Joint developmental trajectories and correlates of internalizing and externalizing problems among Chinese adolescents.

Background: Internalizing and externalizing problems are the most prevalent health problems among adolescents. However, few studies have examined co-occurring internalizing and externalizing problems from a longitudinal perspective.

Methods: A total of 1051 seventh-grade students from two junior high schools were recruited at baseline. Among them, 932 valid participants were reassessed 1 year and 2 years later. Data were analyzed using parallel-process latent class growth analysis and multinominal logistic regression.

Results: Four joint trajectories of internalizing and externalizing problems were identified. Compared with the low-risk group, adolescents in the moderate and chronic co-occurring group had lower resilience, higher levels of insecure attachment, family conflicts, and academic pressure. Adolescents in the pure internalizing group had higher levels of family conflicts and academic pressure compared with the low-risk group.

Conclusions: Co-occurrence of symptoms is very high in adolescents. More individualized intervention programs should be provided to these specific groups.