Emotional and Behavioral Problem Profiles of Preteens With Self-Injurious Thoughts and Behaviors: A Multicultural Study

Objective Self-injurious thoughts and behaviors (SITB) among preteen children have risen to the attention of researchers, practitioners, and policymakers. To shed light on potential treatment/prevention targets, we sought to identify empirically-derived emotional and behavioral problem profiles of preteens with SITB, and determine whether these profiles differ by age, gender, and society. Method Caregivers of 46,719 children aged 6 - 12 from 42 societies across the world completed the Child Behavior Checklist (CBCL/6-18). There were 1,656 children whose caregivers indicated that their child experienced SITB. We conducted a latent profile analysis (LPA) using scores from eight CBCL/6-18 problem scales to derive problem profiles of children with SITB. Multilevel modelling was used to estimate differences in the profiles by SITB, society, gender, and age. Results A four-profile model provided the best fit to the data with profiles reflecting: low problems (39.7%), mild problems (42.6%), moderate problems (15.4%), and rule-breaking/thought problems (2.3%). The low problems profile had CBCL problem scale scores nearly indistinguishable from those of children without SITB. Children in the rule-breaking/thought problems group were mostly female whereas the other profiles were mostly male. Children in the rule-breaking/thought problems profile also were most likely to have both suicidal thoughts and self-harm behaviors. Conclusion Problem profiles of preteens with SITB are heterogeneous, with most having relatively low levels of other psychopathology. Selectively screening only children with clinically significant mental health problems for suicidal thoughts and self-harm behaviors (e.g., only asking about suicidal thoughts among children with depression) risks missing many children experiencing SITB.