This article is from WeChat public account:Back to Park (ID: fanpu2019), author: Cai Cai (Harvard Medical School lecturer), cover: Oriental IC

“The child’s weakness is that he started with a blank sheet of paper. He neither understands nor doubts the society in which he lives. Because of his credulity, others can influence him and make him feel inferior. He is afraid of violating the horrible rules of ignorance.” – George Orwell “So Happy Childhood”

“The filial piety under the stick, the yellow wattle is a good man”, this traditional view is not only widely circulated in the ancient East, but also popular in the West. I remember that the naughty child Tom in “The Adventures of Tom Sawyer” was beaten by his aunt, and he heard friends say that he was corporal punishment and punished at a boarding school in the UK more than 20 years ago. The team was pumped by the teacher… This made me feel cold.

However, the situation is still different now. A survey in 2016 found that in recent years, families of all walks of life in the United States, regardless of their economic status, have significantly reduced their corporal punishment. For example, in middle-income families, the proportion of corporal punishment is down from 46% in 1988 to 21% in 2011[1].

Because, there is growing evidence that corporal punishment of a child may actually be useless, or that it does not have any positive effect.

For example, a 2014 study (Fig. 1) found that most parents verbally teach before they hit a child. Corporal punishment within an average of 30 seconds (that is, corporal punishment is most likely due to parentsImpulsive or emotional reaction), and the effect of corporal punishment is quite short-lived. 73% of children will relapse after 10 minutes of swearing [2< Sup>].

Figure 1

A meta-study in 2016(Figure 2) trying to figure out the role of spanking in children’s education, the result is basically There is no evidence from the literature that corporal punishment is useful and supports corporal punishment. On the contrary, most of the literature shows that corporal punishment is not only ineffective, but also harmful [3].

Figure 2

For example, a study tracked 1,933 children and their parents born in 20 cities in the United States between 1998 and 2000, and found corporal punishment children Ass) will have a negative impact on their subsequent development, behavior and cognition:

A child who was beaten by his father when he was 5 years old, compared with a child who was not detained.It is prone to cognitive impairment. When you are 9 years old, you will be able to understand and understand fewer words;

Children who are being spanked by their mothers when they are 5 years old, even if they are not beaten many times, they will be more likely to show externalization like attack and opposition at the age of 9 and become more likely to become violent, impulsive, and Aggressive [4].


The harm that corporal punishment brings to children is not only the pain and aggression of the present, but long-term, far-reaching, both physical and psychological, behavioral.

Of course, there are many children who have been shackled in their childhood, and they have grown up healthily and become happy adults.

However, there are also many children who have been shackled when they were young. They could have become better adults, but they were dragged down by the physical and psychological effects of corporal punishment.

Recently Am J Psychiatry published a study that analyzes the link between childhood abuse experiences and barriers to interpersonal relationships in adulthood, and discovers that childhood abused people grow up and Distance and contact with people are more sensitive and easier to feel uncomfortable, so it is more prone to interpersonal barriers in social interaction, and it is more likely to cause mental illness due to interpersonal barriers[5].

For childhood abuse, see the Merck’s Medical Handbook Volkswagen Edition:

Physical abuse

Medical abuse or physical harm to children is physical abuse, including excessive corporal punishment of children. Children of any age may be physically abused, but babies and toddlers are particularly vulnerable. Physical abuse is the most common cause of severe head injury in infants. Physical abuse is more likely to cause a child with a toddler to suffer from abdominal damage, which can be fatal. Physical abuse (including homicide) occupies the top ten causes of child death. In general, the risk of physical abuse of children is reduced early in school and increased during puberty.

More than 3/4 of the abuser is the child’s parents. Most practitioners of physical abuse are male, born in povertyPoor families, children who follow single parents are the most dangerous. Family stress can lead to all physical abuse. Stress can come from unemployment, frequent relocations, social isolation from friends or family members, and ongoing domestic violence. Difficult children (Irritable, over-required, hyperactivity) or have special needs (Development or Physical Disability) may be more susceptible to physical abuse. Physical abuse is often triggered by crises in other stresses. The crisis can be unemployment, family member death, discipline issues, etc.

Sexual abuse

Adults or children of different ages, any behavior done to the child to satisfy sexual desire is considered sexual abuse, including genital access to the child’s vagina, anus or mouth, no access but sexual touch, for children Expose genitals or show erotic images, and use erotic products for children. Sexual abuse does not include sex games. In sex games, children are under the age of 4 years old, seeing or touching each other’s genital area without violence or threats.

