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Family Risk Factors Associated With Aggressive Behavior in Chinese Preschool Children
Journal of Pediatric Nursing (2016) xx, xxx–xxx
Family Risk Factors Associated With Aggressive Behavior in Chinese Preschool Children Shoumei Jia PhD a , Ling Wang PhD b,⁎, Yingjuan Shi MB c , Ping Li BN d a
School of Nursing, Fudan University, Shanghai, P.R.C. School of Public Health, Fudan University, Shanghai, P.R.C. c Putuo Mental Health Centre, Shanghai, Shanghai, P.R.C. d Nursing Department, Putuo Mental Health Centre, Shanghai, P.R.C. b
Received 19 August 2015; revised 8 August 2016; accepted 8 August 2016
Keywords: Aggression; Aggressive behavior; Family risk factor; Parenting style; Preschool children
Purpose: The study explored family predictors of aggressive behavior in preschool children in China. Design and Methods: Using a stratified cluster sampling method, 1382 preschool children were recruited from ten kindergarten schools in Shanghai, China. Their parents completed the Child Behavior Checklist (CBCL)-aggression subscale, the Parent Behavior Inventory, the Family Environment Scale, and a demographic questionnaire. Results: The mean age of the 1382 children was 4.97 years (SD = .88), with 55.1% (762) boys, and 44.9% (620) girls. According to the CBCL, the prevalence of aggressive behavior in preschool children was 12.4%. Multivariate logistic regression analysis showed that family conflicts (OR = 1.231, 95% CI: 1.115–1.360), hostile/coercive parenting (OR = 1.083, 95% CI: 1.051–1.116), inconsistent parenting between grandparents and parents (OR = 1.658, 95% CI: 1.175–2.341), and more time spent watching TV (OR = 1.999, 95% CI: 1.568–2.550) significantly predicted aggressive behavior of children. Conclusions: Children with more family conflicts who experience hostile/coercive parenting were more likely to engage in aggressive behavior. Moreover, inconsistent parenting attitudes between grandparents and parents, and excessive TV exposure also contributed to childhood aggression. Given that the results of this study show a high prevalence of aggressive behavior in preschool children, future research must pay greater attention to this aspect. Practice Implications: Family risk factors identified as relevant to children's aggression in this study provide avenues to develop family-focused strategies for curbing aggression in preschool children. © 2016 Elsevier Inc. All rights reserved.
Aggression can be defined as a behavior that is intended to hurt, harm, or injure another person (Dodge, Coie, & Lynanl, 2006). Aggressive behavior has been identified as a serious mental health issue in young children in both western and eastern cultures (Chen, Chen, Wang, & Liu, 2002; Harachi et al., 2006; McNamara, Selig, & Hawley, 2010; Valles & Knutson, 2008; Vitaro, Barker, Boivin, Brendgen, & Tremblay, 2006).
⁎ Corresponding author. Ling Wang, PhD. E-mail address: [email protected]. http://dx.doi.org/10.1016/j.pedn.2016.08.001 0882-5963/© 2016 Elsevier Inc. All rights reserved.
From a developmental perspective, childhood aggression is a significant phenomenon due to its high stability, as it can last to adulthood, and its robust and pervasive effects on long-term outcomes, such as poorer psychosocial functioning (Huesmann, Dubow, & Boxer, 2009). Previous studies have demonstrated that early aggressive behavior can have adverse consequences, such as poor physical and psychological health, negative effects on social development, adolescent behavioral disorders, and crimes in adulthood (Chen et al., 2002; Harachi et al., 2006; Huesmann et al., 2009; Valles & Knutson, 2008). Population-based investigations have shown that a high level
2 of aggressive behavior results in high social costs (due to high rates of service use for the treatment of psychiatric disorders, delinquency, incarceration, and unemployment) and impaired family functioning, even as early as preschool years (children aged six years or younger) (Huesmann et al., 2009; Raaijmakers, Posthumus, van Hout, van Engeland, & Matthys, 2011; Serbin, Temcheff, Cooperman, et al., 2011). Therefore, in order to promote adequate child development, family functioning, and social stability, it is important to identify factors that may promote aggressive behavior during childhood. Family environment plays an important role in the development of children's aggressive behavior (Andreas & Watson, 2009; Cummings, Goeke-Morey, & Papp, 2004; Ehrenreich, Beron, Brinkley, & Underwood, 2014; Jester et al., 2005; Yu, Shi, Huang, & Wang, 2006). It has been found when studying preschool children and school children, that family conflict and lack of family cohesiveness predict a developmental trajectory toward aggressive behavior (Jester et al., 2005; Litrownik, Newton, & Hunter, 2003). In contrast, school children who were exposed to positive family environments, including fewer family conflicts and more family cohesion, were less likely to develop aggressive behavior or have reduced levels of aggression, even when they had high aggressive beliefs or hostile cognitions (Andreas & Watson, 2009; Yu et al., 2006). Yu et al. (2006) used the Child Behavior Checklist (CBCL) on a sample of 4010 school children and found that children raised in more intellectual and recreational environments were less likely to develop aggressive behavior. While supportive/engaged parenting is correlated with positive outcomes regarding children's behavior and a lower likelihood of acting aggressively (Crick & Dodge, 1994), several studies have emphasized the relationship between hostile/ aversive parenting and children's aggressive behavior (Braza et al., 2015; Chang, Schwartz, Dodge, & McBride-Chang, 2003; Vitaro et al., 2006). It has been proposed that supportive/engaged parenting approaches include warm, supportive, sensitive, responsive parenting; parental involvement; and parental monitoring (Beyers, Bates, Pettit, & Dodge, 2003; O'Connor, 2002), while hostile/aversive parenting are often characterized by harsh discipline, frequent use of physical punishment, verbal assaults, punitive/non-reasoning strategies, hostile parental control, and low levels of parental warmth (Braza et al., 2015; Vitaro et al., 2006; Xu, Farver, & Zhang, 2009). Hostile/Aversive parenting is a significant contributor to aggressive behavior in early childhood (Benzies, Keown, & Magill-Evans, 2009; Cote, Vaillancourt, Barker, Nagin, & Tremblay, 2007; Nelson, Hart, Yang, Olsen, & Jin, 2006; Tremblay et al., 2004; Vitaro et al., 2006; Yu et al., 2006). Moreover, children of parents who use highly restrictive and controlling parental styles also demonstrate more aggressive behavior (Braza et al., 2015; McNamara et al., 2010). Studies often describe Chinese parents as more controlling or authoritarian than their western counterparts (Chan, 2010; Pearson & Rao, 2003). Studies in China have indicated that
S. Jia et al. authoritarian parenting was positively correlated with aggressive behavior in children (Chan, 2010; Chang et al., 2003; Chen et al., 2002; Nelson et al., 2006). However, more detailed information regarding Chinese parenting styles and its contribution to children's aggression is still needed. Other family characteristics, such as family structure, parenting consistency, education, and parental occupation, might also have an impact on children's aggressive behavior. It was reported that children living in single parent family received higher scores of aggression than children living in a nuclear family (Ehrenreich et al., 2014; Yu et al., 2006). Studies also revealed that parental consistency between family members was related to the development of aggressive behavior in Chinese children (Nelson et al., 2006; Yu et al., 2006). Moreover, Yu et al. found that there was a higher incidence of aggression among children whose mothers' education level was lower, and whose parents were engaged in manual labor, while children whose parents had a higher level of education, parents engaged in intellectual work, and lived in high-income families, had lower CBCL aggression scores (Yu et al., 2006). It was also reported that more TV exposure increased young children's risk of aggressive behavior (Manganello & Taylor, 2009). The relationship between family characteristics and preschool children's aggression requires further exploration. Only a few studies in China have addressed the relationship between family contextual factors and aggressive behavior in preschool children. There is limited empirical evidence as to the influence of family factors on children's aggression. This study explored family risk factors associated with aggressive behavior within a sample of preschool children. The results provide a theoretical foundation for the prevention and intervention of childhood aggression.
