Context Matters: Co-Development of Internalizing and Externalizing Symptoms from Early Childhood to Adolescence: Influences of Neighborhood Factors

Background: Although previous studies have suggested internalizing and externalizing symptoms often develop together, findings have been inconsistent. Thus, clarifying the long-term relationship between internalizing and externalizing symptoms from early childhood to middle adolescence is important for future intervention and prevention programs. Additionally, previous studies haven’t discussed the longitudinal influences of neighborhood factors on the trajectories of internalizing and externalizing symptoms. Therefore, this study examined the trajectories of internalizing and externalizing symptoms from early childhood to adolescence and the long-term effects of early childhood neighborhood factors on such trajectories.

Methods: This secondary data analysis used the Year 3, 5, 9, and 15 data from the restricted version of the Fragile Family Child Wellbeing Study. After using full maximum likelihood estimation to deal with missing data, the final sample size was 2,385. Internalizing and externalizing symptoms were measured at the focal child’s ages 3, 5, 9, and 15 using the Child Behavioral Checklist. Neighborhood structural factors were measured at children’s age 3, broken down into three components: economic disadvantage, residential instability, and ethnic heterogeneity. Neighborhood process factors were measured by informal social control and social cohesion at children’s age 3. The focal child’s demographic information, child maltreatment experience, and mother’s drug use, anxiety, and depression were controlled. Parallel-process growth curve modeling was conducted using Mplus 8.0 (Muthen & Muthen, 2015). RMSEA, SRMR, and CFI were used to assess the goodness of fit of the models.

Results: This study found that compared with the linear unconditional parallel-process model (AIC = 115,902.30, BIC = 116,067.09), the quadratic unconditional parallel-process model had a significantly better model fit (AIC = 114,143.63, BIC = 114,390.83). Both internalizing and externalizing symptoms decreased from age 3, reached a stationary point around age 9, and then increased thereafter to age 15. The cross-domain correlations among all interceptions, linear slopes, and quadratics of both internalizing and externalizing symptoms were significant. Furthermore, the results show in neighborhoods with higher levels of economic disadvantage, the initial level of children’s internalizing symptoms was higher, and the trend of internalizing symptoms was a steeper decrease. Children in neighborhoods with a higher level of social cohesion had a lower initial level of both internalizing and externalizing symptoms. In communities with a higher level of social cohesion, children’s initial level of externalizing symptoms was lower, and the trend of externalizing symptoms was a steady decrease.

Conclusion: This study captured the co-development and cross-domain relations of internalizing and externalizing symptoms from early childhood to adolescence and the long-term influences of different neighborhood factors on such trajectories, which enriches the understanding of child behavioral problems from a neighborhood perspective. Because children’s exposure to neighborhoods featuring high economic disadvantage is pervasive, living in such neighborhoods brings substantial risk regarding internalizing symptoms. Therefore, policies and interventions that reduce neighborhood poverty are needed urgently. Moreover, urban design and land use should also be considerate about improving the positive influences of social cohesion on future residents. More community activity spaces that help promote connections among residents can benefit child health and well-being.