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June 17, 1992, Vol 267, No. 23 >
ARTICLE | June 17, 1992

Attitudes of Primary Care Physicians Toward Corporal Punishment FREE

Kenelm F. McCormick, MD
[+] Author Affiliations

Reprint requests to Barberton Citizen's Hospital, Family Practice Residency, 155 Fifth St NE, Barberton, OH 44203 (Dr McCormick).


JAMA. 1992;267(23):3161-3165. doi:10.1001/jama.1992.03480230053027
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Published online
Article
References

Objective.  —The purpose of this study was to determine whether or not family physicians and pediatricians support the use of corporal punishment. The frequency with which these physicians offer anticipatory guidance on discipline was also studied.

Design.  —Self-report survey, mailed to study participants.

Participants.  —The sample for this study was 800 family physicians and 400 pediatricians, randomly selected from the Ohio State Medical Board's roster of family physicians and pediatricians. Physicians with a subspecialty were excluded. Participants who did not return their surveys received a second, and if necessary, a third mailing of the survey. After three mailings, a total of 619 physicians (61%) completed a survey.

Main Outcome Measure.  —Participants were considered to support corporal punishment if they would tell a parent in their medical practice that spanking would be an appropriate response to any one of a series of childhood misbehaviors presented in the survey.

Results.  —Of family physicians, 70% (95% confidence interval [Cl], 66% to 75%) support use of corporal punishment. Of pediatricians, 59% (95% Cl, 52% to 66%) support corporal punishment. Of pediatricians, 90% (95% Cl, 86% to 94%) indicated that they include discipline issues either always or most of the time when providing anticipatory guidance to parents. Significantly fewer family physicians (52%; 95% Cl, 47% to 57%) indicated that they discuss discipline either always or most of the time when providing anticipatory guidance (P<.01).

Conclusions.  —Most family physicians and pediatricians support the use of corporal punishment in spite of evidence that it is neither effective nor necessary, and can be harmful. Pediatricians offer anticipatory guidance on discipline more often than family physicians.(JAMA. 1992;267:3161-3165)

