key: cord-0073216-xfa3o4l4
authors: Thor, Pa; Yang, Sejung; Park, Yangjin
title: Child Maltreatment in Asian American and Pacific Islander Families: The Roles of Economic Hardship and Parental Aggravation
date: 2022-01-08
journal: Int J Child Maltreat
DOI: 10.1007/s42448-021-00111-8
sha: c9260788364441cefaf0e16f923b9eb4499eabaa
doc_id: 73216
cord_uid: xfa3o4l4

Parents face various stressors in their daily lives, and their child discipline practices are likely to be affected by the stressors. Existing research suggests that parental stress is a significant contributor to child maltreatment, but more research is needed, particularly among Asian American and Pacific Islander (AAPI) families. This study examined the relationship between economic hardship and aggravation in parenting and three types of child maltreatment (i.e., psychological aggression, physical assault, and neglect) in AAPI families through secondary data analysis of a longitudinal de-identified data set. This study analyzed a sample size of 146 AAPI children, with mothers as the primary caregiver. Economic hardship was positively associated with psychological aggression (β = 3.104, p < .01) and physical assault (β = 1.803, p < .05). Aggravation in parenting was positively associated with neglect (β = 0.884, p < .05). The findings suggest that AAPI parents are more likely to use certain child maltreatment methods when they experience specific stressors. Researchers and practitioners should consider the various stressors that AAPI families face and how other social or economic challenges can compound these stressors.

dissatisfaction, lack of social support) can cause parents to experience emotional distress. Specifically, parenting stress is the perceived demands of parenting and perceived available resources (Abidin, 1997) . Parenting stress results from various child-related (e.g., demandingness and distractibility/hyperactivity) and parent-related (e.g., sense of competence and emotional functioning) characteristics, which subsequently contribute to the overall pressure a parent may feel in their parenting role (Yoon, 2013) . Other child characteristics such as negative temperament and a lack of adaptability can likely contribute to parental stress. How a parent responds to these stressors can impact their parenting and the interactions towards their child. Parenting is both a predictive and protective factor in adolescent outcomes (Choi et al., 2017) .

Asian immigrant parents who experience a high level of parenting stress are less likely to engage in positive parent-child interactions and more likely to demonstrate negative parenting behaviors, increasing the risk of child abuse (Yoon et al., 2021) . Asian American and Pacific Islander parents are known to endorse strict and assertive parenting styles and often use corporal discipline; as a result, their parenting style may result in child maltreatment, such as physical abuse. Additionally, Asian American and Pacific Islander parents are inextricably linked to their immediate and extended families, frequently relying on them for child-rearing support. Parents of AAPI origin who lack the necessary familial support are more likely to perceive situations as stressful, resulting in negative parenting behaviors.

This model assumes that all factors have equal potential concerning the total stress load. Although our primary interest in the current analyses is in the influence of aggravation and stress in parenting, guided by this framework, we also consider the factors-child, parent, and situational factors-in our analyses. Together, these stressors determine the overall level of parenting stress parents experience.

Child maltreatment is, in general, categorized into four types: neglect, physical abuse, emotional abuse, and sexual abuse (U.S. Department of Health and Human Services, 2021). According to the U.S. Department of Health and Human Services (2021), the most common child maltreatment is neglect, followed by physical discipline. Neglect is defined as the failure of caregivers to provide necessary care for a child or meet their basic needs (Font & Berger, 2015; Schumacher et al., 2001) . Many perpetrators are a parent or guardian to the child victim. Children who experience child abuse and neglect may suffer from adverse long-term physical or psychological outcomes, including depression during adolescence and later adulthood (Brown et al., 1999; Widom et al., 2007) . Additionally, children who experienced physical abuse during childhood are at an increased risk of perpetrating child maltreatment later as parents (Greene et al., 2020) . Although child maltreatment is broad and encompasses many forms, due to the sensitivity of acquiring sexual abuse data, the scope of this study focuses on neglect, physical assault, and psychological abuse.

