Corporal punishment and primary prevention of physical abuse.

OBJECTIVE: To bring to the attention child maltreatment professionals the potential for primary prevention of physical abuse of ending or reducing corporal punishment by parents. METHOD: The October 1999 special issue of Child Abuse & Neglect on "A National Call to Action: Working Toward the Elimination of Child Maltreatment" was reviewed in relation to coverage of corporal punishment by parents. RESULTS: Corporal punishment was not mentioned in any of the nine articles. CONCLUSIONS: The combination of research showing that corporal punishment is a major risk factor for physical abuse and research showing the wide prevalence and chronicity of corporal punishment suggests that the "National Call For Action" should include steps to end use of corporal punishment as a mode of discipline.

Corporal punishment by American parents: national data on prevalence, chronicity, severity, and duration, in relation to child and family characteristics.

We present data on corporal punishment (CP) by a nationally representative sample of 991 American parents interviewed in 1995. Six types of CP were examined: slaps on the hand or leg, spanking on the buttocks, pinching, shaking, hitting on the buttocks with a belt or paddle, and slapping in the face. The overall prevalence rate (the percentage of parents using any of these types of CP during the previous year) was 35% for infants and reached a peak of 94% at ages 3 and 4. Despite rapid decline after age 5, just over half of American parents hit children at age 12, a third at age 14, and 13% at age 17. Analysis of chronicity found that parents who hit teenage children did so an average of about six times during the year. Severity, as measured by hitting the child with a belt or paddle, was greatest for children age 5-12 (28% of such children). CP was more prevalent among African American and low socioeconomic status parents, in the South, for boys, and by mothers. The pervasiveness of CP reported in this article, and the harmful side effects of CP shown by recent longitudinal research, indicates a need for psychology and sociology textbooks to reverse the current tendency to almost ignore CP and instead treat it as a major aspect of the socialization experience of American children; and for developmental psychologists to be cognizant of the likelihood that parents are using CP far more often than even advocates of CP recommend, and to inform parents about the risks involved.

Impulsive corporal punishment by mothers and antisocial behavior and impulsiveness of children.

This study tested the hypothesis that corporal punishment (CP), such as spanking or slapping a child for purposes of correcting misbehavior, is associated with antisocial behavior (ASB) and impulsiveness by the child. The data were obtained through interviews with a probability sample of 933 mothers of children age 2-14 in two small American cities. Analyses of variance found that the more CP experienced by the child, the greater the tendency for the child to engage in ASB and to act impulsively. These relationships hold even after controlling for family socioeconomic status, the age and sex of the child, nurturance by the mother, and the level of noncorporal interventions by the mother. There were also significant interaction effects of CP with impulsiveness by the mother. When CP was carried out impulsively, it was most strongly related to child impulsiveness and ASB; when CP was done when the mother was under control, the relationship to child behavior problems was reduced but still present. In view of the fact that there is a high risk of losing control when engaged in CP, even by parents who are not usually impulsive, and the fact that impulsive CP is so strongly associated with child behavior problems, the results of this study suggest that CP is an important risk factor for children developing a pattern of impulsive and antisocial behavior which, in turn, may contribute to the level of violence and other crime in society.

Identification of child maltreatment with the Parent-Child Conflict Tactics Scales: development and psychometric data for a national sample of American parents.

OBJECTIVE: To create a parent-to-child version of the Conflict Tactics Scales, the CTSPC. METHOD: Description of the conceptual and methodological approaches used and psychometric data for a nationally representative sample of 1,000 U.S. children. RESULTS: (1) Improved Psychological Aggression and Physical Assault scales. (2) New Nonviolent Discipline scale, supplementary scale for Neglect, and supplemental questions on discipline methods and sexual abuse. (3) Reliability ranges from low to moderate. (4) Evidence of discriminant and construct validity. CONCLUSIONS: The CTSPC is better suited to measuring child maltreatment than the original CTS. It is brief (6 to 8 minutes for the core scales) and therefore practical for epidemiological research on child maltreatment and for clinical screening. Methodological issues inherent in parent self-report measures of child maltreatment are discussed.

