Co-Occurring Internalizing and Externalizing Behavioral Problems: The Mediating Effect of Negative Self-Concept

Association among internalizing problems, white matter integrity, and social difficulties in children with autism spectrum disorder

Autism spectrum disorder (ASD) is characterized by social difficulties and often accompanied by internalizing and externalizing problems, which are frequently overlooked. Here, we examined and compared fractional anisotropy (FA) between 79 children with ASD (aged 4-7.8 years) and 70 age-, gender-, and handedness- matched typically developing controls (TDCs, aged 3-7.2 years). We aimed to explore the relationship among social difficulties, internalizing and externalizing problems, and brain structural foundation (characterized by white matter integrity). Compared with the TDCs, the children with ASD exhibited more severe internalizing and externalizing problems, which were positively correlated with social difficulties. Reduced FA values were observed in specific white matter tracts that integrate a fronto-temporal-occipital circuit. In particular, the FA values within this circuit were negatively correlated with internalizing problems and SRS-TOTAL scores. Mediation analysis revealed that internalizing problems mediated the relationship between the FA values in the left middle longitudinal fasciculus (L-MdLF) and corpus callosum forceps major (CCM) and social difficulties in children with ASD. These findings contribute to our understanding of social difficulties, internalizing and externalizing problems, and white matter integrity in children with ASD and highlight internalizing problems as a mediator between social difficulties and white matter integrity.

Between- and within-child level associations between externalizing and internalizing behavior problems in a nationally representative sample of US elementary school children

BACKGROUND

Both transactional and common etiological models have been proposed as explanations of why externalizing behavior problems (EBP) and internalizing behavior problems (IBP) co-occur in children. Yet little research has empirically evaluated these competing theoretical explanations. We examined whether EBP and IBP are transactionally related at the within-child level while also identifying antecedents commonly associated with between-child differences in underlying stability of both EBP and IBP across elementary school.

METHODS

We analyzed a nationally representative and longitudinal sample of US schoolchildren (N = 7,326; 51% male) using random-intercept cross-lagged panel modeling (RI-CLPM). We used teacher ratings of EBP and IBP as annually assessed from the spring of kindergarten (Mage = 6.12 years) through the spring of 5th grade (Mage = 11.09 years). Early childhood antecedents included child internal (i.e. inhibitory control, cognitive flexibility, working memory, and language/literacy) and external factors (i.e. parental warmth, harsh parenting, parenting stress, and maternal depressive symptoms).

RESULTS

We found little evidence for within-child, transactional relations between EBP and IBP. Both types of behavior problems instead were substantially associated at the between-child level. Inhibitory control was the strongest common antecedent that explained this longitudinal overlap. Cognitive flexibility, working memory, language/literacy skills, and maternal depression contributed specifically to the stability of IBP. Measures of parenting were specific to the stability of EBP.

CONCLUSIONS

Common etiological factors rather than transactional relations better explain the co-occurrence of EBP and IBP during elementary school. Inhibitory control is a promising target of early intervention efforts for schoolchildren at risk of displaying both EBP and IBP.

The effects of two types of neighborhood factors on trajectory of internalizing and externalizing symptoms from early childhood to adolescence

Although a robust body of previous empirical studies investigated the long-term trend of child behavior problems, limited research discussed the influences of various types of neighborhood factors on such trajectory (e.g., neighborhood structural characteristics and collective efficacy). Using a nationally representative longitudinal dataset the Fragile Families and Child Wellbeing Study (FFCWS), with six waves from 1998 to 2017, this study captures the longitudinal effects of two types of early childhood neighborhood factors on the co-development of internalizing and externalizing symptoms. Data was collected at the focal child's age 3, age 5, age 9, age 15 (N = 2,385), and the parallel-process growth curve models were applied. Results suggest that the trajectories of both internalization and externalizing symptoms showed U-shape and bidirectional relationships among internalizing and externalizing problems. The long-term effects of neighborhood social cohesion and economic disadvantages were significantly associated with children's internalizing and externalizing symptoms. The implication of this study was further discussed.

Sleep and internalizing problems in primary school children with attention-deficit hyperactivity disorder

BACKGROUND

Internalizing and externalizing problems have received great attention, and children with ADHD exhibit high rates of comorbid internalizing and externalizing disorders. This study aimed to explore the relationship between sleep and internalizing problems in children with attention-deficit hyperactivity disorder (ADHD) and the probable mediating role of externalizing problems.

