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

2016 ◽  
Vol 29 (3) ◽  
pp. 919-928 ◽  
Author(s):  
Michel G. Nivard ◽  
Gitta H. Lubke ◽  
Conor V. Dolan ◽  
David M. Evans ◽  
Beate St. Pourcain ◽  
...  
Keyword(s):  
Developmental Trajectories ◽  
Specific Treatment ◽  
Externalizing Disorders ◽  
Childhood And Adolescence ◽  
Multinomial Regression ◽  
Treatment Needs ◽  
Growth Mixture Models ◽  
Growth Mixture ◽  
Dsm Iv ◽  
Internalizing And Externalizing

AbstractThis 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.

scholarly journals Neuropsychological deficits in internalizing and externalizing disorders

Psychologica ◽  
2020 ◽  
Vol 63 (2) ◽  
pp. 69-92
Author(s):  
Daniel Rama-Victor ◽  
Jose A. Piqueras
Keyword(s):  
Mental Disorders ◽  
Behavioral Therapy ◽  
Cognitive Strategies ◽  
Externalizing Disorders ◽  
Neuropsychological Deficits ◽  
Childhood And Adolescence ◽  
Obsessive Compulsive ◽  
Empirically Supported ◽  
Assessment And Treatment ◽  
Internalizing And Externalizing

Over the past three decades, our understanding of the nature, assessment and treatment of childhood mental disorders has increased significantly. Some of the most recent advances come from transdiagnostic and neuropsychological-based approaches. While the relationship of similar neuropsychological deficits with some mental disorders, such as neurodevelopmental and severe mental disorders like schizophrenia or bipolar disorder, is widely established, there is more controversy about their relationship with the so-called internalizing and externalizing disorders. In this article, our goal was to highlight the potential of incorporating cognitive strategies from integrative neuropsychological and transdiagnostic approaches to improve the effectiveness of empirically-supported cognitive-behavioral therapy for internalizing and externalizing mental disorders in childhood and adolescence. The results of the present work indicate that the vast majority of internalizing disorders, including the presence of anxiety, depressive, trauma-and stress-related, and obsessive-compulsive and related disorders, as well as externalizing symptoms (corresponding to conduct disorder and ODD), present neuropsychological deficits and that their consideration may be relevant to improve the effectiveness of psychotherapeutic interventions in children and adolescents by incorporating neuropsychology-based assessment and treatment tools. The inclusion of neuropsychological support strategies in therapy for childhood mental disorders implies an advance and has clear implications for the enhancement of psychological care for childhood mental disorders.

scholarly journals Confirmatory test of two factors and four subtypes of bipolar disorder based on lifetime psychiatric co-morbidity

2015 ◽  
Vol 45 (10) ◽  
pp. 2181-2196 ◽  
Author(s):  
P. O. Monahan ◽  
T. Stump ◽  
W. H. Coryell ◽  
J. Harezlak ◽  
G. A. Marcoulides ◽  
...  
Keyword(s):  
Latent Class ◽  
Externalizing Disorders ◽  
Model Fit ◽  
Confirmatory Test ◽  
Course Of Illness ◽  
First Degree Relatives ◽  
Co Morbidity ◽  
Two Factors ◽  
Dsm Iv ◽  
Internalizing And Externalizing

BackgroundThe first aim was to use confirmatory factor analysis (CFA) to test a hypothesis that two factors (internalizing and externalizing) account for lifetime co-morbid DSM-IV diagnoses among adults with bipolar I (BPI) disorder. The second aim was to use confirmatory latent class analysis (CLCA) to test the hypothesis that four clinical subtypes are detectible: pure BPI; BPI plus internalizing disorders only; BPI plus externalizing disorders only; and BPI plus internalizing and externalizing disorders.MethodA cohort of 699 multiplex BPI families was studied, ascertained and assessed (1998–2003) by the National Institute of Mental Health Genetics Initiative Bipolar Consortium: 1156 with BPI disorder (504 adult probands; 594 first-degree relatives; and 58 more distant relatives) and 563 first-degree relatives without BPI. Best-estimate consensus DSM-IV diagnoses were based on structured interviews, family history and medical records. MPLUS software was used for CFA and CLCA.ResultsThe two-factor CFA model fit the data very well, and could not be improved by adding or removing paths. The four-class CLCA model fit better than exploratory LCA models or post-hoc-modified CLCA models. The two factors and four classes were associated with distinctive clinical course and severity variables, adjusted for proband gender. Co-morbidity, especially more than one internalizing and/or externalizing disorder, was associated with a more severe and complicated course of illness. The four classes demonstrated significant familial aggregation, adjusted for gender and age of relatives.ConclusionsThe BPI two-factor and four-cluster hypotheses demonstrated substantial confirmatory support. These models may be useful for subtyping BPI disorders, predicting course of illness and refining the phenotype in genetic studies.

