摘要：Objectives. We examined the associations of intimate partner violence (IPV) and maternal risk factors with maternal child maltreatment risk within a diverse sample of mothers. Methods. We derived the study sample (N = 2508) from the Fragile Families and Child Well-Being Study. We conducted regression analyses to examine associations between IPV, parenting stress, major depression, key covariates, and 4 proxy variables for maternal child maltreatment. Results. Mothers reported an average of 25 acts of psychological aggression and 17 acts of physical aggression against their 3-year-old children in the year before the study, 11% reported some act of neglect toward their children during the same period, and 55% had spanked their children during the previous month. About 40% of mothers had experienced IPV by their current partner. IPV and maternal parenting stress were both consistent risk factors for all 4 maltreatment proxy variables. Although foreign-born mothers reported fewer incidents of child maltreatment, the IPV relative risk for child maltreatment was greater for foreign-born than for US-born mothers. Conclusions. Further integration of IPV and child maltreatment prevention and intervention efforts is warranted; such efforts must carefully balance the needs of adult and child victims. Nearly 900 000 cases of child maltreatment were substantiated in the United States in 2005; 63% of these children were reported to be victims of neglect and 17% were reported to be victims of physical abuse. 1 Children 3 years and younger have the highest rate of victimization (16.5 per 1000). 1 Child maltreatment jeopardizes the physical, mental, social, and behavioral health of children in both the short and long terms, 2 – 25 and when considered cumulatively with other adverse childhood experiences, child maltreatment raises the risk of health problems such as alcoholism, drug abuse, smoking, sexually transmitted disease, obesity, and heart disease. 26 – 29 A majority of parents in the United States report using corporal punishment, such as spanking, with their children 30 – 32 ; past-year prevalence rates seem to peak when the child is aged 3 or 4 years. 32 Corporal punishment is an important risk factor for physical child maltreatment, 33 increases risk for psychiatric morbidity as an adolescent or adult, 34 and is banned in the home in 23 countries. 35 A meta-analysis found that corporal punishment was associated with decreased moral internalization and mental health for the child, decreased quality of the parent–child relationship, and increased childhood and adulthood aggressive, delinquent, criminal, and antisocial behavior. 33 Most child maltreatment victims (83%) are abused by a parent. 1 In the plurality of cases, the mother is acting alone (40%). She is acting with the father 17% of the time and with someone else 6% of the time; fathers act alone in roughly 18% of cases. 1 This high prevalence of maternal child maltreatment is primarily because of exposure opportunity (i.e., mothers generally spend more time with their children than does any other person). However, fathers and father surrogates who perpetrate intimate partner violence (IPV) may play an important role in raising the risk for child maltreatment. Maternal stress, 36 – 38 maternal depression, 39 , 40 and unwanted or unintended pregnancy 41 , 42 are all associated with both child maltreatment and IPV victimization. 43 Increased child maltreatment risk among mothers who are IPV victims may be explained by increased stress, depression, or unintended pregnancy resulting from IPV. Physical and psychological IPV co-occur in homes with identified child maltreatment at a median rate of about 40%. 44 Among a nationally representative sample of investigated child maltreatment cases, the past-year prevalence of IPV was 29% and the lifetime prevalence was 45%. 40 A longitudinal study found that the presence of IPV raised the odds of subsequent child maltreatment by 2 to 3 times; however, the study examined a specialized sample of mothers who were participants in a child abuse prevention program, examined few covariates, and was unable to separate out the effects of some possible confounders such as parenting stress and depression. 45 Ethnic variations in rates 1 , 46 and consequences of child maltreatment 47 and IPV 48 , 49 suggest a need to continue to assess the nature of such differences (e.g., the rate of child maltreatment victimization is nearly twice as high among Black children as it is among Hispanic or White children). 1 This variation may arise from sociocultural factors such as social norms regarding the acceptance or use of violence, socioeconomic factors such as income or educational level, or other factors related to ethnicity. 50 Examination of ethnic and nativity differences in maltreatment may help to identify those who are most vulnerable and, in time, to develop a better understanding of the roots of these patterns. Our primary aim was to assess the unique contribution of maternal IPV victimization to maternal child maltreatment risk in a diverse, population-based sample by asking (1) is maternal IPV victimization associated with risk for maternal child maltreatment even after control for potentially confounding maternal risk factors such as parenting stress, depression, and consideration of abortion; (2) are these maternal risk factors associated with maternal child maltreatment even after control for IPV; and (3) is ethnicity or nativity associated with maternal child maltreatment after control for other relevant covariates, such as income and education?
