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around the same time, Poffenberger (1981) offered
one of the first candid observations of parental dis-
cipline practices in his report of child rearing in ru-
ral India. In this qualitative investigation, parents
described discipline practices they deemed accept-
able and unacceptable. Whereas physical punish-
ment was the norm and considered necessary for
the socialization of children, the villagers spoke of
punishments that they considered to be overly
harsh including threats to send children away, invo-
cations of ghosts and evil spirits to do the child
harm, holding burning sticks to penises to control
masturbation, branding, and hanging by hands or
feet. Threats of death were also common.
Suman (1985), noting the paucity of systematic
Journal of Pediatric Psychology, Vol. 25, No. 6, 2000, pp. 435–447
Risk Factors for Severe Child Discipline Practices
in Rural India
Wanda M. Hunter,
1
MPH, Dipty Jain,
2
MBBS, MSc, MD, Laura S. Sadowski,
1
MD, MPH,
and Antonio I. Sanhueza,
3
MPH, MS
1
University of North Carolina at Chapel Hill,
2
Government Medical College, Nagpur, Maharashtra, India,
3
Universidad de La Frontera, Temuco, Chile
Objectives: To determine the type and severity of discipline practices in rural India and to identify risk and
protective factors related to these practices.
Methods: Five hundred mothers, ages 18–50, participated in face-to-face interviews as part of a cross-
sectional, population-based survey. One of the mother’s children was randomly selected as the referent
child. The interview focused primarily on discipline practices and spousal violence. Sociodemographic char-
acteristics, neighbor support, residential stability, and husband’s drinking behavior were also assessed.
Results: Nearly half of the mothers reported using severe verbal discipline and 42% reported using severe
physical discipline. While common, severe discipline practices occurred less frequently than moderate prac-
tices and had different risk factors, notably low maternal education and spousal violence.
Conclusions: Results suggest that increased formal education for rural women in India may have the added
benefit of reducing family violence, including spouse and child abuse.
Key words: discipline; punishment; child abuse; family violence; spouse abuse; domestic violence; maternal depression;
social ecology; India.
Although the vulnerability of children to abusive
practices is recognized in the Indian constitution,
most research to date has focused on children’s sur-
vival needs and societal abuses, such as malnutri-
tion, child labor, child beggary, child marriage, and
child prostitution (Banerjee, 1979; Bhattacharyya,
1979, 1983; Gupta, 1977; Jabbi, 1986; Mehta,
Lokeshwar, Bhatt, Athavale, & Kulkarni, 1979). A
few early clinical studies of child injuries suggested
that some maltreatment of children may be the re-
sult of harsh discipline from family members (Bhat-
tacharyya, 1983; Dave, Dave, & Mishra, 1982). At
䉷2000 Society of Pediatric Psychology
All correspondence should be sent to Wanda M. Hunter, Department of So-
cial Medicine, University of North Carolina at Chapel Hill, CB#7240,
Chapel Hill, North Carolina 27599. E-mail: whunter@med.unc.edu.
and quantitative data related to child physical and
emotional abuse in India, called for research to doc-
ument the prevalence of these phenomena and to
identify the interacting factors that support or dis-
courage child maltreatment within the family envi-
ronment. In response, several investigators have
conducted small studies investigating the extent to
which harsh and abusive practices occur within the
context of normal child rearing and socialization
(Segal, 1992, 1995; Segal & Ashetekar, 1994). Be-
cause there are no universal standards related to op-
timal child rearing or what might be considered
child maltreatment, these early studies confronted
the need to balance cultural norms against the well-
being of children.
Segal’s progression of empirical studies has shed
considerable light on the extent of harsh child disci-
pline practices and the perceptions of the public
and professionals regarding what constitutes abu-
sive behavior (Segal, 1992, 1995; Segal & Ashtekar,
1994). Investigating cultural definitions of child
abuse in India, Segal found very little difference in
the perceptions of severity for different forms of
child abuse among social workers, other human ser-
vice workers, and other service workers (Segal,
1992). Cross-cultural comparisons with a similar
U.S. study (Giovanonni & Bercarra, 1979) indicated
that while both Indian and U.S. samples perceived
sexual abuse as highest on an abuse scale and inade-
quate housing conditions as lowest, the rankings of
the remaining forms of abuse were influenced by
recognition of abuse, national norms, expectations,
and the socioeconomic conditions of each country.
Although the U.S. sample ranked physical abuse
second in severity in terms of its detrimental effects
on the child, the Indian sample ranked it sixth,
after sexual abuse, fostering delinquency, medical
neglect, poor supervision, and exposing children to
parental sexual mores.
A subsequent study that used the Conflict Tac-
tics Scale (Straus, 1979) to investigate the discipline
practices of middle-class professionals in India
found that 57% engaged in “normal” corporal pun-
ishment (spanking, slapping), 42% in “abusive”
forms of discipline (kicked, bit, or hit with fist; hit
or tried to hit with something; beat up child), and
3% in “extreme” forms of violence (threatened
with, or used, a knife or gun on child) (Segal, 1995).
Segal observed that these relatively high rates of
harsh discipline may reflect societal sanction of vio-
lence toward children and the perception that phys-
ical abuse has fewer detrimental effects than other
forms of abuse.
