<![CDATA[<B>Severe physical punishment and mental health problems in an economically disadvantaged population of children and adolescents</B>]]>

Abstract

AbstractObjective: To estimate the prevalence of severe physical punishment of children/adolescents in a low-income community, and to examinechild mental health problems as a potential correlate. Method: This study is a Brazilian cross-sectional pilot study of the World Studies ofAbuse 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 (severephysical punishment of children/adolescents by mother/father) was defined as shaking (if age ≤ 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 touse a weapon. The following standardized questionnaires were applied by trained interviewers: World Studies of Abuse in Family EnvironmentsCore Questionnaire, Child Behavior Checklist, Self-Report Questionnaire. Results: Outcome prevalence was 10.1%. Final logistic regressionmodels 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 physicalpunishment of children/adolescents is frequent in the studied community. The victims have a higher probability of becoming futureperpetrators. When intrafamilial violence occurs, child/adolescent mental health may be compromisedDescriptors: Mental health, statistics & numerical data; Child abuse; Child psychiatry; Prevalence; Risk factorsResumoObjetivo: Estimar a prevalencia de punicao fisica grave de criancas/adolescentes em comunidade de baixa renda e examinar problemasde saude mental nas criancas/adolescentes como um potencial fator associado. Metodo: Este trabalho e um estudo piloto brasileiro decorte transversal do World Studies of Abuse in Family Environments. Foi avaliada uma amostra probabilistica de conglomerados, incluindotodos os domicilios elegiveis (mulheres de 15-49 anos, filho/filha < 18 anos). Uma dupla mae-filho foi aleatoriamente selecionada pordomicilio (n = 89; perda amostral = 11%). O desfecho clinico (punicao fisica grave de criancas/adolescentes por mae/pai) foi definidocomo sacudir/chacoalhar (se ≤ 2 anos), chutar, esganar, sufocar, queimar, espancar ou ameacar com arma. Tres grupos de potenciaisfatores associados foram examinados: crianca/adolescente (idade, sexo, problemas de saude fisica/mental); Mae (escolaridade, desempre-go, problemas de saude fisica/mental, punicao severa na infância, violencia conjugal); Pai (desemprego, embriaguez). Violencia conjugalgrave foi definida como chute, soco, espancamento ou uso/ameaca de uso de arma. Os seguintes questionarios padronizados foramaplicados por entrevistadores treinados: World Studies of Abuse in Family Environments Core Questionnaire, Child Behavior Checklist, Self-Report Questionnaire. Resultados: Prevalencia do desfecho clinico foi de 10,1%. Modelos finais de regressao logistica identificaram doisfatores associados: experiencia materna de punicao severa na infância (amostra total, OR = 5,3, p = 0,047) e problemas de saude mentalna crianca/adolescente (sub-amostra de 4-17 anos, n = 67, OR = 9,1, p = 0,017). Conclusoes: A punicao fisica grave de criancas/adolescentes e frequente na comunidade estudada, sendo que as vitimas tem probabilidade aumentada de se tornarem futuros agressores.Quando ocorre violencia intrafamiliar, a saude mental das criancas e adolescentes pode estar comprometida.Descritores: Saude mental, estatistica e dados numericos; Maus-tratos infantis; Psiquiatria infantil; Prevalencia; Fatores de risco