title: Cognitive functioning in children with internalising, externalising and dysregulation problems: a population-based study.
abstract: Psychiatric symptoms in childhood are closely related to neurocognitive deficits. However, it is unclear whether internalising and externalising symptoms are associated with general or distinct cognitive problems. We examined the relation between different types of psychiatric symptoms and neurocognitive functioning in a population-based sample of 1177 school-aged children. Internalising and externalising behaviour was studied both continuously and categorically. For continuous, variable-centred analyses, broadband scores of internalising and externalising symptoms were used. However, these measures are strongly correlated, which may prevent identification of distinct cognitive patterns. To distinguish groups of children with relatively homogeneous symptom patterns, a latent profile analysis of symptoms at age 6 yielded four exclusive groups of children: a class of children with predominantly internalising symptoms, a class with externalising symptoms, a class with co-occurring internalising and externalising symptoms, that resembles the CBCL dysregulation profile and a class with no problems. Five domains of neurocognitive ability were tested: attention/executive functioning, language, memory and learning, sensorimotor functioning, and visuospatial processing. Consistently, these two different modelling approaches demonstrated that children with internalising and externalising symptoms show distinct cognitive profiles. Children with more externalising symptoms performed lower in the attention/executive functioning domain, while children with more internalising symptoms showed impairment in verbal fluency and memory. In the most severely affected class of children with internalising and externalising symptoms, we found specific impairment in the sensorimotor domain. This study illustrates the specific interrelation of internalising and externalising symptoms and cognition in young children.
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands.|The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Laura M E
authors.initials: LM
authors.lastname: Blanken
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands.|Department of Radiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Tonya
authors.initials: T
authors.lastname: White
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands.|The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Sabine E
authors.initials: SE
authors.lastname: Mous
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands.|The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Maartje
authors.initials: M
authors.lastname: Basten
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands.|The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Ryan L
authors.initials: RL
authors.lastname: Muetzel
authors.affiliation: The Generation R Study Group, Erasmus MC, Rotterdam, The Netherlands.|Department of Paediatrics, Erasmus MC-Sophia, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus MC, room Na-2818, P.O.Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands.|Institute of Psychology, Erasmus University, Rotterdam, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Wals
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: van der Ende
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands.
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia, Rotterdam, The Netherlands. h.tiemeier@erasmusmc.nl.|Department of Epidemiology, Erasmus MC, room Na-2818, P.O.Box 2040, 3000 CA, Rotterdam, The Netherlands. h.tiemeier@erasmusmc.nl.
authors.forename: Henning
authors.identifier: http://orcid.org/0000-0002-4395-1397
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D002648:Child; D002652:Child Behavior / Q000523:psychology*; D002653:Child Behavior Disorders / Q000453:epidemiology*; D002657:Child Development; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D001523:Mental Disorders / Q000523:psychology; D000066553:Problem Behavior / Q000523:psychology*
keywords: Cognition; Externalising symptoms; Internalising symptoms