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Multiple behavioral and health outcomes, including internalizing symptoms, may be predicted from prenatal maternal anxiety, depression, or stress. However, not all children are affected, and those that are can be affected in different ways. Here we test the hypothesis that the effects of prenatal anxiety are moderated by genetic variation in the child's brain-derived neurotrophic factor (BDNF) gene, using the Avon Longitudinal Study of Parents and Children population cohort. Internalizing symptoms were assessed from 4 to 13 years of age using the Strengths and Difficulties Questionnaire (n = 8,584); a clinical interview with the adolescents was conducted at age 15 years (n = 4,704). Obstetric and psychosocial risk and postnatal maternal symptoms were included as covariates. Results show that prenatal maternal anxiety predicted internalizing symptoms, including with the diagnostic assessment at 15 years. There was a main effect of two BDNF polymorphisms (rs6265 [val66met] and rs11030104) on internalizing symptoms up to age 13. There was also genetic moderation of the prenatal anxiety effect by different BDNF polymorphisms (rs11030121 and rs7124442), although significant effects were limited to preadolescence. The findings suggest a role for BDNF gene–environment interactions in individual vulnerability to the effects of prenatal anxiety on child internalizing symptoms.

The main objective of this paper is to study the relationship between different areas of victimization (e.g., sexual victimization) and psychological symptoms taking into account the full range of victimizations adolescents suffer. The final aim is to contribute further evidence regarding the bias that those studies which focus on just one area of victimization may be introducing into our psychological knowledge. A total of 923 adolescents (62.4 % girls) between 14 and 18 years old were recruited from seven secondary schools in Catalonia, Spain. The Youth Self-report and the Juvenile Victimization Questionnaire were employed to assess psychological problems (internalizing and externalizing symptoms) and victimization, respectively. The large majority of adolescents reported having experienced more than one area of victimization. However, Conventional Crime area was the one that was more reported in isolation. Overall, the explicative power of a particular area of victimization was greatly reduced or even lost its significance when the other areas were taken into account. However, some areas remained significant and were different by gender. Clinicians and researchers should take into account the whole range of victimizations adolescents suffer when intending to understand the psychological aftermaths of victimization. Some areas of victimization appear to be more important at explaining particular psychological symptoms, those being Peer and Sibling Victimization in the case of boys, and both Conventional Crime and Internet Victimization in the case of girls.

Children with attention deficit hyperactivity disorder (ADHD) experience high rates of sleep problems and are at increased risk for developing internalizing problems. This study aimed to examine the association of sleep problems and physical activity with internalizing symptoms in children with ADHD. This cross-sectional study included 188 children with ADHD (M age = 8.60 ± 1.38, 78.7% boys). Self-reported questionnaires were used to assess sleep problems (Pittsburgh Sleep Quality Index [PSQI]) and internalizing symptoms (Depression Anxiety Stress Scale 21 [DASS 21]). The presence of sleep problems was defined as a PSQI score > 5. Physical activity was recorded by an ActiGraph GT9X Link accelerometer for 7 consecutive days. In total, 111 children with ADHD presented with sleep problems (59%). Compared with their counterparts without sleep problems, children with sleep problems spent less time in daily moderator-to-vigorous physical activity (MVPA) (F = 15.35, η2 = .079), had a lower proportion of meeting the WHO-recommended 60 min of daily MVPA guideline (F = 9.57, η2 = .050), and showed more internalizing symptoms: depression (F = 10.09, η2 = .053), anxiety (F = 15.84, η2 = .081), and stress (F = 6.98, η2 = .037). BMI, daytime dysfunction of PSQI, and MVPA guideline attainment were significantly associated with internalizing symptoms in children with ADHD. Daytime dysfunction of PSQI is associated with more severe internalizing symptoms, and MVPA guideline attainment may reduce the likelihood of developing depression and anxiety in children with ADHD. Future studies are needed to examine the long-term effects of sleep on internalizing symptoms and the effects of PA-based interventions on sleep and internalizing symptoms in children with ADHD, respectively.

