Joint developmental trajectories of internalizing and externalizing disorders between childhood and adolescence

This study sought to identify trajectories of DSM-IV based internalizing (INT) and externalizing (EXT) problem scores across childhood and adolescence and to provide insight into the comorbidity by modeling the co-occurrence of INT and EXT trajectories. INT and EXT were measured repeatedly between a...

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Bibliographic Details
Published in:Development and psychopathology 2017-08, Vol.29 (3), p.919-928
Main Authors: Nivard, Michel G., Lubke, Gitta H., Dolan, Conor V., Evans, David M., St. Pourcain, Beate, Munafò, Marcus R., Middeldorp, Christel M.
Format: Article
Language:English
Subjects:
Adolescent
Adolescents
Age
Anxiety - diagnosis
Anxiety - psychology
Attention deficit hyperactivity disorder
Child
Child & adolescent psychiatry
Child development
Child Development - physiology
Children
Comorbidity
Defense Mechanisms
Depression - diagnosis
Depression - psychology
Etiology
Female
Humans
Male
Maternal Age
Mental Disorders - diagnosis
Mental Disorders - psychology
Psychology
Psychopathology
Regular Articles
Risk factors
Studies
Teenagers
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Summary:This study sought to identify trajectories of DSM-IV based internalizing (INT) and externalizing (EXT) problem scores across childhood and adolescence and to provide insight into the comorbidity by modeling the co-occurrence of INT and EXT trajectories. INT and EXT were measured repeatedly between age 7 and age 15 years in over 7,000 children and analyzed using growth mixture models. Five trajectories were identified for both INT and EXT, including very low, low, decreasing, and increasing trajectories. In addition, an adolescent onset trajectory was identified for INT and a stable high trajectory was identified for EXT. Multinomial regression showed that similar EXT and INT trajectories were associated. However, the adolescent onset INT trajectory was independent of high EXT trajectories, and persisting EXT was mainly associated with decreasing INT. Sex and early life environmental risk factors predicted EXT and, to a lesser extent, INT trajectories. The association between trajectories indicates the need to consider comorbidity when a child presents with INT or EXT disorders, particularly when symptoms start early. This is less necessary when INT symptoms start at adolescence. Future studies should investigate the etiology of co-occurring INT and EXT and the specific treatment needs of these severely affected children.
ISSN:0954-5794
1469-2198
DOI:10.1017/S0954579416000572