METHODS

A total of 203 primary school children diagnosed with ADHD for the first time were recruited for this study. Children with ADHD were evaluated by Children's Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ). Internalizing problems were represented by emotional symptoms and peer problems of SDQ, and externalizing problems were represented by conduct problems and hyperactivity-inattention problems of SDQ. Multi-step linear regression analysis was used to investigate the mediating effect of externalizing problems on the relationship between sleep and internalizing problems.

RESULTS

Sleep in children with ADHD was associated with emotional problems in internalizing problems, and conduct problems in externalizing problems mediated the association between sleep and emotional problems.

CONCLUSION

For children with ADHD, when it is difficult to identify internalizing problems, especially emotional problems, we can take sleep and externalizing problems as clues to improve our clinical ability to recognize and deal with emotional problems.

IMPACT

1. We first explored the possible mediating role of conduct problems between sleep and emotional problems in primary school children with ADHD. 2. When it is difficult to identify internalizing problems, especially emotional problems, we can take sleep and externalizing problems as clues to improve our clinical ability to recognize emotional problems for children with ADHD. 3. For children with ADHD with potential internalizing problems, especially emotional problems, interventions for their sleep and externalizing problems may be the possible methods to deal with.

Predictors of Impairment and Self-Concept in Children and Adolescents with Persistent Tic Disorder

This study examined predictors of, and associations between, self-concept, demographic variables, and clinical measures in fifty-eight children and adolescents with Persistent Tic Disorder (PTD; 44 males, Mage = 11.9 years, SD = 2.74). Participants completed measures that assessed self-concept, tic severity, tic-related impairment, and comorbid psychological symptoms. Results showed that generalized anxiety disorder, major depressive disorder, persistent depressive disorder, total tic severity, number and complexity of tics, and total and social tic-related impairment were associated with self-concept. Tic-related social impairment mediated the relationship between tic severity and self-concept. Exploratory analyses found that total tic severity, motor tic severity, and vocal tic severity, as well as the number, intensity, and interference of tics predicted social tic-related impairment. Results suggest that treatments to reduce the number and complexity of tics, with additional focus on navigating social interactions, may serve to decrease tic severity and impairment, and in turn, improve self-concept.

Joint developmental trajectories of internalizing and externalizing problems from mid-childhood to late adolescence and childhood risk factors: Findings from a prospective pre-birth cohort

There is limited evidence on heterogenous co-developmental trajectories of internalizing (INT) and externalizing (EXT) problems from childhood to adolescence and predictors of these joint trajectories. We utilized longitudinal data from Raine Study participants (n = 2393) to identify these joint trajectories from 5 to 17 years using parallel-process latent class growth analysis and analyze childhood individual and family risk factors predicting these joint trajectories using multinomial logistic regression. Five trajectory classes were identified: Low-problems (Low-INT/Low-EXT, 29%), Moderate Externalizing (Moderate-EXT/Low-INT, 26.5%), Primary Internalizing (Moderate High-INT/Low-EXT, 17.5%), Co-occurring (High-INT/High-EXT, 17%), High Co-occurring (Very High-EXT/High-INT, 10%). Children classified in Co-occurring and High Co-occurring trajectories (27% of the sample) exhibited clinically meaningful co-occurring problem behaviors and experienced more adverse childhood risk-factors than other three trajectories. Compared with Low-problems: parental marital problems, low family income, and absent father predicted Co-occurring and High Co-occurring trajectories; maternal mental health problems commonly predicted Primary Internalizing, Co-occurring, and High Co-occurring trajectories; male sex and parental tobacco-smoking uniquely predicted High Co-occurring membership; other substance smoking uniquely predicted Co-occurring membership; speech difficulty uniquely predicted Primary Internalizing membership; child's temper-tantrums predicted all four trajectories, with increased odds ratios for High Co-occurring (OR = 8.95) and Co-occurring (OR = 6.07). Finding two co-occurring trajectories emphasizes the importance of early childhood interventions addressing comorbidity.

