The Development of Conduct Problems and Depressive

Symptoms in Early Elementary School Children: The Role

of Peer Rejection
Evelien M. J. C. Gooren, Pol A. C. van Lier, Hedy Stegge,
Mark Meerum Terwogt, and Hans M. Koot
Department of Developmental Psychology, VU University Amsterdam
Conduct problems in childhood often co-occur with symptoms of depression. This study
explored whether the development of conduct problems becomes indirectly linked to
depressive symptoms in a sample of 323 kindergarten children, followed over a period
of 2 school years. Results showed that the development of conduct problems was
indirectly linked to the development of depressive symptoms via experiences of peer
rejection. These links were similar for boys and girls. Results underscore that part of
the development of childhood symptoms of depression in the early years of school
can be explained by a cascade effect in which the development of conduct problems
results into poor peer experiences, which ultimately predict depressive symptoms.
Problems with social relationships, such as peer
rejection, have been the focus of many studies examining
the development of psychopathology. Indeed, several
reviews showed that children who are rejected by their
mainstream peers have higher levels of conduct problems
(e.g., physical aggression, destruction of property, and
lying) and symptoms of depression than children who
do not experience rejection (Boivin, Hymel, & Hodges,
2001; Deater-Deckard, 2001; Parker, Rubin, Erath,
Wojslawowicz, & Buskirk, 2006). Not only is peer rejec-
tion linked to both conduct problems and symptoms of
depression, it may be that such difculties with peers
explain, at least in part, the co-occurrence between these
forms of behavioral and emotional problems. For
example, Achenbach and Rescorla (2001) found an
average correlation of approximately .50 (.54 and .45
for parent and teacher reports, respectively) between
behavioral problems and emotional problems in the gen-
eral population of children in the United States. Similar
correlations have been found in the general Dutch popu-
lation (Verhulst, van der Ende, & Koot, 1996, 1997).
It has been proposed that one of the reasons why
different forms of psychopathology co-occur is because
one set of problems may create a context in which other
problems may develop (Caron & Rutter, 1991). The
phenomenon in which problems in one domain of func-
tioning spread out and affect adaptation in other domains
has been described as a cascade effect, otherwise called
a snowball, indirect, or chain effect (Masten, Burt, &
Coatsworth, 2006; Masten & Cicchetti, 2010; Rutter &
Sroufe, 2000). Following from such studies, this study
explored whether the time-related link between conduct
problems and symptoms of depression may be explained
by a cascade effect. Specically, this study investigated
whether the developmental link between conduct pro-
blems and depressive symptoms is indirect, in that conduct
problems hamper childrens social development, expressed
as experiences of peer rejection, which, in turn, place the
child at risk of developing symptoms of depression. This
is studied in a community sample of kindergarten children
followed longitudinally over 2 school years.
PEER RELATIONS AND CHILDRENS
BEHAVIORAL DEVELOPMENT
Forming satisfactory peer relations is one of the most
important developmental tasks in childhood (Cicchetti
This study was nancially supported by ZonMWGrant #2430.0031.
Correspondence should be addressed to Evelien M. J. C. Gooren,
Department of Developmental Psychology, VU University Amsterdam,
Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
E-mail: emjc.gooren@psy.vu.nl
Journal of Clinical Child & Adolescent Psychology, 40(2), 245253, 2011
Copyright # Taylor & Francis Group, LLC
ISSN: 1537-4416 print=1537-4424 online
DOI: 10.1080/15374416.2011.546045
& Schneider-Rosen, 1986; Cicchetti & Toth, 1998;
Masten & Coatsworth, 1998). In fact, following the tran-
sition to kindergarten, children often need to function in
a formal peer group for the rst time. This peer group
provides valuable opportunities for children to learn
and practice prosocial skills and to understand and inter-
nalize social norms and rules. Establishing satisfactory
peer relations during this period is therefore a major
developmental challenge. However, not all children will
succeed in meeting this challenge, as approximately 10
to 15% of children experience peer rejection (Deater-
Deckard, 2001; Rubin, Bukowski, & Parker, 2006).
Being rejected by a peer group can contribute to the
emergence of psychopathological symptoms in several
ways. Because of their poor social status, rejected chil-
dren are likely to be deprived of the opportunities that
the social context of a peer group provides for learning
social norms and rules. As a consequence, they have
fewer opportunities to practice social skills, which
increase the probability that they will behave inappropri-
ately in social interactions and receive subsequent nega-
tive feedback and negative responses in their encounters
with peers (Hartup, 1992; Rubin, Wojslawowicz,
Rose-Krasnor, Booth-LaForce, & Burgess, 2006). Such
feedback and responses from peers are likely to become
chronic, as levels of peer rejection have been found to
be highly stable (Camodeca, Goossens, Meerum
Terwogt, & Schuengel, 2002; Cillessen, Bukowski, &
Haselager, 2000; Lu Jiang & Cillessen, 2005; Scholte,
Engels, Overbeek, de Kemp, & Haselager, 2007). A pos-
sible consequence of this chronic rejection by peers is
that children may develop a low sense of self competence
resulting from internalized negative feedback on their
social relational failures (Cole, 1991; Cole, Jacquez, &
Maschman, 2001; Cole, Martin, & Powers, 1997; Masten
& Coatsworth, 1998). In addition, these children are
likely to develop (negatively) biased social cognitions
because of their repeated negative experiences with their
peers (Dodge et al., 2003). Because of such cognitive
biases, the chance that these children will display nega-
tive maladaptive behaviors in future peer interactions is
increased. This, in turn, may elicit additional negative
