Understanding adolescents' externalizing and internalizing comorbidity from A multiple-level family perspective

By exploring network analysis, the current study reframed the questions that arise from co-occurring externalizing and internalizing problems and their relationships with multiple-level family risk factors from a developmental perspective, including early, middle, and late adolescence periods. Total 6838 adolescents (early adolescence: 2156; middle adolescence: 2303; late adolescence: 2379) and their parents completed questionnaires regarding externalizing and internalizing problems, and entire, dyadic, and individual level family risk factors. First, anxiety/depression served as a bridging symptom in externalizing and internalizing comorbidity networks. Second, dyadic level family risk factors, particularly parental harsh discipline, were more strongly linked to adolescents' externalizing and internalizing problems and even their comorbidity. Third, middle adolescence was a turning points. This study offers a fresh insight into the comorbidity of externalizing and internalizing problems during adolescence, and highlights that benign interactions between parents and adolescents remain key to addressing psychopathology. Interventions should particularly focus on middle adolescence.