ruor.uottawa.ca Revi… · Web viewThis study examined longitudinal pathways through three domains of adjustment from ages 4-5 to 14-15 (internalizing problems, externalizing problems,

Running head: DEVELOPMENTAL CASCADES AND ADOLESCENT DEPRESSION

Developmental Pathways linking Childhood and Adolescent Internalizing, Externalizing,

Academic Competence, and Adolescent Depression

DEVELOPMENTAL CASCADES AND ADOLESCENT DEPRESSION

Abstract

This study examined longitudinal pathways through three domains of adjustment from ages 4-5

to 14-15 (internalizing problems, externalizing problems, and academic competence) towards

depressive symptoms at age 16-17. Participants were 6,425 Canadian children followed bi-

annually as part of the National Longitudinal Study of Children and Youth. Within-domain (i.e.,

stability) effects were moderate in strength. We found longitudinal cross-domain effects across

one time point (i.e., one-lag cascades) between internalizing and externalizing in early childhood

(positive associations), and between academic competence and externalizing in later childhood

and adolescence (negative associations). We also found cascade effects over multiple time points

(i.e., multi-lag cascades); lower academic competence at age 4-5 and greater internalizing at age

6-7 predicted greater age 12-13 externalizing, and greater age 6-7 externalizing predicted greater

age 16-17 depression. Important pathways towards adolescent depression include a stability path

through childhood and adolescent internalizing, as well as a number of potential paths involving

all adjustment domains, highlighting the multifactorial nature of adolescent depression.

Keywords: depression, longitudinal, cascades, internalizing, externalizing, academic

competence

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Recent research in developmental psychopathology suggests that three general domains of

adaptation are of particular importance in understanding child and adolescent adjustment:

internalizing problems (or internalizing; i.e., anxiety, depression), externalizing problems (or

externalizing; i.e., conduct problems, aggression), and academic competence (e.g., school

grades, test scores) (Bornstein, Hahn, & Suwalsky, 2013; Burt & Roisman, 2010; Masten et al.,

2005; Moilanen, Shaw, & Maxwell, 2010; Obradovic, Burt, & Masten, 2010; Vaillancourt,

Brittain, McDougall, & Duku, 2013). Problems in one domain of adaptation may beget problems

in other domains (Masten, 2006), potentially starting a chain reaction of subsequent problems—

a set of processes referred to most commonly as developmental cascades (Masten & Cicchetti,

2010).

The associations among internalizing, externalizing, and academic competence may be

particularly important for understanding the development of depression, which typically has its

earliest onset in mid-to-late adolescence (Kessler & Bromet, 2013) and represent one of the most

common psychiatric problems experienced during this age period (Thapar, Collishaw, Pine, &

Thapar, 2012). Indeed, prospective studies have positively linked internalizing (Reinherz,

Paradis, Giaconia, Stashwick, & Fitzmaurice, 2003), externalizing (Chronis-Tuscano et al.,

2010) in childhood with adolescent depression. Other research suggests a negative association

between school grades and depression in adolescence (Frojd et al., 2008) and protective effects

of higher IQ in childhood against adolescent depression (Glaser et al. 2011; Harpur et al. 2015).

Therefore, adolescent depression may be seen as a natural extension of the co-

development of internalizing, externalizing, and academic competence. Nevertheless, although a

number of studies have examined the longitudinal inter-associations among these domains of

adaptation, both within domains (i.e., continuity effects) and across domains (i.e., cascade

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effects) (Bornstein et al., 2013; Burt & Roisman, 2010; Masten et al., 2005; Moilanen et al.,

2010; Obradovic et al., 2010; Vaillancourt et al., 2013), no studies have examined adolescent

depressive symptoms as an outcome in developmental cascades models. Previous research has

also focused on one-lag cascade effects (i.e., cascade effects separated by only one time point).

However, it is also important to test higher-order (i.e., multi-lag) effects in order to examine the

unique contribution of early adjustment domains on later adjustment. Indeed, socio-emotional

adjustment early in life has been shown to have a significant impact on adolescent adjustment,

including adolescent depression (Chronis-Tuscano et al., 2010).

Previous Findings

The existing research suggests the relationships among internalizing, externalizing, and

academic competence are complex, involving bidirectional and transactional effects over time. It

has been suggested that externalizing interferes with academic competence, which in turn may

lead to greater internalizing (Patterson & Capaldi, 1990). Indeed, a handful of developmental

cascades studies have found evidence in favor of this pattern (Masten et al., 2005; Moilanen et

al., 2010; Obradovic et al., 2010; van Lier et al., 2012). However, in addition to externalizing,

Moilanen et al. (2010) have argued that internalizing may interfere with academic competence,

which then can negatively impact other domains of adjustment. Indeed, some research has shown

associations from early internalizing to subsequent externalizing (Englund & Siebenbruner,

2012) as well as subsequent math and reading ability (Grover, Ginsburg, & Ialongo, 2007).