Using language to distance oneself from negative stimuli (e.g., by reducing use of the word “I” and present-tense verbs) is associated with effective emotion regulation. Given that internalizing disorders like anxiety and depression are characterized by maladaptive emotion regulation, stronger linguistic distance may be both a diagnostic marker of lower internalizing symptoms and a prognostic indicator of treatment progress. Here, we tested these hypotheses in a large corpus of naturalistic psychotherapeutic exchanges between clients and their therapists (>1.2 million messages from 6,229 clients). In both exploratory (n = 3,729) and validation (n = 2,500) datasets, we found that clients’ internalizing symptoms decreased over therapy, that client linguistic distance increased over therapy, and that internalizing symptoms tracked fluctuations in linguistic distance both within and between individuals. In other words, clients shifted from discussing themselves and the present moment to discussing other people and time points over treatment, and this psycholinguistic shift was related to symptom reductions. However, effect sizes for linguistic results were small, and we failed to find consistent evidence that linguistic distance statistically mediated changes in symptoms over time. Finally, clustering analyses revealed that data-driven groups of clients defined solely on the basis of their linguistic distance differed in both their symptom severity and treatment outcomes. Together, these findings provide replicable evidence that linguistic distance is a marker of internalizing symptom severity and treatment progress in real-world therapeutic interactions.

This meta-analytic review examines the association between attachment and internalizing symptomatology during childhood, and compares the strength of this association with that for externalizing symptomatology. Based on 42 independent samples (N = 4,614), the association between insecurity and internalizing symptoms was small, yet significant (d = 0.15, CI 0.06~0.25) and not moderated by assessment age of internalizing problems. Avoidance, but not resistance (d = 0.03, CI - 0.11~0.17) or disorganization (d = 0.08, CI - 0.06~0.22), was significantly associated with internalizing symptoms (d = 0.17, CI 0.03~0.31). Insecurity and disorganization were more strongly associated with externalizing than internalizing symptoms. Discussion focuses on the significance of attachment for the development of internalizing versus externalizing symptomatology.

Overparenting has been considered to contribute to offspring internalizing mental disorders from theoretical perspectives, which some empirical evidence has supported. However, existing findings are inconsistent. To facilitate the understanding of the association between overparenting and depression, anxiety, and internalizing symptoms, an examination of effect sizes is required. By employing the PRISMA method, a meta-analysis was conducted. Fifty-two articles were identified, with 38 studies examining depression, 30 studies examining anxiety, and 21 studies examining internalizing symptoms. The results show that overparenting is associated with offspring depression (mean age 19.94 years) ( k = 133, r = .15, p < .001), anxiety (mean age 19.57 years) ( k = 101, r = .14, p < .001), and internalizing symptoms (mean age 19.76 years) ( k = 58, r = .19, p < .001). Moderator analyses show that the effect sizes are largely equal across SES groups, cultures, the age of offspring, child gender, and study design but may vary depending on the parental gender and report informants. Implications for interventions and future directions are discussed.

The acquisition of social competence, such as showing prosocial behaviour (fulfilling others’ needs) and social initiative (fulfilling own needs), constitutes one major developmental task in childhood and adolescence. Previous research suggests that in middle childhood, impaired social competences are related to childhood psychopathology, such as externalizing and internalizing disorders. As the period of preschool age is a particularly important time for both the development of social competence and early psychopathological symptoms, we conducted a systematic review to investigate the role of social competence in relation to early childhood psychopathology. Twenty-one clinical as well as subclinical studies published prior to September 2016 were included in a qualitative analysis of the relation between prosocial behaviour, social initiative, and early externalizing and internalizing symptoms in preschool age children (age 3–6). Effect sizes for each study were calculated if required information was available. Our review suggests that from early on in childhood development, externalizing symptoms are accompanied by prosocial behaviour deficits such as lower levels of helping or cooperating, whereas internalizing symptoms may be accompanied by either deficient or excessive levels of prosocial behaviour. Exhibiting social initiative such as initiating contact with others or communicating one’s own needs seems to be impaired in children with internalizing symptoms. Implications for current theory and future research are discussed.

