Time-Varying Associations Between Early Childhood Internalizing and Externalizing Problems: Codevelopment and Sex Differences

• In Event: Continuing the Quest Towards Understanding Co-occurring Internalizing and Externalizing Problems: Methodologies, Risks, and Clinical Implications

Abstract

Background: Children who do not demonstrate stable low or decreasing levels of behavior problems by school entry experience more severe problems in later childhood and adolescence, highlighting the importance of early childhood as a critical period for normative change. The two domains of child problems–internalizing (IP) and externalizing (EP)–may influence each other across development (e.g., Glaser, 1967). However, due to less-developed cognitive and social skills and rapid developmental changes during early childhood (Berk, 2022), the effect of one domain (e.g., EP) on the other (e.g., IP) may be more dynamic, happening within hours/weeks/months. Thus, understanding whether IP or EP has the strongest effect on concurrent problems in the other domain during different sensitive periods in early childhood may provide a basis for individualized preventions. In addition, prior work documents a higher prevalence of EP for males and IP for females (Askari et al., 2022), but whether co-occurring associations differ by child sex during this developmental period is less understood. Objectives: We examined time-varying fluctuations in the effect of EP on co-occurring IP, and vice versa, across early childhood and whether these effects vary as a function of sex in an economically and racially diverse sample with high rates of prenatal and postnatal adversities. Method: Participants were 198 mother-child dyads recruited at birth who participated in a prospective longitudinal study (74% Black; 71% receiving federal assistance; 60% single). Mothers were oversampled for cocaine use during pregnancy with demographically similar mothers who did not use cocaine. Child behavior problems were assessed via caregiver reports every six months (between ages 1.5 – 6.5 years) using the Child Behavior Checklist (Achenbach & Rescorla, 2001). Time-varying effect modeling was used to estimate the regression coefficients of EP on IP, and vice versa, as nonparametric flexible functions of continuous child age and the time-varying moderating effect of child sex (Lanza & Linden-Carmichael, 2021). Results: During early childhood, mean levels of IP remained stable, whereas mean levels of EP showed initial increases followed by a decrease. The time-varying effect of EP on concurrent IP was significantly positive throughout this developmental period, showing a decrease in magnitude from 1.5 to 2.5 years of child age, a subsequent increase through 5 years, and a decrease post-school entry (Fig. 1). The time-varying effect of IP on concurrent EP was significantly positive throughout the early childhood period, with an increase in magnitude from 1.5 to 3.5 years, a subsequent decrease through 5.5 years, followed by an increase post-school entry (Fig. 2). The positive time-varying effect of IP on EP was significantly stronger for males between 2.5 – 4.5 years. Conclusions: Results suggest that there may be distinct sensitive periods that represent a risk for the development of co-occurring problems, with the strongest effect of IP on co-occurring EP during the toddlerhood/preschool period, especially for males, and an increasing effect of EP on co-occurring IP around the early school period. The results suggest a potential avenue for prevention efforts targeting specific skills during different developmental ages to prevent long-term co-occurring problems

Authors

• Miglena Yordanova Ivanova, Pennsylvania State University, University Park
  Presenting Author

• Danielle Marie Seay, Pennsylvania State University, University Park

• Kristin Perry, Pennsylvania State University, University Park

• Rina Das Eiden, The Pennsylvania State Univeristy

• Ashley Linden-Carmichael, Pennsylvania State University