Pubertal progression and its relationship to psychological and behavioral outcomes among adolescent boys

Variations in pubertal timing and tempo have relevance to psychosocial development. Accounting for pubertal timing, tempo, and psychosocial development simultaneously in a model remains challenging. This study aimed to document the typology of pubertal development in a cohort of Taiwanese adolescent boys and then to examine how the associations between psychosocial variables across time vary by the patterns of pubertal development. A group of adolescent boys (n = 1,368) reported pubertal signs and psychosocial variables for 3 years since seventh grade. The growth mixture model revealed three major classes of pubertal transition: average pubertal growth, late-onset with rapid catch-up, and late-onset with slow catch-up. In a cross-lagged panel model, the multigroup analysis found the regression coefficients mostly invariant across all three classes, except those between deviant behavior and subsequent changes in depressive symptoms that were significantly positive only in the late-onset with slow catch-up group. Adolescent boys in this group were estimated to have the highest marginal level of depressive symptoms and deviant behavior in ninth grade among the three classes. Our study highlights the heterogeneity in boys' pubertal development and the role of the pubertal development pattern in their psychosocial development.

Predicting Self-Esteem and Depressive Symptoms from Social Skills Among Youth Referred for an Autism Evaluation

Social skills are associated with depression and self-esteem in autistic youth. Minimal comparisons between youth and parent-reported social skills to clinically relevant samples limit existing studies. This study compared the relationships between parent and youth-reported social skills, self-esteem, and depressive symptoms between autistic youth and youth referred for but not given an autism diagnosis. Regression analyses of cross-sectional data revealed that youth-reported social skills statistically predicted self-esteem, parent-reported social skills statistically predicted depressive symptoms, and self-esteem statistically predicted depressive symptoms. All relationships were weaker in the autistic group, except parent-reported social skills and depressive symptoms, which was stronger. Results indicate that poor social skills are associated with mental health outcomes among youth referred for autism diagnosis, but that autism-related factors may influence these relationships. Implications for future research and clinical practice are discussed.

The validity of transdiagnostic factors in predicting homotypic and heterotypic continuity of psychopathology symptoms over time

Studies of the continuity of psychopathology symptoms mainly involved the traditional conceptualization that mental disorders are discrete entities. However, high comorbidity rates suggest a few transdiagnostic factors that underlie individual disorders. Therefore, the present study examined the validity of transdiagnostic factors in predicting homotypic and heterotypic continuity of comorbidity classes across two waves in a nationally representative sample. We conducted a latent transition analysis to investigate how transdiagnostic factors differentially affect the transition probabilities of comorbidity classes across time. Results found a notable predictive validity of transdiagnostic factors: (a) internalizing strongly predicted the stability of the internalizing class and transition from the externalizing class to internalizing class, and (b) externalizing predicted the transition from the internalizing class to externalizing class. The study also found a more dynamic prediction pattern leading to equifinality and multifinality of psychopathology symptoms. The findings suggest that transdiagnostic factors can provide information on how individuals' symptom manifestations change over time, highlighting the potential benefits of incorporating transdiagnostic factors into assessment, treatment, and prevention.

Developmental cascades of behavior problems and cognitive ability from toddlerhood to middle childhood: A 9-year longitudinal study

Little is known about the direction, ordering, and uniqueness of longitudinal associations between behavior problems and cognitive ability, from toddlerhood to middle childhood. A developmental cascade model was tested in the present study to examine the transactional processes in 103 Chinese children at the ages of 1, 2, 7, and 9 years. Behavior problems were assessed using the maternal reported Infant-Toddler Social and Emotional Assessment at the ages of 1, 2 and parental reported Children Behavior Checklist at the ages of 7, 9. Cognitive ability was measured using Bayley Scales of Infant and Toddler Development at the ages of 1, 2 and Wechsler Intelligence Scale for Children at the ages of 7, 9. The results revealed the stability of behavior problems and cognitive ability from age 1 to age 9 years and concurrent associations between externalizing and internalizing problems. Unique longitudinal associations were identified between (1) age 1 cognitive ability and age 2 internalizing problems, (2) age 2 externalizing problems and age 7 internalizing problems, (3) age 2 externalizing problems and age 7 cognitive ability, (4) age 7 cognitive ability and age 9 externalizing problems. The results indicated essential targets for future interventions aimed at reducing children's behavior problems at 2 years old and promoting cognitive ability at 1 year old and 7 years old.

Through the looking glass: the neural basis of self-concept in young adults with antisocial trajectories

Self-concept is shaped by social experiences, but it is not yet well understood how the neural and behavioral development of self-concept is influenced by a history of antisocial behavior. In this pre-registered study, we examined neural responses to self-evaluations in young adults who engaged with antisocial behavior in childhood and either desisted or persisted in antisocial behavior. A self-concept task was performed by 94 young adults (age range 18-30 years). During the task, participants with a persistent or desistent antisocial trajectory (n = 54) and typically developing young adults (n = 40) rated whether positive and negative traits in different domains (prosocial and physical) described themselves. We examined both the effects of a history of antisocial behavior as well as current heterogeneity in psychopathic traits on self-concept appraisal and its neural underpinnings. Participants endorsed more positive trait statements than negative across domains, which did not differ between antisocial-history groups. However, current psychopathic traits were negatively associated with prosocial self-concept and medial prefrontal cortex activity during self-evaluation. Together, these findings suggest that antisocial tendencies might indeed be reflected in self-concept development of young adults, specifically in the prosocial domain.

