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Children with parents suffering from a psychiatric disorder are at higher risk for developing a mental disorder themselves. This systematic review and meta-analysis of randomized controlled trials aims to evaluate the efficacy of psychosocial interventions to prevent negative mental health outcomes in the offspring of parents with mental illness. Eight electronic databases, grey literature and a journal hand-search identified 14 095 randomized controlled trials with no backward limit to June 2021. Outcomes in children included incidence of mental disorders (same or different from parental ones) and internalizing and externalizing symptoms at post-test, short-term and long-term follow-up. Relative risks and standardized mean differences (SMD) for symptom severity were generated using random-effect meta-analyses. Twenty trials were selected (pooled n = 2689 children). The main therapeutic approaches found were cognitive-behavioural therapy and psychoeducation. A significant effect of interventions on the incidence of mental disorders in children was found with a risk reduction of almost 50% [combined relative risk = 0.53, 95% confidence interval (CI) 0.34–0.84]. Interventions also had a small but significant effect on internalizing symptoms at post-test (SMD = −0.25, 95% CI −0.37 to −0.14) and short-term follow-up (−0.20, 95% CI −0.37 to −0.03). For externalizing symptoms, a decreasing slope was observed at post-test follow-up, without reaching the significance level (−0.11, 95% CI −0.27 to 0.04). Preventive interventions targeting the offspring of parents with mental disorders showed not only a significant reduction of the incidence of mental illness in children, but also a diminution of internalizing symptoms in the year following the intervention.

Identifying Research Domain Criteria (RDoC) constructs in early childhood is essential for understanding etiological pathways of psychopathology. Our central goal was to identify early emotion knowledge and self-regulation difficulties across different RDoC domains and examine how they relate to typical versus atypical symptom trajectories between ages 3 and 10. Particularly, we assessed potential contributions of children's gender, executive control, delay of gratification, and regulation of frustration, emotion recognition, and emotion understanding at age 3 to co-occurring patterns of internalizing and externalizing across development. A total of 238 3-year-old boys and girls were assessed using behavioral tasks and parent reports and reassessed at ages 5 and 10 years. Results indicated that very few children developed “pure” internalizing or externalizing symptoms relative to various levels of co-occurring symptoms across development. Four classes of co-occurring internalizing and externalizing problems were identified: low, low-moderate, rising, and severe-decreasing trajectories. Three-year-old children with poor executive control but high emotion understanding were far more likely to show severe-decreasing than low/low-moderate class co-occurring internalizing and externalizing symptom patterns. Child gender and poor executive control differentiated children in rising versus low trajectories. Implications for early intervention targeting self-regulation of executive control are discussed.

U.S. Latinx youth are growing up in an environment characterized by increased anti-immigrant policy and rhetoric, including experiences of discrimination. Given the salience of the school setting for youth’s development, it is important to understand how experiences of discrimination by teachers and other adults at school, or school discrimination, relate to the emotional and behavioral adjustment of today’s Latinx adolescents. Study participants include 547 Latinx adolescents selected at random from a large, suburban school district in Atlanta, Georgia (55.4% female; age M = 12.8, range = 11–16). Youth provided two time points of survey data spaced roughly 6 months apart during 2018 and 2019. Structural equation models (SEM) were used to test the main and interaction effects of school discrimination and parental support on later internalizing and externalizing symptoms. Multiple group SEM was used to investigate gender differences in pathways to adolescent adjustment. More school discrimination was related to more internalizing and externalizing symptoms at a later time point. Greater parental support was associated with fewer internalizing symptoms, but did not moderate associations between school discrimination and adolescent outcomes. Pathways to adolescent outcomes were similar for males and females. Study results suggest that discrimination by teachers and other adults at school is an important source of adversity potentially jeopardizing Latinx youth’s emotional and behavioral adjustment. Future research is needed to identify factors that mitigate potentially harmful consequences of discrimination for Latinx adolescents.

