The present article attempts to examine cultural factors that determine the use of corporal punishment of their children by parents in different social groups, the prevalence of this disciplinary strategy and the parental beliefs associated with it. We explore related questions, such as the possible causes, phenomenology and consequences for children and parents in diverse social contexts, and alternatives to its use.

The main determinants and negative consequences of physical abuse of children are well established, but much less is known about the determinants and the effects of the far more common practice of physical discipline. This is surprising, as in most social groups parents actually use corporal punishment, whether health professionals agree with the practice or not. We review the available information about this practice in different societies and cultural groups.

Although corporal punishment should be abandoned, parents still adhere to it, particularly in some social groups and there are multiple barriers to its elimination. We believe that any discussion what could be done instead, should be informed by its causes and parental beliefs and cultural factors that make physical discipline possible.  We try to contribute to an understanding of these factors.

Our review is complicated by the several factors. One is that “corporal punishment” can include a gamut of practices: from an occasional spanking given to a 7 year old child by a relatively calm parent on one end of the spectrum, to a customary, daily, harsh and intense use of physical force with a three-year old boy by an enraged parent, even if this “technically’ is not physical abuse. The available published literature does not to make distinctions between these practices, so little is known about the effects of various intensities of corporal punishment. Also, many studies reviewed include relatively small samples. One cannot really conclude from the findings in a sample of families of specific social/ethnic characteristics what might apply to an entire social or ethnic group. The findings from those studies are mentioned to explore correlations and attributions but it should not be concluded that all members of a particular social or ethnic group think equally, endorse the same beliefs or engage in similar disciplinary practices, or that “all children” from a given group respond in the same way. However, an approximation to the topic is necessary to further the clinician’s understanding of the cultural elements associated with physical discipline.

Definition

What is corporal punishment? We make a deliberate distinction between corporal punishment and physical abuse. It could reasonably be argued that any form of physical punishment is by its nature abusive, as it implies the use of force by the stronger person against the weaker one. However, we focus here on physical chastisement which in most societies is not considered as abuse by clinicians or by courts i.e. the “usual” and frequently used strategies such as spanking and physical contact that does not leave even temporary marks (i.e. bruises, welts, etc.) on the child.

Here we use a common (in North America) definition of corporal punishment as physical contact by a parent with the intent of modifying the behavior of the child, by producing an unpleasant and painful sensation. Some restrict this definition to physical contact with an open hand, and to contact on extremities or buttocks (1, 2). It excludes behaviors like kicking, twisting arms, shaking, pinching, pulling ears, stabbing, shoving, choking or beating.

An approximation to the epidemiology of corporal punishment in different societies

Corporal punishment of children is unfortunately “alive and well” in most countries, it is a fact of life, used frequently and regularly in most Westernized societies, and also, perhaps to a lesser degree, in traditional cultural groups.

In the United States, for instance, as in the UK, a majority of parents regularly carry out corporal punishment, and often see it as a normative way to raise children. In the US around 80% of parents practice it (3). A Gallup poll conducted in 1995 showed that 74% of children under 5 years old were hit or slapped by their parents for discipline. The frequency seems to be different for various age groups: in the US and Canada preschool age children are the most frequent receptors of corporal punishment, while the lowest frequency is for adolescents (4). In a survey reported by Straus (5) 95% of  parents of 3 year old children reported having spanked their child at least once in the past year, and a more recent study (6) showed  that 94% of parents had already practiced spanking with children by the time they were four years old. As for adolescents, the frequency varies between 30 % at age 15 (7) to a 50% of teenagers, who report having been beaten recently by their parents (8). Spanking usually means hitting with an open hand, although in a US survey around 35% of parents report using some object (3).

In other developed or “wealthy” countries like Switzerland, a third of parents say they believe in physical punishment and use it regularly. Spanking and slapping are the most common forms of physical punishment.

There are few empirical studies of corporal punishment in “Third world” countries and traditional societies. In a study in seven Latin American cities and Madrid, Spain (9), a smaller proportion of parents reported using spanking during the past month (24% of women and 15% of men). Also, a study involving Hispanics in the US (10) found a lower percentage of parents who practice physical punishment. In another study, with focus groups in Chile and Costa Rica (11), 30% of parents report that children should be hit sometimes or always when they misbehave.

 In contrast, in a study in Jamaica (12, 13) an average of 60% of mothers believe in the practice, and report using instruments to carry it out. About 80% of mothers with preschool children noted the use of instruments to beat their children. The main offenses were disobedience, being disrespectful, not completing chores, crying too much and not finishing their food. In a recent anonymous survey in Chile with over 500 parents of school-age children, 80.4% of parents in public schools said they had practiced physical punishment, but “only” for major transgressions (running away, poor school performance and defiance) (14). This admission was more common in the parents of lower socioeconomic class.