Lower academic competence may also undermine subsequent externalizing problems, in that

students showing lower performance may be placed in classrooms with more problem behaviors,

which could increase their own externalizing behaviors (Moilanen et al., 2010). In fact, there is

evidence of negative cascade effects from standardized test scores to subsequent externalizing

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(Burt & Roisman, 2010; Englund & Siebenbruner, 2012; Moilanen et al., 2010; Vaillancourt et

al., 2013).

Limitations of existing cascades research. Developmental cascade modeling is a robust

and conservative approach, allowing for specific cascade effects while controlling for cross-

sectional correlations between domains and continuity effects within domains (Bornstein, Hahn,

& Haynes, 2010). However, there are several limitations in the existing literature. First and

foremost, developmental cascades research typically includes relatively small samples, typically

with fewer than 300 participants (Masten et al., 2005), and no such studies have included

samples that are representative of the larger population. Thus, the use of population surveys can

greatly enhance the generalizability of findings and overcome the limitations of using small,

highly variable, and unrepresentative samples.

Second, in order to understand the complex developmental pathways among these

domains over time, it is important to examine cascade effects from childhood through to

adolescence with the inclusion of multiple time points. However, studies using time points in

close proximity have included only three or four time points and age ranges of three or four years

during either childhood (van Lier et al., 2012) or early adolescence (Vaillancourt et al., 2013).

Moreover, research following children through adolescence and into adulthood has included only

four time points that are spaced at seven, three, and ten years apart (Masten et al., 2005;

Obradovic et al., 2010). Such large gaps between time points suggest that continuity effects may

be under-controlled in modeling.

Third, research suggests boys exhibit greater externalizing (Baillargeon et al., 2007)

while girls exhibit greater internalizing (Lewinsohn, Gotlib, Lewinsohn, Seeley, & Allen, 1998)

as well as higher rates of adolescent depression (Wade, Cairney, & Pevalin, 2002). However,

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existing studies have either not examined gender (Moilanen et al., 2010) or have only tested

overall gender invariance of cascade models rather than examining gender invariance of specific

longitudinal effects (Burt & Roisman, 2010; Masten et al., 2005; Vaillancourt et al., 2013). In

fact, overall gender invariance between models does not preclude gender non-invariance of

particular pathways, which may have important research implications.

Finally, it is important to determine whether associations observed among domains of

adjustment are robust to the inclusion of possible confounders. However, developmental cascade

studies have typically examined only a small number of additional covariates, most commonly

child IQ/cognitive function, parenting factors, and socio-economic status (Bornstein et al., 2010;

Burt & Roisman, 2010; Masten et al., 2005; Moilanen et al., 2010), while others have not

examined any control variables (van Lier et al., 2012). Past research suggests several other

possible confounders, including maternal depression (Leve, Kim, & Pears, 2005) family

environment (Leve et al., 2005), stressful life events (Cheung, Harden, & Tucker-Drob, 2014)

and childhood physical health problems (Mesman & Koot, 2001).

The Current Study

The purpose of the current study was to examine the relationships among internalizing,

externalizing, and academic competence from age 4-5 to 14-15, and depressive symptoms at age

16-17, in a large and representative sample of Canadians. We expected to find positive continuity

effects from age 4-5 to 14-15, based on previous research (Burt & Roisman, 2010; Englund &

Siebenbruner, 2012; Masten et al., 2005; van Lier et al., 2012). Findings from previous studies

regarding one-lag effects are inconsistent, with only mixed support for specific models and most

studies suggesting more complicated effect patterns. However, based on the findings of previous

studies (Masten et al., 2005; Moilanen et al., 2010), we expected internalizing and externalizing

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to be positively associated cross-sectionally and longitudinally. We also expected internalizing

and externalizing to exhibit negative cross-sectional and longitudinal associations with academic

competence, based on previous research (Masten et al., 2005; Moilanen et al., 2010; Obradovic

et al., 2010; van Lier et al., 2012). Whereas multi-lag effects have not been included in similar

cascades studies, one recent study found a multi-lag effect from early externalizing to adolescent

depression (Nilsen et al., 2013). Thus, our examination of cascade effects among internalizing,

externalizing, and academic competence in the current study was exploratory, particularly with

regards to multi-lag paths.

