ABSTRACT
The difficult and easy temperament groups were balanced for age, sex, and socioeconomic status. The "difficult" pole of our factor is defined by five main temperamental categories: low adaptability, withdrawal from new stimuli, and intensity in emotional reactions, negative mood, and low distractibility. Difficult children with clinical disorders had a preponderance of outwardly directed symptoms at home, particularly opposition to authority figures and norms. An association with family dysfunction in terms of behavior control seemed to increase the risk: there was a lower rate of clinical disorders among children in superior functioning families than among those in dysfunctional families. Paradoxically, at school, even if they displayed some outwardly directed symptoms, these same difficult children with clinical disorders surprisingly showed a preponderance of inwardly directed symptoms: they were described by their teachers as worried, unhappy, tearful or distressed, fearful and afraid of new things, and solitary.
