European Journal of Psychological Assessment, Vol. 18, Issue 2, pp. 149–157 J. Abad et al.: Emotional and Behavioral EJPA 18 (2),Problems © 2002 Hogrefe as Measured & Huber byPublishers the YSR
Emotional and Behavioral Problems as Measured by the YSR Gender and Age Differences in Spanish Adolescents Judit Abad, Maria Forns, and Juana Gómez University of Barcelona, Spain Keywords: Emotional/behavioral problems, age trends, gender differences, developmental psychopathology
Summary: The study focuses on the prevalence of emotional and behavioral problems in adolescents from a secondary educational level, and on the changes of such variables according to age and gender. The Youth Self Report (YSR) designed by Achenbach (1991) was administered to an urban sample of 1342 Catalan adolescents aged 11 to 16, recruited from 15 schools located throughout all of the municipal districts of Barcelona, Spain. The purpose of this study is to offer descriptive data for each YSR syndrome, and to analyze age and gender differences in behavioral and emotional clusters of problems as defined in the YSR. The results show that with age self-perceived maladjustment increases progressively in females from 11 to 16 years, and that the progression is only detected in boys between 11 to 14 years. The age differences on the behavioral and cognitive domain are similar for both genders, while age differences in emotional problems diverge.
Psychological problems are subject to various maturation processes (Kazdin, 1989) and linked to age and gender (Cichetti, 1984). Our understanding of normal processes of change provides valuable information for the study and classification of deviance and helps to explain why risk or protective factors affect individuals in different ways (Rutter, 1988). A developmental perspective has become apparent in child and adolescent psychological assessment because the meaning of a symptom and/or maladjustment pattern acquires full significance in relation to the developmental level of subjects. An understanding of psychological and behavioral variations in normal adolescence is necessary since this is a stage during which many and rapid changes occur (Powers, Hauser, & Kilner, 1989). Psychological adjustment in adolescence stems from the interaction between the multiple normative changes occurring during these times. For example, the increase in the capacity to think about oneself and the future, together with the internalization of social standards are normative changes that take place during adolescence. The conjunction of these changes might lead to the selfcritical thinking and can generate feelings of despair or
guilt (Petersen, Compas, Brooks-Gunn, Stemmeler, Ey, & Grant, 1993). Each normative change has to be understood as an opportunity for personal maturation, but also as a demand that could result in personal adjustment difficulties. Normative changes have been related to the findings of several epidemiological studies. Achenbach, Bird, Canino, Phares, Gould, and Rubio-Stipec (1990) and Lemos, Fidalgo, Calvo, and Menéndez (1992a) reported an increase in self-perceived maladjustment throughout adolescence (11 to 18 years), and Schonert-Reichl and Offer (1992) found an increase in the prevalence of disorders. Moreover, Lemos, Fidalgo, Calvo, and Menéndez (1992b) observed from Youth Self Report (YSR) data that there is an increase in Delinquent behavior, Aggressive behavior, Social problems, and Thought problems syndromes from 11 to 18 years of age. The amount of the increase reported on all these studies is around 7 points measured in T scores. Similarly, Petersen and Hamburg (1986) pointed out that during adolescence there is a marked increase in depressive conditions, bipolar affective disorders, suicide and suicide attempts. Finally, they found a peak in EJPA 18 (2), © 2002 Hogrefe & Huber Publishers DOI: 10.1027//1015-5759.18.2.149
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bulimia, anorexia, antisocial disorders, and delinquency in middle to late adolescence. Besides age differences, gender differences are also reported. In fact, Achenbach’s work (1991) with 11- to 18-year-old adolescents shows that gender effects on behavioral and emotional symptoms are in fact greater than age effects. Also, it has been found that the prevalence of certain disorders follow different patterns in males and females. Domènech, Subirà, and Cuxart (1996) reported that the increase in the rate of emotional disturbances is more marked in females. Both internalizing and externalizing reported problems show an increase in female adolescents, whereas in males the frequency of internalizing problems does not change while externalizing problems decrease (Forehand, Neighbord, & Wierson, 1991). Cohen, Cohen, Kasen, Velez, Hartmark, Johnson, Rojas, Brook, and Streuning (1993) also observed gender specific patterns between ages 10 and 20, with reference to ADHD, conduct and overanxious disorders and depression. Some gender differences can be associated with specific developmental stages, being the age of 13 the inflection point. Canals, Marti-Henneberg, FérnandezBallart, and Domènech (1995) claimed that gender differences in the prevalence of depressive mood become marked at around the age of 13, because a sudden increase in this type of problems occurs in females. Different explanations for the increase in depressive symptoms among adolescent girls have been proposed. It may be due to different response styles to stressful events (Compas, Orosan, & Grant, 1993), with boys preferring emotional