Impact of Children’s Self-Injurious Thoughts and Behaviors on Caregivers’ Mental Health and Family Functioning

Objective: This study examined cross-sectional and prospective differences in mental health and family functioning among caregivers aware of their child’s self-injurious thoughts and behaviors (SITB), caregivers unaware of their child’s SITB, and caregivers of children without SITB. Methods: Data were drawn from an epidemiological U.S. sample of 11,303 children (ages 9-10) and their caregivers who participated in three-yearly assessments as part of the Adolescent Brain and Cognitive Development Study. Caregivers reported on their child’s SITB, family conflict, and their own mental health problems. Children reported on their SITB, family conflict, parental monitoring, and parental acceptance. Results: Compared to caregivers of non-SITB children (81%), both aware (9.9%) and unaware (9.1%) caregivers reported more externalizing problems at baseline and family conflict at baseline and follow-up. Their children reported more family conflict and lower parental monitoring and acceptance at baseline and follow-up. Relative to unaware caregivers and those with non-SITB children, aware caregivers reported higher levels of internalizing problems at baseline and higher odds for SITB at baseline and follow-up. Children of aware caregivers reported lower family conflict and higher parental monitoring and acceptance at baseline, relative to children of unaware caregivers. However, aware caregivers reported higher levels of family conflict at baseline and one year later. Conclusions: Caregivers of children with SITB, whether aware or unaware, experienced externalizing problems and long-term negative effects on family functioning. Aware caregivers faced greater psychological distress. Family-focused interventions that address the quality of parent-child relationships and caregivers’ mental health are vital to reducing youth SITB risk.