An inquiry with school children from four former “Eastern Bloc” countries, i.e. Latvia, Lithuania, Moldova and Macedonia (15) (with around 300 children in each) found a prevalence of approximately 18 to 30% of reported spanking and slapping. In a survey of school children in Alexandria, Egypt (16) 37.47% of children reported that their parents spanked them or disciplined them physically. The main reasons were lying to parents, poor school performance, being disrespectful, disobeying and destroying other people’s property.

These data suggest that overall at least a third of parents in many countries engage in the practice, and mainly when children are of school age. The picture in the US indicates that parents more readily endorse believing in corporal discipline, which is started since early childhood.

    Who is punished?

Even when parents “believe” in physical discipline, there may be differences in the strategies, severity, and frequency, method of disciplining and who the object of the treatment is. It is well known that the “same” parents treat their children differently from one another (17). Some children may elicit more negative parenting strategies, and this may also be associated with cultural factors. For instance children who are more difficult, persistent, intense, who throw temper tantrums or do not easily learn from previously negative experiences may be hit more often (18, 19). Clinically it is common to observe that parents try desperately to correct children who are quite impulsive, difficult and persistent, and parents and their relatives read these child behaviors as a sign of being spoiled, i.e. needing more discipline and punishment. Parenting behavior is influenced by the child’s temperament (19). A study carried out by Brenner and Fox (20) evaluated the association between harsh parental discipline (scolding and corporal punishment) in 1056 mothers of 1 to 5 year old children, and behavioral difficulties in the child. They found a significant association between those two variables. The directionality of these effects remains questionable: do more stressed parents perceive their children more negatively? Do more difficult children elicit more negative parental practices?  Or both factors coexist, difficult children elicit more negative discipline, particularly so if the parent is stressed or challenged. Clinically, one often encounters particularly difficult “combinations” between a challenging child and a parent with more stress, impulsiveness or difficulties in mood regulation. If “difficultness” is perceived in some cultural groups as a voluntary choice of the child (e.g. “being mean”) the parent may try to extinguish these tendencies in the child through harsher disciplinary practices.

In most societies, boys receive more physical discipline than girls. In an American study (21) with premature children, at follow up when they were three years old, boys received more spanking, hitting, scolding and were more readily denigrated, particularly if they were from impoverished homes. In many cultural groups girls are treated in a more restrictive way and more tightly controlled, but they are hit less often than boys.

In Jamaica, for instance, a girl may be punished for wanting to go outside the house alone (22). What constitutes an infraction, and the corrective measures corresponding to it are highly dependent on culture and expectations of the child.

    Who punishes?

In many cultural groups, while mothers do most of the everyday parenting, the father is thought to be the “main disciplinarian”. The mother may wait until the father comes home from work, inform him of transgressions and expect that he would punish the children; this was for instance the pattern in a study of parent child relationships in Australia (23), where mothers were seen as authoritative and fathers as more authoritarian.

However, even in cultures that formally adhere to this model, the role of fathers seems to be changing, as shown in a small study of Puerto Rican and Afroamerican, where fathers were more nurturing and supportive than what would be “traditional” (24). The same was found by Gutmann (25) in his studies on the role of fathers in an impoverished area of Mexico City. Contrary to the expectation of the “macho” and authoritarian male, fathers behaved in a rather nurturing way toward their young children, but in the privacy of their homes. There is little empirical information about the possible differential impact of fathers or mothers as disciplinarians. In most social groups, mothers exceed disciplining children, probably because they do the bulk of the parenting, particularly of younger children. Deater Deckard et al. (26) studying several hundred families, found a somewhat more long term negative impact on the child  when harsh physical discipline was applied by the parent of the same gender as the child.

Family circumstances and parental beliefs

     Circumstances and beliefs promoting corporal punishment

Several studies suggest that –across the board- parents of lower socio-economical status tend to engage in harsher disciplinary techniques (3, 27). Correspondingly, parents who experience more psychosocial stress are more likely to resort to physical means and more often, perhaps as an expression of their frustration or anger. This, for instance, was found in a study of 475 Chinese parents in Hong Kong (28). More stressed parents tended to perceive their children as more difficult.
Also, a close correlate of stress -maternal depression- is another factor in harsher discipline: in a study of mostly Afroamerican mothers, those who had persistent symptoms of depression were twice as likely to use physical discipline, even with very young children (29). A recent meta analytic study of discipline, suggests that a higher level of marital conflict is associated with harsher discipline and lower parental acceptance of the children (30) The National Survey of Families and Households (31) highlighted the parent’s own childhood experience of physical punishments as a predictor to the use of it with one’s own children. Other factors that favor harsher disciplinary strategies are: single parenthood, being divorced (32) as well as a having higher number of children in the household (31). In the study in Alexandria, Egypt (16) crowding in the house and frequent quarrels among family members were additional factors.

