Physical punishment in childhood associated with later mental disorders, study says

Physical punishment in childhood associated with later mental disorders, study says

Physicians should make parents aware of the potential consequences of discipline, such as spanking and hitting, to avoid long-term health effects, experts say.

By Carolyne Krupa,

 

The saying “spare the rod, spoil the child” may be well-ingrained in North American society, but new research shows that physically punishing children can affect their mental health.

Corporal punishments such as spanking, hitting, pushing and grabbing are associated with the development of mood and anxiety disorders, substance abuse and personality disorders, says a study published online July 2 in Pediatrics (ncbi.nlm.nih.gov/pubmed/22753561/).

Pediatricians and family physicians should talk with parents about healthy ways of disciplining their children and recommend they avoid physical punishment, said Tracie O. Afifi, PhD, lead study author and assistant professor in the Dept. of Community Health Sciences at the University of Manitoba in Winnipeg, Manitoba.

“There are still a lot of people that believe that it is safe to hit your child,” she said. “We’re suggesting that physical punishment should not be used on children of any age. We need to focus more on positive reinforcement.”

Researchers analyzed 2004-05 national data on 34,653 adults 20 and older. They found that the 6% of adults who experienced harsh physical punishment as children were more prone to Axis I and Axis II mental disorders, such as major depression, mania and schizophrenia.

The study distinguished between physical punishment and severe child maltreatment. Any physical punishment that left a mark or a bruise was considered maltreatment and was not included in the study, Afifi said.

The research confirms concerns many physicians have had for a while, said Robert Sege, MD, PhD, a professor of pediatrics at Boston University School of Medicine. Though the link between child abuse and mental disorders is well-established, the study’s findings add another dimension.

“This adds to the scientific information that we can provide to parents to help them make decisions about how they want to raise their children,” said Dr. Sege, a member of the American Academy of Pediatrics’ Committee on Child Abuse and Neglect. “Corporal punishment can make children fear their parents rather than looking to them for support.”

Healthier forms of discipline

Though 6% is a small percentage, a large number of children are at risk when one considers there are about 75 million children in the U.S., said Benjamin Siegel, MD, professor of pediatrics at Boston University School of Medicine and chair of the AAP’s Committee on Psychosocial Aspects of Child and Family Health.

The AAP recommends against physical punishment, Dr. Siegel said. Other methods of discipline are more effective, such as giving timeouts, helping children see the natural consequences of their bad behavior and offering positive reinforcement for good behavior.

“Parents have to find ways so that children can learn life lessons in a protected way,” Dr. Sege said.

For example, after his son twice broke a window playing baseball in the yard, Dr. Sege made him miss a fun activity he was excited about to help fix the window. His son learned to avoid breaking the window after that, he said.

Physicians should foster relationships with child patients and their parents so they feel comfortable discussing topics such as discipline, Dr. Siegel said. It can start with simply asking parents or children how they are feeling to help identify if there is stress in the home.

Dr. Sege said most pediatricians discuss discipline with parents. The key is to provide information to help parents make their own decisions, he said.

“I think it is a pretty common conversation,” Dr. Sege said. “What parents don’t want us to do is to tell them they’re doing it the wrong way.”

Back to top

---

The prevalence of physical punishment

About 6% of 34,653 adults surveyed who received harsh physical punishment when they were children were more prone to mental disorders as adults according to a study published online July 2 in Pediatrics. Researchers distinguished physical punishments such as spanking from abuse that left bruises or marks. Physical punishment was most common among males, whites and those from families with higher income and education levels.

Group	No physical punishment	Physical punishment
Gender
Male	48%	59%
Female	52%	41%
Race/Ethnicity
White	73%	72%
Black	10%	14%
American Indian/Alaska Native	2%	2%
Asian/Native Hawaiian/Other Pacific Islander	4%	1%
Hispanic	11%	10%
Education
Less than high school	13%	9%
High school	28%	29%
Some college	21%	23%
Postsecondary degree	38.8%	39.2%
Past year household income
$19,999 or less	17%	11%
$20,000-$39,999	24%	22%
$40,000-$69,999	27%	29%
$70,000 or more	32%	38%

Source: “Physical Punishment and Mental Disorders: Results from a Nationally Representative U.S. Sample,” Pediatrics, published online July 2 (ncbi.nlm.nih.gov/pubmed/22753561/)

Ideas: Children & Physical Punishment

Is corporal punishment – beating, slapping, spanking – a good way to make children behave?

---

Arguments against using corporal (physical) pu/nishment:

• Can cause permanent, lifelong damage, such as poor school performance, juvenile delinquency (misbehavior as a teenager), domestic violence, etc.
• Can cause physical injury to children, such as broken bones, bruises
• Is used more against children who live in poverty, with disabilities, or who are from minorities
• Teaches children that force is an acceptable way of making others do something, that it is acceptable to hit someone smaller or weaker when you are angry
• Damages the relationship between children and the parents
• Shows an emotional lack of control or resources on the part of the parent

Arguments in favor of using corporal (physical) punishment:

• It is immediate. The child can see the result of what he did and the relationship between the wrongdoing and the punishment.
• Other punishments can be even more psychologically damaging or humiliating
• It is effective and easily remembered by the child. It is uncomplicated. Children can understand physical punishment easily.
• Children cannot always understand punishment which is removed from the time or the scene of what they did wrong.
• Parents love their children. They have no intention of hurting them. They are punishing them for a misdeed, not injuring them physically.
• We live a violent world. We cannot pretend that violence does not exist.