Developmental foundations of externalizing problems in young children: the role of effortful control

Examined associations between effortful control temperament and externalizing problems in 220 3-year-old boys and girls, controlling for co-occurring cognitive and social risk factors. We also considered possible additive and/or interactive contributions of child dispositional anger and psychosocial adversity, and whether relations between effortful control and early externalizing problems were moderated by child gender. Individual differences in children's effortful control abilities, assessed using behavioral and parent rating measures, were negatively associated with child externalizing problems reported by mothers, fathers, and preschool teachers. These associations were not overshadowed by other cognitive or social risk factors, or by other relevant child temperament traits such as proneness to irritability. Further analyses revealed that associations between externalizing problem behavior and effortful control were specific to components of child problem behavior indexing impulsive-inattentive symptoms. Thus, children's effortful control skills were important correlates of children's early disruptive behavior, a finding that may provide insight into the developmental origins of chronic behavioral maladjustment.     

Effortful control as modifier of the association between negative emotionality and adolescents' mental health problems

This study examined the extent to which effortful control moderated the risk of internalizing or externalizing problems associated with high negative emotionality in a Dutch population sample of pre- and early adolescents (N = 1,922). Internalizing and externalizing problems were assessed with the Child Behavior Checklist, Youth Self-Report, and Teacher Checklist of Psychopathology. Temperament (effortful control, fearfulness, frustration) was assessed with the parent version of the Revised Early Adolescent Temperament Questionnaire. The effects of fearfulness and frustration appeared to be attenuated by high levels of effortful control. The associations differed between the two domains of mental health investigated: effortful control reduced the effect of fearfulness on internalizing problems and the effect of frustration on externalizing problems. The effects were stronger for externalizing problems and similar for preadolescent (age 11) and adolescent (age 13/14) outcomes.     

Effortful control as a moderator of the relation between contextual risk factors and growth in adjustment problems

Effortful control was examined as a moderator of the relations of three domains of contextual risk factors to growth in internalizing and externalizing problems in a community sample (N = 189) of children (8-12 years at Time 1). Socioeconomic, maternal, and environmental risk factors were examined as predictors of initial levels and growth in children's adjustment problems across 3 years. The effects of the risk factors depended on children's level of effortful control. For children lower in effortful control, socioeconomic risk was related to significantly higher initial levels of internalizing and externalizing problems and decreases over time. However, children lower in effortful control had higher levels of problems at all three time points than children higher in effortful control. Maternal risk was associated with increases in internalizing for children lower in effortful control, and environmental risk was related to increases in internalizing and externalizing problems for children lower in effortful control, but not those higher in effortful control. Children who were lower in effortful control appeared to experience more adverse effects of contextual risk than those higher in effortful control, suggesting that interventions aimed at improving children's effortful control might serve to protect children from increased risk of adjustment problems associated with contextual risk factors.     

Children's coping strategies and coping efficacy: relations to parent socialization, child adjustment, and familial alcoholism

The relations of children's coping strategies and coping efficacy to parent socialization and child adjustment were examined in a sample of school-age children that included families in which some of the grandparents and/or parents had an alcoholism diagnosis. Parents and older children reported on the children's coping strategies; parents reported on their parenting behavior; and teachers reported on children's externalizing and internalizing problems. Measures of parent socialization were associated with parents' and children's reports of active coping strategies and parents' reports of both support-seeking coping and coping efficacy. Some of these relations were moderated by familial alcohol status. Children higher in parent-reported active/support-seeking coping and coping efficacy were rated lower in teacher-reported externalizing and internalizing adjustment problems. The findings were consistent with the view that active/support-seeking coping and coping efficacy mediated the association of parent socialization to children's psychological adjustment and that this relation was sometimes moderated by parental alcohol status.     