Although our tests of effects predicting depressive symptoms at age 16-17 were also

exploratory, we expected internalizing at age 14-15 to be positively associated with adolescent

depressive symptoms, due to the conceptual overlap between these measures. Also, in line with

previous research, we anticipated positive cascade effects from externalizing, and negative

cascade effects from academic competence, to adolescent depressive symptoms (Chronis-

Tuscano et al., 2010; Frojd et al., 2008; Reinherz et al., 2003).

Method

Study Population

Participants were from the National Longitudinal Survey of Children and Youth

(NLSCY), a nationally representative prospective study of Canadians from 1994/1995 until

2008/2009 (Statistics Canada and Human Resources and Skills Development Canada, 2009). Our

sample included 6,425 children (3144 girls; 3281 boys) who were age 4-5 in either 1994/95 or

1996/97, followed every two years across seven waves. Additional demographic details have

been reported elsewhere (Findlay, Garner, & Kohen, 2013).

Procedure

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Measures of internalizing, externalizing, and academic competence were available every

two years from age 4-5 until age 14-15. Additionally, a measure of self-reported depressive

symptoms was available at age 16-17. Informed consent was provided by the Person Most

Knowledgeable (PMK) about the child, who was the mother in roughly 90% of cases. All

measures were assessed via computer-assisted face-to-face interviews, with the exception of

measures of academic competence (see below). The current study received ethical approval from

the Ottawa Health Science Network Research Ethics Board.

Measures

Internalizing and externalizing. Internalizing and externalizing were assessed using

items assessing symptoms of anxiety/depression (7 items; e.g., “My child seems to be unhappy,

sad or depressed,” “My child is too fearful or anxious”) and physical aggression/conduct

problems (7 items; e.g., “My child gets into many fights,” “My child threatens people”) on a

scale from 0 (never) to 2 (often). The items were derived from the Ontario Child Health Study

(OCHS-R) (Boyle et al., 1987) and the Child Behavior Checklist (CBCL) (Achenbach &

Edelbrock, 1981) with the intent of operationalizing DSM-III disorders (Boyle et al., 1993).

From ages 4 to 11, the PMK reported on these symptoms. From ages 12 to 15, the child self-

reported on the same set of items, albeit with slightly different wording (e.g., “I am unhappy or

sad,” “I get into many fights”). Subscale items were summed to create total scores ranging from

0 to 14, with Cronbach’s alphas between 0.79 and 0.81 across all cycles of the NLSCY

(Statistics Canada and Human Resources and Skills Development Canada, 2002, 2008).

Academic competence. Children aged 4-5 completed the Peabody Picture Vocabulary

Test- Revised (PPVT-R) (Dunn & Dunn, 2006), which assesses verbal ability and scholastic

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aptitude. The interviewer administered the test in the child’s home. The child was asked to

identify pictures corresponding to the word the interviewer read out.

Under the supervision of their teacher, children age 6-7 through 14-15 completed a

Mathematics Computation Test (MCT), a shortened version of the MCT component of the

Canadian Achievement Tests (CAT/2) that measures understanding of addition, subtraction,

multiplication, and division of whole numbers. For the PPVT-R and MCT, standard scores were

calculated based on norm samples from across Canada (Statistics Canada and Human Resources

and Skills Development Canada, 1998).

Adolescent depressive symptoms. Adolescents aged 16-17 completed a 12-item version

of the Center for Epidemiologic Studies Depression scale (CES-D) (Radloff, 1977, 1991).

Respondents were asked the following question: “How often have you felt or behaved this way

during the past week (7 days)?”, and rated each item (e.g., “I felt depressed”) on a scale from 0

(rarely or none of the time) to 3 (most or all of the time). Items were summed to create a total

depression score, with scores ranging from 0 to 36. A Cronbach’s alpha of 0.83 was reported in

cycle 8 of the NLSCY (Statistics Canada and Human Resources and Skills Development Canada,

2008).

Additional covariates. A number of covariates were measured at baseline (age 4-5).

Socioeconomic status (SES) was measured with a ratio of household income adjusted for the

low-income cut off, which considers an individual’s income relative to the community in which

they live and the size of their family (Cotton, 2001).

The PMK reported on statements addressing aspects of family functioning such as

problem solving, communications, and affective involvement (12 items; e.g., “We don’t get

along well together”). The PMK indicated the degree to which each item describes their family

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on a scale from 0 (strongly disagree) to 3 (strongly agree), with scores ranging from 0 to 36 and

higher total scores indicating greater family dysfunction.

The PMK completed an adapted version of the Parent Practices Scale (Strayhorn &

Weidman, 1988) to rate the degree to which they engaged in hostile parenting (7 items; e.g.,

“how often do you get angry when you punish your child?”). Items were rated on a scale from 0

(never) to 4 (many times each day), with scores ranging from 0 to 28.

