Journal of Pediatric Psychology, Vol. 25, No. 6, 2000, pp. 435-447
© 2000 Society of Pediatric Psychology
Risk Factors for Severe Child Discipline Practices in Rural India
1 University of North Carolina at Chapel Hill, 2 Government Medical College, Nagpur, Maharashtra, India, 3 Universidad de La Frontera, Temuco, Chile
All correspondence should be sent to Wanda M. Hunter, Department of Social Medicine, University of North Carolina at Chapel Hill, CB#7240, Chapel Hill, North Carolina 27599. E-mail: whunter{at}med.unc.edu .
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Abstract |
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Objectives: To determine the type and severity of discipline practices in rural India and to identify risk and protective factors related to these practices.
Methods: Five hundred mothers, ages 18-50, participated in face-to-face interviews as part of a cross-sectional, population-based survey. One of the mother's children was randomly selected as the referent child. The interview focused primarily on discipline practices and spousal violence. Sociodemographic characteristics, neighbor support, residential stability, and husband's drinking behavior were also assessed.
Results: Nearly half of the mothers reported using severe verbal discipline and 42% reported using severe physical discipline. While common, severe discipline practices occurred less frequently than moderate practices and had different risk factors, notably low maternal education and spousal violence.
Conclusions: Results suggest that increased formal education for rural women in India may have the added benefit of reducing family violence, including spouse and child abuse.
Key words: discipline; punishment; child abuse; family violence; spouse abuse; domestic violence; maternal depression; social ecology; India.
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Introduction |
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Although the vulnerability of children to abusive practices is recognized in the Indian constitution, most research to date has focused on children's survival needs and societal abuses, such as malnutrition, child labor, child beggary, child marriage, and child prostitution (Banerjee, 1979
; Bhattacharyya,
1979,
1983;
Gupta, 1977;
Jabbi, 1986;
Mehta, Lokeshwar, Bhatt, Athavale, &
Kulkarni, 1979). A few early clinical studies of child injuries
suggested that some maltreatment of children may be the result of harsh
discipline from family members
(Bhattacharyya, 1983;
Dave, Dave, & Mishra,
1982). At around the same time, Poffenberger
(1981) offered one of the
first candid observations of parental discipline practices in his report of
child rearing in rural India. In this qualitative investigation, parents
described discipline practices they deemed acceptable and unacceptable.
Whereas physical punishment was the norm and considered necessary for the
socialization of children, the villagers spoke of punishments that they
considered to be overly harsh including threats to send children away,
invocations of ghosts and evil spirits to do the child harm, holding burning
sticks to penises to control masturbation, branding, and hanging by hands or
feet. Threats of death were also common.
Suman (1985), noting the
paucity of systematic and quantitative data related to child physical and
emotional abuse in India, called for research to document the prevalence of
these phenomena and to identify the interacting factors that support or
discourage child maltreatment within the family environment. In response,
several investigators have conducted small studies investigating the extent to
which harsh and abusive practices occur within the context of normal child
rearing and socialization (Segal,
1992,
1995;
Segal & Ashtekar, 1994).
Because there are no universal standards related to optimal child rearing or
what might be considered child maltreatment, these early studies confronted
the need to balance cultural norms against the well-being of children.
Segal's progression of empirical studies has shed considerable light on the
extent of harsh child discipline practices and the perceptions of the public
and professionals regarding what constitutes abusive behavior (Segal,
1992,
1995;
Segal & Ashtekar, 1994).
Investigating cultural definitions of child abuse in India, Segal found very
little difference in the perceptions of severity for different forms of child
abuse among social workers, other human service workers, and other service
workers (Segal, 1992).
Cross-cultural comparisons with a similar U.S. study (Giovanonni &
Bercarra, 1979) indicated that while both Indian and U.S. samples perceived
sexual abuse as highest on an abuse scale and inadequate housing conditions as
lowest, the rankings of the remaining forms of abuse were influenced by
recognition of abuse, national norms, expectations, and the socioeconomic
conditions of each country. Although the U.S. sample ranked physical abuse
second in severity in terms of its detrimental effects on the child, the
Indian sample ranked it sixth, after sexual abuse, fostering delinquency,
medical neglect, poor supervision, and exposing children to parental sexual
mores.