REFERENCES

1 +
Merz B.  Family violence and the physician. Am Med News . (January 6) , 1992;:3.
2 +
Hendricks-Matthews M.  The role of family physicians in violence reduction. Ohio Fam Physician News . 1989;;41:22.
3 +
Hulley SB.  Control of unintended injuries and those due to violence.  In: Wyngaarden JB, Smith LH Jr, eds. Cecil Textbook of Medicine, I . 18th ed. Philadelphia, Pa: WB Saunders Co; 1988;:40-42.
4 +
Sullivan L.  Violence as a public health issue. JAMA . 1991;;265:2778.
5 +
Gelles RJ. An exchange/social control theory. In: Finkelhor D, Gelles RJ, Hotaling GT, Straus MA, eds. The Dark Side of Families: Current Family Violence Research . Beverly Hills, Calif: Sage Publications; 1983;:151-165.
6 +
Straus MA.  Ordinary violence, child abuse, and wife-beating: what do they have in common?  In: Finkelhor D, Gelles RJ, Hotaling GT, Straus MA, eds. The Dark Side of Families: Current Family Violence Research . Beverly Hills, Calif: Sage Publications; 1983;:213-234.
7 +
Korsch BM, Christian JB, Gozzi EK, Carlson PV.  Infant care and punishment: a pilot study. Am J Public Health . 1965;;55:1880-1888.
8 +
American Psychological Association.  Policy statement of the American Psychological Association. Am Psychol . 1975;;30:632.
9 +
Hyman IA, Bongiovanni A, Friedman RH, McDowell E.  Paddling, punishment, and force: where do we go from here? Child Today . (September-October) 1977;;6:17-23.
10 +
Wessel MA.  The pediatrician and corporal punishment. Pediatrics . 1980;;66:639-641.
11 +
Graziano AM, Namaste KA.  Parental use of physical force in childhood discipline: a survey of 679 college students. J Interpers Violence . 1990;;5:449-463.
12 +
Green JL.  Parenting skills and discipline.  In: Hoekelman RA, ed. Primary Pediatric Care . St Louis, Mo: CV Mosby Co; 1987;:606-609.
13 +
Herzberger SD.  Social cognition and the transmission of abuse.  In: Finkelhor D, Gelles RJ, Hotaling GT, Straus MA, eds. The Dark Side of Families: Current Family Violence Research . Beverly Hills, Calif: Sage Publications; 1983;:317-329.
14 +
Surgeon General's Workshop on Violence and Public Health: Report . Rockville, Md: US Dept of Health and Human Services, Public Health Service; 1985;. US Dept of Health and Human Services publication HRS-D-MC 86-1.
15 +
Berger AM, Knutson JF, Mehm JG, Perkins KA.  The self-report of punitive childhood experiences of young adults and adolescents. Child Abuse Negl . 1988;;12:251-262.
16 +
American Public Health Association, Governing Council.  Policy statements. Am J Public Health . 1980;; 70:308-309.
17 +
Christophersen ER.  The pediatrician and parental discipline. Pediatrics . 1980;;66:641-642.
18 +
National Education Association. Report of the Task Force on Corporal Punishment . Washington, DC: National Education Association; 1972;.
19 +
Poole SR, Ushkow MC, Nader PR, et al.  The role of the pediatrician in abolishing corporal punishment in schools. Pediatrics . 1991;;88:162-167.
20 +
Straus MA.  Some social antecedents of physical punishment: a linkage theory interpretation. J Marriage Fam . 1971;;33:658-663.
21 +
Johnston JM.  Punishment of human behavior. Am Psychol . 1972;;27:1033-1054.
22 +
Bongiovanni AF.  An analysis of research on punishment and its relation to the use of corporal punishment in the schools.  In: Hyman IA, Wise JH, eds. Corporal Punishment in American Education: Readings in History, Practice, and Alternatives . Philadelphia, Pa: Temple University Press; 1979;:351-372.
23 +
Bandura A, Huston AC.  Identification as a process of incidental learning. J Abnorm Soc Psychol . 1961;;1:311-318.
24 +
Bandura A, Ross D, Ross SA.  Transmission of aggression through imitation of aggressive models. J Abnorm Soc Psychol . 1961;;63:575-582.
25 +
Flanders J.  A review of research on imitative behavior. Psychol Bull . 1968;;69:316-337.
26 +
Carlson, BE.  Children's beliefs about punishment. Am J Orthopsychiatry . 1986;;56:308-312.
27 +
Owens DJ, Straus MA.  The social structure of violence in childhood and approval of violence as an adult.  In: Hyman IA, Wise JH, eds. Corporal Punishment in American Education: Readings in History, Practice, and Alternatives . Philadelphia, Pa: Temple University Press; 1979;:107-125.
28 +
Lefkowitz MM, Huesmann R, Eron LD.  Parental punishment: a longitudinal analysis of effects. Arch Gen Psychiatry . 1978;;35:186-191.
29 +
