The Development of Co-Occurrent Anxiety and Externalizing Problems from Early Childhood: a Latent Transition Analysis Approach

AbstractResearch into co-occurrent internalizing and externalizing problems during childhood is flourishing. In particular, investigation on the association between anxiety and externalizing problems has yielded mixed findings, focused mainly on the issue of which problem might precede the other, and what role anxiety plays with respect to externalizing problems. Relatively little attention has been paid to the developmental patterns of these behaviors from early childhood, despite the potential of such knowledge to fully delineate etiological models of co-occurrence. This study aimed to examine the longitudinal association of anxiety and externalizing problems in a community sample of preschoolers (ELISA Project; N = 2,341; 48.2% girls), by identifying empirically derived profiles and then describing their change and stability through the use of Latent Transition Analysis. Gender differences were explored. Four different profiles were identified: “typically developing”, “mainly anxious”, “modestly externalizing” and “co-occurrent”. Membership in these profile groups showed high stability over a two-year period. However, children in the “co-occurrent” profile group were the most likely to show changes, predominantly towards “modestly externalizing”. Furthermore, a significant gender difference for transitions towards the “co-occurrent” profile group was found, with girls showing less likelihood of being assigned to such profile. These findings show that it is possible to identify an early persistent course of co-occurrent anxiety and externalizing problems, as well as observe changes in co-occurrence towards a simpler externalizing behavioral expression. Further research should explore predictors of group membership and changes in membership, that are malleable and therefore open to preventative intervention.

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Social Anxiety-Impulsivity Subgroups and Links to Later Emotional Adjustment in Adolescence: A Latent Transition Analysis

The Journal of Early Adolescence ◽

10.1177/0272431620919153 ◽

2020 ◽

Vol 40 (9) ◽

pp. 1397-1426 ◽

Cited By ~ 1

Author(s):

Nejra Van Zalk ◽

Maria Tillfors ◽

Ewa Mörtberg

Keyword(s):

Social Anxiety ◽

Internalizing Problems ◽

Externalizing Problems ◽

Emotional Adjustment ◽

Latent Transition Analysis ◽

Early Adolescent ◽

High Anxiety ◽

Transition Analysis ◽

Latent Transition ◽

Internalizing And Externalizing

A growing body of research has acknowledged the heterogeneity of subclinical social anxiety, identifying a subgroup of individuals who exhibit high levels of impulsivity. In a sample of Swedish early adolescents ( N = 2,509, Mage = 13.64; 52.8% girls), we conducted latent transition analyses (LTA) to identify four classes of subclinical social anxiety-impulsivity across three time points. We identified a Low Social Anxiety-Low Impulsivity class, as well as a High Anxiety-High Impulsivity class for girls and boys, which had high levels of Time-4 internalizing problems. The latter class was less stable but larger for boys. There was also a more typical High Anxiety-Low Impulsivity class for both genders. Nevertheless, Low Anxiety-High Impulsivity girls and boys fared the worst in terms of both internalizing and externalizing problems later on. To our knowledge, this is the first study to adopt an LTA framework to investigate trajectories of early adolescent social anxiety-impulsivity over time.

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Change in the manifestations of asthma and asthma-related traits in childhood: a latent transition analysis

European Respiratory Journal ◽

10.1183/13993003.00284-2015 ◽

2015 ◽

Vol 47 (2) ◽

pp. 499-509 ◽

Cited By ~ 27

Author(s):

Frances L. Garden ◽

Judy M. Simpson ◽

Craig M. Mellis ◽

Guy B. Marks

Keyword(s):

Early Childhood ◽

Respiratory Disease ◽

Respiratory Symptoms ◽

Healthcare Utilisation ◽

Latent Transition Analysis ◽

Atopic Asthma ◽

Degree Relative ◽

Transition Analysis ◽

Latent Transition ◽

Over Time

It is known that asthma is a heterogeneous entity whose manifestations vary with age. Our objective was to examine changes in the manifestation of asthma and asthma-related traits in childhood by defining empirically derived childhood asthma phenotypes and examining their transitions over time.To define the phenotypes we used data on respiratory symptoms, healthcare utilisation, medications, spirometry, airway hyperresponsiveness (AHR), exhaled nitric oxide concentration and atopy from a birth cohort recruited on the basis of having a first-degree relative with asthma. Data were acquired at ages 1.5–11.5 years and analysed using latent transition analysis.In a study population of 370 participants, we classified subjects into four phenotypes: 1) nonatopic, few symptoms (prevalence range from 1.5 to 5 years: 52–60%), 2) atopic, few symptoms (3–21%), 3) nonatopic, asthma and rhinitis symptoms (13–35%), and 4) atopic, asthma and rhinitis symptoms (2–14%) in early childhood; and 1) nonatopic, no respiratory disease (prevalence range from 8 to 11.5 years: 41–46%), 2) atopic, no respiratory disease (23–33%), 3) nonatopic, asthma symptoms, no AHR or airway inflammation (8–12%) and 4) atopic asthma (19%) in mid-childhood. Transitioning between phenotypes was common in early childhood, but less common in later childhood.This analysis represents the first attempt to incorporate longitudinal patterns of several manifestations of asthma into a single model to simultaneously define phenotypes and examine their transitions over time. It provides quantitative support for the view that asthma is a heterogeneous entity, and that some children with wheeze and other respiratory symptoms in early life progress to asthma in mid-childhood, while others become asymptomatic.

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