ABSTRACT
Internalizing disorders in childhood and adolescence include the anxiety and affective disorders. As such, they consist of problems related to worry, fear, shyness, low self-esteem, sadness, and depression. Prevalence of anxiety or depressive disorders in children and adolescents in the general population may be between 8% (Orton, Riggs & Libby, 2009), with clinically elevated symptoms between 9% in boys and 15% in girls (Ghandour, Kogan, Blumberg, Jones & Perrin, 2012), and somewhat higher in high-risk samples, such as children in the welfare system (Letcher, Sanson, Smart & Toumbourou, 2012). These “emotional” problems have frequently been found to be interrelated in clinical settings and to be associated statistically with one another in factor analytic studies. Internalizing problems are contrasted with externalizing problems-problems frequently associated with inattention, conduct problems, opposition and defiance. At the same time, internalizing disorders may include irritability and mood dysregulation, which can resemble symptoms of disruptive externalizing disorders (American Psychiatric Association (2013). It is of historic interest to note that these two broad dimensions of anxiety and depression in children and adolescents have been recognized for many years. Horney (1945), for example, spoke of children who “move against the world” (i.e., externalizing disorder children) and those who “move away from the world” (i.e., internalizing disorder children).
