Childhood predictors of externalizing and internalizing problems in adolescence. A prospective follow-up study from age 8 to 16.

The aim of this study was to assess the childhood predictors of externalizing and internalizing symptoms in adolescence in an epidemiological sample. Behavior ratings were obtained from 609 children at two time-points, accounting for 71% of the target sample. At age 8, children were evaluated with parental and teacher Rutter scales, and with the Child Depression Inventory (CDI), and at age 16 with the Child Behavior Checklist. Evaluations by all informants had a unique contribution to later outcome. In multivariate analysis, among boys, parental reports of hyperactivity independently predicted externalizing problems and teacher reports of hyperactivity independently predicted internalizing problems. Teacher reports of conduct problems independently predicted externalizing problems among both boys and girls. Furthermore, parent reports of emotional problems independently predicted internalizing problems among both boys and girls. Children's own reports of internalized distress measured with CDI predicted a high level of internalizing problems among girls. Perceived need of treatment was the strongest predictor for outcome among girls. Change in family structure (e. g., divorce or remarriage) during follow-up independently predicted externalizing and internalizing problems among boys. The study supports the findings from earlier studies showing that the stability of behavior problems from childhood to adolescence is substantial. This implies a need for early recognition and initiation of treatment efforts.