social feedback. It is therefore not surprising that
research has shown peer rejection contributes to the
development of both conduct problems and internalizing
problems, such as symptoms of depression (DeRosier,
Kupersmidt, & Patterson, 1994; Ladd, 2006).
PEER REJECTION AND THE DEVELOPMENT
OF CONDUCT PROBLEMS AND
DEPRESSIVE SYMPTOMS
It is important to note that experiences of peer rejection
may explain not only the continuity of conduct problems
as well as depressive symptoms but also explain the links
between them (Deater-Deckard, 2001; Rubin et al.,
2006). In fact, according to the failure model proposed
by Patterson and Capaldi (1990), an indirect path from
conduct problems to depressive symptoms is predicted.
These authors proposed that childhood conduct
problems diminish childrens chances of succeeding in
establishing satisfying relations with peers. Possibly
through the processes described earlier (social and social
cognitive), these children may internalize their experience
of failing this major developmental task and develop
symptoms of depression. Thus, according to the failure
model, a time-related, indirect link from conduct pro-
blems to depressive symptoms is expected, because of
the developmental cascade from peer rejection to depress-
ive symptoms which was initiated by conduct problems.
Despite the theoretical feasibility of a time-related link
between conduct problems and symptoms of depression,
few longitudinal studies have explored the role of
troublesome peer relations as a connector in this link
and most of these studies did not include data on social
functioning in kindergarten. However, two sources of
evidence underscore the plausibility of the failure
hypothesis. First, studies have indeed shown that con-
duct problems, or broader behavior problems in kinder-
garten and the early elementary school period, predict
depressive symptoms=emotional problems above and
beyond the stability of such symptoms=problems
(Timmermans, van Lier, & Koot, 2010; van Lier & Koot,
2010). Second, some studies indeed found behavioral and
emotional problems to be related over time via poor peer
relations. For instance, Ladd and Troop-Gordon (2003)
showed that aggression in kindergarten predicted peer
rejection over Grades 1 to 3, which in turn predicted
loneliness and overall internalizing problems at age 10.
In addition, van Lier and Koot (2010) found that the
path from externalizing symptoms in kindergarten to
internalizing symptoms in fourth grade was indeed an
indirect one in which peer rejection in Grades 1 to 3
was the connector. However, neither of these studies
assessed peer rejection in kindergarten, the period in
which poor peer experiences likely emerge for the rst
time. A study by Burt and Roisman (2010) did include
assessments of social competence (not peer rejection)
from preschool onward. They found that externalizing
problems in preschool predicted poor social competence
in the rst grade, which was associated with depressive
symptoms in the fth grade. However, as poor social
skills are theorized and empirically found to follow poor
social status (Haselager, Cillessen, Van Lieshout,
Riksen-Walraven, & Hartup, 2002; Rubin, Bukowski,
et al., 2006), it may well be that the inuence of peer
rejection on internalizing problems starts earlier.
However, other studies found no support for an
indirect link from conduct problems to depressive
246 GOOREN ET AL.
symptoms via peer rejection. For instance, although
Pedersen, Vitaro, Barker, and Borge (2007) did nd that
disruptiveness at age 6 predicted repeated experiences of
rejection over the duration of elementary school, these
experiences of rejection did not predict depressive symp-
toms in early adolescence. They did, however, predict feel-
ings of loneliness in early adolescence. Finally, Kiesner
(2002) did not nd support for links between externalizing
and internalizing problems via peer rejection in late child-
hood. Although he found a path from externalizing
problems to peer rejection, and a path going back from
peer rejection to internalizing problems, the overall
indirect path was nonsignicant.
Thus, despite some evidence for the role of peer rejec-
tion in the link between conduct problems and depres-
sive symptoms, this evidence is not unequivocal, and
most studies did not explore the kindergarten period,
in which peer rejection is expected to emerge possibly
for the rst time. Therefore, the main objective of this
study was to explore whether the development of
conduct problems in children becomes linked to the
development of depressive symptoms because conduct
problems evokes experiences of peer rejection, which
in turn increase the risk of developing depressive symp-
toms (a cascade effect). In our study we focused on the
period from kindergarten to rst grade during which
peer relations become an important part of childrens
lives. We assessed all constructs in parallel, which is an
important methodological advantage of this study, in
that it allowed us to test the expected indirect path using
developmental associations.
Before studying the potential indirect link, as a start-
ing point, we rst explored whether conduct problems
indeed added to the probability of developing symptoms
of depression over time above and beyond the stability of
depressive symptoms. Based on previous studies, we
hypothesized nding such directional links. Then we
tested the cascade hypothesis, that conduct problems
would predict experiences of peer rejection, which in turn
would predict the development of depressive symptoms.
Specically, the hypothesis stating that the developmen-
tal links between conduct problems and depressive symp-
toms are direct (the direct model) was compared with the
alternative hypothesis that this link is indirect, and runs
via experiences of peer rejection (the indirect model). We
hypothesized nding support for the indirect model.
Finally, we tested for sex differences. Studies on the role
of peer rejection in the links between externalizing and
internalizing symptoms did not nd sex differences
(Ladd & Troop-Gordon, 2003; Pedersen, Vitaro, Barker,
& Borge, 2007; van Lier & Koot, 2010). However, other