Housing insecurity and adolescent behavioral outcomes: The mediating role of aggression in parenting

BACKGROUND

Housing insecurity impacts millions of families with children each year and is linked with a range of adverse outcomes. Greater understanding of pathways linking housing insecurity with emotional and behavioral problem is needed to prevent enduring mental health problems. The Family Stress Model and Bronfenbrenner's Ecological Model contribute understanding to the complex dynamics underlying development from childhood to adolescence in the context of economic hardship and parental strain.

OBJECTIVE

The present study aimed to investigate the mediating role of harsh parenting in the relationship between childhood housing insecurity and adolescent behavior problems.

PARTICIPANTS AND SETTING

Data from the Fragile Families and Child Well-being Study, and included a sample of at-risk mothers with children from 20 large U.S. cities (N = 2719).

METHODS

Structural equation modeling with latent variables tested direct and indirect pathways from housing insecurity at age 5 with emotional and behavioral problems at age 15 via intermediary harsh parenting at age 9.

RESULTS

Housing insecurity directly predicted adolescent anxious/depressive behaviors (β = 0.14, p < 0.01); and indirectly predicted rule-breaking (β = 0.04, p < 0.01), aggressive (β = 0.05, p < 0.01), and anxious/depressive (β = 0.03, p < 0.05) behaviors via psychological aggression in parenting.

CONCLUSIONS

Failure to address housing hardship among families with young children increases maltreatment risk and subsequent enduring mental health problems. Efforts to identify and mitigate housing hardship and maltreatment among at-risk families offer promise to promote long-term mental health in the transition from childhood to adolescence.

Ability-grouping and problem behavior trajectories in childhood and adolescence: Results from a U.K. population-based sample

Ability-grouping has been studied extensively in relation to children's academic, but not emotional and behavioral outcomes. The sample comprised 7259 U.K. children (50% male) with data on between-class and within-class ability-grouping at age 7. Peer, emotional, hyperactivity, and conduct problems were measured at ages 7, 11, and 14 years. Children in low within-class ability groups showed more hyperactivity and emotional problems across the study period compared to non-grouped children, after adjustments for the different types of ability grouping and confounding. Additionally, children in the middle within-class ability groups showed more, and those in the top within-class groups less, hyperactivity compared to non-grouped children, after adjustment. Children in lower within-class groups should be monitored closely to ensure that their well-being is not compromised.

Examining Longitudinal Associations between Externalizing and Internalizing Behavior Problems at Within- and Between-Child Levels

Externalizing and internalizing behavior problems are known to often co-occur, but mechanisms underlying this co-occurrence remain unclear: whether the associations are due to causal influences of one domain on the other or due to common risk processes influencing both domains. This study aimed to better understand the sources of co-occurring behavior problems by disentangling within- and between-child levels of associations between the two across the five years of childhood, from pre-kindergarten to Grade 3. We analyzed a longitudinal sample of 1060 children from non-urban settings in the U.S. using random-intercept cross-lagged panel models (RI-CLPMs) as an alternative to the commonly-used standard CLPMs. Results indicate that co-occurring externalizing and internalizing problems can be explained partly by a unidirectional influence from externalizing to internalizing problems operating within children and partly by stable differences between children that influence both domains of problems. Further analyses indicate that an executive function deficit in early childhood is an important shared risk factor for both problems, suggesting the utility of executive function interventions in preventing or addressing externalizing and internalizing problems in childhood.