Spanking by parents and subsequent antisocial behavior of children.

OBJECTIVE: To deal with the causal relationship between corporal punishment and antisocial behavior (ASB) by considering the level of ASB of the child at the start of the study. METHODS: Data from interviews with a national sample of 807 mothers of children aged 6 to 9 years in the National Longitudinal Survey of Youth-Child Supplement. Analysis of variance was used to test the hypothesis that when parents use corporal punishment to correct ASB, it increases subsequent ASB. The analysis controlled for the level of ASB at the start of the study, family socio-economic status, sex of the child, and the extent to which the home provided emotional support and cognitive stimulation. RESULTS: Forty-four percent of the mothers reported spanking their children during the week prior to the study and they spanked them an average of 2.1 times that week. The more spanking at the start of the period, the higher the level of ASB 2 years later. The change is unlikely to be owing to the child's tendency toward ASB or to confounding with demographic characteristics or with parental deficiency in other key aspects of socialization because those variables were statistically controlled. CONCLUSIONS: When parents use corporal punishment to reduce ASB, the long-term effect tends to be the opposite. The findings suggest that if parents replace corporal punishment by nonviolent modes of discipline, it could reduce the risk of ASB among children and reduce the level of violence in American society.

Sexually abused children in a national survey of parents: methodological issues.

In a national survey of 1,000 parents, which primarily concerned disciplinary practices and violence toward their children, two questions were asked about whether the children had been sexually abused. This was to assess the feasibility of epidemiological research on contemporaneous sexual abuse using parental interviews rather than the usual adult retrospective approach. From these questions, rates of sexual abuse for children currently 0-17 were estimated at 1.9% in the last year and 5.7% ever. The cases making up these rates included a nearly equal number of boys and girls and no female victims between the ages of 9 and 12, a distribution different from those generally obtained by other epidemiological methods, but due possibly in this case to normal sampling variation. Cases were more likely to be disclosed for children whose parents had themselves been sexually abused, who were from lower income households, or who were living with only one biologic parent. Although some of the findings suggest caution in generalizing about child sexual abuse from survey samples of parents, the method is worthy of exploration if only to gain better epidemiologic data about parent knowledge, reaction, reporting, and coping strategies.

Screening for physical violence in couple therapy: methodological, practical, and ethical considerations.

Over two-thirds of clients in family therapy clinics engage in some form of physical violence against their partners within the year prior to the initiation of therapy. However, family therapists are aware of only a small proportion of these cases. The purpose of this article is to enhance the ability of family therapists to detect marital violence. We examine client and therapist reasons for why physical violence is not detected. We then review various methods to screen for the presence of physical violence, especially the Conflict Tactics Scales. Finally, indicators of life-threatening violence are presented to help family therapists detect cases that require immediate intervention to protect the partner whose life may be in danger.

Corporal punishment of adolescents by parents: a risk factor in the epidemiology of depression, suicide, alcohol abuse, child abuse, and wife beating.

Over 90% of parents of toddlers spank or use other forms of corporal punishment. Although the rate declines each year from about age five, this study of a large national sample of U.S. adults found that almost half recalled having been corporally punished during their teen years. This high prevalence indicates a need to investigate the possibility that corporal punishment puts adolescents at increased risk of developing mental health and social relationship problems later in life. The analysis, which controlled for a number of possible confounding risk factors such as low socioeconomic status, found that children who experienced corporal punishment in adolescence had an increased risk later in life of depressive symptoms, suicidal thoughts, alcohol abuse, physical abuse of children, and wife beating. The consistent association of corporal punishment with major adult problem behavior, together with the fact that at least half of all adolescents are victims of corporal punishment by their parents, indicates a need to replicate the study using longitudinal data. If the findings are confirmed, it suggests that a major step in primary prevention of violence and mental health problems can be achieved by a national effort to reduce or eliminate all use of corporal punishment.

Social stress and state-to-state differences in smoking and smoking related mortality in the United States.

