Associations of Harsh Physical Punishment and Child Maltreatment in Childhood With Antisocial Behaviors in Adulthood

IMPORTANCE: Inquiry into what childhood experiences are associated with antisocial behaviors in adulthood is necessary for prioritizing and informing efforts for effective prevention. OBJECTIVE: To examine whether harsh physical punishment in the absence of child maltreatment and child maltreatment with and without harsh physical punishment are associated with antisocial behaviors in adulthood. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study using data on the general US population obtained from the National Survey on Alcohol and Related Conditions Wave 3 from April 2012 to June 2013. Participants were civilian, noninstitutionalized adults 18 years and older. This study used a multistage probability sampling design (response rate, 60.1%). Data were analyzed from January 25 to November 27, 2018. EXPOSURES: Harsh physical punishment included pushing, grabbing, shoving, slapping, and hitting. Child maltreatment included physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, and exposure to intimate partner violence. MAIN OUTCOMES OR MEASURES: Lifetime antisocial personality disorder behaviors since age 15 years were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 based on Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria. RESULTS: The number of study participants was 36 309, with 15 862 men (weighted percentage, 48.1%) and 20 447 women (weighted percentage, 51.9%); mean (SE) age was 46.54 (0.19) years. The prevalence of harsh physical punishment and child maltreatment was 18.1% and 46.7%, respectively. Harsh physical punishment only (adjusted β, 0.62; 95% CI, 0.50-0.75), child maltreatment only (adjusted β, 0.65; 95% CI, 0.60-0.69), and harsh physical punishment and child maltreatment (adjusted β, 1.46; 95% CI, 1.38-1.54) were associated with adult antisocial behaviors. It is estimated that harsh physical punishment and/or child maltreatment might account for approximately 45.5% of antisocial behaviors among men in the United States and 47.3% antisocial behaviors among women in the United States. CONCLUSIONS AND RELEVANCE: Harsh physical punishment and child maltreatment appear to be associated with adult antisocial behaviors. Preventing harsh physical punishment and child maltreatment in childhood may reduce antisocial behaviors among adults in the United States.