Families experience economic hardships when they have too few economic resources at any given time. Economic hardship is not solely the result of an individual's actions but also external forces (i.e., recession, viral pandemic). Families undergoing economic hardships also experience stress in varying intensity and duration. Conrad-Hiebner and Byram (2020) report that income losses, food insecurity, and housing and bill paying hardships predict child maltreatment and neglect. Studies that have explored the relationship between stress and child maltreatment conclude that economic difficulties are correlated with a higher frequency of child discipline (Farrington, 1986; Jackson et al. 1998) . Poverty is a risk factor for the abuse or neglect of children because rates of child maltreatment are higher among families whose income falls below the poverty line (Waldfogel, 1998) . Parents in economically disadvantaged communities had more positive attitudes toward using physical discipline (Pei et al., 2020) . Compared to other forms of child maltreatment, parents' socioeconomic status is negatively associated with child neglect (Petersen et al., 2014) . Pelton (1994) reported that the quality of care and discipline parents provide to their children may be inadequate as they experience economic hardships. In addition, heightened parenting stress and depression can be brought on by economic pressure, increasing harsh parenting, and child maltreatment (Conger et al., 1992; Yang, 2015) .

Parental aggravation is defined as perceptions and experiences of strain and intolerance of caregivers toward caring for a child (Guo, 2015; Herbell et al., 2020; Yu & Singh, 2012) . Parental aggravation is a vital risk factor for child abuse and neglect (Mikolajczak et al., 2018) . Among AAPI families, there is a strong positive relationship between parenting stress and the risk of child maltreatment (Yoon, 2013) . Immigration and the associated challenge of transitioning to a new, sometimes aggressive, social setting are highly stressful experiences (Lum, 1998) . Most recently, during the COVID-19 pandemic, Asian Americans report facing higher instances of racism and discrimination, leading to elevated stress and aggravation (Cheah et al., 2020; Chen et al., 2020; Litam, 2020) . In addition, immigrant and ethnic minority families experience stress and aggravation due to the many hardships related to economic, health, acculturation, access to public services, and challenges of English proficiency (Yu & Singh, 2012) .

While AAPIs are the fastest-growing population in the USA (Budman & Ruiz, 2021) , there is a lack of research on child maltreatment in the AAPI community (Hom, 2018) . Although AAPI families demonstrate a relatively lower prevalence of child protective services (CPS) involvement than other racial/ethnic groups, variability exists in different AAPI ethnic groups (Finno-Velasquez et al., 2017) . Specifically, among AAPI families of children born in California in 2006 and 2007 (N = 138,858) , Pacific Islander and Southeast Asian groups were at higher risk of reporting to CPS than other AAPI groups (Finno-Velasquez et al., 2017) . Research has indicated that AAPI children are more likely to die from physical maltreatment than White children and physical abuse was higher among AAPI families than the national average (Dakil et al., 2011) .

Child maltreatment reporting laws and interventions do not account for the variations in child-rearing among multicultural populations (Zayas, 1992) . As a result, child maltreatment and its consequences are not often addressed within the individual norms and culture. Standards concerning acceptable child-rearing and punishment vary by culture and may have evolved to reflect the necessities of the group. For example, Asian parents have typically used authoritarian parenting styles and corporal punishment (Hahm and Guterman, 2001; Pei et al., 2020) . Several different factors, including environmental, stress, physical, social, intellectual, and emotional functioning of caregivers and children, provide conditions for individuals to move beyond culturally sanctioned levels of physical discipline (Gil, 2014) .

There is a need to examine the association between types of stress (e.g., economic hardship and aggravation in parenting) and varied types of child maltreatment among AAPI families. Economic hardship and aggravation in parenting have been examined to contribute separately or jointly to child maltreatment among minority groups (Cardoso et al., 2010; Yu & Singh, 2012) . However, it is still unclear whether parental aggravation and economic hardship are equally associated with various types of child maltreatment. Therefore, this study seeks to explore the following research question: What is the association between stressors (i.e., economic hardship, aggravation in parenting) and the types of child maltreatment (i.e., psychological abuse, physical assault, neglect) among Asian Americans and Pacific Islander families? The following hypothesis guides the current study: Economic hardship and aggravation in parenting are positively associated with the three types of child maltreatment (i.e., psychological abuse, physical assault, neglect).