A subsequent study that used the Conflict Tactics Scale
(Straus, 1979) to investigate
the discipline practices of middle-class professionals in India found that 57%
engaged in "normal" corporal punishment (spanking, slapping), 42%
in "abusive" forms of discipline (kicked, bit, or hit with fist;
hit or tried to hit with something; beat up child), and 3% in
"extreme" forms of violence (threatened with, or used, a knife or
gun on child) (Segal, 1995).
Segal observed that these relatively high rates of harsh discipline may
reflect societal sanction of violence toward children and the perception that
physical abuse has fewer detrimental effects than other forms of abuse.
Yet some parents, like those in Poffenberger's study
(1981), may resort to
practices that they feel are inappropriate and potentially harmful.
Identification of risk and protective factors related to different levels of
severity in discipline practices used in India may help address the question
of whether severe practices are normative or whether they, at some point,
cross a line to become unacceptable or abusive. In this study, risk and
protective factors have been conceptualized using an ecological model that
attributes family interactions (including child abuse and other family
violence) to characteristics of the nested social ecology including the larger
society, the local community, the family itself, and finally the
characteristics of the involved individuals
(Belsky, 1980;
Cicchetti & Lynch, 1993;
Garbarino, 1977). As in all
societies, the treatment of children in India is likely a function of
deepseated cultural norms. Few would deny that there is societal tolerance for
the use of corporal punishment, a cultural factor theorized as a risk factor
for physical abuse (Zigler & Hall,
1989). In addition, India is a patrilineal society in which the
spiritual, economic, and social norms of everyday life reflect an extreme
preference for male offspring and a corresponding denigration of female
children. As a result, female children have been at higher risk for selective
feticide, infanticide, poorer nutrition, poorer health care, poorer
educational opportunities, kidnapping, and forced prostitution
(Poffenberger, 1981;
Wadley, 1993). However no data
indicate that females are more likely to experience harsh parental discipline
than their male counterparts. Although Singh and Kaur
(1981) found that rural Indian
mothers felt that girls need more instruction and discipline than boys, they
did not analyze the harshness or severity of actual childrearing practices by
gender. In China, another country where sons are venerated because they are
seen as insurance against old age and poverty, boys are more strictly
disciplined, perhaps because the stakes connected to their behavior and
success are much higher (Ho,
1996; Tang, 1998;
Wu, 1996). It is reasonable to
expect that the same family dynamics might contribute to harsher punishment of
sons in India.
At the community level, social isolation, lack of social support, and
social change, such as migration away from family of origin, have been
identified in the United States as risk factors for child abuse
(Egeland & Brunquell,
1979; Garbarino & Gilliam,
1980; Starr,
1988). In studies outside the United States, Levinson
(1989) found that child abuse
is less likely in extended family households where child care responsibilities
can be shared. Increasing mobility of Indian families and movement away from
extended family structures may increase the parenting stresses once absorbed
within the joint family (Sinha,
1984). Other types of stresses that occur at the family level
(e.g., alcohol abuse, marital conflict or violence, large family size, and
parent psychological problems) have been shown to increase the probability of
child abuse (Whipple & Richey,
1997). In a 1985 survey of American families, Straus and Gelles
(1990) found that mothers who
were victims of partner violence were at least twice as likely to physically
abuse their children as mothers who were not.
Harsh discipline and child abuse have also been linked with family or
parent socioeconomic characteristics, especially low income
(Straus, 1980), low maternal
education (Brown, Cohen, Johnson, &
Salzinger, 1998; Egeland &
Brunquell, 1979), closely spaced children
(Holden, Willis, & Corcoran,
1992), and a high household crowding index
(Youssef, Attia, & Kamel,
1998).
Characteristics of the child may increase the likelihood of severe
discipline or abuse, especially when other risk factors are present. Wolfe has
reported that the average age of abuse victims in the United States tends to
be younger than the average age of all children
(Wolfe, 1987). Others have
found age related to discipline practices, with parents more likely to
physically discipline younger children and more likely to use nonphysical
discipline techniques including verbal abuse with older children
(Jackson et al., 1999).
