title: Harsh discipline relates to internalizing problems and cognitive functioning: findings from a cross-sectional study with school children in Tanzania.
abstract: BACKGROUND
  Child maltreatment poses a risk to children and adolescents' mental health and may also affect cognitive functioning. Also harsh discipline has been frequently associated with mental health problems. However, within societies in which harsh disciplinary methods are culturally normed and highly prevalent less is known about the association between harsh punishment, mental health problems, and cognitive functioning.
  
  
  METHODS
  In a cross-sectional study, we conducted structured clinical interviews with a sample of Tanzanian primary school students assessing exposure to harsh discipline (Maltreatment and Abuse Chronology of Exposure), internalizing problems (Strength and Difficulties Questionnaire, Children's Depression Inventory), and working memory (Corsi Blocktapping Task). School performance was measured by using the exam grades in 4 core subjects. The 409 children (52% boys) had a mean age of 10.5 years (range: 6 - 15).
  
  
  RESULTS
  Using structural equation modeling, a strong relationship was found between harsh discipline and internalizing problems (β = .47), which were related to lower working memory capacity (β = -.17) and school performance (β = -.17).
  
  
  CONCLUSIONS
  The present study suggests that harsh discipline is closely linked to children's internalizing mental health problems, which are in turn associated with lower cognitive functioning and school performance. Given the high rates of harsh discipline experienced by children in East African homes and elsewhere, the findings of the present study emphasize the need to inform the population at large about the potentially adverse consequences associated with harsh discipline.
authors.affiliation: Department of Psychology, University of Zurich, Binzmuehlestr. 14/17, 8050, Zurich, Switzerland. t.hecker@psychologie.uzh.ch.|Department of Psychology, University of Konstanz, Box 905, 78457, Konstanz, Germany. t.hecker@psychologie.uzh.ch.|vivo international, Box 5108, 78430, Konstanz, Germany. t.hecker@psychologie.uzh.ch.
authors.forename: Tobias
authors.initials: T
authors.lastname: Hecker
authors.affiliation: Department of Psychology, University of Konstanz, Box 905, 78457, Konstanz, Germany.|vivo international, Box 5108, 78430, Konstanz, Germany.
authors.forename: Katharin
authors.initials: K
authors.lastname: Hermenau
authors.affiliation: vivo international, Box 5108, 78430, Konstanz, Germany.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Salmen
authors.affiliation: Department of Psychiatry, Harvard Medical School, 401 Park Drive, 02215, Boston, MA, USA.|Developmental Biopsychiatry Research Program, McLean Hospital, 115 Mill Street, 02478, Belmont, MA, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Teicher
authors.affiliation: Department of Psychology, University of Konstanz, Box 905, 78457, Konstanz, Germany.|vivo international, Box 5108, 78430, Konstanz, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Elbert
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000523:psychology*; D003071:Cognition; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D015995:Prevalence; D011678:Punishment / Q000523:psychology*; D011795:Surveys and Questionnaires; D013636:Tanzania / Q000453:epidemiology
keywords: Harsh discipline; Internalizing problems; Mental health; School performance; Working memory