Methods Participants Using a stratified cluster sampling method, eight public kindergartens and two private kindergartens in six districts of Shanghai, China were chosen. In each kindergarten, children from two first-year classes, two second-year classes, and two third-year classes were recruited, and their parents (who were the children's primary caregivers) were also invited to participate in this study. Inclusion criteria for children were those aged between three and six years, and living in Shanghai. Exclusion criteria for children were those with severe physical disease or mental disease diagnosis. Approximately 1700 children were introduced to the study, and questionnaires were distributed to their parents. Parents who completed the questionnaires completely and effectively (N = 1382, 81.29%) were included in the analysis. Of the 318 questionnaires that were excluded from the sample, 216 were not returned from parents and 102 were returned with more than half of the questions not answered because these parents did not have the desire to complete it. Participants included in final analysis comprised 476 (34.4%) first-year children, 416 (30.1%) second-year children, and 490 (35.5%) third-year children.
Family Risk Factors of Children’s Aggression
Procedure Written consent from the administrators of the ten kindergartens was obtained before the study, and teachers were asked to arrange two group meetings for the study. Children's parents were invited to come to the classes for each group meeting that lasted for approximately 45 minutes. During the first group meeting, the purpose and procedures of the study were explained to the parents, and written consents were obtained prior to data collection. Parents were assured of the confidentiality of their responses, and parents were told they could withdraw themselves and their children from the study at any time without penalty. Questionnaires including the CBCL-aggression subscale “parents' form,” Parent Behavior Inventory (PBI), Family Environment Scale (FES), and a demographics questionnaire were distributed and to be completed at home by the children's parents (who were the children's primary caregivers). The CBCL was used to assess preschool children's aggressive behavior and the PBI and FES were used to assess the main features of the children's family system. Questionnaires were returned during the next meeting a week later, and checked by the investigators to ensure that all the questions were answered. Each family was compensated for their participation with a small gift for the children. All questionnaires were tested for psychometric reliability and validity for application with a Chinese sample. The current study was approved by the Fudan University Institutional Review Board and funded by Fudan University (EYF201030).
Measures Measures included the Child Behavior Checklist (CBCL)-aggression subscale, the Family Environment Scale, the Parent Behavior Inventory, and a demographic questionnaire, which were administered in Chinese. Child Behavior Checklist (CBCL) The CBCL is a standardized measure for assessing behavioral problems and social competencies of children aged between 2 and 16 years. It is based on parental reports or other adults who know the children well. The CBCL is a 113-item scale comprised of eight different syndromes scales. Aggressive behavior can be measured by the aggression subscale that assesses the frequency of children's various kinds of aggression (e.g., attacking, threatening, etc.). The CBCL response options range from 0 (never) to 2 (very often), and individual responses are summed to compute a subscale score (Achenbach, 1991). Aggressive children are those whose aggression score are equal to or above the Chinese norm. According to these norms, the cut-off aggression points among boys and girls are 19–20 and 18–19, respectively (Zhang, 2005). In this study, the Cronbach's alpha coefficient for the CBCL aggression subscale was 0.88, and the test–retest reliability coefficient was 0.98. Family Environment Scale (FES) The FES is a standardized measure of family social and environmental characteristics with 90 true/false items. The
3 FES has ten subscales evaluating family characteristics on cohesion, expressiveness, conflict, independence, achievement orientation, intellectual–cultural orientation, active– recreational orientation, moral–religious emphasis, organization, and control, with a score for each scale ranging from 0 to 9 (Moos & Moos, 1994). The FES Chinese version (FES-CV) has good reliability and validity. In this study, the Cronbach's alpha for the FES-CV was 0.75, and test–retest reliability coefficients for the 10 subscales ranged from 0.98 to 1.00. Parent Behavior Inventory (PBI) The PBI was used to evaluate two types of parenting styles: supportive/engaged and hostile/coercive. The PBI is a brief measure that focuses on parenting behaviors, rather than beliefs or attitudes, making it appropriate for behavioral assessments of young children. The PBI's two independent scales have scores that range from 0 to 50. The PBI has sufficient content validity, adequate internal consistency, and acceptable test–retest reliability, and relates to measures of parental affect, parental stress, and child behavior problems (Lovejoy, Weis, O'Hare, & Rubin, 1999). In this study, the Cronbach's alpha for the PBI was 0.67, and the test–retest reliability coefficients for the support/engaged and hostile/coercive dimensions were 0.96 and 0.99, respectively. Parents also reported the age and sex of the children, number of siblings, time the child spent watching TV, family structure, primary caregivers, parents' age(s), education, occupation, household income, parenting consistency between father and mother, and parenting consistency between grandparents and parents.
Statistical Analysis Data were input and arranged in Epidata 3.1 software and analyzed using SPSS 20.0 statistical software. First, means and standard deviations, frequencies, and percentages were calculated for descriptive purposes. Univariate analysis including chi-square tests and correlational analysis were used to determine what family factors were associated with children's aggressive behavior. A multivariate logistic regression was then performed to analyze family predictors of aggression while controlling for demographic variables.
Results Children's Characteristics The mean age of the children was 4.97 years (SD = .88). Of the 1382 children, 55.1% (762) were boys, and 44.9% (620) were girls. Furthermore, 79.9% of the children (1104) were from public kindergartens, and 20.1% (278) were from private kindergartens; 80.8% (1116) were an “only child,” and 19.2% (266) had siblings; and 32.7% (452) watched TV for no more than 1 hour, while 48.8% (674) spent one to two hours watching TV, and 18.5% (256) spent more than two hours watching TV every day.
4
S. Jia et al.
Family Characteristics of Preschool Children The fathers' and mothers' mean ages were 35.75 years (SD = 4.89) and 32.94 years (SD = 4.03), respectively. Furthermore, 63.27% (873) of the families were stem families (children lived with both parents and grandparents), 35.8% (495) of them were nuclear families (children lived with both parents), and 1.0% (14) of them were single parent families. The majority of families (86%) had a household income of more than RMB 5000 (about 800 US dollars) per month. More than half of the parents had more than 12 years of education, and the majority of parents were professional or skilled workers. In most families (84.2%), the primary caregivers were parents, and 15.8% of children lived with their parents but were typically looked after by their grandparents, babysitters, or others. Parenting attitudes between fathers and mothers were highly consistent (91.8%), while parenting consistency between parents and grandparents was only moderately consistent (66.9%).
Correlations Between Family Environment and Children's Aggressive Behavior Children's aggression had a significantly positive relationship with family conflicts (r = 0.240, p b 0.01) and negative relationships with family cohesion (r = −0.139, p b 0.01), intellectual–cultural orientation (r = −0.142, p b 0.01), active recreational orientation (r = −0.090, p b 0.01), moral– religious emphasis (r = −0.098, p b 0.01), organization (r = −0.185, p b 0.01), and control (r = −0.082, p b 0.01).
Correlations Between Parenting Styles and Children's Aggressive Behavior Regarding parenting styles, the mean scores for the supportive/engaged and hostile/coercive dimensions of the PBI were 37.83 (SD = 7.19) and 17.08 (SD = 5.65), respectively. A correlational analysis revealed that children's aggression was positively associated with hostile/coercive parenting (r = 0.13, p b 0.01) and negatively associated with supportive/engaged parenting (r = −0.07, p b 0.01).
Univariate Analysis of Family Factors Correlating With Children's Aggressive Behavior
Multivariate Analysis of Family Predictors Related to Children's Aggressive Behavior
According to the CBCL, the prevalence of aggressive behavior in preschool children was 12.4%. The prevalence of aggressive behavior in different groups of children and children with different family characteristics is shown in Tables 1 and 2. Children who spent more time watching television exhibited more aggressive behaviors. Inconsistent parenting between fathers and mothers, or between parents and grandparents, were also related to more aggressive behavior among preschool children.
