Childhood Irritability: Predictive Validity and Mediators of Adolescent Psychopathology

Despite its transdiagnostic significance, there is modest evidence with respect to the predictive validity of childhood irritability, especially across developmental periods; similarly, little is known about explanatory factors underlying these predictions. This study had two goals: (1) to test the predictive validity of childhood irritability with respect to adolescent internalizing and externalizing problems, controlling for baseline ADHD and related psychopathology and (2) to test theoretically-derived family (i.e., parenting behavior, parenting stress) and social (i.e., peer status, social skills) constructs as explanatory factors of adolescent psychopathology. Two hundred thirty ethnically diverse (51.5% White) 5–10-year-old youth (32% female) with (n?=?121) and without (n?=?110) ADHD completed three separate laboratory-based assessments across six to seven years. Temporally-ordered predictors, putative mediators, and psychopathology outcomes were assessed using multiple informants (i.e., parent, teacher, youth) and methods (i.e., structured interviews, normed rating scales). Controlling for demographic factors, clinical correlates, and baseline psychopathology, childhood irritability uniquely predicted adolescent externalizing problems, but not internalizing problems. Next, analyses revealed that low social skills partially explained predictions of adolescent internalizing problems. However, family or social factors did not underlie predictions of adolescent externalizing problems. These preliminary findings support the predictive validity of childhood irritability with respect to early adolescent externalizing problems and implicate low social skills as a potentially unique mediator of internalizing outcomes. Intervention-induced improvements in social skills may minimize emergent psychopathology initiated by significant childhood irritability.

     

Response Inhibition and Measures of Psychopathology: A Dimensional Analysis

On the basis of Quay's (1988a, 1988b, 1993, 1997) model in which the Behavioral Inhibition System (BIS) and the Behavioral Activation System (BAS) are linked to various forms of child psychopathology, predictions were made regarding the relation between inhibitory control and two dimensions of psychopathology: externalizing and internalizing behavior. Inhibitory control was measured using two versions of Logan and Cowan's stop signal paradigm (1984; Logan, Cowan, & Davis, 1984; Osman, Kornblum, & Meyer, 1986, 1990). The primary outcome measure for the stop tasks was stop signal reaction time (SSRT) which measures the latency of the inhibition process. A positive relationship was predicted for externalizing behavior, whereas a negative relationship was predicted for internalizing behavior. A total of 42 non-clinical elementary school children, in the age range of 6 to 12 years, participated in the study. Externalizing behavior was positively related to response inhibition. Symptoms of ADHD seem to be better at predicting inhibitory functioning than symptoms of aggressive behavior disorders. Some support was found for a negative relation between internalizing behavior and inhibitory control. These findings support Quay's model and the discriminant validity of inhibitory control with regard to externalizing and internalizing behavior.     

Response inhibition and measures of psychopathology: a dimensional analysis.

On the basis of Quay's (1988a, 1988b, 1993, 1997) model in which the Behavioral Inhibition System (BIS) and the Behavioral Activation System (BAS) are linked to various forms of child psychopathology, predictions were made regarding the relation between inhibitory control and two dimensions of psychopathology: externalizing and internalizing behavior. Inhibitory control was measured using two versions of Logan and Cowan's stop signal paradigm (1984; Logan, Cowan, & Davis, 1984; Osman, Kornblum, & Meyer, 1986, 1990). The primary outcome measure for the stop tasks was stop signal reaction time (SSRT) which measures the latency of the inhibition process. A positive relationship was predicted for externalizing behavior, whereas a negative relationship was predicted for internalizing behavior. A total of 42 non-clinical elementary school children, in the age range of 6 to 12 years, participated in the study. Externalizing behavior was positively related to response inhibition. Symptoms of ADHD seem to be better at predicting inhibitory functioning than symptoms of aggressive behavior disorders. Some support was found for a negative relation between internalizing behavior and inhibitory control. These findings support Quay's model and the discriminant validity of inhibitory control with regard to externalizing and internalizing behavior.     

Identification of Genes Influencing a Spectrum of Externalizing Psychopathology

ABSTRACT— Alcohol dependence, drug dependence, childhood conduct disorder, and adult antisocial behavior commonly occur in combination. Data from multiple literatures, including twin/family studies and electrophysiological studies, suggest that the overlap of these disorders is largely due to a shared genetic liability that contributes to a spectrum of externalizing psychopathology. These findings suggest that some genes will not be specific to any one externalizing disorder but will predispose individuals broadly to a spectrum of externalizing psychopathology. Here we review evidence for specific, identified genes, GABRA2 and CHRM2 , that follow this pattern and confer risk for a spectrum of externalizing disorders. These findings confirm the etiological structure of psychopathology suggested by psychological research and suggest exciting new roles that psychologists can play in understanding the pathways underlying associations between genes and behavior.     

