TRAJECTORIES OF PURE AND CO-OCCURRING INTERNALIZING AND EXTERNALIZING PROBLEMS FROM AGE 2 TO AGE 12: FINDINGS FROM THE NICHD STUDY OF EARLY CHILD CARE by KOSTAS

According to previous research, internalizing and externalizing problems tend to be comorbid or co-occur at different ages in development (Angold, Costello, & Erkanli, 1999). The question that this dissertation addresses is how and why internalizing and externalizing problems, two disorders that represent separate forms of psychopathology, co-occur in children. This is an important question for the developmental psychopathology perspective because an appreciation of the concept of co-occurrence is essential for explaining the development and taxonomy of internalizing and externalizing psychopathology, and for understanding the etiology and course of these symptoms (Achenbach, 1990). Attempts to explain co-occurrence have proposed that co-occurring psychopathology might represent distinct, meaningful syndromes (Angold & Costello, 1992; O’Connor et al., 1998), and in support of this idea, evidence of the existence of pure and co-occurring internalizing and externalizing problems has been found (Keiley et al., 2003). However, no previous study has identified heterogeneous developmental patterns of pure or combined internalizing and externalizing problems within a dynamic framework by taking trajectories of change into account. This dissertation uses data from the NICHD study of Early Child Care to explore the cooccurrence between internalizing and externalizing problems from age 2 to 12 with the use of Latent Class Growth Analysis. The sample included 1232 children (52% male). Different groups of children exhibiting low/normative, pure internalizing, pure externalizing, and co-occurring internalizing and externalizing problems across the 10 year period were identified. The higher risk groups deviated from the low/normative group in terms of antecedents, SES risk, medical risk, difficult temperament, and home environment. Moreover, children who exhibited pure moderate externalizing problems, and children who exhibited chronic externalizing problems, with and without co-occurring internalizing problems, engaged in more risky behaviors and were more likely to have friends who also engaged in risky behaviors. Furthermore, the pure chronic externalizing group and the groups scoring high on internalizing problems, with and without cooccurring externalizing problems, were more asocial with peers. Finally, children exhibiting chronic co-occurring externalizing and internalizing problems were more excluded by peers in comparison to the rest of the sample’s population. INDEX WORDS: Internalizing problems, Externalizing problems, Co-occurrence, Comorbidity, Latent Class Growth Curve Analysis, Socio-economicstatus, Early medical problems, Difficult temperament, Home environment, Cognitive deficiencies, Trajectories TRAJECTORIES OF PURE AND CO-OCCURRING INTERNALIZING AND EXTERNALIZING PROBLEMS FROM AGE 2 TO AGE 12: FINDINGS FROM THE NICHD STUDY OF EARLY CHILD CARE