Clinical Characteristics of Missed Child-to-Parent Violence (CPV) in Child and Adolescent Psychiatric Patients: A Case-Control Study.

This study investigated the clinical characteristics of missed child-to-parent violence (CPV) in child and adolescent psychiatric patients via a retrospective case-control design. Data were obtained from 177 patients aged under 15 years during their initial consultation at the National Kohnodai Medical Center, Japan, between April 2022 and March 2023. We obtained CPV cases identified via the Child-to-Parent Violence Questionnaire Parents' Version (CPV-Q-P), distinguishing missed CPV cases (n = 45) detected exclusively through the questionnaire from reported CPV cases by parents or attending doctors (n = 18), and no CPV cases (n = 114). Logistic regression comparing missed and no CPV cases revealed that missed CPV was associated with younger age and higher scores on attention-deficit/hyperactivity disorder (ADHD)-related measures. This finding highlights a notable prevalence, with 28.3% (45 out of 159) of patients identified via the CPV-Q-P scale. Comparison of missed and reported CPV cases indicated that those in the missed cases had milder oppositional defiant behaviors and higher daily functioning scores, suggesting that parents may have missed less severe forms of CPV. Moreover, female CPV cases were more frequently missed, which potentially reflects gender-based biases in recognizing violent behavior. Our findings underscore the limitations of conventional interviews in detecting CPV and the critical role of systematic screening tools, such as the CPV-Q-P, in identifying missed CPV cases. Future research should make use of these findings to facilitate early detection and targeted intervention.