Understanding child maltreatment in Hanoi: intimate partner violence, low self-control, and social and child care support.

Journal of Interpersonal Violence http://jiv.sagepub.com/

Understanding Child Maltreatment in Hanoi: Intimate Partner Violence, Low Self-Control, and Social and Child Care Support Clifton R. Emery, Hai Trung Nguyen and Jaeyop Kim J Interpers Violence 2014 29: 1228 originally published online 24 December 2013 DOI: 10.1177/0886260513506276 The online version of this article can be found at: http://jiv.sagepub.com/content/29/7/1228

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On behalf of: American Professional Society on the Abuse of Children

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JIVXXX10.1177/0886260513506276Journal of Interpersonal ViolenceEmery

Article

Understanding Child Maltreatment in Hanoi: Intimate Partner Violence, Low Self-Control, and Social and Child Care Support

Journal of Interpersonal Violence 2014, Vol. 29(7) 1228–1257 © The Author(s) 2013 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0886260513506276 jiv.sagepub.com

Clifton R. Emery,1,2 Hai Trung Nguyen,1 and Jaeyop Kim1

Abstract This study aimed to understand the role of low self-control, stress, depression, experience of intimate partner violence (IPV) and child abuse, and social support and child care support in the etiology of child abuse and neglect in Hanoi, Vietnam. The study estimated the prevalence of child maltreatment in a randomly selected, representative cluster sample of 269 Hanoi families. Among these families, 21% reported severe abuse of their children in the past year, 12% reported neglect. Low self-control was found to be strongly associated with child abuse. Life stressors were found to be strongly associated with neglect, but only indirectly with child abuse. Counter-intuitively, a positive interaction between social support and low self-control was found, suggesting that social support of parents low in selfcontrol is associated with more maltreatment. Implications for research, intervention, and criminological theory are discussed.

1Yonsei

University, Seoul, South Korea University, Seoul, South Korea

2Tsinghua

Corresponding Author: Clifton R. Emery, Associate Professor, School of Social Welfare, Yonsei University, 134 Shinchon-dong, Seodaemun-gu, Appenzeller Hall 214, Seoul, 120-749, Korea. Email: [email protected]


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Keywords child maltreatment, abuse, self-control, stress, social support, child care support Extensive research on the etiology of child maltreatment has linked maltreatment to intimate partner violence (IPV; Coohey & Braun, 1997; Cox, Kotch, & Everson, 2003), parental experience of abuse in childhood (Coohey & Braun, 1997; Whipple & Webster-Stratton, 1991), parental depression (Chaffin, Kelleher, & Hollenberg, 1996; Kelleher, Chaffin, Hollenberg, & Fischer, 1994, Whipple & Webster-Stratton, 1991), stress (Altemeier, O’Connor, Sherrod, Tucker, & Vietze, 1986; Mash, Johnston, & Kovitz, 1983), low self-control (Jouriles, McDonald, Slep, Heyman, & Garrido, 2008; Slep & O’leary, 2001), alcohol abuse (Kelleher et al., 1994), Confucian beliefs (Zhai & Gao, 2009), employment (Kinard, 1995; Zuravin, 1988) and socioeconomic status (Freisthler, Needell, & Gruenewald, 2005; Kinard, 1995; Price & Glad, 2003). Although research on informal social control is well known in criminological literature (Sampson, Raudenbush, & Earls, 1997), much less is known about the role played by extended family, friends, and neighbors in exacerbating or ameliorating child maltreatment (Coohey, 2000). This is particularly true for non-Western countries like Vietnam, where the absence of formal social control of family violence means that informal social control may be a matter of life and death. This article begins to fill in this gap by testing a model of child abuse and neglect in Hanoi. Studies of child maltreatment in Vietnam are few. Those carried out suggest maltreatment is a serious problem. Le (1999) found that 65% of children were seriously beaten. Khanh (2003) found that 26% of children were frequently beaten by their parents, while Michaelson (2004) found that 51.5% of Vietnamese children are beaten with a whip. Ruiz-Casares and Heymann (2009) found that 20% of Vietnamese children were left at home unsupervised. Nguyen, Dunne, and Le (2010) found the rate of physical abuse to be 47.5% and the rate of neglect to be 29.3%. Abuse and neglect are associated with higher rates of depression, anxiety, fighting, and low self-esteem among victimized adolescents in Vietnam (Nguyen, 2006; Nguyen et al., 2010). Previous research hence suggests that child maltreatment in Vietnam is a serious social problem. It is also, however, a crime. For this reason, we believe a theoretical lens derived from criminology may be productive.


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Weak Control Versus Strong Motivation There are two different common conceptualizations of crime in the deviance literature. One tradition is characterized by weak control. In that tradition, motivation for crime is relatively plentiful, and what explains the perpetration of crime is weak social (cf. Cloward & Ohlin, 1960; Hirschi, 1969/2002; Kornhauser, 1978; Matza, 1964/1990) or self (cf. Gottfredson & Hirschi, 1990) control. Kornhauser (1978) identified two other traditions; Strain models and Cultural Deviance models. Both of these two latter traditions assume a relative abundance of control; what explains differences in crime rates is strong motivation (cf. Athens, 1992; Merton, 1968; Sellin, 1938); hence we group them together under this term. Of course, it is perfectly reasonable to suggest that motivation and control vary (Gould, 1987; Kornhauser, 1978) and thus must be accounted for. We argue that an adequate understanding of parental violence against children must include both traditions. Using the low control/strong motivation framework, we claim that mental health variables (depression, stress, personality characterized by low self-control), violent social context (IPV, physical abuse of the parent in childhood), social norms (patriarchal and Confucian beliefs), social network support (social and child care support), and substance use (alcohol misuse) all bear on parental violence against children.

Strong Motivation Culture-specific risk factors: Norms. Confucian norms may provide strong motivation to perpetrate violence against children. It has been argued that although Western families physically abuse their children for perceived misbehavior, a predominant motive for abuse in East Asian families is failure to perform in school (Zhai & Gao, 2009). Thus, being steeped in a Confucian tradition that stresses education may lead to the belief that if parents love their children they must give them the “whip of love” (Segal, 2000). Indeed, similar expressions exist in other Confucian countries like South Korea (Chang, Rhee, & Weaver, 2006). Those Vietnamese parents who embrace the Confucian tradition more fully may thus be at higher risk of the perpetration of maltreatment. Stress. Strong empirical links between child maltreatment and caregiver stress are well documented (Altemeier et al., 1986; Guterman, Lee, Taylor, & Rathouz, 2009). Following strain theory, stress may increase motivation to perpetrate violence against children by increasing conflict and anger (Margolin & Gordis, 2003).