Children perceived as being difficult to parent or manage have been identified
as being at higher risk (Blackson, Tarter,
& Mezzich, 1996; Korbin,
1991; Youssef et al.,
1998), especially when the mother is depressed and has few
available supports (Hetherington,
1989). Poor health and handicapping conditions have also been
found to be associated with child abuse
(Dubowitz, Hampton, Bithoney, &
Newberger, 1987; Youssef et
al., 1998), possibly because the child is perceived as different
or as the source of increased stress
(Kotelchuck, 1982).
The goal of this study was to determine the type and severity of discipline practices used in this area of central India and to analyze how characteristics of the social ecology are associated with these practices. Based on ecological theory and previous studies, we expected that high levels of family stress (characterized by household crowding, high numbers of children in the household, low numbers of adults in the household, domestic violence, and alcohol abuse) and low levels of community support (characterized by having lived in the community for less than 5 years and by maternal perceptions of poor support from neighbors) would be associated with more severe discipline practices. At the individual level, low parent education, child gender (male), younger child age, child disobedience, and child health problems were also expected to be risk factors for more severe discipline practices.
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Method |
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Study Design and Development
This investigation was a rural pilot study for a larger multiregion study that will ultimately collect data from 10,000 mothers across India. In turn, the Indian project is part of a larger international collaboration, called WorldSAFE (World Studies of Abuse in the Family Environment), which is using a common research protocol to address questions related to family violence and risk factors in the social ecology. WorldSAFE's conceptual framework and study methods have been formulated over a period of years by an international multidisciplinary group of investigators from the International Clinical Epidemiology Network who are dedicated to reducing family violence in countries around the world by advancing understanding of its etiology and impact.
Although the core survey instrument focuses primarily on child discipline practices and spousal/partner violence, demographic characteristics and other characteristics of the social ecology hypothesized to be related to family violence (e.g., husband's alcohol abuse, residential stability, neighborhood support, child disobedience, child health problems, and maternal depression) are also included. The instrument for this study was formulated in English, translated into Marathi, the local language, and then back-translated, by a different professional. Comparisons were made with the original version and modifications implemented wherever necessary to ensure equivalence in meaning between the English and translated version.
Focus Groups
Prior to the development of the survey and the field procedures, focus
group discussions were conducted in an attempt to anchor our research
methodology to the culture of rural Maharashtra. As others have noted, focus
groups and other qualitative methods can enhance quantitative studies by
providing direct access to the language and the concepts that participants use
in thinking about and describing their experiences
(Bauman & Adair, 1992;
Hughes & DuMont,
1993).
The principal investigator (DJ) conducted the focus groups in three rural villages that were close in proximity to those selected for the survey and believed to be similar in sociodemographic characteristics. Each focus group was composed of a convenience sample of 10-16 mothers recruited from a list of mothers identified by village leaders. The goal of the focus groups was to discover who typically disciplines children in the village, the range of discipline practices employed, and opinions about the acceptability of these practices. In addition, participants were asked to comment on proposed field procedures for recruitment and data collection. We expected that the discussions would provide access to the language and concepts that these mothers used to describe their interactions with their children and thus inform the final terminology used in the survey questionnaire. A structured discussion guide specifying the order in which topics were to be introduced was prepared by the research team. While the principal investigator served as the moderator in each group, the field interviewers sat on the outside of circle and transcribed the discussions. The data were analyzed by identifying themes that emerged across groups that related to common discipline practices and the perceived appropriateness of these practices.
Procedure
The study was conducted in five villages in the Saoner district of northern
Maharastra in central India. Villages in this district were stratified into
two sizes: large (
2,000) and small (<2,000). Five villages were
randomly selected and proportionately sampled. Households were approached up
to three times, to screen for eligibility. Households that included a married
woman who had at least one coresiding child under 18 years old were considered
eligible. After obtaining permission from the village authorities, trained
interviewers approached homes from a standardized starting point, screening
for eligible households from all four quadrants until the sample size for that
village was reached.