Yet some parents, like those in Poffenberger’s
study (1981), may resort to practices that they feel
are inappropriate and potentially harmful. Identi-
fication of risk and protective factors related to dif-
ferent levels of severity in discipline practices used
in India may help address the question of whether
severe practices are normative or whether they, at
some point, cross a line to become unacceptable or
abusive. In this study, risk and protective factors
have been conceptualized using an ecological
model that attributes family interactions (including
child abuse and other family violence) to character-
istics of the nested social ecology including the
larger society, the local community, the family it-
self, and finally the characteristics of the involved
individuals (Belsky, 1980; Cicchetti & Lynch, 1993;
Garbarino, 1977). As in all societies, the treatment
of children in India is likely a function of deep-
seated cultural norms. Few would deny that there is
societal tolerance for the use of corporal punish-
ment, a cultural factor theorized as a risk factor for
physical abuse (Zigler & Hall, 1989). In addition, In-
dia is a patrilineal society in which the spiritual,
economic, and social norms of everyday life reflect
an extreme preference for male offspring and a cor-
responding denigration of female children. As a
result, female children have been at higher risk
for selective feticide, infanticide, poorer nutrition,
poorer health care, poorer educational opportuni-
ties, kidnapping, and forced prostitution (Poffen-
berger, 1981; Wadley, 1993). However no data in-
dicate that females are more likely to experience
harsh parental discipline than their male counter-
parts. Although Singh and Kaur (1981) found that
rural Indian mothers felt that girls need more in-
struction and discipline than boys, they did not ana-
lyze the harshness or severity of actual childrearing
practices by gender. In China, another country
where sons are venerated because they are seen as
insurance against old age and poverty, boys are
more strictly disciplined, perhaps because the stakes
connected to their behavior and success are much
higher (Ho, 1996; Tang, 1998; Wu, 1996). It is rea-
sonable to expect that the same family dynamics
might contribute to harsher punishment of sons
in India.
At the community level, social isolation, lack of
social support, and social change, such as migration
away from family of origin, have been identified in
the United States as risk factors for child abuse (Ege-
land & Brunquell, 1979; Garbarino & Gilliam, 1980;
Starr, 1988). In studies outside the United States,
Levinson (1989) found that child abuse is less likely
436 Hunter, Jain, Sadowski, and Sanhueza
adults in the household, domestic violence, and al-
cohol abuse) and low levels of community support
(characterized by having lived in the community
for less than 5 years and by maternal perceptions of
poor support from neighbors) would be associated
with more severe discipline practices. At the indi-
vidual level, low parent education, child gender (male),
younger child age, child disobedience, and child health
problems were also expected to be risk factors for
more severe discipline practices.
Method
Study Design and Development
This investigation was a rural pilot study for a larger
multiregion study that will ultimately collect data
from 10,000 mothers across India. In turn, the In-
dian project is part of a larger international collabo-
ration, called WorldSAFE (World Studies of Abuse in
the Family Environment), which is using a com-
mon research protocol to address questions related
to family violence and risk factors in the social ecol-
ogy. WorldSAFE’s conceptual framework and study
methods have been formulated over a period of
years by an international multidisciplinary group of
investigators from the International Clinical Epide-
miology Network who are dedicated to reducing
family violence in countries around the world by ad-
vancing understanding of its etiology and impact.
Although the core survey instrument focuses
primarily on child discipline practices and spousal/
partner violence, demographic characteristics and
other characteristics of the social ecology hypothe-
sized to be related to family violence (e.g., hus-
band’s alcohol abuse, residential stability, neigh-
borhood support, child disobedience, child health
problems, and maternal depression) are also in-
cluded. The instrument for this study was formu-
lated in English, translated into Marathi, the local
language, and then back-translated, by a different
professional. Comparisons were made with the orig-
inal version and modifications implemented wher-
ever necessary to ensure equivalence in meaning
between the English and translated version.
Focus Groups
Prior to the development of the survey and the field
procedures, focus group discussions were conducted
in an attempt to anchor our research methodology
to the culture of rural Maharashtra. As others have
in extended family households where child care re-
sponsibilities can be shared. Increasing mobility of
Indian families and movement away from extended
family structures may increase the parenting
stresses once absorbed within the joint family
(Sinha, 1984). Other types of stresses that occur at
the family level (e.g., alcohol abuse, marital conflict
or violence, large family size, and parent psycholog-
ical problems) have been shown to increase the
probability of child abuse (Whipple & Richey,
1997). In a 1985 survey of American families, Straus
and Gelles (1990) found that mothers who were vic-
tims of partner violence were at least twice as likely
to physically abuse their children as mothers who
were not.
Harsh discipline and child abuse have also been
linked with family or parent socioeconomic charac-
teristics, especially low income (Straus, 1980), low
maternal education (Brown, Cohen, Johnson, & Sal-
zinger, 1998; Egeland & Brunquell, 1979), closely
spaced children (Holden, Willis, & Corcoran, 1992),
and a high household crowding index (Youssef, At-
tia, & Kamel, 1998).
Characteristics of the child may increase the
likelihood of severe discipline or abuse, especially
when other risk factors are present. Wolfe has re-
ported that the average age of abuse victims in the
United States tends to be younger than the average
age of all children (Wolfe, 1987). Others have found
age related to discipline practices, with parents
more likely to physically discipline younger chil-
dren and more likely to use nonphysical discipline
techniques including verbal abuse with older chil-
dren (Jackson et al., 1999). Children perceived as
being difficult to parent or manage have been iden-
tified as being at higher risk (Blackson, Tarter, &
Mezzich, 1996; Korbin, 1991; Youssef et al., 1998),
especially when the mother is depressed and has
few available supports (Hetherington, 1989). Poor
health and handicapping conditions have also been
found to be associated with child abuse (Dubowitz,
Hampton, Bithoney, & Newberger, 1987; Youssef
et al., 1998), possibly because the child is perceived
as different or as the source of increased stress (Ko-
telchuck, 1982).