scholarly journals Sex differences in ADHD trajectories across childhood and adolescence

2018 ◽  
Author(s):  
Aja Louise Murray ◽  
Tom Booth ◽  
Manuel Eisner ◽  
Bonnie Auyeung ◽  
George Murray ◽  
...  
Keyword(s):  
Sex Differences ◽  
Secondary School ◽  
Early Adolescence ◽  
Age Of Onset ◽  
Developmental Trajectories ◽  
Childhood And Adolescence ◽  
Mixture Modelling ◽  
Growth Mixture ◽  
Growth Mixture Modelling ◽  
Males And Females

Background: Previous studies have hinted at sex differences in developmental trajectories in ADHD symptoms; however, little is known about the nature or cause of these differences and their implications for clinical practice.Method: We used growth mixture modelling in a community-ascertained cohort of n=1571 participants to study sex differences in ADHD symptom developmental trajectories across the elementary and secondary school years. Participants were measured at ages 7, 8, 9, 10, 11, 12, 13, and 15.Results: We found that females were more likely to show large symptom increases in early adolescence while males were more likely to show elevated symptoms from childhood. For both males and females, early adolescence represented a period of vulnerability characterised by relatively sudden symptom increases. Conclusions: Females affected by hyperactivity/impulsivity may be more likely to be excluded from diagnosis due to current age of onset criteria. More attention should be paid to early adolescence as a period of risk for hyperactivity/impulsivity symptom onset or worsening.

scholarly journals Child and Adolescent Behavior Inventory (CABI): A New Instrument for Epidemiological Studies and Pre-Clinical Evaluation

2013 ◽  
Vol 9 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Carlo Cianchetti ◽  
Andrea Pittau ◽  
Valeria Carta ◽  
Grazia Campus ◽  
Roberta Littarru ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Normative Data ◽  
Normal Population ◽  
Epidemiological Studies ◽  
Externalizing Disorders ◽  
Anxiety And Depression ◽  
New Instrument ◽  
Dsm Iv ◽  
Depression Scales ◽  
Internalizing And Externalizing

Background: Some questionnaires have already been elaborated to collect information from parents of children and adolescents, both as preparation for clinical evaluation and for screening and epidemiological studies. Here a new questionnaire, the CABI, is proposed, and it is validated in a population of 8-10 year-old children. Compared to existing questionnaires, the CABI has been organized so as to be of medium length, with items concerning the most significant symptoms indicated by the DSM-IV-TR for the pertinent disorders, and covering a wider range than existing instruments. There is no charge for its use. Methods: The answers of the parents of 302 children in the last 3 years of primary school provided the normative data. A discriminant validation was done for internalizing and externalizing disorders and as a comparison with self-administered anxiety and depression scales. Exploratory factor analysis and internal consistency were also performed. Results: Distribution of scores on the main scales in the normal population shows positive skewness, with the most frequent score being zero. A highly discriminant capability was found in regard to the sample of children with internalizing and externalizing disorders, with high correlation with the self-administered anxiety and depression scales. Conclusion: The CABI appears to be capable, at least for 8-10 year-old children, of effectively discriminating those with pathological symptoms from those without. Compared with the widely- used CBCL, it has the advantages of a lower number of items, which should facilitate parental collaboration especially in epidemiological studies, and of being free of charge.

scholarly journals Developmental Trajectories of Tobacco/Nicotine and Cannabis Use and Patterns of Product Co-use in Young Adulthood

2020 ◽  
Vol 13 ◽  
pp. 1179173X2094927
Author(s):  
Michael S Dunbar ◽  
Jordan P Davis ◽  
Joan S Tucker ◽  
Rachana Seelam ◽  
Regina A Shih ◽  
...  
Keyword(s):  
Young People ◽  
Young Adulthood ◽  
Developmental Trajectories ◽  
Cannabis Use ◽  
Rapid Progression ◽  
Online Surveys ◽  
Developmental Patterns ◽  
Growth Mixture Models ◽  
Growth Mixture ◽  
Early Progression

Introduction: Concurrent co-use of tobacco/nicotine and cannabis (T/C) products is common among young people and may increase risks for negative health and psychosocial outcomes, but little is known about developmental patterns of T/C co-use. This study aimed to identify distinct trajectory classes of concurrent T/C co-use from ages 16 to 21 and compare groups on T/C co-use behaviors in young adulthood. Methods: Participants (n = 2497) reported T/C use on annual online surveys from 2015 to 2019 (ages 16-22). We used parallel process growth mixture models to model simultaneous trajectories of past-month cigarette, e-cigarette, smokeless tobacco, and cannabis use and identify latent classes of T/C trajectories. Classes were then compared on types and number of T/C products used and types of T/C co-use in young adulthood. Results: Models revealed 4 T/C classes: Low/No T/C Use, Early Concurrent T/C Co-use, Late Concurrent T/C Co-use, and Tobacco Quitters/Cannabis Maintainers. Compared to other classes, the Early Concurrent T/C Co-use group—individuals with rapid progression to concurrent T/C co-use during adolescence—were more likely to report poly-tobacco use, poly-cannabis use, same-occasion sequential T/C co-use and T/C co-administration (ie, mixing T/C) of both combustible and vaping products in young adulthood. Conclusion: Early progression to concurrent T/C co-use in adolescence is prospectively linked to poly-product use and co-use of T/C products in young adulthood. Prevention efforts targeting co-use of T/C products in adolescence may help to reduce riskier patterns of T/C use and co-use in young adulthood.