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Low Control Low self-control. Gottfredson and Hirschi (1990) argued that low self-control is an important cause of all forms of crime. People with low self-control have a preference for easy and immediate gratification of their desires. Low selfcontrol is a construct composed of impulsivity, preference for simple tasks, risk seeking, preference for physical activities, self-centeredness, and temper (Grasmick, Tittle, Bursik, & Arneklev, 1993). Low self-control may also be related to maltreatment because it decreases the amount of time parents give to consideration of alternative, non-violent punishments. Alcohol abuse. There are strong empirical links between child maltreatment and alcohol use (Widom & Hiller-Sturmhofel, 2001; Kelleher et al., 1994). Alcohol abuse may increase child maltreatment because it interferes with emotional self-regulation, or it may operate via cognitive disorganization, deviance disavowel, or disinhibition (Miller, Maguin, & Downs, 1997). All of these mechanisms would fall under weaker control explanations. Emotional, instrumental, and child care support received from social networks. Involvement by networks of friends and family represents the potential for increased social control (cf. Sampson et al., 1997). Coohey (2000) found strong relationships between child maltreatment and social and child care support received from family, friends, and neighbors. Social support is composed of emotional and instrumental support. Intuitively, such support may decrease the risk of child abuse by decreasing stress and child care burden (Coulton, Crampton, & Su, 1999). However, the frequent involvement and physical presence of others in the household also allows for increased monitoring and thus may act as a form of informal social control.

Complex Not all constructs fall simply into a low control/strong motivation dichotomy. At the conceptual level there is good theoretical reason to believe that some constructs may influence motivation and control. These are discussed further below. Depression. Anhedonia may lead to apathy and decreased empathy, resulting in a weakening of control. However, the negative mood associated with depression may result in cognitive distortions that in turn lead to biased attributions (cf. Barlow, 2001). Distorted caregiver attributions about child behavior are strongly associated with abuse (Steele, 1997), presumably


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because motivation (anger) is increased. There are strong empirical links between child maltreatment and parental depression (Chaffin et al., 1996). These links between maltreatment and psychological distress and depression may also occur because these may interfere with parents’ emotional self-regulation and other coping mechanisms (Aspinwall & Taylor, 1997), decreasing control. However, the relationship between depression and child maltreatment in Vietnam is likely to be complicated by research findings of starkly different somatic and mood factors in East Asia (Lee, 2011). IPV and parents’ child abuse victimization. IPV and the parent’s own history of maltreatment may be associated with weakened control because internalized norms against child abuse may be weakened. Furthermore, distress associated with both may increase motivation to perpetrate. Empirical correlations between IPV and child maltreatment are well known (Appel & Holden, 1998; Jouriles et al., 2008). This link may also occur because of the presence of one aggressive individual, stress, or because one type of aggression sets the stage for the other (see Emery, Kim, Song, & Song, 2013; Jouriles et al., 2008). The link between parents’ exposure to child abuse as children (Coohey & Braun, 1997) may occur via learning (Bandura, 1973) or via a lack of alternative heuristics for child discipline. Model logic. Figure 1 shows the theoretical model we seek to test. It is divided into variables we conceptualize as motivators, variables having to do with control (or lack of control), and variables that are complex and may act as motivators and disinhibitors. Stress and Confucian beliefs are conceptualized as motivators, child care support, low self-control, social support, and alcohol dependence are all conceptualized as pertaining to decreases or increases in control, and IPV and parental depression may play both roles. Patriarchal beliefs and the parent’s experience of abuse as a child are thought to play indirect (mediated) roles through IPV and low self-control. Although Gottfredson and Hirschi (1990) argued that consistent punishment of wrongdoing by parents was important in the development of self-control. This may be insufficient, however, if violent punishment is rendered ineffective because it is viewed as illegitimate by the child, apparently largely the case among Vietnamese youth (Le, 1999). Violence seen as illegitimate may decrease selfcontrol. Low self-control may increase reckless use of alcohol and hence be mediated (Baron & Kenny, 1986) by alcohol dependence. Social support may decrease depression and hence the effects of social support may also be mediated. Four interaction effects are hypothesized; one could not be shown in Figure 1. High levels of child care support may weaken the relationship


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Figure 1. Theoretical model of child maltreatment in Hanoi.

Note. For the sake of simplicity and conserving space, some constructs that are analyzed in more than one dimension (e.g., depression: mood and somatic) are shown here as single constructs. The tables provide full details of the relationships found and not found.

between stress and maltreatment by decreasing exposure of children to stressed parents. Large amounts of social support, acting as informal social control, may compensate for the absence of self-control, weakening the relationship between low self-control and maltreatment. Finally, even when parents experience serious depression, social support and child care support (interaction not shown) may weaken the relationship between depression and maltreatment by increased monitoring of the parent. The analyses also investigate differences in models by sex of the parent reporting. To keep this article within a reasonable length, the approach to sex differences is exploratory. The broader logic of the model rests on the idea that child abuse and neglect represent a kind of social deviance or crime. This, along with evidence from research that child abuse and neglect are strongly interrelated (Dong et al., 2004), argues for using similar theoretical models and constructs to explain abuse and neglect. However, given the differences between physical child abuse and neglect (abuse often consisting of active use of violence


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versus neglect often consisting of passive failure to intervene), different causal structures for these two forms of maltreatment seem likely. Given that physical child abuse and neglect are not well understood in the Vietnamese context, we choose to begin with a single theoretical model for both.

Method Data The Hanoi Child Maltreatment Project (HCMP) is a representative random probability sample of families in Hanoi, Vietnam in 2011. The sample was drawn by probability proportional to size (PPS) sampling of 30 wards in Hanoi, followed by simple random samples (SRSs; 10 families per ward) of police registration lists of ward residents. The data were originally collected to study neighborhoods. Based on power analysis of neighborhood effects, the target sample size was 300 respondents. When a randomly selected household had been contacted and refused to participate twice, the household was replaced by recruiting a neighboring household. The final sample included 282 families out of 366 families contacted, making the response rate 77%. One parent was interviewed in each household. Of the respondents, 52% were female, 46% had completed 4 years of university training, 29% had completed high school, 21% had some schooling after primary school, 2% had only primary school education, and 2% of the sample did not answer the education question. Each household had an average of 1.67 children living at home. Thirty-seven families (13%) had children older than age 19 living in the home. Thirteen families did not have any children below the age of 18 living in the home. These families were dropped from further analyses, leaving 269 responses in the data. There were 390 minor children living in these 269 households, with a mean age of 8.1 years and a standard deviation of 4.9 years. The mean household income (measured in Vietnamese Dong but converted to U.S. dollar for the reader’s convenience) was $278 per month, with a standard deviation of $150. Sixteen percent of households owned cars. Sixty-five percent of respondents were employed full-time; 28% were employed part-time.

