Introduction
Giftedness is often associated with high levels of cognitive performance and creativity, but it can also predispose individuals to emotional and behavioral challenges. Studies suggest that gifted children are more vulnerable to internalizing symptoms, such as anxiety and depression, and externalizing symptoms, such as impulsivity and behavioral dysregulation. However, the interrelationship of these symptoms is still poorly understood. This cross-sectional study applied network analysis to investigate the psychopathological structure of internalizing and externalizing symptoms in Arab gifted children, seeking to identify core symptoms that play a critical role in the psychopathological network.
Methods
Design and Sampling
A cross-sectional study was conducted between September 2023 and October 2024, involving 239 gifted children (IQ > 120) aged 7–12 in Jordanian schools. Selection was made by convenience, including only children without intellectual disabilities, neurological disorders, or associated syndromes. Parents completed the Arabic version of the Child Behavior Checklist (CBCL), a validated instrument for assessing psychiatric disorders in children.
Statistical Analysis
Network analysis was performed using the graphical least absolute shrinkage and selection operator (gLASSO) algorithm and the extended Bayesian criterion (EBIC). The network structure was estimated using qgraph, and centrality measures, including betweenness, closeness, and strength, were calculated to identify the most influential symptoms. The model was validated by bootstrap resampling (n = 1000) to assess the stability of connections between symptoms.
Results
Internalizing Symptoms
The analysis revealed three main clusters of internalizing symptoms:
Affective problems – Insomnia (sleeps less) emerged as the strongest core symptom (centrality strength = 2.04, connection weight = 0.33), correlated with depressive symptoms and suicidal thoughts.
Anxiety – Excessive worry (worries) showed strong centrality (strength = 1.89), being associated with symptoms such as fear of school and emotional dependence.
Somatization – Headaches were highly interconnected with somatic pain and gastrointestinal symptoms (strength = 2.35, connection weight = 0.41).
Externalizing Symptoms
Three main clusters were identified:
ADHD – Difficulty remaining seated (cannot sit still) and impulsivity (impulsive) were the symptoms with the greatest centrality, suggesting a crucial role in behavioral dysregulation.
Oppositional problems – Explosive temperament (temper) and disobedience (disobedient at home/school) showed strong connectivity, indicating difficulties with self-control.
Behavioral problems – Physical aggression (attacks) and lying/deception (lies, cheats) were central symptoms in the network, suggesting a relationship with risk behaviors.
Centrality Analysis
The symptoms with the greatest impact on the global network were:
Insomnia (strength = 2.04)
Excessive worry (strength = 1.89)
Headaches (strength = 2.35)
Impulsivity (strength = 1.93)
Difficulty remaining seated (strength = 1.77)
The stability of the centrality indices was confirmed (bootstrap CS-C > 0.50), validating the robustness of the findings.
Discussion
The findings indicate that gifted children have interrelated internalizing and externalizing symptoms, highlighting insomnia, anxiety and headache as the main markers of the psychopathological network. These results converge with previous studies that identify sleep disorders and cognitive hyperactivity as frequent characteristics in gifted children. From a clinical point of view, symptoms such as excessive worry and insomnia can act as triggers for more serious disorders, becoming priority targets for psychological and psychiatric interventions.
In the externalizing spectrum, difficulties in regulating behavior and impulsivity appear to be central to the psychopathological dynamics of gifted children, corroborating research that suggests a behavioral profile similar to that of Attention Deficit Hyperactivity Disorder (ADHD), but with distinct cognitive characteristics.
Clinical and Educational Implications
The findings reinforce the need for multidisciplinary approaches in the identification and management of psychiatric symptoms in gifted children. Interventions aimed at improving sleep and emotional regulation may reduce the impact of cognitive hyperarousal and minimize the risk of developing psychiatric disorders. In the school environment, strategies for controlling impulsivity and psychosocial support should be incorporated to avoid behavioral and academic maladjustments.
Conclusion
This study highlighted the interconnectivity of internalizing and externalizing symptoms in Arab gifted children, identifying insomnia, anxiety, and headache as central symptoms in the psychopathological network. These findings provide support for the development of early intervention strategies aimed at promoting the mental well-being of these children.
Reference:
AL-ROUSAN, Ayoub Hamdan; AYASRAH, Mohammad Nayef; KHASAWNEH, Mohamad Ahmad Saleem. Network Analysis of Internalizing and Externalizing Symptoms in Arab Gifted Children: A Cross-Sectional Study. Psychiatric Quarterly, [sl], v. 96, no. 1, p. 1-25, 2025. DOI: 10.1007/s11126-025-10112-2. Available at: https://www.researchgate.net/publication/388001195.