Berkowitz L, Cochran S, Embree M.  Physical pain and the goal of aversively stimulated aggression. J Pers Soc Psychol . 1981;;40:687-700.
30 +
Thyer B.  Punishment-induced aggression: a possible mechanism of child abuse? Psychol Rep . 1987;; 60:129-130.
31 +
Emery RE.  Family violence. Am Psychol . 1989;; 44:321-328.
32 +
Hoffman M, Saltzstein H.  Parent discipline and child's moral development. J Pers Soc Psychol . 1967;; 5:45-57.
33 +
McCord J.  Parental behavior in the cycle of aggression. Psychiatry . 1988;;51:14-23.
34 +
Farley AC, Kreutter KJ, Russel RR, Blackwell S, Finklestein H, Hyman IA.  The effects of eliminating corporal punishment in the schools: a preliminary study. Inequality Educ . 1978;;23:57-60.
35 +
Alevisos KJ.  The effects of verbalizing contingency in time-out procedures. J Behav Ther Exp Psychiatry . 1975;;6:253-255.
36 +
Bernal ME.  Behavioral feedback in the modification of brat behaviors. J Nerv Ment Dis . 1969;;148: 375-385.
37 +
Drabman RS, Jarvie G.  Counseling parents of children with behavior problems: the use of extinction and time-out techniques. Pediatrics . 1987;;59:78-85.
38 +
Drabman R, Spitalnik R.  Social isolation as a punishment procedure: a controlled study. J Exp Child Psychol . 1973;;16:236-249.
39 +
Forehand R, Roberts MW, Doleys DM, Hobbs SA, Resick PA.  An examination of disciplinary procedures with children. J Exp Child Psychol . 1976;; 21:109-120.
40 +
Williams CD.  The elimination of tantrum behavior by extinction procedures. J Abnorm Soc Psychol . 1959;;59:269.
41 +
Gardner HL, Forehand R, Roberts M.  Time-out with children: effects of an explanation and brief parent training on child and parent behaviors. J Abnorm Child Psychol . 1976;;4:277-288.
42 +
American Academy of Pediatrics, Committee on Psychological Aspects of Child and Family.  The pediatrician's role in discipline. Pediatrics . 1983;;72:373-374.
43 +
American Academy of Pediatrics, Committee on School Health.  Corporal punishment in schools. Pediatrics . 1984;;73:258.
44 +
American Academy of Pediatrics, Committee on School Health.  Corporal punishment in schools. Pediatrics . 1991;;88:173.
45 +
 Corporal punishment in schools. Am J Psychiatry . 1989;;146:1524.
46 +
Kelly PC, Weir MR, Fearnow RG.  Pediatrician's views: latchkey children, corporal punishment. Tex Med . 1987;;83:40-42.
47 +
Morris JL, Johnson CF, Clasen M.  To report or not to report: physicians' attitudes toward discipline and child abuse. AJDC . 1985;;139:194-197.
48 +
Anderson KA, Anderson DE.  Psychologists and spanking. J Clin Child Psychol . (Fall) 1976;:46-49.
49 +
Poole SR.  Pediatric behavioral science in family practice. J Fam Pract . 1983;;16:365-374.
50 +
Christophersen ER.  Anticipatory guidance on discipline. Pediatr Clin North Am . 1986;;33:789-798.
51 +
Erickson MT.  Common behavior problems of childhood.  In: Gabel S, Erickson MT. Child Development and Developmental Disabilities . Boston, Mass: Little Brown & Co Inc; 1980;:411-432.
52 +
Roster of Registered Physicians, Osteopathic Physicians, and Podiatrists in the State of Ohio . 10th ed. Columbus, Ohio: State Medical Board of Ohio; 1990;.
53 +
Active Member Practice Profile for Chapter Ohio . Kansas City, Mo; American Academy of Family Physicians: July 2, 1991;.
54 +
Demographic Characteristics by Membership Type for Chapter Ohio . Kansas City, Mo; American Academy of Family Physicians: July 2, 1991;.
55 +
US Bureau of the Census. Statistical Abstract of the United States: 1989 . 109th ed. Washington, DC: US Dept of Commerce; 1989;.
56 +
Dean AD, Dean JA, Burton AH, Dicker RC. Epi Info, Version 5: A Word Processing, Database, and Statistics Program for Epidemiology on Micro-computers . Stone Mountain, Ga: USD Inc; 1990;.
57 +
BMDP Statistical Software . Los Angeles, Calif: BMDP Statistical Software Inc; 1988;.
58 +
Goodwin J.  Family violence: principles of intervention and prevention. Hosp Community Psychiatry . 1985;;36:1074-1079.
59 +
Greenblat CS.  A hit is a hit is a hit... or is it? approval and tolerance of the use of physical force by spouses.  In: Finkelhor D, Gelles RJ, Hotaling GT, Straus MA, eds. The Dark Side of Families: Current Family Violence Research . Beverly Hills, Calif: Sage Publications; 1983;:235-260.
60 +
Keller K, Podell RN.  The survey in family practice research. J Fam Pract . 1975;;2:449-453.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Merz B.  Family violence and the physician. Am Med News . (January 6) , 1992;:3.