distraction methods and girls turning their attention more to their emotional experience. Another explanation is that girls experience more challenges in early adolescence, because earlier physical maturity raises the probability of co-occurrence or proximity with transition to junior high school (Petersen, Sarigani, & Kennedy, 1991). Different gender patterns in psychopathological manifestations may also emerge from the way risk and protective factors are perceived by each gender. Kirchner and Forns (2000) found that adolescent girls valued as risk or protective factors mainly family or friendship events, whereas adolescent boys included other areas (such as leisure, school, and health). The authors suggest that girls may have a greater vulnerability to the negative effects of friendship and dating frustrations. This study analyzes age and gender normal changes during adolescence in behavioral and emotional problem clusters by using the “Youth Self-Report” developed by Achenbach (1991). First, mean values of all YSR syndromes are offered for an urban group of Catalan adolescents. Second, we analyze the extent to which YSR syndromes vary according to age and gender. PsychopathoEJPA 18 (2), © 2002 Hogrefe & Huber Publishers
logical norms of YSR syndromes are differentiated by gender but not by age (ages 11 to 18); nevertheless, an increase related to age in general self-perceived maladjustment – expressing emotional vulnerability in females and behavioral problems in males – is expected.
Method Subjects The sample included 1,342 adolescents (685 males and 657 females) aged between 11 and 16 years, attending 15 schools located throughout the city of Barcelona (Spain). Students were drawn from the 6th year of primary school (EGB) to the 3rd year of secondary school (BUP) or vocational training (FP), from both public and private schools. The representativeness requirement was met by dividing the city map of Barcelona into five sectors. The sampling procedure assured that for each sector, public and private schools were selected as well as all educational levels being imparted (EGB, BUP, FP, and ESO) [EGB: Educación General Básica, FP: Formación Profesional I/II, BUP: Bachillerato Unificado Polivalente, ESO: Eseñanza Secundaria Obligatoria]. Table 1. Number of subjects composing each age/gender group. Age groups
Boys
Girls
Total
11–12 years 13–14 years 15–16 years Total
174 247 264 685
197 228 232 657
371 475 496 1342
Measure The “Youth Self-Report” (YSR) (Achenbach, 1991) is a well-known psychopathological instrument designed to obtain adolescent reports of their competencies and behavioral/emotional problems. Competencies are assessed with reference to participation in activities, like sports and hobbies, and in social events such as organizations and friendships. The emotional/behavioral part contains 112 items, scored from 0 (“not true”) to 2 (“very true or often true”), according to the behavior displayed during the last six months. From this set of items a “Total problem” score (103 specific problem items) and a “Total socially desirable” score (16 socially desirable items) can be derived. The total problem scale is a measure of perceived general maladjustment level. The problem items were organized by Achenbach (1991) into eight narrow-band syndromes, identified
J. Abad et al.: Emotional and Behavioral Problems as Measured by the YSR
through PC analysis with orthogonal varimax rotations, for both genders. A ninth syndrome identified in boys did not have a clear counterpart among girls. After performing a second-order factor analysis, Achenbach (1991) identified two broad-band syndromes, named “Internalizing” and “Externalizing.” The narrow-band syndromes of “Withdrawn,” “Somatic complaints,” and “Anxious/Depressed” define the Internalizing band syndrome. “Delinquent behavior” and “Aggressive behavior” syndromes define the “Externalizing” grouping. Finally, “Social problems,” “Thought problems,” and “Attention problems” did not consistently have high loadings on Internalizing or Externalizing factors, and they were grouped by Achenbach (1991) under the heading “Mixed scales.” The test-retest reliabilities for the YSR broad-band syndromes and total problem score were about .80 in American adolescents, and for narrow-band syndromes only Social problems and Somatic complaints had low coefficients. The internal consistency for narrow-band syndromes were higher than .70, except for Withdrawn (Achenbach, 1991). The cross-cultural value of this instrument has also been established by De Groot, Koot, and Verhulst (1996) in a Dutch population and by Lemos et al. (1992a) and Abad (1998) in Spanish populations. A confirmatory factor analysis of the YSR eight narrow-band syndromes performed by De Groot et al. (1996) yielded a high percentage (95%) of replicated loadings, whereby Social problems and Attention problems syndromes fitted somewhat less well. Lemos et al. (1992a) reported a test-
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retest reliability of .93 for the Total problem score. Abad (1998) found adequate levels of internal consistency for broad- and narrow-band scales (around .85 for the former and most of the later being around .70); but for boys Withdrawn and Social problems did not reach the .60 level. The diagnostic accuracy found in this research was not very high (AUC = .65). Here we used a linguistic revision of a previous Spanish translation made by Lemos et al. (1992a). Wording changes for the 1991 YSR version were considered, and all items were back translated.