A multiple logistic regression was used to identify family predictors of children's aggressive behavior. Independent variables included demographic characteristics of the children and their families and FES and PBI subscales. Results of the logistic regression analysis (Table 3) demonstrated that family conflicts, hostile/coercive parenting, parenting inconsistency between grandparents and parents, and more time spent watching TV time were significant, positive predictors of children's aggressive behavior.
Discussion Aggressive Behavior Among Preschool Children Table 1 Prevalence of aggressive behavior among different groups of children (n = 1382) Characteristics of children Gender Boys Girls Age 3 years 4 years 5 years 6 years Only child in family Yes No Watching TV Less than 1 h/d 1–2 h/d More than 2 h/d ⁎⁎ p b 0.01.
Aggressive behavior Yes (%)
No
100 (13.12) 72 (11.61)
662 548
5 59 56 52
(13.51) (13.29) (13.43) (10.74)
32 385 361 432
144 (12.90) 28 (10.53)
972 238
20 (4.42) 102 (15.13) 50 (19.53)
432 572 206
χ2
p
0.716
0.398
1.985
0.576
0.291 1.114 0.000 ⁎⁎ 42.950
This study showed that the prevalence of aggressive behavior in preschool children was 12.4%, which was similar to another Chinese investigation of preschool children by Guan et al. (2005) (11.9%), and is higher than the rate reported for older children or adolescents at home and abroad by Lee, Baillargeon, Vermunt, Wu, and Tremblay (2007) (3.7% in boys and 0.5%–2.3% in girls) and Yu et al. (2006) (3.27%). The rate of aggressive behavior among boys was slightly higher than that of girls, which was consistent with previous reports that stated that boys had more aggressive behaviors than girls (Chen et al., 2002; Cote, Vaillancourt, LeBlanc, Nagin, & Tremblay, 2006; Cote et al., 2007). Some other studies have shown that children might manifest different forms of aggression between boys and girls. For example, boys showed more direct aggressive behavior including physical and verbal aggression than girls, while girls demonstrated more indirect or relational aggression than boys (Chen et al., 2002; Murray-Close & Ostrov, 2009; Valles & Knutson, 2008; Yu et al., 2006). Our results showed that aggressive behavior did not differ by children's age, which has also been observed in previous research (Yu et al., 2006). There were some studies mentioned that children exhibited various types of aggression
Family Risk Factors of Children’s Aggression Table 2
5
Prevalence of aggressive behavior among children with different family characteristics (n = 1382)
Family characteristics
Yes (%) Father age No more than 30 years From 31 to 40 years More than 40 years Mother age No more than 30 years From 31 to 40 years More than 40 years Family structure Stem family Nuclear family Single parent family Primary caregivers of children Grandparents or others Parents Family monthly income b5000 Yuan 5000–10,000 Yuan ≥10,000 Yuan Father education More than 12 years From 10 to 12 years No more than 9 years Mother education More than 12 years From 10 to 12 years No more than 9 years Father occupation Administrator Professional worker Skilled worker Unemployed Mother occupation Administrator Professional worker Skilled worker Unemployed Parenting attitudes between fathers and mothers Consistent Inconsistent Parenting attitudes between grandparents and parents Consistent Inconsistent
χ2
Aggressive behavior
p
No 0.092
33 (17.19) 117 (11.87) 22 (10.78)
159 869 182
63 (15.04) 104 (11.47) 5 (8.93)
356 803 51
116 (13.29) 54 (10.91) 2 (14.29)
757 441 12
30 (13.76) 142 (12.20)
188 1022
24 (12.44) 98 (13.37) 50 (10.96)
169 635 406
96 (12.52) 43 (11.72) 33 (13.31)
671 324 215
93 (13.01) 38 (10.56) 41 (13.36)
622 322 266
45 72 50 5
(11.51) (13.69) (11.71) (13.16)
346 454 377 33
25 79 38 30
(10.78) (12.64) (12.22) (14.02)
207 546 273 184
146 (11.51) 26 (23.01)
1123 87
12.601
90 (9.74) 82 (17.90)
834 376
18.728
4.782 0.134 4.014 1.684
0.431
0.521 0.411 0.474 1.492 0.839 0.351 0.445 1.620 0.731 1.290
0.773 1.116 0.0001 ⁎⁎ 0.0001 ⁎⁎
⁎⁎ p b 0.01.
at different ages, with proactive aggression increasing with age and reactive aggression decreasing with age (Cote et al., 2007; Vaillancourt, Miller, Fagbemi, Cote, & Tremblay, 2007). Therefore, the relationship between sex, age, and types of aggression needs to be explored further in future studies.
Family Environment and Children's Aggressive Behavior Given the chronic and pervasive nature of aggression, it is beneficial to explore the family contextual factors that might
affect the development of childhood aggression. This study's results in terms of family environment replicated findings from previous studies (Cummings et al., 2004; Yu et al., 2006) that children's aggression was significantly associated with family conflicts when controlling for socio-demographic characteristics (OR = 1.231, 95% CI: 1.115–1.360). Cummings et al. (2004) proposed that parents' destructive conflict tactics and negative emotionality were linked with a higher likelihood of aggression, while exposure to constructive conflict tactics and
6
S. Jia et al. Table 3
Risk factors of aggressive behavior among preschool children
Risk factors of aggressive behavior
Model log likelihood
β
S.E.
Constant Family conflicts Hostile/Coercive parenting Inconsistent parenting attitudes between grandparents and parents More time spent watching TV
834.745 424.234 432.888
−5.981 0.208 0.080
0.471 0.051 0.015
b0.0001 b0.0001 ⁎⁎ b0.0001 ⁎⁎
420.839
0.506
0.176
431.681
0.693
0.124
p
OR
95% CI Lower
Upper
1.231 1.083
1.115 1.051
1.360 1.116
0.004 ⁎⁎
1.658
1.175
2.341
b0.0001 ⁎⁎
1.999
1.568
2.550
Forward stepwise method was used. ⁎⁎ p b 0.01.
positive parental emotionality decreased the probability of aggression among children aged between 8 and 16 years (Cummings et al., 2004). Negative family conflict may create harmful situational influences, leading to the development of childhood aggression. This study also indicated that children who lived in families with more cohesion, intellectual–cultural orientation, active recreational orientation, moral–religious emphasis, and organization were less likely to develop aggression, which was consistent with a previous study (Yu et al., 2006). Tremblay et al. (2004) also observed that family dysfunction was one of the best predictors of a heightened trajectory toward physical aggression among children as young as 5-months-old. These results suggest that positive, harmonious, well-organized, moral focused, and intellectual and recreational family environments will help create a positive family atmosphere, which can promote healthy development and socialization of children.
Parenting Styles and Children's Aggressive Behavior This study indicated that children's aggression had a significantly positive relationship with hostile/coercive parenting after controlling for socio-demographic characteristics (OR = 1.083, 95% CI: 1.051–1.116). This finding is in keeping with previous studies demonstrating that hostile parenting, physical punishment, verbal assaults, rejection, or punitive/non-reasoning strategies significantly contribute to the development of children's aggression (Benzies et al., 2009; Braza et al., 2015; Cote et al., 2007; McNamara et al., 2010; Nelson et al., 2006; Tremblay et al., 2004; Vitaro et al., 2006; Yu et al., 2006). This association may be explained by social learning theory (Bandura, 1973). Parents' frequent use of coercion, threats, or physical punishment strategies may create a situation wherein aggressive behaviors are directly reinforced and perceived as functional. This might socialize children to use these behaviors in resolving peer conflicts or other problems (Chan, 2010; Vitaro et al., 2006; Xu et al., 2009). Although Chinese parents have been prototypically described as strict or controlling in mainland China (Chen et al., 2002), parents in this study showed more supportive/engaged parenting (mean = 37.83, SD = 7.19) than hostile/coercive parenting (mean = 17.08, SD = 5.66), which may be explained
by the fact that most of the children in the study are the only child (80.8%) and thus the “center” of their family (Lu & Chang, 2013). It was observed that supportive/engaged parenting was correlated with a decreased likelihood for child aggression. Similar results have been revealed elsewhere (Cote et al., 2006). Parental warmth and support are thought to positively affect children enhancing child's self-concept and social information processing skills, which in turn is associated with a lower likelihood of acting aggressively (Crick & Dodge, 1994).