2 +
Hendricks-Matthews M.  The role of family physicians in violence reduction. Ohio Fam Physician News . 1989;;41:22.
3 +
Hulley SB.  Control of unintended injuries and those due to violence.  In: Wyngaarden JB, Smith LH Jr, eds. Cecil Textbook of Medicine, I . 18th ed. Philadelphia, Pa: WB Saunders Co; 1988;:40-42.
4 +
Sullivan L.  Violence as a public health issue. JAMA . 1991;;265:2778.
5 +
Gelles RJ. An exchange/social control theory. In: Finkelhor D, Gelles RJ, Hotaling GT, Straus MA, eds. The Dark Side of Families: Current Family Violence Research . Beverly Hills, Calif: Sage Publications; 1983;:151-165.
6 +
Straus MA.  Ordinary violence, child abuse, and wife-beating: what do they have in common?  In: Finkelhor D, Gelles RJ, Hotaling GT, Straus MA, eds. The Dark Side of Families: Current Family Violence Research . Beverly Hills, Calif: Sage Publications; 1983;:213-234.
7 +
Korsch BM, Christian JB, Gozzi EK, Carlson PV.  Infant care and punishment: a pilot study. Am J Public Health . 1965;;55:1880-1888.
8 +
American Psychological Association.  Policy statement of the American Psychological Association. Am Psychol . 1975;;30:632.
9 +
Hyman IA, Bongiovanni A, Friedman RH, McDowell E.  Paddling, punishment, and force: where do we go from here? Child Today . (September-October) 1977;;6:17-23.
10 +
Wessel MA.  The pediatrician and corporal punishment. Pediatrics . 1980;;66:639-641.
11 +
Graziano AM, Namaste KA.  Parental use of physical force in childhood discipline: a survey of 679 college students. J Interpers Violence . 1990;;5:449-463.
12 +
Green JL.  Parenting skills and discipline.  In: Hoekelman RA, ed. Primary Pediatric Care . St Louis, Mo: CV Mosby Co; 1987;:606-609.
13 +
Herzberger SD.  Social cognition and the transmission of abuse.  In: Finkelhor D, Gelles RJ, Hotaling GT, Straus MA, eds. The Dark Side of Families: Current Family Violence Research . Beverly Hills, Calif: Sage Publications; 1983;:317-329.
14 +
Surgeon General's Workshop on Violence and Public Health: Report . Rockville, Md: US Dept of Health and Human Services, Public Health Service; 1985;. US Dept of Health and Human Services publication HRS-D-MC 86-1.
15 +
Berger AM, Knutson JF, Mehm JG, Perkins KA.  The self-report of punitive childhood experiences of young adults and adolescents. Child Abuse Negl . 1988;;12:251-262.
16 +
American Public Health Association, Governing Council.  Policy statements. Am J Public Health . 1980;; 70:308-309.
17 +
Christophersen ER.  The pediatrician and parental discipline. Pediatrics . 1980;;66:641-642.
18 +
National Education Association. Report of the Task Force on Corporal Punishment . Washington, DC: National Education Association; 1972;.
19 +
Poole SR, Ushkow MC, Nader PR, et al.  The role of the pediatrician in abolishing corporal punishment in schools. Pediatrics . 1991;;88:162-167.
20 +
Straus MA.  Some social antecedents of physical punishment: a linkage theory interpretation. J Marriage Fam . 1971;;33:658-663.
21 +
Johnston JM.  Punishment of human behavior. Am Psychol . 1972;;27:1033-1054.
22 +
Bongiovanni AF.  An analysis of research on punishment and its relation to the use of corporal punishment in the schools.  In: Hyman IA, Wise JH, eds. Corporal Punishment in American Education: Readings in History, Practice, and Alternatives . Philadelphia, Pa: Temple University Press; 1979;:351-372.
23 +
Bandura A, Huston AC.  Identification as a process of incidental learning. J Abnorm Soc Psychol . 1961;;1:311-318.
24 +
Bandura A, Ross D, Ross SA.  Transmission of aggression through imitation of aggressive models. J Abnorm Soc Psychol . 1961;;63:575-582.
25 +
Flanders J.  A review of research on imitative behavior. Psychol Bull . 1968;;69:316-337.
26 +
Carlson, BE.  Children's beliefs about punishment. Am J Orthopsychiatry . 1986;;56:308-312.
27 +
Owens DJ, Straus MA.  The social structure of violence in childhood and approval of violence as an adult.  In: Hyman IA, Wise JH, eds. Corporal Punishment in American Education: Readings in History, Practice, and Alternatives . Philadelphia, Pa: Temple University Press; 1979;:107-125.
28 +
Lefkowitz MM, Huesmann R, Eron LD.  Parental punishment: a longitudinal analysis of effects. Arch Gen Psychiatry . 1978;;35:186-191.
29 +