Procedure Test administration, conducted by two qualified psychologists, was collective, anonymous, and performed in a single session during school time. Previous to any test application, we obtained the verbal agreement of the principal. Subjects were stimulated to answer sincerely and were informed that their answers would help psychologists to understand them better. Protocols containing more than 8 unanswered questions were removed from those analysis dealing with composite scores (see Achenbach, 1991).
Results Table 2 presents the mean raw scores and standard deviations for each gender/age group on “Total problem”
Table 2. Mean raw scores and standard deviations of total problem score, and broad and narrow-band syndromes for each age-gender group. Last two columns inform of the number of items composing the syndrome and the overall range of its scores. Boys age n=
Girls
Boys
Girls
Total group
Number of items
Range
11–12 13–14 15–16 11–12 13–14 15–16 11–16 11–16 11–16 174 247 264 197 228 232 685 657 1342
Total Problem X Score σ
40.1 18.8
47.2 20.5
46.1 18.1
39.1 19.0
47.8 19.6
53.2 19.1
45.0 19.3
47.1 20.0
46.0 19.7
101
0–202
Broad-band syndromes Internalizing Externalizing
12.0 11.9
12.7 14.9
11.9 14.9
12.2 10.5
15.0 13.5
16.1 15.5
12.2 14.2
14.5 13.3
13.3 13.7
31 30
0–62 0–60
Narrow-band syndromes I. Withdrawn II. Somatic complaints III. Anxious/depressed
2.9 2.4 6.9
3.3 2.2 7.6
3.3 1.8 7.1
2.8 2.7 7.0
3.5 2.9 9.1
3.8 3.0 9.9
3.2 2.1 7.2
3.4 2.9 8.7
3.3 2.5 7.9
7 9 16
0–14 0–18 0–32
IV. Social problems V. Thought problems VI. Attention problems
2.8 1.7 5.7
2.8 2.3 7.1
2.3 2.5 7.4
2.5 2.0 5.6
2.4 2.4 7.2
2.7 2.8 8.2
2.6 2.2 6.8
2.5 2.4 7.0
2.6 2.3 6.9
8 7 9
0–16 0–14 0–18
VII. Delinquent behavior VIII. Aggressive behavior
3.1 8.8
4.4 10.6
4.8 10.1
2.5 7.9
3.6 9.9
4.7 10.8
4.2 9.9
3.6 9.6
3.9 9.8
11 19
0–22 0–38
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J. Abad et al.: Emotional and Behavioral Problems as Measured by the YSR
Table 3. Summary of results for factorial analysis of variance 2 (gender) × 3 (age). Prin. Age effect Total problem F score p η2
Gender Age × Gender
21.86 30.76 5.96 .0001 .0001 .015 .044 .010
5.697 .003 .009
score*, which followed a normal distribution in each age group. Scores on broad- and narrow-band syndromes did not follow a normal distribution, in which case only mean values are presented. All mean values are located within the normal range according to the original standardization sample (Achenbach, 1991). The relationship of age and gender with the total prob-
lems score, as analyzed by factorial analysis of variance, with a 2 (gender) × 3 (age: 11–12, 13–14,15–16) design, is shown in Table 3. Significant differences are found, with age having a greater influence (p = .001) than gender (p = .015). The interaction between both variables is also significant (p = .003). However, this significance has to be qualified taking into account that effect sizes (η2) are low. This result suggests that the differences identified are actually not very noteworthy, and that the high significance level is probably influenced by the large size of the sample studied. In order to analyze each simple effect of the variables involved in the interaction, we examined the differences between genders for each age group and those related to age for males and females. As can be seen in Table 4, total problem score follows a different age pattern for boys
Table 4. Summary of results for one-way analysis of variance on total problem score. Total problem score Group 1 (ages 11–12) Group 2 (ages 13–14) Group 3 (ages 15–16)
Gender
F p F p F p
.26 .61 .10 .74 18.19 .0001
Scheffe’s test
Age
(p < .05)
Total problem score
–
Boys
–
Girls
7.60 Gr.1 < Gr.2 ≈ Gr.3 .0005 28.73 Gr.1 < Gr.2 < Gr.3 .0001
F p F p
Scheffe’s test (p < .05)
boys < girls
Table 5. Significant differences for gender and age variables. Age Effect* Boys
Girls
Gender Effect** Group 1 Group 2