TV Exposure and Children's Aggressive Behavior A link was found between children's TV exposure and aggression (OR = 1.999, 95% CI: 1.568–2.550). This finding supports the results of a previous study proposing that 3-year-old children, who were exposed to more TV both directly and indirectly, were at an increased risk of more aggression compared with those who spent less time watching TV (Manganello & Taylor, 2009). The concept of observational learning from social cognitive theory suggests that children learn to model aggressive behavior viewed on television (Han & Chen, 2010). Even if the purpose of watching TV is to pursue nonviolent educational content, children may still be exposed to violence through commercials or movies (Manganello & Taylor, 2009). Children who extensively view violent content may also become desensitized to violence, which could lead to increased aggressive behavior. Therefore, parents and caregivers should be cautious about their children's media exposure.
Other Family Factors and Children's Aggressive Behavior This study also found that inconsistent parental attitudes between fathers and mothers, and parents and grandparents, contributed to children's aggressive behavior (OR = 1.658, 95% CI: 1.175–2.341). This phenomenon was also observed in previous studies in Chinese children (Nelson et al., 2006; Yu et al., 2006). Inconsistent parental attitudes in this study referred to lack of unified rules and standards of conduct for children's behavior among caregivers (Halgunseth, Perkins, Lippold, & Nix, 2013). More than half of the families (63.27%, 873) were stem families (had grandparents living together with the parents and children). Since grandparents help parents take care of children within this family structure,
Family Risk Factors of Children’s Aggression parenting consistency between grandparents and parents is very important for the child's socialization process. Inconsistent parental attitudes, and changeable practices among families, make it difficult for children to form a clear, ethical concept, which may result in aggression and behavioral problems (Halgunseth et al., 2013). This study did not find that family structure was related to children's aggressive behavior, which was inconsistent with some other studies that have found children living in single parent family were more likely to be aggressive (Ehrenreich et al., 2014; Yu et al., 2006). This may be because only 1.0% (14) of our sample was from single parent families. Moreover, links between children's aggression and parental education, occupation, and household income were not observed. One plausible explanation for the lack of an association with these variables was that the socioeconomics of the families in our study did not significantly differ (e.g., the majority of parents had more than nine years of education). Future studies should include families with more diverse demographic backgrounds. Overall, the rate of aggressive behavior among preschool children was very high, a phenomenon that requires more attention. Our findings add to emerging evidence concerning the interactive relationship between negative family conflicts and childhood aggression, and support that children with more positive family environments were less liable to develop aggression (Cummings et al., 2004; Yu et al., 2006). This study also demonstrated the association found by previous studies between hostile/coercive parenting and children's aggressive behavior (Braza et al., 2015; Chang et al., 2003; Vitaro et al., 2006). Moreover, this study extends the literature by revealing that inconsistent parenting attitudes toward children and increased TV exposure as strong risk factors for preschool children's aggressive behavior with certain cultural characteristics. Therefore, this study provides significant practice cues for developing family prevention program to reduce aggressive behavior in preschool children, and also has clinical implications for further intervention work for children's behavioral problems.
Limitations One limitation of the current study was the cross-sectional design employed; therefore, causal inferences cannot be made. This study is also limited by using ratings of parental behavior. Previous research has shown differential associations between maternal and paternal parenting on child outcomes (Chang et al., 2003; Chen et al., 2002). In this study, parenting referred to the primary caregiver behaviors. Therefore, the influences of maternal and paternal parenting on aggression cannot be distinguished clearly with our design. However, from an ecological perspective, children are typically being parented by multiple people and the primary caregiver parenting behaviors must have a significant impact on the children's outcomes. Another issue is that most of the parents in this study were gainfully employed (i.e., most were administrators or professional workers), and were college educated. This might be due to the fact that Shanghai is a well-developed city;
7 however, this limitation might influence the findings' representativeness. Despite the limitations, this study adds to the literature regarding aggressive behavior and its relations with family context among preschool children. The study findings reveal that family-focused measures can be used to decrease the children's aggression.
Acknowledgments We are grateful to the parents and children who participated in this study. We are also grateful to administrators and teachers who helped with data collection. We appreciate the statistical instructions provided by Dr. Ren (Dianxu Ren, MD, PhD, Assistant Professor of School of Nursing, Pittsburgh University, USA). The research project was funded by Fudan University (EYF201030).
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8 Dodge, KA, Coie, JD, & Lynanl, D (2006). Handbook of child psychology: Social, emotional, and personality development. Toronto: Wiley. Ehrenreich, SE, Beron, KJ, Brinkley, DY, & Underwood, MK (2014). Family predictors of continuity and change in social and physical aggression from ages 9 to 18. Aggressive Behavior, 40, 421–439. Guan, HY, Wang, SY, Liu, ZM, Wu, CP, Chen, QS, Chen, Y, & Fu, M (2005). Analysis on the influential factors of aggressive behavior among preschool children in Zhuhai city. Chinese Journal of Public Health, 21, 476–477. Halgunseth, LC, Perkins, DF, Lippold, MA, & Nix, RL (2013). Delinquentoriented attitudes mediate the relation between parental inconsistent discipline and early adolescent behaviour. Journal of Family Psychology, 27, 293–302. Han, L, & Chen, L (2010). Under dual aspects the influence study of carnography on children's aggressive behaviour—From the perspectives of psychological and communication. Science of Social Psychology, 15, 38–41. Harachi, TW, Fleming, CB, White, HR, Ensminger, ME, Abbott, RD, Catalano, RF, & Haggerty, KP (2006). Aggressive behaviour among girls and boys during middle childhood: Predictors and sequelae of trajectory group membership. Aggressive Behavior, 32, 279–293. Huesmann, LR, Dubow, EF, & Boxer, P (2009). Continuity of aggression from childhood to early adulthood as a predictor of life outcomes: implications