homes with lower SES levels had higher initial levels of externalizing behaviors and teacher-reported internalizing behaviors. Males showed greater increases in teacher-reported externalizing behavior over time than did the females. Rejected children had trajectories of mother-reported externalizing and internalizing behavior that began at higher levels and either remained stable or increased more rapidly than did the trajectories for non-rejected children which decreased over time.
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Loneliness is typically defined in terms of feeling states. In this review, we take a somewhat different approach, describing loneliness in terms of perceived social isolation. Vulnerabilities to perceived social isolation differ across the lifespan. Unique properties of adolescence are identified that carry special risk for perceived social isolation. These include (but are not limited to) developmental changes in companions, developmental changes in autonomy and individuation, identity exploration, cognitive maturation, developmental changes in social perspective taking, and physical maturation. Scholars are encouraged to consider loneliness through the lens of perceived social isolation so as to better understand how the experience of physical isolation varies across adolescence. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
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While a large body of research consistently finds that internalizing and externalizing problems are closely related and commonly co-occur, the literature is mixed regarding the unique and shared risk processes in the development of both domains of problems. The present study examined the nature and timing of relationships between internalizing and externalizing problems as well as the mediating effects of negative self-concept on both. Using a developmental cascade model as a guiding framework, we conducted a cross-lagged panel modeling on a sample of 2,844 Korean fourth graders (54% boys and 46% girls) followed over 4 years. Findings suggest that internalizing and externalizing problems were reciprocally reinforcing, each leading to increases in the other indirectly through the mediating influence of negative self-concept. Negative self-concept exacerbates the development of both internalizing and externalizing problems, which in turn further undermines one's self-concept. Although there were significant gender differences in the stability of internalizing and externalizing problems, the developmental pathways between negative self-concept and both internalizing and externalizing problems held for both boys and girls. Implications for future research and intervention are discussed.
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The term and concept of "comorbidity" has been mired in controversy, although there is little question that the existence of covariation among psychiatric diagnoses poses significant challenges to current models of psychiatric classification and diagnosis. The papers in this Special Section underscore a number of important issues relevant to the comorbidity between and within childhood externalizing and internalizing disorders, and illustrate both methodological and substantive reasons for such comorbidity. Weiss, Susser, and Catron's distinction among common, broad-band specific, and narrow-band specific features provides a helpful framework for understanding the comorbidity of childhood externalizing and internalizing disorders (B. Weiss, K. Susser, & T. Catron, 1998). Hierarchical models of psychopathology help to dissolve the distinction between "splitters" and "lumpers" and point to variables that may elucidate the etiology of externalizing and internalizing disorders.
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The current study was initiated to increase understanding of developmental cascades in childhood in a sample of at-risk boys (N = 291; 52% White). Mothers, teachers, and boys reported on boys' externalizing problems, internalizing difficulties, and academic competence. Consistent with hypotheses regarding school-related transitions, high levels of externalizing problems were associated with both low levels of academic competence and high levels of internalizing problems during the early school-age period, and with elevations in internalizing problems during the transition to adolescence. Low levels of academic competence were associated with high levels of internalizing problems in middle childhood, and with high levels of externalizing problems during the transition from elementary school to middle school. Shared risk factors played a minimal role in these developmental cascades. Results suggest that there are cascading effects of externalizing problems and academic competence in childhood and early adolescence, and that some cascading effects are more likely to occur during periods of school-related transitions. Implications of developmental cascade effects for research and intervention are discussed.
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A substantial proportion of children and adolescents come to suffer from psychological disorders. This article focuses on the temperament factors that are involved in the pathogenesis of child psychopathology. It is argued that besides the reactive temperament factor of emotionality/neuroticism, the regulative process of effortful control also plays an important role in the etiology and maintenance of internalizing and externalizing problems in youths. More specifically, vulnerability to child psychopathology is determined by a temperament that is characterized by high levels of emotionality/neuroticism and low levels of effortful control. Models are hypothesized in which reactive and regulative temperament factors either have interactive or additive effects on the development of psychological disorders in children, and conceptualized in terms of a developmental psychopathology perspective. Directions for future research and clinical implications of this temperamental view on psychopathology are discussed.