Broad-band syndromes Internalizing Externalizing
.0001 →
.0001↑ .0001↑
– –
.0002G –
.0001G –
Narrow-band syndromes I. Withdrawn II. Somatic complaints III. Anxious/depressed
– .0100↓ –
.0001↑ – .0001↑
– –
– .0009G .0001G
– .0001G .0001G
IV. Social problems V. Thought problems VI. Attention problems
– .0001↑ .0001↑
– .0003↑ .0001↑
– – –
– – –
– – .0018G
.0001↑ .0044 →
.0001↑ .0001↑
.0010B –
.0002B –
– –
VII. Delinquent behavior VIII. Aggressive behavior
* Age effects: – significant differences by age: Kruskal-Wallis results: p↑ = a general upward trend is shown p↓ = a general downward trend is shown p→ = an up-and-stableward trend is shown (groups 2 and 3 are equivalents and higher than 1)
Group 3
** Gender effects: pB = males scored higher pG = females scored higher
* As explained by Achenbach (1991) Allergy and Asthma items were excluded from the total score calculation because they do not discriminate between normal and clinical subjects. EJPA 18 (2), © 2002 Hogrefe & Huber Publishers
J. Abad et al.: Emotional and Behavioral Problems as Measured by the YSR
and girls. Males and females aged 11–12 show an equivalent number of similar intensity of problems. These problems increase significantly between 13–14 years, with the overall level still equal for both genders. At the age of 15–16 years, the number and intensity of problems in females increase significantly, while males show no significant mean increase in relation to the preceding age group. In sum, the increase in the general level of problems is progressive for females through 11 to 16 years of age. In the male group, an increase is observed between 11–12 and 13–14 years, and a subsequent stabilization up to 15–16 years. Age and gender effects on broad- (internalizing and externalizing) and narrow-band scales were also studied. As the scores of these scales were not normally distributed, group comparisons were carried out using nonparametric tests (Mann-Whitney U for gender contrasts and Kruskal-Wallis H for age contrasts). These tests do not allow us to study interactions, so that age and gender effects on each syndrome were analyzed independently. Table 5 shows the significance level of these effects. Age contrasts allow identification of an upward trend, a downward trend, and an up-and-stableward trend (superindex ↑, ↓, →); while gender contrasts inform about the group scoring higher (superindex G or B). Male and female age differences for Externalizing of both narrow- and broad-band, and Mixed syndromes are quite similar. For both genders, the increase in age is accompanied by a rise in reported externalizing problems, and also in the Thought and Attention problem scales. The Social problems score remains stable with age for both genders. But a gender difference is detected on the Aggressive behavior syndrome: The score increases as females get older, while for males the increase appears only between the first and the second age groups and later becomes stable. As can be seen in Table 5, the main age differences between male and female adolescents appear in the Internalizing problems area. With age, Withdrawn and Anxious/Depressed scales remain stable in males, while these problems show a significant increase in females. Somatic complaints decrease in males, but not in females. The gender differences in each age group suggest that females aged between 13 and 16 years score higher than males in the Internalizing syndrome and specifically in Somatic complaints and Anxious/Depressed. No significant gender differences are found in the Externalizing syndrome, with one exception: Males between 11 and 14 have higher scores in Delinquent behavior than females. As for Mixed syndromes, older females (15–16) obtain higher scores than males in Attention problems. Figure 1 helps to understand the significant differences commented above, showing graphically the age and gender tendencies.