studies do suggest that there are differences between boys
and girls. For instance, peer rejection may inuence
boys externalizing problems more negatively than girls
(DeRosier et al., 1994; Moftt, Caspi, Rutter, & Silva,
2001), whereas negative peer experiences may be more
strongly linked with internalizing problems for girls
(Crick & Zahn-Waxler, 2003).
METHOD
Participants
Eighteen schools from the northern and the eastern part
of the Netherlands were recruited via municipal health
services to participate in a longitudinal study on chil-
drens social-emotional development. Children who were
in kindergarten (N323, 54% boys; M age 5.10 years,
SD0.37 at baseline) were included in the study. The
children were followed over 2 school years. In each school
year they were assessed twice (four assessments in total),
starting in the fall of kindergarten (baseline, T1). Reas-
sessments occurred at 6 (T2), 12 (T3), and 18 (T4)
months. The parents of all the children were informed
about the study and given the opportunity to refuse to
consent to the participation of their child. Almost all of
the children (99.9%) were allowed to participate. The vast
majority (95%) of the children were of Dutch=Caucasian
background, 0.3% were Surinamese, 2.5% were Turkish,
and 2.2% belonged to another ethnic group.
Half of the study sample received a preventive inter-
vention program, the PATHS curriculum (Kusche &
Greenberg, 1994), aimed at improving childrens social
and emotional competence. Children were assigned to
the intervention or a control condition using a quasi-
experimental design. In the fall of Year 1, the program
was implemented in the intervention classes.
Data on conduct problems and symptoms of
depression at T4 (last assessment) were missing for 27
children (8.36%) due to absence during data collection
because of illness, grade retention, or they moved to
another school. This loss was not related to the
childrens sex, v
2
(1, N323) .31, p .58. However,
children with missing data had higher baseline levels
of conduct problems, F(1, 322) 4.60, p <.05, g
2
.01,
as well as symptoms of depression, F(1, 322) 5.35,
p <.05, g
2
.02, compared to the children with complete
data.
Procedure
Face-to-face interviews were used to obtain peer nomina-
tions. These individual interviews with each child were
carried out by trained graduate or undergraduate stu-
dents. To ascertain that each child knew who he or she
was nominating, interviewers had photos of the children.
Children were asked to point at these when nominating a
specic child. At the end of each assessment, the children
received a little gift as a reward for their assistance.
CONDUCT PROBLEMS AND DEPRESSIVE SYMPTOMS 247
Psychopathology ratings were obtained from the
teachers in the same months in which the children were
assessed. Teachers also received a gift as a token of
appreciation for participating in the study.
Measures
Teacher ratings of conduct problems and depressive symp-
toms were obtained using the Problem Behavior at
School Interview (PBSI; Erasmus MC, 2000). The PBSI
is a 42-item questionnaire assessing the psychosocial
adjustment of children. Teachers rated their pupils
behavior on a 5-point scale ranging from never appli-
cable to often applicable. Conduct problems were rated
through 12 items (e.g., threatens other people, starts
ghts, truancy, attacks other children physically,
tells lies, does not feel guilty when misbehaves).
Cronbachs alpha ranged from .91 to .92 over the assess-
ments. Symptoms of depression were rated through four
items: is unhappy or depressed; is indifferent,
apathetic and unmotivated; does not take pleasure
in activities; and feels inferior. Cronbachs alpha
ranged from .82 to .83 over the assessments. The conver-
gent validity of the PBSI was found to be good as
indicated by the correlations between the PBSI and the
Teachers Report Form (Achenbach, 1991), which were
.75 (p <.01) for externalizing behavior and .55 (p <.01)
for internalizing behavior (Witvliet, van Lier, Cuijpers, &
Koot, 2010).
Peer nominations of aggression were measured by
asking children to nominate all classmates who t the fol-
lowing description: someone who hits other children.
The total number of nominations that each child in the
class received was summed and divided by the class size
minus 1 (self-nominations were not allowed). Other stu-
dies reported peer-nominated aggression to be reliable
and to correlate signicantly with self-reports as well as
teacher reports of similar behavior (Dodge, Pettit, &
Bates, 1994; Epkins, 1995). In the current study, the
correlations between peer nominations of aggression
and teacher-rated conduct problems ranged from .52 to
.59. The z standardized peer scores and teacher scores
were therefore summed to create a multi-informant
conduct problems score.
Peer social-preference was assessed using the peer
nominations of like most and like least, as deli-
neated by Coie, Dodge, and Coppotelli (1982). Children
were asked to nominate an unlimited number of class-
mates whom they liked most and whom they liked least.
For each child the total number of the like most nomi-
nations and the like least nominations were divided
by the number of children in the class minus 1 (self-
nomination was not allowed). The like least score
was then subtracted from the like most score to gener-
ate the social preference score. These social preference
scores were then multiplied by 1 so that the high scores
represented poor social preference (peer rejection).
Social preference is generally regarded as a reliable and
valid measure of sociometric status (Cillessen & Mayeux,
2004; Rubin et al., 2006).
Data Analyses
First, to test the hypothesis that already in kindergarten
and rst-grade elementary school conduct problems pre-
dict the development of depressive symptoms, an auto-
regressive cross-lagged model (Joreskog, 1970) was
used. In the autoregressive paths, variables were regressed
on their immediate prior values, to study stability within
processes. Cross-sectional correlations between conduct
problems and depressive symptoms were included in the
models. To study possible cross-over effects, cross-time
