The dynamics of internalizing and externalizing comorbidity across the early school years.
The dynamics of internalizing and externalizing comorbidity across the early school years.
复制标题
DOI：
10.1017/s0954579416000687
复制
发表时间：
2016-11
影响因子：
3.3
通讯作者：
Bray BC
中科院分区：
文献类型：
--
作者：
Willner CJ;Gatzke-Kopp LM;Bray BC
在内化和外化问题之间观察到高比率的共病，但共病症状表现的发展动态尚未得到很好的理解。本研究探讨幼儿园、一、二年级儿童内、外化症状的发展历程。样本包括336名来自城市低收入社区的儿童，根据入学时相对较高（61%）或较低（39%）的攻击性/对立行为问题（64%男性; 70%非洲裔美国人，20%西班牙裔）进行选择。教师每年报告儿童的症状。对儿童攻击/对立、多动/注意力不集中、焦虑和社交退缩症状因子的评分进行探索性潜在特征分析，发现4种潜在症状特征：共病（每年样本的48%）、内化（19-23%）、外化（21-22%）和适应良好（7-11%）。这些症状谱的发展过程进行了检查，使用一个潜在的过渡分析，这揭示了显着的高连续性的共病症状谱（89%，从一年到下一年）和适度的高连续性的内化和外化配置文件（80%和71%，分别）。内化儿童有20%的概率在第二年缓解到良好调整的轮廓，而外化儿童有25%的概率过渡到共病轮廓。这些结果是一致的假设，一个共同的脆弱性因素有助于发展稳定的内化-外化共病，同时也表明，一些儿童的外化症状的风险，随后积累内化症状。
High rates of comorbidity are observed between internalizing and externalizing problems, yet the developmental dynamics of comorbid symptom presentations are not yet well understood. This study explored the developmental course of latent profiles of internalizing and externalizing symptoms across kindergarten, 1st, and 2nd grade. The sample consisted of 336 children from an urban, low-income community, selected based on relatively high (61%) or low (39%) aggressive/oppositional behavior problems at school entry (64% male; 70% African American, 20% Hispanic). Teachers reported on children’s symptoms in each year. An exploratory latent profile analysis of children’s scores on aggression/oppositionality, hyperactivity/inattention, anxiety, and social withdrawal symptom factors revealed 4 latent symptom profiles: comorbid (48% of the sample in each year), internalizing (19–23%), externalizing (21–22%), and well-adjusted (7–11%). The developmental course of these symptom profiles was examined using a latent transition analysis, which revealed remarkably high continuity in the comorbid symptom profile (89% from one year to the next) and moderately high continuity in both the internalizing and externalizing profiles (80% and 71%, respectively). Internalizing children had a 20% probability of remitting to the well-adjusted profile by the following year, whereas externalizing children had a 25% probability of transitioning to the comorbid profile. These results are consistent with the hypothesis that a common vulnerability factor contributes to developmentally stable internalizing-externalizing comorbidity, while also suggesting that some children with externalizing symptoms are at risk for subsequently accumulating internalizing symptoms.