for the adolescent-limited and life-course-persistent models. Aggressive Behavior, 35, 136–149. Jester, JM, Nigg, JT, Adams, K, Fitzgerald, HE, Puttler, LI, Wong, MM, & Zucker, RA (2005). Inattention/hyperactivity and aggression from early childhood to adolescence: Heterogeneity of trajectories and differential influence of family environment characteristics. Development and Psychopathology, 17, 99–125. Lee, KH, Baillargeon, RH, Vermunt, JK, Wu, HX, & Tremblay, RE (2007). Age differences in the prevalence of physical aggression among 5-11year-old Canadian boys and girls. Aggressive Behavior, 33, 26–37. Litrownik, AJ, Newton, R, & Hunter, WM (2003). Exposure to family violence in young at-risk children: A longitudinal look at the effects of victimization and witnessed physical and psychological aggression. Journal of Family Violence, 18, 59–73. Lovejoy, MC, Weis, R, O'Hare, E, & Rubin, EC (1999). Development and initial validation of the parent behavior inventory. Psychological Assessment, 11, 534–545. Lu, HJ, & Chang, L (2013). Parenting and socialization of only children in urban China: An example of authoritative parenting. Journal of Genetic Psychology, 174, 335–343. Manganello, JA, & Taylor, CA (2009). Television exposure as a risk factor for aggressive behavior among 3-year-old children. Archives of Pediatrics & Adolescent Medicine, 163, 1037–1045. McNamara, KA, Selig, JP, & Hawley, PH (2010). A typological approach to the study of parenting: Associations between maternal parenting patterns
S. Jia et al. and child behavior and social reception. Early Child Development and Care, 180, 1185–1202. Moos, RH, & Moos, BS (1994). Family environment scale manual: Development applications, research (3rd ed.). Palo Alto, CA: Consulting Psychologist Press. Murray-Close, D, & Ostrov, JM (2009). A longitudinal study of forms and functions of aggressive behavior in early childhood. Child Development, 80, 828–842. Nelson, DA, Hart, CH, Yang, C, Olsen, JA, & Jin, S (2006). Aversive parenting in China: Association with child physical and relational aggression. Child Development, 77, 554–572. O'Connor, TG (2002). Annotation: The ‘effects’ of parenting reconsidered: findings, challenges, and applications. Journal of Child Psychology and Psychiatry, 43, 555–572. Pearson, E, & Rao, N (2003). Socialization goals, parenting practices, and peer competence in Chinese and English preschoolers. Early Child Development and Care, 173, 131–146. Raaijmakers, MA, Posthumus, JA, van Hout, BA, van Engeland, H, & Matthys, W (2011). Cross-sectional study into the costs and impact on family functioning of 4-year-old children with aggressive behavior. Prevention Science, 12, 192–200. Serbin, LA, Temcheff, CE, Cooperman, JM, et al. (2011). Predicting family poverty and other disadvantaged conditions for child rearing from childhood aggression and social withdrawal: A 30-year longitudinal study. International Journal of Behavioral Development, 35, 97–106. Tremblay, RE, Nagin, DS, Seguin, JR, Zoccolillo, M, Zelazo, PD, Boivin, M, ... Japel, C (2004). Physical aggression during early childhood: Trajectories and predictors. Pediatrics, 114, e43–e50. Vaillancourt, T, Miller, JL, Fagbemi, J, Cote, S, & Tremblay, RE (2007). Trajectories and predictors of indirect aggression: Results from a nationally representative longitudinal study of Canadian children aged 2-10. Aggressive Behavior, 33, 314–326. Valles, NL, & Knutson, JF (2008). Contingent responses of mothers and peers to indirect and direct aggression in preschool and school-aged children. Aggressive Behavior, 34, 497–510. Vitaro, F, Barker, ED, Boivin, M, Brendgen, M, & Tremblay, RE (2006). Do early difficult temperament and harsh parenting differentially predict reactive and proactive aggression? Journal of Abnormal Child Psychology, 34, 685–695. Xu, Y, Farver, JA, & Zhang, Z (2009). Temperament, harsh and indulgent parenting, and Chinese children's proactive and reactive aggression. Child Development, 80, 244–258. Yu, Y, Shi, J, Huang, Y, & Wang, J (2006). Relationship between family characteristics and aggressive behaviors of children and adolescents. Journal of Huazhong University of Science and Technology. Medical Sciences, 26, 380–383. Zhang, ZJ (2005). Behavioral medicine scale manual. Beijing: Chinese Medical Audio-Video Organization.
Family Risk Factors Associated With Aggressive Behavior in Chinese Preschool Children Shoumei Jia PhD a , Ling Wang PhD b,⁎, Yingjuan Shi MB c , Ping Li BN d a
School of Nursing, Fudan University, Shanghai, P.R.C. School of Public Health, Fudan University, Shanghai, P.R.C. c Putuo Mental Health Centre, Shanghai, Shanghai, P.R.C. d Nursing Department, Putuo Mental Health Centre, Shanghai, P.R.C. b
Received 19 August 2015; revised 8 August 2016; accepted 8 August 2016
Keywords: Aggression; Aggressive behavior; Family risk factor; Parenting style; Preschool children
Purpose: The study explored family predictors of aggressive behavior in preschool children in China. Design and Methods: Using a stratified cluster sampling method, 1382 preschool children were recruited from ten kindergarten schools in Shanghai, China. Their parents completed the Child Behavior Checklist (CBCL)-aggression subscale, the Parent Behavior Inventory, the Family Environment Scale, and a demographic questionnaire. Results: The mean age of the 1382 children was 4.97 years (SD = .88), with 55.1% (762) boys, and 44.9% (620) girls. According to the CBCL, the prevalence of aggressive behavior in preschool children was 12.4%. Multivariate logistic regression analysis showed that family conflicts (OR = 1.231, 95% CI: 1.115–1.360), hostile/coercive parenting (OR = 1.083, 95% CI: 1.051–1.116), inconsistent parenting between grandparents and parents (OR = 1.658, 95% CI: 1.175–2.341), and more time spent watching TV (OR = 1.999, 95% CI: 1.568–2.550) significantly predicted aggressive behavior of children. Conclusions: Children with more family conflicts who experience hostile/coercive parenting were more likely to engage in aggressive behavior. Moreover, inconsistent parenting attitudes between grandparents and parents, and excessive TV exposure also contributed to childhood aggression. Given that the results of this study show a high prevalence of aggressive behavior in preschool children, future research must pay greater attention to this aspect. Practice Implications: Family risk factors identified as relevant to children's aggression in this study provide avenues to develop family-focused strategies for curbing aggression in preschool children. © 2016 Elsevier Inc. All rights reserved.
Aggression can be defined as a behavior that is intended to hurt, harm, or injure another person (Dodge, Coie, & Lynanl, 2006). Aggressive behavior has been identified as a serious mental health issue in young children in both western and eastern cultures (Chen, Chen, Wang, & Liu, 2002; Harachi et al., 2006; McNamara, Selig, & Hawley, 2010; Valles & Knutson, 2008; Vitaro, Barker, Boivin, Brendgen, & Tremblay, 2006).
⁎ Corresponding author. Ling Wang, PhD. E-mail address: [email protected]. http://dx.doi.org/10.1016/j.pedn.2016.08.001 0882-5963/© 2016 Elsevier Inc. All rights reserved.
