During the past two decades, physical punishment of children has become an issue of public concern rather than a private family affair. This growing societal interest has led to greater research and improvements in methodology (Black, 1991). Data indicate an association between physical punishment and deficiencies in psychological and social development. Several studies also point to a greater prevalence of psychopathology in physically abused children.
Trickett (1993) compared 29 families of physically abused children (ages 4-11) with 29 control families, matched for race, gender of the child, and family socioeconomic status (SES). Using structured interviews, standardized tests, and standardized observations, he found that the physically abused children had poorer cognitive maturity, poorer interpersonal problem-solving skills, and less social competence.
Kurtz and associates (1993) compared 22 physically abused children (ages 8-16), 47 neglected children, and controls. They reported that the physically abused children displayed pervasive and severe academic and socioemotional problems at school.
Allen and Tarnowsky (1989) compared physically abused and nonabused children. They found that the former evidenced more dysphoric characteristics, heightened externality (on a locus of control scale), lower self- esteem, and greater hopelessness concerning the future.
Oates, Forrest, and Peacock (1985) studied the self-esteem of children (ages 4-14) who were admitted to hospital emergency rooms because of physical abuse. Using structured interviews and a self-concept scale, they found that the abused children saw themselves as having significantly fewer friends than did the comparison sample. They also played with friends less often. They were less ambitious than the nonabused children with regard to the occupations to which they aspired, and scored significantly lower in self-concept. However, the study did not control for SES. As Rutter (1989) points out, since social disabilities go hand in hand with parenting problems, it is difficult to ascertain (unless SES is controlled satisfactorily) whether psychosocial deficiencies in battered children are due to the physical punishment or to the broader context of the socioeconomic environment.
Salzinger et al. (1993) compared the social behavior and peer status of 87 physically abused children (ages 8-12) and 87 case-matched classmates. Abused subjects had lower peer status and less positive reciprocity with peers chosen as friends. They were rated by peers as more aggressive and less cooperative, and by parents and teachers as more disturbed. These results raise questions as to the role of the child in physical abuse and factors that heighten the risk of abuse (Ammerman, 1991).
Haskett and Kistner (1991) investigated the peer interaction of 14 physically abused children and 14 control children (ages 3-6) using behavior observation, teacher ratings, and peer psychometric ratings. Abused children initiated fewer positive interactions with peers and exhibited higher proportions of negative behavior than did nonabused children. Teachers viewed abused children as more behaviorally disturbed.
Several studies have reported that a higher proportion of adults suffering from psychiatric disturbances had been physically abused during childhood. Bremner et al. (1993) compared rates of childhood physical abuse in 38 Vietnam combat veterans who sought treatment for posttraumatic stress disorder (PTSD) and 28 Vietnam combat veterans without PTSD who sought treatment for medical disorders. Premilitary and military stressful and traumatic events were assessed. Subjects with PTSD had higher rates of childhood physical abuse than did subjects without PTSD. The association between childhood physical abuse and PTSD persisted after controlling for the differences in the level of combat exposure between the two groups. The authors concluded that childhood physical abuse may be an antecedent of combat-related PTSD. Similarly, Zaidy (1994) found a positive correlation between physical abuse history and the severity of combat-related PTSD.
Kirby, Chu, and Dill (1993) studied psychiatric inpatients. They found a positive correlation between frequency of physical abuse in childhood and degree of dissociative symptomatology.
The studies reviewed thus far investigated the psychological well- being of children who suffered from physical punishment, or the history of abuse of adult psychiatric patients. The purpose of the present study was to investigate signs of mental distress in the general population of normal adolescents. Extreme cases of battered children (for example, those observed in emergency rooms) were not addressed. Items dealing with violent punitive behavior of parents were administered as part of a general study of adolescence. SES and basic parental attitudes toward the adolescent, conceptualized and quantified by the Parental Bonding Instrument (Parker et al., 1979), were controlled.
