A panel network approach of internalizing and externalizing problems in early childhood: Evidence from American and Chinese preschoolers

Internalizing and externalizing problems tend to co-occur beginning in early childhood. However, the dynamic interplay of symptom-level internalizing and externalizing problems that may drive their co-occurrence is poorly understood. Within the frameworks of the Network Approaches to Psychopathology and the Developmental Cascade Perspective, this study used a panel network approach to examine how symptoms of internalizing and externalizing problems are related in early childhood both concurrently and longitudinally and whether the pattern may differ in American (<i>N</i> = 1,202) and Chinese (<i>N</i> = 180) preschoolers. Internalizing and externalizing problems were rated by mothers in two waves. Results from cross-sectional networks showed that the bridge symptoms underlying the co-occurrence of internalizing and externalizing problems were largely consistent in American and Chinese preschoolers (e.g., withdrawal, aggressive behavior, anxiety and depressive moods). Results from cross-lagged panel networks further showed that the co-occurrence was manifested by unidirectional relations from internalizing to subsequent externalizing symptoms in both American and Chinese preschoolers. The findings contribute needed cross-cultural evidence to better understand the co-occurrence of internalizing and externalizing problems and highlight the temporal heterogeneity of the symptom networks of internalizing and externalizing problems in early childhood.