A Bi-Dimensional Taxonomy of Social Responsivity in Middle Childhood: Prosociality and Reactive Aggression Predict Externalizing Behavior Over Time

Developing social skills is essential to succeed in social relations. Two important social constructs in middle childhood, prosocial behavior and reactive aggression, are often regarded as separate behaviors with opposing developmental outcomes. However, there is increasing evidence for the co-occurrence of prosociality and aggression, as both might indicate responsivity to the social environment. Here, we tested whether a bi-dimensional taxonomy of prosociality and reactive aggression could predict internalizing and externalizing problems over time. We re-analyzed data of two well-validated experimental tasks for prosociality (the Prosocial Cyberball Game) and reactive aggression (the Social Network Aggression Task) in a developmental population sample (n = 496, 7-9 years old). Results revealed no associations between prosociality and reactive aggression, confirming the independence of those constructs. Interestingly, although prosociality and reactive aggression independently did not predict problem behavior, the interaction of both was negatively predictive of changes in externalizing problems over time. Specifically, only children who scored low on both prosociality and reactive aggression showed an increase in externalizing problems 1 year later, whereas levels of externalizing problems did not change for children who scored high on both types of behavior. Thus, our results suggest that at an individual level, reactive aggression in middle childhood might not always be maladaptive when combined with prosocial behavior, thereby confirming the importance of studying social competence across multiple dimensions.

Bullying Victimization and Developmental Trajectories of Internalizing and Externalizing Problems: The Moderating Role of Locus of Control Among Children

This longitudinal study examined the developmental trajectories of internalizing and externalizing problems, as well as the moderating role of children's locus of control on the relations between traditional and cyberbullying victimization and developmental trajectories of internalizing and externalizing problems. A total of 4180 Chinese elementary school students (M_age = 9.90 years) completed measures of bullying victimization (Time 1), locus of control (Time 1), internalizing and externalizing problems (from Time 1 to Time 5, 6-month intervals). Latent growth curve analyses indicated (a) internalizing problems first gradually decreased and then increased across time, whereas externalizing problems decreased slowly and remained steady over time; (b) both traditional and cyberbullying victimization served as risk factors for internalizing and externalizing problems; however, the effects of traditional bullying victimization on internalizing and externalizing problems were stronger than those for cyberbullying victimization; (c) locus of control moderated the relations between traditional bullying victimization and developmental trajectories of internalizing and externalizing problems. Consistent with cognitive diathesis-stress models, children who experienced higher levels of traditional bullying victimization and reported an external locus of control were more likely to experience internalizing and externalizing problems. This study also identified meaningful gender differences. Implications for the prevention of behavior problems were discussed.

Within-person analysis of developmental cascades between externalising and internalising problems

BACKGROUND

In a large body of previous research, cross-lagged panel models (CLPMs) have been used to provide empirical support for developmental models that posit a cascade from externalising-to-internalising problems. These developmental models, however, arguably refer to within-person processes whereas CLPMs provide a difficult-to-interpret blend of within- and between- person effects.

METHODS

We used autoregressive latent trajectory models with structured residuals (ALT-SR) to evaluate whether there is evidence for externalising-to-internalising cascades at the within-person level when disaggregating between- and within- person effects. We used eight waves of data (age 7-15) from the Zurich Project on Social Development from Childhood to Adulthood (z-proso).

RESULTS

ALT-SR fit better than the corresponding CLPMs. Using an ALT-SR, we found evidence for externalising-to-internalising cascades, consistent with previous CLPM studies. However, we also found some evidence for effects in the ALT-SR that were not apparent in the CLPM, including a negative effect of externalising on internalising problems in adolescence. In addition, a negative effect of internalising on externalising problems in adolescence was found in both the CLPM and ALT-SR.

CONCLUSIONS

Within-person results were largely consistent with previous evidence from CLPMs; however, at the within-person level, externalising and internalising may negatively influence one another in adolescence.

The relationships among parental psychological control/autonomy support, self-trouble, and internalizing problems across adolescent genders

This study aimed to explore the relationships among early adolescents' perceived parental psychological control/autonomy support, self-trouble, and internalizing problems as well as the potential gender differences in these relationships. Multiple-group path analysis was performed on the data collected from 1,089 adolescents in Beijing junior high schools. Results revealed that parental psychological control (autonomy support) was associated with adolescents' more (fewer) internalizing problems, and self-trouble acted as a mediator in these two relationships. Moreover, only the indirect relationship between parental autonomy support and internalizing problems via self-trouble was moderated by gender, with girls showing a little stronger indirect effect than boys, and specifically, it was the relationship between autonomy support and self-trouble that existed gender differences, with girls showing higher coefficient than boys. The relationship between parental psychological control/autonomy support and early adolescents' internalizing problems was discussed with regard to self-trouble and gender differences.

