Skip to main content
Log in

Impairment and Distress Judgments of Symptoms Composing Childhood Externalizing and Internalizing Syndromes

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

The pattern of perceived dysfunction associated with symptoms composing the externalizing childhood disorder syndrome was compared to the pattern characterizing the internalizing syndrome. In Study 1, undergraduate students (N = 205) judged the social impairment, academic/occupational impairment and personal distress associated with symptoms from the child and adolescent psychopathology scale (Lahey et al. 2004) related to externalizing and internalizing syndromes. As predicted, symptoms composing the externalizing syndrome were judged as involving less personal distress and more impairment than those composing the internalizing syndrome. Converging findings emerged in Study 2 when undergraduates (N = 183) judged DSM-IV symptoms composing externalizing and internalizing disorders. This research reveals systematic differences in perceptions of impairment and distress related to the symptoms that compose the externalizing and internalizing syndromes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Achenbach, T. M. (1966). The classification of children’s psychiatric symptoms: A factor-analytic study. Psychological Monographs, 80(615).

  • Achenbach, T. M. (1985). Assessment and taxonomy of child and adolescent psychopathology. Sage Publications: Beverly Hills.

    Google Scholar 

  • Achenbach, T. M. (1991). Manual for the child behavior checklist/4–18 and 1991 profile. Burlington, VT: University of Vermont Department of Psychiatry.

    Google Scholar 

  • Achenbach, T. M., & Edelbrock, C. S. (1978). The classification of child psychopathology: A review and analysis of empirical efforts. Psychological Bulletin, 85, 1275–1301. doi:10.1037/0033-2909.85.6.1275.

    Article  PubMed  Google Scholar 

  • Acton, G. S., & Zodda, J. J. (2005). Classification of psychopathology: Goals and methods in an empirical approach. Theory and Psychology, 15, 373–399. doi:10.1177/0959354305053220.

    Article  Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Angold, A., Costello, E. J., & Erkanli, A. (1999a). Comorbidity. Journal of Child Psychology and Psychiatry and Allied Disciplines, 40, 57–87. doi:10.1017/S0021963098003448.

    Article  Google Scholar 

  • Angold, A., Costello, E. J., Farmer, E. M. Z., Burns, B. J., & Erkanli, A. (1999b). Impaired but undiagnosed. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 129–137. doi:10.1097/00004583-199902000-00011.

    Article  PubMed  Google Scholar 

  • Bird, H. R., Andrews, H., Schwab-Stone, M., Goodman, S., Dulcan, M., Richters, J., et al. (1996). Global measures of impairment for epidemiologic and clinic use with children and adolescents. International Journal of Methods in Psychiatric Research, 6, 295–307. doi :10.1002/(SICI)1234-988X(199612)6:4<295::AID-MPR173>3.3.CO;2-5.

    Article  Google Scholar 

  • Bird, H. R., Canino, G. J., Davies, M., Ramirez, R., Chavez, L., & Duarte, C. (2005). The brief impairment scale (BIS): A multidimensional scale of functional impairment for children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 699–707. doi:10.1097/01.chi.0000163281.41383.94.

    Article  PubMed  Google Scholar 

  • Bird, H. R., Davies, M., Fisher, P., Narrow, W. E., Jensen, P. S., Hoven, C., et al. (2000). How specific is specific impairment? Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1182–1189. doi:10.1097/00004583-200009000-00019.

    Article  PubMed  Google Scholar 

  • Caspi, A., Elder, G. H., & Bem, D. J. (1987). Moving against the world: Life-course patterns of explosive children. Developmental Psychology, 23, 308–313. doi:10.1037/0012-1649.23.2.308.

    Article  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Cohen, N. J., Gotlieb, H., Kershner, J., & Wehrspann, W. (1985). Concurrent validity of the internalizing and externalizing profile patterns of the Achenbach child behavior checklist. Journal of Consulting and Clinical Psychology, 53, 724–728. doi:10.1037/0022-006X.53.5.724.

    Article  PubMed  Google Scholar 

  • Costello, E. J., Angold, A., Burns, B. J., Erkanli, A., Stangl, D. K., & Tweed, D. L. (1996). The great smoky mountains study of youth: Functional impairment and serious emotional disturbance. Archives of General Psychiatry, 53, 1137–1143.

    PubMed  Google Scholar 

  • Costello, E. J., Angold, A. A., & Keeler, G. P. (1999). Adolescent outcomes of childhood disorders: The consequences of severity and impairment. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 121–128.

    Google Scholar 

  • Costello, E. J., & Shugart, M. A. (1992). Above and below the threshold: Severity of psychiatric symptoms and functional impairment in a pediatric sample. Pediatrics, 90, 359–368.

    PubMed  Google Scholar 

  • De Clercq, B., De Fruyt, F., Van Leeuwen, K., & Mervielde, I. (2006). The structure of maladaptive personality traits in childhood: A step toward an integrative developmental perspective for DSM-V. Journal of Abnormal Psychology, 115, 639–657. doi:10.1037/0021-843X.115.4.639.

    Article  PubMed  Google Scholar 

  • Funtowicz, M. N., & Widiger, T. A. (1999). Sex bias in the diagnosis of personality disorders: An evaluation of the DSM-IV criteria. Journal of Abnormal Psychology, 108, 195–201. doi:10.1037/0021-843X.108.2.195.