Given the equivocal literature on the relationship between internalizing symptoms and early adolescent alcohol use (AU) and AU disorder (AUD), the present study took a developmental perspective to understand how internalizing and externalizing symptoms may operate together in the etiology of AU and AUD. We pit the delayed onset and rapid escalation hypothesis (Hussong et al., 2011) against a synthesis of the dual failure model and the stable co-occurring hypothesis (Capaldi, 1992; Colder et al., 2013, 2018) to test competing developmental pathways to adolescent AU and AUD involving problem behavior, peer delinquency, and early initiation of AU. A latent transactional and mediational framework was used to test pathways to AUD spanning developmental periods before AU initiation ( M age = 11) to early and high risk for AUD ( M age = 14–15 and M age = 17–18). The results supported three pathways to AUD. The first started with “pure” externalizing symptoms in early childhood and involved multiple mediators, including the subsequent development of co-occurring symptoms and peer delinquency. The second pathway involved stable co-occurring symptoms. Interestingly, chronically elevated pure internalizing symptoms did not figure prominently in pathways to AUD. Selection and socialization effects between early AU and peer delinquency constituted a third pathway.

Childhood trauma is a leading early adverse environment that increases psychopathological symptoms. Respiratory sinus arrhythmia (RSA) suppression to challenges as a marker of self-regulation is found to linearly moderate the link between early adverse experiences and psychopathological symptoms, but yielding mixed findings. The present study examined the relationships between childhood trauma and internalizing and externalizing symptoms via a 1.5-year longitudinal design and the quadratic moderation effect of RSA suppression on these relationships among adolescents. In November 2021 (T1), the final sample of 275 Chinese adolescents (Mage = 12.94, SDage = 0.79; 49.82% females) completed the short form of Childhood Trauma Questionnaire and the Achenbach Youth Self-Report-2001 and underwent a speech task during which their baseline RSA and stress exposure RSA were obtained. In June 2023 (T2), 251 adolescents completed the Achenbach Youth Self-Report-2001. Results showed that childhood trauma at T1 was positively correlated with internalizing and externalizing symptoms at T1 and T2. RSA suppression to stress quadratically moderated these associations, such that adolescents with moderate rather than higher or lower RSA suppression had the least internalizing and externalizing symptoms at T1 and T2 when exposed to childhood trauma. The findings suggest that moderate RSA suppression to stress as a marker of optimal vagal regulation buffers the risk of developmental psychopathology from early adverse experiences.

Effectiveness of psychodynamic therapy for adolescents in reducing internalizing and externalizing psychopathology was determined by comparing treated adolescents (86 sessions) with the normative developmental progression in two groups without treatment: healthy and diabetic adolescents. In a three-wave longitudinal study, n = 531 adolescents ( n = 303 patients, n = 119 healthy, n = 109 diabetics) and their mothers filled out psychopathology questionnaires (Youth Self-Report and Child Behavior Checklist). Latent growth curve modeling and multilevel modeling were used to analyze and compare within-person symptoms changes across groups. Analyses showed a significant reduction over the course of treatment for internalizing (Cohen’s d = .90–.92) and externalizing ( d = .58–.72) symptoms, also when the developmental progression of both control groups was accounted for ( d = .48–.76). Mothers reported lower levels than their children in internalizing symptoms ( p ≤ .01) while this discrepancy increased over time for treated adolescents ( p = .02). Results established the effectiveness of psychodynamic treatment for adolescents both with externalizing and internalizing symptoms in comparison with growth and change in nonclinical samples. Cross-informant differences and age-specific trajectories require attention in psychotherapy treatment and research.

Emotion awareness (EA) and regulation (ER) are each known to associate with mental health symptoms, yet there is a paucity of longitudinal studies examining them jointly during adolescence. Furthermore, little is known about these skills and their relations in deaf and hard-of-hearing (DHH) adolescents, who are at risk for reduced emotion socialization and for more mental health symptoms. This longitudinal study examined the development and unique contributions of EA (emotion differentiation, emotion communication and bodily unawareness) and ER (approach, avoidance and worry/rumination) to internalizing and externalizing symptoms in adolescents with and without hearing loss. Using self- and parent's reports, we assessed 307 adolescents (age 9–15) three times over 18-month period. We found stability over time in development of EA and avoidance ER, increase in approach ER and decrease in worry/rumination. High levels and increases over time in two aspects of EA, emotion differentiation and communication, and in approach and avoidance ER were related to decreases in depressive symptoms. An increase in approach ER was also related to a decrease in anxiety symptoms. Yet, low levels or decreases in worry/rumination were related to decreased levels of depressive, anxiety and externalizing symptoms. Hearing loss did not moderate any of the variables or relations tested. Preliminary tests suggested heterogeneity within the DHH group according to educational placement, language abilities and parental education level. Overall, findings pointed at unique contributions of EA and ER to mental health development, suggesting that DHH adolescents, especially in mainstream schools, do not differ from their hearing peers in their emotion awareness and regulation.