Regarding parental beliefs, in the United States several surveys (3) have shown that most parents, up to 90% of them,  “believe” in spanking. Only about 17% of middle-class families in the US say they do not believe in it. Also, a majority of family physicians and pediatricians report that they approve of the practice and may recommend it to parents, despite organizations like the America Academy of Pediatrics that recommends not using corporal punishment.

Parents in the US and UK readily speak of the importance of spanking, even for very young children, and often as the primary discipline strategy (33). In a survey of 200 parents in the US, most parents believed that very young children should be spanked (19% endorsed spanking even during the first year of the child’s life). A similar finding was obtained in a follow up study of 715 premature infants at age 3 (21) in which less warmth in the caregiver, less parent-child interaction and harsher discipline were correlated. An investigation (34) comparing the beliefs and attitudes of 102 Canadian and 97 Swedish mothers of preschoolers, observed that the Canadian mothers (who tended to use more physical punishment, usually mild) were more interested in having a hierarchical relationship vis a vis their child, while the Swedish mothers were more “solidary” in their style..

A high index of “machismo” in a family tends to be associated with more use of spanking (35, 36). Machismo means a strong adherence to rigid gender roles, a callous attitude toward women, being dominant and aggressive, authoritarian and inhibiting nurturing tendencies (36).

Straus (7) has suggested that in societies where there is a high legitimation of violence by institutions (such as the police and other agencies), there is a stronger justification for use of violence in child rearing. Straus contrasts the US and its high social index of violence as well as its endorsement of physical discipline with more “primitive’ societies, where physical discipline is generally less used by parents.  Also, some suggest that in societies with a high rate of ownership of guns, and approval for the death penalty, more parents are likely to express violent ideas about raising their children (31). There seems to be a correlation between the belief in spanking and a general interest in harsher discipline and a more negative view of children. In a similar vein, Milburn and Conrad (37) in a study involving subjects’ recall of physical punishment by their caregivers, found a significant correlation between having experienced more physical punishment and a justification of its use in one’s own children. Also, there was an association with more “authoritarian” ideas and attitudes, such as endorsing the death penalty, strong rugged individualism and “every man for him” ideology.

In North America, among some of the more radical forms of Christianism, corporal punishment is advocated. Some schools of “Christian-based parenting” in the US rely on what they see as Biblical parenting (38). One of the anxieties of parents is that their child will become “spoiled” or entitled, weak and unable to rely on him or herself if not punished enough. The basic belief is that children come to the world with negative biases (original sin), which have to be systematically corrected by their parents (39). In the United States a segment of the population fear that if punishment is not hard enough, i.e. physical, the child may develop into a person without limits and boundaries, without self-discipline and respect, so every transgression must be followed by corresponding punishment.

     Circumstances and beliefs promoting less use of corporal punishment

Latino parents, both in the US and those living in Latin America, tend not to use physical punishment with young children, like infants and preschoolers, even when they employ it with older ones. Parents place great emphasis in the child being respectful of adults and elders, not to be “malcriado” (raised badly) and to “know their place in the world”, and not as much on obedience or compliance (40). Through home observations of Mexican immigrants in the US (40) it has been observed that preschool children tend not to have as high self-care skills and independence as it is typical in Euro American children ( e.g. to get dressed by themselves, pick up their toys, eating alone, going to bed alone). Latino parents often expect that their children will be dependent on them for a comparatively long time, and give assistance in all of these activities (40). With the young child, mothers tend to be indulgent and families idealize the closeness between mother and child, which is also the prevalent expectation in many other traditional groups (41). When these Latino parents spanked their child, they reported regret about it, and said that they would prefer not to lose their patience. They ascribed its use more to frustration with stressors, such as financial and environmental problems (42). They tend to believe children should not be hit, even when they do it.

Familism is common in many traditional societies. It consists of a strong belief in the importance of family, a sense of obligation among its members and a duty to look after children and elderly. In a study of 150 families comparing the beliefs and practices of Afro American, Latino and Euro American families in the US (35) parents with a strong endorsement of “familism” tended to use less physical punishment. In some US groups, for instance in rural Afro American poor families, a stronger sense of religiosity may be associated with less use of coercive parenting strategies (43).

