Between- and within-child level associations between externalizing and internalizing behavior problems in a nationally representative sample of US elementary school children
Corresponding Author
Yoonkyung Oh
Children's Learning Institute, Department of Pediatrics, The University of Texas—Health Science Center at Houston, Houston, TX, USA
Correspondence
Yoonkyung Oh, Children's Learning Institute, The University of Texas—Health Science Center at Houston, 7000 Fannin St., Suite 2478, Houston, TX 77030, USA; Email: [email protected]
Search for more papers by this authorPaul L. Morgan
Department of Health Policy, Management and Behavior, University at Albany, SUNY, Albany, NY, USA
Search for more papers by this authorMark T. Greenberg
Prevention Research Center, Pennsylvania State University, University Park, PA, USA
Search for more papers by this authorTricia A. Zucker
Children's Learning Institute, Department of Pediatrics, The University of Texas—Health Science Center at Houston, Houston, TX, USA
Search for more papers by this authorSusan H. Landry
Children's Learning Institute, Department of Pediatrics, The University of Texas—Health Science Center at Houston, Houston, TX, USA
Search for more papers by this authorCorresponding Author
Yoonkyung Oh
Children's Learning Institute, Department of Pediatrics, The University of Texas—Health Science Center at Houston, Houston, TX, USA
Correspondence
Yoonkyung Oh, Children's Learning Institute, The University of Texas—Health Science Center at Houston, 7000 Fannin St., Suite 2478, Houston, TX 77030, USA; Email: [email protected]
Search for more papers by this authorPaul L. Morgan
Department of Health Policy, Management and Behavior, University at Albany, SUNY, Albany, NY, USA
Search for more papers by this authorMark T. Greenberg
Prevention Research Center, Pennsylvania State University, University Park, PA, USA
Search for more papers by this authorTricia A. Zucker
Children's Learning Institute, Department of Pediatrics, The University of Texas—Health Science Center at Houston, Houston, TX, USA
Search for more papers by this authorSusan H. Landry
Children's Learning Institute, Department of Pediatrics, The University of Texas—Health Science Center at Houston, Houston, TX, USA
Search for more papers by this authorConflict of interest statement: No conflicts declared.
Abstract
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.
Open Research
Data availability statement
Key points
- It is widely known that children with externalizing or internalizing behavior problems tend to show higher problems in the other domain. However, it remains unclear whether this is due to transactional processes between the two domains or common risk factors predisposing children to both domains.
- Evidence from the random-intercept cross-lagged panel model provides support for a shared-risk model—with a particular emphasis on the role of inhibitory control as a common etiology—rather than transactional hypotheses focusing on influences of one domain on the other.
- Our findings suggest that inhibitory control may be a promising target of early interventions for children at risk of externalizing-internalizing co-occurrence over the first 6 years of formal schooling.
Supporting Information
Filename | Description |
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jcpp13950-sup-0001-Supinfo.docxWord 2007 document , 894.3 KB | Table S1. Descriptive statistics for analytic sample. Table S2. Correlations among all study variables. Table S3. Model fit statistics. Table S4. RI-CLPM, CLPM, ALT-SR results of linking externalizing and internalizing problems. Table S5. Predictors of latent stability of externalizing and internalizing problems. Table S6. Results of conditional models entering predictors in sequence. Figure S1. Model diagram of RI-CLPM of externalizing-internalizing problems. Figure S2. Observed individual trajectories of externalizing and internalizing problems. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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