The Dysregulation Profile in Young Children: Empirically Defined Classes in the Generation R Study

Abstract

Objective Children with co-occurring internalizing and externalizing problems have higher levels of impairment and worse outcomes later in life, but it is unclear whether these children can be distinguished validly from children who have problems in a single domain. We used a person-centered statistical approach to examine whether a group of children with co-occurring internalizing and externalizing problems can be identified in a general-population sample of young children. Method This study included a population-based sample of 6,131 children, aged 5 to 7 years. Mothers (92.6%) reported emotional and behavioral problems using the Child Behavior Checklist/1.5–5 (CBCL). A latent profile analysis was performed on the CBCL syndrome scales. Identified classes were compared on early socioeconomic and parental risk factors using multinomial logistic regression. Results We identified 4 classes: 1) a class scoring high on all internalizing and externalizing scales (1.8%), 2) a class with internalizing problems (5.3%), 3) a class with externalizing problems and emotional reactivity (7.3%), and 4) a class without problems (85.6%). The first class, with co-occurring problems, was associated with higher levels of maternal and paternal affective symptoms and hostility than the other 3 classes. Conclusions The class with co-occurring internalizing and externalizing problems appears to be highly similar to the CBCL Dysregulation Profile described in older children. This empirically-based dysregulation profile offers a promise to the study of the development of poor self-regulation.

The Child Behavior Checklist Dysregulation Profile in Preschool Children: A Broad Dysregulation Syndrome

“…[8][9][10] Furthermore, the wide-spread associations between DP and impairments 18 months later are in line with longitudinal studies with older children 6,7 and add to existing knowledge by indicating that DP in preschool years forms a valid marker for developmental risks.…”

“…These operationalizations suggest different underlying assumptions concerning the conceptualization of DP. Conceptualizing DP as a syndrome fits well with using the sum of the AAA scales 9 , or latent classes/profiles 10 . Assuming DP to represent comorbidity is best accompanied by cut-off approaches for each separate AAA scale.…”

“…9 Moreover, in a community sample of relatively young children (mean age of 6), a group of children scoring high on all CBCL scales and a group of children scoring high on externalizing problem behavior and emotional reactivity were identified using latent profile analysis. 10 The highly problematic class was especially associated with more maternal and paternal psychological problems 10 and child's lower non-verbal intelligence 11 , and was therefore proposed to resemble DP.…”

Wechsler profiles in referred children with intellectual giftedness: Associations with trait-anxiety, emotional dysregulation, and heterogeneity of Piaget-like reasoning processes

“…Indeed, emotional dysregulation is a robust predictor of future negative outcomes, with a high risk when entering adulthood for a series of affective disorders, 42,45,55e57 temperamental and personality impairment, 42,45,53,55 and impoverished overall functioning. 45 This may have some implications when considering psychopathological prognosis and treatment in referred children with asynchronous giftedness, and is consistent with the hypothesis they display emotional and behavioural problems which may be earlyrooted in development.…”

“…40e45 Though there is no absolute consensus regarding the precise definition of the syndrome, 40 Achenbach's dimensional approach allowed individualizing an emotional and behavioural pattern, consisting of elevations on the attention problems, aggressive behaviour and anxious/ depressed subscales of the Child Behaviour Checklist (CBCL 46 ), which has been termed the "dysregulation profile" (CBCL-DP). 41 Since children with distributed behavioural problems frequently suffer from emotional dysregulation, 45 clinicallyreferred gifted children with a SVPD, who preferentially exhibit mixed behavioural syndromes, 10 may display a CBCL-DP more frequently than gifted children with homogeneous IQs.…”