Internalizing and externalizing symptoms in Spanish children aged 6-8: Results of a latent profile analysis.

Abstract Background : Internalizing and externalizing problems are widely addressed in research. However, most studies use variable-centred approaches and ignore the possible co-occurrence of both types of symptoms. This study aimed to identify homogeneous groups of children with similar psychological difficulties and strengths, using latent profile analysis as a person-centred approach. Methods : The parents of 107 Spanish children aged 6 to 8 years completed the Strengths and Difficulties Questionnaire (SDQ). Results : The results revealed the existence of four latent groups. The children who belonged to the high difficulties group showed the most severe symptoms in emotional problems, peer problems and hyperactivity. The children classified in the externalizing group showed high levels of hyperactivity, behavioral problems, and emotional problems. On another hand, the internalizing profile grouped children with emotional and peer problems. Finally, the well-adjusted group showed an adequate psychological adjustment in all evaluated variables. High difficulties were associated with lower educational attainment of their parents. Limitations : Data were reported from a single source of information, father or mother. Also, the socio-demographic variables that were related to each one of the four profiles only considered the age and educational level of the main informant. Conclusions : These data suggest that co-occurrence of symptoms is very high in young Spanish children. It is essential to carry out clinical assessments that include both types of symptoms. Considering externalization and internalization as independent and exclusive phenomena can compromise the effectiveness of psychological treatments and preventive programs.