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School-Wide Positive Behavioral Interventions and Supports (SWPBIS) has a large evidence base for preventing and addressing externalizing problem behavior, but there is little research examining its effects on internalizing problems, such as anxiety and depression. Given the prevalence of internalizing problems in today’s children and youth, it is worthwhile to examine the SWPBIS research base for evidence of effectiveness in preventing and treating internalizing problems. Hypothesized mechanisms by which the SWPBIS approach may support students with or at risk of internalizing problems include improving the clarity and predictability of the social environment, discouraging problem behavior that can threaten student safety, allowing instruction to take place, teaching effective responses to perceived environmental threats, and indirectly reducing internalizing problems by addressing externalizing problems. Support for internalizing challenges within a SWPBIS framework can be enhanced by adding evidence-based interventions for supporting internalizing needs within SWPBIS systems, providing professional development in identifying internalizing problems, and incorporating screening for internalizing problems into existing screening systems.
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Four different sources for cascade effects were examined using 9-year process and outcome data from a randomized controlled trial of a preventive intervention using the Parent Management Training-Oregon Model (PMTO™). The social interaction learning model of child antisocial behavior serves as one basis for predicting change. A second source addresses the issue of comorbid relationships among clinical diagnoses. The third source, collateral changes, describes events in which changes in one family member correlate with changes in another. The fourth component is based on the long-term effects of reducing coercion and increasing positive interpersonal processes within the family. New findings from the 9-year follow-up show that mothers experienced benefits as measured by standard of living (i.e., income, occupation, education, and financial stress) and frequency of police arrests. It is assumed that PMTO reduces the level of coercion, which sets the stage for a massive increase in positive social interaction. In effect, PMTO alters the family environment and thereby opens doors to healthy new social environments.
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The study investigated continuity, comorbidity and longitudinal associations between depression Beck depression inventory (RBDI) and antisocial behaviour Youth self-report (YSR) in middle adolescence. Data were used from a community sample of 2070 adolescents who participated in a 2-year prospective follow-up study. The results indicate that both depression and antisocial behaviour had considerable continuity, and concurrent comorbidity between these disorders was strong. In contrast to several previous studies, antisocial behaviour did not predict subsequent depression, but conversely, depression predicted subsequent antisocial behaviour among girls. Among boys history of depression seemed to protect from subsequent antisocial behaviour. Gender differences in longitudinal associations are discussed.
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Adolescent and parent reports of adolescent mental health problems often correlate poorly, and understanding this discrepancy has clinical importance. Yet contextual factors have only been inconsistently explained. At the 14- and 17-year follow-ups of the Western Australian Pregnancy Cohort (Raine) Study, 1,596 parent-child dyads completed the parent-reported Child Behaviour Checklist (CBCL) and the adolescent-rated Youth Self-Report (YSR). Maternal, family, adolescent, and parent factors were examined as potential predictors of discrepancies. When adolescent YSR scores were in the clinical range but parents' CBCL ratings were not, adolescents were more likely to report alcohol intoxication in the last 6 months, illicit drug use, low school motivation, and depression. When parents reported externalizing behaviour in the clinical range but adolescents did not, the characteristics associated with this were a younger maternal age, receiving social security benefit, stress related to parenting, depression, and poor family functioning. These new results will inform clinical management and research with adolescents who present with behavioural disorders. Statement of contribution What is already known on this subject? We know that adolescent and parent reports of adolescent mental health problems often correlate poorly, but little is known about which contextual factors lead to disagreement. Understanding the factors that influence agreement is clinically relevant for predicting and identifying externalizing behavioural disorders. This is a large-scale study with the ability to assess the impact of numerous psychosocial factors on instrument disagreement. What the present study adds We found that substance use, depression and low school motivation impacted on discrepancy in externalizing behaviour scores for 14-year-old male adolescents and their parents. Parental depression, stress, low family income, and family dysfunction also led to a higher likelihood of discrepancy in scores.© 2018 The British Psychological Society.
