Defining Subtypes in Children with Nail Biting: A Latent Profile Analysis of Personality

Objective This study aimed to examine personality profiles and behavioral problems of children with nail biting (NB) to gain insight into the developmental trajectory of pathological NB. Methods 681 elementary school students were divided into non NB (n=436), occasional NB (n=173) and frequent NB group (n=72) depending on the frequency of NB reported in Child Behavioral Checklist (CBCL). Children's personality was assessed using the Junior Temperament and Character Inventory (JTCI), and behavioral problems were assessed using the CBCL. Latent Profile Analysis (LPA) was performed using JTCI profiles to classify personalities of the children with NB (belonging to frequent and occasional NB group, n=245). Results For subscale scores of CBCL, the total, internalizing, externalizing, anxious/depressed withdrawn/depressed, depression, thought, rule -breaking, and aggressive behavior problems, were most severe in the frequent NB group followed by occasional NB and non NB group. LPA of personality profile in children with NB revealed four classes ("adaptiveness," "high reward dependence," "low self-directedness," and "maldaptiveness"). The four personality classes demonstrated significant group differences in all of the CBCL subscales. Children who showed low self-directedness and cooperativeness and high novelty seeking and harm avoidance personality profiles demonstrated high- est tendency for problematic behavior irrespective of the frequency of NB. Conclusion Children with NB reported significantly more problematic behaviors compared to children without NB. Children with spe- cific personality profile demonstrated higher tendency for problematic behavior irrespective of the frequency of NB. Therefore, accom- panying personality profiles should be considered when assessing behavioral problems in children with NB.