paths from conduct problems to depressive symptoms
(and vice versa) were allowed for. Signicant cross-lagged
paths from conduct problems to depressive symptoms
would reect the anticipated prediction of depressive
symptoms by prior levels of conduct problems, while con-
trolling for stability within and concurrent links between
these domains of psychopathology.
After having studied the direction of effect between
conduct problems and depressive symptoms, the hypoth-
esis on the connecting role of poor social preference in
this longitudinal link was tested using triple latent
growth models. The development of each construct was
represented by two latent growth parameters, an inter-
cept (centered at the rst assessment) to assess initial
level differences and a linear slope, which represents
growth over the repeated assessments. Given our focus
on developmental links, we focused on slope associa-
tions, although links between intercepts were allowed
for. A test for the joint signicance of the two directional
paths between the slopes (MacKinnon, Lockwood, &
Williams, 2004) was used to test for the signicance of
the indirect path (cascade effect) from conduct problems
to depressive symptoms via poor social preference. To
test for possible sex differences, multiple group models
were used. A model in which the path estimates were
freely estimated across gender was compared to a model
in which the path estimates were constrained to be equal
across boys and girls using a chi-square difference test.
All models were tted using Mplus 5.1 (Muthen &
Muthen, 19982009). Model t was determined through
the comparative t index (CFI; values .90; Bollen &
Long, 1993), the TuckerLewis index (TLI; values
.90; Bollen & Long, 1993), and the root mean square
error of approximation (RMSEA; values .08; Browne
& Cudeck, 1992). As data were nested within classes,
standard errors were adjusted using a sandwich esti-
mator (Williams, 2000). Missing data were handled
through Full Information Maximum Likelihood
248 GOOREN ET AL.
estimation. To account for the nonnormal distribution of
all scores, an MLR estimator, which provides robust
standard errors, was used.
RESULTS
Descriptive Statistics
The means and standard deviations of all the study
variables for boys and girls are shown in Table 1. Boys
scored higher on conduct problems and poor social
preference than girls. No differences were found in the
levels of depressive symptoms between boys and girls.
The bivariate Pearson correlations among the study
variables are reported in Table 2 for boys and girls sep-
arately. For boys and girls signicant within-variable
correlations were found for conduct problems, depres-
sive symptoms (except for T2T3), and poor social pref-
erence. Moreover, the general pattern of the time lagged
correlations showed signicant correlations between
conduct problems and depressive symptoms, conduct
problems and poor social preference, and poor social
preference and depressive symptoms, for both boys
and girls.
Developmental Links Between Conduct Problems
and Depressive Symptoms
To test for the direction of effect between the four waves
of assessments of conduct problems and symptoms of
depression, a cross-lagged model was tted. In addition
to the autoregressive and within-time correlations,
cross-lagged paths from conduct problems to depressive
symptoms and vice versa were allowed for. This model t-
ted the data well (CFI .96, TLI .94, RMSEA.07).
The results are depicted in Figure 1. Signicant stability
estimates for conduct problems were found, as well as
for symptoms of depression (except for T2T3). Further-
more, conduct problems consequently added to the pre-
diction of depressive symptoms over time. Specically,
the results showed that although the stability path of
depressive symptoms within 1 school year (rated by the
same teacher) differed from the stability path across the
school years (rated by different teachers), the estimates
of the cross-over paths from conduct problems to
depressive symptoms did not differ within school year
as compared to across school years. No additive effects
from depressive symptoms to conduct problems were
found. Having established the anticipated direction of
effect from conduct problems to symptoms of depression
across kindergarten and the rst grade of elementary
school, we then tested for the role of poor social prefer-
ence in this developmental link.
Poor Social Preference and the Development of
Conduct Problems and Depressive Symptoms
We tested for the potential role of poor social preference
in the developmental link between conduct problems
and depressive symptoms using a triple latent growth
model. Signicant variances in the slope parameters of
conduct problems (r
2
0.01, SE0.00, p <.01), symp-
toms of depression (r
2
0.20, SE0.08, p <.05), and
poor social preference (r
2
0.07, SE0.08, p <.01)
were all present.
First, we tted a model containing directional links
from the growth parameters of conduct problems to
the growth parameters of depressive symptoms. In this
model, no links between the growth parameters of poor
social preference (the hypothesized connector) and the
growth parameters of conduct problems or depressive
symptoms were allowed for (the direct model). This
model was compared with a model in which poor social
preference was specied as the connecter. Directional
paths from the growth parameters of conduct problems
to those of poor social preference, and from the growth
parameters of poor social preference to those of depres-
sive symptoms, were specied (the indirect model). Note
that no direct link from conduct problems to depressive
symptoms was specied. Thus, different from classical
mediation our cascade hypothesis does not assume that
the preexisting direct link between conduct problems
and depressive symptoms is explained by poor social
preference. Rather, it assumes a pure indirect path
between the three variables. However, a signicant
indirect path has been described as a mediation effect
(MacKinnon, Lockwood, Hoffman, West, & Sheets,
TABLE 1
Means and Standard Deviations of Assessed Study Variables
Boys Girls
M SD M SD Test: F
Conduct Problems
T1 0.33 0.99 0.38 0.55 59.38