THE EFFECTS OF PHYSICAL DISCIPLINE ON CHILDREN FROM DIFFERENT CULTURES. Is there a different effect?

In the short term, violence, physical discipline and corporal punishment may bring about immediate desired results (44, 45) i.e. compliance by the child, who stops some unwanted behavior.  The American Academy of Pediatrics (46) warns that parents may then have to escalate their punishments in order to keep that external threat hanging over the child.

The picture is different in the long term, where many studies have shown negative consequences of physical discipline. For example, adolescents who have been physically disciplined are more likely to show aggressive behavior (47). In a longitudinal study in the US, children who were exposed to physical punishment were more likely to have conduct problems 10 years later (48). This could be due to multiple mechanisms. One possible explanation is that corporal discipline may not exist in isolation, but may be a marker of a constellation of parental features and ways of relating (e.g. more coercion and conflict resolved by violence).

There is controversy on the question of whether physical discipline may have different consequences for children of other cultural or ethnic groups. For instance, several authors have suggested from studies in the US that in African American children, spanking may have a less negative long term impact than in Caucasian children (49, 50, 51). It has been hypothesized that the cultural perception and meaning of the corporal punishment may be different: in the case of Afro American children it may mean that parents care for and love their children, therefore strongly disciplining them (49, 50. 51). In Caucasian families it may mean something closer to a parent-centered household where parents are at times out of control. This is suggested by the studies of Deater-Deckard et al, (49) which included 466 Euro American and 100 Afro American families. Other studies arrive at the same conclusion and suggest that spankings may be perceived in Afro American familes (where children are more often in higher levels of distress, poverty and exposed to community violence) as a protective strategy to prevent the development of further disruptive behavior (52). A similar effect was reported in two studies involving the outcome of spanking for Hispanic children, where strictness and spanking were not associated with a negative behavioral outcome (53, 54).

The emotional and cultural context of the punishment, as well as the importance of emotional support as a protective factor, even in the context of physical discipline, is suggested by the review of McLoyd and Smith (55) which compared the outcome of children at a six years follow up as a part of the National Longitudinal Study. There was no difference in outcome between Euro American, Latino and Afro American children as long as there was strong emotional support from the mother. Studies from Norway (56, 57) comparing the Sami (rural and non-Westernized culture) with those of the “mainstream” Norwegian culture also suggest among the Sami, corporal punishment is not associated with negative behavioral outcomes, while it is among the mainstream Norwegian children. The investigator postulated that in harsher life conditions, this punishment may be perceived by the child as protective and indicating caring from the parents.

Nevertheless, in all contexts, when the punishment is harsh enough, it may lead to very undesirable effects: hiding from the parenting figure, going behind his or her back, lying and failure to acknowledge responsibility for fear of the retaliation (58). In other words, it can destroy a sense of openness and trust, or alter the moral development of the child.

Two meta analytic studies of the long term effects of physical punishments are relevant. One from Gershoff (59) evaluates 62 years of collected data and included 88 studies.  It concludes that physical punishment is only “effective” in the short course but it causes long term behavioral problems i.e. aggressive behavior.  Another meta analysis, conducted by Paolucci and Violato (60) looked a 70 studies published between 1961 -2000 (involving 47 751 persons), mostly from the US (83.3. %). It finds small negative effects of corporal punishment on emotional state and behavior (negative behaviors) and no negative effects on cognition. Finally, a study looking at the association between physical punishment and cruelty to animals, with 267 college students found such an association during childhood (61). By contrast, a recent study of follow up of 608 children who had been exposed to harsh discipline in childhood found a correlation between this variable and intimate partner violence in adulthood (62).

There may be also a price to be paid in terms of internalization of moral values and the capacity for empathy (63). Another issue is the possible association with low self esteem and depression (31). This was suggested in the studies of  MacMillan et al. (4) in a community survey in Ontario, Canada, of 4 888 adults without a history of physical abuse, but of having undergone physical discipline during their childhood. The authors studied whether there was a “dose response” relationship between the intensity and frequency of physical punishment and emotional/behavioral disturbance in adulthood. There was a linear association between such a history (without constituting “abuse”) and higher rates of anxiety disorders, substance abuse/dependency and externalization disorders. A similar result (negative impact on adult mental health) was obtained in a retrospective study of adult Mexican women (64). Straus et al. (65) through analysis of data of the National Longitudinal Survey of Youth (in which 807 mothers are asked about their disciplinary practices and their child’s behavioral difficulties) also found a dose-response effect: higher levels of physical punishment correlated with more dissocial and aggressive behavior in the child. The same can be concluded from a study with Taiwanese adolescents who were asked about their history of more or less physical punishment: an association between more intense punishment and antisocial behavior (66).
In terms of locus of control,- a sense in the child about how effective he or she is in controlling what happens to him or her- a study compared two groups of Iranian children: one who had experienced physical punishment (89 children) one that had not been hit (174 children). The second group had a higher rate of “internal locus of control” in comparison with the physically disciplined group (67). An internal locus of control is thought to be related to better self-esteem and less need for external limits.

