Judgments of impairment and distress associated with symptoms of internalizing and externalizing disorders

Anxiety Stress Coping. 2008 Apr;21(2):143-54. doi: 10.1080/10615800701455973.

Abstract

The pattern of dysfunction (i.e. impairment vs. distress) judged to be associated with disorders empirically identified by Krueger, Caspi, Moffitt and Silva (1998) as internalizing (e.g. major depressive episode; agoraphobia) was compared to the pattern characterizing disorders classified as externalizing (e.g. antisocial personality disorder; alcohol dependence). In Study 1, lay raters (N=270) judged the social impairment, occupational impairment, and personal distress associated with symptoms of seven internalizing and four externalizing disorders. As predicted, symptoms composing internalizing disorders were perceived as involving a greater degree of distress, and a lesser degree of impairment, relative to symptoms composing externalizing disorders. In Study 2, conducted with a small sample of clinician judges (N=21), symptoms composing internalizing disorders were again judged as involving a greater degree of distress (but, in this case, not a lesser degree of impairment) relative to symptoms composing externalizing disorders. This research provides a novel means of validating the distinction between internalizing and externalizing groups of disorders.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Adolescent
  • Adult
  • Analysis of Variance
  • Diagnostic and Statistical Manual of Mental Disorders
  • Disability Evaluation
  • Employment / psychology
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / psychology*
  • Middle Aged
  • Models, Psychological
  • Reproducibility of Results
  • Social Adjustment*
  • Stress, Psychological / psychology*