Early risk indicators of internalizing problems in late childhood

a 9-year longitudinal study

Ashford, Janka
Smit, Filip
van Lier, Pol A.C.
Cuijpers, Pim
Koot, Hans M.

¹Department of Clinical Psychology, VU University Amsterdam, The Netherlands; ²Trimbos Institute, The Netherlands Institute of Mental Health and Addiction, The Netherlands; ³Department of Developmental Psychology, VU University Amsterdam, The Netherlands

Correspondence to Hans Koot, Department of Developmental Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Tel: +31 (0) 20 598 8901; Fax: +31(0)20–598 8745; Email: [email protected]

Conflict of interest statement: No conflicts declared.

Abbreviations: AF: attributable fraction; IRR: incidence rate ratio; LEQ: Life Events Questionnaire; NNT: numbers needed to be treated; RD: risk difference.

Manuscript accepted 12 December 2007

Journal of Child Psychology and Psychiatry 49(7):p 774-780, July 2008.

Background

Longitudinal studies on risk indicators of internalizing problems in childhood are in short supply, but could be valuable to identify target groups for prevention.

Methods

Standardized assessments of 294 children's internalizing problems at the age of 2–3 years (parent report), 4–5 years (parent and teacher report) and 11 years (parent and teacher) were available in addition to risk indicators from the child, family and contextual domain.

Results

Low socioeconomic status, family psychopathology at child age 2–3, parenting stress at child age 4–5 years, and parents' reports of child internalizing problems at age 4–5 years were the strongest predictors of internalizing problems at the age of 11. If these early risk factors were effectively ameliorated through preventive interventions, up to 57% of internalizing cases at age 11 years could be avoided.

Conclusions

Predictors from as early as 2–5 years of age are relevant for identifying children at risk of internalizing problems in late childhood. The methodological approach used in this study can help to identify children who are most in need of preventive interventions and help to assess the potential health gain and efficiency of such interventions.