title: Speak softly--and forget the stick. Corporal punishment and child physical abuse.
abstract: BACKGROUND
  Previous studies have shown an association between spanking and child physical abuse. However, the relationship between more frequent and severe corporal punishment and abuse remains unknown. The objective of this study was to examine the associations between reported spanking, spanking frequency, or spanking with an object and the odds of physical abuse in a representative sample of mothers from North and South Carolina.
  
  
  METHODS
  This study is a cross-sectional, anonymous telephone survey of adult mothers with children aged<18 years living in the Carolinas in 2002. The analysis was conducted in 2007. Survey responses were used to determine the association between corporal punishment (spanking, spanking frequency, and spanking with an object) and an index of harsh physical punishment consistent with physical abuse (beating, burning, kicking, hitting with an object somewhere other than the buttocks, or shaking a child aged<2 years).
  
  
  RESULTS
  Mothers who report that the child was spanked are 2.7 (95% CI=1.2, 6.3) times more likely to report abuse. Increases in the frequency of reported spanking in the last year are also associated with increased odds of abuse (OR=1.03, 95% CI=1.01, 1.06). Mothers reporting spanking with an object are at markedly increased odds of reporting abuse (OR=8.9, 95% CI=4.1, 19.6).
  
  
  CONCLUSIONS
  Although reported spanking increases the odds of reported physical abuse, the relationship between the reported hitting of a child with an object and reported abuse is much stronger. Reduction in this form of discipline through media, educational, and legislative efforts may reduce child physical abuse.
authors.affiliation: Department of Family Medicine, Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7595, USA. ajzolo@med.unc.edu
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Zolotor
authors.forename: Adrea D
authors.initials: AD
authors.lastname: Theodore
authors.forename: Jen Jen
authors.initials: JJ
authors.lastname: Chang
authors.forename: Molly C
authors.initials: MC
authors.lastname: Berkoff
authors.forename: Desmond K
authors.initials: DK
authors.lastname: Runyan
mesh_terms: D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000523:psychology*; D009657:North Carolina / Q000453:epidemiology; D011678:Punishment / Q000523:psychology*; D013022:South Carolina / Q000453:epidemiology