Brain structure abnormalities in young women who presented conduct disorder in childhood/adolescence

The phenotype and genotype of antisocial behavior among females are different from those among males. Previous studies have documented structural brain alterations in males with antisocial behavior, yet little is known about the neural correlates of female antisocial behavior. The present study examined young women who had presented conduct disorder (CDW) prior to age 15 to determine whether brain abnormalities are present in adulthood and whether the observed abnormalities are associated with comorbid disorders or maltreatment that typically characterize this population. Using magnetic resonance imaging and voxel-based morphometry, we compared gray matter volumes (GMV) of 31 women who presented CD by midadolescence and 25 healthy women (HW), age, on average, 23 years. Participants completed structured, validated interviews to diagnose mental disorders, and validated questionnaires to document physical and sexual abuse. Relative to HW, CDW presented increased GMV in the left superior temporal gyrus that was associated with past alcohol and drug dependence, current use of alcohol and drugs, and current anxiety and depression symptoms and maltreatment. Additionally, CDW displayed reduced GMV in lingual gyrus, hippocampus, and anterior cingulate cortex that was associated with past comorbid disorders, current alcohol and drugs use, current anxiety and depression symptoms, and maltreatment. The CDW also presented reduced total GMV that was associated with past comorbid disorders and current anxiety/depression symptoms. Alterations of brain structure were observed among young adult females with prior CD, relative to HW, all of which were associated with internalizing and externalizing disorders and maltreatment that typically accompany CD.     

心身障碍共病与慢性疼痛关联的结构模型

常见的心身障碍共病可以理解为一种新的精神疾病结构模型：情绪障碍、抑郁、焦虑及躯体化障碍等归为内化性疾病谱系的组成元素,物质滥用和反社会行为障碍归为外化性疾病谱系的组成元素。本文分析探讨评估慢性疼痛与这一模型的联系。社会心理和生物学的研究证据表明慢性疼痛与内化性障碍密切相关,提示内化-外化性疾病模型可以作为一个有效的研究架构,为探讨慢性疼痛与情感、抑郁焦虑及其他相关精神障碍的关联共病机制提供新的研究方向和新思路。     

Explaining the Asian American Youth Paradox: Universal Factors versus Asian American Family Process Among Filipino and Korean American Youth

This study used longitudinal survey data of Filipino American and Korean American youth to examine ways in which universal factors (e.g., peer antisocial behaviors and parent–child conflict) and Asian American (AA) family process variables (e.g., gendered norms) independently and collectively predict grade point average (GPA), externalizing, and internalizing problems. We aimed to explain the “Asian American youth paradox” in which low externalizing problems and high GPA coexist with high internalizing problems. We found that universal factors were extensively predictive of youth problems and remained robust when AA family process was accounted for. AA family process also independently explained youth development and, in part, the AA youth paradox. For example, gendered norms increased mental distress. Academic controls did the opposite of what it is intended, that is, had a negative impact on GPA as well as other developmental domains. Family obligation, assessed by family-centered activities and helping out, was beneficial to both externalizing and internalizing youth outcomes. Parental implicit affection, one of the distinct traits of AA parenting, was beneficial, particularly for GPA. This study provided important empirical evidence that can guide cross-cultural parenting and meaningfully inform intervention programs for AA youth.     

Stepfamily Relationship Quality and Children's Internalizing and Externalizing Problems

The stepfamily literature is replete with between‐group analyses by which youth residing in stepfamilies are compared to youth in other family structures across indicators of adjustment and well‐being. Few longitudinal studies examine variation in stepfamily functioning to identify factors that promote the positive adjustment of stepchildren over time. Using a longitudinal sample of 191 stepchildren (56% female, mean age = 11.3 years), the current study examines the association between the relationship quality of three central stepfamily dyads (stepparent–child, parent–child, and stepcouple) and children's internalizing and externalizing problems concurrently and over time. Results from path analyses indicate that higher levels of parent–child affective quality are associated with lower levels of children's concurrent internalizing and externalizing problems at Wave 1. Higher levels of stepparent–child affective quality are associated with decreases in children's internalizing and externalizing problems at Wave 2 (6 months beyond baseline), even after controlling for children's internalizing and externalizing problems at Wave 1 and other covariates. The stepcouple relationship was not directly linked to youth outcomes. Our findings provide implications for future research and practice.     

