TY - JOUR
T1 - Joint developmental trajectories of internalizing and externalizing disorders between childhood and adolescence
AU - Nivard, Michel G
AU - Lubke, Gitta H
AU - Dolan, Conor V
AU - Evans, David M
AU - St Pourcain, Beate
AU - Munafò, Marcus R
AU - Middeldorp, Christel M
PY - 2017/8
Y1 - 2017/8
N2 - This 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.
AB - This 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.
KW - Journal Article
UR - http://www.scopus.com/inward/record.url?scp=84978484194&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84978484194&partnerID=8YFLogxK
U2 - 10.1017/S0954579416000572
DO - 10.1017/S0954579416000572
M3 - Article
C2 - 27427290
SN - 0954-5794
VL - 29
SP - 919
EP - 928
JO - Development and Psychopathology
JF - Development and Psychopathology
IS - 3
ER -