By the age of 18, approximately 12% to 25% of girls and 8% to 10% of boys have been sexually abused. Most abusers are children who are known to the child, usually a stepfather, uncle or mother’s boyfriend. Female abusers are relatively rare.

Some conditions increase the risk of sexual abuse. For example, there are several caregivers or people with several sexual partners who care for children and are at increased risk of sexual abuse. Being isolated from society, low self-esteem, family members being sexually abused, and involvement with criminal gangs also increase the risk.

Emotional abuse

The psychological abuse of children using language or behavior is emotional abuse. Emotional abuse makes children feel that they are worthless, flawed, unloved, no one wants, and at risk, only valuable if they meet the requirements of others.

Emotional abuse includes contempt, exploitation, intimidation, isolation and neglect. Defiance means looking down on children’s abilities and achievements. Use refers to encouraging abnormal or criminal behavior, such as crime, alcohol or substance abuse. Intimidation means bullying, threatening or scaring children. Isolation means that children are not allowed to communicate with other adults and children. Emotional neglect means neglecting children, not communicating with children and not giving children love and attention. Emotional abuse tends to occur over time.

Physical punishment and cold violence are all areas of childhood abuse.

This study examined the mental state and childhood abuse/conspiracy of 92 [span class=”text-remarks” label=”remarks”> (64 female 28 males) of the average age of 28 participants. The level of achievement was assessed and the assessment covered five childhood abuses including cold and hot violence. (Emotional abuse, physical abuse, sexual abuse, and emotional and physical Careless negligence).

The participants were then assessed for interpersonal distance and found that people who were more abused in childhood were more sensitive to the distance from others. People who are less abused in childhood can feel comfortable when they are 80 cm away from others; but those who are more abused in childhood tend to stay farther away from people, when the distance between the two is less than 90 cm, you will feel unwell (Figure 3) .

Figure 3. People with different levels of childhood abuse have significant differences in comfortable social distances. The abscissa: low degree of abuse in childhood – medium to high; ordinate: social distance; red for comfortable distance and orange for uncomfortable distance.

The researchers also conducted a social touch test on the participants, and performed a slow (5 cm per second) on the calf bones of the participants. /span> and fast (20 cm per second) touch, find people who have been abused more seriously in childhood, more likely to feel uncomfortable with fast touch 膈应 (Fig. 4). The discomfort that occurs in social touch experiments is related to the extent to which participants are hated to be touched in their daily lives.

Figure 4. The more people abused in childhood, the more difficult it is to endure a quick touch. Abscissa: Low level of abuse in childhood – medium to high; ordinate: touch comfort; blue for slow touch and green for fast touch.

Participants also received a functional nuclear magnetic scan (fMRI) and found that people who were more abused in childhood, the hippocampus, The gray matter of the primary somatosensory cortex, the hindbrain island, and the left amygdala is significantly reduced. However, their right primary somatosensory cortex and posterior insula cortex react more quickly to others than others, and they feel more intense discomfort.

The results of these studies explain to a certain extent why a person is more abused in childhood and more likely to experience communication difficulties and mental disorders in adulthood: childhood abuse experiences may change the way the nervous system processes social information. It makes people more sensitive, and thus unconsciously avoids interpersonal sensory stimulation, so as to reduce the discomfort and emotional distress that comes with it – it is easier to encounter obstacles in interpersonal communication.

People are social animals, and everyone is inevitably dealing with others.

How important is interpersonal communication for a person, especially an adult, is not to be described here. Who knows who.


In addition, JAMA Netw Open published a study earlier this year (Fig. 5) interviewed 36,309 American adults with an average age of 47 and found that nearly half of the general public’s antisocial behavior and childhood corporal punishment and abuse were experienced among the general public. About [6].

Figure 5

In this study, the gender of the participants was 52% female and 48% male, and 18.1% of them experienced severe corporal punishment before the age of 18 (17.7% of women and 18.5% of men; corporal punishment includes being shirked, caught, slap in the face, bedding, etc.), 46.7% of people experienced abuse before the age of 18 Span class=”text-remarks” label=”Remarks”> (46.8% of women and 46.6% of men; abuse includes physical abuse, sexual abuse, emotional abuse, emotional neglect, physical neglect, and experience of witnessing marriage violence, etc.) /span>.

