Tracie O. Afifi

BACKGROUND: The use of physical punishment is controversial. No studies have comprehensively examined the relationship between physical punishment and several physical health conditions in a nationally representative sample. The current study investigated possible associations between harsh physical punishment (ie, pushing, grabbing, shoving, slapping, and hitting) in the absence of more severe child maltreatment (ie, physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, and exposure to intimate partner violence) and several physical health conditions. METHODS: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions collected in 2004 and 2005 (n = 34 226 in the current analysis). The survey was conducted with a representative US adult population sample (20 years or older). Eight past year physical health condition categories were assessed. Models were adjusted for sociodemographic variables, family history of dysfunction, and Axis I and II mental disorders. RESULTS: Harsh physical punishment was associated with higher odds of cardiovascular disease (borderline significance), arthritis, and obesity after adjusting for sociodemographic variables, family history of dysfunction, and Axis I and II mental disorders (adjusted odds ratios ranged from 1.20 to 1.30). CONCLUSIONS: Harsh physical punishment in the absence of child maltreatment is associated with some physical health conditions 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 associated with a higher likelihood of physical health conditions.

Objective: To examine the association between a history of 5 types of childhood maltreatment (that is, physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect) and several substance use disorders (SUDs), including alcohol, sedatives, tranquilizers, opioids, amphetamines, cannabis, cocaine, hallucinogens, heroin, and nicotine, in a nationally representative US adult sex-stratified sample. Method: Data were drawn from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative US sample of adults aged 20 years and older (n = 34 653). Logistic regression models were conducted to understand the relations between 5 types of childhood maltreatment and SUDs separately among men and women after adjusting for sociodemographic variables and Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I and II mental disorders. Results: All 5 types of childhood maltreatment were associated with increased odds of all individual SUDs among men and women after adjusting for sociodemographic variables, with the exception of physical neglect and heroin abuse or dependence, emotional neglect, and amphetamines and cocaine abuse or dependence among men (adjusted odds ratio range 1.3 to 4.7). After further adjustment for other DSM Axis I and II mental disorders, the relations between childhood maltreatment and SUDs were attenuated, but many remained statistically significant. Differences in the patterns of findings were noted for men and women for sexual abuse and emotional neglect. Conclusions: This research provides evidence of the robust nature of the relations between many types of childhood maltreatment and many individual SUDs. The prevention of childhood maltreatment may help to reduce SUDs in the general population.

BACKGROUND: 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.METHODS: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions collected between 2004 and 2005 (N = 34 653). The survey was conducted with a representative US adult population sample (aged ≥20 years). Statistical methods included logistic regression models and population-attributable fractions.RESULTS: 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.CONCLUSIONS: 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.

The aim of this study was to examine the relationship between perpetration and victimization of physical and sexual intimate partner violence (IPV) in the past year and substance use disorders (SUDs) in the past year, including alcohol, sedatives/tranquilizers, cocaine, cannabis, and nicotine stratified according to sex. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions. A series of adjusted logistic regression models were conducted. Among men and women, all types of SUDs were associated with increased odds of IPV perpetration (odds ranging from 1.4 to 8.5 adjusting for sociodemographic variables). IPV victimization increased the odds of having all types of SUDs for male and female victims, with the exception of sedatives/tranquilizer abuse/dependence among women (odds ranging from 1.5 to 6.0 adjusting for sociodemographic variables). Substances that had the most robust relationship with perpetration and victimization of IPV included alcohol and cannabis, after adjusting for sociodemographic variables, mood disorders, anxiety disorders, personality disorders, and mutual violence.

Research has shown that the expansion of gambling is an important public health concern and a public health approach should be applied to study problem gambling (Canadian Public Health Association, 2000; Korn, 2000; Korn & Shaffer, 1999). However, such an approach is underutilized. Therefore, a conceptual framework was developed to study problem gambling (or pathological gambling) based on Evans and Stoddart's (1990) popular population health model. This framework can be used to identify psychosocial/social, genetic, and environmental correlates of problem gambling and important relationships between problem gambling and health and functioning, mental and physical health conditions, and help-seeking behaviours.