Can Fear Drive Problem Behaviors? An Examination of Temperamental and Environmental Precursors to Externalizing Problems

Abstract

Children are thought to be at greater relative risk for internalizing or externalizing disorders based on whether they are high in temperamental fear (inhibition behaviors) or frustration (activation behaviors). Yet, despite this, as many as 40-62% of children have lifetime comorbidities of both internalizing and externalizing disorders (Nock et al., 2007; Simonoff et al., 1997). Experiences of multiple or chronic stressors are known to increase vulnerability for developing these kinds of disorders. One possible developmental path for this type of comorbidity is that temperamentally fearful children, under conditions of high environmental stress, develop externalizing behaviors as a way of coping with heightened levels of fear. This study examined whether age 3 levels of fear or frustration and externalizing were related as well as whether change in fear or frustration was associated with change in externalizing behaviors. Further, it tested whether or not the number of environmental stressors experienced at age 3 moderated those relations controlling for child sex and child age 3 effortful control. The time specific effects of fear, frustration, stress, and externalizing behaviors were also assessed. Given well-known discrepancies between parent-report, youth-report, and observer rated measures of temperament and psychopathology, network analyses were also conducted to assess the extent to which youth and parent reported externalizing symptoms are related to each other and to observer rated temperamental fear. The initial sample included 306 children (who were 3 years old at time 1) and their parents. Children's temperaments, externalizing psychopathology symptoms, and exposure to negative life events were evaluated 4 times (T1-T4) in 9-month periods. Two-hundred twenty-seven children and their parents participated in a follow-up assessment (T5) when children were 11 years old and reported on the youth's externalizing symptoms. Results indicated that though children's age 3 levels of frustration predicts growth in externalizing, change in frustration does not predict change in externalizing across time. Regarding fear, the evidence suggests that, when children experience a greater number of stressors, more externalizing behaviors at age 3 predicts greater growth in fear during the preschool years. This growth in fear may be due to punishing experiences that children with more externalizing behaviors have that leave them subsequently fearful of future aversive experiences. Findings from network analyses showed that there were no relations between children's observed fearfulness in early childhood and their parent or self-reported symptoms of aggression or delinquency in late childhood. These analyses did, however, show that parents have a more integrated way of thinking of children's externalizing symptoms than youths and that youths more readily endorse isolated clusters of symptoms. This study highlights the utility of examining constructs (i.e. negative reactivity, aggression, and delinquency) at a fine-grain level. Findings support the idea that temperamental frustration, but not fear, is predictive of later externalizing problems, thus providing added evidence to the vulnerability model of psychopathology. Findings also add support for the idea that the onset of anxiety is secondary to externalizing behaviors for children with this comorbidity. Finally, study findings speak to the importance of examining not only agreements, but disagreements across reporters to inform treatment targets.