The goal of this study was to determine the type
and severity of discipline practices used in this area
of central India and to analyze how characteristics
of the social ecology are associated with these prac-
tices. Based on ecological theory and previous stud-
ies, we expected that high levels of family stress
(characterized by household crowding, high num-
bers of children in the household, low numbers of
Severe Child Discipline in India 437
noted, focus groups and other qualitative methods
can enhance quantitative studies by providing di-
rect access to the language and the concepts that
participants use in thinking about and describing
their experiences (Bauman & Adair, 1992; Hughes &
DuMont, 1993).
The principal investigator (DJ) conducted the
focus groups in three rural villages that were close
in proximity to those selected for the survey and
believed to be similar in sociodemographic charac-
teristics. Each focus group was composed of a con-
venience sample of 10–16 mothers recruited from a
list of mothers identified by village leaders. The goal
of the focus groups was to discover who typically
disciplines children in the village, the range of disci-
pline practices employed, and opinions about the
acceptability of these practices. In addition, partici-
pants were asked to comment on proposed field
procedures for recruitment and data collection. We
expected that the discussions would provide access
to the language and concepts that these mothers
used to describe their interactions with their chil-
dren and thus inform the final terminology used in
the survey questionnaire. A structured discussion
guide specifying the order in which topics were to
be introduced was prepared by the research team.
While the principal investigator served as the mod-
erator in each group, the field interviewers sat on
the outside of circle and transcribed the discussions.
The data were analyzed by identifying themes that
emerged across groups that related to common dis-
cipline practices and the perceived appropriateness
of these practices.
Procedure
The study was conducted in five villages in the
Saoner district of northern Maharastra in central In-
dia. Villages in this district were stratified into two
sizes: large (ⱖ2,000) and small (⬍2,000). Five vil-
lages were randomly selected and proportionately
sampled. Households were approached up to three
times, to screen for eligibility. Households that in-
cluded a married woman who had at least one co-
residing child under 18 years old were considered
eligible. After obtaining permission from the village
authorities, trained interviewers approached homes
from a standardized starting point, screening for eli-
gible households from all four quadrants until the
sample size for that village was reached.
At each eligible household, a census was con-
ducted and names of all residents and their relation-
ships to each other were recorded on a standardized
form. When more than one eligible woman resided
in the household, the interviewer randomly se-
lected one for interview by using tables of randomly
generated numbers that conformed to the number
of possible eligible women that might be encoun-
tered in a household (2–5 women). For example, for
a household that contained three eligible women,
the interviewer would use the table with the numer-
als 1, 2, and 3 listed in random order. She would
use the first available number on the list to indicate
which woman she should select from among those
identified as eligible on the census form. She would
then strike through the “used” number, so that in
the next household of three eligible women, she
would choose the next number on the list. When
the selected mother had more than one eligible
child, one was randomly selected as the referent
child in a similar fashion, using a different set of
tables (for 2–10 children).
The field supervisor and interviewers were fe-
male social workers with prior experience in rural
villages. They received extensive standardized train-
ing in all aspects of study protocol prior to entry
into the field. Following training, the instrument
was pretested in 25 households resulting in minor
modifications. Because illiteracy was a concern in
targeted villages, the informed consent procedure
was verbal. Eligible women were invited to partici-
pate in a study related to maternal and child health
that consisted of an interview on private and sensi-
tive family matters. After receiving consent, all face-
to-face interviews were conducted privately, either
within or close to the woman’s residence. Study
methodology was reviewed and received approval
by the Ethical Review Board of the Government
Medical College in Nagpur.
Measures
Child disciplinary practices were assessed using a
modified version of the Parent-Child Conflict Tac-
tics Scale (Straus, Hamby, Finkelhor, Moore, &
Runyan, 1998). This has been one of the more com-
monly used measures of discipline and abusive
practices in the United States and it has been pre-
viously used in India (Segal, 1995) and in other
Asian countries (Tang, 1998). The time frame for
self-report was reduced from 1 year to 6 months and
the range of response options was condensed from
an 8-point scale (ranging from never to more than
20 times in past year) to a 3-point scale (not at all,
sometimes, or many times in the last 6 months).
The scale itself was expanded to include 12 addi-
438 Hunter, Jain, Sadowski, and Sanhueza
was created by summing all endorsements from this
list. A global rating of poor health was counted as
one point on the health problem index; thus, the
range for the index extended from 0–8. Child dis-
obedience was examined with one global question:
“Compared to other children of the same age, how
obedient is s/he?” Response options were more obe-
dient, about average, and less obedient.
Demographic data including household charac-
teristics, residential stability, mother’s age, mother’s
and father’s level of education, religion, child age,
and child gender were based on the mother’s re-
sponse to structured questions within the interview.
Data Analysis
Prior to analyses of data, the internal consistency
reliability of the CES-D and the Neighborhood Sup-
port scale (both with unknown psychometric prop-
erties in this population) was evaluated by cal-
culating Cronbach’s alpha coefficient for each scale.
