Evaluating a Unified Screener for Adolescent Internalizing and Externalizing Problems

Abstract

Internalizing and externalizing problems are common targets for school mental health screening. Prior research supports the interpretation of scores from the Youth Internalizing Problems Screener (YIPS) and the Youth Externalizing Problems Screener (YEPS), which were developed separately yet intended as companion measures. We extended previous work by evaluating the psychometric defensibility of integrated measurement models that combined items from the YIPS and YEPS into a unified screener (YIEPS). Specifically, we evaluated (a) a unidimensional model, (b) a correlated-factors model with two latent variables representing internalizing and externalizing problems, and (c) a bifactor model with two specific factors—internalizing and externalizing—and a general factor representing global mental health problems. We then tested the reliabilities of the several factors from these models and the informational value added of the competing models. Results indicated the bifactor YIEPS model had the best data-model fit for representing the unified screener. However, exploratory analyses suggested an alternative bifactor model with three specific factors—parsing attention problems from externalizing and internalizing content—might be an even better fit for the data. Reliability findings suggested the general factor—representing global mental health problems—was the most psychometrically defensible. Future directions for research and practice are discussed.