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Developmental cascade models linking childhood peer victimization, internalizing and externalizing problems, and academic functioning were examined in a sample of 695 children assessed in Grade 3 (academic only) and Grades 5, 6, 7, and 8. Results revealed several complex patterns of associations in which poorer functioning in one domain influenced poorer outcomes in other areas. For example, a symptom driven pathway was consistently found with internalizing problems predicting future peer victimization. Support for an academic incompetence model was also found-- lower GPA in Grade 5, 6, and 7 was associated with more externalizing issues in the following year, and poor writing performance in Grade 3 predicted lower grades in Grade 5, which in turn predicted more externalizing problems in Grade 6. Results highlight the need to examine bidirectional influences and multifarious transactions that exist between peer victimization, mental health, and academic functioning over time.
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Van der Ende, J.,
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Van der Giessen, D.,
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This study explored whether early elementary school aged children's externalizing problems impede academic functioning and foster negative social experiences such as peer victimization, thereby making these children vulnerable for developing internalizing problems and possibly increasing their externalizing problems. It also explored whether early internalizing problems contributed to an increase in externalizing problems. The study examined 1,558 Canadian children from ages 6 to 8years. Externalizing and internalizing problems, peer victimization, and school achievement were assessed annually. Externalizing problems lead to academic underachievement and experiences of peer victimization. Academic underachievement and peer victimization, in turn, predicted increases in internalizing problems and in externalizing problems. These pathways applied equally to boys and girls. No links from internalizing to externalizing problems were found.© 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.
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The relations between antisocial behavior and depressive symptoms were examined both longitudinally and concurrently in a sample of Italian early-adolescents. Structural equation modelling was applied to 10-month longitudinal data from a sample of 107 youths (54 girls; mean age at baseline = M = 12.5). Early adolescents completed a questionnaire in which they reported antisocial behaviors and depressive symptoms. Results show temporal stability for both constructs. Moreover, results show a significant longitudinal relation between depression at t1 and antisocial behavior at t2. This relation dropped to not significant when controlling for concurrent relations between these two measures of psychosocial adjustment at t2. A multigroup comparison suggests that these findings are similar across gender. Implications of the results for theory and intervention are discussed.
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Psychological disorders co-occur often in children, but little has been done to document the types of conjoint pathways internalizing and externalizing symptoms may take from the crucial early period of toddlerhood or how harsh parenting may overlap with early symptom codevelopment. To examine symptom codevelopment trajectories, we identified latent classes of individuals based on internalizing and externalizing symptoms across ages 3-9 and found three symptom codevelopment classes: normative symptoms (low), severe-decreasing symptoms (initially high but rapidly declining), and severe symptoms (high) trajectories. Next, joint models examined how parenting trajectories overlapped with internalizing and externalizing symptom trajectories. These trajectory classes demonstrated that, normatively, harsh parenting increased after toddlerhood, but the severe symptoms class was characterized by a higher level and a steeper increase in harsh parenting and the severe-decreasing class by high, stable harsh parenting. In addition, a transactional model examined the bidirectional relationships among internalizing and externalizing symptoms and harsh parenting because they may cascade over time in this early period. Harsh parenting uniquely contributed to externalizing symptoms, controlling for internalizing symptoms, but not vice versa. In addition, internalizing symptoms appeared to be a mechanism by which externalizing symptoms increase. Results highlight the importance of accounting for both internalizing and externalizing symptoms from an early age to understand risk for developing psychopathology and the role harsh parenting plays in influencing these trajectories.