Subsequent analyses included generating descrip-
tive statistics for the variables of interest and con-
ducting univariate tests for association between the
dependent variables and the demographic and so-
cial context variables considered as potential risk
factors. Chi-square tests were used to test for sig-
nificant associations between categorical variables,
and Pearson correlation coefficients and Kruskal-
Wallis tests were used for continuous variables. In-
dependent variables that demonstrated a relation-
ship with a dependent variable (at p⬍.20) were
selected for further testing in multivariate models.
Logistic regression was used to estimate the odds of
having used each type of discipline for each pre-
dictor variable, while simultaneously controlling
for the other variables in the model. Selected inde-
pendent variables were entered into the model
simultaneously, and a backward elimination proce-
dure was used to select the “best” model. Odds ra-
tios (ORs) were calculated to estimate the strength
of the association between the different categories
of discipline practice and the sociocontextual risk
factors.
Results
Focus Group Results
There was consensus in all three focus groups that
within local villages mothers are the primary disci-
plinarians of their children and that scolding, slap-
tional practices identified by the focus groups as
among the strategies employed by mothers in the
villages of this area. For this investigation, the disci-
pline practices were classified as belonging to one of
five different categories: nonviolent discipline (four
items), moderate verbal/ psychological aggression
(four items); severe verbal/psychological aggression
(three items); minor physical aggression (ten items);
and severe physical aggression (eight items). Two
items (putting chili pepper in the mouth and tying
to something) were not classified because the rela-
tive severity of these actions was difficult to assess.
The discipline classification schemes were consis-
tent overall with those used by both Straus et al. in
U.S. studies (1998) and Segal in Indian studies
(1995). For the analyses, the values for the catego-
ries of discipline practices were dichotomized (by
combining response options, sometimes and many
times) to simply indicate whether that mode of dis-
cipline was used or not used within the specified
time period.
Maternal depression was assessed using the 20-
item Center for Epidemiologic Studies-Depression
Scale (CES-D) (Radloff, 1977). The standard cut-
point for “caseness” (a score of 16 or higher) was
used to classify the mothers as depressed or not de-
pressed.
If the husband was reported to get drunk at least
1–3 days a month, then husband drunkenness was
classified as present. Spousal abuse of the mother was
classified as present if the mother said she had been
slapped, kicked, hit, or beaten by her husband.
Neighborhood support was measured using a 5-
item scale (In this neighborhood . . . people help
each other out, people watch out for each other’s
children, there are people I can count on, there are
people who care about me, and there are people I
can talk to about my problems.) These items were
scored on a 4-point Likert scale ranging from very
much to not at all. For analysis purposes, mothers
who responded very much or somewhat to all five
items were scored as having “high” support. Moth-
ers who responded very little or not at all to all five
items were scored as having “low” support. All oth-
ers were classified as having “moderate” support.
Mothers were asked to rate the referent child’s
health on a 3-point scale. In addition, they were
asked if the child had any of seven chronic health
problems or conditions, including hearing prob-
lems, speech problems, vision problems (not cor-
rected by glasses), physical handicap or deformity,
mental retardation, chronic condition like asthma
or tuberculosis, and polio. A health problem index
Severe Child Discipline in India 439
ping, and beating with a broom, shoe, or stick are
the most common punishments. The mothers de-
scribed a range of other practices also used in their
villages, including: threatening the child with
ghosts or evil spirits, tying the child’s hands and
feet, hanging the child by hands or feet, forcing
chili pepper into child’s mouth, threatening to
burn, threatening to beat, pulling hair, kicking,
withholding food, calisthenics, and forced kneeling
for a period of time with some added burden, such
as in hot sand or holding a brick in each hand. Al-
though scolding, slapping, and spanking were con-
sidered both appropriate and necessary for the
socialization of children, some mothers felt that
beating should be reserved for only the most severe
offenses. There was general agreement that hang-
ing, burning, kicking, threatening abandonment,
and threatening with evil spirits are not appropriate
strategies, and some mothers expressed remorse at
having resorted to such severe practices. Even
though not a focus group topic, reasons for harsh dis-
cipline were occasionally volunteered and seemed to
be related to the mother’s stress, the child’s escalat-
ing misbehavior, or both. In one group, the mothers
agreed that children who were difficult to manage
required harsher methods of discipline. They also
said that as children get older it is easier to correct
their behavior with verbal explanations without
having to resort to physical punishment.
Survey Participation Rates
Seventy-nine percent (N⫽500) of the eligible
women selected for survey in the five villages agreed
to participate and completed the interview. Nonpar-
ticipants were women who said they were not inter-
ested or were too busy with household tasks to afford
the time (n⫽77), women who could not be found at
home after three visits (n⫽47), and women who
were not permitted to interview by their husbands
or mothers-in-law (n⫽6). One interview was at-
tempted, then aborted, because privacy could not
be maintained. Demographic data were not gath-
ered on nonparticipants.
Reliability of Measurement Scales
Internal consistency reliability of the CES-D in this
sample was very acceptable (Cronbach’s alpha ⫽
.93). Only two of the items had low item-total corre-
lations: “I felt I was as good as other people” (r⫽.28)
and “I felt hopeful about the future” (r⫽.27). All
other item-total correlations ranged from .45 (“I
talked less than usual”) to .77 (“I felt sad” and “I felt
depressed”). The alpha coefficient for the Neighbor-
hood Support scale was .86, also quite satisfactory
given the relative shortness of the scale (five items).
Item-total correlations ranged from .58 to .76.
