Afifi, T.O., Brownridge, D.A., Cox, B.J., & Sareen, J. (2006). Physical punishment, childhood abuse and psychiatric disorders. Child Abuse & Neglect, 30, 1093-1103.
Une controverse existe selon laquelle la punition corporelle d'un enfant dans un contexte disciplinaire serait associée à des résultats négatifs à l'âge adulte. Utilisant les données d'une enquête représentative à l'échelle nationale sur la santé mentale conduite au début des années 90 (la National Comorbidity Survey ou NCS), cette étude a examiné trois catégories de sévérité croissante pour les enfants confrontés à l'adversité (pas de punition corporelle ou d'abus, punition corporelle seulement, et abus envers l'enfant) afin de déterminer si seule l'expérience de punition corporelle chez l'enfant serait associée à une psychopathologie à l'âge adulte. La prévalence des troubles psychiatriques, ainsi que la prévalence de faibles protection et soutien affectif parentaux augmentent progressivement au fur et à mesure qu'augmente la sévérité pour les enfants confrontés à l'adversité. Également, après avoir ajusté les variables socio-démographiques (âge, sexe, éducation, revenu, statut marital et ethnicité) et les liens parentaux (sur trois échelles: le soutien affectif parental perçu, la protection et l'autoritarisme), la punition corporelle a été associée à une probabilité accrue de dépression majeure, d'abus ou de dépendance à l'alcool, et d'extériorisation des problèmes rendu à l'âge adulte. De tels résultats étaient toutefois moins probables chez les enfants n'ayant expérimenté que la punition corporelle plutôt que de l'abus. Finalement, des analyses plus poussées ont démontré que souffrir d'un ou de plusieurs troubles psychiatriques est significativement associé à l'expérience de punition corporelle ou d'abus.
This study used the entire sample of the NCS (5,838 respondents aged between 15 and 54), where 35.5% experienced no physical punishment or child abuse (reference group), 48% experienced physical punishment only and 16.5% experienced child abuse (physical and/or sexual). The Conflict Tactic Scales (CTS) was used to distinguish these three groups. Physical punishment was measured by the minor physical assault or physical punishment items from the CTS, which include: having something thrown at you, being pushed, grabbed, shoved, and being slapped or spanked. Child abuse was measured by the following items of the CTS: being kicked, bit, hit with a fist or an object, being beat up, choked, burned or scalded. Respondents indicating that a parent did one or more of these actions often, sometimes or rarely were included in the relevant childhood adversity group. Respondents indicating they had been raped or sexually molested at age 18 or younger were also included in the group having experienced child abuse. The Parental Bonding Index (PBI) was used to assess respondents' perceptions of maternal and paternal bonding experiences. Trained interviewers administered the Composite International Diagnostic Interview 1.1 (CIDI) to assess the presence of psychiatric disorders based on the criteria of the Diagnostic and Statistical Manual 3rd edition (DSM-III-R). Psychiatric disorders were divided into four groups: 1) major depression, 2) any anxiety disorder (including generalized anxiety disorder, simple phobia, social phobia, panic disorder, post traumatic stress disorder, and agoraphobia), 3) alcohol abuse or dependence, and 4) one or more externalizing problems (including drug abuse or dependence, conduct disorder and antisocial personality disorder). Descriptive statistics were used to understand the sample and prevalence of childhood adversity, parental bonding and psychiatric disorders. Binary logistic regressions were used to determine the association between the experience of childhood adversity and psychiatric disorders in adulthood. Multinomial logistic regressions were conducted to investigate the association between childhood adversity and number of psychiatric disorders.