title: The relationship between maternal depression, in-home violence and use of physical punishment: what is the role of child behaviour?
abstract: BACKGROUND
  The combined impact of maternal depression and in-home violence, and how their relationship with physical punishment varies with child behaviour are unknown.
  
  
  OBJECTIVE
  To determine the combined impact of maternal depression and violence exposure on smacking and explore the role of child behaviours in this relationship.
  
  
  METHODS
  Multivariable regression analysis of a sample of kindergarten children. Maternal depressive symptoms, violence exposure and smacking were measured by parent interview. Child behaviours were reported by teachers.
  
  
  RESULTS
  12,764 mother-child dyads were examined. The adjusted odds ratio (aOR) for smacking among depressed mothers was 1.59 (95% CI 1.40 to 1.80), mothers exposed to in-home violence 1.48 (95% CI 1.18 to 1.85) and dually exposed mothers 2.51 (95% CI 1.87 to 3.37). Adjusting for child self-control or externalising behaviour did not change these associations, and no effect modification by child behaviour was detected. Among mothers smacking children, depression was associated with increased smacking frequency (adjusted incident rate ratio (aIRR) 1.12; 95% CI 1.01 to 1.24), but became borderline significant after adjusting for child self-control or externalising behaviour (aIRRs 1.10; 95% CI 1.00 to 1.21). Depressed mothers exposed to violence demonstrated higher rates of smacking (aIRR 1.29; 95% CI 1.09 to 1.53); this remained stable when adjusting for child behaviours.
  
  
  CONCLUSIONS
  Maternal depression and violence exposure are associated with smacking, particularly when depression and violence co-exist, when they are also associated with smacking frequency. Child self-control and externalising behaviour do not substantially impact the association between maternal depressive symptoms, violence exposure and smacking.
authors.affiliation: Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts 02118, USA. michael.silverstein@bmc.org
authors.forename: M
authors.initials: M
authors.lastname: Silverstein
authors.forename: M
authors.initials: M
authors.lastname: Augustyn
authors.forename: R
authors.initials: R
authors.lastname: Young
authors.forename: B
authors.initials: B
authors.lastname: Zuckerman
mesh_terms: D018585:Battered Women / Q000523:psychology; D002648:Child; D002649:Child Abuse; D002652:Child Behavior / Q000523:psychology*; D016241:Child of Impaired Parents / Q000523:psychology; D002675:Child, Preschool; D003863:Depression / Q000523:psychology*; D017579:Domestic Violence / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D011678:Punishment / Q000523:psychology*; D013179:Spouse Abuse / Q000523:psychology
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