Sociodemographic Characteristics
Sociodemographic characteristics of the final
sample are described in Table I. The women’s ages
ranged from 18–60 years, with a mean age of
around 30 years. Almost one-third (30.4%) had no
formal education at all. More than one-third
(34.1%) described themselves as illiterate. The
women’s husbands were better educated than their
wives, with twice the number having attended
school more than 10 years. Almost 90% of the fami-
lies were Hindu and more than half lived in one-
room dwellings. There were no single-adult house-
holds; close to half (46.2%) had three or more
adults. Likewise, almost half (49.4%) had three or
more children. The mean household crowding ratio
was approximately four persons per room. Among
the children selected for study, boys outnumbered
girls, 53% to 47%. This ratio conforms closely to
the male-female ratio reported in the Maharashtra
census, 52.3 males: 47.9 females (Maharashtra State
Government, 1991). Child age covered the full
range from infancy to 17 years old. When child age
was categorized into three 6-year spans—0–5 years,
6–11 years, and 12–17 years—there was a higher
percentage of children in the youngest group than
in the other two (40% vs. 30%, respectively). The
majority of the children were described as healthy,
but more than 36% of the mothers described the
referent child as having one or more health prob-
lems. More than 20% described the child as more
disobedient than average.
Almost one-third (30.6%) of the mothers re-
ported having lived in the village for fewer than 5
years. Slightly more than one-quarter of the moth-
ers were classified as having low neighbor support,
21% had high neighbor support, and all others were
classified in the moderate category. Almost half said
they had been slapped, hit, kicked, or beaten by
their husbands at some time. More than half were
at or above the clinical cutpoint for depression
based on CES-D scores and about one-third said
that their husbands got drunk at least 1–3 times
per month.
440 Hunter, Jain, Sadowski, and Sanhueza
Frequency and Interrelatedness of
Discipline Practices
The mothers’ reports regarding discipline practices
are summarized in Table II. Each of the five different
categories of discipline practice is followed by the
behaviors included within the category and corre-
sponding frequencies. Ninety-five percent of the
mothers used some mode of nonviolent discipline
with their children, primarily “explaining why a be-
havior was wrong.” The next most common forms
Table II. Percentage of Mothers Using Various Discipline
Practices in the Last 6 Months (n⫽499)
Practice %
Nonviolent discipline 95.2
Explained why wrong 94.4
Took away privileges 43.3
Gave something else to do 27.2
Time-out/sent to room 4.6
Moderate verbal/psychological 75.0
Shouted, yelled, screamed 70.2
Threatened physical punishment 35.3
Refused to speak to child
a
31.0
Withheld food
a
9.8
Severe verbal/psychological 49.1
Called names like stupid, ugly, useless 28.6
Threaten to send away or give away 20.2
Threatened with ghosts/evil spirits
a
20.0
Moderate physical 76.4
Hit buttocks with bare hand 57.8
Slapped face/head 57.8
Pulled hair
a
28.6
Rapped head with knuckles
a
27.6
Hit buttocks with stick, etc. 23.4
Pinched 16.6
Pulled or twisted ear
a
15.6
Shook 12.2
Required calisthenics (e.g., push-ups)
a
9.6
Forced position with added burden
a
2.4
Severe physical 42.3
Hit elsewhere (not buttocks) with stick, etc. 35.6
Kicked 10.4
Threw or knocked down 7.2
Hung by hands
a
2.2
Hung by feet
a
2.0
Grabbed by neck and choked 1.6
Burned/scalded/branded 1.2
Threatened with knife/gun 1.2
Unclassfied
Tied to something
a
5.8
Hot pepper in mouth
a
2.6
a
Item added to Parent-Child Conflict Tactics Scale (Straus et al., 1998)
for this study.
Severe Child Discipline in India 441
Table I. Sociocontextual Characteristics of Sample
Frequency/Mean
(SD)
Mother characteristics
Mean age (years) 29.5 (6.9)
Education (n⫽493)
None 30.4%
1–6 years 24.3%
7–10 years 36.1%
⬎10 years 9.1%
Illiterate (n⫽500) 34.1%
Victim of spousal abuse (n⫽499) 46.9%
Depressed (CES-D ⱖ16) (n⫽494) 54.3%
Resident in village ⬍5 years (n⫽499) 30.6%
Perceived neighborhood support (n⫽500)
High 21.4%
Moderate 52.4%
Low 26.2%
Paternal characteristics
Education (n⫽490)
None 16.9%
1–6 years 22.7%
7–10 years 38.6%
⬎10 years 21.8%
Drunk behavior (ⱖ1 time/mo) (n⫽500) 31.7%
Family/household characteristics
Religion (n⫽500)
Hindu 89.0%
Buddhist 10.0%
Other 1.0%
Children in home (n⫽500)
1 20.2%
2 30.4%
3 29.0%
ⱖ4 20.4%
Adults in home (n⫽500)
2 53.8%
3 23.8%
ⱖ4 22.4%
Rooms (excluding kitchen) (n⫽499)
One room 55.9%
Two rooms 28.5%
⬎2 rooms 15.6%
Mean household crowding (person/room) 3.9 (1.8)
Child characteristics
Age (n⫽497)
0–5 years 39.4%
6–11 years 30.4%
12–17 years 30.2%
Gender (n⫽499)
Male 53.1%
Female 46.9%
Health problems (n⫽497)
None 63.2%
1 24.2%
2 or more 12.6%
Perceived as disobedient (n⫽498) 21.5%
Ns for descriptive statistics vary slightly due to missing data or
deletion of outliers.
of discipline, used by more than three-quarters of
the sample, were moderate verbal/psychological ag-
gression (primarily shouting) and moderate physi-
cal aggression (primarily spanking and slapping).