From a developmental perspective, childhood aggression is a significant phenomenon due to its high stability, as it can last to adulthood, and its robust and pervasive effects on long-term outcomes, such as poorer psychosocial functioning (Huesmann, Dubow, & Boxer, 2009). Previous studies have demonstrated that early aggressive behavior can have adverse consequences, such as poor physical and psychological health, negative effects on social development, adolescent behavioral disorders, and crimes in adulthood (Chen et al., 2002; Harachi et al., 2006; Huesmann et al., 2009; Valles & Knutson, 2008). Population-based investigations have shown that a high level
2 of aggressive behavior results in high social costs (due to high rates of service use for the treatment of psychiatric disorders, delinquency, incarceration, and unemployment) and impaired family functioning, even as early as preschool years (children aged six years or younger) (Huesmann et al., 2009; Raaijmakers, Posthumus, van Hout, van Engeland, & Matthys, 2011; Serbin, Temcheff, Cooperman, et al., 2011). Therefore, in order to promote adequate child development, family functioning, and social stability, it is important to identify factors that may promote aggressive behavior during childhood. Family environment plays an important role in the development of children's aggressive behavior (Andreas & Watson, 2009; Cummings, Goeke-Morey, & Papp, 2004; Ehrenreich, Beron, Brinkley, & Underwood, 2014; Jester et al., 2005; Yu, Shi, Huang, & Wang, 2006). It has been found when studying preschool children and school children, that family conflict and lack of family cohesiveness predict a developmental trajectory toward aggressive behavior (Jester et al., 2005; Litrownik, Newton, & Hunter, 2003). In contrast, school children who were exposed to positive family environments, including fewer family conflicts and more family cohesion, were less likely to develop aggressive behavior or have reduced levels of aggression, even when they had high aggressive beliefs or hostile cognitions (Andreas & Watson, 2009; Yu et al., 2006). Yu et al. (2006) used the Child Behavior Checklist (CBCL) on a sample of 4010 school children and found that children raised in more intellectual and recreational environments were less likely to develop aggressive behavior. While supportive/engaged parenting is correlated with positive outcomes regarding children's behavior and a lower likelihood of acting aggressively (Crick & Dodge, 1994), several studies have emphasized the relationship between hostile/ aversive parenting and children's aggressive behavior (Braza et al., 2015; Chang, Schwartz, Dodge, & McBride-Chang, 2003; Vitaro et al., 2006). It has been proposed that supportive/engaged parenting approaches include warm, supportive, sensitive, responsive parenting; parental involvement; and parental monitoring (Beyers, Bates, Pettit, & Dodge, 2003; O'Connor, 2002), while hostile/aversive parenting are often characterized by harsh discipline, frequent use of physical punishment, verbal assaults, punitive/non-reasoning strategies, hostile parental control, and low levels of parental warmth (Braza et al., 2015; Vitaro et al., 2006; Xu, Farver, & Zhang, 2009). Hostile/Aversive parenting is a significant contributor to aggressive behavior in early childhood (Benzies, Keown, & Magill-Evans, 2009; Cote, Vaillancourt, Barker, Nagin, & Tremblay, 2007; Nelson, Hart, Yang, Olsen, & Jin, 2006; Tremblay et al., 2004; Vitaro et al., 2006; Yu et al., 2006). Moreover, children of parents who use highly restrictive and controlling parental styles also demonstrate more aggressive behavior (Braza et al., 2015; McNamara et al., 2010). Studies often describe Chinese parents as more controlling or authoritarian than their western counterparts (Chan, 2010; Pearson & Rao, 2003). Studies in China have indicated that
S. Jia et al. authoritarian parenting was positively correlated with aggressive behavior in children (Chan, 2010; Chang et al., 2003; Chen et al., 2002; Nelson et al., 2006). However, more detailed information regarding Chinese parenting styles and its contribution to children's aggression is still needed. Other family characteristics, such as family structure, parenting consistency, education, and parental occupation, might also have an impact on children's aggressive behavior. It was reported that children living in single parent family received higher scores of aggression than children living in a nuclear family (Ehrenreich et al., 2014; Yu et al., 2006). Studies also revealed that parental consistency between family members was related to the development of aggressive behavior in Chinese children (Nelson et al., 2006; Yu et al., 2006). Moreover, Yu et al. found that there was a higher incidence of aggression among children whose mothers' education level was lower, and whose parents were engaged in manual labor, while children whose parents had a higher level of education, parents engaged in intellectual work, and lived in high-income families, had lower CBCL aggression scores (Yu et al., 2006). It was also reported that more TV exposure increased young children's risk of aggressive behavior (Manganello & Taylor, 2009). The relationship between family characteristics and preschool children's aggression requires further exploration. Only a few studies in China have addressed the relationship between family contextual factors and aggressive behavior in preschool children. There is limited empirical evidence as to the influence of family factors on children's aggression. This study explored family risk factors associated with aggressive behavior within a sample of preschool children. The results provide a theoretical foundation for the prevention and intervention of childhood aggression.
Methods Participants Using a stratified cluster sampling method, eight public kindergartens and two private kindergartens in six districts of Shanghai, China were chosen. In each kindergarten, children from two first-year classes, two second-year classes, and two third-year classes were recruited, and their parents (who were the children's primary caregivers) were also invited to participate in this study. Inclusion criteria for children were those aged between three and six years, and living in Shanghai. Exclusion criteria for children were those with severe physical disease or mental disease diagnosis. Approximately 1700 children were introduced to the study, and questionnaires were distributed to their parents. Parents who completed the questionnaires completely and effectively (N = 1382, 81.29%) were included in the analysis. Of the 318 questionnaires that were excluded from the sample, 216 were not returned from parents and 102 were returned with more than half of the questions not answered because these parents did not have the desire to complete it. Participants included in final analysis comprised 476 (34.4%) first-year children, 416 (30.1%) second-year children, and 490 (35.5%) third-year children.
Family Risk Factors of Children’s Aggression
Procedure Written consent from the administrators of the ten kindergartens was obtained before the study, and teachers were asked to arrange two group meetings for the study. Children's parents were invited to come to the classes for each group meeting that lasted for approximately 45 minutes. During the first group meeting, the purpose and procedures of the study were explained to the parents, and written consents were obtained prior to data collection. Parents were assured of the confidentiality of their responses, and parents were told they could withdraw themselves and their children from the study at any time without penalty. Questionnaires including the CBCL-aggression subscale “parents' form,” Parent Behavior Inventory (PBI), Family Environment Scale (FES), and a demographics questionnaire were distributed and to be completed at home by the children's parents (who were the children's primary caregivers). The CBCL was used to assess preschool children's aggressive behavior and the PBI and FES were used to assess the main features of the children's family system. Questionnaires were returned during the next meeting a week later, and checked by the investigators to ensure that all the questions were answered. Each family was compensated for their participation with a small gift for the children. All questionnaires were tested for psychometric reliability and validity for application with a Chinese sample. The current study was approved by the Fudan University Institutional Review Board and funded by Fudan University (EYF201030).
Measures Measures included the Child Behavior Checklist (CBCL)-aggression subscale, the Family Environment Scale, the Parent Behavior Inventory, and a demographic questionnaire, which were administered in Chinese. Child Behavior Checklist (CBCL) The CBCL is a standardized measure for assessing behavioral problems and social competencies of children aged between 2 and 16 years. It is based on parental reports or other adults who know the children well. The CBCL is a 113-item scale comprised of eight different syndromes scales. Aggressive behavior can be measured by the aggression subscale that assesses the frequency of children's various kinds of aggression (e.g., attacking, threatening, etc.). The CBCL response options range from 0 (never) to 2 (very often), and individual responses are summed to compute a subscale score (Achenbach, 1991). Aggressive children are those whose aggression score are equal to or above the Chinese norm. According to these norms, the cut-off aggression points among boys and girls are 19–20 and 18–19, respectively (Zhang, 2005). In this study, the Cronbach's alpha coefficient for the CBCL aggression subscale was 0.88, and the test–retest reliability coefficient was 0.98. Family Environment Scale (FES) The FES is a standardized measure of family social and environmental characteristics with 90 true/false items. The
3 FES has ten subscales evaluating family characteristics on cohesion, expressiveness, conflict, independence, achievement orientation, intellectual–cultural orientation, active– recreational orientation, moral–religious emphasis, organization, and control, with a score for each scale ranging from 0 to 9 (Moos & Moos, 1994). The FES Chinese version (FES-CV) has good reliability and validity. In this study, the Cronbach's alpha for the FES-CV was 0.75, and test–retest reliability coefficients for the 10 subscales ranged from 0.98 to 1.00. Parent Behavior Inventory (PBI) The PBI was used to evaluate two types of parenting styles: supportive/engaged and hostile/coercive. The PBI is a brief measure that focuses on parenting behaviors, rather than beliefs or attitudes, making it appropriate for behavioral assessments of young children. The PBI's two independent scales have scores that range from 0 to 50. The PBI has sufficient content validity, adequate internal consistency, and acceptable test–retest reliability, and relates to measures of parental affect, parental stress, and child behavior problems (Lovejoy, Weis, O'Hare, & Rubin, 1999). In this study, the Cronbach's alpha for the PBI was 0.67, and the test–retest reliability coefficients for the support/engaged and hostile/coercive dimensions were 0.96 and 0.99, respectively. Parents also reported the age and sex of the children, number of siblings, time the child spent watching TV, family structure, primary caregivers, parents' age(s), education, occupation, household income, parenting consistency between father and mother, and parenting consistency between grandparents and parents.