scholarly journals The contribution of familial internalizing and externalizing liability factors to borderline personality disorder

2014 ◽  
Vol 44 (11) ◽  
pp. 2397-2407 ◽  
Author(s):  
J. I. Hudson ◽  
M. C. Zanarini ◽  
K. S. Mitchell ◽  
L. W. Choi-Kain ◽  
J. G. Gunderson
Keyword(s):  
Major Depressive Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Externalizing Disorders ◽  
Diagnostic Interview ◽  
Borderline Personality ◽  
Major Depressive ◽  
Dsm Iv ◽  
Internalizing And Externalizing

BackgroundIndividuals with borderline personality disorder (BPD) frequently display co-morbid mental disorders. These disorders include ‘internalizing’ disorders (such as major depressive disorder and anxiety disorders) and ‘externalizing’ disorders (such as substance use disorders and antisocial personality disorder). It is hypothesized that these disorders may arise from latent ‘internalizing’ and ‘externalizing’ liability factors. Factor analytic studies suggest that internalizing and externalizing factors both contribute to BPD, but the extent to which such contributions are familial is unknown.MethodParticipants were 368 probands (132 with BPD; 134 without BPD; and 102 with major depressive disorder) and 885 siblings and parents of probands. Participants were administered the Diagnostic Interview for DSM-IV Personality Disorders, the Revised Diagnostic Interview for Borderlines, and the Structured Clinical Interview for DSM-IV.ResultsOn confirmatory factor analysis of within-person associations of disorders, BPD loaded moderately on internalizing (factor loading 0.53, s.e. = 0.10, p < 0.001) and externalizing latent variables (0.48, s.e. = 0.10, p < 0.001). Within-family associations were assessed using structural equation models of familial and non-familial factors for BPD, internalizing disorders, and externalizing disorders. In a Cholesky decomposition model, 84% (s.e. = 17%, p < 0.001) of the association of BPD with internalizing and externalizing factors was accounted for by familial contributions.ConclusionsFamilial internalizing and externalizing liability factors are both associated with, and therefore may mutually contribute to, BPD. These familial contributions account largely for the pattern of co-morbidity between BPD and internalizing and externalizing disorders.

Developmental pathways from preschool irritability to multifinality in early adolescence: the role of diurnal cortisol

2019 ◽  
pp. 1-9 ◽  
Author(s):  
Ellen M. Kessel ◽  
Allison Frost ◽  
Brandon L. Goldstein ◽  
Sarah R. Black ◽  
Lea R. Dougherty ◽  
...  
Keyword(s):  
Internalizing Symptoms ◽  
Developmental Trajectories ◽  
Externalizing Symptoms ◽  
Externalizing Disorders ◽  
Developmental Pathways ◽  
Stress System ◽  
Diurnal Cortisol ◽  
System Functioning ◽  
Internalizing And Externalizing

Abstract Background Early irritability predicts a broad spectrum of psychopathology spanning both internalizing and externalizing disorders, rather than any particular disorder or group of disorders (i.e. multifinality). Very few studies, however, have examined the developmental mechanisms by which it leads to such phenotypically diverse outcomes. We examined whether variation in the diurnal pattern of cortisol moderates developmental pathways between preschool irritability and the subsequent emergence of internalizing and externalizing symptoms 9 years later. Method When children were 3 years old, mothers were interviewed about children's irritability and completed questionnaires about their children's psychopathology. Six years later, children collected saliva samples at wake-up and bedtime on three consecutive days. Diurnal cortisol patterns were modeled as latent difference scores between evening and morning samples. When children were approximately 12 years old, mothers again completed questionnaires about their children's psychopathology. Results Among children with higher levels of irritability at age 3, a steeper diurnal cortisol slope at age 9 predicted greater internalizing symptoms and irritability at age 12, whereas a blunted slope at age 9 predicted greater externalizing symptoms at age 12, adjusting for baseline and concurrent symptoms. Conclusion Our results suggest that variation in stress system functioning can predict and differentiate developmental trajectories of early irritability that are relatively more internalizing v. those in which externalizing symptoms dominate in pre-adolescence.

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