Spanking in early childhood and later behavior problems: a prospective study of infants and young toddlers

Growing up unequal: Objective and subjective economic disparities and authoritarian parenting

BACKGROUND

Although there is evidence of economic disparities in parents' financial and time investments in children, little existing empirical work has considered the disparities in authoritarian parenting, a risk for child maltreatment. Similarly, existing research has largely focused on the role of objective markers of socioeconomic status (SES), although perceived subjective social status (SSS) may be equally powerful in shaping disparities in parenting behaviors.

DATA

This article draws on 30 years of General Social Survey data to examine the association between objective socioeconomic status and subjective social status and parents' endorsement of authoritarian parenting practices.

METHODS

We model the association between parents' SES and SSS and approval of authoritarian parenting practices estimated with odds ratios from logistic regressions and examine parental race as a potential moderator.

RESULTS

We find that SES and SSS are both associated with increased odds of endorsing authoritarian parenting, that SSS-based disparities are independent of SES, and that white parents' parenting may be more influenced by both SES and SSS than Black parents' parenting.

CONCLUSIONS

This work provides evidence that SES not only drives gaps in parental investments in children, but also gaps in their endorsement of authoritarian parenting. This is important because authoritarian parenting is not only directly associated with adverse outcomes for children, but is also associated with an increased risk for child maltreatment. It also expands the existing literature by showing that subjective measures of social status are important and distinct from objective measures of SES, and that these associations vary by race.

Racial and Ethnic Differences in the Relation Between Parenting and Preschoolers' Externalizing Behaviors

This study examined racial/ethnic differences in the relations between three dimensions of parenting practices (harsh, lax, and warm parenting) and children's externalizing behaviors across European American, African American, and Latinx families. Participants included 221 mothers who identified as African American (n = 32), Latina (n = 46), or European American (n = 143). Mothers' self-rated and observer-coded harshness, laxness, and warmth, and their ratings of their 3-year-old children's externalizing behaviors (hyperactivity, aggression) were analyzed. Multiple regression analyses indicated some racial/ethnic differences in the relations between harsh and warm parenting, and children's externalizing behaviors. The slopes of the relation between greater harshness and greater aggression and hyperactivity were more positive for European American families than for African American or Latinx families. The slopes of the relation between greater warmth and less aggression were more negative for European American and Latinx families than for African American families. Results indicated no racial/ethnic differences in the relation between laxness and externalizing behaviors. These findings suggest racial/ethnic differences in the relation between some parenting practices and externalizing behaviors, which has important implications in culturally sensitive clinical practice for different racial/ethnic groups. More research is necessary to replicate these findings, and to identify other parenting practices that may be more important in racial/ethnic minority families.

Parental Discipline and Early Childhood Development in Rural China

Children who are under the age of five in underdeveloped and developing countries, including China, exhibit developmental delays due to their exposure to risks such as impoverishment, deprived health conditions, parental punishment, neglect, and poor psychosocial stimulation. Adverse experiences during the formative years of life, such as harsh parental discipline, may put them at risk for poor physical and mental well-being. The aim of this research is to explore the pervasiveness and developmental outcomes of different forms of discipline practices in the underdeveloped rural areas of China. To do this, we used cross-sectional data on child–caregiver dyads from a large survey held in 22 poor counties in the QinBa Mountain Region. The sample included 1622 children aged 12–36 months. Partakers were requested to respond to a general survey on parenting which included basic demographic questions, the Ages and Stages Questionnaire: Social-Emotional (ASQ-SE), the Bayley Scales of Infant and Toddler Development (BSID-III), and questions on exposure of children to different discipline practices. Our findings from OLS estimates reveal that aversive discipline methods adversely affect cognitive, language, and socio-emotional development, whereas, non-aversive discipline practices have constructive effects on cognitive, language, and motor development of children.

Physical Punishment and Child Externalizing Behavior: Comparing American Indian, White, and African American Children

This study examined if, compared to White and African American children, maternal spanking of American Indian children was associated with child externalizing behavior problems. Using a community-based sample of 3,632 children (1,183 White, 2,183 African American, 266 American Indian), multiple-group autoregressive cross-lagged models examined the associations between maternal spanking and child externalizing behavior across the first 5 years of life. Rates of spanking for American Indian and White children were similar at all three time points (age 1, age 3, and age 5). When comparing White and American Indian groups, maternal spanking at age 1 predicted child externalizing behavior at age 3 (White: β = .10, p < .001; American Indian: β = .08, p < .01), and maternal spanking at age 3 predicted child externalizing behavior at age 5 (White: β = .09, p < .05; American Indian: β = .08, p < .01). When comparing African American and American Indian groups, maternal spanking at age 1 predicted child externalizing behavior at age 3 (African American: β = .08, p < .01; American Indian: β = .06, p < .001), and maternal spanking at age 3 predicted child externalizing behavior at age 5 (African American: β = .08, p < .001; American Indian: β = .07, p < .001). Structural invariance tests suggested that the associations observed among American Indian children were not distinguishable from those observed among White and African American children. Results of this study can be interpreted in light of the recent American Academy of Pediatrics statement that encourages pediatricians to counsel parents against the use of physical punishment. Similar to White and African American families, American Indian families may benefit from reducing or eliminating the use of physical punishment.

Physical punishment and child outcomes: a narrative review of prospective studies

Physical punishment is increasingly viewed as a form of violence that harms children. This narrative review summarises the findings of 69 prospective longitudinal studies to inform practitioners and policy makers about physical punishment's outcomes. Our review identified seven key themes. First, physical punishment consistently predicts increases in child behaviour problems over time. Second, physical punishment is not associated with positive outcomes over time. Third, physical punishment increases the risk of involvement with child protective services. Fourth, the only evidence of children eliciting physical punishment is for externalising behaviour. Fifth, physical punishment predicts worsening behaviour over time in quasi-experimental studies. Sixth, associations between physical punishment and detrimental child outcomes are robust across child and parent characteristics. Finally, there is some evidence of a dose-response relationship. The consistency of these findings indicates that physical punishment is harmful to children and that policy remedies are warranted.

Factors Associated With Family Member's Spanking of 3.5-year-old Children in Japan

Background

Spanking can cause adverse psychological development and biological functional changes in children. However, spanking is widely used by parents in Japan. This study explored the risk factors for family member’s spanking of 3.5-year-old children using nationwide population data in Japan.

Methods

Surveys were administered to family members in Japan who had a child in 2001 (first cohort) or in 2010 (second cohort), and the data when their child was 0.5, 1.5, and 3.5 years old were used. We used multivariate binary and ordinal logistic regression analyses to examine the associations between risk factors and spanking children at 3.5 years of age, which was subcategorized into frequencies of never, sometimes, and always spanking, presented with odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Among 70,450 families, 62.8% and 7.9% sometimes and always spanked their children, respectively. Children in the second cohort were spanked less frequently compared with those in the first cohort, and fathers who responded to the questionnaire spanked children less frequently than mothers who responded. Identified associated factors for spanking were male child, presence of siblings of the child, not living in a two-parent household, not living in a three-generation household, younger parents, parents with lower education, no outside work or unstable work, and lower family income.

Conclusions

We found a high prevalence of spanking and its associated factors. Approaching those with lower socioeconomic factors and promoting fathers’ involvement in parenting may be important public health strategies for reducing and preventing spanking.

Commonalities and Differences in Social Norms Related to Corporal Punishment Among Black, Latino and White Parents

To establish commonalities and differences in social norms related to corporal punishment among Black, Latino, and White parents, we first examine survey data from a random sample of a nationally representative opt-in internet panel (n = 2500) to establish the frequency of corporal punishment among parents of children under five (n = 540) and their perceptions of the frequency of use of corporal punishment in their community and whether they ought to use corporal punishment. We disaggregate by race/ethnicity and education to identify higher risk groups. To better understand the beliefs underlying these perceptions among the higher risk group (i.e., less educated), we used a grounded theory approach to analyze data from 13 focus groups (n = 75) segmented by race/ethnicity (i.e., Black, Latino, or White), gender (i.e., mothers or fathers), and population density (i.e., rural or urban). Survey findings revealed that 63% of parents spanked, albeit the majority seldom or sometimes. Spanking was most frequent among Latinos (73%) and lowest among White parents (59%). While all participants across racial/ethnic groups believed the majority of parents spanked, even more than the proportion that actually do, about half believed they ought to spank. Perceptions of the frequency and acceptability of corporal punishment were associated with use of corporal punishment. The qualitative findings highlight more similarities than differences across Black, Latino, and White communities. The findings suggest social norms change efforts might focus on parents with less education and influencing perceptions around whether they ought to spank.

The association between perceived injunctive norms toward corporal punishment, parenting support, and risk for child physical abuse

The use of corporal punishment (CP) is a strong risk factor for many poor outcomes for children including child maltreatment. The use of CP occurs within social contexts which are important to understand. Although it is known that perceived social norms regarding CP are related to its use, the specific role that a mother's primary support person plays in influencing attitudes toward and use of CP remains unknown. The current study assessed linkages between maternal perceived social support in parenting and perceived injunctive norms of CP from her primary source of support, with maternal attitudes toward and use of CP. Survey data were collected from female primary caregivers (N = 436) of children age 2 to 7 years (mean age = 3.7) enrolled in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinics in Southeastern Louisiana. Most frequently, the biological father of the child (37.9%) and the maternal grandmother of the child (24.2%) were identified as the participant's primary source of social support in parenting. Perceived injunctive norms of this support person toward CP use were significantly and positively associated with attitudes toward, AOR = 5.97, 95% CI = [4.04, 8.82], and use of CP, AOR = 3.77, 95% CI = [2.55, 5.59]. However, perceived social support was not associated with these outcomes and also did not moderate these associations. Findings suggest that efforts to reduce maternal risk for child physical abuse and use of CP must include the mother's primary source of social support if they are to be successful.

Associations of Harsh Physical Punishment and Child Maltreatment in Childhood With Antisocial Behaviors in Adulthood

IMPORTANCE

Inquiry into what childhood experiences are associated with antisocial behaviors in adulthood is necessary for prioritizing and informing efforts for effective prevention.

OBJECTIVE

To examine whether harsh physical punishment in the absence of child maltreatment and child maltreatment with and without harsh physical punishment are associated with antisocial behaviors in adulthood.

DESIGN, SETTING, AND PARTICIPANTS

Cross-sectional study using data on the general US population obtained from the National Survey on Alcohol and Related Conditions Wave 3 from April 2012 to June 2013. Participants were civilian, noninstitutionalized adults 18 years and older. This study used a multistage probability sampling design (response rate, 60.1%). Data were analyzed from January 25 to November 27, 2018.

EXPOSURES

Harsh physical punishment included pushing, grabbing, shoving, slapping, and hitting. Child maltreatment included physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, and exposure to intimate partner violence.

MAIN OUTCOMES OR MEASURES

Lifetime antisocial personality disorder behaviors since age 15 years were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 based on Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria.

RESULTS

The number of study participants was 36 309, with 15 862 men (weighted percentage, 48.1%) and 20 447 women (weighted percentage, 51.9%); mean (SE) age was 46.54 (0.19) years. The prevalence of harsh physical punishment and child maltreatment was 18.1% and 46.7%, respectively. Harsh physical punishment only (adjusted β, 0.62; 95% CI, 0.50-0.75), child maltreatment only (adjusted β, 0.65; 95% CI, 0.60-0.69), and harsh physical punishment and child maltreatment (adjusted β, 1.46; 95% CI, 1.38-1.54) were associated with adult antisocial behaviors. It is estimated that harsh physical punishment and/or child maltreatment might account for approximately 45.5% of antisocial behaviors among men in the United States and 47.3% antisocial behaviors among women in the United States.

CONCLUSIONS AND RELEVANCE

Harsh physical punishment and child maltreatment appear to be associated with adult antisocial behaviors. Preventing harsh physical punishment and child maltreatment in childhood may reduce antisocial behaviors among adults in the United States.

Parent Spanking and Verbal Punishment, and Young Child Internalizing and Externalizing Behaviors in Latino Immigrant Families: Test of Moderation by Context and Culture

Objective

This study examined the prevalence and correlates of spanking and verbal punishment in a community sample of Latino immigrant families with young children, as well as the association of spanking and verbal punishment with child internalizing and externalizing problems 1 year later. Parenting context (e.g., warmth) and cultural context (e.g., the cultural value of respeto) are considered as potential moderators.

Design

Parenting and cultural socialization practices were assessed via parent self-report in sample of 633 Mexican and Dominican immigrant families with young children (M age = 4.43 years). Parent and teacher assessments of child internalizing and externalizing were also collected at baseline and 12 months later.

Results

At Time 1, male child gender was positively correlated with concurrent spanking; familial social support and U.S. American cultural knowledge were negatively correlated with mothers' spanking. Verbal punishment at Time 1 was associated with externalizing problems at Time 2 among both Mexican and Dominican American children, and this relation was not moderated. Additionally, verbal punishment was associated with Time 2 child internalizing problems among Mexican American children. There were no significant associations between spanking and later child internalizing or externalizing behaviors.

Conclusion

It is important that researchers examine both physical and verbal discipline strategies to understand their unique influences on Latino child outcomes, as well as contextual influences that may elucidate the use and long-term effects of spanking and verbal punishment on Latino children at different developmental stages.

The Influence of Race and Income on Community Mothers' Acceptance of Child Management Methods

The consideration of diverse family factors on parents' acceptance of behavioral parent training (BPT) components aids in the development and delivery of culturally sensitive parenting programs. Perceptions of acceptability are particularly important to investigate among low-income and racial-minority families, as they are less likely to engage in nonadapted BPT programs. Therefore, the current study examines the synergistic effects of race and income on mothers' acceptance of five common child management methods relevant to BPT. The relationship between mothers' acceptability ratings and self-reported parenting practices was also explored. Participants were 106 White and Black mothers from different income levels who completed measures related to the acceptability of response cost, positive reinforcement, time-out, spanking, and medication. The results indicated that mothers from varying backgrounds differed in their acceptance of child management methods, particularly with regard to corporal punishment. Additionally, a relationship was found between parents' acceptability ratings and their self-reported parenting behavior. The findings support the consideration of parents' perceptions of child discipline methods when recommending and delivering BPT programs to diverse parents.

How to Convince Parents to Stop Spanking Their Children

English- and Spanish-speaking parents of 1- to 5-year-old children were invited to view 5-10 minutes of parent training program, "Play Nicely," as part of the well-child checkup. Key measures were parents' plans to change how they discipline and, if they planned to use less spanking, how the program worked in their situation. Of 197 parents who participated, 128 (65.0%) planned to change how they discipline. Nineteen parents (9.6%) reported that they planned to spank less. The most common reasons for parents to plan to spank less were that the program taught other discipline options (12/19, 63.2%) and that the program taught that spanking was not recommended as a form of discipline (6/19, 31.6%). The majority of parents report that the program works because it offers alternatives to spanking. This study has implications for the development of parent training programs and the primary prevention of child abuse, violence, and other health problems.

Social Support, Parenting, and Social Emotional Development in Young Mexican and Dominican American Children

This study focused on social support and its association with child developmental outcomes, indirectly through parenting practices, in families of 4-5 year old Latino children. Data were collected from mothers and teachers of 610 Mexican American (MA) and Dominican American (DA) children. Mothers reported on perceived social support, parenting practices and children's problem and adaptive behavior functioning at home, and teachers reported on mothers' parent involvement and children's problem and adaptive behavior functioning in the classroom. Results showed that support received from family was higher than support received from school networks for both ethnic groups. Moreover, familial support was associated with child behavior, mediated by positive parenting practices, whereas support from school networks was not associated with child outcomes. During early childhood, social support from family members may be an important protective factor that can promote positive behavioral functioning among Latino children.

Longitudinal associations of neighborhood collective efficacy and maternal corporal punishment with behavior problems in early childhood

Neighborhood and parenting influences on early behavioral outcomes are strongly dependent upon a child's stage of development. However, little research has jointly considered the longitudinal associations of neighborhood and parenting processes with behavior problems in early childhood. To address this limitation, this study explores the associations of neighborhood collective efficacy and maternal corporal punishment with the longitudinal patterns of early externalizing and internalizing behavior problems. The study sample consisted of 3,705 families from a nationally representative cohort study of urban families. Longitudinal multilevel models examined the associations of collective efficacy and corporal punishment with behavior problems at age 3, as well as with patterns of behavior problems between the ages 3 to 5. Interactions between the main predictors and child age tested whether neighborhood and parent relationships with child behavior varied over time. Mediation analysis examined whether neighborhood influences on child behavior were mediated by parenting. The models controlled for a comprehensive set of possible confounders at the child, parent, and neighborhood levels. Results indicate that both maternal corporal punishment and low neighborhood collective efficacy were significantly associated with increased behavior problems. The significant interaction between collective efficacy and child age with internalizing problems suggests that neighborhood influences on internalizing behavior were stronger for younger children. The indirect effect of low collective efficacy on behavior problems through corporal punishment was not significant. These findings highlight the importance of multilevel interventions that promote both neighborhood collective efficacy and nonphysical discipline in early childhood. (PsycINFO Database Record

Is the Use of Physical Discipline Associated with Aggressive Behaviors in Young Children?

OBJECTIVE

To determine the association between use of physical discipline and parental report of physically aggressive child behaviors in a cohort of young children who were without indicators of current or past physical abuse.

METHODS

The data for this study were analyzed from an initial cohort of patients enrolled in a prospective, observational, multicenter pediatric emergency department-based study investigating bruising and familial psychosocial characteristics of children younger than 4 years of age. Over a 7-month period, structured parental interviews were conducted regarding disciplinary practices, reported child behaviors, and familial psychosocial risk factors. Children with suspected physical abuse were excluded from this study. Trained study staff collected data using standardized questions. Consistent with grounded theory, qualitative coding by 2 independent individuals was performed using domains rooted in the data. Inter-rater reliability of the coding process was evaluated using the kappa statistic. Descriptive statistics were calculated and multiple logistic regression modeling was performed.

RESULTS

Three hundred seventy-two parental interviews were conducted. Parents who reported using physical discipline were 2.8 (95% confidence interval [CI], 1.7-4.5) times more likely to report aggressive child behaviors of hitting/kicking and throwing. Physical discipline was used on 38% of children overall, and was 2.4 (95% CI, 1.4-4.1) times more likely to be used in families with any of the psychosocial risk factors examined.

CONCLUSIONS

Our findings indicated that the use of physical discipline was associated with higher rates of reported physically aggressive behaviors in early childhood as well as with the presence of familial psychosocial risk factors.

Short- and Mid-Term Effects of Violent Victimization on Delinquency: A Multilevel Growth-Curve Modeling Approach

The present study investigates how adolescents' experiences of violent victimization exert short- and mid-term effects on their involvement in delinquency. The study compares and contrasts delinquency trajectories of youths whose experiences of violent victimization differ. A multilevel growth-curve modeling approach is applied to analyze data from five waves of the National Youth Survey. The results show that, although delinquency involvement increases as youths experience violent victimization, delinquency trajectories differ with the type of violent victimization, specifically, parental versus non-parental victimization. Violent victimization by parents produced a sharp initial decline in delinquency (short-term effect) followed by a rapid acceleration (mid-term effect). In turn, non-parental violence showed a stable trend over time. The findings have important implications for prevention and treatment services.

Race as a Moderator of Associations Between Spanking and Child Outcomes

The cultural normativeness perspective argues that parenting practices such as spanking are more beneficial for children when they occur in cultural groups within which they are normative. Research on this issue in the United States has focused on race as a marker of culture, and findings have been mixed. The present study presents meta-analyses of five studies that reported effect sizes separately for White (n = 11,814) and Black (n = 3,065) American children (5 to 14 years of age). Mean weighted effect sizes for both groups indicated statistically significant associations with detrimental outcomes; they were not statistically significantly different from one another. Contrary to the cultural normativeness perspective, these results demonstrate that spanking is similarly associated with detrimental outcomes for White and Black children in the United States.

Systematic Review of Engagement in Culturally Adapted Parent Training for Disruptive Behavior

This article reviews the literature reporting engagement (enrollment, attendance, and attrition) in culturally adapted parent training for disruptive behavior among racial/ethnic minority parents of children ages 2-7 years. The review describes the reported rates of engagement in adapted interventions and how engagement is analyzed in studies, methods to develop adaptations, and adaptations that have been implemented. Seven studies were identified. Parental engagement varied across and within studies. Only one study examined whether adaptations improved engagement compared to non-adapted intervention. Frequent methods to develop adaptations were building partnerships or conducting interviews/focus groups with minority parents or community members. Adaptations included addressing cultural beliefs (perceptions of parenting skills), values (interdependence), or experiences (immigration) that affect parenting or receptivity to interventions; ensuring racial/ethnic diversity of interventionists; and addressing cultural relevancy and literacy level of materials. Future research should examine engagement in adapted interventions compared to non-adapted interventions and examine factors (e.g., immigration status) that may moderate impact on engagement.

Lässt sich körperliche Bestrafung durch ein Elterntraining reduzieren?

Körperliche Bestrafung ist in Deutschland keine Randerscheinung und mit einer Vielzahl von negativen Folgen für die leidtragenden Kinder verbunden. Mangelnde erzieherische Fähigkeiten gelten hierbei als ein bedeutender Risikofaktor für physische Disziplinarmaßnahmen. Demnach erscheinen Elterntrainings als sinnvolle Maßnahme zur Reduzierung der Prävalenz körperlicher Strafen. In der vorliegenden Arbeit wurde untersucht, ob sich durch das Elterntraining Positive Parenting Program von Sanders (Triple P; 2012 ) die Häufigkeit körperlicher Bestrafung im Rahmen einer universellen Präventionsmaßnahme reduzieren lässt. Es wurden die Angaben von 279 Müttern im Rahmen einer 3-Jahres-Längsschnittuntersuchung aus einem randomisierten Kontrollgruppen-Design ausgewertet. Eine Analyse mittels latenter Wachstumskurvenmodelle ergab für die Selbsteinschätzung der Mütter einen signifikanten Rückgang der Häufigkeit von Körperstrafen bei kleiner Effektstärke. Da körperliche Strafen, neben einer Vielzahl negativer Entwicklungskonsequenzen, auch mit späterer Kindesmisshandlung im Zusammenhang stehen, erscheint dieser Befund relevant und vielversprechend.

Children's emotional and behavioral problems and their mothers' labor supply

It has been documented that about 20% of children and adolescents suffer from a diagnosable mental or addictive disorder in the United States. The high prevalence of children’s emotional and behavioral problems (EBP) might have a negative effect on their mothers’ labor market outcomes because children with EBP require additional time for treatment. However, these children may require additional financial resources, which might promote mothers’ labor supply. Previous studies have only considered chronic conditions in analyzing the impact of children’s health on parental work activities. Moreover, most of these studies have not accounted for endogeneity in children’s health. This article estimates the effects of children’s EBP on their mothers’ labor supply by family structure while accounting for endogeneity in children’s health. We used the 1997 and 2002 Child Development Supplements (CDS) to the Panel Study of Income Dynamics (PSID). We used probit and bivariate probit models to estimate mothers’ probability of employment, and tobit and instrumental variable tobit models to estimate the effects of children’s EBP on their mothers’ work hours. Findings show negative effects of children’s EBP on their married mothers’ employment and on their single mothers’ work hours.

Cumulative effects of maternal age and unintended pregnancy on offspring aggression

Research on physical aggression often points to teen motherhood as being a primary contributor in the development of aggressive tendencies among young children. As a result of poor parenting practices, limited education, and a lack of emotional, physical, and financial resources, children born to young mothers often exhibit high levels of aggression across the life course. Meanwhile, unintentional pregnancy and young motherhood are likely to share many of the same risk factors and negative consequences for offspring, yet there is a dearth of research examining pregnancy intentionality and offspring aggression. Using the Fragile Families and Wellbeing Study, our study examines how mother's age and pregnancy intention status influence aggression among their 5-year-old children. We find that young motherhood and unintended births, despite being likely to co-occur, each provide distinct mechanisms for the formation of aggressive behavior in childhood.

Bringing back the social history

The social environment of a child is a key determinant of the child's current and future health. Factors in a child's family environment, both protective and harmful, have a profound impact on a child's long-term health, brain development, and mortality. The social history may be the best all-around tool available for promoting a child's future health and well-being. It is a key first step in identifying social needs of a child and family so that they may benefit from intervention. This article focuses on key social history elements known to increase a child's risk of maltreatment and provides case examples.

Early parental physical punishment and emotional and behavioural outcomes in preschool children

OBJECTIVE

To determine whether there is an association between being smacked by your main caregiver in the first two years and emotional and behavioural problems at age four.

DESIGN

Secondary analysis of data from the Growing Up in Scotland Prospective Study (GUS).

SETTING

Scotland, UK.

PARTICIPANTS

GUS birth cohort children, whose main caregiver had no concerns about their behaviour at 22 months.

EXPOSURE

Ever smacked by main caregiver in first 22 months, as measured by caregiver self-report at 22 months.

MAIN OUTCOME

Emotional and behavioural problems as measured by parental assessment and the Strengths and Difficulties Questionnaire (SDQ) at 46 months.

RESULTS

Preschool children exposed to main caregiver smacking in the first two years were twice as likely to have emotional and behavioural problems as measured by parental assessment [odds ratio (OR) 2.5, 95% confidence interval (CI) 1.9-3.2; absolute risk reduction (ARR) 17.8%, 95% CI 12.1-23.5] and SDQ (OR 2.5, 95% CI 1.7-3.7; ARR 7.5%, 95% CI 3.7-11.5), as children never smacked by their main caregiver. The association remained significant after adjusting for child age and sex, caregiver age, sex, ethnicity, educational attainment and mental health status, sibling number, structural family transitions and socioeconomic status (adj. OR 2.4, 95% CI 1.8-3.2 for parental assessment and adj. OR 2.2, 95% CI 1.4-3.5 for SDQ).

CONCLUSIONS

Parental use of physical punishment in the first two years may be a modifiable risk factor for emotional and behavioural difficulties in preschool children.

A brief intervention affects parents' attitudes toward using less physical punishment

Consecutive English and Spanish speaking caregivers of 6-24 month old children were randomly assigned to either a control or intervention group. Parents in the intervention group were instructed to view at least 4 options to discipline a child in an interactive multimedia program. The control group participants received routine primary care with their resident physician. After the clinic visit, all parents were invited to participate in a research study; the participation rate was 98% (258/263). The key measure was the Attitudes Toward Spanking (ATS) scale. The ATS is correlated with parents' actual use of physical punishment. Parents with higher scores are more likely to use physical punishment to discipline their children. Parents in the intervention group had an ATS score that was significantly lower than the ATS score of parents in the control group (median=24.0, vs. median=30; p=0.043). Parents in the control group were 2 times more likely to report that they would spank a child who was misbehaving compared with parents in the intervention group (16.9% vs. 7.0%, p=0.015). In the short-term, a brief intervention, integrated into the primary care visit, can affect parents' attitudes toward using less physical punishment. It may be feasible to teach parents to not use physical punishment using a population-based approach. The findings have implications for how to improve primary care services and the prevention of violence.

The Relationship Between Postpartum Depression, Domestic Violence, Childhood Violence, and Substance Use

The objective of this study was to determine the contribution of interpersonal violence and substance use to the prediction of postpartum depressive symptomatology. A community-based sample of 634 women in British Columbia, Canada was screened for interpersonal violence and substance use using the Antenatal Psychosocial Health Assessment (ALPHA) form. Of these women, 497 (78%) subsequently completed questionnaires at 8 weeks postpartum to assess for depressive symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). A predictive model for postpartum depressive symptomatology (EPDS > 9) was developed using regression analysis. Findings suggest that women who experience past or current interpersonal violence or personal or partner substance use problems should be considered for targeted screening for postpartum depression (PPD).

Racial-ethnic disparities in maternal parenting stress: the role of structural disadvantages and parenting values

Although researchers contend that racial-ethnic minorities experience more stress than whites, knowledge of racial-ethnic disparities in parenting stress is limited. Using a pooled time-series analysis of data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (n = 11,324), we examine racial-ethnic differences in maternal parenting stress, with a focus on structural and cultural explanations and variations by nativity and child age. In kindergarten, black mothers, albeit U.S.-born only, report more parenting stress than white mothers due to structural disadvantages and authoritarian parenting values. The black-white gap increases from kindergarten to third grade, and in third grade, U.S.-born black mothers' higher stress than white mothers' persists after controlling for structural and parenting factors. Hispanic and Asian mothers, albeit foreign-born only, report more stress than white mothers at both ages due to structural disadvantages and authoritarian values. Despite structural disadvantages, American Indian mothers report less stress.

Spanking and child development during the first 5 years of life

Using data from the Fragile Families and Child Wellbeing Study (N=3,870) and cross-lagged path analysis, the authors examined whether spanking at ages 1 and 3 is adversely associated with cognitive skills and behavior problems at ages 3 and 5. The authors found spanking at age 1 was associated with a higher level of spanking and externalizing behavior at age 3, and spanking at age 3 was associated with a higher level of internalizing and externalizing behavior at age 5. The associations between spanking at age 1 and behavioral problems at age 5 operated predominantly through ongoing spanking at age 3. The authors did not find an association between spanking at age 1 and cognitive skills at age 3 or 5.

Beating and insulting children as a risk for adult cancer, cardiac disease and asthma

The use of physical punishment for children is associated with poor psychological and behavioral outcomes, but the causal pathway is controversial, and the effects on later physical health unknown. We conducted a cross-sectional survey of asthma, cancer, and cardiac patients (150 in each category, 75 male) recruited from outpatient clinics and 250 healthy controls (125 male). All participants were 40-60 years old and citizens of Saudi Arabia, where the use of beating and insults is an acceptable parenting style. Demographic data and recalled frequency of beatings and insults as a child were assessed on an 8-point scale. Beating and insults were highly correlated (ρ = 0.846). Propensity score matching was used to control for demographic differences between the disease and healthy groups. After controlling for differences, more frequent beating (once or more per month) and insults were associated with a significantly increased risk for cancer (RR = 1.7), cardiac disease (RR = 1.3) and asthma (RR = 1.6), with evidence of increased risk for cancer and asthma with beating frequency of once every 6 months or more. Our results show that a threatening parenting style of beating and insults is associated with increased risk for somatic disease, possibly because this form of parenting induces stress. Our findings are consistent with previous research showing that child abuse and other early life stressors adversely affect adult somatic health, but provide evidence that the pathogenic effects occur also with chronic minor stress. A stress-inducing parenting style, even when normative, has long term adverse health consequences.

Physical punishment and mental disorders: results from a nationally representative US sample

BACKGROUND

The use of physical punishment is controversial. Few studies have examined the relationship between physical punishment and a wide range of mental disorders in a nationally representative sample. The current research investigated the possible link between harsh physical punishment (ie, pushing, grabbing, shoving, slapping, hitting) in the absence of more severe child maltreatment (ie, physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, exposure to intimate partner violence) and Axis I and II mental disorders.

METHODS

Data were from the National Epidemiologic Survey on Alcohol and Related Conditions collected between 2004 and 2005 (N = 34653). The survey was conducted with a representative US adult population sample (aged ≥ 20 years). Statistical methods included logistic regression models and population-attributable fractions.

RESULTS

Harsh physical punishment was associated with increased odds of mood disorders, anxiety disorders, alcohol and drug abuse/dependence, and several personality disorders after adjusting for sociodemographic variables and family history of dysfunction (adjusted odds ratio: 1.36-2.46). Approximately 2% to 5% of Axis I disorders and 4% to 7% of Axis II disorders were attributable to harsh physical punishment.

CONCLUSIONS

Harsh physical punishment in the absence of child maltreatment is associated with mood disorders, anxiety disorders, substance abuse/dependence, and personality disorders in a general population sample. These findings inform the ongoing debate around the use of physical punishment and provide evidence that harsh physical punishment independent of child maltreatment is related to mental disorders.

Longitudinal links between spanking and children's externalizing behaviors in a national sample of White, Black, Hispanic, and Asian American families

This study examined whether the longitudinal links between mothers' use of spanking and children's externalizing behaviors are moderated by family race/ethnicity, as would be predicted by cultural normativeness theory, once mean differences in frequency of use are controlled. A nationally representative sample of White, Black, Hispanic, and Asian American families (n = 11,044) was used to test a cross-lagged path model from 5 to 8 years old. While race/ethnic differences were observed in the frequency of spanking, no differences were found in the associations of spanking and externalizing over time: Early spanking predicted increases in children's externalizing while early child externalizing elicited more spanking over time across all race/ethnic groups.

Using baby books to change new mothers' attitudes about corporal punishment

OBJECTIVE

Research has found corporal punishment to have limited effectiveness in altering child behavior and the potential to produce psychological and cognitive damage. Pediatric professionals have advocated reducing, if not eliminating its use. Despite this, it remains a common parenting practice in the US.

METHODS

Using a three-group randomized design, this study explored whether embedding educational information about typical child development and effective parenting in baby books could alter new mothers' attitudes about their use of corporal punishment. Low-income, ethnically diverse women (n=167) were recruited during their third trimester of pregnancy and followed until their child was 18 months old.

RESULTS

Findings from home-based data collection throughout this period suggest that educational baby books compared with non-educational baby books or no books can reduce new mothers' support for the use of corporal punishment (respective effect sizes=.67 and .25) and that these effects are greater for African-American mothers (effect sizes=.75 and .57) and those with low levels of educational attainment (high school diploma, GED, or less) (effect sizes=.78 and .49).

CONCLUSION

Given their low cost and ease of implementation, baby books offer a promising way to change new mothers' attitudes and potentially reduce the use of corporal punishment with infants and toddlers.

Who Spanks Infants and Toddlers? Evidence from the Fragile Families and Child Well-Being Study

We use data from the Fragile Families and Child Well-Being Study (FFCW), a birth cohort study of children in 18 medium to large U.S. cities, to examine the prevalence and determinants of spanking among infants and toddlers (at mean age 14 months). Taking advantage of the large and diverse sample in FFCW, we conduct separate analyses for children of African American (N=1,710), Hispanic (N=853), and white non-Hispanic (N=812) mothers. Overall, about 15% of children are spanked at 12 months, with this share rising to 40% by 18 months and nearly 50% for children age 20 months or older. We find that there are marked differences in the use of spanking across the three racial/ethnic groups, with children of African American mothers more likely to be spanked and at a younger age. Moreover, while some predictors of spanking are seen across all three groups, others vary. Mothers who are young, who report more parental stress, or report their child has a more difficult temperament are more likely to spank across all three groups. However, being a boy increases the risk of spanking only within African American families. First-born children are at elevated risk of spanking to at least some extent in all groups, but much more so within Hispanic families. In addition, maternal employment is associated with a greater likelihood of spanking in Hispanic families.Although spanking at these young ages is not necessarily indicative of maltreatment, it may be a marker for families who are at elevated risk of maltreatment. As such, our findings, by highlighting some risk factors that are common across groups as well as some that are more important for particular groups, may have implications for child abuse prevention.

Perceived Instrumentality and Normativeness of Corporal Punishment Use among Black Mothers

Corporal punishment (CP) remains highly prevalent in the U.S. despite its association with increased risk for child aggression and physical abuse. Five focus groups were conducted with parents (n=18) from a community at particularly high risk for using CP (Black, low socioeconomic status, Southern) in order to investigate their perceptions about why CP use is so common. A systematic qualitative analysis was conducted using grounded theory techniques within an overall thematic analysis. Codes were collapsed and two broad themes emerged. CP was perceived to be: 1) instrumental in achieving parenting goals and 2) normative within participants' key social identity groups, including race/ethnicity, religion, and family of origin. Implications for the reduction of CP are discussed using a social ecological framework.

The emergence of spanking among a representative sample of children under 2 years of age in north Carolina

Spanking is common in the United States but less common in many European countries in which it has been outlawed. Being spanked has been associated with child abuse victimization, poor self-esteem, impaired parent-child relationships, and child and adult mental health, substance abuse, and behavioral consequences. Being spanked as a child has also been shown to increase the likelihood of abusing one's own children or spouse as an adult. Spanking of very young children less than two is almost never recommended even among experts that consider spanking as reasonable in some circumstances. Using a cross-sectional anonymous telephone survey, we describe spanking rates among a representative sample of North Carolina mothers of children less than 2 years old and the association of spanking with demographic characteristics. A substantial proportion of mothers admit to spanking their very young children. The rate of spanking in the last year among all maternal respondents was 30%. Over 5% of the mothers of 3-month olds reported spanking. Over 70% of the mothers of 23-month olds reported spanking. Increased spanking was associated with higher age of the child and lower maternal age. With every month of age, a child had 27% increased odds of being spanked. Early spanking has been shown to be associated with poor cognitive development in early childhood. Further, early trauma has been shown to have significant effects on the early developing brain. It is therefore critical that health and human services professionals address the risk of corporal punishment as a method of discipline early in the life of the child. The spanking of very young children may be an appropriate locus for policy and legislative debates regarding corporal punishment.

A brief intervention may affect parents' attitudes toward using less physical punishment

Ninety-six parents in a preschool and pediatric clinic participated in a randomized study of a brief parenting intervention. The Attitudes Toward Spanking (ATS) scale was measured at baseline, and, on average, 4 months postintervention. Higher ATS scores are correlated with increased use of physical punishment. In the intervention group, there was a 2.7-point decrease in the ATS score at follow-up compared with baseline (P = 0.01). There was no decrease in the ATS in the control group. Brief interventions may shift parental attitudes toward using less physical punishment and have implications for improving anticipatory guidance within primary care and early education.

Correlates and consequences of spanking and verbal punishment for low-income white, african american, and mexican american toddlers

This study examined the prevalence, predictors, and outcomes of spanking and verbal punishment in 2,573 low-income White, African American, and Mexican American toddlers at ages 1, 2, and 3. Both spanking and verbal punishment varied by maternal race/ethnicity. Child fussiness at age 1 predicted spanking and verbal punishment at all 3 ages. Cross-lagged path analyses indicated that spanking (but not verbal punishment) at age 1 predicted child aggressive behavior problems at age 2 and lower Bayley mental development scores at age 3. Neither child aggressive behavior problems nor Bayley scores predicted later spanking or verbal punishment. In some instances, maternal race/ethnicity and/or emotional responsiveness moderated the effects of spanking and verbal punishment on child outcomes.

Parenting attitudes and infant spanking: the influence of childhood experiences

OBJECTIVES

To assess associations among maternal childhood experiences and subsequent parenting attitudes and use of infant spanking (IS), and determine if attitudes mediate the association between physical abuse exposure and IS.

METHODS

We performed a prospective study of women who received prenatal care at community health centers in Philadelphia, Pennsylvania. Sociodemographic characteristics, adverse childhood experiences (ACEs), attitudes toward corporal punishment (CP), and IS use were assessed via face-to-face interviews, conducted at the first prenatal care visit, 3 months postpartum, and 11 months postpartum. Bivariate and multiple logistic regression analyses were conducted.

RESULTS

The sample consisted of 1265 mostly black, low-income women. Nineteen percent of the participants valued CP as a means of discipline, and 14% reported IS use. Mothers exposed to childhood physical abuse and verbal hostility were more likely to report IS use than those not exposed (16% vs 10%, P = .002; 17% vs 12%, P = .02, respectively). In the adjusted analyses, maternal exposure to physical abuse, other ACEs, and valuing CP were independently associated with IS use. Attitudes that value CP did not mediate these associations.

CONCLUSIONS

Mothers who had childhood experiences of violence were more likely to use IS than mothers without such experiences. Intergenerational transmission of CP was evident. Mothers who had experienced physical abuse as a child, when compared to those who had not, were 1.5 times more likely to use IS. Child discipline attitudes and maternal childhood experiences should be discussed early in parenting in order to prevent IS use, particularly among at-risk mothers.

Screening for harsh punishment in a pediatric primary care clinic

OBJECTIVES

To determine: (1) the prevalence of harsh punishment among parents in a pediatric clinic, and (2) the sensitivity, specificity, predictive values, and stability of a brief screening measure.

METHODS

A subset of families involved in a study of child maltreatment prevention were recruited for this study. Two items in a parent screening questionnaire (PSQ) were related to child punishment. Comparisons were made between parents' responses on the PSQ and on the Parent-Child Conflict Tactic Scale (CTSPC).

RESULTS

On the PSQ, 7% of parents of infants and 32% of parents of toddlers/preschoolers reported that their child was difficult to take care of or needed to be hit or spanked. On the CTSPC, 14% of the infants had experienced physical assault and 21% psychological aggression. For older children, subscales were modified to exclude common discipline measures, resulting in 20% experiencing physical assault and 19% psychological aggression. Sensitivities for the PSQ were relatively poor for infants, but moderate for older children. Specificities were good. Stability was adequate.

CONCLUSIONS

Harsh punishment experienced by older children was similar to that in published studies. Punishment of infants is concerning. The PSQ can be used to screen out parents who are not using harsh discipline measures.

PRACTICE IMPLICATIONS

The PSQ has variable utility in determining which families are using harsh punishment. Until the measure can be further refined, universal counseling is needed.

Reduced prefrontal cortical gray matter volume in young adults exposed to harsh corporal punishment

OBJECTIVE

Harsh corporal punishment (HCP) during childhood is a chronic, developmental stressor associated with depression, aggression and addictive behaviors. Exposure to traumatic stressors, such as sexual abuse, is associated with alteration in brain structure, but nothing is known about the potential neurobiological consequences of HCP. The aim of this study was to investigate whether HCP was associated with discernible alterations in gray matter volume (GMV) using voxel-based morphometry (VBM).

METHODS

1455 young adults (18-25 years) were screened to identify 23 with exposure to HCP (minimum 3 years duration, 12 episodes per year, frequently involving objects) and 22 healthy controls. High-resolution T1-weighted MRI datasets were obtained using Siemens 3 T trio scanner.

RESULTS

GMV was reduced by 19.1% in the right medial frontal gyrus (medial prefrontal cortex; MPFC, BA10) (P=0.037, corrected cluster level), by 14.5% in the left medial frontal gyrus (dorsolateral prefrontal cortex; DLPFC, BA9) (P=0.015, uncorrected cluster level) and by 16.9% in the right anterior cingulate gyrus (BA24) (P<0.001, uncorrected cluster level) of HCP subjects. There were significant correlations between GMV in these identified regions and performance IQ on the WAIS-III.

CONCLUSIONS

Exposing children to harsh HCP may have detrimental effects on trajectories of brain development. However, it is also conceivable that differences in prefrontal cortical development may increase risk of exposure to HCP.

Temperament and parenting during the first year of life predict future child conduct problems

Predictive associations between parenting and temperament during the first year of life and child conduct problems were assessed longitudinally in 1,863 offspring of a representative sample of women. Maternal ratings of infant fussiness, activity level, predictability, and positive affect each independently predicted maternal ratings of conduct problems during ages 4-13 years. Furthermore, a significant interaction indicated that infants who were both low in fussiness and high in predictability were at very low risk for future conduct problems. Fussiness was a stronger predictor of conduct problems in boys whereas fearfulness was a stronger predictor in girls. Conduct problems also were robustly predicted by low levels of early mother-report cognitive stimulation when infant temperament was controlled. Interviewer-rated maternal responsiveness was a robust predictor of conduct problems, but only among infants low in fearfulness. Spanking during infancy predicted slightly more severe conduct problems, but the prediction was moderated by infant fussiness and positive affect. Thus, individual differences in risk for mother-rated conduct problems across childhood are already partly evident in maternal ratings of temperament during the first year of life and are predicted by early parenting and parenting-by-temperament interactions.

Predictors of mothers' use of spanking with their infants

OBJECTIVES

This study describes mothers who report spanking their infants in the first 13 months of life.

METHODS

Two hundred forty-six (246) mothers were interviewed in the Mother-Baby Unit of a large university-affiliated hospital in a large southeastern city of the United States. Ninety-three percent (93%) of those mothers were reinterviewed in their homes when infants were 6-13 months of age.

RESULTS

Younger mothers, those who endorsed fewer alternatives to corporal punishment, and those who experienced their infants as "difficult" were significantly more likely to spank their infants.

CONCLUSIONS

The findings suggest the importance of more anticipatory guidance from physicians, nurses, social workers, and other professionals about discipline in the first few months of life, particularly given the risks associated with spanking infants and popular support for corporal punishment.

Physical punishment, culture, and rights: current issues for professionals

Once considered a legitimate parenting tool, physical punishment is increasingly being redefined as a developmental risk factor by health professionals. Three forces that have contributed to this significant social change are the evolution of pediatric psychology, increasing understanding of the dynamics of parental violence, and growing recognition of children as rights bearers. However, despite the consistency of research findings demonstrating the risks of physical punishment, some practitioners still struggle with the question of whether physical punishment is an appropriate practice among some cultural or ethnic groups. This issue is explored through an analysis of studies examining cultural differences and similarities in physical punishment's effects, as well as legal decisions made throughout the world. Despite practitioners' awareness of the prevalence and impact of parental violence, some still struggle with deciding where to "draw the line" in advising parents about spanking. This issue is addressed through an examination of the role that physical punishment plays in child maltreatment. Finally, the human rights perspective on physical punishment is offered as a new lens through which practitioners may view physical punishment to clarify the fuzzy issues of cultural relativity and the punishment-abuse dichotomy.

Körperliche Bestrafung: Prävalenz und Einfluss auf die psychische Entwicklung bei Vorschulkindern

Zusammenfassung. Körperliche Bestrafung (kB) in der Erziehung ist immer noch weit verbreitet, obwohl die negativen Folgen vor allem von harter kB für die kindliche Entwicklung unumstritten sind. Seit November 2000 ist in der Bundesrepublik Deutschland jede physische und psychische Gewalt in der Erziehung untersagt (Neufassung des § 1631 BGB). Wie hoch ist die Prävalenzrate von kB bei Kindergartenkindern, welche Auswirkungen hat kB auf die kindliche Entwicklung? N = 477 Mütter (359 Väter) wurden zu prä und nach einem Jahr mit einer multimethodalen Fragebogenbatterie untersucht, die Mütter außerdem im Rahmen von Hausbesuchen befragt. Die Prävalenzrate von kB betrug 73 % bei den Müttern (58.5 % bei den Vätern, wobei diese Angaben auf Mütterurteilen beruhten). KB korrelierte wie erwartet bedeutsam mit soziodemografischen Variablen, der Häufigkeit kindlicher Verhaltensstörungen, dysfunktionalem Erziehungsverhalten und mütterlicher psychischer Befindlichkeit. Schlussfolgerungen: Eltern sollten die im Gesetz verankerten flankierenden Maßnahmen (z. B. Elterntrainings) zur gewaltfreien Bewältigung von Konfliktsituationen niedrig-schwellig zugänglich gemacht werden, nicht nur um die Inzidenz von kB zu reduzieren, sondern auch um negative Einflüsse bereits durchgeführter kB abzufedern.