T2 0.26 1.01 0.31 0.56 35.96

T3 0.33 0.97 0.39 0.56 55.29

T4 0.25 0.96 0.32 0.66 31.99

Depressive Symptoms
T1 0.84 0.60 0.80 0.58 0.37
T2 0.69 0.67 0.57 0.53 3.13
T3 0.75 0.56 0.71 0.57 0.39
T4 0.80 0.66 0.69 0.62 2.28
Poor Social Preference
T1 0.04 0.26 0.15 0.23 14.57

T2 0.12 0.28 0.20 0.25 6.97

T3 0.07 0.35 0.21 0.24 14.94

T4 0.08 0.31 0.19 0.24 11.34

Note: Tmeasurement wave.

p <.01.
CONDUCT PROBLEMS AND DEPRESSIVE SYMPTOMS 249
2002). In this model links from the intercept of conduct
problems to the slope of social preference and from the
intercept of social preference to the slope of depressive
symptoms were also allowed for.
Results showed that the indirect model had a signi-
cantly better t to the data than the direct model,
Dv
2
(3) 33.91, p .00. The indirect model had a satis-
factory t to the data (CFI .93, TLI .92,
RMSEA.07). The results are shown in Table 3. The
slope of conduct problems predicted the slope of social
preference, which in turn predicted the slope of depres-
sive symptoms. The test to see whether these paths
formed the hypothesized indirect path from the slope
of conduct problems to the slope of depressive symptoms
via the slope of poor social preference indeed was signi-
cant (b.56, p <.01).
Sex Invariance and Intervention Effect
We tested whether the strengths of the associations
comprising the indirect path from conduct problems to
depressive symptoms via poor social preference was
sex-invariant. To this end, a multiple group model was
tted in which boys were compared to girls. First, we
tted a model in which all path estimates were freely
estimated for boys and girls. This model was compared
to the second model in which the paths comprising the
indirect path (the path from the slope of conduct
problems to the slope of social preference and the path
from the slope of social preference to the slope of
depressive symptoms) were constrained to be equal
across sex. Results showed that these links did not differ
between boys and girls, Dv
2
(2) 0.17, p .92.
Finally, as stated, approximately half of the sample
received a preventive intervention. Studying inter-
vention effects is not an objective of our study, but we
tested whether the path estimates were similar for the
intervention and control children using a multiple group
model. The model in which path estimates were
constrained to be equal across the conditions did not
differ signicantly from the one in which the growth
parameters were freely estimated, Dv
2
(2) 2.94, p .23.
TABLE 2
Correlations Between Conduct Problems, Depressive Symptoms, and Poor Social Preference
Variables 1 2 3 4 5 6 7 8 9 10 11 12
1. Conduct Problems T1 .66

.58

.60

.34

.20

.29

.28

.45

.36

.38

.49

2. Conduct Problems T2 .78

.61

.63

.23

.33

.33

.29

.35

.21

.22

.35

3. Conduct Problems T3 .58

.65

.84

.09 -.05 .44

.47

.35

.25

.37

.53

4. Conduct Problems T4 .53

.61

.84

.13 -.05 .35

.47

.29

.24

.32

.57

5. Depressive Symptoms T1 .38

.30

.12 .16 .56

.22

.14 .14 .15 .30

.18

6. Depressive Symptoms T2 .37

.44

.18

.29

.70

.14 .11 .19

.08 .10 .07

7. Depressive Symptoms T3 .16

.07 .32

.36

.18

.05 .61

.22

.19

.12 .34

8. Depressive Symptoms T4 .16

.20

.31

.44

.20

.26

.69

.12 .30

.26

.36

9. Poor Social Preference T1 .50

.46

.52

.44

.19

.19

.14 .18

.44

.44

.48

10. Poor Social Preference T2 .42

.53

.54

.53

.12 .16

.20

.27

.45

.56

.53

11. Poor Social Preference T3 .40

.45

.68

.61

.07 .08 .20

.16 .49

.57

.56

12. Poor Social Preference T4 .24

.34

.53

.53

.06 .21

.15 .24

.36

.53

.64

Note: Correlations for boys are below the diagonal, those for girls are above the diagonal. Tmeasurement wave.

p <.05.

p <.01.
FIGURE 1 Results of the autoregressive cross-lagged model on the
cross-time links between conduct problems and symptoms of
depression. Note: CPconduct problems; DSdepressive symptoms.

p <.05.

p <.01.

p <.001.
TABLE 3
Results From the Triple Growth Model Testing for an
Indirect Path From Conduct Problems to Depressive Symptoms
via Poor Social Preference
Direct Effects Indirect Effect
CP ! PSP PSP ! DS CP ! PSP ! DS
B SE b B SE b B SE b
Intercept 0.18 0.02 .75

0.87 0.19 .56

0.16 0.03 .42

Slope 0.21 0.04 .92

2.04 0.86 .61

0.43 0.14 .56

Note: CPconduct problems; PSPpoor social preference;

DS depressive symptoms.

p <.05.

p <.01.

