A low exercise capacity can be translated into more internalising problems.
Females were reported to have more internalising problems like anxiety and depression, more often feel stressed and overwhelmed trying to live up to social expectations, have lower self-esteem, and more often show self-injurious behaviour and suicidal attempts.
In terms of symptomatology, females diagnosed with ADHD may present with lower ratings of hyperactivity, inattention, impulsivity and externalising problems (e.g. aggression) than ADHD males, but greater intellectual impairments and more internalising problems (e.g. affective, eating and somatisation disorders) (Gershon, 2002).
This result is likely to be a consequence of the gender-specific trends in mental health problems, with boys more frequently displaying externalising problems that are connected to more obvious limitations, while girls in this age group tend to show internalising problems [ 23] where interferences with functioning are less observable.
The dysfunction group was significantly more likely to have experienced more internalising (anxiety/depression) symptoms.
A study in primary and secondary education showed that 13% of all pupils had internalising problems, 11% had externalising problems and 3% had other behavioural problems [ 6].
This section is subdivided into an overview of the literature covering (1) hyperactivity or inattention problems such as ADHD, (2) externalising problems such as conduct disorder and antisocial behaviour and (3) emotional or internalising problems such as depression and anxiety.
The lack of association with internalising problems was contrary to previous studies that had demonstrated associations of parental education (not necessarily the mother's) with internalizing problems in adolescents [ 45, 48, 49].
The preschool years of a child are generally considered important, since during this period many clinically significant problem behaviours may occur. 1 2 Externalising (eg, aggression, conduct problems, hyperactivity) and internalising problems (eg, emotional problems, anxiety, depression) can often be identified first in early childhood, which then shows considerable stability across older ages.
Several studies confirm that also in elementary school age children, a higher level of alexithymia and other problems in the domain of emotion awareness are related to internalising problems, such as depression, fear or anxiety, somatic complaints, worry and rumination [ 16– 19, 21].
While children and adolescents with asthma have been found to be at increased risk for mental health problems, particularly internalising problems (emotional well-being) [ 41] leading to suggestions of accumulative risks for HRQoL-impairments [ 42] it may also be necessary to look at the amount of external resources available (e.g. social support).