Moderators of informant agreement in the assessment of adolescent psychopathology: extension to a forensic sample

A well-documented finding in developmental psychopathology research is that different informants often provide discrepant ratings of a youth's internalizing and externalizing problems. The current study examines youth- and parent-based moderators (i.e., youth age, gender, and IQ; type of psychopathology; offense category; psychopathic traits; parental education, income, and stress) of informant discrepancies in a sample of young offenders and compares the utility of youth and caregiver reports against relevant clinical outcomes. Results indicate that gender moderated the discrepancy between informant reports of somatic complaints, while parenting stress moderated the discrepancies across reports of internalizing and externalizing psychopathology. Variables unique to the forensic context (e.g., offense category) were found to moderate cross-informant discrepancies in reports of internalizing and externalizing psychopathology. Further, youth self-reports of internalizing symptoms predicted a clinician-generated diagnosis of a mood disorder, while caregiver reports of aggressive behaviors predicted the presence of an externalizing diagnosis. Results highlight the importance of assessing informant agreement in the context of forensic assessment and raise questions surrounding the optimal use of informant data in this setting.     

Suicidal and criminal behavior among female offenders: the role of abuse and psychopathology

Childhood abuse is relatively prevalent among women and is an important risk factor for both criminal behavior and suicide-related behavior (SRB). Based on a sample of 266 female offenders, we address one theoretical and one practical issue. First, from a theoretical perspective, we assess whether internalizing (depression and anxiety) and externalizing (substance abuse and antisocial behavior) psychopathology mediate the relation between abuse on the one hand, and SRB or criminal behavior, on the other. Results indicate that externalizing problems mediate the relation between childhood abuse and both lifetime SRB (fully) and lifetime criminality (partially). Second, at a practical level, results indicate that a subscale of the Revised Psychopathy Checklist (PCL-R; Hare, 1991) that assesses lifetime criminal behavior adds incremental utility to postdicting SRB, beyond the variance accounted for by self-report measures of abuse and externalizing problems. However, none of the measures-including the PCL-R-predicted future recidivism.     

Exposure to Bullying and General Psychopathology: A Prospective,Longitudinal Study

Although there is mounting evidence that the experience of being bullied associates with both internalizing and externalizing symptoms, it is not known yet whether the identified associations are specific to these symptoms, or shared between them. The primary focus of this study is to assess the prospective associations of bullying exposure with both general and specific (i.e., internalizing, externalizing) factors of psychopathology. This study included data from 6,210 children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC). Child bullying was measured by self-report at ages 8 and 10 years. Child psychopathology symptoms were assessed by parent-interview, using the Development and Well-being Assessment (DAWBA) at ages 7 and 13 years. Bullying exposure significantly associated with the general psychopathology factor in early adolescence. In particular, chronically victimized youth exposed to multiple forms of bullying (i.e., both overt and relational) showed higher levels of general psychopathology. Bullying exposure also associated with both internalizing and externalizing factors from the correlated-factors model. However, the effect estimates for these factors decreased considerably in size and dropped to insignificant for the internalizing factor after extracting the shared variance that belongs to the general factor of psychopathology. Using an integrative longitudinal model, we found that higher levels of general psychopathology at age 7 also associated with bullying exposure at age 8 which, in turn, associated with general psychopathology at age 13 through its two-year continuity. Findings suggest that exposure to bullying is a risk factor for a more general vulnerability to psychopathology.

     

The basic trait of Antagonism: An unfortunately underappreciated construct

Antagonism, the low pole of Agreeableness, references traits related to immorality, combativeness, grandiosity, callousness, and distrustfulness. It is a robust correlate of externalizing behaviors such as antisocial behavior, aggression, and substance use; in fact, in many cases, it is the strongest trait correlate. It represents the core of many important and impactful psychopathological constructs (e.g., psychopathy, antisocial and narcissistic personality disorders). It is also central to models of general and disordered personality, psychopathology, and interpersonal behavior. As Neuroticism is core to understanding the intense distress and suffering that comes with internalizing disorders, Antagonism is core to understanding the impairment and suffering (to the individual and society at large) that comes with externalizing disorders.     