The study conducted a secondary data analysis of the Fragile Families and Child Well-being Study ([FFCWS], 2021), which follows a cohort of nearly 5000 children born in US cities between 1998 and 2000 (Reichman et al., 2001) . Due to oversampling of unmarried mothers, the FFCWS includes many vulnerable children and their families regarding socioeconomic status, race/ethnicity, and marital status (FFCWS, 2021) . The data set also provides various socioeconomic and psychological variables, including economic hardship and aggravation in parenting, allowing for adequate analysis of stressors of abusive parenting. Data for the present study comes from wave 5, collected when the children were 9 years old between 2007 and 2010. If not asked at year 9, some demographic information on the participants was drawn from the baseline data set. The study sample only included children from Asian or Pacific Islander families for this study. Biological mothers and fathers were asked which racial identity best describes their race (with response options including White, Black, Asian or Pacific Islander, and American Indian). If either parent reported being Asian or Pacific Islander, they were included in the study. After excluding cases with missing information on all independent variables, the present study has a sample size of 146. This study was exempt from IRB approval because it analyzed broadly available, de-identified data from the Fragile Families and Child Well-being Study ([FFCWS], 2021).

This study used 15 of the 22 items on the Parent-Child Conflict Tactics Scales (CTSPC; Straus et al., 1998) to assess primary caregivers' child maltreatment. The CTSPC was established to address limitations of the original Conflict Tactics Scales (CTS), which was developed to measure interpersonal violence within the context of intimate relationships (Straus et al., 1998) . Thus, child maltreatment in this study encompasses physical and psychological abuse and neglect. The scores for each item ranged from 0 to 7, with higher values demonstrating more frequent incidents in the past year.

The primary caregivers were asked five questions about spanking, pinching, shaking, slapping, and hitting with a hard object. The example items include "slapped him/her on the hand, arm or leg," and "hit him/her with a fist or kicked him/her hard." Cronbach's alpha based on the entire sample was 0.70 (N = 3007; Bendheim-Thoman Center for Research on Child Wellbeing, 2013), and the alpha of this study sample was 0.68.

Psychological Aggression Five items measured psychological aggression. Examples are whether parents "shouted, yelled, or screamed at him/her" and "threatened to spank or hit him/her but did not actually do it." The alpha based on the entire sample was 0.62 (N = 3180; Bendheim-Thoman Center for Research on Child Wellbeing, 2013), and the alpha of this study sample was 0.77.

Neglect Neglect was measured by five items, including physical and supervisory neglect (Font & Berger, 2015) . Physical neglect was measured by two items about caregiver omissions or failures to offer for a child's basic needs (e.g., food and nutrition and medical care, or education). For example, participants were asked whether they "were not able to make sure [their] child got the food he/she needed." Supervisory neglect was measured by three items asking primary caregivers about situations where a parent does not adequately care for a child. An example item is "too intoxicated or too preoccupied with their problems to care for a child." An example of supervisory neglect includes asking whether they "had to leave your child home alone, even when [they] thought some adult should be with him/her." The alpha based on the entire sample is 0.57 (N = 3289; Bendheim-Thoman Center for Research on Child Wellbeing, 2013), and the study sample was 0.45. The low alpha coefficient may be explained by the heterogeneity of the items covering different child neglect experiences (Mulder et al. 2018) . The even lower alpha of the AAPI community is consistent with previous research. A cross-cultural study on the measurement quality of a neglect scale indicated that the internal consistency is wide-ranging across geographical regions, and the lowest alpha coefficients were found among Latin America, the Middle East, and Asia countries (Straus, 2006) .

Economic hardship was measured by ten dichotomous questions derived from the Survey of Income and Program Participation (Bauman, 1998 . Mothers were asked about the situations where they encountered specific financial problems. Example items include whether in the past 12 months, mother "borrowed money from friends or family to pay bills and had trouble with," "having stable housing (e.g., was there any time when you did not pay the full amount of the rent or mortgage?)." The ten dichotomous items were summed.

Aggravation in parenting was measured by four questions from the Child Development Supplement of the Panel Study of Income Dynamics (Primary Caregiver of Target Child Household Questionnaire for the Child Development Supplement to the Family Economics Study (PSID), 1997). The questions are scored on a 4-point scale, ranging from "1 = strongly agree" to "4 = strongly disagree." Item examples are "finding that taking care of their child(ren) is much more work than pleasure," and "feeling trapped by my responsibilities as a parent." For the current study, Cronbach's alpha was 0.62. However, as Cronbach's alpha is quite sensitive to the number of items in the scale, Pallant (2007) suggests alphas greater than or equal to 0.5 can be considered acceptable if the number of items on the scale is less than ten.