At each eligible household, a census was conducted and names of all residents and their relationships to each other were recorded on a standardized form. When more than one eligible woman resided in the household, the interviewer randomly selected one for interview by using tables of randomly generated numbers that conformed to the number of possible eligible women that might be encountered in a household (2-5 women). For example, for a household that contained three eligible women, the interviewer would use the table with the numerals 1, 2, and 3 listed in random order. She would use the first available number on the list to indicate which woman she should select from among those identified as eligible on the census form. She would then strike through the "used" number, so that in the next household of three eligible women, she would choose the next number on the list. When the selected mother had more than one eligible child, one was randomly selected as the referent child in a similar fashion, using a different set of tables (for 2-10 children).
The field supervisor and interviewers were female social workers with prior experience in rural villages. They received extensive standardized training in all aspects of study protocol prior to entry into the field. Following training, the instrument was pretested in 25 households resulting in minor modifications. Because illiteracy was a concern in targeted villages, the informed consent procedure was verbal. Eligible women were invited to participate in a study related to maternal and child health that consisted of an interview on private and sensitive family matters. After receiving consent, all face-to-face interviews were conducted privately, either within or close to the woman's residence. Study methodology was reviewed and received approval by the Ethical Review Board of the Government Medical College in Nagpur.
Measures
Child disciplinary practices were assessed using a modified
version of the Parent-Child Conflict Tactics Scale
(Straus, Hamby, Finkelhor, Moore, &
Runyan, 1998). This has been one of the more commonly used
measures of discipline and abusive practices in the United States and it has
been previously used in India (Segal,
1995) and in other Asian countries
(Tang, 1998). The time frame
for self-report was reduced from 1 year to 6 months and the range of response
options was condensed from an 8-point scale (ranging from never to
more than 20 times in past year) to a 3-point scale (not at all,
sometimes, or many times in the last 6 months). The scale itself was expanded
to include 12 additional practices identified by the focus groups as among the
strategies employed by mothers in the villages of this area. For this
investigation, the discipline practices were classified as belonging to one of
five different categories: nonviolent discipline (four items), moderate
verbal/ psychological aggression (four items); severe verbal/psychological
aggression (three items); minor physical aggression (ten items); and severe
physical aggression (eight items). Two items (putting chili pepper in the
mouth and tying to something) were not classified because the relative
severity of these actions was difficult to assess. The discipline
classification schemes were consistent overall with those used by both Straus
et al. in U.S. studies (1998)
and Segal in Indian studies
(1995). For the analyses, the
values for the categories of discipline practices were dichotomized (by
combining response options, sometimes and many times) to simply indicate
whether that mode of discipline was used or not used within the specified time
period.
Maternal depression was assessed using the 20-item Center for
Epidemiologic Studies-Depression Scale (CES-D)
(Radloff, 1977). The standard
cutpoint for "caseness" (a score of 16 or higher) was used to
classify the mothers as depressed or not depressed.
If the husband was reported to get drunk at least 1-3 days a month, then husband drunkenness was classified as present. Spousal abuse of the mother was classified as present if the mother said she had been slapped, kicked, hit, or beaten by her husband.
Neighborhood support was measured using a 5-item scale (In this neighborhood... people help each other out, people watch out for each other's children, there are people I can count on, there are people who care about me, and there are people I can talk to about my problems.) These items were scored on a 4-point Likert scale ranging from very much to not at all. For analysis purposes, mothers who responded very much or somewhat to all five items were scored as having "high" support. Mothers who responded very little or not at all to all five items were scored as having "low" support. All others were classified as having "moderate" support.
Mothers were asked to rate the referent child's health on a 3-point scale. In addition, they were asked if the child had any of seven chronic health problems or conditions, including hearing problems, speech problems, vision problems (not corrected by glasses), physical handicap or deformity, mental retardation, chronic condition like asthma or tuberculosis, and polio. A health problem index was created by summing all endorsements from this list. A global rating of poor health was counted as one point on the health problem index; thus, the range for the index extended from 0-8. Child disobedience was examined with one global question: "Compared to other children of the same age, how obedient is s/he?" Response options were more obedient, about average, and less obedient.