Measures Child maltreatment. Child maltreatment was measured using a modified version of the Conflict Tactics Scale for measuring parent–child relationships (CTSPC; Straus & Hamby, 1997) translated into Vietnamese. The entire questionnaire was back-translated into English and adjusted to maintain


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accuracy. To keep the response rate high and the questionnaire length short, questions on psychological abuse from the CTSPC were eliminated and questions on neglect were kept to a minimum. Because the CTSPC does not measure neglect, two new items were added to capture neglect. These new items were as follows: (a) were not able to make sure he or she got the food he or she needed and (b) did not take care of your children or provide medicine when your child was sick. The scale was divided into corporal punishment, minor abuse, severe abuse, very severe abuse, and neglect. Each item was measured on a scale of frequency ranging from once in the past year (1) to more than 20 times in the past year (6). Lifetime prevalence was captured with the measure “not in the last year but it did happen before.” Use of corporal punishment in the last year was reported by 81% of the sample. This included spanking the bottom with a bare hand and hitting the bottom with a hard object. Minor abuse in the last year (slapped arm, hand or leg, pinched, shook, slapped face or head) was reported by 64%. Severe abuse in the last year (hit some part of the body other than the bottom with a hard object, threw or knocked down, hit with fist or kicked hard) was reported by 22%. Very severe abuse (beat up, choked, burned, threatened with a knife or gun) was reported by 5%. Neglect (not providing food for your child or not providing medical care when it was needed) was reported by 12% of the sample. Unlike neglect, we did not opt to add items measuring sexual abuse to Straus and Hamby’s (1997) original scale. This was done to keep the response rate and existing construct measurement quality high by limiting the number of constructs measured. The Conflict Tactics Scale has adequate evidence of construct validity (Straus & Gelles, 1990). It is also fairly reliable for the physical abuse (Cronbach’s α = .87) and neglect (Cronbach’s α = .88) items. IPV. The measure of IPV perpetration and victimization is participant report of Straus and Douglas (2004) Conflict Tactics Scale Short Form (CTS2S), which has been found to have good concurrent validity with the longer form, the CTS2 (Straus & Douglas, 2004). The 20-item scale was translated into Vietnamese, then back-translated to check for accuracy. It includes two physical violence Likert-type scale items (pushed, shoved, or slapped partner and punched, kicked or beat up partner) and two consequences of physical violence items (had a sprain, bruise, small cut or felt pain the next day because of a fight with the partner and had to see a doctor [MD] because of a fight with partner). Reliability for the overall scale was good (Cronbach’s α = .95). IPV was coded ever in past year for minor violence (pushed, shoved, or slapped), severe violence (punched, kicked, or beat up), and injury. Rates of IPV were high. Of the sample, 38% reported minor IPV, 21% reported severe


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IPV, and 25% reported injury in the last 12 months. As dichotomous items were used, the scale was not standardized. Self-control. Self-control was measured using the 24-item scale that Grasmick et al. (1993) used to test Gottfredson and Hirschi (1990). The scale measures impulsivity, preference for simple tasks, risk seeking, preference for physical activities, self-centeredness, and temper. The scale had good reliability (Cronbach’s α = .92), and was created using z scores. Parental depression. Depression was measured using a Vietnamese translation of the Beck Depression Inventory–II (BDI-II; Beck, Steer, Ball, & Ranieri, 1996; Beck, Steer, & Brown, 1996). Because previous research suggests that depression is more accurately characterized by a two-factor construct in East Asia, (perhaps because individual expression of emotion is considered selfish under collectivist ideals, cf. Lee, 2011), we conducted principal components analysis. Analysis of the covariance matrix of the BDI-II examined the eigenvalues. This principal components analysis suggested that a two-factor solution is indeed appropriate. The difference in eigenvalues for the first component and the second component was 4.60 − 1.81 = 2.79. The difference in eigenvalues between the second and third components is 1.81 − 0.91 = 0.90. The difference between the third and fourth eigenvalues is 0.91 − 0.85 = 0.06. Analysis of a scree plot makes the elbow after the first two components abundantly clear. Factor loadings (varimax rotation) are provided in Table 1. The loadings of the variables onto two separate factors is consistent with much of the research literature on depression in the east Asian population, which finds depression in other cultures to be more characterized by a somatic dimension (American Psychiatric Association, 1994). Indeed, although in the present case the distinction is not perfect (irritability and sadness are moods), it strongly suggests a somatic-mood distinction. Depression may take on a more somatic form for Vietnamese with a more traditional, collectivist mindset and more of a mood form for Vietnamese with a more Westernized outlook. Based on these findings and previous literature, we accordingly use a two-factor model to capture depression. Reliability was good for the items in each factor (Cronbach’s α = .91 for the somatic factor; Cronbach’s α = .89 for the mood factor). Stress. Stress was measured using a Vietnamese translation of the Holmes and Rahe (1967) Social Readjustment Rating Scale (SRRS). This is a frequently used inventory of 30 stressful life events experienced in the last 12 months, weighted for severity. Minor stressful events range from minor infractions of the law (11 points) to death of a spouse (100 points). The item


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Emery Table 1. Factor Analysis of the BDI. Variable Tiredness Irritability Concentration difficulty Loss of energy Loss of interest Loss of interest in sex Indecisiveness Appetite Changes in sleeping pattern Sadness Loss of pleasure Agitation Punishment feelings Guilty feelings Self-dislike Past failure Self-criticalness Worthlessness Pessimism Suicidal thoughts Crying

Factor 1

Factor 2

.75 .69 .61 .58 .53 .52 .51 .45 .44 .42 .38 .34 .24

.24 .18 .19 .31 .16 .39 .17 .15 .35 26 .21 .67 .64 .63 .60 .54 .46 .44 .42 .33

.26 .16 .22 .40 .35 .19 .27

Note. BDI = Beck Depression Inventory.