Exuberant and inhibited toddlers: stability of temperament and risk for problem behavior

Temperament, effortful control, and problem behaviors at 4.5 years were assessed in 72 children classified as exuberant, inhibited, and low reactive as 2-year-olds. Exuberant toddlers were more positive, socially responsive to novel persons, less shy, and rated as having more problem behaviors, including externalizing and internalizing behaviors, than other children as preschoolers. Two forms of effortful control, the ability to delay a response and the ability to produce a subdominant response, were associated with fewer externalizing behaviors, whereas expressing more negative affect (relative to positive/neutral affect) when disappointed was related to more internalizing behaviors. Interaction effects implicated high levels of unregulated emotion during disappointment as a risk factor for problem behaviors in exuberant children.     

Family stability as a protective factor against psychopathology for urban children receiving psychological services.

Family stability, defined as the consistency of family activities and routines, was examined in a sample of urban families (n = 70) with children (ages 7 to 16) receiving psychological services. Parent-reported family stability was associated with lower parent-reported children's internalizing behavior problems. Child-reported family stability significantly attenuated the influence of parental depressive symptoms on parent-reported children's internalizing, externalizing, and total behavior problems, while controlling for the effect of children's age. Parental depressive symptoms were associated with problems in child adjustment only at the low level of family stability.     

Longitudinal relations between parental drinking problems, family functioning, and child adjustment

Relations between maternal and paternal problem drinking symptoms and destructive marital conflict, parenting problems, and children's internalizing and externalizing problems were investigated. Participants were community families with a child in kindergarten who completed questionnaire measures at baseline (N=235), 1 year later (N=227), and 2 years later (N=215). Structural equation modeling revealed that paternal problem drinking at Time 1 was associated with greater destructive marital conflict 1 year later. In turn, destructive marital conflict was related to decreased parental warmth and increased parental psychological control; these parenting problems were associated with greater child internalizing and externalizing problems at the third time point. Further analyses revealed that the indirect effects of paternal drinking on children's adjustment were significant, and that relations remained even after including autoregressive effects. Findings are discussed in terms of family process models for relations between parental drinking and child adjustment problems.     

The Depression Prevention Initiative: Impact on Adolescent Internalizing and Externalizing Symptoms in a Randomized Trial

This randomized controlled trial examined the longitudinal effects of two school-based indicated depression prevention programs on adolescents’ internalizing and externalizing symptoms, as measured by adolescents, their parents, and their teachers. One hundred eighty-six adolescents participated in this study. The average age was 14.01 (SD = 1.22) years, and the sample was 66.7% female. One third of the sample belonged to a racial minority. Youth received either Interpersonal Psychotherapy–Adolescent Skills Training or group counseling. Symptoms were assessed using adolescent, parent, and teacher reports on the Achenbach System of Empirically Based Assessment at baseline, postintervention, and 6-month follow-up. Adolescents reported the most robust effects in favor of Interpersonal Psychotherapy–Adolescent Skills Training. Adolescents in Interpersonal Psychotherapy–Adolescent Skills Training reported significantly greater reductions in internalizing symptoms through the 6-month follow-up and significantly greater reductions in externalizing symptoms during the intervention as compared to group counseling. Less robust effects were found when examining parent and teacher reports, although there was evidence of significant within-group change in parent- and teacher-reported internalizing symptoms for both interventions and significant between-group differences in teacher-reported externalizing symptoms. This study provides additional evidence supporting the efficacy of Interpersonal Psychotherapy–Adolescent Skills Training as a depression prevention program for adolescents. Interpersonal Psychotherapy–Adolescent Skills Training appears to have fast-acting effects on broadband internalizing and externalizing symptoms as reported by adolescents. This suggests that Interpersonal Psychotherapy–Adolescent Skills Training may serve as a transdiagnostic preventive intervention. Moreover, given the disparate reports of adolescents, parents, and teachers, this study demonstrates the significance of collecting information from multiple sources when possible.     

