Abstract
Using latent class analyses (LCA), the present study aimed to test whether meaningful subtypes of internalizing and externalizing behaviors could be found among Chinese community-based adolescents. A total of 5244 adolescents, ages 11–18 years (M = 15.11, SD = 1.79) recruited from 16 Chinese middle schools completed the Chinese version of the Strengths and Difficulties Questionnaire (SDQ-C). We examined the data using Latent Class Analysis to identify subtypes of internalizing and externalizing behaviors among the adolescents. Multivariate Logistic regression was subsequently implemented to ascertain the relationships between latent classes and demographic covariates. Three distinct subtypes were uncovered: a high-risk group, a middle-risk group and a low-risk group; the three subtypes accounted for 19.8, 31.1, and 49.1 % of the total sample variance respectively. Youth with elevations in one behavior type were likely to have elevations in the other behavior type. Further analyses revealed that compared to the low-risk group, the adolescents from the high-risk group and middle-risk groups were female and older. Significant heterogeneity in internalizing and externalizing behaviors was revealed in this Chinese adolescent’s sample. Profiling behavior problems patterns is potentially useful as a first step in developing tailored prevention and intervention programs. Suggestions for future research, including cross-national studies, and implications for mental health professionals were discussed.
Similar content being viewed by others
References
Akaike, H. (1987). Factor analysis and AIC. Psychometrika, 52, 317–332.
Anderson, C. A. (1999). Attributional style, depression, and loneliness: a cross-cultural comparison of American and Chinese students. Personality and Social Psychology Bulletin, 25, 482–499.
Andrews, J. A., & Lewinsohn, P. M. (1992). Suicidal attempts among older adolescents: prevalence and co-occurrence with psychiatric disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 655–662.
Angold, A., & Costello, E. J. (1993). Depressive comorbidity in children and adolescents: empirical, theoretical, and methodological issues. The American Journal of Psychiatry, 150(12), 1779–1791.
Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57–87.
Arnold, L. E., Ganocy, S. J., Mount, K., Youngstrom, E. A., Frazier, T., Fristad, M., Horwitz, S. M., Birmaher, B., Findling, R., & Kowatch, R. A. (2014). Three-year latent class trajectories of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms in a clinical sample not selected for ADHD. Journal of the American Academy of Child & Adolescent Psychiatry, 53(7), 745–760.
Boylan, K., Vaillancourt, T., Boyle, M., & Szatmari, P. (2007). Comorbidity of internalizing disorders in children with oppositional defiant disorder. European Child & Adolescent Psychiatry, 16, 484–494.
Capaldi, D. M. (1991). Co-occurrence of conduct problems and depressive symptoms in early adolescent boys: I. Familial factors and general adjustment at Grade 6. Development and Psychopathology, 3, 277–300.
Dickey, W. C., & Blumberg, S. J. (2004). Revisiting the factor structure of the strengths and difficulties questionnaire: United States, 2001. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 1159–1167.
Gilreath, T. D., Astor, R. A., Estrada, J. N., Johnson, R. M., Benbenishty, R., & Unger, J. B. (2014). Substance use among adolescents in California: a latent class analysis. Substance Use & Misuse, 49, 116–123.
Goodman, R. (1997). The strengths and difficulties questionnaire: a research note. Journal of Child Psychology and Psychiatry, 38, 581–586.
Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 1337–1345.
Goodman, R., Meltzer, H., & Bailey, V. (1998). The strengths and difficulties questionnaire: a pilot study on the validity of the self-report version. European Child & Adolescent Psychiatry, 7, 125–130.
Goodman, R., Ford, T., Simmons, H., Gatward, R., & Meltzer, H. (2003). Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. International Review of Psychiatry, 15, 166–172.
Goodman, A., Lamping, D. L., & Ploubidis, G. B. (2010). When to use broader internalising and externalising subscales instead of the hypothesised five subscales on the Strengths and Difficulties Questionnaire (SDQ): data from British parents, teachers and children. Journal of Abnormal Child Psychology, 38, 1179–1191.
Guo, J. C., Li, J. Y., Huang, L., & Wang, Y. X. (2012). Correlations between self-concepts and behavior problems among children and adolescents in Gansu Province. Chinese Journal of Public Health, 28, 1439–1442.
Hinnant, J. B., & El-Sheikh, M. (2013). Codevelopment of externalizing and internalizing symptoms in middle to late childhood: sex, baseline respiratory sinus arrhythmia, and respiratory sinus arrhythmia reactivity as predictors. Development and Psychopathology, 25, 419–436.
Jackson, N., Denny, S., Sheridan, J., Fleming, T., Clark, T., Teevale, T., & Ameratunga, S. (2014). Predictors of drinking patterns in adolescence: a latent class analysis. Drug and Alcohol Dependence, 135, 133–139.
Jing, J. (2010). Mental health problems and strategies among children and adolescents in China. Chinese Mental Health Journal, 24, 321–324.
Kiesner, J. (2002). Depressive symptoms in early adolescence: their relations with classroom problem behavior and peer status. Journal of Research on Adolescence, 12, 463–478.
Koskelainen, M., Sourander, A., & Vauras, M. (2001). Self-reported strengths and difficulties in a community sample of Finnish adolescents. European Child & Adolescent Psychiatry, 10, 180–185.
Kovacs, M., Paulauskas, S., Gatsonis, C., & Richards, C. (1988). Depressive disorders in childhood III. A longitudinal study of comorbidity with and risk for conduct disorders. Journal of Affective Disorders, 15, 205–217.
Lahey, B. B., Loeber, R., Burke, J., Rathouz, P. J., & McBurnett, K. (2002). Waxing and waning in concert: Dynamic comorbidity of conduct disorder with other disruptive and emotional problems over 17 years among clinic-referred boys. Journal of Abnormal Psychology, 111, 556.
