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Originalia

Externalisierende und internalisierende Störungen in der Kindheit: Untersuchungen zur Entwicklungspsychopathologie

Published Online:October 01, 2000https://doi.org/10.1026//0084-5345.29.4.284

Abstract

Zusammenfassung. Theoretischer Hintergrund: In taxonomischen Systemen psychischer Auffälligkeiten des Kindesalters werden externalisierende von internalisierenden Störungen abgegrenzt. Fragestellung: Es wurde der Frage nachgegangen, ob diesen Störungsmustern eine spezifische Pathogenese und eine differentielle Ätiologie zugrunde liegen. Methode: Im Rahmen einer prospektiven Längsschnittstudie an 362 Kindern mit unterschiedlichen organischen und psychosozialen Risikobelastungen wurden emotionale und Verhaltensauffälligkeiten vom Säuglings- bis zum Grundschulalter mittels eines standardisierten klinischen Interview diagnostiziert. Merkmale der frühen Mutter-Kind-Interaktion wurden mit Hilfe einer standardisierten Verhaltensbeobachtung im Alter von 3 Monaten erfaßt. Ergebnisse: Externalisierende Störungen manifestierten sich früher, kamen auf jeder Altersstufe häufiger vor, und zeigten eine größere Stabilität als internalisierende Störungen. Frühindikatoren späterer Störungen ließen sich bereits ab dem Kleinkindalter nachweisen. Vor allem externalisierende Störungen standen im Zusammenhang mit frühen psychosozialen Risiken. Vorläufer späterer Störungen fanden sich in spezifischen dysfunktionalen Interaktionsmustern der Mutter-Kind-Interaktion im frühen Säuglingsalter. Schlussfolgerungen: Die Ergebnisse stehen im Einklang mit der Vorstellung entwicklungspsychopathologisch distinkter Störungskategorien.


Externalizing and internalizing disorders in childhood: studies on developmental psychopathology

Abstract. Background: In taxonomic systems of child psychopathology, externalizing and internalizing disorders are differentiated. Objective: The question of whether a specific pathogenesis and etiology becomes discernible for these diagnostic categories was addressed. Method: In a prospective longidudinal study of 362 children born with different organic and psychosocial risks, emotional and behavioral problems from infancy to school age were assessed using a standardized clinical interview. At the age of 3 months infants were observed interacting with their mothers. Results: Externalizing disorders manifested themselves earlier, were more frequent at every age, and showed a greater stability than internalizing disorders. Early indicators of later disorders became apparent in toddlerhood. In particular, externalizing disorders were associated with early psychosocial risks. Dysfunctional patterns of mother-child interaction in early infancy emerged as precursors of later disorders in school age. Conclusions: The results support the notion of distinct categories of developmental psychopathology.

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