Articles
Early Preschool Predictors of Preadolescent Internalizing and Externalizing DSM-IV Diagnoses

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ABSTRACT

Objective

To investigate the independent predictive value of parent-reported psychopathology and family risk factors in early preschool in relation to parent-reported internalizing and externalizing psychopathology in preadolescence.

Method

Subjects were participants in a longitudinal study of 420 two-to three-year-olds from the general population of Zuid-Holland, the Netherlands, which started in 1989. At a second follow-up 8 years later (ages 10–11 years), 358 children participated. For this study, 332 children were included for whom DSM-IV diagnoses (derived from the Diagnostic Interview Schedule for Children-Version 4-Parent Version) were obtained at age 10 to 11 years. Preschool risk factors were obtained through the Child Behavior Checklist for ages 2 to 3 years and a parent interview.

Results

Early preschool internalizing and externalizing problems were predictive of their DSM-IV counterparts 8 years later, independent of the influence of early parent-reported family risk factors. Preschool child physical problems were independently predictive of both internalizing and externalizing diagnoses in preadolescence. Of the environmental risk factors, only stressful life events contributed independently to the prediction of later externalizing problems.

Conclusions

Early adverse family circumstances and parenting characteristics do not contribute to the prediction of later psychopathology once child characteristics are accounted for.

Section snippets

Sample and Procedure

A more detailed description of the sample and procedure can be found elsewhere (Mesman and Koot, 2000a, Mesman and Koot, 2000b). The procedures for all three times of assessment were approved by the medical-ethical committee of the Erasmus University Rotterdam/University Hospital Dijkzigt.

Subjects were participants in the second follow-up of a longitudinal study of preschool children from the general population (Koot et al., 1997, Koot and Verhulst, 1991). The original time 1 sample of

Psychopathology at Time 3

As shown in Table 1, at time 3, 22.3% of the sample met criteria for one or more parent-reported DSM-IV diagnoses (N = 74). Prevalence rates for any internalizing and externalizing diagnosis were similar (13.3% and 12.0% respectively). The most prevalent diagnoses were specific phobia (9.0%), attention-deficit/hyperactivity disorder-inattentive type (6.0%), and oppositional defiant disorder (4.8%). Furthermore, 27 boys and 29 girls received a single diagnosis, 8 boys and 6 girls had two

DISCUSSION

This study reported the independent predictive value of early preschool child and family risk factors regarding internalizing and externalizing DSM-IV diagnoses in preadolescence obtained from parent report. The 1-year prevalence of DSM-IV diagnoses found in our study (22.3%) is slightly higher than in other studies, which report overall prevalences of diagnoses ranging from 17.6% to 21.4% in preadolescent samples (Anderson et al., 1987, Kashani et al., 1989, Velez et al., 1989). These studies

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    This study was supported by grant 224 from the Sophia Foundation for Medical Research.

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