Transcript Predicting externalizing and internalizing problems in

Gonneke W.J.M.Stevens; Wilma A.M.Vollebergh; Trees V.M.Pels
Sco Psychiatry Psychiar Epidemiol(2005) 40: 571-579
Impact factor: 2.052
Date:99/10/14
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Introduction
◦ Externalizing
◦ Internalizing

Methods

Result
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Discussion

Conclusion

This aim of the current study is to contribute to the
knowledge in this field
◦ Externalizing problems
◦ Internalizing problems

Child factor
◦ Internalizing
 According to Zahn-Waxler et al. , the strongest risk factor for
emotional Problems is gender: Female adolescents were found to be at
least twice as likely as males to become anxious and depressed, a
pattern that continues throughout adulthood
◦ Externalizing
 Associations between child variables and externalizing behavior
are well established in literature

Family factor
◦ Internalizing
 Several processes in, and characteristics of, the family influence
the development of emotional problems in adolescents
◦ Externalizing
 Parental behavior in interaction with the child is the family
factor most proximal to the child’s everyday experience

School/peer factor
◦ Internalizing
 Although parents still occupy a central position in the lives of their
children, relations with peers become increasingly important
during adolescence
◦ Externalizing
 The child’s progress into adolescence is marked by increased
involvement with peers. In this period, parental influence
diminishes whereas peer influence increases

Migration factor
◦ Internalizing
 Moroccan adolescents may be faced with risk factors related to
their (or their parents‘) migration
◦ Externalizing
 Variables specific for migration, like country of birth and fluency
in the language used in the current country may influence the level
of externalizing problems in Moroccan immigrant adolescents

Three goals- Externalizing
◦ First: Gain insight into the predictors of externalizing problems
in Moroccan immigrant adolescents living in the Netherlands
in the age range of 11-18 years
◦ Second: The gender specificity of the associations is examined
◦ Third: Want to find out which factor is most strongly
associated with externalizing problems in Moroccan immigrant
adolescents
Three goals-Internalizing
◦ First: Gain insight into the predictors of internalizing problems in
Moroccan immigrant adolescents living in the Netherlands in the
Netherlands

◦ Second: Examine the gender specificity of the associations
◦ Third: Examine the contribution of child, proximal family, parent,
contextual family, global family, school/peer, and migration
factors to the prediction of emotional problems with and without
controlling for the other predictor sets
Population
Aged 4 through 8
At least one parent born in Morocco of two
of the four largest cities in Netherlands

Sample
April 2000 to July 2002
Mentally retarded
Lived in Moroccan
Excluded 37
N=1260
Only one child
per family
Excluded 96
N=1127
Adolescents report
Aged 11 through 18
N=376
Parent report
N=415
For 73%
N=819
Permission for parents and adolescents
teacher report
N=296
excluded 7
Response rate 82%
N=238

Sample

Instruments
◦ Internalizing and externalizing behavior
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Child Behavior Checklist (CBCL)
Youth Self-Report (YSR)
Teacher’s Report Form (TRF)
Internalizing
 Sum of scores on items in the Withdraws, Somatic Complaints,
and Anxious/Depressed syndrome profiles
 Externalizing
 Sum of scores on the Delinquent and Aggressive behavior
syndromes

Instruments
◦ Child factor


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
Gender
Age
Internalizing
Chronic health problems of the child were obtained from the
parent

Instruments
◦ Proximal family factor
 Affection
 0=highly disagree to 5=highly agree
 Monitoring
 0=nothing to 3=everything
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Support from father (α=0.86)
Support from mother (α=0.78)
Parent-child conflict (parent report α=0.90)
Parent-child conflict (adolescent report α=0.85)
 0=never to 4=very often

Instruments
◦ Parent factor
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
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Somatic symptoms
Anxiety/Insomnia (α=0.90)
Social Dysfunction (α=0.77)
Severe Depression
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Instruments
◦ Contextual family factor
 Conflicts parents about parenting
 Conflicts parents about other things
 0=never to 2=often
 Positive communication parents
 Destructive communication parents
 Total number of life-events

Instruments
◦ Global family factor
 Marital status
 0=married
 1=not married
 Family education level
 0=no education at all to 4=high level of vocational training or
university
 Family employment level
 0=no job to 3=high job level
 Number of children in the family

Instruments
◦ School/peer factor
 Problems at school
 Being bored
 0=never to 4=each day
 Support from friends (α=0.86)
 Deviant peers
 0=no; 1=yes (α=0.86)
 Hanging out
 0=never to 4=each day

Instruments
◦ Migration factor
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Country of birth adolescent
Muslim identification adolescent (α=0.76)
Perceived group discrimination adolescent
Muslim identification parent (α=0.59)
Perceived group discrimination parent
Fluency in Dutch parent (understanding)
Fluency in Dutch parent (speaking)
 0=not all to 3=very well

Statistical analysis
◦
◦
◦
◦
Cross-sectional study
Univariate analysis
Linear regression analysis
Cronbach's alpha

Externalizing problems

Internalizing problems

Externalizing problems

Internalizing problems

Internalizing problems
internalizing
Externalizing
Gender
Gender
externalizing
Internalizing
Parent-child conflict (parent report)
Affection
Conflicts parents about parenting
Monitoring
Perceived group discrimination adolescent
Support from father
Support from mother
Parent-child conflict (parent report)
Problems at school
Deviant peers
Hanging out

Study limitations
◦ Unable to examine the causal directions of the associations
◦ Unable to test whether the associations about externalizing or
internalizing problems between Moroccan immigrant and
Western populations
◦ Not all important predictors have been taken into account
 temperament for externalizing and internalizing

Study limitations
◦ Sample might not be representative for the entire Moroccan
immigrant population in Netherlands
 Almost 50% of the Moroccans
◦ Unable generalized to other migrant populations, as differences
between migrant populations are numerous

Study suggest that the child, school/peer, and proximal
family factors are essential in models predicting the
development of externalizing and internalizing
problems turned out to be relatively small