First grade emotion knowledge as a predictor of fifth grade self-reported internalizing behaviors in children from economically disadvantaged families

In this longitudinal study, we examined the relations between emotion knowledge in first grade, teacher reports of internalizing and externalizing behaviors from first grade, and children's self-reported internalizing behaviors in fifth grade. At Time 1, we assessed emotion knowledge, expressive vocabulary, caregiver-reported earned income, and teacher-rated internalizing and externalizing behaviors in 7-year-old children from economically disadvantaged families (N = 154). At Time 2, when the children were age 11, we collected children's self-reports of negative emotions, depression, anxiety, and loneliness. First grade teacher-reported externalizing behaviors, but not first grade internalizing behaviors, were positively related to children's self-reports of internalizing behaviors in fifth grade. First grade emotion knowledge accounted for a significant amount of variance in children's self-reports of internalizing symptoms 4 years later, after controlling for per capita earned income, expressive vocabulary, and teacher-reported internalizing and externalizing behaviors in first grade.     

Childhood and adolescent resiliency, regulation, and executive functioning in relation to adolescent problems and competence in a high-risk sample

This study first examined the respective relations of resiliency and reactive control with executive functioning. It then examined the relationship of these different domains to the development of academic and social outcomes, and to the emergence of internalizing and externalizing problem behavior in adolescence. Resiliency and reactive control were assessed from preschool to adolescence in a high-risk sample of boys and girls (n = 498) and then linked to component operations of neuropsychological executive functioning (i.e., response inhibition, interference control, fluency, working memory/set-shifting, planning, and alertness), assessed in early and late adolescence. Consistent, linear relations were found between resiliency and executive functions (average r = .17). A curvilinear relationship was observed between reactive control and resiliency, such that resiliency was weaker when reactive control was either very high or very low. In multivariate, multilevel models, executive functions contributed to academic competence, whereas resiliency and interference control jointly predicted social competence. Low resiliency, low reactive control, and poor response inhibition uniquely and additively predicted internalizing problem behavior, whereas low reactive control and poor response inhibition uniquely predicted externalizing problem behavior. Results are discussed in relation to recent trait models of regulation and the scaffolded development of competence and problems in childhood and adolescence.     

Agreement Among Parents,Teachers, and Children on Internalizing and Externalizing Behavior Problems

Investigated agreement between mothers, fathers, teachers, and children on equivalent forms of a standardized measure of behavioral and emotional problems. Ninety-eight children, age 13 years, completed the Youth Self-Report (Achenbach, 1991d). Their mothers and fathers completed the Child Behavior Checklist (Achenbach, 1991b), and their teachers completed the Teacher Report Form (Achenbach, 1991c). Children generally reported the most problems and teachers the least. Agreement was highest between mothers and fathers on internalizing and externalizing problems, and lowest for rater pairs involving teachers on internalizing problems. Analyses of a multitrait-multimethod matrix for ratings of internalizing and externalizing problems indicated good convergent validity, large rater effects, and weaker discriminant validity. Conditional probabilities for agreement on deviant and nondeviant scores indicated that ratings by no informant could substitute for those of any other rater. Teacher ratings of externalizing problems were the best predictor of referral for mental health services.     

Latent change score modeling of psychophysiological data: an empirical instantiation using electrodermal responding

We examined latent change score (LCS) modeling as an approach to the analysis of children's skin conductance level (SCL) throughout a stressful task-a simulated interadult argument-as it relates to externalizing and internalizing symptoms. LCS is an extension of traditional multilevel modeling (MLM), which allows estimation of proportional growth terms. Children (age 6-12 years; N=150) were from two-parent families. Mothers reported on children's internalizing and externalizing symptoms. Results indicated that the LCS models outperformed the traditional MLM. The use of LCS yielded important novel information regarding profile and pattern of responding for various children and is likely to advance understanding of relations between children's physiological responses and psychopathology symptoms.     

