The Risk Factors For Internalizing And Externalizing Problems In Adolescents: A Multiwave Longitudinal Study

Purpose: (1) One aim of the study was to examine the reliability and validity of the Chinese version of the self-report form of the Strengths and Difficulties Questionnaire (SDQ), on the purpose of establishing a brief and comprehensive screening tool for adolescent psychopathology. (2) The other aim of the study was to investigate the roles of involuntary responses, rumination, self-criticism and dependency, self-perception and social support, as well as stress, in the development of both internalizing and externalizing problems.Methods: (1) The psychometric study included 1,135 participants, recruited from five schools in Changsha, Hunan. 157 students in Grade 2 participated in the test-retest reliability assessment after 8 weeks. Reliability was evaluated by Cronbach'sαcoefficients, test-retest reliability, item-subscale correlations, while validity was assessed by constructural validity and content validity. (2) 618 first graders in two high schools located in urban and rural areas in Changsha, Hunan, participated in the longitudinal study for one year, with an interval of 3 months. All participants finished the Chinese version of responses to stress questionnaire, response style questionnaire, depressie experiences questionnaire for adolescents, what I am like, social support scale for adolescents, adolescent life events questionnaire and the Chinese version of the self-report strengths and difficulties questionnaire (SDQ) at Time 1, and questionnaires assessing internalizing and externalizing symptoms as well as life events at each follow-up. Hierarchical Lineal Modeling (HLM) was used in data analysis.Results: (1) The difficulties subscale in SDQ had a Cronbach'sαcoefficient of 0.81. The internal consistency estimates of all subscales ranged from 0.52 to 0.87. The test-retest reliability was 0.71. Item-subscale correlations ranged from 0.47 to 0.75. The results of confirmatory factor analysis indicated good structural validity of SDQ. It also had satisfactory convergent and discriminant validity. (2) The results of hierarchical lineal modeling showed: risk factors that can predict changes of emotional symptoms included the interaction between global self-perception and stress, that between social support and stress, involuntary engagement, involuntary disengagement, rumination of depressive symptoms, brooding, rumination of stressful events, self-criticism and dependency, and, appearance, behavior and social self-perception; risk factors that can predict changes of conduct problems were the interaction between social support and stress, involuntary engagement, involuntary disengagement, rumination of stressful events, self-criticism, and, behavior, social and global self-perception; risk factors that can predict changes of hyperactivity/inattention related symptoms included the interaction between involuntary engagement and stress, that between involuntary engagement and stress, that between social support and stress, rumination of stressful events, self-criticism, and, academic, behavior and global self-perception.Conclusions: (1) The Chinese version of self-report SDQ represented satisfactory reliability and validity, with promising prospects. (2) Involuntary responses, rumination of stressful events, self-perception, behavior and global self-perceptio, and social support were found to be shared risked factors for both internalizing and externalizing problems. Social self-perception was the risk factor for both emotional symptoms and conduct problems. Brooding, dependency and appearance self-perception were risk factors only for emotional symptoms.