p <.001.
250 GOOREN ET AL.
DISCUSSION
The aim of this study was to test whether conduct pro-
blems and depressive symptoms become longitudinally
linked via peer rejection in a sample followed from the
beginning of kindergarten until the end of the rst
grade. In accordance with the theoretical model, early
conduct problems repeatedly predicted depressive symp-
toms over time. However, as expected, this link was
indirect. The development of conduct problems caused
experiences of peer rejection, which in turn increased
the risk of developing depressive symptoms. These
results applied equally to boys and girls, despite sex dif-
ferences in levels of conduct problems and experiences
of peer rejection. This nding is in line with previous
research reporting no sex differences in cross-time links
from behavioral to emotional problems via peer rejec-
tion (Ladd & Troop-Gordon, 2003; Pedersen et al.,
2007; van Lier & Koot, 2010). Thus, it seems that
although girls are less likely to exhibit conduct problems
and are less likely to become rejected, those who have
early conduct problems are as likely as boys to be affec-
ted by poor experiences with peers in their development
of depressive symptoms.
The results of this study concur with previous studies
showing that behavioral and emotional problems
become linked via poor relations with peers (Capaldi,
1992; Ladd & Troop-Gordon, 2003; van Lier & Koot,
2010). However, in our study, parallel assessments of
all constructs were used, and links from conduct pro-
blems to peer rejection, and from peer rejection to
depressive symptoms, were found using slope (i.e., devel-
opmental) parameters. Thus, although longitudinal links
were reported in previous studies, our study adds to this
by showing that such longitudinal links exist above and
beyond concurrent links. The young age of the children
in this study should also be taken into account. Unlike
the studies by Ladd and Troop-Gordon (2003) and van
Lier and Koot (2010), peer rejection was assessed at
the beginning of kindergarten. The signicant stability
correlations showed that the rst assessment of peer
rejection, assessed only 2 months after the children
entered kindergarten, predicted future experiences of
rejection. For instance, the correlation coefcient
between social preference at T1 and T4 was .36
(p <.01) for boys and .48 (p <.01) for girls. Therefore,
peer rejection may start early and these rst experiences
may result in chronic rejection.
The nding that early experiences of peer rejection
may explain why children with conduct problems also
develop depressive symptoms has developmental signi-
cance in at least two ways. First, unlike conduct pro-
blems, which decrease as children grow older (Bongers,
Koot, van der Ende, & Verhulst, 2003), internalizing
problems become more prevalent and stable when
children grow older (Bongers et al., 2003; Zahn-Waxler,
Shirtcliff, & Marceau, 2008). Poor social experiences
early on may explain why children develop depressive
symptoms for the rst time. Second, peer rejection was
assessed after 2 months in kindergarten and was found
to be quite stable thereafter. This implies that children
receive their social position swiftly and, once poorly
accepted, remain poorly accepted by peers, implying
that chronic rejection may emerge early in life. As
childrens cognitive capacity develops and matures over
the successive years in elementary school, it is likely that
they will become increasingly aware of difculties
concerning social relations, and will be more affected
by them because they will be better able to incorporate
these experiences into their self-beliefs (Ladd &
Troop-Gordon, 2003). Indeed, Ladd (2006) showed that
peer rejection increasingly added to the development of
externalizing as well as internalizing problems over the
course of childhood. Therefore, not only did our study
underscore that the postulated cascade effect starts right
after the transition to kindergarten, it may well be that
these early experiences set off a chain of negative social
and cognitive effects that may further hamper the suc-
cessful development of children, and make them likely
to develop psychopathology, both of internalizing and
externalizing natures.
Thus, although not decisive, these results are mostly
supportive of the hypothesis that in kindergarten, the
development of conduct problems already puts children
at risk of becoming rejected by their peers. Experiencing
rejection, in turn, places these children at risk of also
developing symptoms of depression. Our results thereby
support the failure model delineated by Patterson and
Capaldi (1990) and offer a possible explanation for the
well-established fact that difculty with peer relations
is linked to both conduct problems and symptoms of
depression. Furthermore, these results underscore that
in addition to studying the personal and environmental
factors underlying specic forms of psychopathology,
research should address the cross-time additive effects
of one type of psychopathology on another.
The results of this study should be interpreted keep-
ing several limitations in mind. First, our study sample
was composed of predominately Caucasian children liv-
ing in rural areas in the Netherlands. It is therefore
uncertain whether our results can be generalized to a
more diverse population, including children from
high-risk environments. Second, despite a sizeable
sample and the use of repeated assessments, the power
to detect sex differences in the associations between con-
duct problems, peer rejection, and depressive symptoms
may have been limited. A third limitation is the rela-
tively short follow-up period of 2 school years.
Although focusing on the start of formal education,
our conclusions are limited to a restricted age group
CONDUCT PROBLEMS AND DEPRESSIVE SYMPTOMS 251
and possible consequences for the long term cannot be
inferred from this study.
Implications for Research, Policy, and Practice
This research provides valuable insights into the develop-
ment of psychopathology and peer relationships in early
childhood, which have implications for research into, as
well as the prevention of, childrens behavioral and