Children’s attitudes toward physical discipline

Little is known about how children themselves perceive their parents spanking them, as few studies have asked them or evaluated this issue. In South Africa, a questionnaire was used with over 700 middle school students of mixed ethnic background to ask their opinion about the practice. A majority of them reported having been physically disciplined. Most said they were angry or sad right after the beating. However they also said that later on, they felt happy or proud. Boys in particular endorsed a cultural belief in callousness (i.e. the ability to endure pain is a sign of greater masculinity) and acceptance of violence as a necessary tool. The authors found a relationship between this stance and an interest in competition between men, machismo and difficulty to express painful emotions (68).

In Macedonia (15) a survey found that families tend to disapprove of children who speak badly about what the parents do, and children are often taught that “spankings come from heaven” and they should be happy for them. In this study (15) children reported that physical pain and suffering was an important element of learning the right things. This suggests that consciously many children may “justify” their parents hitting them for their own good, if this is the prevalent social notion about the practice. There may be a point beyond which even this belief does not have a protective effect, e.g. with harsh or frequent physical discipline.

Intergenerational transmission

Frequently, parents who were spanked (even if severely) by their own parents say that they “turned out well”. Many of them believe that corporal punishment is innocuous or a “necessary evil”. Several investigations have found that adolescents, who have experienced physical punishment, tend to have a favorable attitude toward it. A study with young adolescents in the US (425 subjects), whose parents had been interviewed when they were 5 years old (565 children) found that those children who had been spanked had a more favorable attitude toward the strategy (69). A similar finding was obtained in Costa Rica from a survey with 497 students at a university: most students thought it was quite natural for parents to spank or hit their children, as a majority of them had experienced it (70). Also in a Canadian sample (436 adults) in Manitoba (71), 75% reported having had physical punishment as children, and 40% endorsed it as a necessary means of discipline. There is tendency toward an intergenerational transmission of disciplinary strategies.

ALTERNATIVES

Can physical punishment of children be eliminated?

Several countries (Scandinavian countries, but also Germany, Austria, Croatia and Italy) have made it illegal to use physical punishment against children. This view is endorsed by the international convention on the rights of children (United Nations) which has been ratified by almost all countries (but not the US).

The case of Sweden is of much interest: there is controversy about whether the banning of corporal punishment in 1979 has produced positive results. A careful examination of the evidence (72, 73, 74) of the effects decades later shows that there has been a decrease in the prevalence of child abuse, and of child deaths due to abuse. Also, out of home placements due to child abuse declined by about 26% between 1982 and 1995. There has been an increased number of children that receive help from social services, which is related to the introduction of a non-professional ‘contact persons or family’ to provide support to families at risk, a preventive community intervention.

Additionally, it is important to contextualize the ban on physical punishment as the result of a shift in public attitudes and the recognition of the human rights of children (74). The social attitude is that hitting a child is as unacceptable as hitting a woman, and that children as individuals should be respected. By contrast, in Canada, despite recent heated debate, the Supreme Court recently upheld the right of parents to infringe “reasonable chastisement” on their children.

There are alternatives spanking, but parents often feel at a loss when they have a “template” they learned from their own parents (75). In societies like the US and UK where parents strongly endorse spanking, changing these attitudes enough to ban spanking seems very difficult at present. It would require a social policy of respect of the child and implementing educational programs to help parents explore alternative techniques of discipline and a social commitment to non-violence.

It has been suggested than in parents who are not educated and do not use verbal (reasoning) means to deal with children spanking may be difficult to change (60). The pediatrician can have an important role in discussing issues of child development, behavior and behavioral management, suggesting effective alternatives to physical discipline (76). Although abolishing corporal punishment seems only remotely possible in many countries, the experiences in some societies suggests that when the public attitude toward violence and children changes, improvements are possible and alternative methods of limit setting and promoting child development can be learned by parents.
 

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