Department of Social Work, University of Michigan-Flint, Flint, MI.
School of Social Work, University of Michigan, Ann Arbor, MI.
J Pediatr. 2021 Aug;235:170-177. doi: 10.1016/j.jpeds.2021.01.072. Epub 2021 Feb 3.
To examine whether adverse childhood experiences (ACEs) and physical punishment (ie, spanking) are unique risk factors for behavior problems in early childhood, and whether ACEs moderate the associations of spanking with child behavior problems.
We conducted prospective, longitudinal analyses on 2380 families in the Fragile Families and Child Wellbeing Study. Mothers reported outcomes of externalizing and internalizing behavior problems at age 5 years; and the main predictors, ACEs and spanking, at age 3 years. ACEs included 9 items: physical abuse, emotional abuse, physical neglect, emotional neglect, mother's exposure to intimate partner violence, parental mental health problem, parental substance use, parental incarceration, and parental death. Multilevel models examined the associations between ACEs, spanking, and behavior problems, and the moderating effect of ACEs in the associations of spanking with behavior problems. Analyses were adjusted for preexisting behavior problems, demographics, and neighborhood conditions.
ACEs (β = 0.028; P < .001) and spanking (β = 0.041; P < .001) at 3 years were unique risk factors for increased externalizing behavior problems at 5 years, after controlling for covariates. The magnitude of the associations of ACEs and spanking with externalizing behavior were statistically indistinguishable. ACEs did not moderate the association between spanking and externalizing behavior.
ACEs and spanking have similar associations in predicting child externalizing behavior. Results support calls to consider physical punishment as a form of ACE. Our findings also underscore the importance of assessing exposure to ACEs and physical punishment among young children and providing appropriate intervention to children at risk.
探讨儿童期逆境经历(ACEs)和体罚(即打屁股)是否是幼儿期行为问题的独特风险因素,以及 ACEs 是否调节了打屁股与儿童行为问题之间的关系。
我们对脆弱家庭和儿童福利研究中的 2380 个家庭进行了前瞻性、纵向分析。母亲在 5 岁时报告了外化和内化行为问题的结果;主要预测因素 ACEs 和打屁股在 3 岁时报告。ACEs 包括 9 个项目:身体虐待、情感虐待、身体忽视、情感忽视、母亲遭受亲密伴侣暴力、父母心理健康问题、父母药物滥用、父母监禁和父母死亡。多层次模型检验了 ACEs、打屁股和行为问题之间的关系,以及 ACEs 在打屁股与行为问题之间的关系中的调节作用。分析调整了先前存在的行为问题、人口统计学和邻里条件。
在控制了协变量后,3 岁时的 ACEs(β=0.028;P<0.001)和打屁股(β=0.041;P<0.001)是 5 岁时外化行为问题增加的独特风险因素。ACEs 和打屁股与外化行为之间的关联强度具有统计学意义。ACEs 并没有调节打屁股和外化行为之间的关系。
ACEs 和打屁股在预测儿童外化行为方面具有相似的关联。结果支持将体罚视为 ACEs 的一种形式的呼吁。我们的研究结果还强调了评估幼儿期暴露于 ACEs 和体罚的重要性,并为有风险的儿童提供适当的干预措施。