Using the Early Childhood Longitudinal Study (Kindergarten Class), this research explored the developmental trajectories of internalizing and externalizing behaviors during the elementary school years, with an emphasis on the connections between these behaviors, how they are embedded in social structural settings defined by broad stratification systems, and what their implications are for the future. Specifically, this study was organized around three aims: (1) To estimate trajectories of internalizing and externalizing behaviors (e.g., co-occurrence and dynamic interplay); (2) To explore variations in those trajectories across segments of the population (e.g., race/ethnicity); and (3) To examine the links between children's internalizing and externalizing pathways in elementary school and their 8th grade academic functioning, as well as possible group variation in those links. Four analytical techniques -- growth curve analysis, latent class growth analysis, cross-lagged modeling and regression analysis -- were used. Results indicated a low incidence of internalizing and externalizing symptoms in the whole sample as well as small incremental changes over time and small differences across groups. More in-depth investigation revealed that children of Black parents and boys were at greater risk for present and future problematic behaviors, and boys and children of immigrants were at greater risk for future academic failure when their earlier overall combined symptom trajectories fell in the risky category. In addition, the general patterns of children's internalizing symptoms serving as protective factors for future externalizing symptoms and of externalizing symptoms serving as risk factors for future internalizing symptoms tended to be most consistent among children of White parents and children of non-immigrants. Moreover, findings revealed that what matters about the symptom trajectories in relation to later school functioning is not just the initial level of symptoms but also the change in levels from kindergarten through fifth grade. Overall, this study suggested that intervention efforts need to take into account both the symptomatic child's initial (and overall) levels of symptoms as well as over-time change of symptoms when putting together a specific intervention plan for the affected individual. Finer prevention and intervention efforts are also needed for boys and for children of immigrants to facilitate positive academic functioning. / text

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Many adults suffering from mental health problems often report that the onset of these concerns began in adolescence, highlighting the importance of identifying and treating mental health concerns from an early age. In high schools, some students are identified as having externalizing or internalizing disorders. The majority of these students, especially those with internalizing symptoms, go untreated. One potential reason may be that limited school resources are used to correct behavior problems, leaving those with internalizing disorders to silently suffer, which often exacerbates the issues. Recent research suggests many individuals have high levels of resilience which can be taught, and which positively contributes to mental health. Social emotional learning (SEL) is one approach to teaching resilience. In this study we implemented an SEL program called Strong Teens at the high school level. The high school identified students with internalizing symptoms and provided them with this curriculum, intended to reduce those symptoms. We used a time series design to evaluate changes in internalizing symptoms (e.g., depression, anxiety, and withdrawal) and resilience. Results indicated that with the implementation of the Strong Teens curriculum, student levels of internalizing symptoms decreased from pretest to posttest, according to self-report. Teacher reports did not indicate any significant change in internalizing symptoms or resilience. This study supports the findings o fthe Strong Teens curriculum as a generalizable program which significantly reduces internalizing symptoms.

Internalizing disorders cause serious psychological problems for many adolescents. The effects can be both debilitating and long lasting. However, assessment of internalizing disorders has been plagued by limited measurement strategies. Historically, individual measures were developed to assess the narrow-band symptoms that are subsumed under the broad construct of internalizing disorders (e.g., depression, anxiety, somatic complaints, and social withdrawal). Recently, the Internalizing Symptom Scale for Adolescents has been created. The Internalizing Symptom Scale for Adolescents is a short screening measure that includes newer models of affect such as the tripartite model of affect. Additionally, there has been limited research on the relationship between self-concept and internalizing disorders. Although the inverse relationship between depression and self-concept is well documented, the relationship between self-concept and other internalizing syndromes is essentially unknown. The present study addressed the underlying factor structure of the Internalizing Symptom Scale for Adolescents. A factor analysis using principal axis extraction with varimax rotation was conducted. A two-factor solution was identified as superior to any other factor solution considered. The two factors accounted for 34.2% of the total variance in the Internalizing Symptom Scale for Adolescents scores and were identified as Factor 1, Negative Affect/General Distress and Factor 2, Positive Affect. The two-factor solution of the Internalizing Symptom Scale for Adolescents provided some support for Watson and Clark's tripartite model of affectivity. The present study also considered the relationship between the Internalizing Symptom Scale for Adolescents and the Multidimensional Self-Concept Scale. Bivariate correlations were run to evaluate the relationship between internalizing symptoms and self-concept. The correlations ranged from moderate to large (-.42 to -.78) and were inversely related as expected. Multiple regression analyses were conducted to determine if the Multidimensional Self-Concept Scale subscales could predict internalizing symptoms. The combined predictors accounted for 62% of the variance in the Internalizing Symptom Scale for Adolescents. These findings indicate that self-concept is a robust predictor for internalizing disorders. The study provides evidence for the use of the Internalizing Symptom Scale for Adolescents a s a pscyhometrically sound measure for assessing internalizing disorders in adolescents. Implications of this study for clinical practice and directions for future research are discussed.