“Christmas” was changed to an important Vietnamese holiday. The dichotomous nature of the items in the scale renders factor analysis inappropriate. The scale had good reliability (Cronbach’s α = .89). Points on the scale were assigned based on the weights created by Holmes and Rahe. This variable had a mean of 160 points and a standard deviation of 119 points. Unlike other continuous constructs in the model, the stress scale was not standardized. That is because points on the scale have a useful meaning that would be lost for standardization. For example, a divorce is worth 73 divorce points on the Holmes and Rahe stress scale. To estimate the effect of divorce on child abuse, one simply multiplies the odds ratio for stress by 73. This would not be possible were the scale to be standardized. Alcohol misuse. Alcohol use and abuse were measured using the four-item Cut down, Annoyed, Guilty, Eye-opener (CAGE) checklist (Castells & Furlanetto, 2005). The four questions are as follows: (a) Have you ever thought


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that you should reduce or stop drinking? (b) Do you feel unhappy when someone criticizes your drinking? (c) Do you often drink in the morning to calm down or as a cure? (d) Does your drinking habit make you feel guilty? Compared with the semi-structured interview used in the field (the Mini International Neuropsychiatric Interview [MINI]), Castells and Furlanetto (2005) found the CAGE had maximum sensitivity (93.8%) when a cutoff point of 1 positive response was used as an indicator of alcohol dependence. Specificity for the 1 cutoff was 85.5% (Castells & Furlanetto, 2005). Likely alcohol dependence is coded as a dichotomous variable. Confucian beliefs. Based on Ornatowski’s (1996) discussion of Confucian beliefs, a four-item scale was created. Ornatowski argued that Confucianism was composed of (a) “a high public regard for education and widespread use of meritocratic entrance exams,” (b) an emphasis mutual obligations between superior and inferior,” (c) “an overall stress on social harmony as opposed to individualism” (Ornatowski, 1996). Ornatowski claimed these were summarized by four key phrases: (a) respect for learning, (b) loyalty, (c) filial piety, and (d) harmony. Confucian beliefs were accordingly measured with four Likert-type scale items: (a) Confucian values are still a good guide for life; (b) I have a lot of respect for educated people; (c) it is very important to show respect for one’s parents; (d) keeping good relationships with others is more important than showing disagreement. Possible responses were strongly agree, agree, disagree, or strongly disagree. We believe loyalty to be a more generalized form of filial piety, and thus did not create a separate item to reflect that. Reliability was good for this measure (Cronbach’s α = .88). The Confucian beliefs scale was created by calculating the z scores for each item and summing the result. The resulting scale had a mean of 0 and a standard deviation of 2.66. Child care support. Coulton, Crampton, Irwin, Spilsbury, and Korbin (2007) found child care burden to be strongly related to maltreatment in a systematic review of the literature. The measure of child care support by family and friends is drawn from Coohey (2000). This is a checklist of friends and relatives who listened to your child, gave gifts to your child, disciplined your child, cared for your child even while you were there, and taught your child new things in the last month. The number of relatives and friends who provided each type of child care support in the last month were summed up for each item. The z-score transformations of each item were added up to create the scale. This five-item measure had acceptable reliability (Cronbach’s α = .84). The resulting scale had mean 0 and standard deviation 3.79.


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Social support. The measure of social support by family and friends is drawn from Coohey (2000). This is a checklist of friends and relatives who gave you money or a loan, did housework or errands for you, supervised your children, listened carefully to your problems, helped you make decisions, or did something with you in the last month. This six-item measure had acceptable reliability (Cronbach’s α = .83). The z-score transformations of each item were added up to create the scale. The resulting scale had mean 0 and standard deviation 4.21. Patriarchal beliefs. The patriarchal beliefs scale (Emery et al., 2013) was developed to measure patriarchal beliefs in East Asian populations. Our measure has seven Likert-type scale items: (a) men should be the leaders in society, (b) wives should do most of the household chores, (c) men should be the ones to initiate romantic relationships, (d) men have the right to make the economic decisions in the household, (e) the husband has the right to make decisions about his wife’s job, (f) important decisions about children, education or employment should be made by husbands, and (g) husbands sometimes need to use violence against their wives to preserve their authority. These items met minimal criteria for reliability (Cronbach’s α = .75). The z-score transformations of each item were added up to create the scale. The resulting scale had a mean of zero and a standard deviation of 4.33. Parental history of abuse. Parental history of abuse was measured using three dichotomous items (Coohey, 2000). These were ever hit with an object (79% of the sample endorsed), ever hit with a closed fist (40%), and ever hit a lot at one time (beaten up; 14%).

Analytic Issues A PPS sample of clusters followed by a SRS within each cluster generates inclusion probabilities of n/N for every member of the population. This allows the data to be treated as an SRS. Diagnostics, ordinary least squares (OLS) regression for continuous variables and logistic regression for binary variables, were carried out in R and Stata10. Regression and logistic regression analyses control for education, income (in hundreds of U.S. dollars), car ownership, mean age of children in the household, number of children living in the household, respondent sex, and whether the respondent works full-time or is married. Respondent’s education is measured in a series of dummy variables to catch differences between high school education and college, and to increase the variance explained by education.


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Ramsey’s RESET test did not reveal any significant evidence of nonlinearity in the controls only model. The largest variance inflation factor (VIF) was 1.99. The Cook–Weisberg test did not reveal significant evidence of non-constant error variance (χ2 = .88, p = .35). The most serious problem identified in this model was that a skewness–kurtosis test found that residuals were not normally distributed (χ2 = 26.7, p < .001). This non-normality was partly driven by an outlier, the removal of which does not affect main conclusions. Because there were few cases of very severe abuse, this category was combined with the severe abuse category in the analyses. Thus, results are shown for the combined severe abuse categories and neglect. The full logistic regression model for neglect had difficulty achieving convergence, apparently because the relationship between education and neglect was pushing the coefficients toward the edge of the maximum-likelihood surface (toward infinity). This occurred because the model perfectly predicted 23 cases of the absence of neglect. Removing the high school education variable from the neglect model results in convergence in six iterations without substantive changes to the other findings. The three education variables are left in both models for comparative purposes. Sobel tests were used to test inferences about mediation. These test for significant change in the estimated parameters for the independent variable when the mediator is introduced as a predictor in the model, with all other predictors (controls) appearing in both models. Although this approach does not prove the direction of the relationship or rule out the possibility of omitted variables, it does rule out the possibility that parameter change occurs because of one of the other (control) variables in the model. Because hypothesized mediators are many, the models run to test mediation are not shown; only the significance of the final Sobel statistics are reported.

