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.
Physical punishment has been a com-monlyusedmethodofdisciplineinNorthAmerica and is considered socially ac-ceptable by many caregivers.
In a USsample of the Carolinas, for example,46% of mothers reported slapping orspanking in the past year.
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.
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.
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.
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.
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,
just like the broad associa- tions found in the literature on childmaltreatment. In addition, perhaps theexperienceofphysicalpunishment,evenif not
may generateacute or chronic stress through experi-encesofanxiety,fear,andshame,amongothers, that are associated with physio-logic and emotional dysregulation
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.
Reviewsoftheliteraturehaveindicated that physical punishment is related tohigher levels of aggression, delinquency,andinternalizingconditionsinadditiontolower levels of internalizing morals andoverall mental health.
There is someevidencethatphysicalpunishmentisalsoassociatedwithimmediatecompliance.
Many studies have found a link betweenphysical punishment and poor childand adolescent social, emotional, cog-nitive, developmental, and behavioralproblems or impairment.
There isalsoevidenceforanassociationbetweenphysical punishment and poor adultmental health outcomes. For example,physical punishment has been associ-ated with depressive symptoms in UScollege samples.
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.
Similarly, 2other studies involving representativeadult samples found that physical pun-ishment was associated with adult de-pression,
and externaliz-ing problems
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.
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.
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,
and pa-rental mental disorders may increase thelikelihoodofmentaldisordersamongoffspring.
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.
AFIFI et al