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Associations of Internalizing and Externalizing Scores with Psychiatric Diagnoses at Ages 2 and 3

 

After long neglect, behavioral and emotional problems of preschoolers are receiving increased attention. Because the DSM has provided few categories for early childhood disorders, another system has been developed that is known as the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC 0-3; National Center for Infants, Toddlers, and Families, 1994). Jean Thomas, M.D., and Karen Guskin, Ph.D., (2001) tested associations of CBCL Internalizing and Externalizing scores with psychiatric diagnoses among disruptive preschoolers who received any of the following DC 0-3 diagnoses at an early childhood psychiatry clinic: Traumatic Stress Disorder, Disorder of Affect, or Regulatory Disorder. Thomas and Guskin found elevated Internalizing and Externalizing scores for substantial percentages of children who received each diagnosis. The highest rate of elevated CBCL scores was found for children receiving diagnoses of Affective Disorder: 79% of these children obtained Externalizing T scores of 67 or higher, which was a significantly higher percentage of elevated T scores than obtained by children who received diagnoses of Traumatic Stress Disorder or children who received diagnoses of Regulatory Disorder. The DC 0-3 Parent-Infant Relationship Global Assessment Scale (PIR-GAS), which assesses relationship factors, also correlated significantly with both the Internalizing and Externalizing scores of the CBCL. Thomas and Guskin concluded that "By comparing the DC 0-3 with the CBCL, . . . this study provides some preliminary evidence for the validity of the DC 0-3" (p. 49).

Reference: Thomas, J.M., & Guskin, K.A. (2001). Disruptive behavior in young children: What does it mean? Journal of the American Academy of Child and Adolescent Psychiatry, 40, 44-51.