Abstract

BackgroundPsychopathology in childhood and adolescence, commonly indexed by co-occurring internalizing and externalizing problem behaviors, has been found to predict psychotic-like experiences (PLEs) in adults. However, studies to date have rarely examined internalizing and externalizing problem behaviors simultaneously or identified in which developmental period do these problem behaviors predict PLEs in adults. This study tests to what extent internalizing and externalizing problem behaviors in childhood (4–9 years) or adolescence (11–16 years) predict PLEs in young-adulthood (18 years). MethodsParent-rated child internalizing and externalizing problems on the Strengths and Difficulties Questionnaire at ages 4, 6, 8, 9, 11, 13, and 16 years from the Avon Longitudinal Study of Parents and Children (N = 4717) were modelled using two-piece latent growth curve modelling to predict clinician-rated PLEs at age 18 years, controlling for confounders (gender, ethnicity, socio-economic status, parental education and stressful life events) assessed prior to baseline at age 4 years. ResultsControlling for confounders, an increase in childhood internalizing problems from 4 to 9 years and externalizing problems at baseline (at 4 years) predicted PLEs at 18 years, explaining 9.5% of the variance in adult PLEs. These associations were independent to controls for any changes in adolescent internalizing and externalizing problems from 11 to 16 years. ConclusionsHigh baseline levels of externalizing problems and increasing internalizing problems throughout childhood can predict PLEs at 18 years. Externalizing problems around the transition to primary school and internalizing problems throughout childhood may be particularly helpful in informing risk of PLEs in young-adulthood.

Highlights

  • Psychotic symptoms exist in adult patients, young adults, and community youths at varying degrees of severity (Bebbington et al, 2013; Bird et al, 2017; Wong et al, 2014)

  • In this large-scale study of modelling childhood (4–9 years) and adolescent (11–16 years) trajectories of internalizing and externalizing problems simultaneously using two-piece growth modelling (2-PGM), we found that baseline externalizing problems at age 4 years and changes in internalizing problems in childhood predicted psychoticlike experiences (PLEs) at age 18 years, above and beyond baseline internalizing and changes of either type of problems in adolescence

  • These findings suggest that information about the changes in emotional problems in childhood (4–9 years) and about the level of externalizing problems as early as 4 years of age, rather than information about mental health in adolescence, has greater utility in predicting clinicianassessed psychotic-like experiences (PLEs) in young-adulthood

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Summary

Background

Psychopathology in childhood and adolescence, commonly indexed by co-occurring internalizing and externalizing problem behaviors, has been found to predict psychotic-like experiences (PLEs) in adults. Studies to date have rarely examined internalizing and externalizing problem behaviors simultaneously or identified in which developmental period do these problem behaviors predict PLEs in adults. This study tests to what extent internalizing and externalizing problem behaviors in childhood (4–9 years) or adolescence (11–16 years) predict PLEs in young-adulthood (18 years). Methods: Parent-rated child internalizing and externalizing problems on the Strengths and Difficulties Questionnaire at ages 4, 6, 8, 9, 11, 13, and 16 years from the Avon Longitudinal Study of Parents and Children (N = 4717) were modelled using two-piece latent growth curve modelling to predict clinician-rated PLEs at age 18 years, controlling for confounders (gender, ethnicity, socio-economic status, parental education and stressful life events) assessed prior to baseline at age 4 years. Conclusions: High baseline levels of externalizing problems and increasing internalizing problems throughout childhood can predict PLEs at 18 years. Externalizing problems around the transition to primary school and internalizing problems throughout childhood may be helpful in informing risk of PLEs in youngadulthood

Introduction
Participants
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Missing data
Descriptive analyses
Main findings
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