This paper reports on the relationship between the stressfulness of the social environment, smoking and mortality rates for malignant neoplasms of the respiratory system and chronic obstructive pulmonary disease (COPD). A macro-social approach was employed with the 50 states of the United States serving as the units of analysis. A 'State Stress Index' was computed using stressful events in 15 categories (divorce rate, business failures, natural disasters, etc.). Smoking behavior was measured by percentage smokers and the average cigarette sales per capita. Mortality rates for lung cancer and COPD were standardized by age. The percent population living in metropolitan areas, black, below poverty line, and with less than high school education were included as controls in the multiple regression analysis. The results show that populations that experience higher levels of stressful events smoke more heavily and eventually experience higher mortality from lung cancer and COPD. These relationships are robust: they are replicated for different time periods, for different measures of the independent and dependent variables, and with different analytic methods. The pattern of findings is consistent with a 'health behavior' model of stress in which populations under stress engage in behavior which is extremely inimical to health.

Family patterns and primary prevention of family violence.

Although services for victims and treatment programs for batterers have priority in efforts to ameliorate family violence, primary prevention programs are also essential. The importance of primary prevention lies not only in the suffering which can avoided, but also because it is unlikely that sufficient treatment resources can be allocated to match the magnitude of the problem. The latter point is illustrated by the results of a study of nationally representative samples of 2,143 families (studied in 1975) and 6,002 families (studied in 1985). These studies show that a minimum of 16% of American couples experienced an assault during the year of the study, and that about 40% of these involved severely violent acts, such as kicking, biting, punching, choking, and attacks with weapons. These studies also identified risk factors that can serve as the focus for primary prevention, for example, early marriage, male dominance in the family and use of physical punishment. Educational and therapeutic efforts, and economic changes, which encourage equality and which teach the skills necessary for an equal relationship, can help prevent family violence.

Mother's age and risk for physical abuse.

It is widely believed that young mothers are at greater risk of engaging in physical abuse. However, this relationship is not clearly supported by previous empirical research. This study reexamines the issue using a nationally representative sample of 1,997 mothers. All analyses controlled for family income, race, number of minor children in the home, age of abused child, mother's education, and whether mother was a single parent. Physical abuse was measured with the Conflict Tactics Scales. Using mother's age at time of birth of the abused child, the younger the mother, the greater the rate of child abuse; however, there was not a significant relationship when mother's age was measured at age at time of abuse. Large families and minority group children were also found to be at greater risk of abuse. The paper discusses implications for further research and for prevention of child abuse.

Verbal aggression by parents and psychosocial problems of children.

Analyses of data on a nationally representative sample of 3,346 American parents with a child under 18 living at home found that 63% reported one or more instances of verbal aggression, such as swearing and insulting the child. Children who experienced frequent verbal aggression from parents (as measured by the Conflict Tactic Scales) exhibited higher rates of physical aggression, delinquency, and interpersonal problems than other children. This relationship is robust since it applies to preschool-, elementary school-, and high school-age children, to both boys and girls, and to children who were also physically punished as well as those who were not. Children who experienced both verbal aggression and severe physical violence exhibited the highest rates of aggression, delinquency, and interpersonal problems.

Rape and its relation to social disorganization, pornography and inequality in the USA.

A theoretical model seeks to integrate social disorganization and feminist theories of rape, reporting an empirical test of that model using data on rapes per 100,000 population known to the police in the 50 states of the United States. The model includes the following aspects of the social organization of the states: social disorganization (measured by a six item index), sexual inequality (measured by a status of women index to men), pornography (measured by a sex magazine circulation index for eight sexually explicit magazines) and the level of culturally legitimate violence (measured by a 12 item legitimate violence index using indicators like corporal punishment in schools. There were marked differences between states of the USA in the incidence of rape during the 1980-82. Path analysis was used to test the theoretical model, which posits rape as a function of the direct and indirect effects of social disorganization, sexual inequality, pornography, legitimate violence and seven control variables. The results show that all four variables play an important part in explaining differences between states in rape; and that together, the variables in the model explain 83 per cent of the state-to-state variation in rape. Women are in much greater danger of being raped in some American states than in others. Since the FBI began compiling statistics on rape, states like Alaska, Nevada, and California have consistently registered many more rapes per capita than North Dakota, Maine, and Iowa. What factors account for such differences between states? Could the variation in the rape rate be explained by four aspects of the social structure of states: (1) the proliferation of pornography (2) sexual inequality (3) culturally legitimate violence and (4) social disorganization. Each factor represents a theory which will be examined within the context of an integrated theory on rape.

