Sex Differences in Internalizing and Externalizing Behaviors in Children with Autism Spectrum Disorder

This study used a retrospective practice-based research method to compare levels of internalizing and externalizing behaviors of a clinically-ascertained sample of young children with autism spectrum disorder (ASD; n=90). As measured by the Child Behavior Checklist (CBCL), internalizing and externalizing behaviors were compared to normative behavior, and between boys and girls with ASD. Findings suggest that in a clinical sample, children with ASD are more likely than typically developing children to have internalizing and/or externalizing problems. No significant sex differences were found for Internalizing Problems, Externalizing Problems, or Total Problems scores on either the parent or teacher versions of the CBCL. These findings may help clinicians better understand how children with ASD are affected by co-morbid psychiatric disorders, and could help to inform diagnosis and intervention

Peer victimization in childhood and internalizing problems in adolescence : a prospective longitudinal study

Traumatic childhood experiences have been found to predict later internalizing problems. This prospective longitudinal study investigated whether repeated and intentional harm doing by peers (peer victimization) in childhood predicts internalizing symptoms in early adolescence. 3,692 children from the Avon Longitudinal Study of Parents and Children (ALSPAC), as well as their mothers and teachers, reported on bullying in childhood (7–10 years) and internalizing problems in early adolescence (11–14 years). Controlling for prior psychopathology, family adversity, gender and IQ, being a victim of bullying was associated with higher overall scores, as well as increased odds of scoring in the severe range (>90th percentile) for emotional and depression symptoms. Victims were also more likely to show persistent depression symptoms over a 2-year period. These associations were found independent of whether mothers, teachers or the children reported on bullying. It is concluded that peer victimization in childhood is a precursor of both short-lived and persistent internalizing symptoms, underlining the importance of environmental factors such as peer relationships in the etiology of internalizing problems

Examining Children’s Cognitions in Response to Interparental Conflict

Extensive research has found that interparental conflict is associated with children’s adjustment and cognitive appraisals. This study aims to address two questions. First, does exposure to interparental conflict predict children’s immediate and long-term cognitions regarding interparental conflict? Second, do children’s immediate and long-term cognitions predict internalizing problems, such as anxiety and depression? Children ages 9- to 11-years-old (n = 96; 59 females, 1 gender-neutral) were shown video presentations of conflict between two actors portraying a married couple. Children evaluated the actors’ behaviors as good or bad, and these evaluations were used as a measure of their immediate cognitions regarding interparental conflict stimuli. These immediate cognitions were compared to measures of children’s long-term cognitions regarding interparental conflict, exposure to interparental conflict, and internalizing problems using bivariate correlation and simple regression analyses. In contrast to the hypotheses, more exposure to interparental conflict did not predict immediate or long-term cognitions, nor did immediate or long-term cognitions predict children’s internalizing problems. Implications for future studies comparing immediate and long-term cognitions are discussed

Internalizing Symptoms as Predictors of School Absenteeism Severity at Multiple Levels: Ensemble and Classification and Regression Tree Analysis

School attendance problems are highly prevalent worldwide, leading researchers to investigate many different risk factors for this population. Of considerable controversy is how internalizing behavior problems might help to distinguish different types of youth with school attendance problems. In addition, efforts are ongoing to identify the point at which children and adolescents move from appropriate school attendance to problematic school absenteeism. The present study utilized ensemble and classification and regression tree analysis to identify potential internalizing behavior risk factors among youth at different levels of school absenteeism severity (i.e., 1+%, 3+%, 5+%, 10+%). Higher levels of absenteeism were also examined on an exploratory basis. Participants included 160 youth aged 6–19 years (M = 13.7; SD = 2.9) and their families from an outpatient therapy clinic (39.4%) and community (60.6%) setting, the latter from a family court and truancy diversion program cohort. One particular item relating to lack of enjoyment was most predictive of absenteeism severity at different levels, though not among the highest levels. Other internalizing items were also predictive of various levels of absenteeism severity, but only in a negatively endorsed fashion. Internalizing symptoms of worry and fatigue tended to be endorsed higher across less severe and more severe absenteeism severity levels. A general expectation that predictors would tend to be more homogeneous at higher than lower levels of absenteeism severity was not generally supported. The results help confirm the difficulty of conceptualizing this population based on forms of behavior but may support the need for early warning sign screening for youth at risk for school attendance problems

Lost Toy? Monsters Under the Bed? Contributions of Temperament and Family Factors to Early Internalizing Problems in Boys and Girls

This study was designed to examine the contribution of multiple risk factors to early internalizing problems and to investigate whether family and ecological context moderated the association between child temperament and internalizing outcomes. A sample of 1,202 mothers of 2- and 3-year-old children completed a survey of child social-emotional functioning, family environment, and violence exposure. Child temperament, maternal affective symptoms, and family expressiveness were associated with child anxiety and depression problems. Violence exposure was related only to child anxiety. When maternal affective symptoms were elevated, inhibited girls but not boys were rated as more anxious and youngsters with heightened negative emotionality were rated as more depressed. Family expressiveness moderated the association between inhibited temperament and anxiety symptoms

Behavior profiles in children with functional urinary incontinence before and after incontinence treatment

