Klinge Johanna Lilian, Warschburger Petra, Klein Annette Maria
International Psychoanalytic University Berlin, Stromstr. 1, 10555, Berlin, Germany.
Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476, Potsdam, Germany.
Child Adolesc Psychiatry Ment Health. 2025 Aug 31;19(1):101. doi: 10.1186/s13034-025-00958-6.
Internalizing symptoms are highly prevalent in childhood and adolescence. Several studies have demonstrated heterogeneity in symptom trajectories and examined their predictors. However, little is known about their outcomes in late adolescence. Building on a previous study that identified a stable low, an increasing and an (early high) decreasing trajectory of internalizing symptoms in childhood, this follow-up study examines their outcomes, including mental health-related measures and self-regulation facets.
Trajectories of internalizing symptoms were identified using parent reports at three measurement points in a community sample of N = 1453 children aged 6-13 years, based on the Emotional Problems Scale of the Strengths and Difficulties Questionnaire. At the 8-year follow-up, n = 556 adolescents aged 16-21 years participated, providing self-reports on mental health-related measures and self-regulation facets (emotional reactivity, emotion regulation, planning behavior, risk taking, impulsiveness, delay discounting). Additionally, three self-regulation facets (working memory updating, inhibition, risk taking) were assessed behaviorally.
Adolescents in the increasing trajectory reported significantly greater internalizing symptoms, more specific anxiety symptoms, greater distress and social impairment, and more impaired personality functioning than those in the stable low trajectory, and more specific depressive symptoms than those in the stable low and decreasing trajectories. Regarding SR facets, they reported lower planning behavior and less use of the emotion regulation strategies reappraisal and positive reappraisal than those in the stable low trajectory, and greater use of the emotion regulation strategy catastrophizing than those in the stable low and decreasing trajectories.
Children with increasing internalizing symptoms in childhood present internalizing symptoms and self-regulation deficits in late adolescence that can hinder further development. In contrast, the differences observed in childhood between the decreasing and the stable low trajectories are no longer detectable. Promoting self-regulation could be a promising prevention and intervention target. Future research should investigate protective factors contributing to symptom remission.
内化症状在儿童和青少年中极为普遍。多项研究已证实症状轨迹存在异质性，并对其预测因素进行了研究。然而，对于这些症状在青少年晚期的结果却知之甚少。基于先前一项研究确定了儿童期内化症状的稳定低水平、上升和（早期高水平）下降轨迹，本随访研究考察了它们的结果，包括与心理健康相关的指标和自我调节方面。
在一个由N = 1453名6 - 13岁儿童组成的社区样本中，基于优势与困难问卷的情绪问题量表，通过家长报告在三个测量点确定内化症状轨迹。在8年随访时，n = 556名16 - 21岁的青少年参与，提供关于与心理健康相关指标和自我调节方面（情绪反应性、情绪调节、计划行为、冒险、冲动性、延迟折扣）的自我报告。此外，通过行为评估了三个自我调节方面（工作记忆更新、抑制、冒险）。
与稳定低水平轨迹的青少年相比，上升轨迹的青少年报告有更显著的内化症状、更具体的焦虑症状、更大的痛苦和社交障碍，以及更受损的人格功能，并且比稳定低水平和下降轨迹的青少年有更具体的抑郁症状。关于自我调节方面，他们报告的计划行为比稳定低水平轨迹的青少年少，重新评估和积极重新评估等情绪调节策略的使用比稳定低水平轨迹的青少年少，而灾难化情绪调节策略的使用比稳定低水平和下降轨迹的青少年多。
儿童期内化症状增加的儿童在青少年晚期存在内化症状和自我调节缺陷，这可能会阻碍进一步发展。相比之下，下降轨迹和稳定低水平轨迹在儿童期观察到的差异在此时已不再明显。促进自我调节可能是一个有前景的预防和干预目标。未来的研究应调查有助于症状缓解的保护因素。