The PMK was asked the following question to assess the presence of a chronic illness in

their child: “Does [child] have any of the following long-term conditions that have been

diagnosed by a health professional”? (16 conditions; e.g., diabetes, high blood pressure).

Two additional variables were used as time-varying covariates (measured at baseline

through age 14-15). The PMK completed the same short version of the CES-D (Radloff, 1977,

1991) as completed by children at age 16-17, as a measure of maternal depression. Also, the

PMK reported whether their child had experienced any of 14 stressful life events (SLEs) (e.g.,

death of a family member). Previous research indicates that two or more childhood traumatic and

stressful events are particularly predictive of adolescent depression compared to one event or no

events (Colman et al., 2013). We thus dichotomized this variable such that the presence of two or

more SLEs indicated ‘high stress’.

Statistical Analysis

Structural equation modeling was used to examine the associations among internalizing,

externalizing, and academic competence over time. Three models were compared in terms of

relative fit, starting with the most constrained (i.e., most parsimonious). In all models, cross-

sectional correlations (i.e., cross-domain associations at each time point) were estimated. Model

1 (autoregressive model) included cross-sectional correlations at each age, as well as continuity

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paths. Due to conceptual and measurement similarity, a continuity path from internalizing at age

14-15 to depression at age 16-17 was included in these models. Model 2 (one-lag cascades

model) included paths from Model 1, with the addition of one-lag cascade paths (i.e., variables at

one time point could only predict cross-domain variables at the next time point). Model 3 (multi-

lag cascades model) included all paths in the previous models, and also included all multi-lag

cascade paths.

Models were fitted using Mplus Version 6 (Muthén & Muthén, 1998-2010). Relative fit

of models was assessed using a scaled chi-square difference test (Satorra & Bentler, 2001).

Absolute model fit was evaluated using the comparative fit index (CFI), with values > .90

indicating acceptable fit and values > .95 indicating a close fit (Hu & Bentler, 1999), the root

mean square error of approximation (RMSEA), with values < .05 indicating a good fit

(MacCallum, Browne, & Sugawara, 1996), and the standardized root mean square residual

(SRMR), with values < .08 indicating a good fit (Hu & Bentler, 1998). Missing data were

handled using full information maximum likelihood (FIML) estimation under a missing at

random (MAR) assumption.

Survey responses were weighted using sampling weights provided by Statistics Canada.

These weights have been adjusted to account for non-response at each cycle, resulting in

representativeness among responders and non-responders (Statistics Canada and Human

Resources and Skills Development Canada, 2008). In order to accommodate the use of these

sampling weights, as well as to account for non-normal data, MLR estimators with robust

standard errors were used in model estimation.

Following previous cascades research (Vaillancourt et al., 2013; van Lier et al., 2012),

overall gender invariance of cascade paths in Model 3 was tested by comparing a model with all

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one-lag and multi-lag paths constrained to be equal across gender to an unconstrained model.

Model 3 was then examined separately for boys and girls to identify potential non-invariance of

significant cascade paths. Finally, scaled chi-square tests were used to compare a constrained

model (i.e., gender-specific path constrained across gender) to an unconstrained model for each

path of interest.

Finally, in order to test the robustness of observed paths in Model 3, the model was

examined with the inclusion of covariates. Indeed, FIML is optimized with the inclusion of

additional variables. All observed variables were regressed on baseline covariates, and observed

variables at each age were regressed on the two time-varying covariates measured at that age

(with those at age 14-15 in the case of depression at age 16-17).

Results

Preliminary Analysis

Descriptive statistics for the main study variables are presented in Table 1. As shown, the

number of responses decreases at each subsequent time point. We examined the degree to which

dropout was associated with study covariates as well as the main cascade variables. Results

indicated that dropout was associated with the presence of a chronic illness (OR = 1.17; 95% CI:

1.00, 1.37) and 2 or more SLEs (OR = 1.59, 95% CI: 1.13, 2.25), as well as lower SES (b = -

0.12, SE = 0.03, p < .0001) and less hostile parenting (b = -0.08, SE=0.11, p < .0001), at

baseline. Also, greater academic competence at age 4-5 was negatively associated with dropout

(OR = 0.98, 95% CI: 0.96, 0.99).

Cascade Analysis

Results for structural equation models are presented in Table 2. Results indicated that the

‘one-lag cascades’ model (Model 2) showed a significant improvement in fit over the

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‘autoregressive’ model (Model 1). However, the ‘multi-lag cascades’ model (Model 3) showed a

significant improvement in fit as compared to Model 2. Model 3 also had acceptable absolute fit

statistics, and was thus chosen as the best fitting model.

Significant cross-sectional correlations among variables are shown in Table 3.

Internalizing and externalizing were positively correlated at each time point, whereas

externalizing and academic competence were negatively correlated at ages 12-13 and 14-15.