Almost one-half of the mothers had used severe ver-
bal aggression, while 42% had used severe physical
aggression. The highest frequency behavior in the
severe physical aggression category was hitting or
beating the child somewhere other than the but-
tocks, with a stick or other object. Thirty-six percent
of the mothers had used this form of discipline in
the last six months.
The relationship between the five discipline
types was assessed by computing Pearson correla-
tions between all pairs. As would be expected from
the high frequency observed for all the forms of dis-
cipline, each category of discipline was significantly
correlated with the other. Nonviolent discipline and
severe physical discipline had the lowest correlation
(r⫽.44, p⬍.0001), and moderate physical disci-
pline and severe physical discipline had the highest
correlation (r⫽.67, p⬍.0001).
Univariate Associations
Relationships between the hypothesized risk factors
and the four outcome variables are shown in Table
III. Child gender and short-term residence in the
village were the only variables that demonstrated
no relationship with any of the discipline practices.
Neighbor support was related to only the moderate
forms of discipline but in the opposite direction of
that expected. Women who reported higher levels
of neighbor support were more likely to use moder-
ate verbal and physical discipline with their chil-
dren. The education of the mother and the father
were significantly related to more severe forms of
discipline, but not to the moderate forms. The
strongest relationships were with husband drunk-
enness, spousal abuse of the mother, and maternal
depression. Child age was strongly associated with
all discipline categories, with children in the mid-
range (6–11 years) appearing to be at highest risk.
Logistic Regression Models
The logistic regression models allowed examination
of the association of each potential risk factor with
the outcome variables while controlling for the
variance accounted for by the other predictor vari-
ables. Table IV presents the logistic regression
models for moderate and severe verbal aggression;
Table V presents the models for moderate and se-
vere physical aggression. Following backward elimi-
nation, child age was retained as a significant risk
factor in all four models. Younger children were
more likely than their adolescent counterparts to
experience moderate and severe verbal aggression
and moderate physical aggression. Children ages
6–11 years were 2.6 times more likely than both
younger and older children to experience severe
physical aggression.
Maternal depression was related to all types of
discipline, except severe physical. Interestingly,
husband drunkenness and spousal abuse of the
mother, both significantly correlated with maternal
depression, split across the four models, with
drunkenness showing the highest association with
the two moderate levels of discipline, whereas spou-
sal abuse was a significant risk factor for the two
severe categories. (Chi-square analyses examining
the relationship between each set of paired variables
yielded the following: husband drunkenness/spou-
Table III. Chi-square Statistics From Tests for Significant
Associations Between Potential Sociocontextual Risk Factors and
Aggregated Discipline Practices (n⫽499)
Mod Severe Mod Severe
Variable (df) Verb Verb Phys Phys
Mother’s 0.67 9.14* 0.77 10.17*
education (3)
Mother depressed 11.51*** 23.14*** 15.44*** 10.37***
(1)
Spouse abuse of 13.14*** 23.67* 14.98*** 16.75***
mother (1)
Husband’s 3.86 13.56** 5.21 10.22*
education (3)
Husband 9.93** 15.46*** 9.16** 10.34***
drunkenness (1)
No. adults in home 2.73 6.36* 10.19** 9.99**
(3)
No. children in 19.01** 7.18 14.84** 17.82**
home (3)
Village resident ⬍0.53 0.58 0.47 0.61
5 yrs. (1)
Neighbor support 14.45*** 0.14 8.21** 3.24
(1)
Child gender (1) 0.00 0.85 0.05 0.24
Child age (2) 6.61*** 6.96*** 18.92*** 23.66***
Child disobedience 5.02*** 4.17*** 4.59*** 5.78***
(1)
Child health index 0.61 5.10 7.87* 4.40
(2)
*p⬍.05.
**p⬍.01.
***p⬍.001.
442 Hunter, Jain, Sadowski, and Sanhueza
crease in education the likelihood of severe disci-
pline increased by 6%. This means that mothers
with no education were 16.5% more likely than
mothers with 10 or more years to use severe disci-
pline strategies.
Discussion
Although the rates for moderate physical aggression
were somewhat higher in this study than those
found by Segal (1995), the rates associated with se-
vere physical practices were remarkably similar. Our
results from poorly educated women in rural vil-
lages and Segal’s results from middle-class profes-
sionals in metropolitan areas converge to suggest
that physical punishment is currently more preva-
lent in India than in the United States. This finding
may reflect cultural differences between the two
countries as well as the shifting social norms and
child protection laws in the United States that have
corresponded to an increased awareness of child
maltreatment.
To our knowledge, the analyses presented here
are the first to examine the sociocontextual risk fac-
tors associated with child discipline practices in In-
dia. Our hypothesis that boys would receive harsher
discipline than girls was not supported by the data.
sal abuse,
2
⫽28.23 [1] p⬍.0001; husband drunk-
enness/depression [using CES-D cutpoint],
2
⫽
43.04 [1], p⬍.0001; spousal abuse/depression,
2
⫽
20.41, p⬍.0001. In a linear regression model,
depression as a continuous variable was indepen-
dently predicted by both husband drunkenness and
spousal abuse, F⫽50.62 [2], p⬍.0001, R
2
⫽.17.)