Along with the socio-demographic variables, this study included foreign-born status (Zhai & Gao, 2009 ) and family structure (Oliver et al., 2006) which were reported to be associated with child maltreatment. A prior study reported that fewer risks and lower CPS involvement rates were found among foreign-born mothers than US-born AAPI mothers (Finno-Velasquez et al., 2017) . Additionally, relatively higher levels of aggravation in parenting were found among immigrant and minority families (Yu & Singh, 2012) .

Stata version 14 (StataCorp, 2015) was used for data cleaning, and Mplus version 7 was used for the main analysis (Muthén & Muthén, 2012) . A descriptive analysis was conducted for prevalence rates. Correlation analysis was performed to examine the association between variables. Lastly, a series of multiple regression analyses were conducted to examine the factors associated with three types of child maltreatment (i.e., psychological abuse, physical assault, neglect).

Table 1 presents sample characteristics (N = 146). Table 2 presents the correlation coefficients of the variables. Table 3 presents the estimates of the coefficients of the series of multiple regression models controlling for covariates. Regarding Asian child maltreatment, the squared multiple correlations for the endogenous variables indicate that the model accounts for 21.7% of the variance of the psychological aggression, 12.9% of physical assault, and 15.4% of neglect. The results of model 1 showed that economic hardship was positively associated with psychological aggression (β = 3.104, p < 0.01), and age was negatively associated with psychological aggression (β = − 0.562, p < 0.05). Model 2 presented that economic hardship was positively associated with physical assault (β = 1.803, p < 0.05). Model 3 presented that aggravation in parenting was positively associated with neglect (β = 0.884, p < 0.01).

Child maltreatment among AAPI families remains understudied (Finno-Velasquez et al., 2017; Hom, 2018) . Although economic hardship and aggravation in parenting have been documented to lead to child maltreatment, they are not often explored as potential stressors that could lead to child maltreatment among AAPI families. Guided by the family stress model, this study examined the association between two stressors (e.g., economic hardship, aggravation in parenting) and the types of child maltreatment in AAPI families. Overall, when the primary caregivers report experiencing economic hardship, they are also more likely to report using psychological and physical abuse toward their children. In addition, primary caregivers experiencing aggravation in parenting were more likely to report neglect toward their children. Details are discussed below.

Economic hardship is a social determinant of health that can lead to severe forms of child maltreatment by parents (i.e., psychological aggression and physical assault). Our findings are in line with a systematic review that shows that economic hardship increases family stress, leading to harsh parenting and child maltreatment (Conrad-Hiebner & Byram, 2020) . Among ethnic minorities, low SES is associated with psychological distress, leading to less positive parenting (Emmen et al., 2013) . The "spillover effect" from economic hardship might increase the risk of parents practicing violent behavior toward their children (Jones et al., 2021) . Despite the stereotype of model minority, due to relatively high socioeconomic status among Asian Americans in general (Ishii-Kuntz et al., 2010) , their socioeconomic status can vary. Thus, it is essential to investigate the impact of economic hardships which may lead to psychological and physical abuse among AAPI families. Although the average income in our study sample was approximately $65,000, which is a higher average household income than the general US population, it should be noted that the income varies among AAPI families. For instance, the average annual income varies between subgroups of Asian Americans, varying from $44,000 to $119,000 (Budman & Ruiz, 2021) . Similarly, our study sample's income varies from $0 to $450,000 among AAPI mothers in this study; experiencing some form of economic hardship is associated with the use of psychological aggression and physical assault toward their children.

Furthermore, our study findings indicate that parental aggravation is likely associated with child neglect. Parenting stress may increase due to repeated and increased demands related to their children's needs. Although, in general, caregivers experiencing high parenting stress were more likely to engage in psychological aggression, corporal punishment, and neglect of their children (Xu et al., 2020) , aggravation in parenting was particularly associated with neglect among children of AAPI families. AAPI mothers experiencing strain and intolerance toward caring for a child are likely to provide inadequate protection or be unable to meet their children's minimum needs, meaning neglect of their children. Parental burnout, which is the outcome of chronic parenting stress, is also reported to be associated with parents' neglectful and violent behaviors toward their children (Mikolajczak et al., 2018) . Thus, neglect may be caused in part by caregivers who experience aggravation in parenting and, in turn, are not capable of meeting their children's needs. Parenting can be a great experience and a stressful job (Mikolajczak et al., 2019) . Parenting necessitates a constant responsibility, and when parents become stressed, they may have difficulty performing parenting activities and display negative attitudes toward their children.