Analysis of these participants found that up to 46.7% of antisocial behaviors were related to corporal punishment or/and abused experiences in childhood (47.3% among women and 45.5% among men)……

The “antisocial behavior” in this study is based on the “Spirical Disease Diagnosis and Statistics Manual (Fifth Edition, “DSM-5”) include unethical or illegal behaviors, deceptive behaviors that are not taken into account, reckless, irresponsible, operational, or risky behavior. The specific list is shown in Figure 6.

Figure 6

Adults who make these anti-social behaviors are often more difficult to develop and maintain positive relationships, and they will encounter difficulties in successful employment and compliance with the law.

Frankly speaking, it is not surprising that corporal punishment/abuse in childhood will trigger adult antisocial behavior.

However, the existence of this association revealed by this study is (nearly half), which is quite surprising.

Although correlation does not mean causality, the association revealed in this study has been similar to smoking/lung cancer…

This association is very worthy of social vigilance.


There are many more examples of this type.

For example, a research paper by Lancet Psychiatry points out that childhood abuse/corporal punishment experiences can adversely affect the brain structure that is still developing. People with such experiences, right The cortical surface area of ​​the lateral insula is reduced, and depression is likely to recur after adulthood in the future [7].

For example, Canadian researchers analyzed data on 34,653 US adults and found that they had experienced strict corporal punishment in their childhood (non-abuse Children) people who are more likely to develop mental disorders such as mood disorders, anxiety disorders, drug dependence, personality disorders, etc.[8], and is more susceptible to cardiovascular disease, arthritis and obesity [9].

Recently, the American Academy of Pediatrics issued a paper advising parents to advise parents and other adults who interact with children not to take children when they are angry, and not to treat corporal punishment as a form of punishment for children after making mistakes. [10].

It’s not easy to raise a child…but playing a child doesn’t make it easier.


[1] Ryan, RM, Kalil, A., Ziol-Guest, KM & Padilla, C. Socioeconomic Gaps in Parents’ Discipline Strategies From 1988 to 2011. Pediatrics 138, Doi:10.1542/peds.2016-0720 (2016).

[2] Holden, GW, Williamson, PA & Holland, GW Eavesdropping on the family: a pilot investigation of corporal punishment in the home. Journal of family psychology : JFP : journal Of the Division of Family Psychology of the American Psychological Association (Division 43) 28, 401-406, doi:10.1037/a0036370 (2014).

[3] Gershoff, E. T. & Grogan-Kaylor, A. SpankAnd others outcomes: Old controversies and new meta-analyses. Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43) 30, 453-469, doi:10.1037/fam0000191 (2016) .

[4] MacKenzie, MJ, Nicklas, E., Waldfogel, J. & Brooks-Gunn, J. Spanking and child development across the first decade of life. Pediatrics 132, E1118-1125, doi:10.1542/peds.2013-1227 (2013).

[5] Maier, A. et al. Association of Childhood Maltreatment With Interpersonal Distance and Social Touch Preferences in Adulthood. The American journal of psychiatry, appiajp201919020212, doi:10.1176/appi .ajp.2019.19020212 (2019).

[6] Afifi, TO, Fortier, J., Sareen, J. & Taillieu, T. Associations of Harsh Physical Punishment and Child Maltreatment in Childhood With Antisocial Behaviors in Adulthood. JAMA network open 2, e187374, doi:10.1001/jamanetworkopen.2018.7374 (2019).

[7] Opel, N. et al. Mediation of the influence of childhood maltreatment on depression relapse by cortical structure: a 2-year longitudinal observational study. The lancet. Psychiatry 6 , 318-326, doi:10.1016/s2215-0366(19)30044-6 (2019).

[8] Afifi, TO, Mota, NP, Dasiewicz, P., MacMillan, HL & Sareen, J. Physical punishment and mental disorders: results from a nationally representative US sample Pediatrics 130, 184-192, doi:10.1542/peds.2011-2947 (2012).

[9] Afifi, TO, Mota, N., MacMillan, HL & Sareen, J. Harsh physical punishment in childhood and adult physical health. Pediatrics 132, e333-340, Doi:10.1542/peds.2012-4021 (2013).

[10] Sege, R. D. & Siegel, B. S. Effective Discipline to Raise Healthy Children. Pediatrics 142, doi:10.1542/peds.2018-3112 (2018).

This article is from WeChat public account:Back to Park (ID: fanpu2019), author: Cai Cai (Harvard Medical School lecturer), cover: Oriental IC