Substance abuse as a precipitant of wife abuse victimizations.

This study examines the question of whether drug and alcohol use by victims constitutes a risk factor increasing the chances of their being assaulted by their partners. Data from a subsample of the 1985 National Family Violence Survey consisting of the 2,033 female respondents who were currently married or living in a male-female couple relationship are used as the basis of the analysis. The logistic analysis revealed that, of the ten variables in the model, the most important for distinguishing abused from nonabused women are husband's drug use, a history of paternal violence in womens' family or origin, husband's drunkenness, low income, and wife's drunkenness. Women who abuse alcohol are more likely to be victims of minor marital violence, but female substance abuse of any type is not a significant factor in severe violence.

Sexual climate and reported rape: a state-level analysis.

Data on the US states are used to study two aspects of sexual climate: sexually liberal attitudes and sex magazine readership, and their relationship to reported rape. The two sexual climate measures are correlated (r = 0.50), but each also seems to measure a different facet of sexual climate: tolerance for the sexual behavior of others in the case of the Sexual Liberalism Index, and perhaps sexuality per se in the case of sex magazine readership. States in the Northeast have the highest average sexual liberalism score, and states in the West have the highest average readership of sex magazines. The relationship between sexual climate and the incidence of reported rape was investigated using multiple regression. Results indicate no relationship between sexually liberal attitudes and rape, but that sex magazine readership, urbanization, poverty, and a high percentage of divorced men are each significantly associated with the incidence of reported rape. The findings are interpreted within a theoretical model that posits rape as a function of social disorganization and hypermasculine gender roles and sexuality.

Social stress, normative constraints and alcohol problems in American states.

Robert Bales' theory explains rates of alcoholism in populations by the combination of socially induced stress and tension together with a normative system that promotes the use of alcohol for releasing that tension. This paper provides the first systematic test of that theory by combining the variables of social stress and normative approval of alcohol within the same research design. Ecological correlations are used with the 50 states as units of analysis. Stress was measured by a 'state stress index' based on 15 stressful 'life events' aggregated to the state level. Events vary from rates of divorce to community disaster. Normative constraints on drinking were measured by a multi-indicator proscriptive norms index based on religious composition and legal impediments to the purchase and consumption of alcohol. The states were divided into quartiles based on normative constraints surrounding alcohol use from proscriptive to permissive. Alcohol problems were measured by three indicators of heavy drinking and three indicators of alcohol related arrests. All but one of the 24 correlations between the state stress index and the indicators of alcohol problems were highest within the context of strong cultural support for the use of alcohol, thus supporting Bales' original theory. For the arrest variables there was also a clear pattern of curvilinearity, with a second distinct 'peak' in the correlations within the polar opposite quartile of proscriptive states. Competing explanations for the pattern are discussed including the 'social control' hypothesis and the 'ambivalence' hypothesis.

Capital intensive hospital technology and illness: an analysis of American state data.

This paper: describes the development of a 'hospital technology index' to measure the level of capital intensive medical technology in each of the 50 U.S. states and the District of Columbia, reports differences between states in scores on this index, and tests the hypothesis that there is a low but significant negative correlation between the level of capital intensive medical technology and the level of illness. The three subscales of the hospital technology index have high alpha coefficients of reliability, are reasonably orthogonal, and there is at least some evidence of construct and discriminant validity for each. The multiple regression analysis suggests that there is either no relation between capital intensive medical technology and the rate of illness or that there is a slight tendency for the illness rate to increase as the level of technology increases. Eight possible explanations for the findings are discussed.