Demographic data including household characteristics, residential stability, mother's age, mother's and father's level of education, religion, child age, and child gender were based on the mother's response to structured questions within the interview.
Data Analysis
Prior to analyses of data, the internal consistency reliability of the
CES-D and the Neighborhood Support scale (both with unknown psychometric
properties in this population) was evaluated by calculating Cronbach's alpha
coefficient for each scale. Subsequent analyses included generating
descriptive statistics for the variables of interest and conducting univariate
tests for association between the dependent variables and the demographic and
social context variables considered as potential risk factors. Chi-square
tests were used to test for significant associations between categorical
variables, and Pearson correlation coefficients and Kruskal-Wallis tests were
used for continuous variables. Independent variables that demonstrated a
relationship with a dependent variable (at p <.20) were selected
for further testing in multivariate models. Logistic regression was used to
estimate the odds of having used each type of discipline for each predictor
variable, while simultaneously controlling for the other variables in the
model. Selected independent variables were entered into the model
simultaneously, and a backward elimination procedure was used to select the
"best" model. Odds ratios (ORs) were calculated to estimate the
strength of the association between the different categories of discipline
practice and the sociocontextual risk factors.
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Results |
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Focus Group Results
There was consensus in all three focus groups that within local villages mothers are the primary disciplinarians of their children and that scolding, slapping, and beating with a broom, shoe, or stick are the most common punishments. The mothers described a range of other practices also used in their villages, including: threatening the child with ghosts or evil spirits, tying the child's hands and feet, hanging the child by hands or feet, forcing chili pepper into child's mouth, threatening to burn, threatening to beat, pulling hair, kicking, withholding food, calisthenics, and forced kneeling for a period of time with some added burden, such as in hot sand or holding a brick in each hand. Although scolding, slapping, and spanking were considered both appropriate and necessary for the socialization of children, some mothers felt that beating should be reserved for only the most severe offenses. There was general agreement that hanging, burning, kicking, threatening abandonment, and threatening with evil spirits are not appropriate strategies, and some mothers expressed remorse at having resorted to such severe practices. Even though not a focus group topic, reasons for harsh discipline were occasionally volunteered and seemed to be related to the mother's stress, the child's escalating misbehavior, or both. In one group, the mothers agreed that children who were difficult to manage required harsher methods of discipline. They also said that as children get older it is easier to correct their behavior with verbal explanations without having to resort to physical punishment.
Survey Participation Rates
Seventy-nine percent (N = 500) of the eligible women selected for
survey in the five villages agreed to participate and completed the interview.
Nonparticipants were women who said they were not interested or were too busy
with household tasks to afford the time (n = 77), women who could not
be found at home after three visits (n = 47), and women who were not
permitted to interview by their husbands or mothers-in-law (n = 6).
One interview was attempted, then aborted, because privacy could not be
maintained. Demographic data were not gathered on nonparticipants.
Reliability of Measurement Scales
Internal consistency reliability of the CES-D in this sample was very
acceptable (Cronbach's alpha =.93). Only two of the items had low item-total
correlations: "I felt I was as good as other people" (r
=.28) and "I felt hopeful about the future" (r =.27). All
other item-total correlations ranged from.45 ("I talked less than
usual") to.77 ("I felt sad" and "I felt
depressed"). The alpha coefficient for the Neighborhood Support scale
was.86, also quite satisfactory given the relative shortness of the scale
(five items). Item-total correlations ranged from.58 to.76.
Sociodemographic Characteristics
Sociodemographic characteristics of the final sample are described in
Table I. The women's ages
ranged from 18-60 years, with a mean age of around 30 years. Almost one-third
(30.4%) had no formal education at all. More than one-third (34.1%) described
themselves as illiterate. The women's husbands were better educated than their
wives, with twice the number having attended school more than 10 years. Almost
90% of the families were Hindu and more than half lived in oneroom dwellings.