Berkowitz L, Cochran S, Embree M.  Physical pain and the goal of aversively stimulated aggression. J Pers Soc Psychol . 1981;;40:687-700.
30 +
Thyer B.  Punishment-induced aggression: a possible mechanism of child abuse? Psychol Rep . 1987;; 60:129-130.
31 +
Emery RE.  Family violence. Am Psychol . 1989;; 44:321-328.
32 +
Hoffman M, Saltzstein H.  Parent discipline and child's moral development. J Pers Soc Psychol . 1967;; 5:45-57.
33 +
McCord J.  Parental behavior in the cycle of aggression. Psychiatry . 1988;;51:14-23.
34 +
Farley AC, Kreutter KJ, Russel RR, Blackwell S, Finklestein H, Hyman IA.  The effects of eliminating corporal punishment in the schools: a preliminary study. Inequality Educ . 1978;;23:57-60.
35 +
Alevisos KJ.  The effects of verbalizing contingency in time-out procedures. J Behav Ther Exp Psychiatry . 1975;;6:253-255.
36 +
Bernal ME.  Behavioral feedback in the modification of brat behaviors. J Nerv Ment Dis . 1969;;148: 375-385.
37 +
Drabman RS, Jarvie G.  Counseling parents of children with behavior problems: the use of extinction and time-out techniques. Pediatrics . 1987;;59:78-85.
38 +
Drabman R, Spitalnik R.  Social isolation as a punishment procedure: a controlled study. J Exp Child Psychol . 1973;;16:236-249.
39 +
Forehand R, Roberts MW, Doleys DM, Hobbs SA, Resick PA.  An examination of disciplinary procedures with children. J Exp Child Psychol . 1976;; 21:109-120.
40 +
Williams CD.  The elimination of tantrum behavior by extinction procedures. J Abnorm Soc Psychol . 1959;;59:269.
41 +
Gardner HL, Forehand R, Roberts M.  Time-out with children: effects of an explanation and brief parent training on child and parent behaviors. J Abnorm Child Psychol . 1976;;4:277-288.
42 +
American Academy of Pediatrics, Committee on Psychological Aspects of Child and Family.  The pediatrician's role in discipline. Pediatrics . 1983;;72:373-374.
43 +
American Academy of Pediatrics, Committee on School Health.  Corporal punishment in schools. Pediatrics . 1984;;73:258.
44 +
American Academy of Pediatrics, Committee on School Health.  Corporal punishment in schools. Pediatrics . 1991;;88:173.
45 +
 Corporal punishment in schools. Am J Psychiatry . 1989;;146:1524.
46 +
Kelly PC, Weir MR, Fearnow RG.  Pediatrician's views: latchkey children, corporal punishment. Tex Med . 1987;;83:40-42.
47 +
Morris JL, Johnson CF, Clasen M.  To report or not to report: physicians' attitudes toward discipline and child abuse. AJDC . 1985;;139:194-197.
48 +
Anderson KA, Anderson DE.  Psychologists and spanking. J Clin Child Psychol . (Fall) 1976;:46-49.
49 +
Poole SR.  Pediatric behavioral science in family practice. J Fam Pract . 1983;;16:365-374.
50 +
Christophersen ER.  Anticipatory guidance on discipline. Pediatr Clin North Am . 1986;;33:789-798.
51 +
Erickson MT.  Common behavior problems of childhood.  In: Gabel S, Erickson MT. Child Development and Developmental Disabilities . Boston, Mass: Little Brown & Co Inc; 1980;:411-432.
52 +
Roster of Registered Physicians, Osteopathic Physicians, and Podiatrists in the State of Ohio . 10th ed. Columbus, Ohio: State Medical Board of Ohio; 1990;.
53 +
Active Member Practice Profile for Chapter Ohio . Kansas City, Mo; American Academy of Family Physicians: July 2, 1991;.
54 +
Demographic Characteristics by Membership Type for Chapter Ohio . Kansas City, Mo; American Academy of Family Physicians: July 2, 1991;.
55 +
US Bureau of the Census. Statistical Abstract of the United States: 1989 . 109th ed. Washington, DC: US Dept of Commerce; 1989;.
56 +
Dean AD, Dean JA, Burton AH, Dicker RC. Epi Info, Version 5: A Word Processing, Database, and Statistics Program for Epidemiology on Micro-computers . Stone Mountain, Ga: USD Inc; 1990;.
57 +
BMDP Statistical Software . Los Angeles, Calif: BMDP Statistical Software Inc; 1988;.
58 +
Goodwin J.  Family violence: principles of intervention and prevention. Hosp Community Psychiatry . 1985;;36:1074-1079.
59 +
Greenblat CS.  A hit is a hit is a hit... or is it? approval and tolerance of the use of physical force by spouses.  In: Finkelhor D, Gelles RJ, Hotaling GT, Straus MA, eds. The Dark Side of Families: Current Family Violence Research . Beverly Hills, Calif: Sage Publications; 1983;:235-260.
60 +
Keller K, Podell RN.  The survey in family practice research. J Fam Pract . 1975;;2:449-453.

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