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Early environmental risks and the developmental dynamics of internalizing and externalizing problems from birth to
Kehui Wu1, Francesca Zecchinato2, Canghai Guan3
1Department of Sociology, Faculty of Social Sciences, University of Macau, Macau, China.
European Child & Adolescent Psychiatry
|November 6, 2025
Summary
Early life adversity impacts adolescent mental health, with internalizing and externalizing problems interacting differently across development. These issues are linked from childhood to adolescence, influenced by early risks and gender, requiring tailored interventions.
Area of Science:
- Developmental Psychology
- Child and Adolescent Psychiatry
- Public Health
Background:
- Internalizing and externalizing problems frequently co-occur, influenced by shared early environmental risks.
- Existing research often overlooks how these problems evolve with age, limiting understanding of adversity's long-term mental health effects.
- The interplay between internalizing and externalizing symptoms and their developmental trajectories requires further investigation.
Purpose of the Study:
- To examine the bidirectional associations between internalizing and externalizing problems from ages 5 to 17.
- To assess the lasting impact of early environmental risks on these symptom domains across development.
- To identify potential gender differences in these relationships.
Main Methods:
- Utilized data from 7,377 participants in the UK Millennium Cohort Study (MCS) across seven waves.
- Employed random-intercept cross-lagged panel analyses to investigate longitudinal associations.
- Examined early environmental risks including prenatal, neonatal, maternal mental health, parenting, and socioeconomic status.
Main Results:
- High stability was observed in both internalizing and externalizing problems over time.
- A positive bidirectional relationship existed between internalizing and externalizing problems from childhood to early adolescence.
- The relationship shifted in late adolescence, with externalizing problems negatively predicting internalizing symptoms, while internalizing problems no longer predicted externalizing ones. Early risks impacted both domains, generally decreasing with age, with notable gender differences observed.
Conclusions:
- Early environmental adversity has a lasting impact on adolescent mental health.
- The interaction between internalizing and externalizing problems is dynamic and changes throughout development.
- Findings support the need for early, sustained interventions that address multiple risks and adapt to evolving adolescent mental health needs.
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