title: Spanking and adult mental health impairment: The case for the designation of spanking as an adverse childhood experience.
abstract: Adverse Childhood Experiences (ACEs) such as child abuse are related to poor health outcomes. Spanking has indicated a similar association with health outcomes, but to date has not been considered an ACE. Physical and emotional abuse have been shown in previous research to correlate highly and may be similar in nature to spanking. To determine if spanking should be considered an ACE, this study aimed to examine 1): the grouping of spanking with physical and emotional abuse; and 2) if spanking has similar associations with poor adult health problems and accounts for additional model variance. Adult mental health problems included depressive affect, suicide attempts, moderate to heavy drinking, and street drug use. Data were from the CDC-Kaiser ACE study (N=8316, response rate=65%). Spanking loaded on the same factor as the physical and emotional abuse items. Additionally, spanking was associated with increased odds of suicide attempts (Adjusted Odds Ratios (AOR)=1.37; 95% CI=1.02 to1.86), moderate to heavy drinking (AOR)=1.23; 95% CI=1.07 to 1.41), and the use of street drugs (AOR)=1.32; 95% CI=1.4 to 1.52) in adulthood over and above experiencing physical and emotional abuse. This indicates spanking accounts for additional model variance and improves our understanding of these outcomes. Thus, spanking is empirically similar to physical and emotional abuse and including spanking with abuse adds to our understanding of these mental health problems. Spanking should also be considered an ACE and addressed in efforts to prevent violence.
authors.affiliation: Departments of Community Health Sciences and Psychiatry, University of Manitoba, Canada. Electronic address: tracie.afifi@umanitoba.ca.
authors.forename: Tracie O
authors.initials: TO
authors.lastname: Afifi
authors.affiliation: Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: wsn4@cdc.gov.
authors.forename: Derek
authors.initials: D
authors.lastname: Ford
authors.affiliation: Department of Human Development and Family Sciences, University of Texas at Austin, USA. Electronic address: liz.gershoff@asutin.utexas.edu.
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Gershoff
authors.affiliation: Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: mmerrick@cdc.gov.
authors.forename: Melissa
authors.initials: M
authors.lastname: Merrick
authors.affiliation: School of Social Work, University of Michigan, USA. Electronic address: agrogan@umich.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Grogan-Kaylor
authors.affiliation: Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: kports@cdc.gov.
authors.forename: Katie A
authors.initials: KA
authors.lastname: Ports
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences and Department of Pediatrics, McMaster University, Hamilton, Canada. Electronic address: macmilnh@mcmaster.ca.
authors.forename: Harriet L
authors.initials: HL
authors.lastname: MacMillan
authors.affiliation: Department of Psychology, Southern Methodist University, Dallas, TX, USA. Electronic address: gholden@smu.edu.
authors.forename: George W
authors.initials: GW
authors.lastname: Holden
authors.affiliation: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, USA. Electronic address: ctaylor5@tulane.edu.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Taylor
authors.affiliation: School of Social Work, University of Michigan, USA. Electronic address: shawnal@umich.edu.
authors.forename: Shawna J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Child Mental Health Specialist, Psychotherapist Private Practice, Portland, OR, USA. Electronic address: robbynpeters@comcast.net.
authors.forename: Robbyn
authors.initials: R
authors.lastname: Peters Bennett
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008350:Manitoba; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D016017:Odds Ratio; D000066550:Physical Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D012307:Risk Factors; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000453:epidemiology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data
keywords: Adverse childhood experiences (ACEs); Alcohol; Child abuse; Drug use; Emotional abuse; Physical abuse; Spanking; Suicide attempts