Parsing between- and within-person effects: Longitudinal associations between irritability and internalizing and externalizing problems from early childhood through adolescence

Introduction: This report examines between- and within-person associations between youth irritability and concurrent and prospective internalizing and externalizing symptoms from early childhood through adolescence. Distinguishing between- and within-person longitudinal associations may yield distinct, clinically relevant information about pathways to multifinality from childhood irritability. Methods: Children’s irritability and co-occurring symptoms were assessed across five waves between ages 3 and 15 years using the mother-reported Child Behavior Checklist (N = 605, 46% female). Parental history of depressive disorders was assessed with a clinical interview. Results: Results demonstrated that between- and within-person irritability were uniquely associated with concurrent depressive, anxiety, and defiance symptoms, but not ADHD. Prior wave within-person irritability also predicted next wave depressive, anxiety, and defiance symptoms, controlling for prior symptoms; these prospective associations were bidirectional. Child sex and parental depressive disorders moderated associations. Discussions: Findings identify pathways from within- and between-person irritability to later internalizing and externalizing psychopathology. Results demonstrate the importance of parsing within- and between-person effects to understand nuanced relations among symptoms over childhood.

Assessment of Attachment Representations in Basque Adolescents and their Relationship with Internalizing and Externalizing Problems

Research has shown a relationship between attachment style and psychosocial adjustment in adolescents. Whereas secure attachment is related to fewer internalizing and externalizing symptoms, the opposite is the case for the various insecure attachment styles. The aim of the two studies reported in this paper was to adapt and validate the CaMir-R (a self-report measure of attachment that has shown adequate psychometric properties) for use among Basque adolescents, and to analyse the relationship between attachment and internalizing and externalizing symptoms. In Study 1, the instrument was adapted using the back translation method and applied to a sample of 203 adolescents and young adults. Confirmatory factor analysis supported the theoretical dimensions of the scale, and its psychometric properties were found to be adequate. In Study 2 we obtained additional validity evidence by applying, in a sample of 786 adolescents and young adults, the attachment representations section of the CaMir-R alongside other measures of attachment and clinical symptoms. The results once again supported the dimensional structure of the instrument, and evidence of convergent validity was obtained based on correlations between CaMir-R scores and scores on the Inventory of Parent and Peer Attachment (IPPA). In addition, scores on the five dimensions of attachment representations (Security, Family concerns, Parental interference, Self-sufficiency and resentment of parents and Childhood trauma) were correlated with scores on other measures of internalizing and externalizing symptoms. Based on these results, we conclude that the Basque version of the CaMir-R is a valid instrument for assessing the quality of attachment representations among adolescents, and also that internalizing and externalizing problems are related to attachment style. We discuss the importance of attachment in relation to behaviour problems and clinical symptoms.

Polytraumatization in young male refugees from the Middle East and its association with internalizing and externalizing symptoms

Background Young Middle Eastern male refugees are currently among the most vulnerable groups in Europe. Most of them have experienced potentially traumatic events (PTEs) such as rape, torture, or violent assaults. Compared to their peers, young refugees suffer more from internalizing and externalizing symptoms, especially when unaccompanied. Little is known about the cumulative impact of experiencing different types of PTEs on mental health outcomes (polytraumatization) of young male refugees from the Middle East. We investigated (1) whether there is a dose–response relationship between multiple PTE types experienced and mental health outcomes, (2) whether individual types of PTEs are particularly important, and (3) to what extent these are differentially associated with mental health outcomes among unaccompanied or accompanied peers. Methods In total, 151 young Middle Eastern male refugees in Germany (Mage = 16.81 years, SDage = 2.01) answered questionnaires on PTEs, mental health, and post-migration stress. Results Hierarchical regression analyses revealed, while controlling for age, duration of stay, unaccompanied status, and post-migration stress, (1) a dose–effect between PTE types on both internalizing and externalizing symptoms. Moreover, (2) regarding internalizing symptoms, violent family separation and experiencing life-threatening medical problems were particularly crucial. The latter was driven by unaccompanied refugees, who also reported higher levels of substance use. Conclusions The results extend findings from the literature and suggest that not only may greater polytraumatization be related to greater depression among refugees, but also to a range of other mental health outcomes from the internalizing and externalizing symptom domains. Furthermore, the results highlight the mental health risks that unaccompanied and accompanied refugee adolescents face after exposure to PTEs, and provide information for practitioners as well as researchers about event types that may be particularly relevant.