    Article  PubMed  Google Scholar 

  • Garb, H. N. (1997). Race bias, social class bias, and gender bias in clinical judgment. Clinical Psychology: Science and Practice, 4, 99–120.

    Article  Google Scholar 

  • Horney, K. (1945). Our inner conflicts. New York: Norton.

    Google Scholar 

  • Howell, A. J., & Watson, D. C. (2002). Perceived dysfunction of male-typed and female-typed DSM-IV personality disorder criteria. Journal of Personality Disorders, 16, 536–548. doi:10.1521/pedi.16.6.536.22142.

    Article  PubMed  Google Scholar 

  • Howell, A. J., & Watson, D. C. (2005). Impairment and distress associated with symptoms of male-typed and female-typed DSM-IV Axis-I disorders. Journal of Clinical Psychology, 61, 389–400. doi:10.1002/jclp.20019.

    Article  PubMed  Google Scholar 

  • Howell, A. J., & Watson, D. C. (2008). Judgments of impairment and distress associated with symptoms of internalizing and externalizing disorders. Anxiety, Stress, and Coping, 21, 143–154.

    Article  PubMed  Google Scholar 

  • King, S. M., Iacono, W. G., & McGue, M. (2004). Childhood externalizing and internalizing psychopathology in the prediction of early substance use. Addiction Abingdon England, 99, 1548–1559. doi:10.1111/j.1360-0443.2004.00893.x.

    Google Scholar 

  • Krueger, R. F., Caspi, A., Moffitt, T. E., & Silva, P. A. (1998). The structure and stability of common mental disorders (DSM-III-R): A longitudinal-epidemiological study. Journal of Abnormal Psychology, 107, 216–227. doi:10.1037/0021-843X.107.2.216.

    Article  PubMed  Google Scholar 

  • Lahey, B. B., Applegate, B., Waldman, I. D., Loft, J. D., Hankin, B. L., & Rick, J. (2004). The structure of child and adolescent psychopathology: Generating new hypotheses. Journal of Abnormal Psychology, 113, 358–385. doi:10.1037/0021-843X.113.3.358.

    Article  PubMed  Google Scholar 

  • Langley, A. K., Bergman, L., McCracken, J., & Piacentini, J. C. (2004). Impairment in childhood anxiety disorders: Preliminary examination of the child anxiety impact scale—parent version. Journal of Child and Adolescent Psychopharmacology, 14, 105–114. doi:10.1089/104454604773840544.

    Article  PubMed  Google Scholar 

  • Lilienfeld, S. O. (2003). Comorbidity between and within childhood externalizing and internalizing disorders: Reflections and directions. Journal of Abnormal Child Psychology, 31, 285–291. doi:10.1023/A:1023229529866.

    Article  PubMed  Google Scholar 

  • Oldehinkel, A. J., Hartman, C. A., De Winter, A. F., Veenstra, R., & Ormel, J. (2004). Temperament and profiles associated with internalizing and externalizing problems in preadolescence. Development and Psychopathology, 16, 421–440. doi:10.1017/S0954579404044591.

    Article  PubMed  Google Scholar 

  • Parker, G., Both, L., Olley, A., Hadzi-Pavlovic, D., Irvine, P., & Jacobs, G. (2002). Defining disordered personality functioning. Journal of Personality Disorders, 16, 503–522. doi:10.1521/pedi.16.6.503.22139.

    Article  PubMed  Google Scholar 

  • Phares, V., & Danforth, J. S. (1994). Adolescents’, parents’, and teachers’ distress over adolescents’ behavior. Journal of Abnormal Child Psychology, 22, 721–732. doi:10.1007/BF02171998.

    Article  PubMed  Google Scholar 

  • Staller, J. A. (2006). Diagnostic profiles in outpatient child psychiatry. The American Journal of Orthopsychiatry, 76, 98–102. doi:10.1037/0002-9432.76.1.98.

    Article  PubMed  Google Scholar 

  • Walker, J. L., Lahey, B. B., Russo, M. F., Frick, P. J., Christ, M. A. G., McBurnett, K., et al. (1991). Anxiety, inhibition, and conduct disorder in children: I. Relations to social impairment. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 187–191. doi:10.1097/00004583-199103000-00004.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Hawley, K. M., & Doss, A. J. (2004). Empirically tested psychotherapies for youth internalizing and externalizing problems and disorders. Child and Psychiatric Clinics of North America, 13, 729–815. doi:10.1016/j.chc.2004.05.006.

    Article  Google Scholar 

  • Wu, P., Hoven, C. W., Bird, H. R., Moore, R. E., Cohen, P., Alegria, M., et al. (1999). Depressive and disruptive disorders and mental health service utilization in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1081–1090. doi:10.1097/00004583-199909000-00010.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrew J. Howell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Howell, A.J., Watson, D.C. Impairment and Distress Judgments of Symptoms Composing Childhood Externalizing and Internalizing Syndromes. J Child Fam Stud 18, 172–182 (2009). https://doi.org/10.1007/s10826-008-9217-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-008-9217-y

Keywords

Navigation