Persistent and Transitory Sexualized Behavior Problems in Children

The aim of this longitudinal study was to examine the course of sexualized behavior problems (SBP) over 2 years in a sample comprised of 104 children aged 2-12, including 62 children with histories of child sexual abuse (CSA). Parents completed questionnaires assessing SBP, internalizing and externalizing difficulties at baseline, as well as 2 years later. In more than half (56.7%) of children with clinically significant SBP at baseline, sexualized behaviors persisted and remained at a clinically significant level over time. In children with CSA, 48.4% presented persistent SBP, 27.4% presented transitory SBP, while 19.4% did not present clinically significant SBP at either time. CSA increased the relative risk of persistent SBP 3.29 times, and for each one-unit increase in scores of externalizing difficulties, the odds of persistent SBP increased by 21%. The findings suggest that SBP consequent to CSA, especially when it co-occurs with externalizing difficulties, is likely to remain at levels warranting clinical intervention.

Sports participation and psychosocial health: a longitudinal observational study in children

BACKGROUND

It is well known that sports participation is positively associated with psychosocial health in children, but details about this association over time are lacking. This study aimed to explore longitudinal associations between several characteristics of sports participation and three aspects of psychosocial health (internalizing problems, externalizing problems and prosocial behaviour) in Dutch children aged 10-12 years.

METHODS

Data from 695 fourth-grade primary school children were included at baseline; 10-13 months later, 487 children (response rate 70.1%) were retained. At both time points, children reported on their sports participation (Move and Sports Monitor Questionnaire - Youth Aged 8-12 Years) and psychosocial health (Strength and Difficulties Questionnaire). Longitudinal associations between several characteristics of sports participation and the three aspects of psychosocial health were analysed using linear mixed models, both clustering the repeated measures within children and clustering the children within schools. In addition to crude analyses, analyses were performed adjusting for sex, age, BMI, household composition, SES and frequency of sports participation.

RESULTS

Membership in a sports club, moderate or high frequency of sports participation, performing team sports, performing outdoor sports, performing contact sports and involvement in competition were longitudinally associated with fewer internalizing problems. The longitudinal association of higher frequency of sports participation with fewer internalizing problems was stronger as a child's BMI increased. The association of performing team sports with fewer internalizing problems was only observed for boys. Membership in a sports club and moderate or high frequency of sports participation were also longitudinally associated with better prosocial behaviour. These associations with prosocial behaviour were stronger for girls. None of the characteristics of sports participation examined were longitudinally associated with externalizing problems.

CONCLUSIONS

This study shows that from a longitudinal perspective, fewer internalizing problems and better prosocial behaviour were seen in children who were active in sports. Fewer internalizing problems were also associated with the kind of sports participation; for example, with performing outdoor sports. No associations were found for externalizing problems. Future research should preferably take the form of an intervention to investigate whether the observed statistical associations are of a causal nature.

Boys' and girls' latent profiles of behavior and social adjustment in school: Longitudinal links with later student behavioral engagement and academic achievement?

Using a person-centered approach, this study identified profiles of students exhibiting behavior and social adjustment problems in school. We conducted Latent Profile Analysis to identify these subgroups in a sample of 582 fifth and sixth graders. We found four profiles among girls-well-adjusted girls (66.10%); girls displaying externalizing behaviors and student-teacher conflict (4.75%); girls exhibiting internalizing behaviors and isolation from peers (10.17%); and girls with student-teacher nonclose interactions and nonprosocial behaviors toward peers (18.98%). We found three profiles among boys-well-adjusted boys (78.05%); boys displaying externalizing behaviors and student-teacher conflict (10.10%); and boys with externalizing, internalizing, and social problems with peers and teachers (11.85%). Next, we investigated longitudinal associations between these profiles and student behavioral engagement and academic achievement. Path analysis revealed that, compared to students with a well-adjusted profile, having a non-adjusted profile was associated with negative changes in teacher-reported behavioral engagement. Girls with an Externalizing Problem/Student-teacher Conflict profile or an Internalizing Problems/Peer Isolation profile also showed negative changes throughout the school year in their self-reported behavioral engagement and in academic achievement. We discussed these results and their practical implications in light of existing literature.

Children's Mathematics and Verbal Self-concepts and Externalizing Behaviors: The Moderating Role of Peer Rejection at School

Previous research has found a strong correlation between children’s academic self-concept and their behavioral problems. The present study examined whether children’s peer rejection moderated the relationship between children’s math and verbal self-concepts and their behavioral problems at school. We expected that children’s social competence, as measured by peer rejection, moderated the negative effect of low self-concept on children’s externalizing behaviors. Participants were 173 children (males = 93, M_age = 10.31 years, SD = 1.43). The main findings showed that peer rejection moderated the effect of both low verbal and math self-concepts on children’s externalizing behavior. The results are discussed in terms of the protective factor played by children’s social competence reducing the impact of low self-concept on children’s externalizing behaviors.

