ArticleSocial psychiatry and psychiatric epidemiology2022
Structure and trends of externalizing and internalizing psychiatric symptoms and gender differences among adolescents in the US from 1991 to 2018.
Article in Social psychiatry and psychiatric epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 37 papers, 3 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- The relationship between 24-h movement behaviors and internalizing and externalizing problems in children: a systematic review.BMC pediatrics · 2025Pooled it
- The global prevalence of mental health disorders among runaway and homeless youth: A meta-analysis.European child & adolescent psychiatry · 2025Pooled it
- An integrative literature review of birth cohort and time period trends in adolescent depression in the United States.Social psychiatry and psychiatric epidemiology · 2024Pooled it
- Convergence and divergence of mental health symptoms among adolescents and their friends.European child & adolescent psychiatry · 2026Article
- Adolescent Worries About Societal Challenges: Changing Associations With Internalizing Symptoms, 1977-2021.Journal of adolescence · 2026Article
- Persistence of loneliness and low self-esteem from adolescence through age 60 in the United States: results from the Monitoring the Future Panel Study.Social psychiatry and psychiatric epidemiology · 2026Article
- Changes in Cross-Sectional Associations Between Cannabis Use and Anxiety, Depression, and Suicidality in a Nationally Representative Sample of Canadians From 2012 to 2022: Évolution des relations transversales entre la consommation de cannabis et la dépression, l'anxiété et les idées suicidaires au sein d'un échantillon représentatif de Canadiens à l'échelle nationale, de 2012 à 2022.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2026Article
- Exploring the Role of Basic Psychological Needs in the Relationship Between Overparenting and Adolescent Psychological Outcomes.Scandinavian journal of psychology · 2026Article
- Patterns of Cognitive-Emotional Responses to Online Body Shaming and Pathological Behavior Odds Among Adolescents (11-17).Scandinavian journal of psychology · 2026Article
- A Closer Look at Adolescent Mental Health: Prevalence of Internalizing and Externalizing Problems Across Educational and Gender Groups.Iranian journal of psychiatry · 2026Article
- The Impact of Psychological Capital and Perceived Social Support on the Development of Problem Behaviors Among Rural Adolescents: A Cross-Lagged Study.Behavioral sciences (Basel, Switzerland) · 2026Article
- Exploring Gender Differences in Adolescent Psychiatric Disorders: A Decade of Research.Healthcare (Basel, Switzerland) · 2026Review
- Ethnic Discrimination Moderates Genetic Influences on Adolescent Internalizing and Externalizing Psychopathology.Behavior genetics · 2026Article
- Bidirectional associations between accelerometer-based sleep metrics and mental health symptoms from childhood to late adolescence: data from a Brazilian birth cohort.BMC medicine · 2025Article
- Aggression, Suicidality, and Emotion Profiles in Youth: Links to Early Life Adversity.Aggressive behavior · 2025Article
- Longitudinal internalizing psychopathology structure in a diverse community sample of Los Angeles adolescents from 9th to 12th grade.SSM. Mental health · 2025Article
- Associations between academic achievement and internalizing disorders in Swedish students aged 16 years between 1990 and 2018.European child & adolescent psychiatry · 2025Article
- Adolescents and Social Media: Longitudinal Links Between Motivations for Using Social Media and Subsequent Internalizing Symptoms.Journal of youth and adolescence · 2025Article
- Toward dimensional psychiatry in youth: A data-driven analysis of transdiagnostic internalizing symptoms in childhood and adolescence.PLOS mental health · 2025Article
- Childhood internalizing, externalizing and attention symptoms predict changes in social and nonsocial screen time.Social psychiatry and psychiatric epidemiology · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
purposeWe aimed to estimate the structure of internalizing and externalizing symptoms and potential time dynamics in their association. This is understudied among adolescents, despite increasing internalizing and decreasing externalizing symptoms in recent years.
methodsWe analyzed data from US Monitoring the Future cross-sectional surveys (1991-2018) representative of school-attending adolescents (N = 304,542). Exploratory factor analysis using maximum likelihood estimation method and promax rotation resulted in a two-factor solution (factor correlation r = 0.24) that differentiated eight internalizing and seven conduct-related externalizing symptoms. Time-varying effect modification linear regression models estimated the association between standardized internalizing and externalizing symptoms factor scores over time overall and by gender.
resultsIn 2012, trends in average factor scores diverged for internalizing and externalizing factors. The average standardized internalizing factor score increased from - 0.03 in 2012 to 0.06 in 2013 and the average externalizing factor score decreased from - 0.06 in 2011 to - 0.13 in 2012. We found that for every one-unit increase in standardized internalizing factor score, standardized externalizing factor score increased by 0.224 units in 2010 (95% CI: 0.215, 0.233); the magnitude of this increase was 22.3% lower in 2018 (i.e., 0.174 units; 95% CI: 0.160, 0.188). Decoupling of internalizing and externalizing symptoms began earlier among boys (~ 1995) than among girls (~ 2010).
conclusionThe decoupling of internalizing and externalizing symptoms among adolescents suggests that changes in the prevalence of shared risk factors for adolescent psychiatric symptoms affect these dimensions in opposing directions, raising the importance of considering symptoms and their risk factors together in prevention and intervention efforts.
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