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Discussion This paper assesses the perceived behavioral/emotional changes of adolescents aged between 11 and 16, bearing in mind age and gender differences. The research was conducted within a developmental psychopathological perspective, which seeks to identify variations in normal/pathological behavior associated with age and gender (Cichetti, 1984). As found by Forehand, Neighbors, and Wierson (1991) and Cohen et al. (1993), this study shows that males and females do exhibit different developmental patterns. The results indicate that age leads to an increase of self-perceived maladjustment – reflected by an increase in the total problem score of the YSR. This tendency has also been observed in American (Achenbach et al., 1990), Asturian (Lemos et al., 1992a), and Irish adolescents (Fitzpatrick & Deehan, 1999). Moreover, both in Catalan and Asturian adolescents this increase is greater in females than in males. It can be stated, according to Petersen et al. (1993), that this increase in the perceived maladjustment is related to a greater capacity for reflective thought and self-criticism, characteristics that appear earlier in females. The general tendency of behavioral/emotional problems to increase in females is particularly evident in the Internalizing domain, but it is also observed over the whole psychopathological spectrum assessed, except for Somatic complaints and Social problems. Forehand et al. (1991) found also a widespread increase involving several psychopathological areas, and Domènech et al. (1996) confirmed that the increase in the frequency of emotional alterations is more marked in females. In males, the increase in behavioral/emotional problems is found mainly in Externalizing symptoms and in Thought and Attention problems. Forehand et al. (1991), using the Revised Behavior Problem Checklist, reported that from parents’ viewpoint a stabilization of Internalizing problems also occurs in males. However, in contrast to our findings, these authors observed a decrease in the number of Externalizing problems; this difference could be explained by the fact that a different technique and informant were used. In sum, for males versus females a different developmental course is apparent in Internalizing problems. That is based on two facts: First, females show an increasing tendency toward isolation and toward reacting in an anxious or depressive way. Second, males resort less to maladjustment in favor of Somatic Complaints. Thus, it can be seen that development during adolescence, at least from 11 to 16 years, brings about changes in the emotional area, particularly in females. This tendency is also confirmed by Lemos et al. (1992b). EJPA 18 (2), © 2002 Hogrefe & Huber Publishers
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J. Abad et al.: Emotional and Behavioral Problems as Measured by the YSR
Total problem score 60 50 40 30 20 11-12
13-14
15-16
age groups
boys
Internalizing
Externalizing
20
20
15
15
10
10
5
5
0 11-12
13-14
15-16
0 11-12
age groups
age groups
Withdrawn
Somatic complaints
10
10
8
8
6
6
4
4
2
2
0 11-12
13-14
13-14
15-16
age groups
Figure 1. Mean YSR total and scale scores for boys and girls. EJPA 18 (2), © 2002 Hogrefe & Huber Publishers
0 11-12
13-14
age groups
girls
15-16
15-16
J. Abad et al.: Emotional and Behavioral Problems as Measured by the YSR
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Figure 1. Mean YSR total and scale scores for boys and girls (continued). EJPA 18 (2), © 2002 Hogrefe & Huber Publishers
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J. Abad et al.: Emotional and Behavioral Problems as Measured by the YSR
The increased emotional instability as measured by the Internalization syndrome could be related to girls’ preferred coping style, characterized – according to Compas et al. (1993) – by focusing attention in negative emotional states, something that has been called rumination. But it also might be explained by their earlier physical maturation and dating experiences – and the prominent value that girls confer to these two facts (Kirchner & Forns, 2000). A similar developmental course for males and females can be noted in the increase in Thought problems, Attention problems, Delinquent behavior, and Aggressive behavior scores as well as in the stabilization of Social problems scores. The new emerging cognitive capacities in adolescence can lead to an increase in those syndromes that imply the use of thought. Also, the perception of more attention difficulties could be related to this added thinking activity as well as the increase in school demands. The need for self-reaffirmation and to achieve a sense of freedom from parents could explain the increase in rebelliousness and therefore the highest implication in some delinquent and aggressive behaviors that has been found in both genders. Although these changes lie in the behavioral domain, neither boys nor girls perceive increased social interaction difficulties. This could be especially true with regard to peer interactions, because of adolescence increases the involvement with peers (Petersen & Hamburg, 1986). The social, emotional and behavioral self-perception of males and females at 11–12 years is quite similar, and they become increasingly different parallel to the last developmental stages of puberty in females. In the middle stage (13–14 years), differences are not a question of the overall degree of maladjustment, but rather reflect the way in which this maladjustment is expressed. In females, it adopts the form of internalizing problems, which could be associated with a greater vulnerability to depression, and in males it adopts the form of externalizing problems, associated to behavioral disorders. Canals et al. (1995) also located the increase in the prevalence of emotional disorders for females at this age. Later, at around 15–16 years, differences refer not only to type, but also to the magnitude acquired by conflicts, with females showing a greater degree of perceived maladjustment. Finally, it must be noted that psychological assessment and taxonomical proposals in adolescence are enriched if not only gender is taken into account, but also developmental age differences.
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Judit Abad UB Facultat de Psicologia Departament de Personalitat (Edifici Ponent) Passeig de la Vall d’Hebron, 171 E-08035 Barcelona Spain Tel. +34 (9)3 312-5113 Fax +34 (3)3 402-1362 E-mail
[email protected]
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