Statistical Analysis Data were input and arranged in Epidata 3.1 software and analyzed using SPSS 20.0 statistical software. First, means and standard deviations, frequencies, and percentages were calculated for descriptive purposes. Univariate analysis including chi-square tests and correlational analysis were used to determine what family factors were associated with children's aggressive behavior. A multivariate logistic regression was then performed to analyze family predictors of aggression while controlling for demographic variables.
Results Children's Characteristics The mean age of the children was 4.97 years (SD = .88). Of the 1382 children, 55.1% (762) were boys, and 44.9% (620) were girls. Furthermore, 79.9% of the children (1104) were from public kindergartens, and 20.1% (278) were from private kindergartens; 80.8% (1116) were an “only child,” and 19.2% (266) had siblings; and 32.7% (452) watched TV for no more than 1 hour, while 48.8% (674) spent one to two hours watching TV, and 18.5% (256) spent more than two hours watching TV every day.
4
S. Jia et al.
Family Characteristics of Preschool Children The fathers' and mothers' mean ages were 35.75 years (SD = 4.89) and 32.94 years (SD = 4.03), respectively. Furthermore, 63.27% (873) of the families were stem families (children lived with both parents and grandparents), 35.8% (495) of them were nuclear families (children lived with both parents), and 1.0% (14) of them were single parent families. The majority of families (86%) had a household income of more than RMB 5000 (about 800 US dollars) per month. More than half of the parents had more than 12 years of education, and the majority of parents were professional or skilled workers. In most families (84.2%), the primary caregivers were parents, and 15.8% of children lived with their parents but were typically looked after by their grandparents, babysitters, or others. Parenting attitudes between fathers and mothers were highly consistent (91.8%), while parenting consistency between parents and grandparents was only moderately consistent (66.9%).
Correlations Between Family Environment and Children's Aggressive Behavior Children's aggression had a significantly positive relationship with family conflicts (r = 0.240, p b 0.01) and negative relationships with family cohesion (r = −0.139, p b 0.01), intellectual–cultural orientation (r = −0.142, p b 0.01), active recreational orientation (r = −0.090, p b 0.01), moral– religious emphasis (r = −0.098, p b 0.01), organization (r = −0.185, p b 0.01), and control (r = −0.082, p b 0.01).
Correlations Between Parenting Styles and Children's Aggressive Behavior Regarding parenting styles, the mean scores for the supportive/engaged and hostile/coercive dimensions of the PBI were 37.83 (SD = 7.19) and 17.08 (SD = 5.65), respectively. A correlational analysis revealed that children's aggression was positively associated with hostile/coercive parenting (r = 0.13, p b 0.01) and negatively associated with supportive/engaged parenting (r = −0.07, p b 0.01).
Univariate Analysis of Family Factors Correlating With Children's Aggressive Behavior
Multivariate Analysis of Family Predictors Related to Children's Aggressive Behavior
According to the CBCL, the prevalence of aggressive behavior in preschool children was 12.4%. The prevalence of aggressive behavior in different groups of children and children with different family characteristics is shown in Tables 1 and 2. Children who spent more time watching television exhibited more aggressive behaviors. Inconsistent parenting between fathers and mothers, or between parents and grandparents, were also related to more aggressive behavior among preschool children.
A multiple logistic regression was used to identify family predictors of children's aggressive behavior. Independent variables included demographic characteristics of the children and their families and FES and PBI subscales. Results of the logistic regression analysis (Table 3) demonstrated that family conflicts, hostile/coercive parenting, parenting inconsistency between grandparents and parents, and more time spent watching TV time were significant, positive predictors of children's aggressive behavior.
Discussion Aggressive Behavior Among Preschool Children Table 1 Prevalence of aggressive behavior among different groups of children (n = 1382) Characteristics of children Gender Boys Girls Age 3 years 4 years 5 years 6 years Only child in family Yes No Watching TV Less than 1 h/d 1–2 h/d More than 2 h/d ⁎⁎ p b 0.01.
Aggressive behavior Yes (%)
No
100 (13.12) 72 (11.61)
662 548
5 59 56 52
(13.51) (13.29) (13.43) (10.74)
32 385 361 432
144 (12.90) 28 (10.53)
972 238
20 (4.42) 102 (15.13) 50 (19.53)
432 572 206
χ2
p
0.716
0.398
1.985
0.576
0.291 1.114 0.000 ⁎⁎ 42.950
This study showed that the prevalence of aggressive behavior in preschool children was 12.4%, which was similar to another Chinese investigation of preschool children by Guan et al. (2005) (11.9%), and is higher than the rate reported for older children or adolescents at home and abroad by Lee, Baillargeon, Vermunt, Wu, and Tremblay (2007) (3.7% in boys and 0.5%–2.3% in girls) and Yu et al. (2006) (3.27%). The rate of aggressive behavior among boys was slightly higher than that of girls, which was consistent with previous reports that stated that boys had more aggressive behaviors than girls (Chen et al., 2002; Cote, Vaillancourt, LeBlanc, Nagin, & Tremblay, 2006; Cote et al., 2007). Some other studies have shown that children might manifest different forms of aggression between boys and girls. For example, boys showed more direct aggressive behavior including physical and verbal aggression than girls, while girls demonstrated more indirect or relational aggression than boys (Chen et al., 2002; Murray-Close & Ostrov, 2009; Valles & Knutson, 2008; Yu et al., 2006). Our results showed that aggressive behavior did not differ by children's age, which has also been observed in previous research (Yu et al., 2006). There were some studies mentioned that children exhibited various types of aggression
Family Risk Factors of Children’s Aggression Table 2
5
Prevalence of aggressive behavior among children with different family characteristics (n = 1382)
Family characteristics
Yes (%) Father age No more than 30 years From 31 to 40 years More than 40 years Mother age No more than 30 years From 31 to 40 years More than 40 years Family structure Stem family Nuclear family Single parent family Primary caregivers of children Grandparents or others Parents Family monthly income b5000 Yuan 5000–10,000 Yuan ≥10,000 Yuan Father education More than 12 years From 10 to 12 years No more than 9 years Mother education More than 12 years From 10 to 12 years No more than 9 years Father occupation Administrator Professional worker Skilled worker Unemployed Mother occupation Administrator Professional worker Skilled worker Unemployed Parenting attitudes between fathers and mothers Consistent Inconsistent Parenting attitudes between grandparents and parents Consistent Inconsistent
χ2
Aggressive behavior
p
No 0.092
33 (17.19) 117 (11.87) 22 (10.78)
159 869 182
63 (15.04) 104 (11.47) 5 (8.93)
356 803 51
116 (13.29) 54 (10.91) 2 (14.29)
757 441 12
30 (13.76) 142 (12.20)
188 1022
24 (12.44) 98 (13.37) 50 (10.96)
169 635 406
96 (12.52) 43 (11.72) 33 (13.31)
671 324 215
93 (13.01) 38 (10.56) 41 (13.36)
622 322 266
45 72 50 5
(11.51) (13.69) (11.71) (13.16)
346 454 377 33
25 79 38 30
(10.78) (12.64) (12.22) (14.02)
207 546 273 184
146 (11.51) 26 (23.01)
1123 87
12.601
90 (9.74) 82 (17.90)
834 376
18.728
4.782 0.134 4.014 1.684
0.431
0.521 0.411 0.474 1.492 0.839 0.351 0.445 1.620 0.731 1.290
0.773 1.116 0.0001 ⁎⁎ 0.0001 ⁎⁎
⁎⁎ p b 0.01.
at different ages, with proactive aggression increasing with age and reactive aggression decreasing with age (Cote et al., 2007; Vaillancourt, Miller, Fagbemi, Cote, & Tremblay, 2007). Therefore, the relationship between sex, age, and types of aggression needs to be explored further in future studies.