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| [54] |
High rates of comorbidity are observed between internalizing and externalizing problems, yet the developmental dynamics of comorbid symptom presentations are not yet well understood. This study explored the developmental course of latent profiles of internalizing and externalizing symptoms across kindergarten, first grade, and second grade. The sample consisted of 336 children from an urban, low-income community, selected based on relatively high (61%) or low (39%) aggressive/oppositional behavior problems at school entry (64% male; 70% African American, 20% Hispanic). Teachers reported on children's symptoms in each year. An exploratory latent profile analysis of children's scores on aggression/oppositionality, hyperactivity/inattention, anxiety, and social withdrawal symptom factors revealed four latent symptom profiles: comorbid (48% of the sample in each year), internalizing (19%–23%), externalizing (21%–22%), and well-adjusted (7%–11%). The developmental course of these symptom profiles was examined using a latent transition analysis, which revealed remarkably high continuity in the comorbid symptom profile (89% from one year to the next) and moderately high continuity in both the internalizing and externalizing profiles (80% and 71%, respectively). Internalizing children had a 20% probability of remitting to the well-adjusted profile by the following year, whereas externalizing children had a 25% probability of transitioning to the comorbid profile. These results are consistent with the hypothesis that a common vulnerability factor contributes to developmentally stable internalizing–externalizing comorbidity, while also suggesting that some children with externalizing symptoms are at risk for subsequently accumulating internalizing symptoms.
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| [55] |
Psychiatric diagnostic covariation suggests that the underlying structure of psychopathology is not one of circumscribed disorders. Quantitative modeling of individual differences in diagnostic patterns has uncovered several broad domains of mental disorder liability, of which the Internalizing and Externalizing spectra have garnered the greatest support. These dimensions have generally been estimated from lifetime or past-year comorbidity patters, which are distal from the covariation of symptoms and maladaptive behavior that ebb and flow in daily life. In this study, structural models are applied to daily diary data (Median = 94 days) of maladaptive behaviors collected from a sample (N = 101) of individuals diagnosed with personality disorders (PDs). Using multilevel and unified structural equation modeling, between-person, within person, and person specific structures were estimated from 16 behaviors that are encompassed by the Internalizing and Externalizing spectra. At the between-person level (i.e., individual differences in average endorsement across days) we found support for a two-factor Internalizing Externalizing model, which exhibits significant associations with corresponding diagnostic spectra. At the within person level (i.e., dynamic covariation among daily behavior pooled across individuals) we found support for a more differentiated, four-factor, Negative Affect-Detachment-Hostility-Disinhibition structure. Finally, we demonstrate that the person-specific structures of associations between these four domains are highly idiosyncratic.
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| [56] |
Chinese adolescents who experience potentially traumatic events may develop posttraumatic internalizing and externalizing problems. However, it remains controversial whether interventions should focus first on internalizing or externalizing problems (or simultaneously on both). Previous studies have attempted to elucidate the developmental trajectories of posttraumatic internalizing and externalizing problems, temporal associations between them, and the between-person effects on this association to identify appropriate primary interventions. However, these studies overlooked the potential codevelopment of internalizing and externalizing problems along with the within-person effects on this association. To address these gaps, this study examined the codevelopment of and within-person temporal association between internalizing and externalizing problems. Participants were 391 Chinese adolescents who completed self-report questionnaires at 1, 1.5, 2, and 2.5 years after the 2008 Wenchuan earthquake. Parallel latent growth curve modeling and random intercept cross-lagged panel modeling were used to test the hypotheses. The results showed that both internalizing and externalizing problems were stable over time following the earthquake. Moreover, internalizing problems positively predicted externalizing problems at the within-person level and showed a positive between-person relationship with externalizing problems. These findings suggest that internalizing and externalizing problems may codevelop, and internalizing problems are risk factors for externalizing problems in adolescents following trauma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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