Revision of ENTIRE Essay

RESEARCH ARTICLE

Associations between childhood experiences

of parental corporal punishment and

neglectful parenting and undergraduate

students’ endorsement of corporal

punishment as an acceptable parenting

strategy

Naomi KitanoID 1,2,3*, Kouichi YoshimasuID

4*, Beverley Anne Yamamoto3, Yasuhide Nakamura

5

1 Research Center for Community Medicine, Wakayama Medical University, Wakayama, Japan,

2 Department of Public Health, School of Medicine, Wakayama Medical University, Wakayama, Japan,

3 Graduate School of Human Sciences, Osaka University, Suita, Japan, 4 Department of Hygiene, School of

Medicine, Wakayama Medical University, Wakayama, Japan, 5 Faculty of Nursing and Rehabilitation, Konan

Women’s University, Kobe, Japan

* [email protected] (NK); [email protected] (KY)

Abstract

This study evaluated the effects of childhood experiences of parental corporal punishment

(CP) and neglectful parenting (NP) on Japanese university students’ endorsement of paren-

tal CP (EPP) to discipline children, in relation to subjective happiness (SH). A total of 536

undergraduate students who showed no physical symptoms completed anonymous paper-

based questionnaires addressing demographic characteristics, undergraduate classes, and

recent health conditions on SF-8 (PCS, MCS). It was found that the proportions of partici-

pants who experienced pervasive CP and NP were larger in men than in women (36.5% vs.

19.4% for CP; 22.1% vs. 9.7% for NP). Multiple regression analyses (n = 346) revealed that

the CP score was associated with positive EPP (β = 0.310, p < 0.001). Further, students whose major was nursery education reported significantly lower level of EPP; however, nei-

ther SH nor good recent health conditions significantly reduced EPP. The NP score was

inversely associated with the SH score (β = -0.253, p < 0.001) (n = 346). In conclusion, child- hood experiences of parental CP may affect adolescents’ views related to their own parent-

ing. Further investigation using internationally comparable methodologies, especially in

prospective cohort studies, is warranted, not only in Japan but also in other Asian countries.

Introduction

The prevention of child maltreatment is one of the most urgent public health issues worldwide

[1,2]. Recent neurobiological, morphological, genetic, and epigenetic findings have offered

PLOS ONE | https://doi.org/10.1371/journal.pone.0206243 October 26, 2018 1 / 16

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OPEN ACCESS

Citation: Kitano N, Yoshimasu K, Yamamoto BA,

Nakamura Y (2018) Associations between

childhood experiences of parental corporal

punishment and neglectful parenting and

undergraduate students’ endorsement of corporal

punishment as an acceptable parenting strategy.

PLoS ONE 13(10): e0206243. https://doi.org/

10.1371/journal.pone.0206243

Editor: Neha John-Henderson, Montana State

University, UNITED STATES

Received: June 25, 2018

Accepted: October 9, 2018

Published: October 26, 2018

Copyright: © 2018 Kitano et al. This is an open access article distributed under the terms of the

Creative Commons Attribution License, which

permits unrestricted use, distribution, and

reproduction in any medium, provided the original

author and source are credited.

Data Availability Statement: There are ethical

restrictions on making data publicly available.

Since the data set of the current study contains

potentially sensitive student information, data

availability is under strict control of the Research

Ethics Committee of the Graduate School of

Human Sciences, Osaka University (email: jinka-

[email protected]).

experimental evidence to support the relationship between child maltreatment and increased

susceptibility to health impairments later in life [3,4]. Furthermore, many longitudinal cohort

studies have suggested that child maltreatment and adverse familial environments have nega-

tive effects on long-term health [5–8]. Epidemiological studies have consistently shown a high

prevalence of mental health problems among children and adolescents in community popula-

tions [9]. The heterogeneity in individual responses to such experiences of maltreatment and

emotional abuse is an important predictor of poor mental health throughout life [10,11], and

this might lead to the perpetuation of child abuse or neglect between generations. Such inter-

generational transmission of maltreatment has been reported based on several theoretical

models in Western countries [12–14]. The moderating effects of cultural factors on the link

between parenting and child outcomes have been inconsistent [15–17]. Across cultural groups,

more frequent use of corporal punishment is associated with greater externalizing behaviors in

children [18]. However, previous multicultural studies did not include Japan, where parenting

styles and discipline tactics are somewhat different compared with even other East Asian coun-

tries [19], suggesting that Japan has set comparatively high value on ‘loyalty’ while Korea has

set higher value on ‘piety for their parents’. In Japan, a dramatic increase in the number of

reported cases of child maltreatment [20] has raised concerns about not only the health and

welfare of the children most at risk but also the long-term impacts of corporal punishment

(CP) [21] and neglectful parenting (NP). Therefore, we sought to identify young people who

experienced childhood parenting problems in a population of university students without

physical symptoms to explore the effects of such experiences on young adulthood.

Hence, this study assessed the frequencies of reported parental CP and/or NP and their

effects on young adults, focusing on their endorsement of CP as an acceptable parenting strat-

egy and self-reported well-being, such as subjective happiness (SH). We also examined the

confounding effects of SH and subjective mental and physical health conditions on the associa-

tion between experiences of CP and/or NP and endorsement of CP. Those with poor SH or

with bad mental health and experiences of CP and/or NP may endorse CP. However, consider-

ing the traditional background of home discipline, even those with good SH might strongly

endorse CP.