Internalizing and academic competence were only correlated cross-sectionally at age 12-13.

Figure 1 shows the standardized path coefficients for all significant pathways in Model 3.

All continuity effects within each domain were positive and significant. A number of significant

one-lag cascade effects were identified. Greater internalizing at age 4-5 predicted greater

externalizing at age 6-7 and greater externalizing at age 4-5 predicted greater internalizing at age

6-7. Academic competence negatively predicted externalizing from age 8-9 to age 10-11, and

from age 10-11 to 12-13. Externalizing at age 8-9 negatively predicted academic competence at

age 12-13. Externalizing at age 12-13 negatively predicted academic competence at age 14-15

and positively predicted depression at age 16-17.

A number of multi-lag cascades were also identified. Greater age 4-5 internalizing

predicted greater academic competence at age 10-11, greater age 6-7 externalizing predicted

greater depression at age 16-17, and lower age 4-5 academic competence predicted greater

internalizing and externalizing at age 12-13.

The gender-constrained model had a significantly worse fit than the unconstrained model

(∆χ2=161.79 (118), p= .005), suggesting overall gender non-invariance. Gender-stratified models

indicated that four paths remained significant only for girls, while four paths remained

significant only for boys. Constrained versus unconstrained models were examined for each

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apparent gender-specific path (see Table 4). In two cases, the constrained model provided a

significantly worse fit, suggesting gender non-invariance. Specifically, the path from

externalizing at age 12-13 to depression at age 16-17 was found to be stronger among girls,

while the path from internalizing at age 8-9 to externalizing at age 12-13 was found to be

stronger among boys. These two paths are noted in Figure 1 (the G superscript).

Finally, Model 3 was examined with the inclusion of baseline and time-varying

covariates (Model 4). This model showed an acceptable absolute fit (CFI= 0.926; RMSEA=

0.020; SRMR= 0.03), and all significant paths from Model 3 remained significant. However,

Model 4 also had a relatively poor fit compared to Model 3 (∆χ2=245.20 (192), p= .006) and thus

Model 3 was retained as the final model. However, for contextual purposes, significant pathways

involving additional covariates from Model 4 are presented in Supplemental Table 1.

Discussion

We used a representative sample of Canadians to examine developmental cascade

pathways among externalizing, internalizing, and academic competence from age 4-5 to age 14-

15 in the prediction of age 16-17 adolescent depressive symptoms. We identified unique effects

of early adjustment on later adjustment, while controlling for significant cross-sectional

correlations and continuity effects. These effects were also robust to the inclusion of a large

number of additional covariates. Our findings add to the growing evidence of complex inter-

associations among these domains in childhood and adolescence, as well as their role in

predicting adolescent depressive symptoms.

Continuity Paths

Significant continuity paths were consistent with previous research showing the relative

stability of internalizing and externalizing in early childhood and adolescence (Pianta &

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Caldwell, 1990; Reitz, Dekovic, & Meijer, 2005) and of academic achievement in later

childhood (Feshbach & Feshbach, 1987), as well as previous developmental cascade studies

(Bornstein et al., 2010; Englund & Siebenbruner, 2012; Vaillancourt et al., 2013; van Lier et al.,

2012). These results highlight the central role of previous adjustment in each of these domains of

development in predicting later adjustment in the same domain.

Cascade Paths

Internalizing and externalizing. Several significant cascade paths were also identified.

Internalizing and externalizing showed reciprocal positive effects between age 4-5 and 6-7,

consistent with previous studies examining the co-development of internalizing and externalizing

(Gilliom & Shaw, 2004). A possible explanation is that internalizing and externalizing in early

childhood are being driven by common factors, such as high negative emotionality (Gilliom &

Shaw, 2004). Additionally, our subsequent examination of covariates indicated that greater

hostile parenting predicted greater internalizing and externalizing at age 4-5, suggesting that both

factors might be driven by parent-child interactions. In fact, previous research has shown that

increases in negative parenting are associated with the development of internalizing and

externalizing throughout childhood (Braza et al., 2015). These findings add to previous cascades

research, wherein almost no studies have followed children any earlier than age 6 and thus have

been unable to examine these pathways.

Greater internalizing at age 6-7 predicted greater externalizing at age 12-13. Although

this findings is consistent with effects shown in one previous cascades study (Bornstein et al.,

2010), most similar studies have not shown longitudinal associations from internalizing to

externalizing. Importantly, the current study included an examination of multi-lag effects. It is

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not clear whether similar effects from internalizing to externalizing would have been found in

previous research if such effects had been examined.