Background and Objective: Type 1 diabetes mellitus (T1DM) is one of the most common pediatric chronic illnesses. Youth with T1DM have been shown to be at risk for internalizing problems and obtaining insufficient sleep. An emerging body of literature has demonstrated the feasibility and potential benefit of increasing sleep duration as a strategy to improve psychological outcomes in nondiabetic school age populations. The current study seeks to investigate the relationship between sleep and internalizing symptoms and empirically examine the effect of a sleep extension intervention on internalizing symptoms in youth with T1DM. Methods: The sample consisted of 106 youth with T1DM (mean age = 13.5 ± 2.1 years) who were part of a larger study recruited over a three-year period. Participants were 52.8% male and 50.9% identified as non-white. The primary outcome measure was the Behavior Assessment System for Children, Second Edition (BASC-2), both parent and self-report. Other behavioral and sleep measures included actigraphy, sleep diary, the School Sleep Habits Survey (SSHS), Pediatric Symptoms Checklist (PSC), and the Child Sleep Habits Questionnaire (CSHQ). Participants were randomly assigned to either the Sleep Extension condition (n = 50), in which they were asked to extend their sleep duration, or the Fixed Sleep Duration condition (n = 56), in which they were asked to maintain the same amount of sleep as their baseline. Results: Average sleep durations varied across measures, with all values falling in the lower range or below national recommendations. More than a third (34.5%) of the sample had elevated scores for internalizing problems based on parent report, and 17.7% were elevated based on self-report. Pearson correlations indicated that parent reported sleep duration was negatively related to self-reported anxiety, r(106) = -0.237, p = 0.018, as well as parent-reported depression, r(106) = -0.218, p = 0.028, and emotional self-control, r(106) = -0.232, p = 0.018. No other measure of sleep duration was significantly correlated with internalizing symptoms. Secondary analyses of measures of sleep quality including sleep efficiency (SE), wake after sleep onset (WASO), and sleepiness, were significantly related to internalizing problems based on both parent and self-report (all p < 0.05), whereas more variability in sleep duration (CV) was related to higher self-reported depression, r(106) = 0.210, p = 0.033. Following the sleep intervention, participants in the Sleep Extension condition increased their average sleep duration by 26.71 minutes based on actigraphy, while participants in the Fixed Sleep duration decreased by 0.14 minutes from pre- to post-intervention. Participants in the Sleep Extension condition had significantly lower scores on the BASC-2 Internalizing Problems Composite than participants in the Fixed Sleep Duration condition following the intervention, after controlling for sex and baseline internalizing symptoms, F(1, 98) = 4.18, p = 0.044. On average, the Internalizing Problems Composite score of participants in the Sleep Extension condition decreased by almost half a standard deviation (4.65 ± 6.41 points), compared to a decrease of 2.31 ± 6.59 points for participants in the Fixed Sleep Duration condition. There were no significant effects for self-report. Conclusions: Youth with T1DM obtained insufficient sleep and experienced high rates of internalizing symptoms. The results also suggest that relations between sleep and internalizing symptoms exist; however, these associations may be more driven by other aspects of sleep rather than actual sleep loss, such as nighttime sleep disturbance, daytime sleepiness, and variability of the sleep schedule. The findings further indicated that a sleep extension intervention was effective in increasing sleep duration, as well as reducing parent-reported internalizing symptoms in a sample of children and adolescents with T1DM. This intervention has the potential to be utilized as a cost effective, and relatively easy to implement method for reducing internalizing symptoms in youth with T1DM.