Prenatal maternal stress, child internalizing and externalizing symptoms, and the moderating role of parenting: findings from the Norwegian mother, father, and child cohort study

Background Few studies have examined how parenting influences the associations between prenatal maternal stress and children's mental health. The objectives of this study were to examine the sex-specific associations between prenatal maternal stress and child internalizing and externalizing symptoms, and to assess the moderating effects of parenting behaviors on these associations. Methods This study is based on 15 963 mother–child dyads from the Norwegian Mother, Father, and Child Cohort Study (MoBa). A broad measure of prenatal maternal stress was constructed using 41 self-reported items measured during pregnancy. Three parenting behaviors (positive parenting, inconsistent discipline, and positive involvement) were assessed by maternal report at child age 5 years. Child symptoms of internalizing and externalizing disorders (depression, anxiety, attention-deficit hyperactivity disorder, conduct disorder, and oppositional-defiant disorder) were assessed by maternal report at age 8. Analyses were conducted using structural equation modeling techniques. Results Prenatal maternal stress was associated with child internalizing and externalizing symptoms at age 8; associations with externalizing symptoms differed by sex. Associations between prenatal maternal stress and child depression, and conduct disorder and oppositional-defiant disorder in males, became stronger as levels of inconsistent discipline increased. Associations between prenatal maternal stress and symptoms of attention-deficit hyperactivity disorder in females were attenuated as levels of parental involvement increased. Conclusions This study confirms associations between prenatal maternal stress and children's mental health outcomes, and demonstrates that these associations may be modified by parenting behaviors. Parenting may represent an important intervention target for improving mental health outcomes in children exposed to prenatal stress.

Refugee Children’s Social–Emotional Capacities: Links to Mental Health upon Resettlement and Buffering Effects on Pre-Migratory Adversity

Refugee children who experience severe pre-migratory adversity often show varying levels of mental health upon resettlement. Thus, it is critical to identify the factors that explain which refugee children experience more vs. less healthy outcomes. The present study assessed child social–emotional capacities (i.e., emotion regulation, sympathy, optimism, and trust) as potential moderators of associations between child, parental, and familial pre-migratory adversities and child mental health (i.e., internalizing and externalizing symptoms) upon resettlement. Participants were N = 123 five- to 12-year-old Syrian refugee children and their mothers living in Canada. Children and mothers reported their pre-migratory adverse life experiences, and mothers reported their children’s current social–emotional capacities, internalizing symptoms, and externalizing symptoms. Greater familial (i.e., the sum of children’s and their mother’s) pre-migratory adversity was associated with higher child internalizing and externalizing symptoms upon resettlement. Higher emotion regulation and optimism were associated with lower internalizing and externalizing symptoms, and higher sympathy was associated with lower externalizing symptoms. In contrast, higher trust was associated with higher internalizing symptoms. Finally, higher child optimism buffered against the positive association between familial pre-migratory adversity and child internalizing symptoms. In sum, select social–emotional capacities may serve as potential protective factors that support mental health and buffer against the deleterious effects of pre-migratory adversity in refugee children.

Cultural Differences in the Association of Harsh Parenting with Internalizing and Externalizing Symptoms: A Meta-Analysis

The goal of the present meta-analysis was to compare associations of harsh parenting with internalizing and externalizing symptoms across regions of the globe and ethnic groups, and to search for moderator effects of indicators of cultural normativeness of harsh parenting. The systematic search in electronic databases and cross-referencing identified 971 studies. Random-effects meta-analyses were computed on bivariate and cross-lagged associations. Harsh parenting was associated with more internalizing and externalizing symptoms in all assessed regions of the globe and in all compared ethnic groups within western countries. Cross-lagged statistical effects of harsh parenting on change in child symptoms were found in North America, Western Europe, Latin America, East Asia, South-East Asia, and North Africa/the Arabian Peninsula, while there were no data from Eastern Europe. In line with the cultural normativeness hypothesis, a few moderating effects of the legal ban of physical punishment of children, acceptance and prevalence of physical punishment, and individualism-collectivism were identified. Externalizing symptoms predicted a stronger increase in harsh parenting if physical punishment was more accepted in the individual country. However, national levels of acceptance of physical punishment did not affect associations of harsh parenting with change in child outcomes. Although most associations of harsh parenting with child symptoms were statistically small (bivariate associations) or very small (cross-lagged associations), it is concluded that parents across the globe should be recommended to avoid harsh parenting. More longitudinal studies are needed for analyzing regional differences in parent and child effects.

Hybrid Education Associated with Worse Psychological Outcomes During COVID-19 Pandemic

The aim of this research is to further elucidate the deleterious effects of the COVID-19 pandemic and specifically the associated educational disruptions on youth’s psychological functioning. This original research is the first to investigate the effect of schoolhouse modality on internalizing and externalizing symptoms in a large, geographically diverse sample of youth spanning elementary, middle, and high school ages.