OBJECTIVE. The purpose of this work was to analyze prospectively the prevalence of behavioral disorders in children with urinary incontinence because of nonneuropathic bladder-sphincter dysfunction before and after treatment for incontinence. METHODS. A total of 202 children with nonneuropathic bladder-sphincter dysfunction were enrolled in the European Bladder Dysfunction Study, in branches for urge syndrome (branch 1) and dysfunctional voiding (branch 2); 188 filled out Achenbach's Child Behavior Checklist before treatment and 111 after treatment. Child Behavior Checklist scales for total behavior problems were used along with subscales for externalizing problems and internalizing problems. RESULTS. After European Bladder Dysfunction Study treatment, the total behavior problem score dropped from 19% to 11%, the same prevalence as in the normative population; in branch 1 the score dropped from 14% to 13%, and in branch 2 it dropped from 23% to 8%. The prevalence of externalizing problems dropped too, from 12% to 8%: in branch 1 it was unchanged at 10%, and in branch 2 it dropped from 14% to 7%. The decrease in prevalence of internalizing problems after treatment, from 16% to 14%, was not significant. CONCLUSION. More behavioral problems were found in dysfunctional voiding than in urge syndrome, but none of the abnormal scores related to the outcome of European Bladder Dysfunction Study treatment for incontinence. With such treatment, both the total behavior problem score and the score for externalizing problems returned to normal, but the score for internalizing problems did not change. The drops in prevalence are statistically significant only in dysfunctional voiding

An exploratory study on internet addiction, somatic symptoms and emotional and behavioral functioning in school-aged adolescents

Objective: In the last two decades there has been a significant transformation regarding the use of new technologies. Despite growing acknowledgement concerning the different activities and functions of digital technologies, there remains a lack of understanding on how technology overuse may negatively impact both physical and psychosocial well-being. Although researchers have begun to explore the meaning and implications of excessive Internet use in non-clinical populations of children and adolescents, there is still little consistent knowledge on the topic. This study aimed to extend existing knowledge on the excessive use of the Internet among school-aged adolescents, focusing on its association with recurrent somatic symptoms, depressive risk and behavioral and emotional problems. Method: Two hundred and forty adolescents (51.9% females) aged between 10 and 15, participated in this study. Data was collected using the Children’s Somatization Inventory, the Internet Addiction Test, the Children’s Depression Inventory, the Youth Self Report and the Emotion Regulation Questionnaire. Structural Equation Model analysis was used to analyse the data. Results: Approximately 21.8% of participants reported excessive Internet use based on Young’s criteria. Higher levels of Internet use were associated with somatic and depressive symptoms as well as emotional and behavioral problems. Depressive Symptoms predicted both Internet Addiction (b = 0.304, p < 0.001) and Internalizing (b = 0.542, p <0.001) and Externalizing problems (b = 0.484, p < 0.001). Internet Addiction also significantly predicted both Internalizing (b = 0.162, p = 0.02) and Externalizing problems (b = 0.183, p = 0.02). Finally, Structural Equation Modeling showed that the indirect effect of Depressive Symptoms (via Internet Addiction) on Internalizing or Externalizing problems were significant. Conclusions: Longitudinal studies are needed to confirm these findings and to identify the mechanisms linking Internet use, somatic symptoms and adaptive functioning

Verbal abuse and internalizing problems in early adolescence: negative attributional style as mediator

This study examined the contributions of verbal abuse to internalizing problems among 324 early adolescent students (aged 11-13 years) in Selangor, and the mediating role negative attributional style plays in this relationship. Students were selected using a cluster sampling method and responded to a self-administered questionnaire. Children.s Perception of Parental Verbal Aggression (CPPVA; Solomon & Serres, 1999), The Children.s Attributional Style Questionnaire (CASQ; Seligman et al., 1984) and Internalizing Symptoms Scale for Children (ISSC; Merrell & Walters, 1998) were used to measure the variables in this study. Data were analyzed using Baron and Kenny.s (1986) statistical framework for assessing the mediational effects. Findings suggest that negative attributional style partially mediates verbal abuse and internalizing problems. This study sheds light on how verbal abuse contributes to internalizing problems in Asian context. Implications for intervention and prevention work related to internalizing problems among early adolescent students are also discussed

Early risk indicators of internalizing problems in late childhood: A 9-year longitudinal study

Background: Longitudinal studies on risk indicators of internalizing problems in childhood are in short supply, but could be valuable to identify target groups for prevention. Methods: Standardized assessments of 294 children’s internalizing problems at the age of 2–3 years (parent report), 4–5 years (parent and teacher report) and 11 years (parent and teacher) were available in addition to risk indicators from the child, family and contextual domain. Results: Low socioeconomic status, family psychopathology at child age 2–3, parenting stress at child age 4–5 years, and parents’ reports of child internalizing problems at age 4–5 years were the strongest predictors of internalizing problems at the age of 11. If these early risk factors were effectively ameliorated through preventive interventions, up to 57% of internalizing cases at age 11 years could be avoided. Conclusions: Predictors from as early as 2–5 years of age are relevant for identifying children at risk of internalizing problems in late childhood. The methodological approach used in this study can help to identify children who are most in need of preventive interventions and help to assess the potential health gain and efficiency of such interventions. Keywords: Internalizing disorder, risk factors, prevention. Abbreviations: AF: attributable fraction; IRR: incidence rate ratio; LEQ: Life Events Questionnaire; NNT: numbers needed to be treated; RD: risk difference