First, the FFCWS data set did not disaggregate study participants by Asian or Pacific Islander ethnic subgroups. Our sample includes families who self-identify as AAPI.

Families were included in the analysis if at least one parent reported an AAPI racial background; thus, these families were identified as AAPI, and the possibility of including multiracial families cannot be ruled out. Due to the heterogeneity of Asian populations, researchers have suggested that there is a need for research on Asian Americans disaggregated by racial/ethnic subgroups, which may uncover crucial differences in characteristics among Asian-American subgroups (Stella et al., 2016) . One study reported significantly different prevalence estimates for AAPI subgroups in health conditions and risks from those for the aggregated group (Gordon et al., 2019) . To date, the lack of disaggregated data and the model minority stereotype on Asian Americans has resulted in the exclusion of Asian American populations from consideration of public health funding and programming (Stella et al., 2016) . Notably, the AAPI community consists of about 40 heterogeneous subgroups regarding language, cultural and religious background, socioeconomic status, and immigration/migration history (Litam, 2020) . Thus, future research should explore child maltreatment risk factors and protective factors among AAPIs using disaggregated data set by ethnic subgroups. Next, while the FFCWS includes a large and national sample, it is not representative of AAPIs in the USA as the FFCWS samples disproportionately include individuals in nonmarital relationships to address issues regarding nonmarital childbearing (Reichman et al., 2001) . Thus, our findings may be applicable to this sample. Third, as AAPI immigrant families integrate into Western society, they undergo enculturation and acculturation, gradually losing both collectivist and family-oriented aspects of their cultures. First-generation Asian Americans, who are strongly connected to their culture, may be hesitant to disclose stress or seek assistance from others. Around 44% of our sample fell into the first-generation category. Acculturative stress can occur due to the pressure to maintain a balance between the parent's own culture and the dominant culture. Future research should examine acculturative stressors as potential risk factors for child maltreatment in AAPI families. Fourth, the low Cronbach's alpha of neglect representing the relatively low measurement reliability of the measure poses a limitation. Fifth, due to limited data variables, sexual abuse was not included in the subcategory of child maltreatment despite its significance. Thus, future research should investigate the relationship between economic hardship and aggravation in parenting and sexual abuse. Additionally, social desirability biases might have affected the primary caregivers' responses about child maltreatment. Finally, we used cross-sectional data when the children were 9 years old, so we cannot infer causality. Future research should utilize longitudinal data to examine temporal ordering.

Practitioners should not lose sight of both the intrapersonal and social factors leading to child maltreatment. Economic hardship and aggravation in parenting can impose added stress on existing social stressors affecting the individual's parenting practices. Hence, effectively helping parents cope with economic stressors can improve parenting and reduce physical discipline or abuse (Fontes, 2002) . The social support that parents receive can ameliorate their parenting stress, such that low social support and low partner support were found to be related to higher levels of stress (Cardoso et al., 2010) . AAPI parents may interact with children differently when experiencing different stressors. As shown in this study, experiencing economic hardship or parental aggravation is likely to result in various forms of child maltreatment. However, resources for families can negate stressors from parental aggravation and economic hardship. These resources and support can come from the other parent or extended family because many AAPI families reside in intergenerational households or closeknit communities (Cross, 2018) . Conversely, foreign-born parents' extended family members may reside in their country of origin, leaving them with less social support from their families. In our data, 44.5% of the mothers were foreign-born, meaning that fewer resources may come from their extended families, and the possible presence of acculturation difficulties and language barriers among mothers resulting in additional stress, influencing their parenting practices. Thus, it is important to access available resources among AAPI families considering their heterogeneity. The presence of different stressors among AAPI families points to the need for culturally competent interventions from practitioners to make engagement with AAPI families more equitable. Child-rearing is highly influenced by ethnic culture, and familial factors may mitigate the impact of specific stressors (Fontes, 2002) . AAPI families have various cultural and environmental factors such as socioeconomic status and a relatively high acceptance of corporal discipline as a form of social control within some Asian cultures that can be utilized in interventions to address child maltreatment (Lum, 1998) . In this context, community values and norms must be considered and accessed for intervention with cultural humility. Specifically, it is important to understand and address the underlying problems beyond child maltreatment.

The authors declare no competing interests.

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