emotional problems. First, unlike behavioral or conduct
problems, which have their onset in early childhood,
and may be stable or even decrease in elementary
school (Keenan & Shaw, 2003), symptoms of depression
increase over the course of elementary school (Zahn-
Waxler et al., 2008). Our study signals the need to
consider the inuence of early conduct problems and
the resultant peer rejection as a possible explanatory fac-
tor for why such depressive problems in young children
tend to increase from the early elementary school period
onward. Second, our sample was composed of kinder-
garteners. It showed that already in this rst phase of
formal education, conduct problems predict peer rejec-
tion, with demonstrable consequences in terms of the
development of depressive symptoms. This signals the
need to start identifying and preventing conduct pro-
blems and their resulting adverse social consequences
in kindergarten. This is not only because conduct
problems may become intrinsically linked to poor peer
relations, thereby explaining their further development,
but also because the early identication of and inter-
vention in this process may forestall the early develop-
ment of depressive symptoms.
REFERENCES
Achenbach, T. M. (1991). Manual for the Teachers Report Form and
1991 Proles. Burlington: University of Vermont, Department of
Psychiatry.
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA
School-Age Forms & Proles. Burlington: University of Vermont,
Research Center for Children, Youth, & Families.
Boivin, M., Hymel, S., & Hodges, E. V. E. (2001). Toward a process
view of peer rejection and harassment. In J. Juvonen & S. Graham
(Eds.), Peer harassment in school: The plight of the vulnerable and
victimized (pp. 265289). New York: Guilford.
Bollen, K. A., & Long, J. S. (1993). Testing structural equation models.
Thousand Oaks, CA: Sage.
Bongers, I. L., Koot, H. M., van der Ende, J., & Verhulst, F. C. (2003).
The normative development of child and adolescent problem
behavior. Journal of Abnormal Psychology, 112, 179192.
Browne, M. W., & Cudeck, R. (1992). Alternative ways of assessing
model t. Sociological Methods and Research, 21, 230258.
Burt, K. B., & Roisman, G. I. (2010). Competence and psychopath-
ology: Cascade effects in the NICHD study of early child care and
youth development. Development and Psychopathology, 22, 557567.
Camodeca, M., Goossens, F. A., Meerum Terwogt, M., & Schuengel,
C. (2002). Bullying and victimization among school-age children:
Stability and links to proactive and reactive aggression. Social
Development, 11, 332345.
Capaldi, D. M. (1992). Co-occurrence of conduct problems and
depressive symptoms in early adolescent boys: II. A 2-year follow-up
at Grade 8. Development and Psychopathology, 4, 125144.
Caron, C., & Rutter, M. (1991). Comorbidity in child psychopath-
ology: Concepts, issues and research strategies. Journal of Child
Psychology and Psychiatry and Allied Disciplines, 32, 10631080.
Cicchetti, D., & Schneider-Rosen, K. (1986). An organizational
approach to childhood depression. In M. Rutter, C. E. Izard, &
P. B. Read (Eds.), Depression in young people: Developmental and
clinical perspectives (pp. 71134). New York: Guilford.
Cicchetti, D., & Toth, S. L. (1998). The development of depression in
children and adolescents. American Psychologist, 53, 221241.
Cillessen, A. H. N., Bukowski, W. M., & Haselager, G. J. T. (2000).
Stability of sociometric categories. In A. H. N. Cillessen & W. M.
Bukowski (Eds.), Recent advances in the measurement of acceptance
and rejection in the peer system. New direction for child and ado-
lescent development, No. 88 (pp. 7593). San Francisco: Jossey-Bass.
Cillessen, A. H. N., & Mayeux, L. (2004). Sociometric status and peer
group behavior: Previous ndings and current directions. In J. B.
Kupersmidt & K. A. Dodge (Eds.), Childrens peer relations: From
development to intervention (pp. 320). Washington, DC: American
Psychological Association.
Coie, J. D., Dodge, K. A., & Coppotelli, H. (1982). Dimensions and
types of social status: A cross-age perspective. Developmental
Psychology, 18, 557570.
Cole, D. A. (1991). Preliminary support for a competency-based
model of depression in children. Journal of Abnormal Psychology,
100, 181190.
Cole, D. A., Jacquez, F. M., & Maschman, T. L. (2001). Social origins
of depressive cognitions: A longitudinal study of self-perceived
competence in children. Cognitive Therapy and Research, 25,
377395.
Cole, D. A., Martin, J. M., & Powers, B. (1997). A competency-based
model of child depression: A longitudinal study of peer, parent,
teacher, and self-evaluations. Journal of Child Psychology and
Psychiatry, 38, 505514.
Crick, N. R., & Zahn-Waxler, C. (2003). The development of psycho-
pathology in females and males: Current progress and future
challenges. Development and Psychopathology, 15, 719742.
Deater-Deckard, K. (2001). Annotation: Recent research examining
the role of peer relationships in the development of psychopath-
ology. Journal of Child Psychology and Psychiatry and Allied
Disciplines, 42, 565579.
DeRosier, M. E., Kupersmidt, J. B., & Patterson, C. J. (1994). Chil-
drens academic and behavioral adjustment as a function of the
chronicity and proximity of peer rejection. Child Development, 65,
17991813.
Dodge, K. A., Lansford, J. E., Burks, V. S., Bates, J. E., Pettit, G. S.,
Fontaine, R., et al. (2003). Peer rejection and social information-
processing factors in the development of aggressive behavior
problems in children. Child Development, 74, 374393.
Dodge, K. A., Pettit, G. S., & Bates, J. E. (1994). Socialization media-
tors of the relation between socioeconomic status and child conduct
problems. Child Development, 65, 649665.
Epkins, C. C. (1995). Peer ratings of internalizing and externalizing
problems in inpatient and elementary school. Journal of Emotional
and Behavioral Disorders, 3, 203.
Erasmus MC. (2000). Problem behavior at school interview. Rotterdam,
The Netherlands: Department of Child and Adolescent Psychiatry,
Erasmus MC.
Hartup, W. W. (1992). Friendships and their developmental signi-
cance. In H. McGurk (Ed.), Childhood social development: Contem-
