Association between developmental patterns of single and concurrent externalizing behaviors and internalizing problems over the preschool years.

Abstract

The present study investigated whether distinct developmental patterns of externalizing behaviors (EBs: hyperactivity-impulsivity, noncompliance, physical aggression) based on parent reports were repeatedly and differentially associated with separate dimensions of internalizing problems such as general anxiety, separation anxiety, and depressive symptoms across the early, middle, and late preschool years in a population birth cohort (N = 2,057, 50.7% boys). Six high trajectory classes obtained by latent growth modeling were used as longitudinal indicators of single EB and co-occurrent EBs. Children following low or moderate trajectories for all EBs served as the reference class. Results revealed that children in trajectory classes reflecting high levels of co-occurring EBs showed higher levels of general anxiety, separation anxiety, and depressive symptoms across the preschool years. In contrast, children in trajectory classes reflecting single EB manifested higher levels of some, but not all, dimensions of internalizing problems. In addition, their scores varied from one period to another. No sex differences were observed in the above associations. These results underline the need for comprehensive assessments across distinct types of EBs and internalizing problems to better reflect the characteristics that distinguish individual children. Finally, results suggest that children showing early co-occurrent EBs and internalizing symptoms may be an important group to target for in-depth assessment and possibly preventive intervention. Public Significance StatementChildren who show a high level of externalizing behaviors (EB: hyperactivity-impulsivity, noncompliance, or physical aggression) from the early to late preschool years-and especially preschoolers with high levels of multiple EBs-also present higher levels of anxiety, separation anxiety, and depressive symptoms. These findings are consistent with a developmental approach to psychopathology and emphasize the importance of early preventive evaluation and potential intervention with these children.