Internalizing Problems as a Predictor of Change in Externalizing Problems in At-Risk Youth

Abstract

Intervention and prevention programs for children with externalizing problems frequently involve children with co-occurring internalizing problems. Little is known about how these co-occurring internalizing problems predict outcomes, particularly for programs involving cognitive-behavioral strategies. The current study examined how a set of child-related risk factors (including anxiety and depressive symptoms) predicted change in parent- and teacher-reported externalizing problems following a school-based preventative intervention for children at risk for externalizing problems. Participants included 112 preadolescent children (ages 9–12) who participated in a study designed to evaluate the efficacy of the Coping Power Program (Lochman & Wells, 2004 Lochman , J. E. , & Wells , K. C. ( 2004 ). The Coping Power Program for preadolescent aggressive boys and their parents: Outcomes effects at the one-year follow-up . Journal of Consulting and Clinical Psychology , 72 , 571 – 578 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Participants included 81 boys (68%) who were primarily African American (69%) or Caucasian (30%). Regression analyses were conducted to examine predictors of change in parent- and teacher-reported externalizing problems on the Behavior Assessment System for Children (Reynolds & Kamphaus, 1992 Reynolds , C. R. , & Kamphaus , R. W. ( 1992 ). Behavior Assessment System for Children (BASC) . Circle Pines , MN : American Guidance Service . [Google Scholar]). Results indicated that greater child depression symptoms (as reported by parent or teacher) were associated with a larger reduction in externalizing behavior problems based on parent or teacher report. This effect was found in both the parent and teacher models and held after controlling for a number of child-oriented baseline variables including baseline aggression. Future research studies should examine whether co-occurring symptoms of depression relate to enhanced changes in externalizing problems following intervention for externalizing problems, particularly when cognitive-behavioral interventions are utilized. In addition, it will be important for studies to examine such effects relative to a control group and/or alternative treatment conditions and to further explore possible mechanisms of change.