Family Environment and Children's Aggressive Behavior Given the chronic and pervasive nature of aggression, it is beneficial to explore the family contextual factors that might
affect the development of childhood aggression. This study's results in terms of family environment replicated findings from previous studies (Cummings et al., 2004; Yu et al., 2006) that children's aggression was significantly associated with family conflicts when controlling for socio-demographic characteristics (OR = 1.231, 95% CI: 1.115–1.360). Cummings et al. (2004) proposed that parents' destructive conflict tactics and negative emotionality were linked with a higher likelihood of aggression, while exposure to constructive conflict tactics and
6
S. Jia et al. Table 3
Risk factors of aggressive behavior among preschool children
Risk factors of aggressive behavior
Model log likelihood
β
S.E.
Constant Family conflicts Hostile/Coercive parenting Inconsistent parenting attitudes between grandparents and parents More time spent watching TV
834.745 424.234 432.888
−5.981 0.208 0.080
0.471 0.051 0.015
b0.0001 b0.0001 ⁎⁎ b0.0001 ⁎⁎
420.839
0.506
0.176
431.681
0.693
0.124
p
OR
95% CI Lower
Upper
1.231 1.083
1.115 1.051
1.360 1.116
0.004 ⁎⁎
1.658
1.175
2.341
b0.0001 ⁎⁎
1.999
1.568
2.550
Forward stepwise method was used. ⁎⁎ p b 0.01.
positive parental emotionality decreased the probability of aggression among children aged between 8 and 16 years (Cummings et al., 2004). Negative family conflict may create harmful situational influences, leading to the development of childhood aggression. This study also indicated that children who lived in families with more cohesion, intellectual–cultural orientation, active recreational orientation, moral–religious emphasis, and organization were less likely to develop aggression, which was consistent with a previous study (Yu et al., 2006). Tremblay et al. (2004) also observed that family dysfunction was one of the best predictors of a heightened trajectory toward physical aggression among children as young as 5-months-old. These results suggest that positive, harmonious, well-organized, moral focused, and intellectual and recreational family environments will help create a positive family atmosphere, which can promote healthy development and socialization of children.
Parenting Styles and Children's Aggressive Behavior This study indicated that children's aggression had a significantly positive relationship with hostile/coercive parenting after controlling for socio-demographic characteristics (OR = 1.083, 95% CI: 1.051–1.116). This finding is in keeping with previous studies demonstrating that hostile parenting, physical punishment, verbal assaults, rejection, or punitive/non-reasoning strategies significantly contribute to the development of children's aggression (Benzies et al., 2009; Braza et al., 2015; Cote et al., 2007; McNamara et al., 2010; Nelson et al., 2006; Tremblay et al., 2004; Vitaro et al., 2006; Yu et al., 2006). This association may be explained by social learning theory (Bandura, 1973). Parents' frequent use of coercion, threats, or physical punishment strategies may create a situation wherein aggressive behaviors are directly reinforced and perceived as functional. This might socialize children to use these behaviors in resolving peer conflicts or other problems (Chan, 2010; Vitaro et al., 2006; Xu et al., 2009). Although Chinese parents have been prototypically described as strict or controlling in mainland China (Chen et al., 2002), parents in this study showed more supportive/engaged parenting (mean = 37.83, SD = 7.19) than hostile/coercive parenting (mean = 17.08, SD = 5.66), which may be explained
by the fact that most of the children in the study are the only child (80.8%) and thus the “center” of their family (Lu & Chang, 2013). It was observed that supportive/engaged parenting was correlated with a decreased likelihood for child aggression. Similar results have been revealed elsewhere (Cote et al., 2006). Parental warmth and support are thought to positively affect children enhancing child's self-concept and social information processing skills, which in turn is associated with a lower likelihood of acting aggressively (Crick & Dodge, 1994).
TV Exposure and Children's Aggressive Behavior A link was found between children's TV exposure and aggression (OR = 1.999, 95% CI: 1.568–2.550). This finding supports the results of a previous study proposing that 3-year-old children, who were exposed to more TV both directly and indirectly, were at an increased risk of more aggression compared with those who spent less time watching TV (Manganello & Taylor, 2009). The concept of observational learning from social cognitive theory suggests that children learn to model aggressive behavior viewed on television (Han & Chen, 2010). Even if the purpose of watching TV is to pursue nonviolent educational content, children may still be exposed to violence through commercials or movies (Manganello & Taylor, 2009). Children who extensively view violent content may also become desensitized to violence, which could lead to increased aggressive behavior. Therefore, parents and caregivers should be cautious about their children's media exposure.
Other Family Factors and Children's Aggressive Behavior This study also found that inconsistent parental attitudes between fathers and mothers, and parents and grandparents, contributed to children's aggressive behavior (OR = 1.658, 95% CI: 1.175–2.341). This phenomenon was also observed in previous studies in Chinese children (Nelson et al., 2006; Yu et al., 2006). Inconsistent parental attitudes in this study referred to lack of unified rules and standards of conduct for children's behavior among caregivers (Halgunseth, Perkins, Lippold, & Nix, 2013). More than half of the families (63.27%, 873) were stem families (had grandparents living together with the parents and children). Since grandparents help parents take care of children within this family structure,
Family Risk Factors of Children’s Aggression parenting consistency between grandparents and parents is very important for the child's socialization process. Inconsistent parental attitudes, and changeable practices among families, make it difficult for children to form a clear, ethical concept, which may result in aggression and behavioral problems (Halgunseth et al., 2013). This study did not find that family structure was related to children's aggressive behavior, which was inconsistent with some other studies that have found children living in single parent family were more likely to be aggressive (Ehrenreich et al., 2014; Yu et al., 2006). This may be because only 1.0% (14) of our sample was from single parent families. Moreover, links between children's aggression and parental education, occupation, and household income were not observed. One plausible explanation for the lack of an association with these variables was that the socioeconomics of the families in our study did not significantly differ (e.g., the majority of parents had more than nine years of education). Future studies should include families with more diverse demographic backgrounds. Overall, the rate of aggressive behavior among preschool children was very high, a phenomenon that requires more attention. Our findings add to emerging evidence concerning the interactive relationship between negative family conflicts and childhood aggression, and support that children with more positive family environments were less liable to develop aggression (Cummings et al., 2004; Yu et al., 2006). This study also demonstrated the association found by previous studies between hostile/coercive parenting and children's aggressive behavior (Braza et al., 2015; Chang et al., 2003; Vitaro et al., 2006). Moreover, this study extends the literature by revealing that inconsistent parenting attitudes toward children and increased TV exposure as strong risk factors for preschool children's aggressive behavior with certain cultural characteristics. Therefore, this study provides significant practice cues for developing family prevention program to reduce aggressive behavior in preschool children, and also has clinical implications for further intervention work for children's behavioral problems.
Limitations One limitation of the current study was the cross-sectional design employed; therefore, causal inferences cannot be made. This study is also limited by using ratings of parental behavior. Previous research has shown differential associations between maternal and paternal parenting on child outcomes (Chang et al., 2003; Chen et al., 2002). In this study, parenting referred to the primary caregiver behaviors. Therefore, the influences of maternal and paternal parenting on aggression cannot be distinguished clearly with our design. However, from an ecological perspective, children are typically being parented by multiple people and the primary caregiver parenting behaviors must have a significant impact on the children's outcomes. Another issue is that most of the parents in this study were gainfully employed (i.e., most were administrators or professional workers), and were college educated. This might be due to the fact that Shanghai is a well-developed city;
7 however, this limitation might influence the findings' representativeness. Despite the limitations, this study adds to the literature regarding aggressive behavior and its relations with family context among preschool children. The study findings reveal that family-focused measures can be used to decrease the children's aggression.
Acknowledgments We are grateful to the parents and children who participated in this study. We are also grateful to administrators and teachers who helped with data collection. We appreciate the statistical instructions provided by Dr. Ren (Dianxu Ren, MD, PhD, Assistant Professor of School of Nursing, Pittsburgh University, USA). The research project was funded by Fudan University (EYF201030).
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