Work

Emotional and behavioural problems and non-suicidal self-injury in preadolescent children: complementary insights from child and parent reports

Year: 2026

Type: article

Abstract: Objective Given the scarcity of research on preadolescent non-suicidal self-injury (NSSI) and its clinical significance, this study examined its prevalence and associations with emotional/behavioural problems, and the differences and complementarity between child and parent reports in a Chinese community sample. Methods In total, 1,923 children (mean age = 11.01 years, SD = 0.79; 49.8% male) were recruited via convenience sampling from eight primary schools in Tianjin. NSSI was assessed by child self-report. Emotional and behavioural problems were measured using child and parent versions of the Strengths and Difficulties Questionnaire (SDQ). Multivariable logistic regression, formal Wald tests, hierarchical regression, and ROC curve analyses were used to examine associations, compare informant-specific effects, assess incremental validity, and evaluate model performance. Results Of the participants, 484 (25.2%) reported at least one NSSI episode in the past six months. Logistic regression revealed overlapping and discrepant patterns: emotional symptoms and hyperactivity were significant in both reports; peer interaction problems were unique to child reports, while conduct problems were unique to parent reports. However, formal comparisons using joint models and Wald tests showed that only emotional symptoms, hyperactivity, and peer interaction problems showed significantly larger effects in child reports (all p < 0.001). No significant differences were found for conduct problems or prosocial behaviour. Child reports provided greater incremental information beyond parent reports (Δ R ² = 0.124 vs. 0.014, both p ≤ 0.001). The child-report model showed significantly better discrimination than the parent-report model (AUC = 0.753 vs. 0.659; DeLong test: Z = -7.75, p < 0.001). Conclusion NSSI was common among preadolescents in this sample. The overlapping yet discrepant patterns suggest that child and parent reports provide complementary information: children appear more attuned to internalising symptoms and peer distress, whereas parents appear more sensitive to conduct problems. These findings highlight the value of multi-informant assessment in school-based screening.

Source: Frontiers in Psychiatry

DOI: 10.3389/fpsyt.2026.1973448