Preschool-age irritability is a transdiagnostic marker of internalizing and externalizing problems. However, researchers have generally been reluctant to examine irritability within a clinically salient framework at younger ages due to some instability during the “terrible twos” period. Developmentally sensitive and dense measurements to capture intra- and inter-individual variability, as well as exploration of developmental processes that predict change, are needed. This study aimed to examine (1) the trajectories of irritability at the transition to toddlerhood (12–24 months of age) using repeated measures, (2) whether effortful control was associated with individual differences in level and growth rate of irritability, and (3) whether individual differences in the irritability trajectories were associated with later psychopathology. Families were recruited when the child was 12–18 months old ( N  = 333, 45.65% female). Mothers reported on their toddler’s irritability at baseline and every two months until a follow-up laboratory assessment approximately one year later. Effortful control was measured at baseline. Clinical internalizing/externalizing symptoms were measured at the follow-up assessment. Hierarchical linear models revealed an increase in irritability over time, yet there was relatively little within-person variability. Effortful control was only associated with the level of irritability and not growth rate. Level of irritability was associated with internalizing, externalizing, and combined symptoms, but growth rate was not. Findings suggest intraindividual stability in irritability at the transition to toddlerhood and the possibility that screening for elevated irritability at toddler age is meaningful.

Background This study evaluates the psychometric properties of the newly developed semi-structured interview, Interview Version of the Symptoms and Functioning Severity Scale (SFSS-I), which is designed to provide a dimensional assessment of internalizing and externalizing symptoms. Methods Multi-informant baseline data from the OPTIE study was used, involving 358 children and adolescents aged 6 to 17 years ( M  = 11.54, SD  = 3.4, n  = 140 [39.1%] were female). Participants were screened for internalizing and externalizing symptoms. For validity analyses, caregiver (Child Behavior Checklist), youth (Youth Self Report), and teacher ratings (Teacher Report Form) were used. We performed Receiver Operating Characteristic (ROC) analyses to evaluate the effectiveness of the SFSS-I subscales in distinguishing between children and adolescents diagnosed with internalizing and externalizing disorders, as determined by clinical judgement in routine care. Results Confirmatory factor analyses supported a correlated two-factor model for internalizing and externalizing symptoms. Acceptable to good internal consistencies (α = 0.76 to 0.89; ω = 0.76 to 0.90) and excellent interrater reliability on the scale level (ICC ≥ 0.91) was found. The ROC analyses showed an acceptable accuracy in identifying internalizing diagnoses (AUC = 0.76) and excellent accuracy for externalizing diagnoses (AUC = 0.84). Conclusion The SFSS-I demonstrates potential as a clinically-rated instrument for screening and routine outcome monitoring, offering utility in both clinical practice and research settings for the dimensional assessment of broad psychopathological dimensions. Trial registration German Clinical Trials Register (DRKS) DRKS00016737 ( https://www.drks.de/DRKS00016737 ). Registered 17 September, 2019.

Background/Objectives: Cognitive Disengagement Syndrome (CDS) is a clinical condition primarily characterized by inattention, hypoactivity, and mind-wandering, which has not yet been recognized as an official diagnostic category. Although there are overlaps between CDS and ADHD, evidence supports the semi-independence of CDS from the ADHD-Inattentive subtype. Importantly, while the impact of ADHD on parenting styles has been studied, no previous research has investigated the potential influence of CDS difficulties on parenting behaviors. Both CDS and ADHD are associated with internalizing and externalizing symptoms, which are influenced by negative parenting styles. The severity of ADHD is known to predict the use of dysfunctional parenting patterns; however, no studies have yet investigated how CDS difficulties might affect parenting styles. Due to the similarities between CDS and ADHD, it is reasonable to hypothesize a similar relationship. This study aims to examine the potential mediating role of parenting styles—both negative and positive—in the relationship between CDS difficulties and internalizing and externalizing symptoms. Methods: The sample is composed of 369 Italian school-aged children (9.38 ± 2.34 years old). Parents reported on their children’s psychopathology, CDS difficulties, and their own parenting strategies. Results: Analyses conducted using Hayes’ PROCESS tool indicated that only negative parenting styles partially mediated the relationship between CDS difficulties and parent-reported youth anxiety, depression, and oppositional defiant disorder. Conclusions: These findings highlight the importance of interventions aimed at both addressing CDS in children and improving parenting strategies to enhance youth psychopathological outcomes.