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Cited by 68Child and Adolescent Psychosocial and Emotional DevelopmentPersonality Disorders and PsychopathologyMental Health Research Topics

Associations between infant and toddler regulatory problems, childhood co‐developing internalising and externalising trajectories, and adolescent depression, psychotic and borderline personality disorder symptoms

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Winsper, Catherine, Bilgin, Ayten, Wolke, Dieter·2020·Journal of Child Psychology and Psychiatry
DOI 10.1111/jcpp.13125
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Abstract

Background: Early regulatory problems (RPs) are associated with childhood internalising and externalising symptoms. Internalising and externalising symptoms, in turn, are associated with adolescent psychopathology (e.g. personality disorders, depression). We examined whether RPs are directly associated with adolescent psychopathology, or whether associations are indirect via childhood internalising and externalising symptoms. Methods: We used data from the Avon Longitudinal Study of Parents and Children. Mothers reported on their child's RPs at 6, 15–18 and 24–30 months, and internalising and externalising symptoms at 4, 7, 8 and 9.5 years. Adolescent psychotic, depression and BPD symptoms were assessed at 11–12 years. Children were grouped by their patterns of co‐developing internalising and externalising symptoms using parallel process latent class growth analysis (PP‐LCGA). Path analysis was used to examine direct and indirect associations from RPs to the three adolescent outcomes. Results: There were four groups of children with distinct patterns of co‐developing internalising and externalising (INT/EXT) symptoms. Most children (53%) demonstrated low–moderate and stable levels of INT/EXT symptoms. A small proportion (7.7%) evidenced moderate and increasing INT and high stable EXT symptoms: this pattern was strongly predictive of adolescent psychopathology (e.g. depression at 11 years: unadjusted odds ratio = 5.62; 95% confidence intervals = 3.82, 8.27). The other two groups were differentially associated with adolescent outcomes (i.e. moderate–high increasing INT/moderate decreasing EXT predicted mother‐reported depression at 12, while low stable INT/moderate–high stable EXT predicted child‐reported depression at 11). In path analysis, RPs at each time‐point were significantly indirectly associated with symptoms of BPD and child‐ and mother‐reported depression symptoms via the most severe class of INT/EXT symptoms. Conclusions: Consistent with a cascade model of development, RPs are predictive of higher levels of co‐developing INT/EXT symptoms, which in turn increase risk of adolescent psychopathology. Clinicians should be aware of, and treat, early RPs to prevent chronic psychopathology.

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  • Adult BPD may be preceded by BPD in adolescence, or by BPD-like symptoms that manifest earlier in childhood among adolescents and adults diagnosed with BPD.

    “Adult BPD also may be preceded by BPD in adolescence [194], or by BPD-like symptoms that manifest earlier in childhood among adolescents and adults diagnosed with BPD (e.g., self-harm; disorganized controlling behavior; regulatory problems) [110, 187, 191].”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [187]

    The Discussion reports that regulatory problems from as early as 6 months were indirectly associated with adolescent BPD symptoms through childhood internalising and externalising symptoms. This supports the regulatory-problems example, but the Measures section explicitly says the adolescent outcome was not a BPD diagnosis, and the study does not establish a pathway to diagnosed adult BPD. (LLM, conf=0.86)

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  1. Muthen, L. K., & Muthen, B. O. (2010). Mplus Statistical Analysis with Latent Variables User's Guide. Sixth Edition. Los Angeles: Muthen & Muthen.

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Authors
Winsper, C., Bilgin, A., & Wolke, D.
Affiliations
  • University of Warwick (GB)
  • Division of Mental Health and Wellbeing Warwick Medical School University of Warwick Coventry UK
ORCID
Venue
Journal of Child Psychology and Psychiatry
Publisher
Wiley
Published
2019-08-30
Volume
61
Issue
2
Pages
182-194
ISSN
  • 0021-9630 (ISSN-L)
  • 1469-7610
DOI
10.1111/jcpp.13125
OpenAlex
W2970777310
Cited by
68
References
58
Citations by year
2026: 12 · 2025: 7 · 2024: 12 · 2023: 14 · 2022: 5 · 2021: 13 · 2020: 5
FWCI
6.72
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Child Psychology and Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
  • Kent Academic Repository (University of Kent) (submittedVersion)
Funders
Wellcome Trust (102215/2/13/2)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords
internalizing problems, externalising symptoms, adolescent depression, borderline symptoms, developmental trajectories
MeSH terms
Self-Control, Behavioral Symptoms, Borderline Personality Disorder, Child, Child Development, Child, Preschool, Depressive Disorder, Female, United Kingdom, Humans, Infant, Longitudinal Studies, Male, Psychotic Disorders, Comorbidity

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