Co-Occurring Non-Suicidal Self-Injury and Firesetting Among At-Risk Adolescents: Experiences of Negative Life Events, Mental Health Problems, Substance Use, and Suicidality

Co-occurring internalizing and externalizing problem behaviors in adolescence typically marks more severe psychopathology and poorer psychosocial functioning than engagement in a single problem behavior. We examined the negative life events, emotional and behavioral problems, substance use, and suicidality of school-based adolescents reporting both non-suicidal self-injury (NSSI) and repetitive firesetting, compared to those engaging in either behavior alone. Differences in NSSI characteristics among self-injurers who set fires, compared to those who did not, were also assessed. A total of 384 at-risk adolescents aged 12-18 years (58.8% female) completed self-report questionnaires measuring NSSI, firesetting, and key variables of interest. Results suggest that adolescents who both self-injure and deliberately set fires represent a low-prevalence but distinct high-risk subgroup, characterized by increased rates of interpersonal difficulties, mental health problems and substance use, more severe self-injury, and suicidal behavior. Implications for prevention and early intervention initiatives are discussed.

High impulsivity as a risk factor for the development of internalizing disorders in detained juvenile offenders

BACKGROUND

Whilst impulsivity is most commonly linked to the development of internalizing disorders, high levels of impulsivity, anxiety, and depression have been found in detained juvenile offenders. We therefore sought to determine whether impulsivity is associated with the development of self-reported anxiety or depression in a sample of detained juvenile offenders.

METHODS

323 male juvenile offenders and 86 typically developing controls, aged 15-17 were assessed. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (SADS-PL) was used to assess psychiatric diagnoses, the Barratt Impulsivity Scale (BIS-11) was used to measure impulsivity, and the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Birleson Depression Self-Rating Scale (DSRS) were used to assess self-reported anxiety and depression respectively.

RESULTS

Compared to controls, juvenile offenders had significantly higher scores on the BIS-11 total, as well as on the motor and nonplanning subscales (all p values <0.001), as well as higher DSRS (p<0.001) and SCARED (p<0.05) scores. Within the juvenile offender group, scores on the SCARED correlated positively with BIS-11 total, attention subscale, motor subscale, and total DSRS (all p values <0.01). DSRS scores correlated positively with BIS-11 total, attention subscale, nonplanning subscale, and total SCARED scores (all p values <0.01). Participants were then categorized low, middle or high impulsivity according to scores on the BIS-11. One-way ANOVAs demonstrated a significant difference between these tertiles on DSRS [F(2,320)=4.862, p<0.05] and SCARED total scores [F(2,320)=3.581, p<0.05]. Specifically, post-hoc analyses found that the high impulsivity tertile scored significant higher than the remaining tertiles on both DSRS (16.1 ± 0.3 vs. 14.0 ± 0.6, p<0.05) and SCARED (23.3 ± 0.9 vs. 18.4 ± 1.4, p<0.05) scores. Using multiple linear regression, BIS-11 attention scores, number of months served in custody, age, and BIS-11 nonplanning scores predicted higher levels of anxiety, whilst only BIS-11 attention and nonplanning scores predicted higher levels of depression.

CONCLUSIONS

In detained juvenile offenders, high impulsivity may be an important risk factor not only for the externalizing disorders, but also for anxiety and depression. Results of this study, therefore, suggest that specific facets of impulsivity may represent one mechanism underlying the emergence of anxiety and depression in this population.

Accumulation of lifestyle and psychosocial problems and persistence of adverse lifestyle over two-year follow-up among Finnish adolescents

BACKGROUND

Adolescent'psychosocial problems associate with unhealthy behaviors, but data on co-occurring patterns is sparse. We investigated 1) whether adolescents could be categorized into meaningful subgroups with respect to psychosocial and lifestyle factors, 2) whether the prevalence of physical inactivity, overweight and smoking vary within the subgroups and 3) whether these unhealthy behaviors persist in a two-year follow-up.

METHODS

The study was based on a subgroup of the 1986 Northern Finland Birth Cohort, which consisted of adolescents who replied to a postal questionnaire at 16 years (n = 6792) and a subgroup of this sample at 18 years (n = 1552). Latent class analysis (LCA) was performed to establish clusters at 16 years.