Externalizing and academic competence. We also found negative cascade effects

between academic competence and externalizing in from age 8-9 to age 12-13. These findings

are consistent with some previous cascades research (Englund & Siebenbruner, 2012; Moilanen

et al., 2010; van Lier et al., 2012). However, our findings also highlight the potential importance

of academic success as a protective factor against antisocial behavior beyond childhood. The

bidirectional nature of these effects supports the findings of one cascades study with a similar

age range as in the current study (Moilanen et al., 2010). Notably, lower academic competence at

age 4-5 predicted greater externalizing at age 12-13. Although there were no cross-sectional

associations between these variables before age 12-13, there may be lingering effects of early

cognitive problems on behavior problems many years later. Also, our subsequent analysis of

covariates showed that lower SES at age 4-5 predicted lower academic competence at age 4-5

and age 12-13 as well as greater internalizing and externalizing at age 12-13, which supports past

research (Letourneau, Duffett-Leger, Levac, Watson, & Young-Morris, 2013). Therefore, this

finding may reflect a more overarching effect of economic disadvantage.

Internalizing and academic competence. Lower academic competence at age 4-5 also

predicted greater internalizing at age 12-13, which is consistent with a recent study showing

protective effects of childhood IQ on depressive symptoms in early adolescence (Glaser et al.,

2011) and which might explained by previously mentioned socioeconomic factors. In contrast,

we found no evidence that internalizing interfered with academic competence, consistent with

some cascades studies (Masten et al., 2005; Vaillancourt et al., 2013; van Lier et al., 2012). As

suggested by Masten and colleagues (Masten et al., 2005), internalizing might only interfere with

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academic outcomes for those in the clinical range of internalizing symptoms. The only

significant cascade path from internalizing to academic competence was a positive association

from age 4-5 to age 10-11. One possible explanation is that children with elevated internalizing

symptoms are more likely to worry about academic performance, which could potentially result

in more diligent school work and, in turn, greater subsequent academic achievement. However,

this result contradicts previous research showing a negative association between internalizing

and academic achievement in childhood (Rapport, Denney, Chung, & Hustace, 2001) and may

reflect our use of different measures of academic competence, as well as a younger age range,

than in previous research.

Cascades predicting adolescent depression. Greater externalizing at age 6-7 predicted

greater depression at age 16-17, consistent with research showing that aggressive behavior in

childhood predicts greater odds of mood disorders 14 years later (Hofstra, van der Ende, &

Verhulst, 2002), as well as a recent study that showed a direct link from externalizing at age 4.5

to depressive symptoms in adolescence (ages 14.5 – 16.5), over and above the effects of

internalizing and maternal distress (Nilsen et al., 2013). These authors suggest that this effect

might be due to externalizing behavior becoming increasingly non-normative through childhood,

as evidenced by trajectories research (Cheung et al., 2014). However, apart from the gender-

modified path from age 12-13, our findings suggest that externalizing in later childhood and

adolescence were not predictive of subsequent adolescent depressive symptoms, also mirroring

the findings of Nilsen and colleagues (2013). One possible explanation is that delinquency is

more normative during adolescence than in childhood (Moffitt, Caspi, Harrington, & Milne,

2002), as noted by Nilsen et al. (2013).

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Due to the large number of possible indirect pathways, such pathways were not tested in

the current study. However, the pattern of findings suggests that adolescent depression can be the

end result of a number of indirect pathways, which highlights the concept of equifinality (i.e., the

same effect resulting from a number of different events) (Cicchetti & Rogosch, 1996), and

reinforces the notion that adolescent depression is a multifactorial phenomenon. However, our

findings also suggest that externalizing at 12-13 may be particularly important in terms of

understanding the associations among these variables. It is worth noting that this age period

coincides with the transition to middle school and the onset of puberty. Middle school transition

is known to be a potentially stressful period often marked by changes in peer relationships

(Hirsch & Rapkin, 1987), distress levels (Crockett, Peterson, Graber, Schulenberg, & Ebata,

1989), and academic achievement (Simmons & Blyth, 1987), all of which could negatively affect

child adjustment. Also, children who mature sooner are more likely to exhibit externalizing,

possibly as a result of affiliation with delinquent peers (Ge, Brody, Conger, Simons, & Murry,

2002).