porary perspectives (pp. 175205). Hillsdale, NJ: Erlbaum.
252 GOOREN ET AL.
Haselager, G. J. T., Cillessen, A. H. N., Van Lieshout, C. F. M.,
Riksen-Walraven, J. M., & Hartup, W. W. (2002). Heterogeneity
among peer-rejected boys across middle childhood: Developmental
pathways of social behavior. Developmental Psychology, 38,
446456.
Jo reskog, K. G. (1970). A general method for analysis of covariance
structures. Biometrika, 57, 239251.
Keenan, K., & Shaw, D. S. (2003). Starting at the beginning: Exploring
the etiology of antisocial behavior in the rst years of life. In B. B.
Lahey, T. E. Moftt, & A. Caspi (Eds.), Causes of conduct disorder
and juvenile delinquency (pp. 153181). New York: Guilford.
Kiesner, J. (2002). Depressive symptoms in early adolescence: Their
relations with classroom problem behavior and peer status. Journal
of Research on Adolescence, 12, 463478.
Kusche, C. A., & Greenberg, M. T. (1994). The PATHS curriculum.
South Deereld, MA: Channing-Bete Co.
Ladd, G. W. (2006). Peer rejection, aggressive or withdrawn behavior,
and psychological maladjustment from ages 5 to 12: An examination
of four predictive models. Child Development, 77, 822846.
Ladd, G. W., & Troop-Gordon, W. (2003). The role of chronic peer
difculties in the development of childrens psychological adjust-
ment problems. Child Development, 74, 13441367.
Lu Jiang, X., & Cillessen, A. H. N. (2005). Stability of continuous
measures of sociometric status: A meta-analysis. Developmental
Review, 25, 125.
MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., &
Sheets, V. (2002). A comparison of methods to test mediation and
other intervening variable effects. Psychological Methods, 7, 83104.
MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Con-
dence limits for the indirect effect: Distribution of the product and
resampling methods. Multivariate Behavioral Research, 39, 99128.
Masten, A. S., Burt, K. B., & Coatsworth, J. D. (2006). Competence
and psychopathology in development. In D. Cicchetti & D. J.
Cohen (Eds.), Developmental psychopathology, Vol. 3: Risk, dis-
order, and adaptation (2nd ed., pp. 696738). Hoboken, NJ: Wiley.
Masten, A. S., & Cicchetti, D. (2010). Developmental cascades. Devel-
opment and Psychopathology, 22, 491495.
Masten, A. S., & Coatsworth, J. D. (1998). The development of com-
petence in favorable and unfavorable environments: Lessons from
research on successful children. American Psychologist, 53, 205220.
Moftt, T. E., Caspi, A., Rutter, M., & Silva, P. A. (2001). Sex differ-
ences in antisocial behaviour: Conduct disorder, delinquency, and
violence in the Dunedin Longitudinal Study. New York: Cambridge
University Press.
Muthen, B. O., & Muthen, L. K. (19982009). Mplus users guide (5th
ed.). Los Angeles, CA: Muthe n & Muthe n.
Parker, J. G., Rubin, K. H., Erath, S. A., Wojslawowicz, J. C., &
Buskirk, A. A. (2006). Peer relationships, child development, and
adjustment: A developmental psychopathology perspective. In D.
Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology,
Vol. 1: Theory and method (2nd ed., pp. 419493). Hoboken,
NJ: Wiley.
Patterson, G. R., & Capaldi, D. M. (1990). A mediational model for
boys depressed mood. In J. E. Rolf, A. S. Masten, D. Cicchetti,
K. H. Nuechterlein, & S. Weintraub (Eds.), Risk and protective
factors in the development of psychopathology (pp. 141163).
New York, NY: Cambridge University Press.
Pedersen, S., Vitaro, F., Barker, E. D., & Borge, A. I. H. (2007). The
timing of middle-childhood peer rejection and friendship: Linking
early behavior to early-adolescent adjustment. Child Development,
78, 10371051.
Rubin, K. H., Bukowski, W. M., & Parker, J. G. (2006). Peer interac-
tions, relationships, and groups. In N. Eisenberg, W. Damon, &
R. M. Lerner (Eds.), Handbook of child psychology: Vol. 3, Social,
emotional, and personality development (6th ed., pp. 571645).
Hoboken, NJ: Wiley.
Rubin, K., Wojslawowicz, J., Rose-Krasnor, L., Booth-LaForce, C., &
Burgess, K. (2006). The best friendships of shy=withdrawn children:
Prevalence, stability, and relationship quality. Journal of Abnormal
Child Psychology, 34, 139153.
Rutter, M., & Sroufe, L. A. (2000). Developmental psychopathology:
Concepts and challenges. Development and Psychopathology, 12,
265296.
Scholte, R., Engels, R., Overbeek, G., de Kemp, R., & Haselager, G.
(2007). Stability in bullying and victimization and its association
with social adjustment in childhood and adolescence. Journal of
Abnormal Child Psychology, 35, 217228.
Timmermans, M., van Lier, P. A. C., & Koot, H. M. (2010). The role
of stressful events in the development of behavioral and emotional
problems from early childhood to late adolescence. Psychological
Medicine, 40, 16591668.
van Lier, P. A. C., & Koot, H. M. (2010). Developmental cascades of
peer relations and symptoms of externalizing and internalizing
problems from kindergarten to fourth-grade elementary school.
Development and Psychopathology, 22, 569582.
Verhulst, F. C., van der Ende, J., & Koot, J. M. (1996). Handleiding
voor de CBCL=418 [Manual for the CBCL=418]. Rotterdam,
The Netherlands: Afdeling Kinder- en Jeugdpsychiatrie, Sophia
Kinderziekenhuis=Academisch Ziekenhuis Rotterdam=Erasmus
Universiteit Rotterdam.
Verhulst, F. C., van der Ende, J., & Koot, J. M. (1997). Handleiding
voor de Teachers Report Form [Manual for the Teachers Report
Form]. Rotterdam, The Netherlands: Afdeling Kinder-en Jeugdpsy-
chiatrie, Sophia Kinderziekenhuis=Academisch Ziekenhuis
Rotterdam=Erasmus Universiteit Rotterdam.
Williams, R. L. (2000). A note on robust variance estimation for
cluster-correlated data. Biometrics, 56, 645646.
Witvliet, M., van Lier, P. A. C., Cuijpers, P., & Koot, H. M. (2010).
Change and stability in childhood clique membership, isolation from
cliques, and associated child characteristics. Journal of Clinical Child
and Adolescent Psychology, 39, 1224.
Zahn-Waxler, C., Shirtcliff, E. A., & Marceau, K. (2008). Disorders of
childhood and adolescence: Gender and psychopathology. Annual
Review of Clinical Psychology, 4, 275303.
CONDUCT PROBLEMS AND DEPRESSIVE SYMPTOMS 253
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