Results Table 2 shows the findings for each abuse item broken down by frequency in the last year and sex of the parent reporting. Fathers are apparently somewhat more likely to shake and slap, while mothers are more likely to pinch. With the exception of burning, mothers appear to be slightly less likely to perpetrate any of the more severe acts of violence. The rate of weapons use is small compared with less serious forms of violence, but is nonetheless distressingly high. Table 3 shows bivariate relationships between the independent variables of interest and child abuse and neglect in Hanoi. The bivariate results are consistent with the predictions of the model for child abuse, with the


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Emery Table 2. Frequency of Child Abuse.

Abuse Slapped arm, hand or leg Pinched

Parent Sex

Male Female Male Female Shook Male Female Slapped head Male or face Female Hit with hard Male object Female Threw/knocked Male down Female Punched or Male kicked hard Female Beat up Male Female Choked Male Female Burned Male Female Used knife Male Female

11-20 × More Than Not in the Past Year 1 × Past 2 × Past 3-5 × Past 6-10 × Past Past Year 20 × Past Year (%) (%) (%) Year (%) Year (%) Year (%) Year (%) 40.90 44.20 82.70 75.40 72.40 89.10 67.70 80.40 74.00 84.80 84.30 91.30 92.10 97.80 95.30 98.60 95.30 97.80 99.20 98.60 97.60 97.80

24.40 13.80 10.20 10.10 15.00 3.60 13.40 12.30 15.00 8.00 10.20 6.50 3.90 1.50 2.40 0 3.90 0.70 0.80 0.70 2.40 0.70

16.50 23.20 3.90 9.40 7.10 4.40 11.80 4.40 4.70 5.10 3.20 0.70 1.60 0 1.60 0 0.80 0 0 0 0 0

10.20 13.80 1.60 4.40 2.40 2.90 4.70 2.20 3.90 1.50 1.60 1.50 1.60 0 0.80 1.50 0 0 0 0 0 0

5.50 4.40 0 0.70 2.40 0 0.80 0 0.80 0 0.80 0 0 0 0 0 0 0.70 0 0.70 0 0

1.60 0.70 0 0 0 0 0.80 0.70 0.80 0.70 0 0 0.80 0.70 0 0 0 0.70 0 0 0 0

0.80 0 1.60 0 0 0 0.80 0 0.80 0 0 0 0 0 0 0 0 0 0 0 0 1.50

exception of Confucian beliefs, depressed mood, child care support, and parent hit with an object as a child. Because the Confucian beliefs variable did not have a significant relationship with either abuse or neglect in any of the models run, it is dropped from further analyses. The bivariate results provided limited support for the model for neglect. At the bivariate level, IPV, stress, social support, child care support, and whether the parent was hit a lot as a child had significant relationships with neglect. Table 4 shows logistic regression results for the abuse and neglect models, while Figures 2 and 3 show the models that were supported by empirical analyses. Inferences are drawn from Likelihood-ratio tests. Several findings were surprising with respect to the model for severe and very severe abuse. Given the lack of significance of main effects for stress and depression in the larger model of abuse, we sought to understand what might explain the shift from significance in the bivariate models to non-significance in Table 4. Using the Baron and Kenny (1986) approach to mediation,1 rather than direct effects, results were consistent with a model in which the effects of stress (Sobel coefficient = .0002, p < .05) and somatic depression (Sobel


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Table 3. Child Maltreatment in Hanoi: Bivariate Logistic Regression Model Results (n = 245). Physical Abuse Variable Full-time Own car Income (100 $) College grad Some college High school M age of children Number of children Married Male Minor IPV Severe IPV Injury IPV Patriarchal beliefs Confucian beliefs Somatic symptoms Mood symptoms Stress Low self-control Potential alcohol problem Social support Child care support R hit with hand as child R hit with object as child R hit a lot as child

β

SE β

−0.72 −0.61 −0.36 −1.10 −1.61 −0.50 0.07 0.36 −2.04 0.55 0.90 1.47 0.53 −0.11 0.02 0.45 0.15 0.004 0.05 0.61

0.31 0.47 0.11 0.53 0.59 0.60 0.02 0.21 0.53 0.32 0.31 0.33 0.32 0.04 0.05 0.16 0.16 0.001 0.02 0.29

−0.11 −0.07 0.95

Neglect β

SE β

0.49* 0.54 0.69*** 0.33* 0.20** 0.60 1.07† 1.43† 0.13*** 0.58† 2.46** 4.35*** 1.70† 0.90** 1.02 1.57** 1.16 1.004** 1.05** 1.84*

−0.25 −0.56 −0.48 15.46 15.55 15.53 0.06 0.12 −2.28 0.18 0.75 0.97 −0.09 −0.04 0.03 0.30 0.17 0.01 0.03 0.49

0.40 0.64 0.16 Inf Inf Inf 0.03 0.28 0.52 0.39 0.42 0.42 0.45 0.04 0.07 0.21 0.20 0.002 0.02 0.38

0.77 0.57 0.62 Inf* Inf* Inf* 1.06† 1.13 0.10*** 1.20 2.12† 2.64* 0.91 0.96 1.03 1.35 1.19 1.01*** 1.03 1.63

0.04 0.04 0.31

0.90** 0.93 2.59**

−0.13 −0.15 0.80

0.06 0.07 0.42

0.89* 0.86* 2.21†

0.05

0.38

1.05

0.10

0.52

1.11

0.69

0.37

1.99†

1.46

0.44

4.31**

OR

OR

Note. OR = odds ratio; IPV = intimate partner violence. †p < .10. *p < .05. **p < .01. ***p < .001.

coefficient = .02, p < .05) were fully mediated by IPV. The predicted pathway from parent abused as child through low self-control to abuse could not be done for the full model because it failed to converge. A smaller model was statistically significant (Sobel coefficient = .04, p < .05). The predicted pathway from low self-control to severe IPV to abuse was marginally significant


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Table 4. Child Maltreatment in Hanoi: Full Logistic Regression Models (n = 245). Physical Abuse Variable