The interactive effect of marital conflict and stress reactivity on externalizing and internalizing symptoms: the role of laboratory stressors

Growing evidence supports the biological sensitivity to context theory, which posits that physiologically reactive children, as indexed by autonomic nervous system (ANS) reactivity to laboratory stressors, are more susceptible to both negative and positive environmental influences than their low reactive peers. High biological sensitivity is a risk factor for behavioral and health problems in the context of high adversity, whereas in contexts of low adversity it has been found to promote positive adaptation. However, several studies have shown the opposite effect, finding that children who exhibited high ANS reactivity in response to interpersonal stressors were buffered from the deleterious effects of marital conflict, whereas children who showed low ANS reactivity were more vulnerable to high levels of marital conflict. Using an ethnically diverse sample of 260 kindergartners (130 girls, 130 boys), the current study investigated whether the interaction effect of marital conflict and the two branches of ANS reactivity on children's externalizing and internalizing symptoms differs with the nature of the laboratory challenge task used to measure children's stress response. As hypothesized, results indicate that the interaction between ANS reactivity and marital conflict significantly predicted children's behavior problems, but the direction of the effect varied with the nature of the challenge task (i.e., interpersonal or cognitive). This study illustrates the importance of considering the effect of laboratory stimuli when assessing whether children's ANS reactivity moderates the effects of adversity exposure on adaptation.     

The relations among depression in fathers, children's psychopathology, and father-child conflict: a meta-analysis

Research on parental depression is beginning to recognize the importance of studying fathers in relation to maladaptive outcomes in their offspring. Paternal depression is hypothesized to correlate with internalizing and externalizing psychopathology in children and adolescents and to compromise adaptive parent-child relationships (e.g., increased conflict). In the present paper, meta-analytic procedures were applied to this literature to address the magnitude and direction of covariation between paternal depression and children's functioning. In addition, we tested whether variation in findings could be accounted for by study characteristics. Results indicated that paternal depression was significantly related to offspring internalizing and externalizing psychopathology and father-child conflict. Larger effects for internalizing symptoms were associated with the use of community samples and symptom rating scales of internalizing problems.     

Adrenocortical responses to strangers in preschoolers: relations with parenting, temperament, and psychopathology

Previous research has provided inconsistent evidence for the relations between young children's hypothalamic-pituitary-adrenal (HPA) functioning and their temperament, parenting, and adjustment. Building biopsychosocial models of adjustment, we examined how temperamental inhibition and maternal punishment contributed to preschoolers' adrenocortical activity while interacting with adult strangers. We also examined whether HPA functioning moderated relations between dispositional and familial factors and children's internalizing and externalizing problems. A total of 402 preschool-aged children from three independent samples with parallel and overlapping measures were studied. Salivary cortisol levels were measured twice while interacting with adult strangers during testing protocols. Mothers reported on temperamental inhibition, maternal punishment and children's problems. Maternal punishment predicted higher cortisol levels 20 and 65 min after meeting adult strangers. Prolonged cortisol elevation was associated with having fewer externalizing problems. Boys who experienced more maternal punishment and had higher cortisol 20 min after meeting strangers manifested more externalizing problems. Girls who were more inhibited and had prolonged cortisol elevations had more internalizing problems. In accord with biopsychosocial models of psychopathology, HPA functioning in preschoolers was sensitive to variations in socialization experiences, and moderated children's risk for emotional and behavioral problems.     

The expression and regulation of negative emotions: risk factors for young children's peer victimization

Using a short-term longitudinal design, internalizing and externalizing emotions were examined as risk factors for being victimized by peers in early childhood. Regulation, aggression, and withdrawal were also tested as mediators. We found that anger, mediated by aggression and regulation, positively predicted being victimized, although the way in which anger related to victimization risk varied for boys and girls and across time. These findings were robust, particularly for girls, attesting to the importance of externalizing variables as risk factors for young children's victimization. Support for internalizing variables as risk factors for being victimized was weak. The implications of the findings for developmental models connecting symptomatology and victimization are discussed.     

