Early behavior problems: Pathways to mental disorders in adolescence

From teachers' rating in kindergarten through third grade, mutually exclusive groups of internalized, externalized, and mixed behavior problems were examined as pathways to three groups of psychiatric diagnosis in later adolescence: depression/anxiety, conduct/oppositional defiant, and other disorders. In looking both forward and backwards, the relation between behavior problems in the early school years, regardless of type, and psychopathology in adolescence, regardless of diagnosis, was very strong. The relations between type of early problems and specific outcomes were weak. The findings provided support for both the constructs of multifinality and equifinality; however the nature of the pathways differed somewhat by disorder. There was a substantial amount of multifinality (dispersion of outcomes) for the early internalizing pathway. There was less multifinality for the externalizing pathway, in that there was greater correspondence between early externalizing and later antisocial outcomes than for the internalizing pathway and depressed/anxious outcomes.