SE β

OR

β

SE β

OR

0.96 0.33 −0.26 −1.01 −2.67 −1.25 0.09 −0.13 −1.67 0.27 1.02

0.54 0.69 0.19 0.75 0.86 0.78 0.05 0.36 0.74 0.55 0.43

2.61† 1.39 0.77 0.35 0.07** 0.29 1.09* 0.88 0.19* 1.31 2.79*

0.97 0.81 −0.73 15.12 14.37 14.30 0.02 −0.29 −1.29 1.08 0.18

0.73 1.00 0.32 Inf Inf Inf 0.06 0.54 0.86 0.79 0.61

2.63 2.26 0.48* Inf* Inf Inf 1.01 0.75 0.27 2.93 1.19

−0.74

0.57

0.48

−0.06

0.75

0.94

−0.49 0.35 2.12 −0.62 −0.04 0.37 0.44 −0.22 0.001 0.08 0.03 −0.16 0.02

0.64 0.57 0.64 0.53 0.05 0.54 0.24 0.24 0.002 0.03 0.09 0.08 0.01

0.61 1.42 8.36*** 0.54 0.96 1.45 1.56† 0.80† 1.00 1.09*** 1.03 0.85* 1.02**

1.67 0.23 1.35 −0.65 0.04 0.38 −0.11 −0.46 0.01 0.02 −0.13 −0.04 0.02

0.78 0.78 0.86 0.71 0.06 0.78 0.31 0.37 0.003 0.03 0.13 0.12 0.01

5.31* 1.26 3.86† 0.52 1.04 1.46 0.89 0.63 1.01** 1.02 0.88 0.96 1.02†

0.19

0.07

1.21**

0.20

0.10

1.22*

0.06

0.06

1.06

0.04

0.08

1.04

75.3*** .48

B

Full-time Own car Income (100 $) College grad Some college High school Mean age of children Number of children Married Male R hit with hand as child R hit with object as child R hit a lot as child Minor IPV Severe IPV Injury IPV Patriarchal beliefs Alcohol Somatic symptoms Mood symptoms Stress Low self-control Child care support Social support Low self-control × Social support Child care support × Mood Child care support × Somatic Joint significance (χ2) Pseudo-R2

Neglect

90.9*** .34

Note. Inferences shown are from likelihood-ratio tests, not Wald statistics. OR = odds ratio; IPV = intimate partner violence. †p < .10. *p < .05. **p < .01. ***p < .001.


1244


Figure 2. Empirically supported model of child abuse in Hanoi.

(Sobel coefficient = −.002, p = .07). The predicted interaction between child care support and depressed mood was found (Figure 2). However, the direction of the relationship suggests a selection, rather than a protective effect. When child care support is low, depressed mood is associated with lower odds of abuse. However, when child care support is high, depressed mood is associated with higher odds of abuse. This suggests that extended family, friends, and neighbors may provide additional child care support if depression becomes serious enough to cause abuse. Finally, the predicted interaction between social support and low self-control was found. However, the coefficient for the interaction term was positive, rather than negative as predicted. The theoretical model suggested that the relationship between low self-control and abuse might weaken as social support increased, because informal social control might compensate for lack of self-control. Instead, the empirical model suggests that the relationship between social support and abuse may weaken as self-control gets lower. With respect to child abuse, the findings were striking for IPV and previous experience of abuse. The findings indicate that children of parents who both experienced violence (being hit by their parent’s hand) as children and severe violence in their intimate relationships had e(2.12 + 1.02) = 23 times higher odds of being abused holding all other variables in the model constant. Figure 3 shows the model for neglect that is consistent with the empirical findings. The empirically supported model for neglect is similar to the


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Emery

Figure 3. Empirically supported model of child neglect in Hanoi.

empirically supported model for abuse, but with several notable exceptions. First, the relationships are more tenuous. The interaction term for low selfcontrol and social support was also only marginally significant. As with abuse, this relationship suggests that the relationship between low self-control and maltreatment may become stronger when there is more social support. The weaker findings could occur if the construct of neglect has more measurement error than child abuse or if it is less common (as is the case in these data). The interaction between child care support and parents’ depressed mood suggests the odds of neglect are lower for depressed parents when child care support is low, but higher when child care support is high. This could occur if family, friends, and neighbors step in to ameliorate more serious cases of depression. It is also noteworthy, but not surprising, that income has a stronger and more important negative relationship with neglect than with abuse. Of greater interest is the significant main effect of the stress coefficient, which does not occur for abuse. The IPV and stress variables were noteworthy strong predictors of neglect. The stress of experiencing divorce (73 points) in the last year was associated with e(.01 × 73) = 2.08 times higher odds of neglect holding other variables constant. Experiencing a divorce and severe IPV would be associated with e(.01 × 73) + 1.35 = 8 times higher odds of neglect, holding other variables constant. It is important to note, however, the marginal significance of the severe IPV finding for neglect (p < .10).


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Child Abuse Versus Neglect There are several noticeable differences in the results from models used to predict abuse versus neglect. First, although stress appears to have an important relationship with neglect when other variables in the model are controlled, for abuse this relationship is not significant when IPV is controlled (analyses not shown). Although one could argue that this finding is a function increased measurement error of neglect, it is difficult to reconcile this explanation with the fact that the bivariate coefficient for stress in predicting logged odds of neglect is 10 times larger than the bivariate coefficient for the stress–abuse relationship. The role of low self-control also appears to be different for child neglect versus abuse. Although the interaction effect between self-control and social support appears in both models, it is only marginally significant in the neglect model. Moreover, the strong bivariate relationship between abuse and low self-control contrasts markedly with the lack of a significant bivariate relationship between low self-control and neglect. A larger neglect measurement error explanation for this finding is undermined by the fact that the coefficient standard errors are the same size for the two findings. Finally, there were important differences in the relationships between the demographic variables and abuse and neglect. Holding other variables constant, full-time employment status was marginally associated with more abuse but not more neglect. Higher income, however, was only associated with less neglect. Interestingly, holding other variables constant, higher education was significantly associated with less abuse but more neglect. Education may be functioning as a proxy for high levels of occupational responsibility, which might result in higher work demands on parents’ time and flexibility. Such demands might result in increased likelihood of leaving children alone with inadequate supervision. Table 5 presents the results of the analysis of the model for abuse separately by sex of the parent. Strikingly, many of the predictors are either only significant for men or represent stronger relationships with abuse for male parents. For female parents, only education, IPV, and low self-control were significant main effect predictors of abuse. The interaction between child care support and depressed mood was also significant for females. Many of the other important findings, for example, the interaction between low selfcontrol and social support, appear to be driven by male respondents. Some of these are very large. Both severe IPV in the last year and, surprisingly, fulltime employment were associated with enormous increases in the odds of reporting abuse for men. The direction of the full-time employment and abuse relationship was reversed for women, but it was not significant. For


