Latent profiles of emotional and behavioral problems in Chinese school-aged children and their associations with environmental and lifestyle factors

Childhood emotional and behavioral problems are heterogeneous in presentation, and variable-centered approaches have limited capacity to capture this internal structure. This study aimed to identify distinct profiles of emotional and behavioral problems among Chinese school-aged children and to examine their associations with sociodemographic, family, and lifestyle characteristics. A cross-sectional study was conducted among 3,050 Chinese school-aged children aged 6–12 years. Emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior were assessed using the Strengths and Difficulties Questionnaire (SDQ). Latent profile analysis (LPA) was performed on the five SDQ subscale scores, with the optimal model determined by AIC, BIC, entropy, and class size adequacy. Multinomial logistic regression was used to examine examine associations between profile membership and sociodemographic, family, and lifestyle characteristics. Five profiles were identified: Normative (56.8%), Low Hyperactivity and Low Prosocial Behavior (12.3%), Elevated Emotional Symptoms (18.1%), Elevated Conduct Problems and Low Prosocial Behavior (7.6%), and High Emotional and Multi-Domain Difficulties (5.2%). Physical punishment showed a graded cross-sectional association with profile membership: relative to children never physically punished, frequent exposure was associated with substantially higher odds of membership in the Elevated Conduct Problems and Low Prosocial Behavior profile () and the High Emotional and Multi-Domain Difficulties profile (). Family conflict showed a comparable pattern (aOR = 3.42 and 3.55, respectively). Excessive weekend screen time (> 2 h) was associated with higher odds of membership in the Elevated Emotional Symptoms profile and the Elevated Conduct Problems and Low Prosocial Behavior profile (aOR = 1.91), while short sleep duration (< 9 h) demonstrated its most pronounced association with the Elevated Conduct Problems and Low Prosocial Behavior profile (aOR = 2.12). Emotional and behavioral problems among Chinese school-aged children can be classified into five distinct profiles, with environmental and lifestyle factors differentially associated with profile membership. Child health management should prioritize improving the family parenting environment and promoting healthy lifestyle.