Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Save to My Library
Look up keyword
Like this
1Activity
0 of .
Results for:
No results containing your search query
P. 1
American Academy of Pediatrics - Physical Punishment and Mental Disorders - Results From a Nationally Representative US Sample

American Academy of Pediatrics - Physical Punishment and Mental Disorders - Results From a Nationally Representative US Sample

Ratings: (0)|Views: 30 |Likes:
Abstract and full study PDF link available at http://pediatrics.aappublications.org/content/early/2012/06/27/peds.2011-2947
Abstract and full study PDF link available at http://pediatrics.aappublications.org/content/early/2012/06/27/peds.2011-2947

More info:

Published by: Becki_Jayne_Equality on Jul 03, 2012
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF, TXT or read online from Scribd
See more
See less

12/25/2012

pdf

text

original

 
DOI: 10.1542/peds.2011-2947; originally published online July 2, 2012;
Pediatrics
Jitender SareenTracie O. Afifi, Natalie P. Mota, Patricia Dasiewicz, Harriet L. MacMillan and
Representative US SamplePhysical Punishment and Mental Disorders: Results From a Nationally
 
located on the World Wide Web at:The online version of this article, along with updated information and services, is
of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 2012 by the American Academypublished, and trademarked by the American Academy of Pediatrics, 141 Northwest Pointpublication, it has been published continuously since 1948. PEDIATRICS is owned,PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly
 by guest on July 3, 2012pediatrics.aappublications.orgDownloaded from 
 
Physical Punishment and Mental Disorders: ResultsFrom a Nationally Representative US Sample
WHAT
S KNOWN ON THIS SUBJECT:
Physical punishment isassociated with aggression, delinquency, and internalizingconditions in childhood, as well as a range of Axis I mentaldisorders in adulthood. More research is needed on the possiblelong-term relationship between physical punishment and mentalhealth.
WHAT THIS STUDY ADDS:
To our knowledge, this is the
rstnationally representative examination of physical punishment anda range of Axis I and II disorders, gender interactions, andproportion of mental disorders in the general population thatmay be attributable to physical punishment.
abstract
BACKGROUND:
The use of physical punishment is controversial. Fewstudies have examined the relationship between physical punishmentand a wide range of mental disorders in a nationally representativesample. The current research investigated the possible link betweenharsh physical punishment (ie, pushing, grabbing, shoving, slapping,hitting) in the absence of more severe child maltreatment (ie, physicalabuse, sexual abuse, emotional abuse, physical neglect, emotional ne-glect, exposure to intimate partner violence) and Axis I and II mentaldisorders.
METHODS:
Data were from the National Epidemiologic Survey on Alco-hol and Related Conditions collected between 2004 and 2005 (
= 34653). The survey was conducted with a representative US adult pop-ulation sample (aged
$
20 years). Statistical methods included logis- tic regression models and population-attributable fractions.
RESULTS:
Harsh physical punishment was associated with increasedodds of mood disorders, anxiety disorders, alcohol and drug abuse/dependence, and several personality disorders after adjusting forsociodemographic variables and family history of dysfunction (adjustedodds ratio: 1.36
2.46). Approximately 2% to 5% of Axis I disorders and4% to 7% of Axis II disorders were attributable to harsh physicalpunishment.
CONCLUSIONS:
Harsh physical punishment in the absence of child mal- treatment is associated with mood disorders, anxiety disorders, sub-stance abuse/dependence, and personality disorders in a generalpopulation sample. These
ndings inform the ongoing debatearound the use of physical punishment and provide evidence thatharsh physical punishment independent of child maltreatment isrelated to mental disorders.
Pediatrics 
2012;130:1
9
AUTHORS:
Tracie O. A
fifi
, PhD,
a
,
b
,
c
Natalie P. Mota, MA,
d
Patricia Dasiewicz, MSc,
b
Harriet L. MacMillan, MD,FRCPC,
e
and Jitender Sareen, MD, FRCPC
a
,
b
,
d
Departments of  
Community Health Sciences,
Psychiatry,
Family Social Sciences, and 
Psychology, University of Manitoba,Winnipeg, Manitoba, Canada; and 
Department of Psychiatry and Behavioural Neurosciences and Department of Pediatrics,McMaster University, Hamilton, Ontario, Canada 
KEY WORDS
child abuse, child neglect, mental disorders, mental health,personality disorders
ABBREVIATIONS
aOR
adjusted odds ratioCI
con
dence intervalNESARC
National Epidemiologic Survey on Alcohol and RelatedConditionsPAF
population-attributable fractionDrs A
fifi
and Sareen contributed to the development of theresearch questions, design of the study, supervision of theanalysis, interpretation of the data, writing of the manuscript,and revising of the manuscript; Ms Mota and Dasiewiczcontributed to the development of the research questions,design of the study, data analysis, interpretation of the data,writing of the manuscript, and revising of the manuscript; andDr MacMillan contributed to the theoretical rationale for thestudy, expert consultation regarding physical punishment terminology used in the manuscript, consultation on statisticalmodels, manuscript revisions, and writing of the revisedmanuscript.www.pediatrics.org/cgi/doi/10.1542/peds.2011-2947doi:10.1542/peds.2011-2947Accepted for publication Apr 2, 2012Address correspondence to Tracie O. A
fifi
, PhD, University of Manitoba, S113-750 Bannatyne Ave, Winnipeg, Manitoba, CanadaR3E 0W5. E-mail:t_a
@umanitoba.caPEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).Copyright © 2012 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE:
The authors have indicated they have no 
fi 
nancial relationships relevant to this article to disclose.
FUNDING:
Supported by a Manitoba Medical ServicesFoundation award (Dr A
fifi
), a Winnipeg Foundation award(Dr A
fifi
), a Manitoba Health Research Council establishmentaward (Dr A
fifi
), a Canadian Institutes of Health Research NewInvestigator award (152348 to Dr Sareen), and a ManitobaHealth Research Council Chair Award (Dr Sareen). Dr MacMillanis supported by the David R. (Dan) Offord Chair in Child Studies.PEDIATRICS Volume 130, Number 2, August 2012
1
ARTICLE
 by guest on July 3, 2012pediatrics.aappublications.orgDownloaded from 
 