RESULTS

Smoking co-existed with emotional and behavioral problems in both genders. Boys with the most inactive lifestyle slept poorly, whereas multiple problems co-occurred among girls. Those with a high body mass index (BMI) separated as groups of their own. Different combinations of adverse lifestyle and emotional and behavioral problems were relatively common in both sexes as only 51% of boys and 67% of girls belonged to the reference cluster with low probability for these findings. Physical inactivity, high BMI and smoking tended to persist over the two-year follow-up.

CONCLUSIONS

It seems that lifestyle and psychosocial factors divide adolescents into distinct subgroups in which unhealthy lifestyle patterns remain between the ages of 16 and 18. This may indicate problems in other life areas and expose them to an increased risk of future health problems.

Non-suicidal self-injury and firesetting: shared and unique correlates among school-based adolescents

Distinct behaviors such as non-suicidal self-injury (NSSI) and firesetting may represent functionally equivalent attempts to regulate difficult affective/cognitive or social experiences during adolescence. This study examined possible mechanisms leading to NSSI, as opposed to firesetting, as well as co-occurrence of these behaviors. Participants aged 12-18 years (N = 2,356; 67.5 % female) completed self-report questionnaires measuring NSSI and firesetting, as well as socio-demographic and psychosocial factors including personality traits related to impulsivity and anxiety, negative life events, emotion regulation, and coping. The findings indicated the presence of general risk factors (e.g., negative life events and poor coping) that increase the likelihood that adolescents will engage in any of a range of maladaptive behaviors. The probability of at-risk adolescents engaging in NSSI was increased by psychological states (i.e., rumination and poor self-esteem), whereas socio-demographic and personality traits were associated with firesetting. Implications for prevention and early intervention initiatives are discussed.

Developmental trajectories and predictors of externalizing behavior: a comparison of girls and boys

Recent studies have shown that the development of externalizing behavior in childhood and adolescence can be described through different developmental pathways. However, knowledge about differences between the sexes regarding the trajectories is limited. This study focused on potential differences by examining the trajectories of self-reported externalizing symptoms for girls and boys separately. In addition, the relationships of several familiar and child-specific variables with those developmental courses were assessed. The study was conducted on a large community sample of German youths (N = 3,893; mean age 11.38 years; 50 % girls) over 4 years. Using growth mixture modeling, three different classes of trajectories were found for both sexes. The classes differed with regard to the level and the course of symptoms ("low", "moderate", "high-decreasing"). Girls were overrepresented in the "low" class, whereas boys were predominant in the "moderate" and "high-decreasing" classes. The multiple group analysis revealed that the girls and boys differed significantly in their level and linear course of symptoms with regard to the "high-decreasing" class. In contrast, no sex differences were found in the growth factors of the "low" and "moderate" classes. The regression analyses showed that the children's depressive symptoms, dysfunctional parenting style, and negative family climate were associated significantly with the level and course of symptoms as well as the class membership of girls and boys. Life events predicted class membership only for boys, whereas maternal depressive symptoms and family conflict did not demonstrate any significant relationship. The sizes of the predictive associations with the growth factors were similar for both sexes. The results are discussed with regard to existing developmental models and their possible implications for prevention and future research.

Peer problems mediate the relationship between developmental coordination disorder and behavioral problems in school-aged children

The aim of this study was to gain insights into the relationship between developmental coordination disorder, peer problems, and behavioral problems in school-aged children where both internalizing and externalizing behavioral problems were considered. We assumed that the relationship between developmental coordination disorder and internalizing/externalizing problems in school-aged children is mediated by peer problems and tested the hypothesis that a greater degree of motor impairment causes a greater degree of peer problems and thus a greater degree of internalizing or externalizing problems. Seventy boys and girls aged between 5 and 11 years were examined using the Movement Assessment Battery for Children 2 and the Intelligence and Developmental Scales. The results of path analysis showed that the relationship between developmental coordination disorder and internalizing/externalizing problems in school-aged children is mediated at least in part by peer problems. However, the cross-sectional design of the study does not provide conclusive evidence for a cause-effect relationship and only allows for the conservative prognosis that a greater degree of motor impairment may cause a greater degree of peer problems and thus a greater degree of internalizing/externalizing problems. Nevertheless, the results of this study emphasize the importance of being well-integrated in their peer group especially for children with developmental coordination disorder.