Late adolescent outcomes of childhood trajectories of internalizing symptoms: an 8-year follow-up of depressive and anxiety symptoms and cognitive, emotion- and behavior-related self-regulation facets.

Background: Internalizing symptoms are highly prevalent in childhood and adolescence. Several studies have demonstrated heterogeneity in symptom trajectories and examined their predictors. However, little is known about their outcomes in late adolescence. Building on a previous study that identified a stable low, an increasing and an (early high) decreasing trajectory of internalizing symptoms in childhood, this follow-up study examines their outcomes, including mental health-related measures and self-regulation facets.

Methods: Trajectories of internalizing symptoms were identified using parent reports at three measurement points in a community sample of N = 1453 children aged 6-13 years, based on the Emotional Problems Scale of the Strengths and Difficulties Questionnaire. At the 8-year follow-up, n = 556 adolescents aged 16-21 years participated, providing self-reports on mental health-related measures and self-regulation facets (emotional reactivity, emotion regulation, planning behavior, risk taking, impulsiveness, delay discounting). Additionally, three self-regulation facets (working memory updating, inhibition, risk taking) were assessed behaviorally.

Results: Adolescents in the increasing trajectory reported significantly greater internalizing symptoms, more specific anxiety symptoms, greater distress and social impairment, and more impaired personality functioning than those in the stable low trajectory, and more specific depressive symptoms than those in the stable low and decreasing trajectories. Regarding SR facets, they reported lower planning behavior and less use of the emotion regulation strategies reappraisal and positive reappraisal than those in the stable low trajectory, and greater use of the emotion regulation strategy catastrophizing than those in the stable low and decreasing trajectories.

Conclusions: Children with increasing internalizing symptoms in childhood present internalizing symptoms and self-regulation deficits in late adolescence that can hinder further development. In contrast, the differences observed in childhood between the decreasing and the stable low trajectories are no longer detectable. Promoting self-regulation could be a promising prevention and intervention target. Future research should investigate protective factors contributing to symptom remission.