General psychopathology, internalising and externalising in children and functional outcomes in late adolescence

Abstract

BackgroundInternalising and externalising problems commonly co‐occur in childhood. Yet, few developmental models describing the structure of child psychopathology appropriately account for this comorbidity. We evaluate a model of childhood psychopathology that separates the unique and shared contribution of individual psychological symptoms into specific internalising, externalising and general psychopathology factors and assess how these general and specific factors predict long‐term outcomes concerning criminal behaviour, academic achievement and affective symptoms in three independent cohorts.MethodsData were drawn from independent birth cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), N = 11,612; Generation R, N = 7,946; Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN), N = 408). Child psychopathology was assessed between 4 and 8 years using a range of diagnostic and questionnaire‐based measures, and multiple informants. First, structural equation models were used to assess the fit of hypothesised models of shared and unique components of psychopathology in all cohorts. Once the model was chosen, linear/logistic regressions were used to investigate whether these factors were associated with important outcomes such as criminal behaviour, academic achievement and well‐being from late adolescence/early adulthood.ResultsThe model that included specific factors for internalising/externalising and a general psychopathology factor capturing variance shared between symptoms regardless of their classification fits well for all of the cohorts. As hypothesised, general psychopathology factor scores were predictive of all outcomes of later functioning, while specific internalising factor scores predicted later internalising outcomes. Specific externalising factor scores, capturing variance not shared by any other psychological symptoms, were not predictive of later outcomes.ConclusionsEarly symptoms of psychopathology carry information that is syndrome‐specific as well as indicative of general vulnerability and the informant reporting on the child. The ‘general psychopathology factor' might be more relevant for long‐term outcomes than specific symptoms. These findings emphasise the importance of considering the co‐occurrence of common internalising and externalising problems in childhood when considering long‐term impact.

The wide‐ranging life outcome correlates of a general psychopathology factor in adolescent psychopathology

“…Notably, INT was related to a higher attained educational level both in model A and in the bifactor models (models B and ′B), suggesting that INT may have some advantage, which becomes most obvious when controlling for the underlying psychopathology. This findings is in line with recent findings demonstrating a positive link between internalizing problems and academic achievement and raises the possibility that individuals with internalizing tendencies but no severe psychopathology have more attentional control, which make them do better at school and work . Third, with regard to EXT, most of the associations revealed in model A remained in the bifactor models (models B and ′B) (e.g.…”

“…low effortful control, frustration, antisocial behaviour, smoking, alcohol use, cannabis use and high BMI). Earlier research has found little evidence for an association between EXT and outcomes during adolescence, which may be explained by the limited selection of outcomes assessed (i.e. criminal, academic and affective outcomes).…”

“…For example, Tackett and colleagues suggested that the GEN factor is largely accounted for by neuroticism . In addition, the construct validity of the GEN factor has been studied by examining associations with school functioning and academic outcomes and brain functioning . For example, Lahey and colleagues provided evidence of robust and independent associations with a range of teacher‐reported school functioning measures from childhood to adolescence .…”

The General Factor of Psychopathology

“…Many other studies support the criterion validity of p. Longitudinally, a general factor of psychopathology (assessed in children, whether via parent-report or using multiple informants) predicted adverse mental health outcomes later in adolescence above other latent factors included in the model (Pettersson et al, 2018;Sallis et al, 2019). Negative outcomes predicted include psychiatric diagnoses, court convictions, poor academic performance, criminal behavior, and affective symptoms later in life above and beyond specific internalizing and externalizing factors.…”

“…studied to date: Cognitive deficits, childhood abuse, court convictions, academic achievement, antisocial behaviors, and so on(Caspi et al, 2014; Martel et al, 2017;Pettersson et al, 2013;Sallis et al, 2019).…”