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Emery

Table 5. Child Abuse in Hanoi: Full Logistic Regression Models (nmale = 116, nfemale = 129). R = Male Variable Full-time Own car Income (100 $) College grad Some college High school Mean age of children Number of children Married R hit with hand as child R hit with object as child R hit a lot as child Minor IPV Severe IPV Injury IPV Patriarchal beliefs Alcohol Somatic symptoms Mood symptoms Stress Low self-control Child care support Social support Low self-control × Social support Child care support × Mood Child care support × Somatic Joint significance (χ2) Pseudo-R2

R = Female

β

SE β

OR

β

SE β

OR

4.14 −0.38 −0.92 −1.02 −5.63 −2.76 0.22 −0.18 −4.23 3.36 −3.06

1.32 1.41 0.49 1.45 2.18 1.92 0.10 0.73 1.93 1.25 1.51

62.78*** 0.69 0.40* 0.36 0.004** 0.06 1.24* 0.83 0.01* 28.90*** 0.05*

−1.62 −0.70 0.38 −0.49 −2.96 −1.38 0.11 0.03 −0.26 −0.37 −1.04

1.07 1.14 0.35 1.49 1.67 1.35 0.08 0.74 1.59 0.76 1.02

0.20 0.50 1.46 0.61 0.05† 0.25 1.12 1.02 0.77 0.69 0.35

−1.43 −0.29 4.35 1.99 −0.17 −1.33 1.04 −1.31 −0.01 0.13 0.50 −0.16 0.06

1.12 1.43 1.69 1.20 0.11 1.32 0.71 0.86 0.01 0.10 0.24 0.08 0.03

0.24 0.75 77.81*** 7.33† 0.84 0.26 2.83 0.27† 0.99 1.14 1.65* 0.54** 1.07**

0.53 0.26 3.11 −2.38 0.14 1.13 0.58 −0.17 0.004 0.17 −0.17 −0.08 0.01

1.32 1.70 0.91 1.30 1.47 22.42* 1.25 0.09* 0.11 1.15 1.09 3.11 0.41 1.79 0.40 0.85 0.004 1.00 0.05 1.18*** 0.17 0.84 0.13 0.92 0.01 1.01

0.33

0.23

1.38

0.28

0.13

1.32*

−0.04

0.17

0.96

0.10

0.11

1.11

54.0** .43

83.7*** .60

Note. Inferences shown are from likelihood-ratio tests, not Wald statistics. OR = odds ratio; IPV = intimate partner violence. †p< .10. *p < .05. **p < .01. ***p < .001.


1248


men, being married and having some college education were associated with similarly enormous decreases in the odds of reporting abuse. Differences between men and women for neglect were much less pronounced and are not shown. However, the pattern of findings being driven by male respondents is still present here. Stress (odds ratio [OR] = 1.02, p < .05) and the main effect of low self-control (OR = 1.23, p < .1) are at least marginally significant for men, but not for women. The number of children in the household (OR = 0.03, p < .10) and being married (OR = 0.01, p < .10) are associated with marginally lower odds of neglect for men, but not for women.

Discussion Importance of IPV and Parents’ Experience of Child Abuse Perhaps one of the more striking aspects of this analysis has been the variables that have not been found significant in the full model. When IPV and previous experience of child abuse are controlled, depression, stress, and support with child care cease to be significant predictors of abuse in a main effects model, although a Child care support × Depressed mood interaction remains significant. Instead, the findings are somewhat counter-intuitively consistent with mediation of stress and depression by IPV. This suggests that although stress and depression are important predictors of abuse, most of their effects may be explained by IPV. Likewise, parents’ experience of abuse in childhood did not play the distal role anticipated, but remained significant in the full model. Given the unique relationships between IPV and abuse in childhood variables with child abuse, the findings also suggest a larger, expanded understanding of the impact of other types of exposure to violence. Beyond their relationship to mental health problems, exposure to other types of violence may be important because of learning (Bandura, 1973), perceived behavioral control (Ajzen, 1985; Kernsmith, 2005), or the erosion of norms prohibiting violent abuse of family members (Matza, 1964/1990; Mooney, 2007). That the main effect from exposure to child abuse comes from whether parents were struck with a hand as children also suggests the possibility that an absence of alternate heuristics for child discipline may play a role in child abuse in Hanoi. These alternative explanations of the relationships found merit further research, as do potential roles for IPV interventions in reducing child abuse. Given the significant pathway from patriarchal beliefs to IPV to child abuse, interventions aimed at reducing violence and tolerance for patriarchal beliefs may be helpful in reducing IPV and child abuse. Confucian beliefs, however, do not appear to be related to child maltreatment. Studies of


1249

Emery

the efficacy of alternative parenting interventions and therapy for Vietnamese parents abused in childhood also warrant investigation.

Strong Motivation Versus Weak Control: Importance of Low Self-Control Versus Stress Overall, the results suggest that (weak) control variables may be more important for understanding physical abuse in Vietnam, with motivation variables like stress playing less important, more indirect roles. Although this may seem like evidence that weak control is more important than strong motivation (thus more lending credence to control theories) we would stress caution about this interpretation. Measure of motivation for child maltreatment require further development, and although low self-control in parents was strongly associated with child abuse, in Hanoi, its relationship with neglect was much less pronounced. Conversely, stress appears to be directly implicated with neglect but not abuse. What are we to make of this? It may be the case that stress is more likely to be implicated with passive forms of maltreatment. Higher cognitive loads created by life stressors may cause otherwise responsible parents to forget or ignore their obligations to their children. Low self-control, however, was not associated with neglect in the bivariate logistic regression model. The findings are thus not consistent with impulsive traits as predictive of neglect. Rather, they suggest that investigations of material and emotional assistance in dealing with life stressors as interventions for neglect may bear fruit. Low self-control does appear to play an important role in understanding child abuse in Hanoi, however. The relationship between low self-control and abuse remains strong and significant in the full model, and is consistent with a story in which parents with low self-control fail to regulate their violent impulses. It may be the case that stress is most directly associated with passive forms of child maltreatment, but low self-control is most closely associated with active forms of child maltreatment because of failure to regulate impulses to violence. The relationship between low self-control, IPV, and the relational order (see Emery, 2011) as they bear on child maltreatment may also be worth pursuing, because low self-control may be associated with less order and predictability in intimate relationships.