Being hot-tempered: Autonomic, emotional, and behavioral distinctions between childhood reactive and proactive aggression

Reactive aggression (RA) is an angry response to perceived provocation. Proactive aggression (PA) is a pre-meditated act used to achieve some goal. This study test hypotheses that (1) individuals high in RA and PA will differ in resting levels of autonomic arousal and (2) RA will be related to emotional and behavioral problems, while PA only to behavioral problems.Parents of 68 children (age 6-13) reported on child symptoms, reactive/proactive aggression, and behavior problems. Resting heart rate (HR), skin conductance (SC), and HR variability (HRV) were measured in 42 of the children. RA was significantly related to decreased HRV and a trend for decreased SC, while PA was significantly related to increased SC and HRV. RA was significantly related to increased internalizing behaviors and attention deficits, while PA was significantly related to increased hyperactivity/impulsivity and delinquent behavior problems.Findings support a distinction between child reactive (hot-tempered) and proactive (cold-tempered) aggression in autonomic, emotional (i.e., internalizing problems), and behavioral (i.e., attention deficits, hyperactivity/impulsivity, and delinquent behavior) functioning, and are discussed in relation to theories of antisocial behavior.     

Sleep problems,internalizing and externalizing symptoms,and domains of health-related quality of life: bidirectional associations from early childhood to early adolescence

Study ObjectivesTo examine longitudinal, bidirectional associations among behavioral sleep problems, internalizing and externalizing symptoms, and domains of health-related quality of life (HRQoL) from early childhood to adolescence in a population sample of Australian children.MethodData were drawn from the Longitudinal Study of Australian Children, a national prospective cohort study with 4983 children participating in the Kindergarten cohort. Data were collected when children were aged 4–5, 6–7, 8–9, 10–11, and 12–13 years. At each study wave, the primary parent (97% mothers) reported on behavioral child sleep problems, internalizing and externalizing symptoms, and HRQoL domains (psychosocial and physical). Cross-lagged structural equation models were used to evaluate bidirectional associations.ResultsAt nearly every age, behavioral sleep problems were associated with worse subsequent psychosocial and physical HRQoL. Despite bidirectional associations between mental health and HRQoL at many waves, HRQoL domains more strongly predicted later internalizing symptoms, while externalizing symptoms more strongly predicted later HRQoL. Many of the bidirectional associations among sleep, mental health, and HRQoL were found earlier in childhood.ConclusionsBehavioral sleep problems may forecast later HRQoL psychosocial and physical impairments. Attending to both sleep problems and HRQoL could prevent the progression of internalizing conditions, while a focus on externalizing concerns could prevent the worsening of these symptoms, sleep problems, and HRQoL, particularly during the transition to school.     

Externalizing behaviors and minor unintentional injuries in toddlers: common risk factors?

OBJECTIVE: To investigate predictors for externalizing behaviors and minor unintentional injuries in toddlers and to examine whether common risk factors can be identified. METHODS: Linear regression models were used to investigate the contributions of predictors belonging to the domains of child characteristics and parental characteristics. Participants were 117 boys (M = 16.9 months) and their parents. RESULTS: Two common risk factors for externalizing behaviors and minor injuries were identified: maternal low conscientiousness and paternal low self-control. In addition, children's inhibitory control and dispositional frustration as well as maternal externalizing symptoms contributed independently to children's externalizing behaviors. CONCLUSIONS: Results supply some evidence for the interrelatedness of negative outcomes and on the existence of common risk factors. Interventions could aim to address these common risk factors in order to pursue a number of goals at the same time, instead of focusing on only one type of negative outcome.     

Anger and Sadness Regulation: Predictions to Internalizing and Externalizing Symptoms in Children

Examined the relation between children's self-reported anger and sadness regulation and the presence of internalizing and externalizing symptoms. Participants were 121 boys and 106 girls in the fourth and fifth grades who completed the Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), Emotion Expression Scale for Children (EESC), and Children's Emotion Management Scales (CSMS, CAMS) and rated each other on aggressive behavior. Results of multiple regression analyses indicated that the inability to identify emotional states, the inhibition of anger, the dysregulation of anger and sadness, and the constructive coping with anger predicted internalizing symptoms. The dysregulated expression of sadness and constructive coping with anger were inversely related to externalizing symptoms.