title: Severe physical punishment and mental health problems in an economically disadvantaged population of children and adolescents.
abstract: OBJECTIVE
  To estimate the prevalence of severe physical punishment of children/adolescents in a low-income community, and to examine child mental health problems as a potential correlate.
  
  
  METHODS
  This study is a Brazilian cross-sectional pilot study of the World Studies of Abuse in Family Environments. A probabilistic sample of clusters including all eligible households (women aged 15-49 years, son/daughter < 18 years) was evaluated. One mother-child pair was randomly selected per household (n = 89; attrition = 11%). Outcome (severe physical punishment of children/adolescents by mother/father) was defined as shaking (if age <or= 2 years), kicking, choking, smothering, burning/scalding/branding, beating, or threatening with weapon. Three groups of potential correlates were examined: child/adolescent (age, gender, physical/mental health); mother (education, unemployment, physical/mental health, harsh physical punishment in childhood, marital violence); father (unemployment, drunkenness). Severe marital violence was defined as kicking, hitting, beating or use of /threat to use a weapon. The following standardized questionnaires were applied by trained interviewers: World Studies of Abuse in Family Environments Core Questionnaire, Child Behavior Checklist, Self-Report Questionnaire.
  
  
  RESULTS
  Outcome prevalence was 10.1%. Final logistic regression models identified two correlates: maternal harsh physical punishment in childhood (total sample, OR = 5.3, p = 0.047), and child/adolescent mental health problems (sub-sample aged 4-17 years, n = 67, OR = 9.1, p = 0.017).
  
  
  CONCLUSIONS
  Severe physical punishment of children/adolescents is frequent in the studied community. The victims have a higher probability of becoming future perpetrators. When intrafamilial violence occurs, child/adolescent mental health may be compromised.
authors.affiliation: Social Psychiatry Division, Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil. fbordin@dialdata.com.br
authors.forename: Isabel Altenfelder Santos
authors.initials: IA
authors.lastname: Bordin
authors.forename: Cristiane Silvestre
authors.initials: CS
authors.lastname: Paula
authors.forename: Rosimeire
authors.initials: R
authors.lastname: do Nascimento
authors.forename: Cristiane Seixas
authors.initials: CS
authors.lastname: Duarte
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D010287:Parent-Child Relations; D010865:Pilot Projects; D015995:Prevalence; D011678:Punishment / Q000523:psychology*; D012647:Self-Assessment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population