Impact of children's self-harm on caregivers' mental health and family functioning.

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 (SITBs), caregivers unaware of their child's SITBs, and caregivers of children without SITBs. Data were drawn from an epidemiological U.S. sample of children (ages 9-10) and their caregivers who participated in three yearly assessments as part of the Adolescent Brain Cognitive Development study ( = 11,303, 47.6% female). Caregivers reported on their own mental health problems and SITBs, their child's SITBs, and family conflict. Children reported on their own SITBs, family conflict, parental monitoring, and parental acceptance. Compared to caregivers of children without SITBs (81%), both aware (9.9%) and unaware (9.1%) caregivers reported more externalizing problems at baseline. Their children reported more family conflict and lower parental monitoring and acceptance across assessments. Relative to unaware caregivers and caregivers of children without SITBs, aware caregivers reported elevated internalizing problems at baseline and greater odds of engaging in SITBs at baseline and follow-up. Compared to children of unaware caregivers, children of aware caregivers reported lower family conflict and higher parental monitoring and acceptance at baseline. In contrast, aware caregivers reported higher family conflict at baseline and 1 year later compared to unaware caregivers. Overall, caregivers of children with SITBs, whether aware or unaware, experienced more mental health problems and long-term effects on family functioning. Aware caregivers also reported higher SITB risk. Family-based interventions with a focus on caregivers' mental health may help reduce children's SITBs and family suffering. (PsycInfo Database Record (c) 2026 APA, all rights reserved).