There were no single-adult households; close to half (46.2%) had three or more
adults. Likewise, almost half (49.4%) had three or more children. The mean
household crowding ratio was approximately four persons per room. Among the
children selected for study, boys outnumbered girls, 53% to 47%. This ratio
conforms closely to the male-female ratio reported in the Maharashtra census,
52.3 males: 47.9 females (Maharashtra
State Government, 1991). Child age covered the full range from
infancy to 17 years old. When child age was categorized into three 6-year
spans—0-5 years, 6-11 years, and 12-17 years—there was a higher
percentage of children in the youngest group than in the other two (40% vs.
30%, respectively). The majority of the children were described as healthy,
but more than 36% of the mothers described the referent child as having one or
more health problems. More than 20% described the child as more disobedient
than average.
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Almost one-third (30.6%) of the mothers reported having lived in the village for fewer than 5 years. Slightly more than one-quarter of the mothers were classified as having low neighbor support, 21% had high neighbor support, and all others were classified in the moderate category. Almost half said they had been slapped, hit, kicked, or beaten by their husbands at some time. More than half were at or above the clinical cutpoint for depression based on CES-D scores and about one-third said that their husbands got drunk at least 1-3 times per month.
Frequency and Interrelatedness of Discipline Practices
The mothers' reports regarding discipline practices are summarized in
Table II. Each of the five
different categories of discipline practice is followed by the behaviors
included within the category and corresponding frequencies. Ninety-five
percent of the mothers used some mode of nonviolent discipline with their
children, primarily "explaining why a behavior was wrong." The
next most common forms of discipline, used by more than three-quarters of the
sample, were moderate verbal/psychological aggression (primarily shouting) and
moderate physical aggression (primarily spanking and slapping). Almost
one-half of the mothers had used severe verbal aggression, while 42% had used
severe physical aggression. The highest frequency behavior in the severe
physical aggression category was hitting or beating the child somewhere other
than the buttocks, with a stick or other object. Thirty-six percent of the
mothers had used this form of discipline in the last six months.
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The relationship between the five discipline types was assessed by computing Pearson correlations between all pairs. As would be expected from the high frequency observed for all the forms of discipline, each category of discipline was significantly correlated with the other. Nonviolent discipline and severe physical discipline had the lowest correlation (r =.44, p <.0001), and moderate physical discipline and severe physical discipline had the highest correlation (r =.67, p <.0001).
Univariate Associations
Relationships between the hypothesized risk factors and the four outcome
variables are shown in Table
III. Child gender and short-term residence in the village were the
only variables that demonstrated no relationship with any of the discipline
practices. Neighbor support was related to only the moderate forms of
discipline but in the opposite direction of that expected. Women who reported
higher levels of neighbor support were more likely to use moderate verbal and
physical discipline with their children. The education of the mother and the
father were significantly related to more severe forms of discipline, but not
to the moderate forms. The strongest relationships were with husband
drunkenness, spousal abuse of the mother, and maternal depression. Child age
was strongly associated with all discipline categories, with children in the
mid-range (6-11 years) appearing to be at highest risk.
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Logistic Regression Models
The logistic regression models allowed examination of the association of
each potential risk factor with the outcome variables while controlling for
the variance accounted for by the other predictor variables.
Table IV presents the logistic
regression models for moderate and severe verbal aggression;
Table V presents the models for
moderate and severe physical aggression. Following backward elimination, child
age was retained as a significant risk factor in all four models. Younger
children were more likely than their adolescent counterparts to experience
moderate and severe verbal aggression and moderate physical aggression.
Children ages 6-11 years were 2.6 times more likely than both younger and
older children to experience severe physical aggression.