Gender differences

Two paths were shown to vary by gender. First, although greater internalizing at age 8-9

predicted lower age 12-13 externalizing, this path was stronger among boys, consistent with

previous studies showing similar effects (Masten et al., 2005). In fact, other studies have found

similar effects in male-only samples (Kerr, Tremblay, Pagani, & Vitaro, 1997) or have found this

effect only among boys (Mesman, Bongers, & Koot, 2001). As has been suggested (Moilanen et

al., 2010), this negative association may be due to the potentially attenuating effect of inhibition

on risk-taking behaviors, which are more typical among males (Byrnes, Miller, & Schafer,

1999). Second, greater externalizing at age 12-13 predicted greater depression at age 16-17, but

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was stronger among girls. This result is consistent with the idea of the “gender paradox” effect

(Loeber & Keenan, 1994), where gender non-normative behaviors such as physical aggression in

girls are proposed to result in poorer outcomes. Also, one previous study showed that anger

expression was related to depressed mood among girls, but not boys (Clay, Hagglund, Kashani,

& Frank, 1996). There is also a well-documented gender divergence in the prevalence of

depression at age 14 (Wade et al., 2002), and our findings highlight a possible mechanism

underlying this gender difference.

Limitations

This study had a number of important limitations that are noteworthy. First, measures of

childhood externalizing and internalizing were completed by parents until age 10-11, and were

subsequently self-reported. Also, academic competence was measured with the PPVT-R at age

4-5 and with the MCT subsequently, and these measures may not be comparable to each other.

Although all continuity paths were significant for each adjustment domain, these differences in

construct measurement may have weakened continuities within domains, as can be seen by the

relatively smaller path coefficients between ages 4-5 to 6-7 for academic competence and

between age 10-11 and 12-13 for internalizing and externalizing. Differences in construct

measurement may also have affected the consistency of cascade effects in the current study.

Second, the measures of academic competence in the current study were limited to standardized

measures of verbal ability and math ability. Although standardized measures have been included

in other cascades research (Burt et al., 2010; Masten et al., 2005), this same research also

included additional measures of achievement such as school grades. Thus, some caution is need

in comparing our results to those of previous cascades studies. Third, the chance of Type I errors

is increased due to the large number of associations tested.

19


Contributions

Despite these limitations, our study also contributed to the existing literature in a number

of important ways. First, we used a large and nationally representative sample, giving our results

greater generalizability than those of previous research that included much smaller and less

representative samples. Ours is also among the very few studies that have examined these

adjustment domains from early childhood into adolescence. This allowed for the examination of

direct longitudinal effects over multiple time points. Although the focus of developmental

cascades research has been on one-lag cascade effects, our identification of multi-lag effects

suggests these may be important components of cascade models that are generally overlooked.

Implications

Finally, our findings have implications for intervention programs that may impact

adolescent outcomes such as depressive symptoms. We identified not only stable adjustment

domains, but also unique effects on adjustment several years later, highlighting the potential

long-term impact of early childhood interventions. In particular, early targeting of externalizing

may have beneficial effects on the risk of depression in adolescence. Also, the presence of

complex associations among domains suggests that multiple areas of adjustment should be

jointly targeted in such programs.

20


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Table 1 Means (SDs) or Proportions of Internalizing, Externalizing, Academic Competence, Depressive Symptoms, and Maternal Depression, 1 Stressful Life Event, 2 or More Stressful Life Events, Family Dysfunction, Hostile Parenting, Presence of a Chronic Illness, and Socioeconomic Status

Time point(age in years)

# of cases Int Ext Acad Dep Mat Dep 1 SLE ≥ 2

SLEsFamily

DysfuncHostile

ParChronic Illness SES

1 (4-5) 6425 2.10(2.2)

1.61(2.0)

99.24(15.2)

— 4.74(5.2)

20.02 2.99 8.12 (5.2)

9.08 (3.7)

36.71 1.78(1.2)

2 (6-7) 4939 2.49(2.5)

1.40(1.8)

311.6(48.0)

— 4.48(5.4)

19.22 2.41 — — — —

3 (8-9) 4645 2.64(2.5)

1.31(1.8)

364.6(56.3)

— 4.28(5.5)

18.54 1.95 — — — —

4 (10-11) 4281 2.51(2.4)

1.16(1.7)

439.0(57.2)

— 3.96(5.3)

19.24 1.49 — — — —

5 (12-13) 3975 3.30(2.7)

1.05(1.8)

494.8(70.0)

— 3.67(5.0)

17.93 1.91 — — — —

6 (14-15) 3741 3.39(2.8)

1.01(1.7)

578.0(91.9)

— 3.67(5.1)

16.25 2.12 — — — —

7 (16-17) 3539 — — — 8.04 (5.84)

— — — — — — —

Int = Internalizing; Ext = Externalizing; Aca = Academic Competence; Dep = Depressive symptoms; Mat Dep = Maternal Depression; SLE = Stressful Life Events; Family Dysfunc = Family Dysfunction; Hostile Par = Hostile Parenting; SES = Socioeconomic Status.

