Discrepancies in child maltreatment reporting and its relation to child mental health in Uganda

Background Child maltreatment is a global concern, yet reporting discrepancies between children and caregivers remain understudied, particularly in low-resource settings. This study examines the relationship between child-caregiver discrepancies in reporting psychological aggression and corporal punishment and their association with child mental health outcomes. Methods We collected data from 732 child-caregiver pairs in Mbale, Uganda. Children's mental health was assessed using the Pediatric Symptom Checklist (PSC-17). Psychological aggression and corporal punishment were measured using the Dimensions of Discipline Inventory (DDI). Discrepancy scores were calculated by pairwise subtracting caregiver report scores from child report scores and later rescaled to 1-100. Associations between reporting discrepancies and mental health outcomes were examined using linear mixed-effects models. Results Psychological aggression affected 70.6%, and corporal punishment affected 71.9% according to the children. Child-reported psychological aggression (Estimate = 0.15, 95% CI = 0.11; 0.18, p < 0.001) and corporal punishment (Estimate = 0.15, 95% CI = 0.11; 0.19, p < 0.001) were associated with higher mental health challenges. Discrepancies in psychological aggression reporting showed a small, but significant association with higher mental health challenges in bivariable analysis (Estimate = 0.06, 95% CI = 0.03; 0.09, p < 0.001), but not in the multivariable model. Differences in corporal punishment reporting was associated with higher mental health challenges in the adjusted models (Estimate = 0.10, 95% CI = 0.05; 0.15, p < 0.001). Children interviewed privately, while caregivers were waiting nearby, reported fewer mental health challenges (Estimate = -4.50, 95% CI = -7.23; -1.77, p < 0.001) than those interviewed with caregivers. Conclusions Discrepancies between child and caregiver reports of maltreatment were associated with poorer child mental health outcomes. Children's subjective perceptions provide critical insights that may be overlooked when relying solely on caregiver reports. These findings highlight the importance of incorporating children's voices in mental health assessment and intervention development to combat violence against children in all forms.