Internalizing and Externalizing Problems in Adolescents Following an Earthquake: Codevelopment and Temporal Association

Chinese adolescents who experience potentially traumatic events may develop posttraumatic internalizing and externalizing problems. However, it remains controversial whether interventions should focus first on internalizing or externalizing problems (or simultaneously on both). Previous studies have attempted to elucidate the developmental trajectories of posttraumatic internalizing and externalizing problems, temporal associations between them, and the between-person effects on this association to identify appropriate primary interventions. However, these studies overlooked the potential codevelopment of internalizing and externalizing problems along with the within-person effects on this association. To address these gaps, this study examined the codevelopment of and within-person temporal association between internalizing and externalizing problems. Participants were 391 Chinese adolescents who completed self-report questionnaires at 1, 1.5, 2, and 2.5 years after the 2008 Wenchuan earthquake. Parallel latent growth curve modeling and random intercept cross-lagged panel modeling were used to test the hypotheses. The results showed that both internalizing and externalizing problems were stable over time following the earthquake. Moreover, internalizing problems positively predicted externalizing problems at the within-person level and showed a positive between-person relationship with externalizing problems. These findings suggest that internalizing and externalizing problems may codevelop, and internalizing problems are risk factors for externalizing problems in adolescents following trauma.

Automated summary

Chinese adolescents who experience potentially traumatic events may develop posttraumatic internalizing and externalizing problems. It is unclear whether interventions should prioritize internalizing or externalizing problems. This study fills the research gap by examining the codevelopment and temporal association between internalizing and externalizing problems. The findings suggest that both internalizing and externalizing problems are stable over time, and internalizing problems are a risk factor for externalizing problems in adolescents following trauma.