Physical Punishment and Mental Disorders: Results From a Nationally Representative US Sample

• Published in: Pediatrics (Evanston) 2012-08, Vol.130 (2), p.184-192
• Main Authors: AFIFI, Tracie O, MOTA, Natalie P, DASIEWICZ, Patricia, MACMILLAN, Harriet L, SAREEN, Jitender
• Format: Article
• Language: English
• Subjects: Adult; Alcoholism - epidemiology; Alcoholism - psychology; Anxiety Disorders - epidemiology; Anxiety Disorders - psychology; Biological and medical sciences; Child; Child abuse & neglect; Child Abuse - psychology; Child Abuse - statistics & numerical data; Child discipline; Child psychopathology; Child Rearing - psychology; Child, Preschool; Childhood mental disorders; Cross-Sectional Studies; Demographics; Discipline of children; Educational Status; Emotional disorders; Female; General aspects; Health Surveys; Humans; Infant; Likelihood Functions; Male; Medical sciences; Mental Disorders - epidemiology; Mental Disorders - psychology; Methods; Mood Disorders - epidemiology; Mood Disorders - psychology; Odds Ratio; Pediatrics; Personality disorders; Personality Disorders - epidemiology; Personality Disorders - psychology; Psychological aspects; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Punishment; Regression Analysis; Risk Factors; Socioeconomic Factors; Statistics as Topic; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Surveys; United States; Victimology; Violence - psychology; Violence - statistics & numerical data
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2011-2947

The use of physical punishment is controversial. Few studies have examined the relationship between physical punishment and a wide range of mental disorders in a nationally representative sample. The current research investigated the possible link between harsh physical punishment (ie, pushing, grabbing, shoving, slapping, hitting) in the absence of more severe child maltreatment (ie, physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, exposure to intimate partner violence) and Axis I and II mental disorders. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions collected between 2004 and 2005 (N = 34653). The survey was conducted with a representative US adult population sample (aged ≥ 20 years). Statistical methods included logistic regression models and population-attributable fractions. Harsh physical punishment was associated with increased odds of mood disorders, anxiety disorders, alcohol and drug abuse/dependence, and several personality disorders after adjusting for sociodemographic variables and family history of dysfunction (adjusted odds ratio: 1.36-2.46). Approximately 2% to 5% of Axis I disorders and 4% to 7% of Axis II disorders were attributable to harsh physical punishment. Harsh physical punishment in the absence of child maltreatment is associated with mood disorders, anxiety disorders, substance abuse/dependence, and personality disorders in a general population sample. These findings inform the ongoing debate around the use of physical punishment and provide evidence that harsh physical punishment independent of child maltreatment is related to mental disorders.