Depressed mothers were approximately twice as
likely as nondepressed mothers to use moderate and
severe verbal aggression and moderate physical ag-
gression. Likewise, mothers who had experienced
spouse abuse were also approximately twice as
likely to have used severe violence with their chil-
dren (OR ⫽1.93 for severe verbal, OR ⫽2.03 for
severe physical). After controlling for the associa-
tion with the other independent variables, high
neighbor support was a risk factor for the use of
moderate verbal aggression. Household crowding
was a significant predictor of moderate physical ag-
gression with a 25% increase in the odds of its use
for every unit increase in the ratio of persons per
room. Finally, maternal education (ordinal variable
with four possible values: no education, 1–6 years,
7–10 years, and ⬎10 years) was significantly associ-
ated with both types of severe discipline, but not
with more moderate practices. The odds ratio of .94
(in both severe models) means that for each unit de-
Table IV. Final Multivariate Logistic Regression Models
Predicting Moderate and Severe Verbal Discipline
Wald
Parameter chi- p⬎chi- Odds
Variable estimate square square ratio
Moderate verbal/
psychological
a
Intercept ⫺1.74 9.67 .0019 —
Child age ⫺0.57 5.92 .0149 0.56
(0–11y ⫽1, 12–17y ⫽2)
Mother depressed (Y/N) 0.65 7.90 .0049 1.92
Husband drunkenness (Y/N) 0.81 8.55 .0035 2.24
Neighbor support 0.10 14.17 .0002 1.10
(lo ⫽1, mod ⫽2, hi ⫽3)
Severe verbal/psychological
b
Intercept ⫺1.42 10.97 .0009 —
Child age ⫺0.71 10.41 .0013 0.49
(0–11y ⫽1, 12–17y ⫽2)
Mother education ⫺0.06 6.58 .0103 0.94
(4 ordinal levels)
Domestic violence (Y/N) 0.66 10.63 .0011 1.93
Mother depressed (Y/N) 0.63 9.46 .0021 1.88
a
Model fit: ⫺2 log L
2
⫽41.1, df ⫽4(p⫽.0001).
b
Model fit: ⫺2 log L
2
⫽50.9, df ⫽4(p⫽.0001).
Severe Child Discipline in India 443
Table V. Final Multivariate Logistic Regression Models
Predicting Moderate and Severe Physical Discipline
Wald
Parameter chi- p⬎chi- Odds
Variable estimate square square ratio
Moderate physical
a
Intercept ⫺0.21 0.13 .7216 —
HH crowding ratio 0.23 11.44 .0007 1.26
No. adults in home ⫺0.34 5.91 .0150 0.71
(4 ordinal levels)
Child age ⫺1.04 18.86 .0001 0.36
(0–11y ⫽1, 12–17y ⫽2)
Mother depressed (Y/N) 0.72 9.01 .0027 2.05
Husbanddrunkenness(Y/N) 0.60 4.47 .0345 1.81
Severe physical
b
Intercept ⫺1.39 15.65 .0001 —
Child age 0.98 21.24 .0001 2.60
(6–11y ⫽2, others ⫽1)
Mother education ⫺0.06 7.25 .0071 0.94
(4 ordinal levels)
Domestic violence (Y/N) 0.74 14.43 .0001 2.09
a
Model fit: ⫺2 log L
2
⫽56.1, df ⫽5(p⫽.0001).
b
Model fit: ⫺2 log L
2
⫽47.1, df ⫽3(p⫽.0001).
Unlike recent findings in China (Ho, 1996; Tang,
1998; Wu, 1996), our data revealed no sex differ-
ences for any type of discipline. The finding that
both verbal and physical aggression varied by child
age was not surprising. Straus and Gelles (1990)
found that approximately 80% of American chil-
dren between the ages of 7 and 10 years experience
at least one act of parental physical aggression each
year, compared with about 50% of children be-
tween the ages of 11 and 14 years. Similarly, in a
study of age trends related to parenting practices
and conduct problems, Frick, Christian, and
Wooten (1999) found corporal punishment to be
most strongly associated with conduct problems in
the middle age group (9–12-year-olds). Age effects
for discipline practices were also noted in a recent
study in China where Tang (1998) reported that
3–6-year-olds were the most likely to experience mi-
nor and severe physical punishment; 7–12-year-olds
were second-most likely, followed by 0–2-year-olds
with 13–16-year-olds the least likely to be physically
disciplined. There are several possible explanations
for finding that preschool and school-age children
are the major recipients of harsh punishment. If dis-
cipline practices have the hoped-for result of effec-
tively socializing children to meet their parents’
expectations, children will have fewer problems in
later years that require parental discipline. Severe
verbal aggression may be used more with younger
children because, being more naı
¨ve, they may be
easier to frighten with threats of abandonment or
ghosts and spirits. On the other hand, severe physi-
cal discipline may be considered too harsh for the
youngest group of children. Disobedience, which
was significantly associated with every type of disci-
pline in the univariate analyses, may be correlated
with child age, thus losing its significance in the
multivariate models.