Physical punishment (also referred toas spanking, smacking, and corporalpunishment) involves acts of hitting achildasameansofdiscipline.Theparentor caregiver
s right to use physical pun-ishment has currently been abolished in32nations;Canadaandthe UnitedStatesarenotincludedamongthesecountries.
1
Physical punishment has been a com-monlyusedmethodofdisciplineinNorthAmerica and is considered socially ac-ceptable by many caregivers.
2,3
In a USsample of the Carolinas, for example,46% of mothers reported slapping orspanking in the past year.
4
An examina- tion of nationally representative US dataindicated that 48% of adults retrospec- tively reported a history of physical pun-ishment (having something thrown at them or being pushed, grabbed, shoved,slapped, or spanked) without havingexperienced more severe physical orsexual abuse.
5
It is well established that child maltreat-ment (ie, physical abuse, sexual abuse,emotional maltreatment, physical andemotional neglect) is associated withadult Axis I and II mental disorders.
6
17
Evidence about the negative long-termoutcomes associated with child mal- treatment could provide insights intounderstanding why physical punish-ment is associated with impairmentand provides the theoretical perspec- tive for the current study.
18
Althoughonly a few representative studies havebeen conducted on the relationship be- tween physical punishment and speci
cmental disorders, theoretically similarassociations found in the child mal- treatment literature would be expectedfor physical punishment because phys-ical punishment and child maltreatmentare not separate and unrelated dichoto-mies but rather varying degrees of physical force used on children foundalong a continuum of increasing severityranging from no physical acts to severechild maltreatment.
2,5,19
It is also im-portant to recognize that there can beconsiderable overlap between the 2 typesof exposure; depending on the age, devel-opmental stage, and level of force used, there is considerable agreement thatcertain types of physical punishmentconstituteabuse(eg,spanking aninfantaged
,
6 months or a teenager). Theliterature from the past 20 years indi-cates that the associated impairmentsof physical punishment are broad andenduring,
20
 just like the broad associa- tions found in the literature on childmaltreatment. In addition, perhaps theexperienceofphysicalpunishment,evenif not
physically abusive,
may generateacute or chronic stress through experi-encesofanxiety,fear,andshame,amongothers, that are associated with physio-logic and emotional dysregulation
21
andcharacteristic of a range of Axis I and IIpsychopathologic conditions. As withmaltreatment, genetic variability mayaccount for some of the differencesin speci
c impairment associated withexposure.
22
24
Reviewsoftheliteraturehaveindicated that physical punishment is related tohigher levels of aggression, delinquency,andinternalizingconditionsinadditiontolower levels of internalizing morals andoverall mental health.
25,26
There is someevidencethatphysicalpunishmentisalsoassociatedwithimmediatecompliance.
24,25
Many studies have found a link betweenphysical punishment and poor childand adolescent social, emotional, cog-nitive, developmental, and behavioralproblems or impairment.
27
33
There isalsoevidenceforanassociationbetweenphysical punishment and poor adultmental health outcomes. For example,physical punishment has been associ-ated with depressive symptoms in UScollege samples.
34
36
Results from a UScommunity survey indicated that physi-cal punishment in the teenage yearssigni
cantly increased the likelihood of depression, suicidal thoughts, and alco-hol abuse in adulthood.
2
Similarly, 2other studies involving representativeadult samples found that physical pun-ishment was associated with adult de-pression,
5
anxiety disorders,
19
alcoholabuse/dependence,
5,19
and externaliz-ing problems
5,19
independent of the ef-fects of child physical or sexual abuse.Despite increasing evidence regarding theimpairmentassociatedwithphysicalpunishment, some researchers suggest that the
ndings linking physical pun-ishment with harmful outcomes arebased on
awed studies with weak-nesses in design, measurement, andanalysis, including the lack of statisticaladjustmentforconfoundingfactors.
37
39
An important consideration in this re-search is accounting for the confound-ing effects of child maltreatment. Inaddition,gendermayhaveamoderatingeffect on physical punishment withregard to mental disorders, as is thecase for child maltreatment.
14
Further-more, poor parental mental health maybe a possible confounding factor re-quiring statistical adjustment in the re-lationship between physical punishmentand mental disorders. Lower levels of parentalemotionalwell-beinghavebeenassociated with an increased likelihoodof spanking young children,
40
and pa-rental mental disorders may increase thelikelihoodofmentaldisordersamongoffspring.
41
To our knowledge, there have been noexaminations of the link between phys-ical punishment and a broad range of mental health disorders in a nationallyrepresentative sample controlling forseveral types of child maltreatment.Previous studies have not considered the proportion of mental disorders in the general population that may be at- tributabletophysicalpunishmentalonewithout experiencing more severeforms of child maltreatment. Such in-formation would be useful for pedia- triciansandotherhealthcareproviders to consider when making recommen-dationstoparentsontheuseofphysicalpunishment.
2
AFIFI et al
 by guest on July 3, 2012pediatrics.aappublications.orgDownloaded from 

You're Reading a Free Preview

Download
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->