The impact of child abuse - greater than we might imagine

It became one of those quick national stories that flips onto the front pages for a day and is then lost. But that surely should not be the case with this one. A Canadian study soon top be published in the Canadian Medical Association Journal reports on the prevalence of child abuse and mental disorders. The results are profound.

The sample is based on just over 25,000 Canadians in 10 provinces (The 3 Northern Territories of Canada were not included).The authors looked at physical abuse, sexual abuse and exposure to intimate partner violence.  The adult responders reported on experiences before the age of 16.  Here's what they found:

1. The prevalence of any of the 3 types of child abuse was 32.1%, with physical abuse being the most common (26.1%), followed by sexual abuse (10.1%) and exposure to intimate partner violence (7.9%).
2. All child abuse types were associated with increased odds of all mental conditions (such as depression, bipolar disorder, generalized anxiety disorder, substance abuse and dependence, suicidal ideation and attempts, ADHD, Eating Disorders, PTSD, learning disabilities). 

These are quite profound numbers. It is highly probable that this data would be replicated in many Western countries that share similar family and parenting patterns. The costs (emotional, physical and financial) are astounding. Society is also paying a very large price for this through the health care, child protection, criminal justice and education systems. The strongest linkages that the authors found was between exposure to these 3 types of abuse and suicidal ideation, and attempts as well as substance abuse and dependence. 

Even more profound is the "…the least severe type of physical abuse (being slapped on the face, head or ears, or hit or spanked with something hard) showed a strong association with all mental conditions in models adjusting for sociodemographic covariates." In other words, even mild abuse has long term implications. 

This also brings us back to the spanking debate - minor abuse seems to be harmful. This research comes at a time when a study just published in the Journal of Family Psychology notes that in 73% of the cases where there was corporal punishment, the child misbehaved again within 10 minutes. That research is based on a small sample but it adds the very large body of research that tells us that spanking remains an ineffective form of parenting. The Canadian data also suggests that the impact may be long term and not what most parents would hope for - a greater risk of mental illness.

This research should help social workers and others working with families to underline why other forms of parenting and discipline are better for the child.

Harsh physical punishment creates long term problems

Many may be familiar with the Adverse Childhood Experiences research. This powerful, robust work helps us to see that negative events in childhood have long term implications for physical and emotional health. A new study published in Paediatrics online this week adds to the data that what goes on in childhood has significant implications for our health as adults.

Drawing on data from the US National Epidemiological Survey on Alcohol and Related Conditions, which has a sample size of 34,226 people, the researchers were able to conclude:

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).

This is important as we really come to understand that even in the absence of childhood maltreatment, harsh physical discipline does not lead to the desired outcome of better adults. This is important data in the ongoing debate about the use of corporal punishment. Consistently we see little objective data that supports its use.

Reference:

Harsh Physical Punishment in Childhood and Adult Physical Health

1. Tracie O. Afifi
, PhD, 
2. Natalie Mota, MA, 
3. Harriet L. MacMillan, MD, FRCPC, and 
4. Jitender Sareen, MD, FRCPC.