The subjects for this study were 871 Israeli high school students, 375 males and 496 females. Efforts were made to recruit subjects from a large variety of schools across the country. Students came from eight high schools in Jerusalem, Haifa, and Beer-Sheva: one selective high school (n = 132), two schools for children with learning difficulties (n = 104), three nonselective catchment area high schools in Jerusalem (n = 365), one nonselective high school in Beer-Sheva (n = 230), and one religious yeshiva high school in Jerusalem (n = 40). The selective and the religious high schools are the closest possible equivalents in Israel to private schools in that the students are selected for these institutions on the basis of merit and achievement tests.
Three hundred forty-eight students were in the 10th grade and 523 were in the 12th grade. Their average age was 16.7 years. Eight hundred one (92%) were born in Israel. Twenty (2.3%) immigrated to Israel from Eastern Europe, 39 (4.5%) from America, 9 (1%) from Western Europe, and 2 (0.2%) from Asia and North Africa. Most of the students who immigrated to Israel (86.9%) had done so before the age of 10.
The Brief Symptom Inventory (BSI; Derogatis & Spencer, 1982) is a brief psychological self-report scale that was developed from its longer parent instrument, the Symptom Checklist 90 (SCL-90). It includes 53 items, each of which represents a symptom or a negative state of mind. Subjects are required to rate, on a severity scale from 0 to 4, the degree to which they were disturbed by each of the BSI items during the preceding months. The factor structure includes nine symptom areas: somatization, obsessiveness, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. An overall score can also be obtained; the Global Severity Index (GSI) is the average symptom score for the entire scale. The higher the score, the greater the tendency to report psychiatric symptoms and distress.
Both test-retest and internal reliabilities have been shown to be very good for the primary symptom dimensions of the BSI, and correlations with the comparable dimensions of the SCL-90 are high. High convergence validity has been found between the BSI and similar dimensions of the MMPI. Factor analytic studies of the internal structure of the scale contribute evidence of construct validity.
The General Well-Being Scale (GWB; Dupuy, 1975) is a self-report instrument designed to assess aspects of subjective well-being and distress. Response options were formulated to provide indications of the presence, severity, and frequency of both symptoms and positive feelings that are generally considered important in clinical assessment. The scale contains 33 items. Six subscales measure health worries, energy level, satisfying-interesting life, depressed versus cheerful mood, emotional- behavioral control, and relaxed versus tense-anxious. A total score can also be obtained. The higher the score, the greater the tendency to report better psychological well-being.
The Parental Bonding Instrument (PBI; Parker et al., 1979) measures subjects' perceptions of their parents' attitude toward them. There is a version for each parent, with 12 care items and 13 overprotection- control items. Responses are based on a 4-point scale, where 1 is very like, 2 is moderately like, 3 is moderately unlike and 4 is very unlike the parent. Two scores are obtained for each parent - a care score and a control score. The higher the score, the higher the parent is perceived as providing a high amount of care or as exerting high control. Four categories are produced from the interplay of these two factors: optimal bonding = high care/low control, weak parental bonding = low care/low control, affectionate constraint = high care/high control, and affectionless control = low care/high control. Parker et al. (1979) have reported good test-retest reliability and split- half reliability. There was concurrent validity of the instrument with scores obtained in the interview. Internal reliability (Cronbach' s alpha) was established for the four subscales: maternal care (.75), maternal control (.82), paternal care (.80), and paternal control (.83).
Two questions, supplementing the PBI, tapped the violent punitive behavior of each parent: "sometimes he/she beats me" and "he/she frequently explodes angrily at me." Subjects rated each from not at all like my mother/father to very much like my mother/father. Split-half reliability for the two questions was .33 for mother and .35 for father; .83 and .84, respectively, with correction to 20 items (Carmines & Zeller, 1991).
Questionnaires were administered in the students' classrooms in the presence of their teachers. All students who were present in the class were invited to participate, and anonymity was assured. A negligible number of students refused.
