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Internalizing Behavior in Children – Examples and Risk Factors

Internalizing behavior in children represents inwardly directed behaviors resulting from over-controlled and self-directed responses to negative emotions such as sadness, guilt, fear, worry, depression, and anxiety. These behaviors are often subtle, leading to them going unnoticed by parents and adults, and can manifest as social withdrawal, eating disorders, depressive and anxiety symptoms, emotional distress, selective mutism, self-harm, drug abuse, somatic symptoms, and suicide attempts.

Risk factors for internalizing behaviors include family conflict, parental rejection or hostility, lack of parental warmth, controlling parenting, childhood neglect, sexual abuse, being bullied, and a lack of perceived control over one’s life. To assist children with internalizing problems, recognize and address these mental health issues with seriousness and prompt treatment.

sad boy listens to music

What is internalizing behavior

Behavior problems in childhood and adolescence can be classified as externalizing or internalizing. An internalizing behavior is a behavior directed inwardly toward oneself. It is an over-controlled and self-directed type of behavior. 

Internalizing behavior patterns are subtle and often go unnoticed by parents and other adults. Examples include social withdrawal and eating disorders.

Such behavior can be caused by internalized negative emotions including sadness, guilt, fear, worry, depression, and anxiety. In severe cases, internalizing problems can become internalizing disorders such as depressive disorder and anxiety disorder​1​.

Internalizing behavior vs externalizing behavior

Internalizing behavior is inner-directed behavior and usually the result of negative emotions while externalizing behavior is directed outwardly to others or the environment. 

Externalizing behavior is an under-controlled and outer-directed type of child problem behavior such as aggression, defiance, and conduct disorder. It is overt and usually disruptive to others.

A child shows externalizing behavior when they disturb others and internalizing behavior when they are disturbed themselves​2​.

Researchers have found a small gender difference between these two types of behaviors. Internalizing behaviors are more common in girls than boys, while boys tend to have externalizing behaviors more than girls​3​.

These differences appear to be more a result of cultural differences than biological ones. “Boys don’t cry” and “girls should always be nice” reflect cultural beliefs and expectations that girls should display cheeriness or sadness, while boys should be strong and calm, expressing anger when needed. 

A child may have internalizing behavior and externalizing behavior at the same time​4​.

Internalizing behavior examples

Examples of internalizing behavior:

  • Depressive symptoms
  • Anxiety symptoms
  • Emotional symptoms (sadness, guilt, shame, fear, etc.)
  • Social withdrawal
  • Eating disorder
  • Selective mutism
  • Self-harm
  • Drug abuse
  • Somatic symptoms
  • Suicide attempt

Risk factors for internalizing behavior

Internalization involves the incorporation of values or patterns of culture into one’s self through learning and socialization.

The following early adverse environments and experiences predict internalizing problems in at-risk children.

How to help children with internalizing behavior

Children with internalizing problems tend to keep to themselves. Mental health issues such as depression and anxiety in children must be taken seriously and treated promptly.

If you or someone you know have suicidal thoughts, call 800-273-8255 to speak with someone today

National Suicide Prevention Lifeline

Help is available 24 hours in English and Spanish.

For more help with mental health issues, check out the resources at the National Institute of Mental Health.


  1. 1.
    Graber JA, Sontag LM. Internalizing Problems During Adolescence. Handbook of Adolescent Psychology. Published online October 30, 2009. doi:10.1002/9780470479193.adlpsy001020
  2. 2.
    Algozzine B. The emotionally disturbed child: Disturbed or disturbing. J Abnorm Child Psychol. Published online 1977:205-211. doi:10.1007/bf00913096
  3. 3.
    Chaplin TM, Aldao A. Gender differences in emotion expression in children: A meta-analytic review. Psychological Bulletin. Published online 2013:735-765. doi:10.1037/a0030737
  4. 4.
    GILLIOM M, SHAW DS. Codevelopment of externalizing and internalizing problems in early childhood. Develop Psychopathol. Published online June 2004. doi:10.1017/s0954579404044530
  5. 5.
    Mathiesen KS, Sanson A, Stoolmiller M, Karevold E. The Nature and Predictors of Undercontrolled and Internalizing Problem Trajectories Across Early Childhood. J Abnorm Child Psychol. Published online September 3, 2008:209-222. doi:10.1007/s10802-008-9268-y
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    Groh AM, Roisman GI, van IJzendoorn MH, Bakermans-Kranenburg MJ, Fearon RP. The Significance of Insecure and Disorganized Attachment for Children’s Internalizing Symptoms: A Meta-Analytic Study. Child Development. Published online January 11, 2012:591-610. doi:10.1111/j.1467-8624.2011.01711.x
  7. 7.
    Keller PS, Cummings EM, Davies PT, Mitchell PM. Longitudinal relations between parental drinking problems, family functioning, and child adjustment. Dev Psychopathol. Published online 2008:195-212. doi:10.1017/s0954579408000096
  8. 8.
    BOLGER KE, PATTERSON CJ. Pathways from child maltreatment to internalizing problems: Perceptions of control as mediators and moderators. Dev Psychopathol. Published online December 2001:913-940. doi:10.1017/s0954579401004096
  9. 9.
    Gini G, Card NA, Pozzoli T. A meta-analysis of the differential relations of traditional and cyber-victimization with internalizing problems. Aggr Behav. Published online November 21, 2017:185-198. doi:10.1002/ab.21742


    * All information on is for educational purposes only. Parenting For Brain does not provide medical advice. If you suspect medical problems or need professional advice, please consult a physician. *