Externalizing Disorders of Childhood and Adolescence

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Book Chapter

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It is becoming increasingly clear that a significant number of children and adolescents have severe and impairing emotional or behavioral problems. Prevalence estimates of childhood psychopathology vary greatly depending on the age group studied, the type of disorders included, and the method of assessment used. Research has indicated that the form that these problems take can largely be conceptualized along two major dimensions. One dimension, which is the focus of this chapter, has been labeled as undercontrolled or externalizing and includes various acting out, disruptive, delinquent, hyperactive, and aggressive behaviors. The second broad dimension of childhood psychopathology has been labeled as overcontrolled or internalizing and includes such behaviors as social withdrawal, anxiety, and depression. There has been debate as to whether or not more fine grained distinctions within these broad categories provide any additional useful information for understanding children with psychopathological conditions. The distinction within the externalizing dimension that has received the strongest support in research is the distinction between (a) the problems of attention, impulsivity, and hyperactivity associated with the diagnostic category of attention deficit hyperactivity disorder (ADHD) and (b) the conduct problems and aggressive behavior associated with the diagnostic categories of oppositional defiant disorder (ODD) and conduct disorders (CD). Research indicates that these two problem domains can be separated in factor analyses and they have a number of different correlates. The importance of these correlates for understanding the two types of externalizing disorders is discussed in later sections of this chapter. Although research supports distinguishing between these two forms of externalizing disorders, it is also important to note that they overlap considerably. Though the sections of this chapter provide somewhat separate reviews of the two types of externalizing disorders, the authors emphasize that many children show both patterns of behavior. In addition, understanding this overlap can be important for effectively treating children with disruptive behavior problems.

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Citation / Publisher Attribution

Externalizing Disorders of Childhood and Adolescence, in J. E. Maddux & B. A. Winstead (Eds.), Psychopathology: Foundations for a Contemporary Understanding, Lawrence Erlbaum Associates Publishers, p. 325-351