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Maternal depression was related to all types of discipline, except severe
physical. Interestingly, husband drunkenness and spousal abuse of the mother,
both significantly correlated with maternal depression, split across the four
models, with drunkenness showing the highest association with the two moderate
levels of discipline, whereas spousal abuse was a significant risk factor for
the two severe categories. (Chi-square analyses examining the relationship
between each set of paired variables yielded the following: husband
drunkenness/spousal abuse, 
2 = 28.23 [1] p <.0001;
husband drunkenness/depression [using CES-D cutpoint], 2 =
43.04 [1], p <.0001; spousal abuse/depression, 2 =
20.41, p <.0001. In a linear regression model, depression as a
continuous variable was independently predicted by both husband drunkenness
and spousal abuse, F = 50.62 [2], p <.0001,
R2 =.17.) Depressed mothers were approximately twice as
likely as nondepressed mothers to use moderate and severe verbal aggression
and moderate physical aggression. Likewise, mothers who had experienced spouse
abuse were also approximately twice as likely to have used severe violence
with their children (OR = 1.93 for severe verbal, OR = 2.03 for severe
physical). After controlling for the association with the other independent
variables, high neighbor support was a risk factor for the use of moderate
verbal aggression. Household crowding was a significant predictor of moderate
physical aggression with a 25% increase in the odds of its use for every unit
increase in the ratio of persons per room. Finally, maternal education
(ordinal variable with four possible values: no education, 1-6 years, 7-10
years, and > 10 years) was significantly associated with both types of
severe discipline, but not with more moderate practices. The odds ratio of.94
(in both severe models) means that for each unit decrease in
education the likelihood of severe discipline increased by 6%. This means that
mothers with no education were 16.5% more likely than mothers with 10 or more
years to use severe discipline strategies.
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Discussion |
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Although the rates for moderate physical aggression were somewhat higher in this study than those found by Segal (1995
), the rates associated
with severe physical practices were remarkably similar. Our results from
poorly educated women in rural villages and Segal's results from middle-class
professionals in metropolitan areas converge to suggest that physical
punishment is currently more prevalent in India than in the United States.
This finding may reflect cultural differences between the two countries as
well as the shifting social norms and child protection laws in the United
States that have corresponded to an increased awareness of child
maltreatment.
To our knowledge, the analyses presented here are the first to examine the
sociocontextual risk factors associated with child discipline practices in
India. Our hypothesis that boys would receive harsher discipline than girls
was not supported by the data. Unlike recent findings in China
(Ho, 1996;
Tang, 1998;
Wu, 1996), our data revealed
no sex differences for any type of discipline. The finding that both verbal
and physical aggression varied by child age was not surprising. Straus and
Gelles (1990) found that
approximately 80% of American children between the ages of 7 and 10 years
experience at least one act of parental physical aggression each year,
compared with about 50% of children between the ages of 11 and 14 years.
Similarly, in a study of age trends related to parenting practices and conduct
problems, Frick, Christian, and Wooten
(1999) found corporal
punishment to be most strongly associated with conduct problems in the middle
age group (9-12-year-olds). Age effects for discipline practices were also
noted in a recent study in China where Tang
(1998) reported that
3-6-year-olds were the most likely to experience minor and severe physical
punishment; 7-12-year-olds were second-most likely, followed by 0-2-year-olds
with 13-16-year-olds the least likely to be physically disciplined. There are
several possible explanations for finding that preschool and school-age
children are the major recipients of harsh punishment. If discipline practices
have the hoped-for result of effectively socializing children to meet their
parents' expectations, children will have fewer problems in later years that
require parental discipline. Severe verbal aggression may be used more with
younger children because, being more naïve, they
may be easier to frighten with threats of abandonment or ghosts and spirits.
On the other hand, severe physical discipline may be considered too harsh for
the youngest group of children. Disobedience, which was significantly
associated with every type of discipline in the univariate analyses, may be
correlated with child age, thus losing its significance in the multivariate
models.
We found that husband drunkenness, spouse abuse of the mother, and maternal
depression were interrelated and also independently associated with discipline
practices. These relationships may reflect family patterns of response to
conflict. It is also conceivable that mothers who must endure their husband's
drunken or violent behavior may redirect their anger and frustration toward
safer targets, their children. Our finding that depression was associated with
all but the most severe forms of physical discipline are similar to those of
Zuravin (1989) who found, in a
U.S. study, that moderately but not severely depressed mothers were more
likely to be physically violent, and both moderately and severely depressed
mothers were at increased risk for disciplining with verbal/symbolic
aggression. We did not differentiate between moderately and severely depressed
mothers but used the standard CES-D
(Radloff, 1977) cutpoint to
classify mothers as depressed or not. Based on this cutpoint, more than half
of the mothers in our sample could be described as depressed. Although we are
not aware of prior use or validation of the CES-D in India, others have
reported that Radloff's cutpoint may over-estimate depression in women from
other cultures (Noh, Avison, & Kaspar,
1992; Salgado de Snyder,
Cervantes, & Padilla, 1990). Yet the primary interest of our
study was not examining rates of depression, but rather the association
between depressive symptoms and child discipline practices, a relationship
that seems complex but undoubtedly present.