Pathways of Risk for Accelerated Heavy Alcohol Use Among Adolescent Children of Alcoholic Parents

The current study examined two questions. First, do internalizing symptoms and externalizing behavior each mediate the relations between parent psychopathology (alcoholism, antisocial personality disorder, and affective disorder) and growth in adolescent heavy alcohol use? Second, are there gender differences in these mediated pathways? Using latent curve analyses, we examined these questions in a high-risk sample of 439 families (53% children of alcoholic parents; 47% female). Collapsing across gender, adolescent-reported externalizing behavior mediated both the relation between parent alcoholism and growth in heavy alcohol use and the relation between parent antisociality and growth in heavy alcohol use. Parent-reported externalizing behavior only mediated the relation between parent antisociality and growth in heavy alcohol use in males. No support was found for internalizing symptoms as a mediator of these relations. Avenues are suggested for further exploring and integrating information about different mediating processes accounting for children of alcoholics' risk for heavy alcohol use.     

Influences of Biological and Adoptive Mothers’ Depression and Antisocial Behavior on Adoptees’ Early Behavior Trajectories

Research clearly demonstrates that parents pass risk for depression and antisocial behavior on to their children. However, most research confounds genetic and environmental mechanisms by studying genetically related individuals. Furthermore, most studies focus on either depression or antisocial behavior in parents or children, despite evidence of co-occurrence and shared etiology, and few consider the early origins of these problems in childhood. We estimated the influence of biological and adoptive mothers’ depression and antisocial behavior on growth in child externalizing and internalizing behaviors across early childhood using data from a prospective adoption study. Participants were 346 matched triads of physically healthy children (196 boys; 150 girls), biological mothers (BM), and adoptive mothers (AM). Latent growth curve models were estimated using AM reports of child internalizing and externalizing behaviors at ages 18, 27, and 54 months. Predictors of intercept (18 months) but not slope were identified. BM lifetime histories of major depressive disorder predicted child externalizing behaviors and BM antisocial behavior predicted child internalizing behavior. AM depressive symptoms and antisocial behavior were associated with both child outcomes. AM paths, but not BM paths were partially replicated using adopted fathers’ reports of child outcomes. BM obstetric complications, prenatal depressive symptoms, and postnatal adoptive family contact with BM did not account for BM paths. This adoption study distinguished risks conferred by biological mothers’ depression and antisocial behavior to children’s behaviors from those associated with adoptive mothers’ related symptoms. Future studies should examine gene-environment interplay to explain the emergence of serious problem trajectories in later childhood.     

The Effects of Family Structure and Family Processes on Externalizing and Internalizing Behaviors of Male and Female Youth: A Longitudinal Examination

The present study examined potential gender differences in the effects of family structure and family processes on externalizing and internalizing behavioral outcomes among youth over time. Using data from waves one through three of the Add Health study, results indicated that the relationship between family structure and family processes on behavioral outcomes varied depending on the specific externalizing or internalizing behavior. Family structure directly influenced three different externalizing behaviors, but indirectly influenced internalizing behaviors through its effect on maternal attachment and to some degree parental permissiveness. The long-term influence of family structure, family processes, and later externalizing and internalizing behaviors is complex. These relationships played out similarly across both male and female youth, suggesting that the effect of living in a single-parent home, subsequent family processes, and individual behavior and well-being may not be different across gender.     

Cross-setting consistency in early adolescent psychopathology: deviant friendships and problem behavior sequelae

This study examines adult reports of externalizing and internalizing psychopathology at home and school in a sample of 224 high-risk adolescent boys and girls (average age 12 years). Four groups of young adolescents were defined, based on the consistency of the teacher and parent Child Behavior Checklist reports: normal, internalizing, externalizing only, and comorbid. Group comparisons revealed the comorbid and externalizing groups were more engaged in a deviant peer group and were observed in higher levels of deviancy training with their friends, compared to other young adolescent groups. In general, elevated levels of arrest, drug use, and sexual promiscuity were associated with cross-setting consistency in externalizing disorders. Comorbid youth, however, showed the highest levels of sexual promiscuity in middle adolescence, compared to all other groups. These findings are consistent with a developmental account of adolescent maladjustment and suggest that emotional disturbance in early adolescence might exacerbate youth vulnerability, especially to deviancy training within friendships.     