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Table 2 Nested Model Comparisons and Fit Statistics

Path analyses Difference test of relative fit Absolute fit statistics

Model df c χ2 Comp. cd ∆χ2 ∆df p CFI RMSEA SRMR

1 135 3.070 798.24 2 vs. 1 3.256 92.20 30 .000 .892 .028 .0742 105 3.017 712.77 3 vs. 2 3.068 100.86 70 .009 .901 .030 .0623 35 2.916 631.36 .903 .052 .055

c = weighting constant for computing the chi-square statistic using the robust estimation method; Comp. = model comparison; cd = weighting constant for the difference between two chi-square statistics using the robust estimation method; CFI = Comparitive Fit Index; RMSEA = Root Mean Square Error of Approximation; SRMR = Standardized Root Mean Square Residual.

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Table 3

Significant cross-sectional associations for the final model (Model 3)

Time point(age in years)

Estimated Path β SE p

1 (4-5) Int1 Ext1 0.36 0.02 .000

2 (6-7) Int2 Ext2 0.35 0.02 .000

3 (8-9) Int3 Ext3 0.31 0.03 .000

4 (10-11) Int4 Ext4 0.34 0.04 .000

5 (12-13) Int5 Ext5 0.30 0.30 .000Int5 Aca5 -0.07 0.03 .045Ext5 Aca5 -0.09 0.03 .002

6 (14-15) Int6 Ext6 0.23 0.03 .000Ext6 Aca6 -0.10 0.03 .000

Ext = Externalizing; Int = Internalizing; Aca = Academic Competence.

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Table 4

Model 3 comparisons for gender analysis

Gender-specific pathwaysPath-specific gender invariance tests

cd ∆χ2 ∆df p

Significant paths among girls only:

Ext1 Int2 3.05 1.16 1 .281

Int1 Ext1 3.05 0.57 1 .450

Aca1 Int5 2.77 1.89 1 .170

Ext5 Dep7 2.11 62.26 1 .000

Significant paths among boys only:

Ext2 Dep7 2.98 0.35 1 .556

Ext5 Aca6 2.20 1.15 1 .283

Aca4 Ext5 2.70 0.25 1 .614

Int3 Ext5 1.63 7.21 1 .007

Ext = Externalizing; Int = Internalizing; Aca = Academic Competence; Dep = Depressive symptoms. Numbers denote time point (1= age 4-5; 2 = age 6-7; 3 = age 8-9; 4 = age 10-11; 5 = age 12-13; 6 = age 14-15; 7 = age 16-17).

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Supplemental Table 1

Significant pathways involving additional covariates from Model 4

Estimated Path β SE p

Hostile parenting Ext1 0.43 0.02 .000SLEs Ext1 0.35 0.02 .000

Chronic condition Int1 0.11 0.03 .000Hostile parenting Int1 0.31 0.02 .000

Maternal depression Int1 0.17 0.03 .000SLEs Int1 0.08 0.02 .000SES Aca1 0.22 0.03 .000

Family dysfunction Aca1 -0.09 0.02 .000Maternal depression Aca1 -0.07 0.03 .000

SES Ext2 -0.05 0.02 .000Hostile parenting Ext2 0.09 0.02 .000

Maternal depression Ext2 0.12 0.03 .000SLEs Ext2 0.05 0.02 .015

Maternal depression Int2 0.21 0.02 .000SLEs Int2 0.08 0.02 .000

Chronic condition Aca2 0.18 0.06 .002Hostile parenting Ext3 0.12 0.02 .000

Maternal depression Ext3 0.09 0.02 .000Hostile parenting Int3 0.07 0.03 .016

Maternal depression Int3 0.14 0.03 .000SLEs Int3 0.05 0.02 .003

Hostile parenting Ext4 0.10 0.03 .000Maternal depression Ext4 0.08 0.03 .019

Hostile parenting Int4 0.10 0.03 .000Maternal depression Int4 0.16 0.03 .000

SLEs Int4 0.09 0.04 .012SES Ext5 -0.04 0.02 .046

Maternal depression Ext5 0.07 0.03 .013SES Int5 -0.08 0.02 .000

SES Aca5 0.06 0.02 .006Maternal depression Ext6 0.06 0.03 .015Maternal depression Int6 0.13 0.03 .000Chronic condition Aca6 -0.09 0.02 .008

Maternal depression Dep7 0.09 0.03 .007

Ext = Externalising problems; Int = Internalising problems; Aca = Academic Competence; Dep = Depressive symptoms. Numbers denote time point (1= age 4-5; 2 = age 6-7; 3 = age 8-9; 4 = age 10-11; 5 = age 12-13; 6 = age 14-15; 7 = age 16-17).

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ruor.uottawa.ca Revi… · Web viewThis study examined longitudinal pathways through three domains of adjustment from ages 4-5 to 14-15 (internalizing problems, externalizing problems,