@PHDTHESIS{ 2018:1102878278,
 	title = {Whats makes physical punishment beneficial or harmful?},
 	year = {2018},
 	url = "http://tede2.pucrs.br/tede2/handle/tede/8370",
 	abstract = "Child maltreatment (abuse and neglect) is a global public health problem, with serious consequences to the mental health of those who suffer it. Most studies on abuse have not accounted for the different types of physical punishment (physical abuse, spanking), the interaction between different types of abuse (emotional and sexual), awareness of the children on the motivation for being punished, or their long-term subjective impact in the life of those abused. This study aim is to describe the subjective impact in adulthood of abuse occurred in childhood and adolescence, and to analyze the association of abuse experiences in childhood and adolescence, and the use of psychoactive medication as adults. We analyzed data from a large and anonymous online survey (BRAINSTEP). To assess the history of childhood sexual, physical and emotional abuse, we used the CTQ (Childhood Trauma Questionnaire). For those who did not suffer physical abuse from objects, we asked about spanking frequency. Also, for those with any physical punishment history, we assessed if he/she knew the reason for being punished. The subjective impact was assessed in all participants that suffered any abuse. The outcome was assessed, inquiring on their lifetime psychiatric medication use. We found that emotional and sexual abuse were associated with a negative subjective impact, regardless of intensity. In turn, physical punishment not always was associated with a negative subjective impact, and this was greater for those individuals that did not know the reason for being punished. Emotional abuse showed the highest association with increased psychiatric medication use. Subjects that stated a positive subjective impact from physical punishment used less psychiatric medication. These findings suggest that the mechanisms, which associate abuse to negative consequences, are more complex than previously described; its subjective impact and the simultaneous occurrence of emotional abuse must also be taken into consideration.",
 	publisher = {Pontifícia Universidade Católica do Rio Grande do Sul},
 	scholl = {Programa de Pós-Graduação em Medicina e Ciências da Saúde},
 	note = {Escola de Medicina}
}