2021
DOI: 10.1186/s13034-021-00434-x
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The mediating role of internalizing and externalizing symptoms in the relationship between childhood trauma and suicidality among adolescents: a structural equation model

Abstract: Background The objective of this study is to investigate the direct and indirect effects of childhood trauma, internalizing symptoms, and externalizing symptoms on suicidality among adolescents, thereby establishing a structural equation model. Methods The present study uses a cross-sectional descriptive design. Among 147 adolescents aged 12–17, 93 outpatients diagnosed with major depressive disorder and 54 controls were included in the study. They… Show more

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Cited by 11 publications
(4 citation statements)
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“…Children with internalizing behavior may in fact go undetected in a classroom as it may not overtly appear the children are struggling (NCTSN, 2008). Internalizing symptoms include those related to anxiety and depression such as depersonalization, somatic complaints, dissociation, withdrawal, inattention, low self-esteem, nightmares/flashbacks, shame/guilt, and learning problems (Kim et al, 2021; Perfect et al, 2016). Students with internalizing behavior may avoid certain people or tasks (i.e., social withdrawal), require excessive feedback or reassurance, cry, engage in negative self-talk, express somatic complaints, or present as irritable, and their academic performance may substantially decrease (Stormont et al, 2015).…”
Section: Internalizing Symptomatologymentioning
confidence: 99%
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“…Children with internalizing behavior may in fact go undetected in a classroom as it may not overtly appear the children are struggling (NCTSN, 2008). Internalizing symptoms include those related to anxiety and depression such as depersonalization, somatic complaints, dissociation, withdrawal, inattention, low self-esteem, nightmares/flashbacks, shame/guilt, and learning problems (Kim et al, 2021; Perfect et al, 2016). Students with internalizing behavior may avoid certain people or tasks (i.e., social withdrawal), require excessive feedback or reassurance, cry, engage in negative self-talk, express somatic complaints, or present as irritable, and their academic performance may substantially decrease (Stormont et al, 2015).…”
Section: Internalizing Symptomatologymentioning
confidence: 99%
“…It is important to note that traumatic stress symptoms encompass a wide range of internalizing and externalizing symptomatology and may manifest simultaneously, as the two are not mutually exclusive (National Child Traumatic Stress Network [NCTSN], 2008). Internalizing symptoms are those that are directed inward that may lead to internal psychological distress, while externalizing symptoms are outer-directed behaviors that may negatively impact others and may lead to interpersonal conflict (Kim et al, 2021).…”
mentioning
confidence: 99%
“…These problems are more difficult to recognize; often, these behaviors may not be seen as a problem by the child’s family (Holland et al, 2003). Children with maladaptive and emotional behavior problems have a negative impact on the individual, family, and society and are at high risk of some mental health problems such as school failure, depression and antisocial personality disorders, and suicide (Bolu et al, 2012; Cicek, 2020; İldeniz et al, 2021; Kim et al, 2021; Yasar Ekici, 2014). While the rate of behavioral disorders in children is 11% under normal living conditions, it can increase to 20% to 35% in children who have experienced negative life conditions (Arkan & Ustun, 2009).…”
Section: Introductionmentioning
confidence: 99%
“…Furthermore, childhood trauma has been associated with premature declines in health in midlife and old age, emphasizing the importance of early interventions to mitigate the long-term impact of trauma on health outcomes (Infurna et al, 2015). The mediating role of internalizing and externalizing symptoms in the relationship between childhood trauma and suicidality has been highlighted, indicating the significance of therapeutic interventions for both internalizing and externalizing symptoms to prevent suicide in adolescents with childhood trauma (Kim et al, 2021). Additionally, interpersonal stress has been identified as a mediator of the relationship between childhood trauma and depressive symptoms, suggesting that interventions promoting interpersonal skills may be beneficial for childhood trauma survivors (Fung et al, 2022).…”
Section: Introductionmentioning
confidence: 99%