Low maternal education was an independent risk factor for the severest
forms of discipline. This finding is consistent with study results in the
United States and elsewhere that show low maternal education to be associated
with reported child abuse (Kotch et al.,
1995), physical punishment
(Kelley, Power, & Wimbush,
1992), and attitudes toward physical punishment (Oasim, Mustafa,
Kazem, & Shah, 1998). Separate analyses of our Indian data revealed that
low maternal education is also a risk factor for spousal violence. These
results suggest that increased educational opportunities for women may have
the added benefit of reducing tolerance for husband drunkenness and spouse
abuse, while concomitantly reducing the mother's propensity for using severe
discipline methods with her children.
The finding that severe verbal and physical discipline practices are associated with particular risk factors, namely, low maternal education and physical abuse from her husband, argues that these practices are not necessarily normative for India. This conclusion is also supported by the qualitative data derived from the preliminary focus groups. While severe discipline practices may have unique risk factors and may not be considered appropriate by mothers, the most compelling evidence that such practices are "abusive" and thus requiring societal intervention, is their harmful impact on children. Segal's study on neglected, destitute, and runaway children housed at a residential facility in Bombay revealed that at least half of the children experienced physical abuse in their families of origin. Aside from the early clinical studies documenting injury from severe cases of child maltreatment, Segal's may be the only study from India that raises the issue of negative consequences for children who are disciplined harshly. Prevalence studies are still needed to document the magnitude of the problem of child physical and psychological abuse across India; studies are also needed that examine the impact on children's physical, social, and emotional well-being.
Limitations of Study
Several important limitations of this study must be noted. Both the
predictor and outcome variables were measured by maternal self-report. Shared
method variance and shared source variance may have enhanced the probability
of finding significant relationships. True estimations of the severity of
discipline practices were limited by our measurement techniques. Frequency is
not assessed. Also, there are the problems inherent in dichotomous
classification of behaviors. In this case, one might argue that only a very
fine line separates using a stick to hit a child on the buttocks and hitting
elsewhere. In fact, the categorization of almost all the dependent variables
requires choosing cutpoints that may or may not optimize the detection of
effect because analysis of the full variability of the data is precluded. On
the other hand, effects are not always linear, as was demonstrated in the
analysis of child age.
Finally, because India is a vast country consisting of multiple cultures
and linguistic groups, the generalizability of these findings from rural
villages in central India to the rest of India is speculative. The similarity
of these results and those of Segal's
(1995) study of urban
professionals suggests that there may not be widespread differences in
child-rearing beliefs and practices across regions of India. Our large
multiregion collaborative study currently under way will reveal the extent to
which rates of moderate and severe discipline practices are comparable across
regions, as well as clarify the role of specific risk factors.
Yet despite the limitations, these study results contribute to a growing knowledge base suggesting that Indian children may be subjected to psychological and physical abuse within the context of parental discipline or socialization. Although further research is needed to establish national prevalence rates and to enhance our understanding of the etiology and consequences of child maltreatment in India, a strong argument could be made that addressing some of the risk factors identified in this study (specifically spouse abuse, alcohol abuse, and low education for women) would reap many benefits for Indian society, including the healthy growth and development of its children.
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Acknowledgments |
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Support for this research was provided by OXFAM (India) Trust, Ref. # Mah 229 A6. We thank the International Clinical Epidemiology Network for help in the development of this project, the Nagpur IndiaSAFE field staff who collected the data, and the mothers who made the study possible by freely sharing about their daily lives.
Received March 10, 1999; revision received September 30, 1999; accepted October 5, 1999
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