This cross-temporal meta-analysis examined 40-year trends (1981–2019) in subclinical emotional and behavioral problems among children aged 1–18 years, using 175 population-based studies (N = 418,528) across 44 countries. The Child Behavior Checklist (CBCL/TRF/YSR) provided parent, teacher, and self-report data; year of data collection was the primary predictor, with age, sex, continent, and response rate as moderators.
Overall symptom burden did not increase over 40 years across any informant. The strongest multi-informant finding was a **decrease** in externalizing problems and aggression in middle childhood. Specific domain shifts included: parent-reported attention problems (+0.29 POMP/year, ~3 points/decade) and thought problems (+0.09/year, ~1 point/decade); parent-reported rule-breaking (−0.19/year, ~2 points/decade) and self-reported withdrawn/depressed symptoms (−0.28/year, ~3 points/decade). Single-informant signals showed increased anxiety/depression in teens (parent report, ~2 points/decade) and somatic complaints in teenage boys (self-report, ~1–2 points/decade). The apparent rise in attention problems was confounded by declining reliability of that subscale over time, raising measurement invariance concerns.
- Post-COVID-19 data (2020 onward) were excluded, leaving the most recent and potentially most critical period unstudied. - Heterogeneity was extremely high (I² <90% in nearly all analyses), and many subgroup analyses had few studies (<5), limiting statistical power and risking false positives. - Evidence for temporal measurement invariance of the ASEBA scales is limited and fragmented, making it possible that apparent trends partly reflect changes in how raters interpret items rather than true behavioral change.
Clinicians should not assume today's youth carry a greater overall mental health burden than prior generations—total symptom scores have held steady for four decades. However, the **pattern** has shifted: teens may need more support for anxiety, depression, and somatic complaints, while overt aggression and rule-breaking have declined, suggesting targeted rather than generalized concern.
Explore related topics