Co-rumination is a nuanced emotion socialization process that occurs with parents and friends during adolescence. Although co-ruminating builds closeness with others, it corresponds to increased internalizing symptoms, particularly for adolescent girls. The present study explored how specific features of co-rumination vary by relational context (parents, friends) and adolescent gender. These features were also examined in relation to adolescent internalizing symptoms, with adolescent gender as a potential moderator. Thirty adolescents (13–18 years old; 60% female, 40% male) participated in separate discourse tasks with their parent and their same-gender close friend. Co-rumination was observed during these conversations, and adolescents reported their internalizing symptoms. Features of co-rumination varied by relational context and adolescent gender, with unique links to adolescent internalizing symptoms. This study extends prior research by providing a fine-grained analysis of how co-rumination corresponds to internalizing symptoms across two relational contexts.

Maternal depression is a robust risk factor for heightened internalizing symptoms in offspring. Studies also suggest that maternal depression is associated with greater maternal emotion regulation (ER) difficulties. However, emotion regulation has been conceptualized as a multidimensional construct, and few studies have identified specific components of ER related to maternal depression and the role these components may play in the relationship between maternal depression and child internalizing symptoms. Mothers (n = 73) of young children (ages 4–9; 42 females), recruited from both clinical and community settings, reported their depression symptoms and emotion regulation difficulties. Children’s internalizing symptoms were assessed using both parental report and a semi-structured clinical interview. Regression analyses revealed that maternal depression symptoms were positively related to maternal ER, specifically, limited access to emotion regulation strategies and non-acceptance of emotional responses. Structural equation models revealed that the relation between maternal depression and child internalizing problems was mediated only through mother’s limited access to emotion regulation strategies. Our findings offer new insight for targeting mothers’ limited access to emotion strategies as a novel early intervention method to help break the intergenerational transmission of internalizing symptoms from mother to child.

A sizeable proportion of adults suffer from an anxiety disorder and many of those adults are parents. Parental anxiety, as well as dysfunctional family environment, contributes to both internalizing and externalizing problems in children. Specifically, family control, conflict, and cohesion have been shown to predict child internalizing and externalizing symptoms to varying degrees. However, few studies have examined the association between all three components in the same study: parental psychopathology, family environment, and child outcomes. The current study tested the relationships among these variables in a sample of 189 children (66% male, 93% Caucasian, mean age = 10.34 years). Family conflict predicted child externalizing symptoms for both mothers and fathers, and mediated the relationship between maternal anxiety and child externalizing symptoms. Family cohesion predicted child externalizing problems based on maternal report and mediated the relationship between maternal anxiety and child externalizing symptoms. Furthermore, family cohesion moderated the relationship between maternal anxiety and child internalizing symptoms. These findings provide preliminary support for the role of the family environment in the relationship between parental anxiety and child psychopathology, and these environmental variables may be important targets of intervention in families with elevated parental anxiety. / Master of Science

The need for a self-report instrument that assesses internalizing problems in children ages 8 through 12 is evidenced in the lack of such an instrument, and in the prevalence of internalizing problems in children. A new self-report instrument, the Internalizing Symptoms Scale for Children (ISSC), has been proposed and developed to fit this need. The present study evaluated the criterion-related validity, clinical cutoff points, and discriminating power of the ISSC. Two groups of child subjects, clinic-referred and general-school-population, were recruited and administered the ISSC, and a parent of each subject completed the Child Behavior Checklist (CBCL). Each case within the clinic-referred group was then classified as an Internalizer or non-Internalizer based on the CBCL Internalizing T-score. The CBCL was identified as the criterion because of empirical methods used in creating the factor structure, extensive clinical use, psychometric properties, cross-informant design, and large research representation. Results of the evaluations indicated the ISSC to have moderate, yet adequate evidence of criterion-related validity, an optimum clinical cutoff point of 70 (raw score), and strong discriminating power. These results give support for the clinical use of the ISSC as a screening instrument, and for potential use in diagnosis and treatment planning.

Emotion socialization influences adolescent emotional adjustment. Friendships provide a venue for emotion socialization, yet little research has compared emotion socialization processes with parents versus friends and how they correspond to adolescent outcomes. The present study examined parent and friend socialization of negative emotions in relation to adolescents' emotional coherence, emotion regulation, and internalizing symptoms. Thirty parent-adolescent-friend triads (13–18 years old; 60% female, 40% male) from the community participated. Study variables were measured with a multi-method approach, including observational data, heart rate variability, and self-report. Parents and friends evidenced disparate patterns of socialization responses and unique ties to adolescent outcomes, which has important clinical applications. Friends, as well as parents, are important and distinct socialization agents within the developmental context of adolescence.