The relationship between maternal depression, in-home violence and use of physical punishment: what is the role of child behaviour?

Background: The combined impact of maternal depression and in-home violence, and how their relationship with physical punishment varies with child behaviour are unknown. Objectives: 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. Conclusion: 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.