Introduction: Parenting and parental–child relationship may lead children to develop behavior disorders that can affect many aspects of their later life. This study aimed to examine the impact of parent–child relationship and sex on the development of internalizing symptoms in children. Methods: Childhood and Adolescent Behaviors in Long-term Evolution (CABLE) is a longitudinal healthy-lifestyle research for which 18 elementary schools were randomly selected respectively in Taipei and Hsinchu in Taiwan. Data on sex, parent–child relations, and internalizing symptoms from four waves of follow-up were analyzed: 2003 (9 year olds), 2006 (12 year olds), 2009 (15 year olds) and 2012 (18 year olds). A latent growth model was used to examine the impact of parental–child relationship and sex on the trajectory of children's internalizing symptoms. Results: Results show that internalizing symptoms is more severe (β = 0.21, p < 0.01) and their growth rate faster (β = 0.15, p < 0.01) in girls than in boys. Results from latent growth model show that parent–child relationship is negatively related to the internalizing symptoms intercept (β = −0.59, p < 0.01) and is positively related to the internalizing symptoms slope (β = 0.18, p < 0.01). Limitations: Self-reported measures were used. Parent–child relationship was only provided at 2003. Conclusion: The findings suggest that girls are more susceptible to internalizing symptoms in puberty, and better parent–child relationship can have a protective influence although the protective impact reduced through time. Health professionals should be sensitive to sex, family functioning and provide positive parenting programs for children at risk for internalizing symptoms.
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