Parenting stress and child psychopathology are closely linked in parent-child dyads, but how the bidirectional association varies across childhood and adolescence, and shifts depending on maternal affection are not well understood. Guided by the transactional model of development, this longitudinal, prospective study examined the bidirectional relations between parenting stress and child internalizing and externalizing problems and investigated the moderating role of maternal affection from childhood to adolescence. Participants were from the Future of Families and Child Wellbeing Study, a diverse, nationally representative sample of 2,143 caregiving mothers who completed assessments at children ages 5, 9, and 15. Using cross-lagged panel modeling, we found bidirectional effects between parenting stress and child internalizing and externalizing problems. However, additional multigroup analyses showed that bidirectional associations depend on the levels of maternal affection. In the high maternal affection group, parenting stress at age 5 predicted higher internalizing and externalizing problems at age 9, and reverse child-to-parent paths were found from age 9 to age 15. In contrast, only one cross-lagged path was found in the low maternal affection group. Findings suggest that maternal affection can heighten the transactional associations between parenting stress and child psychopathology.

PurposeWe aimed to estimate the structure of internalizing and externalizing symptoms and potential time dynamics in their association. This is understudied among adolescents, despite increasing internalizing and decreasing externalizing symptoms in recent years.MethodsWe analyzed data from US Monitoring the Future cross-sectional surveys (1991–2018) representative of school-attending adolescents (N = 304,542). Exploratory factor analysis using maximum likelihood estimation method and promax rotation resulted in a two-factor solution (factor correlation r = 0.24) that differentiated eight internalizing and seven conduct-related externalizing symptoms. Time-varying effect modification linear regression models estimated the association between standardized internalizing and externalizing symptoms factor scores over time overall and by gender.ResultsIn 2012, trends in average factor scores diverged for internalizing and externalizing factors. The average standardized internalizing factor score increased from − 0.03 in 2012 to 0.06 in 2013 and the average externalizing factor score decreased from − 0.06 in 2011 to − 0.13 in 2012. We found that for every one-unit increase in standardized internalizing factor score, standardized externalizing factor score increased by 0.224 units in 2010 (95% CI: 0.215, 0.233); the magnitude of this increase was 22.3% lower in 2018 (i.e., 0.174 units; 95% CI: 0.160, 0.188). Decoupling of internalizing and externalizing symptoms began earlier among boys (~ 1995) than among girls (~ 2010).ConclusionThe decoupling of internalizing and externalizing symptoms among adolescents suggests that changes in the prevalence of shared risk factors for adolescent psychiatric symptoms affect these dimensions in opposing directions, raising the importance of considering symptoms and their risk factors together in prevention and intervention efforts.

Experiences of depression, anxiety, and peer victimization have each been found to predict one another, and to predict negative outcomes in the domains of school connectedness, social functioning, quality of life, and physical health. However, the common co-occurrence of depression, anxiety, and peer victimization experiences has made it difficult to disentangle their unique roles in these associations. The present study thus sought to characterize the precise nature of the bidirectional relationships between depressive symptoms, anxiety, and victimization over time, and to examine their unique sequelae during the transition from childhood to early adolescence. Longitudinal multi-informant (child-reported, parent-reported, and teacher-reported) data from a nationally representative sample were analyzed using path analysis when the study child was aged 10–11 (n= 4169; Mage = 10.3; 48.8% female) and aged 12–13 (n= 3956; Mage = 12.4; 48.2% female). Depressive symptoms, anxiety, and peer victimization had small but significant unique bidirectional relationships. All three constructs also uniquely and prospectively predicted poorer life functioning across all domains examined. These results demonstrate that current interventions should broaden their scope to simultaneously target depression, anxiety, and peer victimization, as each of these experiences independently act as additive risk factors for subsequent negative outcomes.