Psychological Medicine

Original Article

Internalizing and externalizing problems in adolescence: general and dimension-specific effects of familial loadings and preadolescent temperament traits

J. ORMEL a1a2c1, A. J. OLDEHINKEL a1a2a3, R. F. FERDINAND a3, C. A. HARTMAN a1a2, A. F. De WINTER a1a2, R. VEENSTRA a4, W. VOLLEBERGH a5a6, R. B. MINDERAA a7, J. K. BUITELAAR a8 and F. C. VERHULST a3
a1 Department of Psychiatry, University Medical Centre, Groningen
a2 Graduate School of Behavioural and Cognitive Neurosciences & Graduate School for Experimental Psychopathology, University of Groningen
a3 Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam
a4 Department of Sociology, University of Groningen
a5 Trimbos Institute, Utrecht
a6 Department of Psychology, University of Leiden
a7 Department of Psychiatry and Graduate School of Behavioural and Cognitive Neurosciences, University of Groningen
a8 Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands

Article author query
ormel j   [PubMed][Google Scholar] 
oldehinkel aj   [PubMed][Google Scholar] 
ferdinand rf   [PubMed][Google Scholar] 
hartman ca   [PubMed][Google Scholar] 
de winter af   [PubMed][Google Scholar] 
veenstra r   [PubMed][Google Scholar] 
vollebergh w   [PubMed][Google Scholar] 
minderaa rb   [PubMed][Google Scholar] 
buitelaar jk   [PubMed][Google Scholar] 
verhulst fc   [PubMed][Google Scholar] 


Background. We investigated the links between familial loading, preadolescent temperament, and internalizing and externalizing problems in adolescence, hereby distinguishing effects on maladjustment in general versus dimension-specific effects on either internalizing or externalizing problems.

Method. In a population-based sample of 2230 preadolescents (10–11 years) familial loading (parental lifetime psychopathology) and offspring temperament were assessed at baseline by parent report, and offspring psychopathology at 2·5-years follow-up by self-report, teacher report and parent report. We used purified measures of temperament and psychopathology and partialled out shared variance between internalizing and externalizing problems.

Results. Familial loading of internalizing psychopathology predicted offspring internalizing but not externalizing problems, whereas familial loading of externalizing psychopathology predicted offspring externalizing but not internalizing problems. Both familial loadings were associated with Frustration, low Effortful Control, and Fear. Frustration acted as a general risk factor predicting severity of maladjustment; low Effortful Control and Fear acted as dimension-specific risk factors that predicted a particular type of psychopathology; whereas Shyness, High-Intensity Pleasure, and Affiliation acted as direction markers that steered the conditional probability of internalizing versus externalizing problems, in the event of maladjustment. Temperament traits mediated one-third of the association between familial loading and psychopathology. Findings were robust across different composite measures of psychopathology, and applied to girls as well as boys.

Conclusions. With regard to familial loading and temperament, it is important to distinguish general risk factors (Frustration) from dimension-specific risk factors (familial loadings, Effortful Control, Fear), and direction markers that act as pathoplastic factors (Shyness, High-Intensity Pleasure, Affiliation) from both types of risk factors. About one-third of familial loading effects on psychopathology in early adolescence are mediated by temperament.

(Published Online August 15 2005)

c1 Department of Psychiatry, University Medical Centre, Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. (Email: