Abstract
OBJECTIVE
To examine the association between maternal use of corporal punishment (CP) against their 3-year-old children and subsequent aggressive behavior among those children two years later.
METHODS
Respondents participated in waves 1, 3, and 5 of the Fragile Families and Child Wellbeing Study (1998–2005), a population-based longitudinal birth cohort study of children (and their parents) born in one of 20 large U.S. cities (n=2,461), with oversampling of unmarried couples. Maternal reports of CP, children’s aggressive behaviors at 3 and 5 years of age, and a host of key demographics and potential confounding factors were assessed including: child physical maltreatment, psychological maltreatment, and neglect, intimate partner aggression and violence, and maternal stress, depression, substance use, and consideration of abortion.
RESULTS
Multiple logistic regression analyses revealed that frequent use of CP (i.e., maternal use of spanking more than twice in the prior month) when the child was 3 years-old was associated with increased risk for higher levels of child aggression when the child was 5 years-old (adjusted odds ratio = 1.49 [CI=1.2–1.8] p<0.0001), even after simultaneously controlling for the child’s level of aggression at 3 years of age as well as all of the aforementioned confounding factors and key demographics.
CONCLUSIONS
Despite American Academy of Pediatrics recommendations to the contrary, most parents in the U.S. approve of and have used CP as a form of child discipline. The current findings support a growing body of evidence that even minor forms of CP, such as spanking, raise risk for increased subsequent child aggressive behavior. Importantly, these findings cannot be attributed to the possible confounding effects of a host of other maternal parenting risk factors. Increased and improved efforts to reduce the use of CP and promote the use of alternative, effective non-physical forms of child discipline among U.S. parents are warranted.
Keywords: corporal punishment, physical punishment, spank, childhood aggression, child aggressive behavior
When parents discipline their children, they generally do so in order to teach their children a lesson, instill values, and/or improve their children’s current and future behavior. Corporal punishment (CP) is one disciplinary strategy that remains highly prevalent in the U.S. despite controversy surrounding its use.1 CP can be defined as “the use of physical force with the intention of causing a child to experience pain, but not injury, for the purpose of correcting or controlling the child’s behavior (p. 3).”2 Percent estimates of U.S. parents who have used CP vary from 35–90% depending on key modifiers such as age and gender of the child and type of punishment specified (e.g., spanking, slapping).3–5 In a highly diverse, U.S. population-based sample of parents with 3-year old children, a majority of the mothers reported spanking their 3 year-old children at least once in the month prior to the interview.6 Furthermore, in a 2005 U.S. poll, 72% of adults reported that it was “OK to spank a child,” with approval ratings being highest in the South and lowest in the Northeast.7
The normativeness of CP in the U.S. stands in contrast with the American Academy of Pediatrics (AAP) recommendations, which are consistent those of other professional organizations, e.g.,8, 9, 10 that “parents be encouraged and assisted in the development of methods other than spanking for managing undesired behavior (p. 723).”11 Such concerns are rooted in the increasing body of empirical evidence suggesting that the risks of using CP against children are likely to outweigh the potential benefits. A 2002 meta-analysis showed linkages between CP of children and risk for poor outcomes in childhood including aggressive and/or anti-social behavior, mental health problems, and physical maltreatment; most of these risks carried into adulthood as well.12
Whether or not CP causes aggression is of particular relevance for public health interests in short-circuiting the cycle of violence. Gershoff’s meta-analysis included 27 studies that examined the link between CP and aggression and found a positive effect (d = 0.36); however, most of these studies were not longitudinal.12, 13 In order to more strongly assert that CP is a causal determinant of aggression, it is necessary to: 1) demonstrate a statistically significant link between CP and aggression as well as, 2) temporality of this link, and to 3) control for the child’s initial level of aggression as well as 4) key potential confounders.12, 13 Other researchers have aimed to meet most of these conditions.e.g., 14–23 However, the current study accounts for all four conditions, has a larger sample size and therefore more statistical power than all but two of the aforementioned studies,22, 23 and controls for key potential maternal parenting risk confounders and that have not previously been examined simultaneously. The current study was designed to answer the following question: Does maternal use of corporal punishment on a 3 year-old child lead to increased risk of aggression when that child is 5 years of age, even after controlling for the child’s initial level of aggression and other important maternal parenting risk factors and demographics?
METHODS
Participants
The sample for this study was obtained from the Fragile Families and Child Well-being Study (FFCWS), which oversampled for non-marital births. FFCWS is a population-based cohort study of families from 20 large US cities. The original sample (n = 4898) was obtained from 1998 to 2000 by sampling births within hospitals from cities with populations over 200,000 in 1994; a detailed description of the FFCWS study design was published previously.24 Four waves of data are available: baseline (around the time of the index child’s birth), and when the index child was one, three, and five years old. Two interviews were conducted when the child was age three and age five: a core interview (analogous to those from the first three waves) and an interview conducted with a sub-sample of mothers for the add-on “In-Home Longitudinal Study of Pre-School Aged Children.” Questions about child aggression and maltreatment were included in the latter interview. Most mothers (79%) who completed the core interview also completed the “In-home” interview.
Mothers who met at least one of the following criteria were excluded from the study sample: 1) did not participate in the 3 year “In-home” interview (n=1610), 2) did not participate in the 5 year “In-home” interview (n=799), 3) answered fewer than 50% of the child aggression scale items so that a valid score could not be calculated (missing item values were imputed when 50% or fewer of the scale items were missing) (n=21), or 4) did not report whether or not they had spanked the index child at age 3 (n=7). Study participants (n=2461) differed demographically from non-participants (n=2437) in that participants were: more likely to have some college education, be Black, be U.S. born, and be Christian (non-Catholic) or non-religious. Participants and non-participants did not differ according to child’s gender, maternal age, household income, or parents’ marital status at child’s birth.
The Institutional Review Board (IRB) of the Tulane University Health Sciences Center reviewed this secondary data analysis study of publicly available data and considered it exempt. All participant recruitment procedures were approved by the IRBs at the academic homes to the FFCWS: Columbia University and Princeton University. Study participants were compensated and informed consent was obtained at each interview. Again, further details pertaining to the original study have been published elsewhere.24
Measures
All data were provided via self-report from the mother. All child-related questions were asked in regard to the identified index child.
Predictor Variable
Maternal use of CP
This variable reflects how frequently the mother spanked her 3-year old child, a peak age for its use,3, 25 for “misbehaving or acting up” in the month prior to the interview. Responses were coded and analyzed ordinally as: never (0), once or twice (1), or more than two times (2).
Dependent Variable
Index Child Aggression at Age Five
This variable was assessed using 12 items from the Child Behavior Checklist version for age five,26 which asked if the child: argues a lot; is cruel, bullies and shows meanness to others; destroys (his/her) own things; destroys things belonging to family or others; is disobedient at home; is disobedient at school or in childcare gets in many fights; physically attacks people; screams a lot; teases a lot; threatens people; and is unusually loud (α = 0.82). Response options were: not true (0), somewhat or sometimes true (1), or very true or often true (2). An average score for the 12 items was obtained (mean=0.40, median=0.33, standard deviation=0.33). Because the variable was highly skewed, it was dichotomized at the median and analyzed as “lower aggression” (score = 0–0.32) versus “higher aggression” (score = 0.33 to 1.83).
Index Child Aggression at Age Three
This variable was assessed using 19 items from the Child Behavior Checklist version for age three,26 which asked if the child: Is defiant; demands must be met immediately; is disobedient; doesn't seem to feel guilty after misbehaving; is easily frustrated; gets in many fights; hits others; has angry moods; Punishment doesn't change (his/her) behavior; screams a lot; is selfish or won't share; is stubborn, sullen, or irritable; has temper tantrums or hot temper; is uncooperative; wants a lot of attention; can't stand waiting, wants everything now; destroys things belonging to family or other children; hurts animals or people without meaning to; physically attacks people (α= 0.88). Response options were: not true (0), somewhat or sometimes true (1), or very true or often true (2). An average score for the 19 items was then obtained (mean=0.62, median=0.58, standard deviation=0.36). Because the variable was highly skewed, it was dichotomized at the median value and analyzed as “lower aggression” (score = 0–0.57) versus “higher aggression” (score = 0.58 to 1.95).
Potential Confounders
The following variables were included because they may potentially confound the association between parental use of CP and child aggression. All were assessed when the child was 3 years of age so as to be consistent with the main predictor variable.
Maternal Parenting Risks
We have shown previously that maternal use of CP against her 3-year old child is associated with her use of other harsh parenting (physical and psychological maltreatmenta), child neglect, intimate partner aggression and violence, and maternal parenting stress, depression, and consideration of abortion;6 use of alcohol and/or drugs also is linked with use of CP27 and parental punitiveness.28 Prior literature also has shown links between most of these variables (especially harsh parenting, exposure to intimate partner aggression and violence, parental depression and stress) and childhood aggression.29–34
Child maltreatment and intimate partner aggression and violence (IPAV)
Three child maltreatment proxies were assessed with the Parent-Child Conflict Tactics Scale (PC-CTS):35 physical maltreatment (4 items), psychological maltreatment (5 items), and neglect (5 items). (The physical maltreatment scale usually contains a fifth item regarding spanking; however, this item was removed so that it would not overlap with our main predictor variable.) IPAV experienced by the mother since the index child’s birth, either from the father or from a current partner, was assessed using seven items: three items from the Conflict Tactics Scale36 were adapted to assess physical aggression and four from the Spouse Observation Checklist37 and Lloyd38 were adapted to assess psychological aggression. Because child physical and psychological maltreatment each were highly skewed, they each were dichotomized at their median values (shown in Table 1) for analysis. Child neglect and IPAV also were dichotomized (any vs. none).
TABLE 1.
Descriptive and Bivariate Statistics of Maternal Characteristics by Mothers’ Use of Corporal Punishment (CP) during the Month Prior to Interview when Child was 3 Years of Age
| Total sample |
Did not Spank |
Spanked 1–2× |
Spanked 3× or more |
||
|---|---|---|---|---|---|
| (n = 2461) | (n=1123) | (n= 686) | (n=652) | ||
| Maternal Parenting Risks | |||||
| Psychological maltreatment
against child, past year incident freq [range=0–115] |
25 | 16 | 25 | 33 | *** |
| Physical maltreatment against
child (spanking not included), past year incident freq [range=0–108] |
12 | 4 | 16 | 26 | *** |
| Any neglect of child, past year % | 11.3 | 8.5 | 13.3 | 14.3 | *** |
| Victim of intimate partner
aggression and/or violence, since birth of index child % |
53.2 | 47.4 | 57.9 | 58.4 | *** |
| Parenting stress, Parenting Stress
Index score [range=0–44] |
12 | 11 | 13 | 13 | *** |
| Major depression, % | 21.3 | 18.2 | 21.4 | 26.5 | *** |
| Use of drugs and/or alcohol, % | 16.1 | 13.0 | 16.6 | 20.9 | *** |
| Considered aborting this child, % | 27.7 | 24.8 | 29.3 | 30.8 | * |
| Maternal and Family Demographics | |||||
| Child gender (boy), % | 51.9 | 48.9 | 53.4 | 55.5 | * |
| Maternal Age, years [range=16–50] | 27 | 28 | 27 | 26 | *** |
| Maternal Education, % | ** | ||||
| < high school | 32.7 | 34.9 | 34.1 | 27.5 | ** |
| High school | 30.6 | 29.1 | 29.2 | 34.8 | * |
| Some college | 25.6 | 23.9 | 26.2 | 27.8 | |
| College grad | 11.0 | 12.1 | 10.2 | 9.8 | |
| Maternal Race / Ethnicity, % | *** | ||||
| Black | 50.7 | 45.3 | 53.6 | 56.8 | *** |
| Hispanic | 24.2 | 29.2 | 23.3 | 16.4 | *** |
| White | 21.9 | 21.9 | 19.7 | 24.1 | |
| Other | 3.1 | 3.2 | 3.2 | 2.6 | |
| Maternal Nativity (Foreign Born), % | 12.6 | 17.5 | 10.5 | 6.1 | *** |
| Maternal Religion, % | *** | ||||
| Catholic | 26.4 | 32.3 | 26.8 | 15.8 | *** |
| Protestant | 39.9 | 36.0 | 40.2 | 46.3 | *** |
| Other Christian | 12.7 | 11.0 | 12.4 | 16.1 | ** |
| No religious preference | 17.0 | 16.6 | 16.8 | 17.9 | |
| Other | 3.1 | 3.5 | 2.9 | 2.8 | |
| Mother and father relationship status, % |
NS | ||||
| Married | 32.1 | 33.6 | 31.5 | 30.4 | |
| Cohabiting | 27.7 | 28.0 | 26.7 | 28.2 | |
| Visiting | 29.6 | 27.8 | 30.9 | 31.3 | |
| No relationship | 10.6 | 10.6 | 10.9 | 10.1 | |
| Maternal Annual Household
Income, natural log of $ [range=0–13.8] (actual median = $23,721) |
10 | 10 | 10 | 10 | NS |
NS = Not statistically significant;
P < .05;
P < .01;
P < .001
Note: Kruskal-Wallis tests were conducted for continuous variables, for which ranges and medians are presented, because equal variance assumptions generally were not met. Chi Squared tests were conducted for binary and categorical variables, for which % of mothers occupying each category are presented. Missing data for each variable equaled less than 1%.
Other maternal risks
Maternal parenting stress, major depression, use of alcohol and/or drugs, and unwantedness of the index child pregnancy were assessed. Stress was measured using eleven items from the Parenting Stress Index39 (α=0.86). Depression was measured based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,40 for major depression using Section A of the Composite International Diagnostic Interview – Short Form;41 detailed scoring methods have been described previously.42 “Unwantedness” of the index child pregnancy was approximated based on the mother’s response to this baseline question: “When you found out you were pregnant, did you think about having an abortion?” Parenting stress was analyzed as a continuous variable. All of the other maternal risk variables were dichotomized (yes vs. no).
Maternal and Family Demographics
These variables were selected based on their availability in the FFCWS dataset and previous empirical evidence suggesting their association with parenting risk and/or use of CP.
Statistical Analysis
Descriptive and bivariate statistics were conducted to examine associations between all assessed maternal parenting risk factors/demographic characteristics and maternal use of CP (Table 1) and child aggression at age 5 (Table 2). The Kruskal-Wallis test was used for the continuous variables because the equal variances assumption generally was not met. Chi-square tests were used with binary and categorical variables.
TABLE 2.
Descriptive and Bivariate Statistics of Maternal Characteristics by Child Aggressive Behavior when Child was 5 Years of Age
| Total sample |
Lower aggression |
Higher aggression |
||
|---|---|---|---|---|
| (n = 2461) | (n= 1,137) | (n= 1,324) | ||
| Maternal Parenting Risks | ||||
| Psychological maltreatment
against child, past year freq [range=0–115] |
25 | 18 | 27 | *** |
| Physical maltreatment against
child (spanking not included), past year freq [range=0–108] |
12 | 9 | 16 | *** |
| Any neglect of child, past year % | 11.3 | 8.1 | 14.1 | *** |
| Victim of intimate partner
aggression and/or violence, since birth of index child % |
53.2 | 47.9 | 57.8 | *** |
| Parenting stress, Parenting Stress
Index score [range=0–44] |
12 | 11 | 13 | *** |
| Major depression, % | 21.3 | 17.5 | 24.6 | *** |
| Use of drugs and/or alcohol, % | 16.1 | 13.9 | 18.0 | ** |
| Considered aborting this child, % | 27.7 | 25.0 | 30.0 | ** |
| Maternal and Family Demographics | ||||
| Child gender (boy), % | 51.9 | 47.5 | 55.7 | *** |
| Maternal Age, years [range=17–50] | 28 | 28 | 26 | *** |
| Maternal Education, % | *** | |||
| < high school | 32.7 | 29.4 | 35.6 | ** |
| High school | 30.6 | 28.5 | 32.5 | * |
| Some college | 25.6 | 28.0 | 23.5 | * |
| College grad | 11.0 | 14.1 | 8.3 | *** |
| Maternal Race / Ethnicity, % | NS | |||
| Black | 50.7 | 49.3 | 51.9 | |
| Hispanic | 24.2 | 24.4 | 24.0 | |
| White | 21.9 | 23.3 | 20.6 | |
| Other | 3.1 | 2.9 | 3.2 | |
| Maternal Nativity (Foreign Born), % | 12.6 | 13.5 | 11.7 | NS |
| Maternal Religion, % | * | |||
| Catholic | 26.4 | 27.7 | 25.3 | |
| Protestant | 39.9 | 41.3 | 38.7 | |
| Other Christian | 12.7 | 12.7 | 12.8 | |
| No religious preference | 17.0 | 14.5 | 19.1 | ** |
| Other | 3.1 | 3.1 | 3.2 | |
| Mother and father relationship status, % |
*** | |||
| Married | 32.1 | 36.6 | 28.3 | *** |
| Cohabiting | 27.7 | 27.1 | 28.2 | |
| Visiting | 29.6 | 25.9 | 32.8 | *** |
| No relationship | 10.6 | 10.4 | 10.7 | |
| Maternal Annual Household
Income, natural log of $ [range=0–13.8] (actual median = $23,721) |
10.1 | 10.1 | 10.0 | *** |
NS = Not statistically significant;
P < .05;
P < .01;
P < .001
Note: Kruskal-Wallis tests were conducted for continuous variables, for which ranges and medians are presented, because equal variance assumptions generally were not met. Chi Squared tests were conducted for binary and categorical variables, for which % of mothers occupying each category are presented. Missing data for each variable equaled less than 1%.
Four mutivariate logistic regression models were conducted to examine prediction of child aggression at 5 years of age (Table 3). All four models controlled for parents’ marital status at birth as well as interview city because these variables were part of the sampling design. Model 1 tested maternal use of CP when the child was 3 years of age as the sole predictor. Model 2 added the child’s initial level of aggression at 3 years of age. Model 3 added the eight assessed maternal parenting risk factors that may confound the association between CP and child aggression. Model 4 added all of the assessed maternal and family demographic characteristics.
TABLE 3.
Odds Ratios of Corporal Punishment (CP) and other Family Characteristics Predicting a Higher Level of Child Aggression at Age 5
| Model 1 (n=2461) | Model 2 (n=2461) | Model 3 (n=2432) | Model 4 (n=2432) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | P> | OR | 95% CI | P> | OR | 95% CI | P> | OR | 95% CI | P> | |
| Mother’s Use of CP | ||||||||||||
| Mother spanked >2 times | 2.03 | (1.82 – 2.26) | 0.000 | 1.59 | (1.42 – 1.79) | 0.000 | 1.43 | (1.22 – 1.69) | 0.000 | 1.49 | (1.24 – 1.78) | 0.000 |
| Mother spanked 1–2 times | 1.37 | (1.17 – 1.61) | 0.000 | 1.21 | (1.02 – 1.45) | 0.032 | 1.15 | (0.93 – 1.40) | ns | 1.17 | (0.94 – 1.44) | ns |
|
Higher Level of Child Aggression at Age 3 |
3.79 | (3.43 – 4.19) | 0.000 | 3.34 | (3.05 – 3.66) | 0.000 | 3.35 | (3.06 – 3.67) | 0.000 | |||
| Maternal Parenting Risks | ||||||||||||
| Psychological maltreatment against child |
0.98 | (0.81 – 1.18) | ns | 0.97 | (0.80 – 1.19) | ns | ||||||
| Physical maltreatment against child (spanking not included) |
1.11 | (0.95 – 1.28) | ns | 1.10 | (0.93 – 1.29) | ns | ||||||
| Neglect of child | 1.14 | (0.84 – 1.55) | ns | 1.13 | (0.83 – 1.53) | ns | ||||||
| Victim of intimate partner aggression and/or violence |
1.14 | (0.94 – 1.38) | ns | 1.15 | (0.94 – 1.39) | ns | ||||||
| Parenting stress | 1.02 | (1.01 – 1.04) | 0.001 | 1.02 | (1.01 – 1.04) | 0.006 | ||||||
| Major depression | 1.07 | (0.91 – 1.26) | ns | 1.07 | (0.92 – 1.25) | ns | ||||||
| Use of drugs and/or alcohol | 1.14 | (0.87 – 1.50) | ns | 1.15 | (0.88 – 1.51) | ns | ||||||
| Considered aborting this child | 1.04 | (0.79 – 1.37) | ns | 1.04 | (0.77 – 1.40) | ns | ||||||
| Demographics | ||||||||||||
| Child gender, boy | 1.31 | (1.09 – 1.58) | 0.004 | |||||||||
| Maternal Age, y | 1.00 | (0.97 – 1.03) | ns | |||||||||
| Maternal Education | ||||||||||||
| < high school (Ref) | 1.00 | |||||||||||
| High school | 0.97 | (0.80 – 1.19) | ns | |||||||||
| Some college | 0.78 | (0.65 – 0.94) | 0.009 | |||||||||
| College grad | 0.66 | (0.44 – 0.99) | 0.043 | |||||||||
| Maternal Race / Ethnicity | ||||||||||||
| Black (Ref) | 1.00 | |||||||||||
| Hispanic | 0.99 | (0.80 – 1.22) | ns | |||||||||
| White | 1.07 | (0.85 – 1.34) | ns | |||||||||
| Other | 1.13 | (0.72 – 1.80) | ns | |||||||||
| Foreign Born | 1.04 | (0.77 – 1.41) | ns | |||||||||
| Maternal Religion | ||||||||||||
| Protestant (Ref) | 1.00 | |||||||||||
| Catholic | 1.10 | (0.75 – 1.60) | ns | |||||||||
| Other Christian | 0.99 | (0.64 – 1.55) | ns | |||||||||
| No religious preference | 1.24 | (1.02 – 1.50) | 0.030 | |||||||||
| Other | 1.32 | (0.77 – 2.26) | ns | |||||||||
| Mother and father relationship status |
||||||||||||
| Married (Ref) | 1.00 | |||||||||||
| Cohabiting | 0.99 | (0.70 – 1.39) | ns | |||||||||
| Visiting | 1.18 | (0.89 – 1.56) | ns | |||||||||
| No relationship | 1.00 | (0.65 – 1.54) | ns | |||||||||
| Maternal Annual Household Income |
0.96 | (0.90 – 1.04) | ns | |||||||||
Note: Missing data for each variable equaled 1.2 % or less. All models were adjusted for two key variables used in the sampling design: parents’ marital status at birth (married or unmarried) and city. In Model 4, a Bonferroni correction for multiple tests suggests that only those findings with P<0.002 should be considered.
RESULTS
Almost half of the mothers reported no use of spanking (45.6%), 27.9% reported spanking 1 to 2 times in the past month, and 26.5% reported spanking more than 2 times. All of the examined risk factors and demographics, except for parental relationship status and income, were significantly associated with CP in bivariate analyses (Table 1). Use of CP was significantly associated with other maternal parenting risks, including proxies for child psychological and physical maltreatment and neglect, IPAV victimization, stress, depression, substance use, and consideration of abortion. Respondents who were Hispanic, foreign born, or Catholic all were at lower than average risk for using CP. Respondents who had a male index child or a high school education, or who were younger, Black, or Christian (non-Catholics) were at higher than average risk for using CP.
As with CP, all of the examined risk and demographic factors, except for race/ethnicity and nativity, were associated with child aggression (Table 2). These findings confirmed that most of the examined factors might indeed confound the link between CP and child aggression and therefore should be controlled for in the final analysis. As with CP, higher levels of each of the assessed maternal parenting risks were associated with risk for higher levels of child aggression. In addition, a few demographics also were relevant: children who were male or whose mothers were younger, had lower education levels or household income, had no religious preference, or had just a “visiting” relationship with the father were at risk for higher levels of aggression.
Table 3 presents results from four logistic regression models predicting higher levels of child aggression at age 5. Across all four models, mothers’ more frequent use of CP (more than twice in the prior month) when the child was age 3 was a statistically significant predictor of higher levels of aggression when the child was age 5. At the bivariate level (model 1), more frequent use of CP more than doubled the odds of higher aggression levels and less frequent use of CP (1 to 2 times in the prior month) raised the odds by almost 40%. When the child’s level of aggression at age 3 was included (model 2), the impact of CP use on subsequent aggression was cut almost in half; this was because, as expected, having a higher level of aggression at age 3 was a strong predictor of a higher level of aggression at age 5. When the assessed maternal parenting risks were included (model 3) the impact of more frequent CP use was cut by another 27% and less frequent CP use was no longer statistically significant. The final model (4), which included all assessed demographics as well, suggests that the odds of the child having a higher level of aggression at age 5 were raised by about 49% with more frequent use of CP at age 3.
DISCUSSION
Our study accounted for eight key “maternal parenting risks” for child aggression, including other forms of harsh parenting besides use of CP (i.e., physical and psychological maltreatment proxies), child neglect, IPAV, and maternal parenting stress, depression, use of substances, and consideration of abortion. As anticipated, all of these factors were found to be associated both with CP use and with child aggression and therefore had the potential to be important confounders of this association. Although prior studies on this topic have accounted for parenting risks such as maternal psychopathology,23 parental marital adjustment or conflict,15, 16 and/or relevant demographics, no studies to date to the authors’ knowledge have accounted simultaneously for all of the confounds addressed in this study, while also addressing the other key conditions (statistical significance, temporality, initial levels of child aggression) that must be met in order to more strongly assert that use of CP leads to higher levels of aggression in children.
We found that even after all of these potential “maternal parenting risk” confounds were controlled for, more frequent maternal use of CP with their 3-year-old children raised the odds of these children being more aggressive at age 5. This finding is consistent with dozens of other studies that also have shown a significant statistical link between the use of CP and child aggression including those summarized by Gershoff12 (e.g., 18, 20, 43, 44–53) and other studies conducted since the time of her meta-analysis;e.g., 23, 54–57 it also is consistent with studies that similarly controlled for child’s initial level of aggression.e.g., 15–23 Interestingly, once all of the demographics were accounted for in our final model, CP was the only examined parenting risk factor that remained statistically linked (after a Bonferroni correction) with subsequent child aggression. This finding seems to support a social learning approach to understanding the cycle of violence,58 whereby the child learns to be aggressive by being treated directly with aggression.
One may wonder, then, why maternal use of child physical maltreatment was not related to child aggression. The physical maltreatment subscale of the PC-CTS contained five items (Shook; Hit on the bottom with something like a belt, hairbrush, a stick or some other hard object; Slapped on the hand, arm, or leg; Pinched; and Spanked on the bottom with your bare hand). However, when the latter item was removed, there was a substantial drop in the reliability coefficient for this subscale (from α = 0.63 to 0.48). Further, two of the remaining four items were reported very rarely (5 % (shook) and 8% (pinched)); in contrast, spanking was much more common. Thus, the lack of association between maternal use of child physical maltreatment and subsequent child aggression may be an issue of statistical power rather than one of theoretical inconsistency.
There are several limitations to our study. First, this study focused on maternal use of CP only and does not account for the father’s or other caregivers’ use of CP with the child. Further, all variables in this study are based on mothers’ self reports; there is no observational data and reports may be subject to biases related to recall and/or social desirability. Also, there is always concern in observational studies that unmeasured confounders may explain the associations found; however, even when this concern was addressed to some extent in a prior study using hierarchical linear modeling, the link between CP and child aggression remained.22
Given the problem of unmeasured confounders, it is not possible to assert causality between CP and child aggression in observational studies such as this. And, as with other studies of risk behaviors (e.g., smoking), it would be unethical to randomize parents to either use CP or not use CP given the existing evidence linking CP with associated harm in children. Thus we must rely largely on evidence from observational studies, such as the current one, that aim to account for as many other possible explanations of the association between CP and child aggression as possible.
CONCLUSIONS
This study adds strength to the growing body of literature suggesting that parental use of CP leads to increased child aggression. This evidence-base suggests that primary prevention of violence can start with efforts to prevent the use of CP against children. Pediatricians and others concerned with children’s well-being know that CP is not a necessary form of child discipline and that other more or equally effective, non-physical forms of discipline exist. Reductions in parents’ use of CP (demonstrated in randomized clinical trials of parenting interventions designed to treat conduct disorder in children) have been shown to reduce children’s subsequent aggression;59 additional studies of this nature could aid in addressing the question of CP as a causal agent in subsequent aggression. However, efforts to teach non-physical discipline strategies to parents via general pediatric office visits have met with mixed success.60, 61 Research to further such efforts is needed given that parents cite pediatricians as the professionals they are most likely to seek advice from regarding child discipline.62 In addition, broader population-based efforts, such as social marketing campaigns, are needed to shift perceived norms regarding CP62 and strengthen the AAP’s message that other effective and less risky child discipline strategies should be used instead of CP.
The authors would like to thank Mili Duggal and Ransome Eke for their assistance with literature review and table construction, as well as Elizabeth Gershoff for sharing reviews of key literature. The authors also thank the 2,461 study participants who gave their valuable time and information to this study along with the reviewers for their helpful comments and critiques of this article.
Acknowledgments
Funding: This research was supported by the Centers for Disease Control and Prevention (grant R49 CE000915-02) and the National Institute of Mental Health and the National Institute of Child Health and Human Development (R01 HD41141-02).
Abbreviations
- AAP
American Academy of Pediatrics
- CP
Corporal Punishment
- FFCWS
Fragile Families and Child Well-being Study
- IPAV
Intimate partner aggression and violence
- PC-CTS
Parent-Child Conflict Tactics Scale
Footnotes
The term “maltreatment” will be used throughout for these variables rather than the more commonly used “aggression” term so that this variable will not be confused with the outcome variable (child aggression).
Conflict of Interest Declaration: No conflicts of interest to report.
Contributor Information
Catherine A. Taylor, Tulane University School of Public Health and Tropical Medicine, Department of Community Health Sciences, 1440 Canal St. Suite 2301 TW19, New Orleans, LA 70112.
Jennifer A. Manganello, University at Albany, SUNY, School of Public Health, Department of Health Policy, Management & Behavior.
Shawna J. Lee, Wayne State University, School of Social Work, Merrill-Palmer Skillman Institute for Child and Family Development.
Janet C. Rice, Tulane University School of Public Health and Tropical Medicine, Department of Biostatistics.
References
- 1.Durrant JE. Physical punishment, culture, and rights: Current issues for professionals. Journal of Developmental & Behavioral Pediatrics. 2008;29(1):55–66. doi: 10.1097/DBP.0b013e318135448a. [DOI] [PubMed] [Google Scholar]
- 2.Donnelly M, Straus MA, editors. Corporal Punishment of Children in Theoretical Perspective. New Haven, CT: Yale University Press; 2005. [Google Scholar]
- 3.Straus MA, Stewart JH. Corporal punishment by American parents: National data on prevalence, chronicity, severity, and duration, in relation to child and family characteristics. Clinical Child & Family Psychology Review. 1999;2(2):55–70. doi: 10.1023/a:1021891529770. [DOI] [PubMed] [Google Scholar]
- 4.Daro D. Public opinion and behaviors regarding child abuse prevention: 1999 survey. Chicago, IL: Prevent Child Abuse America, National Center on Child Abuse Prevention Research; 1999. [Google Scholar]
- 5.Day RD, Peterson GW, McCracken C. Predicting spanking of younger and older children by mothers and fathers. Journal of Marriage & Family. 1998;60(1):79–94. [Google Scholar]
- 6.Taylor CA, Guterman NB, Lee SJ, Rathouz PJ. Intimate Partner Violence, Maternal Stress, Nativity, and Risk for Maternal Maltreatment of Young Children. American Journal of Public Health. 2009;99(1):175–183. doi: 10.2105/AJPH.2007.126722. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Disciplining a Child 08/24/05. Verona NJ: [Accessed July 3, 2009]. Available at: http://www.surveyusa.com/50StateDisciplineChild0805SortedbyTeacher.htm. [Google Scholar]
- 8. [Accessed September 10, 2009];Board of the Canadian Psychological Association Policy Statement on Physical Punishment of Children and Youth. http://www.docstoc.com/docs/5250464/Board-of-the-Canadian-Psychological-Association-Policy-Statement-on.
- 9. [Accessed September 10, 2009];Position Statement on Corporal Punishment in Schools (National Association of School Psychologists (NASP)) http://www.nasponline.org/about_nasp/pospaper_corppunish.aspx.
- 10.Durrant JE, Ensom R. Joint statement on physical punishment of children and youth. Ottawa: Coalition on Physical Punishment of Children and Youth; 2004. [Google Scholar]
- 11.Wolraich ML, Aceves J, Feldman HM, et al. Guidance for effective discipline. Pediatrics. 1998;101(4):723. [Google Scholar]
- 12.Gershoff ET. Corporal punishment by parents and associated child behaviors and experiences: A meta-analytic and theoretical review. Psychol Bull. 2002;128(4):539–579. doi: 10.1037/0033-2909.128.4.539. [DOI] [PubMed] [Google Scholar]
- 13.Baumrind D, Larzelere RE, Cowan PA. Ordinary physical punishment: Is it harmful? Comment on Gershoff (2002) Psychological Bulletin. 2002;128(4):580–589. doi: 10.1037/0033-2909.128.4.580. [DOI] [PubMed] [Google Scholar]
- 14.Lansford JE, Criss MM, Dodge KA, Shaw DS, Pettit GS, Bates JE. Trajectories of Physical Discipline: Early Childhood Antecedents and Developmental Outcomes. Child Development. 2009;80(5):1385–1402. doi: 10.1111/j.1467-8624.2009.01340.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Campbell SB, Pierce EW, Moore G, Marakovitz S, Newby K. Boys' externalizing problems at elementary school age: Pathways from early behavior problems, maternal control, and family stress. Development and Psychopathology. 1996;8:701–719. [Google Scholar]
- 16.Cohen P, Brook JS. The reciprocal influence of punishment and child behavior disorder. In: McCord J, editor. Coercion and punishment in long-term perspectives. New York: Cambridge University Press; 1995. [Google Scholar]
- 17.Grogan-Kaylor A. The effect of corporal punishment on antisocial behavior in children. Social Work Research. 2004;28(3):153–162. [Google Scholar]
- 18.Gunnoe ML, Mariner CL. Toward a developmental-contextual model of the effects of parental spanking on children's aggression. Arch Pediatr Adolesc Med. 1997 Aug 1;151(8):768–775. doi: 10.1001/archpedi.1997.02170450018003. 1997. [DOI] [PubMed] [Google Scholar]
- 19.Kandel DB, Wu P. Disentangling mother-child effects in the development of antisocial behavior. In: McCord J, editor. Coercion and punishment in long-term perspectives. New York: Cambridge University Press; 1995. [Google Scholar]
- 20.Singer JL, Singer DG, Rapaczynski WS. Family patterns and television viewing as predictors of children's beliefs and aggression. Journal of Communication. 1984;34:73–89. [Google Scholar]
- 21.Weiss B, Dodge KA, Bates JE, Pettit GS. Some consequences of early harsh discipline: Child aggression and a maladaptive social information processing style. Child Development. 1992;63(6):1321. doi: 10.1111/j.1467-8624.1992.tb01697.x. [DOI] [PubMed] [Google Scholar]
- 22.Grogan-Kaylor A. Corporal punishment and the growth trajectory of children's antisocial behavior. Child Maltreat. 2005 Aug;10(3):283–292. doi: 10.1177/1077559505277803. [DOI] [PubMed] [Google Scholar]
- 23.Berlin LJ, Ispa JM, Fine MA, et al. Correlates and Consequences of Spanking and Verbal Punishment for Low-Income White, African American, and Mexican American Toddlers. Child Development. 2009;80(5):1403–1420. doi: 10.1111/j.1467-8624.2009.01341.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Reichman NE, Teitler JO, Garfinkel I, McLanahan SS. Fragile Families: Sample and Design. Children and Youth Services Review. 2001;23(4/5):303–326. [Google Scholar]
- 25.Paolucci EO, Violato C. A Meta-Analysis of the Published Research on the Affective, Cognitive, and Behavioral Effects of Corporal Punishment. Journal of Psychology. 2004;138(3):197–221. doi: 10.3200/JRLP.138.3.197-222. [DOI] [PubMed] [Google Scholar]
- 26.Achenbach TM, Rescorla LA. Manual for the ASEBA Preschool Forms and Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth & Families; 2000. [Google Scholar]
- 27.Lee SJ, Perron B, Taylor CA, Guterman NB. Paternal psychosocial characteristics and corporal punishment of their 3-year old children. Journal of Interpersonal Violence. doi: 10.1177/0886260510362888. (in press) [DOI] [PubMed] [Google Scholar]
- 28.Miller BA, Smyth NJ, Mudar PJ. Mothers' alcohol and other drug problems and their punitiveness toward their children. Journal of Studies on Alcohol. 1999;60(5):632–642. doi: 10.15288/jsa.1999.60.632. [DOI] [PubMed] [Google Scholar]
- 29.Brennan PA, Hall J, Bor W, Najman JM, Williams G. Integrating biological and social processes in relation to early-onset persistent aggression in boys and girls. Developmental Psychology. 2003;39(2):309–323. [PubMed] [Google Scholar]
- 30.Koblinsky SA, Kuvalanka KA, Randolph SM. Social skills and behavior problems of urban, African American preschoolers: role of parenting practices, family conflict, and maternal depression. American Journal of Orthopsychiatry. 2006;76(4):554–563. doi: 10.1037/0002-9432.76.4.554. [DOI] [PubMed] [Google Scholar]
- 31.McFarlane JM, Groff JY, O'Brien JA, Watson K. Behaviors of children who are exposed and not exposed to intimate partner violence: An analysis of 330 black, white, and Hispanic children. Pediatrics. 2003 Sep;112(3):E202–E207. doi: 10.1542/peds.112.3.e202. [DOI] [PubMed] [Google Scholar]
- 32.Meadows SO, McLanahan SS, Brooks-Gunn J. Parental depression and anxiety and early childhood behavior problems across family types. Journal of Marriage and Family. 2007 Dec;69(5):1162–1177. [Google Scholar]
- 33.Owens EB, Shaw DS. Predicting growth curves of externalizing behavior across the preschool years. Journal of Abnormal Child Psychology. 2003 Dec;31(6):575–590. doi: 10.1023/a:1026254005632. [DOI] [PubMed] [Google Scholar]
- 34.DeMulder EK, Denham SA, Schmidt M, J M-C. Q-sort assessment of attachment security during the preschool years: Links from home to school. Developmental Psychology. 2000;36(2):274–282. doi: 10.1037//0012-1649.36.2.274. [DOI] [PubMed] [Google Scholar]
- 35.Straus MA, Hamby SL, Finkelhor D, Moore DW, Runyan D. Identification of child maltreatment with the parent-child conflict tactics scales: Development and psychometric data for a national sample of American parents. Child Abuse Negl. 1998;22(4):249–270. doi: 10.1016/s0145-2134(97)00174-9. [DOI] [PubMed] [Google Scholar]
- 36.Straus M, Hamby S, Boney-McCoy S, Sugarman D. The Revised Conflict Tactics Scale (CTS2): Development and preliminary psychometric data. Journal of Family Issues. 1996;17:283–316. [Google Scholar]
- 37.Weiss RL, Margolin G. Assessment of marital conflict and accord. In: Ciminero AR, Calhoun KD, Adams HE, editors. Handbook of behavioral assessment. New York: John Wiley; 1977. pp. 555–602. [Google Scholar]
- 38.Lloyd SA. Physical aggression, distress, and everyday marital interactions. In: Cahn DD, Lloyd SA, editors. Family violence from a communication perspective. Thousand Oaks, CA: Sage Publications Inc; 1996. pp. 177–198. [Google Scholar]
- 39.Abidin RR. Parenting stress index (3rd ed) Odessa, FL: Psychological Assessment Resources, Inc.; 1995. [Google Scholar]
- 40.Diagnostic and Statistical Manual of Mental Disorders. Fourth. Washington, DC: American Psychiatric Association; 1994. [Google Scholar]
- 41.Kessler RC, Andrews G, Mroczek D, Ustun B, Wittchen HU. The World Health Organization Composite International Diagnostic Interview Short-Form (CIDI-SF) Int J Methods Psychiatr Res. 1998;7(4):171–185. [Google Scholar]
- 42. [Accessed July 3, 2009];Fragile families: Scales documentation and question sources for three-year questionnaires, version 4/26/06 (Scoring procedures for depression, pp. 5–8) Available at: http://www.fragilefamilies.princeton.edu/documentation/core/scales/ff_3yr_scales.pdf.
- 43.Becker WC, Peterson DR, Luria Z, Shoemaker DJ, Hellmer LA. RELATIONS OF FACTORS DERIVED FROM PARENT-INTERVIEW RATINGS TO BEHAVIOR PROBLEMS OF FIVE-YEAR-OLDS. Child Development. 1962;33(2):509. doi: 10.1111/j.1467-8624.1962.tb05094.x. [DOI] [PubMed] [Google Scholar]
- 44.Deater-Deckard K, Dodge KA, Bates JE, Pettit GS. Physical discipline among African American and European American mothers: Links to children's externalizing behaviors. Developmental Psychology. 1996;32(6):1065–1072. [Google Scholar]
- 45.Engfer A, Schneewind KA. Causes and consequences of harsh parental punishment : An empirical investigation in a representative sample of 570 German families. Child Abuse & Neglect. 1982;6(2):129–139. doi: 10.1016/0145-2134(82)90005-9. [DOI] [PubMed] [Google Scholar]
- 46.Eron LD. Parent–child interaction, television violence, and aggression of children. American Psychologist. 1982;37(2):197–211. doi: 10.1037//0003-066x.37.2.197. [DOI] [PubMed] [Google Scholar]
- 47.Kandel DB. Parenting Styles, Drug use, and Children's Adjustment in Families of Young Adults. Journal of Marriage & Family. 1990;52(1):183–196. [Google Scholar]
- 48.Levin H, Sears RR. IDENTIFICATION WITH PARENTS AS A DETERMINANT OF DOLL PLAY AGGRESSION. Child Development. 1956;27(2):135–153. doi: 10.1111/j.1467-8624.1956.tb04799.x. [DOI] [PubMed] [Google Scholar]
- 49.Mahoney A, Donnelly WO, Lewis T, Maynard C. Mother and Father Self-Reports of Corporal Punishment and Severe Physical Aggression Toward Clinic-Referred Youth. Journal of Clinical Child Psychology. 2000;29(2):266–281. doi: 10.1207/S15374424jccp2902_12. [DOI] [PubMed] [Google Scholar]
- 50.McCabe KM, Clark R. Family protective factors among urban African American youth. Journal of Clinical Child Psychology. 1999;28(2):137. doi: 10.1207/s15374424jccp2802_2. [DOI] [PubMed] [Google Scholar]
- 51.McLeod JD, Shanahan MJ. POVERTY, PARENTING, AND CHILDREN'S MENTAL HEALTH. American Sociological Review. 1993 Jun;58(3):351–366. [Google Scholar]
- 52.Sears RR. Relation of early socialization experiences to aggression in middle childhood. The Journal of Abnormal and Social Psychology. 1961;63(3):466–492. doi: 10.1037/h0041249. [DOI] [PubMed] [Google Scholar]
- 53.Simons RL, Lin K-H, Gordon LC. Socialization in the family of origin and male dating violence: A prospective study. Journal of Marriage & Family. 1998;60(2):467–478. [Google Scholar]
- 54.Tang CS-k. Corporal punishment and physical maltreatment against children: A community study on Chinese parents in Hong Kong. Child Abuse & Neglect. 2006;30(8):893–907. doi: 10.1016/j.chiabu.2006.02.012. [DOI] [PubMed] [Google Scholar]
- 55.Pagani L, Tremblay R, Nagin D, Zoccolillo M, Vitaro F, McDuff P. Risk factor models for adolescent verbal and physical aggression toward mothers. International Journal of Behavioral Development. 2004;28(6):528–537. [Google Scholar]
- 56.Nelson DA, Hart CH, Chongming Y, Olsen JA, Shenghua J. Aversive Parenting in China: Associations With Child Physical and Relational Aggression. Child Development. 2006;77(3):554–572. doi: 10.1111/j.1467-8624.2006.00890.x. [DOI] [PubMed] [Google Scholar]
- 57.Sim TN, Ong LP. Parent physical punishment and child aggression in a Singapore Chinese preschool sample. Journal of Marriage & Family. 2005;67(1):85–99. [Google Scholar]
- 58.Bandura A. Aggression: A social learning analysis. Englewood Cliffs, NJ: Prentice-Hall; 1973. [Google Scholar]
- 59.Beauchaine TP, Webster-Stratton C, Reid MJ. Mediators, moderators, and predictors of 1-year outcomes among children treated for early-onset conduct problems: A latent growth curve analysis. J Consult Clin Psychol. 2005 Jun;73(3):371–388. doi: 10.1037/0022-006X.73.3.371. [DOI] [PubMed] [Google Scholar]
- 60.Sege RDMDP, Perry CFNPMPH, Stigol LMD, et al. Short-term Effectiveness of Anticipatory Guidance to Reduce Early Childhood Risks for Subsequent Violence. Archives of Pediatrics & Adolescent Medicine. 1997;151(4):392–397. doi: 10.1001/archpedi.1997.02170410066009. [DOI] [PubMed] [Google Scholar]
- 61.Barkin SL, Finch SA, Ip EH, et al. Is office-based counseling about media use, timeouts, and firearm storage effective? Results from a cluster-randomized, controlled trial. Pediatrics. 2008;122:e15–e25. doi: 10.1542/peds.2007-2611. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 62.Taylor CA, Hamvas L, DeJong W, Rice JC. Normative beliefs, expectations, and use of corporal punishment: Findings from an RDD community survey. Philadelphia, PA: American Public Health Association; 2009. [Google Scholar]