The health consequences of child mental health problems and parenting styles: Unintentional injuries among European schoolchildren

Objective: Unintentional injury is the leading cause of death for schoolchildren. We assessed the association between externalizing psychopathology, parenting style, and unintentional injury in European children in the community. Methods: Data were drawn from the School Children Mental Health in Europe project and included 4517 schoolchildren across seven diverse European regions. Past-year injuries serious enough to seek medical attention were reported by mothers. Child mental health problems were assessed using validated measures and reported by the mothers, teachers, and children. Parenting styles were based on The Parenting Scale and the Parent Behaviors and Attitudes Questionnaire. Results: Children with attention-deficit/hyperactivity symptoms and oppositional defiant symptoms had a higher risk of injury compared to other children whether based on parent report (OR. = 1.47, 95% C.I. 1.2-1.9), teacher report (OR. = 1.36, 95% C.I. 1.1-1.7), or parent and teacher report combined (OR. = 1.53, 95% C.I. 1.1-2.1). Children who self-reported oppositional symptoms also had higher risk of injury (OR. = 1.6, 95% C.I. 1.1-2.4). Low-caring behavior of parents increased the risk of injury (OR. = 1.4, 95% C.I. 1.1-1.9). Conclusion: Unintentional injury is a potential adverse health consequence of child externalizing problems. Interventions to improve parent-child relationships and prevention as well as focused treatment for externalizing problems may reduce the burden of injury.