Table 1 reveals increases in BSI scores and decreases in GWB scores with increasing degrees of identification of parents as exerting violent punitive behavior. Tukey tests revealed significant differences between the two extreme groups (not at all like my mother/father and very much like my mother/father), and often between two adjacent groups. These results persisted after SES (defined by parents' education and occupation) was covaried.
Basic parental attitudes, described by Parker (1988) as parental bonding, did not alter the relationship found between physical punishment and adolescent mental health (see Table 2). Punishment was divided in Table 2 into two categories: nonviolent (if the adolescent rated both parents as not exerting violent punitive behavior) and violent (if the adolescent rated at least one parent as exerting violent punitive behavior). There was a main effect of parental bonding on mental health. Adolescents who reported optimal parental bonding had the best mental health scores (BSI and GWB); those with less than optimal bonds with their parents had worse scores on the mental health measures. These results are dealt with in greater detail elsewhere (Canetti et al., 1997). The negative effect of violent parental punitive behavior on adolescent mental health was evident in each bonding category.
[TABULAR DATA FOR TABLE 1 OMITTED]
[TABULAR DATA FOR TABLE 2 OMITTED]
This study investigated signs of mental distress in a large sample of normal adolescents who reported receiving physical punishment from their parents. Adolescents who perceived their parents as being accustomed to using physical punishment reported higher levels of psychiatric symptoms (higher BSI scores) and lower levels of well-being (lower GWB scores). These findings point to the close association between physical punishment and mental distress in adolescents and to quantity and cumulative factors.
Rutter (1989), Kurtz et al. (1993), and Starr et al. (1991) have drawn attention to the possibility that sociodemographic characteristics are linked to the kind of discipline used at home. This necessitates differentiating the distinct role physical punishment plays in mental health from the effects of intervening sociodemographic factors. In the present study, the relationship between physical punishment and mental distress persisted after controlling for SES.
In an effort to determine the distinct role physical punishment plays in adolescent mental health, this study also controlled for global and basic parenting patterns (a methodological step that has been recommended by Wolfe & McGee, 1991), namely parental bonding (Parker et al., 1979). Parental bonding covers a wide range of parent-child interactions and has been found to predict psychopathology and some child behaviors (Parker, 1990; Parker & Lipscombe, 1980). The negative effects of physical punishment persisted across all four categories of parental bonding (produced by the interplay of the parental care and parental control factors). No interaction was found between physical punishment and parental bonding in regard to mental distress.
Ammerman (1991), in a review of the literature, concluded that children have no significant role in the etiology of physical abuse. Ammerman' s conclusion was supported in a study by Whitmore et al. (1993), which found that male adults who had been referred to an attention deficit disorder unit did not report differing from siblings in receiving physical punishment from parents during childhood. They concluded that punitive behavior of parents was not significantly influenced by the child's hyperactive behavior, which sometimes included aggressive features. They refuted the hypothesis that the behavior of ADHD children elicits punitive behavior from parents. The effects of corporal punishment administered in schools was not investigated. Such punishment is prohibited in Israel and is becoming rare throughout the Western world. One may speculate as to the different emotional consequences of physical punishment experienced at home versus at school. It may be argued that the former comes at a deeper emotional price. Starr et al. (1991), for example, found that parents tended to repeat the physical punishment of offspring more often in cases where they themselves had been physically abused by the parent of the opposite sex, leading, perhaps, to psychosexual complications.
It is hoped that the findings of the present study will contribute to efforts to raise public awareness of the harmful effects of physical punishment on children. The findings indicate the need to conduct a longitudinal study (see Black, 1991) that will distinguish the kinds of physical punishment meted out, the duration of the punishment, and the chronicity (Zuravin, 1991).
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Bachar, Eytan; Canetti, Laura; Bonne, Omer; DeNour, Atara Kaplan; Shalev, Arieh Y., Physical punishment and signs of mental distress in normal adolescents.., Vol. 32, Adolescence, 12-22-1997, pp 945(14).