Interaction Between Low Self-Control and Social Support The theoretical model predicted that social support might moderate the relationship between low self-control and child maltreatment because greater


1250


involvement by others might assist parents with low self-control in regulating their behavior. The interaction term should thus be negative. Instead, the interaction term is positive, creating serious problems for this perspective. Larger amounts of social support for parents low in self-control are instead associated with more, not less maltreatment. This problematizes the idea that social support, per se, is an across the board social good. The findings are instead perhaps explained by differential association2 (Sutherland, 1942) and neutralization theory3 (Matza, 1964/1990) in the deviance tradition. Both of these theories stress the norms of one’s associates (networks) as important causes of deviance. The results suggest that normative commitments of network members may matter as much as their supportiveness. Social support may only work to decrease child maltreatment when those providing the support hold norms that oppose maltreatment. However, social support from those who excuse or legitimate physical abuse may increase child maltreatment. In other words, the positive interaction term could have occurred if most of the sample receiving social support receives that support from social networks that excuse or justify physical abuse of children. Social support from such a network would decrease, rather than increase control of child abuse. The validity of this explanation requires further study. However, as a preliminary finding, it appears that social support for parents with low selfcontrol is actually a risk factor, rather than a protective factor for child maltreatment in Hanoi.

Interaction Between Depressed Mood and Child Care Support The interaction between depressed mood and child care support suggest that child care support and depressed mood are important variables in the explanation of child maltreatment in Vietnam. The positive interaction term accompanied by negative main effects for depressed mood and child care support suggest that when the respondent is more depressed than average but receives less child care support than average (the child care support is less than zero), increases in depressed mood are associated with less child abuse and neglect. However, when child care support is above the mean, increases in depressed mood are associated with more child abuse and neglect. This is counterintuitive if one conceptualizes the causal direction as moving from depression to maltreatment. It makes somewhat more sense, however, if the causal direction moves from maltreatment to child care support. That is, it may be that when depression becomes bad enough to cause maltreatment family, friends and neighbors are more likely to step in to provide child care support in an effort to ameliorate the situation. However, we cannot rule out


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Emery

the possibility that the networks providing support to depressed respondents also provide normative support for harsh parenting. Interactions between child care support and low self-control and child care support and depressed mood suggest ambiguity regarding the role of support provided by family, friend, and neighbor networks. Under what circumstances are networks protective to children and when do they constitute risk factors? Determining whether and when networks are acting to exacerbate or ameliorate child maltreatment is critical both to our understanding of the relevant theoretical constructs as well as to what sorts of intervention are needed. If community networks are stepping in to try to protect children, that informal intervention should be studied and supported. However, if networks exacerbate maltreatment by providing normative support for maltreatment, that suggests a different type of community intervention aimed at changing norms is more warranted. Child care support and social support may not be, per se, protective or desirable. Rather, desirability may depend on the characteristics of who is providing the support. Future research must disentangle this ambiguous role via more comprehensive study of networks and child maltreatment.

Limitations There are a number of limitations that affect the strength of the conclusions that can be drawn from these analyses. First, the study is non-experimental, cross-sectional, and subject to reporter bias. Reporters are parents, and results may have differed if children also been interviewed. Some of the null findings may have been significant with better measurement of neglect or a larger sample size. The measure of neglect is small and the measure of maltreatment does not include psychological abuse. In addition, the findings represent a first foray into the variable relationships as seen in Hanoi and require replication. In addition, the number of respondents reporting that they completed university was high (46%). Taking into account the non-response rate, this number could be as low as 35%. However, we cannot rule out that social desirability may have prompted some respondents to lie about their level of education. Furthermore, the fact that most of the relationships in the data were driven by male respondents is cause for concern. To some extent, stronger relationships between variables for men could occur if men are more likely to maltreat children. However, more broadly, differences in predictors for fathers and mothers suggest that female perpetration of maltreatment may be poorly understood. Each facet of child maltreatment—physical, emotional, and sexual abuse and neglect—is a nuanced construct requiring multiple items to ensure


1252


adequate measurement. In our survey, we elected to have a nuanced measure of physical abuse of the child but did not add items on sexual abuse to the original Straus and Hamby (1997) scale. This allowed for the measurement of a larger number of independent variable constructs and hence a more complex explanatory model. At the same time, this approach avoids the proverbial problem of falling between two stools (measuring many constructs with a few items each might result in generally poor measurements). However, the omission of sexual abuse is also a serious limitation of the study. No picture of child maltreatment can be complete without it. We believe that sexual abuse warrants a full study in its own right, and hope to carry out such a study in the near future.

Conclusion Reported rates of child maltreatment in Hanoi are high. More than 1 in 5 parents reported serious abuse of their children in the last year, and more than 1 in 10 parents reports neglect in the last year. Thus, maltreatment in Hanoi appears to be a serious problem that requires the development and implementation of interventions at clinical and policy levels. The findings here suggest that theories from criminology (specifically low self-control and neutralization theory) and psychology (specifically theories of stress and coping, cf. Lazarus & Folkman, 1984) may be useful in understanding maltreatment in Hanoi and guiding intervention. The study also highlights the important role of other types of violence (IPV and parents’ experience of abuse in childhood), and social networks. However, much research remains to be done. Moreover, if Vietnamese children are to be adequately protected from potentially lethal violence, much must be done. Acknowledgments We wish to thank Melissa Jonson-Reid, Brett Drake, and Shali Wu for advice and support. We would also like to thank the data collection team in Vietnam.

Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: H.F. Guggenheim Foundation 20112012 Research Grant facilitated measure development for this study.


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Emery Notes

1. Coefficients for depression were significant in bivariate analyses but dropped to insignificance when intimate partner violence (IPV) was controlled for. The premise is that the relationship between depression and maltreatment is fully explained by the covariance between IPV and maltreatment. 2. The theory of differential association suggest that deviance (in this case maltreatment) is a function of exposure to and acceptance in deviant social networks. 3. Neutralization theory suggests that the development of excuses to violate norms (neutralizing beliefs) is a critical factor in the commission of crime.

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Author Biographies Clifton R. Emery is an associate professor in the School of Social Welfare at Yonsei University in Seoul, South Korea. He obtained his master’s degree in statistics, MSW, and his PhD in social work from the University of Chicago. His research interests include informal social control of domestic violence and child abuse, understanding the effects of domestic violence on children, and theory development.


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Emery

Hai Trung Nguyen is a professor at the University of Labor and Social Affairs in Hanoi, Vietnam. His research interests include physical and sexual abuse of children, and neglect. Jaeyop Kim is a professor of social welfare at Yonsei University in Seoul, Korea. His research interests include family therapy and family violence.


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