We found that husband drunkenness, spouse
abuse of the mother, and maternal depression were
interrelated and also independently associated with
discipline practices. These relationships may reflect
family patterns of response to conflict. It is also con-
ceivable that mothers who must endure their hus-
band’s drunken or violent behavior may redirect
their anger and frustration toward safer targets,
their children. Our finding that depression was as-
sociated with all but the most severe forms of physi-
cal discipline are similar to those of Zuravin (1989)
who found, in a U.S. study, that moderately but not
severely depressed mothers were more likely to be
physically violent, and both moderately and se-
verely depressed mothers were at increased risk for
disciplining with verbal/symbolic aggression. We
did not differentiate between moderately and se-
verely depressed mothers but used the standard
CES-D (Radloff, 1977) cutpoint to classify mothers
as depressed or not. Based on this cutpoint, more
than half of the mothers in our sample could be
described as depressed. Although we are not aware
of prior use or validation of the CES-D in India, oth-
ers have reported that Radloff’s cutpoint may over-
estimate depression in women from other cultures
(Noh, Avison, & Kaspar, 1992; Salgado de Snyder,
Cervantes, & Padilla, 1990). Yet the primary interest
of our study was not examining rates of depression,
but rather the association between depressive symp-
toms and child discipline practices, a relationship
that seems complex but undoubtedly present.
Low maternal education was an independent
risk factor for the severest forms of discipline. This
finding is consistent with study results in the
United States and elsewhere that show low mater-
nal education to be associated with reported child
abuse (Kotch et al., 1995), physical punishment
(Kelley, Power, & Wimbush, 1992), and attitudes to-
ward physical punishment (Oasim, Mustafa, Ka-
zem, & Shah, 1998). Separate analyses of our Indian
data revealed that low maternal education is also a
risk factor for spousal violence. These results suggest
that increased educational opportunities for women
may have the added benefit of reducing tolerance
for husband drunkenness and spouse abuse, while
concomitantly reducing the mother’s propensity for
using severe discipline methods with her children.
The finding that severe verbal and physical dis-
cipline practices are associated with particular risk
factors, namely, low maternal education and physi-
cal abuse from her husband, argues that these prac-
tices are not necessarily normative for India. This
conclusion is also supported by the qualitative data
derived from the preliminary focus groups. While
severe discipline practices may have unique risk fac-
tors and may not be considered appropriate by
mothers, the most compelling evidence that such
practices are “abusive” and thus requiring societal
intervention, is their harmful impact on children.
Segal’s study on neglected, destitute, and runaway
children housed at a residential facility in Bombay
revealed that at least half of the children experi-
enced physical abuse in their families of origin.
Aside from the early clinical studies documenting
injury from severe cases of child maltreatment, Seg-
al’s may be the only study from India that raises the
444 Hunter, Jain, Sadowski, and Sanhueza
that there may not be widespread differences in
child-rearing beliefs and practices across regions of
India. Our large multiregion collaborative study
currently under way will reveal the extent to which
rates of moderate and severe discipline practices are
comparable across regions, as well as clarify the role
of specific risk factors.
Yet despite the limitations, these study results
contribute to a growing knowledge base suggesting
that Indian children may be subjected to psycho-
logical and physical abuse within the context of pa-
rental discipline or socialization. Although further
research is needed to establish national prevalence
rates and to enhance our understanding of the etiol-
ogy and consequences of child maltreatment in
India, a strong argument could be made that ad-
dressing some of the risk factors identified in this
study (specifically spouse abuse, alcohol abuse, and
low education for women) would reap many bene-
fits for Indian society, including the healthy growth
and development of its children.
Acknowledgments
Support for this research was provided by OXFAM
(India) Trust, Ref. # Mah 229 A6. We thank the In-
ternational Clinical Epidemiology Network for help
in the development of this project, the Nagpur In-
diaSAFE field staff who collected the data, and the
mothers who made the study possible by freely
sharing about their daily lives.
Received March 10, 1999; revisions received Septem-
ber 30, 1999; accepted October 5, 1999
teraction between childhood temperament and paren-
tal discipline practices on behavioral adjustment in
preadolescent sons of substance abuse and normal fa-
thers. American Journal of Drug and Alcohol Abuse, 22,
335–348.
Brown, J., Cohen, P., Johnson, J. G., & Salzinger, S. (1998).
A longitudinal analysis of risk factors for child mal-
treatment: Findings of a 17-year prospective study of
officially recorded and self-reported child abuse and
neglect. Child Abuse & Neglect, 11, 1065–1078.
Cicchetti, D., & Lynch, M. (1993). Toward an ecological/
transactional model of community violence and child
maltreatment: Consequences for children’s develop-
ment. Psychiatry, 56, 96–118.
issue of negative consequences for children who are
disciplined harshly. Prevalence studies are still
needed to document the magnitude of the problem
of child physical and psychological abuse across In-
dia; studies are also needed that examine the impact
on children’s physical, social, and emotional well-
being.
Limitations of Study
Several important limitations of this study must be
noted. Both the predictor and outcome variables
were measured by maternal self-report. Shared
method variance and shared source variance may
have enhanced the probability of finding signifi-
cant relationships. True estimations of the severity
of discipline practices were limited by our measure-
ment techniques. Frequency is not assessed. Also,
there are the problems inherent in dichotomous
classification of behaviors. In this case, one might
argue that only a very fine line separates using a
stick to hit a child on the buttocks and hitting else-
where. In fact, the categorization of almost all the
dependent variables requires choosing cutpoints
that may or may not optimize the detection of ef-
fect because analysis of the full variability of the
data is precluded. On the other hand, effects are not
always linear, as was demonstrated in the analysis
of child age.
Finally, because India is a vast country con-
sisting of multiple cultures and linguistic groups,
the generalizability of these findings from rural vil-
lages in central India to the rest of India is specula-
tive. The similarity of these results and those of
Segal’s (1995) study of urban professionals suggests
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