Childhood Predictors of Long-Term Tic Severity and Tic Impairment in Tourette’s Disorder

Tics peak in late childhood and decline during adolescence. Yet, for some with Tourette’s disorder, tics persist into adulthood. We evaluated childhood predictors of adult tic severity and tic impairment, and change over time. Eighty adolescents/adults were evaluated 11 years following a randomized-controlled trial of behavior therapy. An independent evaluator rated tic severity and tic impairment at baseline, posttreatment, and long-term follow-up. At baseline, parents completed demographics/medical history, and youth tic, internalizing, and externalizing symptom ratings. Youth rated premonitory urge severity and family functioning. After controlling for prior tic treatment effects, female sex and higher tic severity predicted higher tic severity in adulthood; and female sex, no stimulant medication use, higher tic severity, and poorer family functioning predicted higher tic impairment. Higher tic severity and premonitory urge severity predicted smaller reductions in tic severity, whereas higher externalizing symptoms predicted greater reduction in tic severity. Female sex predicted smaller reduction in tic impairment, and externalizing symptoms predicted greater reduction in tic impairment. Female sex and childhood tic severity are important predictors of tic severity and tic impairment in adulthood. Family functioning, premonitory urge severity, and tic severity are important modifiable targets for early or targeted intervention to improve long-term outcomes.     

Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD

We followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n = 140) and matched comparison girls (n = 88) over a period of 5 years, from middle childhood through early/midadolescence, with the aim of determining whether childhood levels of executive function (EF) would predict adolescent multi-informant outcomes of social functioning and psychopathology, including comorbidity between externalizing and internalizing symptomatology. Predictors were well-established measures of planning, response inhibition, and working memory, along with a control measure of fine motor control. Independent of ADHD versus comparison group status, (a) childhood planning and response inhibition predicted adolescent social functioning and (b) childhood planning predicted comorbid internalizing/externalizing disorders in adolescence. Subgroup status (ADHD-Combined, ADHD-Inattentive, and comparison) moderated the relationship between childhood planning and adolescent internalizing/externalizing comorbidity, with the combined type revealing particularly strong associations between baseline planning and adolescent comorbidity. Mediation analyses indicated that adolescent social functioning mediated the prediction from childhood EF to comorbidity at follow-up; in turn, in the girls with ADHD, adolescent comorbidity mediated the prediction from childhood EF to social functioning at follow-up. We conclude that childhood interventions should target EF impairments in addition to behavioral symptoms.     

Testing Models of Psychopathology in Preschool-aged Children Using a Structured Interview-based Assessment

A number of studies have found that broadband internalizing and externalizing factors provide a parsimonious framework for understanding the structure of psychopathology across childhood, adolescence, and adulthood. However, few of these studies have examined psychopathology in young children, and several recent studies have found support for alternative models, including a bi-factor model with common and specific factors. The present study used parents’ (typically mothers’) reports on a diagnostic interview in a community sample of 3-year old children (n?=?541; 53.9 % male) to compare the internalizing-externalizing latent factor model with a bi-factor model. The bi-factor model provided a better fit to the data. To test the concurrent validity of this solution, we examined associations between this model and paternal reports and laboratory observations of child temperament. The internalizing factor was associated with low levels of surgency and high levels of fear; the externalizing factor was associated with high levels of surgency and disinhibition and low levels of effortful control; and the common factor was associated with high levels of surgency and negative affect and low levels of effortful control. These results suggest that psychopathology in preschool-aged children may be explained by a single, common factor influencing nearly all disorders and unique internalizing and externalizing factors. These findings indicate that shared variance across internalizing and externalizing domains is substantial and are consistent with recent suggestions that emotion regulation difficulties may be a common vulnerability for a wide array of psychopathology.     

Discrepancy Analysis of Emerging Adult and Parental Report of Psychological Problems and Relationship Quality

Cross-informant discrepancies on reports of psychopathology can have detrimental consequences on the relationship between emerging adults and their parents. The current study utilized emerging adult reports of their own psychopathology and their perspective on their parent’s psychopathology as well as their parents’ reports of parental psychopathology and their perspective on the emerging adult’s psychopathology (measured using the Adult Self Report and Adult Behavior Checklist). Analyses were performed to further examine the associated between the discrepancies between emerging adult and parent reports of psychopathology on dyadic relationship qualities (i.e., affection, conflict, and satisfaction within the emerging adult-parent relationship). Emerging adults and their parents demonstrated significant differences in their reports of parental depression as well as emerging adult depression, anxiety, and antisocial personality problems. Furthermore, discrepancies on parental depression and antisocial problems and emerging adult depression were associated with differences on relationship qualities. Additional results and implications are discussed.