Lanza, S. T., & Rhoades, B. L. (2013). Latent class analysis: an alternative perspective on subgroup analysis in prevention and treatment. Prevention Science, 14, 157–168.
Li, Z.-H., Yin, X.-Y., Cai, T.-S., & Zhu, C.-Y. (2014). Latent class analysis of the characteristics of Left-Behind Children’s emotional and behavioral problems: person-centered perspectives. Psychological Science, 37, 329–334.
Liu, X., Sun, Z., Neiderhiser, J. M., Uchiyama, M., Okawa, M., & Rogan, W. (2001). Behavioral and emotional problems in Chinese adolescents: parent and teacher reports. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 828–836.
Lo, Y., Mendell, N. R., & Rubin, D. B. (2001). Testing the number of components in a normal mixture. Biometrika, 88, 767–778.
Lu, Y., & Zhang, Y. J. (2008). Research into the relationships among attachment, general self-efficacy and depressive symptoms in junior middle school students. Psychological Development and Education, 24, 55–59.
Maslowsky, J., & Schulenberg, J. E. (2013). Interaction matters: Quantifying Conduct Problem × Depressive Symptoms interaction and its association with adolescent alcohol, cigarette, and marijuana use in a national sample. Development and Psychopathology, 25, 1029–1043.
Mezulis, A., Vander Stoep, A., Stone, A. L., & McCauley, E. (2011). A latent class analysis of depressive and externalizing symptoms in nonreferred adolescents. Journal of Emotional and Behavioral Disorders, 19, 247–256.
Muthén, L., & Muthén, B. (2010). Mplus user’s guide (6th ed.). Los Angeles: Muthén & Muthén.
National Bureau of Statistics of China (2010). China statistical yearbook 2010 (Internet). http://www.stats.gov.cn/tjsj/ndsj/2010/indexch.htm
Nock, M. K., Kazdin, A. E., Hiripi, E., & Kessler, R. C. (2006). Prevalence, subtypes, and correlates of DSM-IV conduct disorder in the National Comorbidity Survey Replication. Psychological Medicine, 36, 699–710.
Nurius, P. S., & Macy, R. J. (2008). Heterogeneity among violence-exposed women applying person-oriented research methods. Journal of Interpersonal Violence, 23, 389–415.
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: a Monte Carlo simulation study. Structural Equation Modeling, 14, 535–569.
Olino, T. M., Klein, D. N., Farmer, R. F., Seeley, J. R., & Lewinsohn, P. M. (2012). Examination of the structure of psychopathology using latent class analysis. Comprehensive Psychiatry, 53, 323–332.
Patterson, G. R., & Stoolmiller, M. (1991). Replications of a dual failure model for boys’ depressed mood. Journal of Consulting and Clinical Psychology, 59, 491.
Ramaswamy, V., DeSarbo, W. S., Reibstein, D. J., & Robinson, W. T. (1993). An empirical pooling approach for estimating marketing mix elasticities with PIMS data. Marketing Science, 12, 103–124.
Rosato, N. S., & Baer, J. C. (2012). Latent class analysis: a method for capturing heterogeneity. Social Work Research, 36, 61–69.
Ryder, A. G., Yang, J., Zhu, X., Yao, S., Yi, J., Heine, S. J., & Bagby, R. M. (2008). The cultural shaping of depression: somatic symptoms in China, psychological symptoms in North America? Journal of Abnormal Psychology, 117, 300.
Schwarz, G. (1978). Estimating the dimension of a model. The Annals of Statistics, 6, 461–464.
Sclove, S. L. (1987). Application of model-selection criteria to some problems in multivariate analysis. Psychometrika, 52, 333–343.
Shi, X. D., Lu, J., & Liang, H. N. (2009). Research progress of mental health and risk behavior of adolescent. Modern Preventive Medicine, 36, 1324–1326.
Van Roy, B., Veenstra, M., & Clench‐Aas J. (2008). Construct validity of the five‐factor Strengths and Difficulties Questionnaire (SDQ) in pre‐, early, and late adolescence. Journal of Child Psychology and Psychiatry, 49, 1304–1312.
Wang, J. S., & Ding, X. H. (2003). Depression of secondary school students and correlates. Chinese Journal of School Health, 24, 336–338.
Wang, J. N., Liu, L., & Wang, L. (2014). Prevalence and associated factors of emotional and behavioural problems in Chinese school adolescents: a cross‐sectional survey. Child: Care, Health and Development, 40, 319–326.
Wolff, J. C., & Ollendick, T. H. (2006). The comorbidity of conduct problems and depression in childhood and adolescence. Clinical Child and Family Psychology Review, 9, 201–220.
Yao, S., Zhang, C., Zhu, X., Jing, X., McWhinnie, C. M., & Abela, J. R. (2009). Measuring adolescent psychopathology: psychometric properties of the self-report Strengths and Difficulties Questionnaire in a sample of Chinese adolescents. Journal of Adolescent Health, 45, 55–62.
Yong, M., Fleming, C. B., McCarty, C. A., & Catalano, R. F. (2013). Mediators of the Associations Between Externalizing Behaviors and Internalizing Symptoms in Late Childhood and Early Adolescence. The Journal of Early Adolescence, 0272431613516827.
Zoccolillo, M. (1992). Co-occurrence of conduct disorder and its adult outcomes with depressive and anxiety disorders: a review. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 547–556.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ling, Y., Huebner, E.S., He, Ys. et al. Three Subtypes of Internalizing and Externalizing Behaviors in Chinese Adolescents: Results of a Latent Class Analysis. Applied Research Quality Life 11, 1309–1320 (2016). https://doi.org/10.1007/s11482-015-9438-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11482-015-9438-3