Purpose: This study aimed to determine levels of behaviour problem in primary school children, and to explore key determinants relevant to the Chinese context: being an only child, urban living, school stressors, being bullied and physical punishment.
Methods: We administered a child self-completion questionnaire to children aged 7-13 and Rutter Parent Scales to their parents in nine primary schools, in urban and rural Zhejiang Province, eastern China.
Results: Full data were available for 2,203 child-parent pairs. Rutter Scores showed that 13.2% of the children (16.4% of boys, 9.4% of girls) had a behaviour problem. Girls manifest more emotional problems (5.3 vs. 2.3%) and boys more conduct problems. Questions about school stress showed that 78% worry "a lot" about exams, 80% felt pressure to perform at school "all the time", and 44% were bullied at least sometimes. Seventy-one percent were sometimes or often physically punished by their parents. Conduct problems were strongly significantly associated with male gender (OR 3.8 95% CI 3.0-4.6), rural residence OR 2.3, 1.3-3.4, having been bullied (1.8, 1.5-2.2) and frequent physical punishment (4.5, 3.2-5.8). Emotional problems were most strongly associated with being bullied (OR 4.9, 2.3-7.7). Being an only child was not associated with behaviour problems.
Conclusions: High levels of behaviour problems in these Chinese children could relate to high expectations in a very competitive educational environment. Our results raise concerns for the future mental well-being of those children with behaviour problems.