Children with Internalizing Problems and Peer Problems: Risk Factors, Treatment Effectiveness, Moderation, and Mediation

Abstract

In this dissertation, internalizing and peer problems in children around the age of twelve were examined. These children were all about to make the transition to secondary school, or had just made that transition. The dissertation reports on four studies. First, we examined the extent to which the Big Five personality traits influence the likelihood of a socially anxious child being victimized. Second, we examined the prospective relation between social anxiety and victimization. In both studies gender differences were considered. Third, we examined the effectiveness of the social skills training program ‘Happy at School’ in alleviating internalizing problems and peer problems. In addition, the moderation of gender and initial problem levels was studied. Forth, we examined the working mechanisms behind the effectiveness of ‘Happy at School’ by examining mediating processes. The first study showed that social anxiety and victimization were positively related. Social anxiety was moderately related with all five personality traits. Victimization was moderately related with extraversion, agreeableness, conscientiousness and neuroticism. Moreover, the association between social anxiety and victimization was stronger for boys than for girls. Interaction analyses showed that socially anxious children scoring low on extraversion were more at risk for victimization compared to socially anxious children scoring higher on this trait. In addition, it was found that socially anxious boys scoring low on agreeableness were more at risk for victimization compared to socially anxious boys scoring higher on this trait. These results indicate that high scores of extraversion and high scores of agreeableness (for boys) are protective factors against victimization for socially anxious children. Study two showed that both social anxiety, and peer-reported victimization and social anxiety and self-reported victimization were related at baseline. Moreover, social anxiety, and self- and peer reported victimization were all relatively stable over time. Cross-lagged analyses showed that that higher baseline social anxiety scores predicted increased future peer- and self- reported victimization in boys, and increased future self-reported victimization in girls, over and above the stability of victimization. Reverse cross-lagged effects of victimization on changes in social anxiety were not found. These results indicate that social anxiety leads to victimization, both according to self-reports and peer-reports (for boys). Study three showed that ‘Happy at School’ was effective for all children in increasing self-esteem and in decreasing parent reported internalizing problems. In addition, the program was largely effective in reducing social anxiety, self-reported victimization and social disintegration in boys, with higher initial problem scores, but not in girls. ‘Happy at School’ is not effective in reducing parent-reported peer problems and peer-reported victimization. Teachers reported noticing more internalizing problems in the intervention group compared to the control group for both boys and girls. This could be explained by lower thresholds for children to report problems to teachers as a result of ‘Happy at School’. Results of the fourth study showed that decreasing negative beliefs is an important working mechanism of the training program ‘Happy at School’ in decreasing social anxiety, victimization, and social disintegration and in increasing self-esteem.