We also hypothesized that students who experienced childhood CP and/or NP would

report lower levels of subjective well-being regardless of their most recent physical/mental

health status. A previous study has suggested that adolescents’ exposure to maternal negative

affective behavior is associated with adolescents’ subjective daily well-being [22]. Happiness is

a composite of life satisfaction, coping resources, and positive emotions [23]. Positive emotions

are a powerful source of growth and change, predicting both individuals’ judgments about life

and their skills for living well, including recovery from illness [24,25].

Additionally, studying nursery education may be a possible factor for the prevention of

maltreatment, which is inversely associated with endorsing CP. Children exposed to school-

based programs show improvements in protective behaviors and knowledge as well as increase

disclosure of abuse [26]. A nursery educational course includes a variety of social sciences

such as psychology, psychiatry, and welfare, including prevention or coping with child

maltreatment.

As such, the main purpose of this study was to examine the association between childhood

experiences of parental CP and/or NP and endorsement of CP in relation to current subjective

well-being in apparently healthy Japanese university students. Next, to explore whether the

endorsement of CP can be changed by students’ appropriate recognition, we also examined

whether university students who study nursery education are less likely to endorse CP as a

suitable parenting practice.

Child abuse and endorsement of corporal punishment

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Funding: This research was supported by an Osaka

University, Graduate School of Human Sciences

‘Support Program for Improving Graduate School

Education’ grant: ‘Promoting the Use of Human

Science Data in General and Professional

Education’. The funder had no role in study design,

data collection and analysis, decision to publish, or

preparation of the manuscript.

Competing interests: The authors have declared

that no competing interests exist.

Material and methods

The present study was an exploratory, cross-sectional investigation targeting undergraduate

students at five universities in Western Japan. It was conducted from September 2007 to July

2008. The study protocol was reviewed and approved by the Research Ethics Committee of the

Graduate School of Human Sciences, Osaka University. Completing and returning the anony-

mous questionnaires indicated participants’ tacit informed consent.

Study participants

Participants were recruited from first- and second-year undergraduate classes in nursery edu-

cation, health nursing, social welfare, domestic science, nutrition, and psychosociology. Eligi-

ble students were those studying in the Kansai area who could be contacted by the first author

(NK), who was the principal investigator, in cooperation with co-investigators at multiple uni-

versities. A total of 692 students from five universities were recruited. Valid responses were

received from 536 respondents (104 men and 432 women, valid response rate: 77.5%). None of

the study participants had any experience in caring for children.

Definitions

In the present study, the definition of CP reflected the definitions by the American Association

of Pediatrics [27] and Straus and Donnelly [28]. We defined CP as the use of physical force,

including spanking and hitting, for correcting or controlling a child’s behavior.

We employed the definition of NP behaviors developed by Straus and Kantor [29]. NP

behaviors are those that constitute a failure to act in ways presumed by a society’s culture to be

necessary to meet a child’s developmental needs and that are the caregiver’s responsibility to

provide.

Measurements

We constructed a five-part questionnaire, drawing on existing instruments for use in the general

population. Our self-reported anonymous questionnaire (paper-based) covered demographic

characteristics, experiences of CP and NP, recent physical and mental health conditions, endorse-

ment of parental use of CP, and subjective well-being. Since no official Japanese version existed

for a pre-existing instrument, we conducted a translation using cross-cultural translation method-

ology and validation based on Acquadro et al. [30], and we checked the reliability of these transla-

tions by confirmatory factor analyses and calculation of Cronbach’s α coefficients.

Demographic data

The first part of the questionnaire collected basic demographic data (i.e., gender, age, number of

siblings, birth-order, mother’s and father’s ages, and years of education completed by parents) and

basic information about the participant’s academic affiliation and major (i.e., university classes).

Experience of parental corporal punishment

To assess participants’ experience of parental CP, two items were translated into Japanese and

administered: one asked whether respondents had been hit or spanked “a lot” before the age of

12, and the other asked whether they were hit “a lot” during their teenage years [31]. These

items were chosen because they have been used internationally [31], facilitating comparisons

between findings.

Any response to these two items other than “strongly disagree” was highly suggestive of the

respondent having experienced CP because of the inclusion of the word “a lot” [31]; even if

Child abuse and endorsement of corporal punishment

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they disagreed with “a lot,” they might agree with “a little.” Thus, for either question, responses

of “strongly agree,” “agree,” and “disagree” were considered suggestive of CP, and responses of

“agree” and “strongly agree” were considered to indicate pervasive CP.

To form the predictor measure in this study, responses to the two items concerning CP

(strongly agree = 4, agree = 3, disagree = 2, and strongly disagree = 1) were summed to pro-

duce the score representing the experience of CP (CP score).

Experience of neglectful parenting

To assess participants’ experience of NP, the eight-item revised version of the Multidimen-

sional Neglectful Behavior Scale Adult Recall Short Form (revised MNBS-AS) was employed

[32]: two items concerning physical neglect (e.g., my parents did not keep me clean), two

items concerning cognitive neglect (e.g., my parents did not help me to do my best), two items

concerning emotional neglect (e.g., my parents did not comfort me when I was upset), and

two items concerning supervisory neglect (e.g., my parents did not care if I did things like

shoplifting). The revised MNBS-AS was developed as a brief instrument for use in surveys tar-

geting general populations [29,32,33].

As a predictor measure in the study, responses to the eight items of the revised MNBS-AS

were rated (strongly agree = 4, agree = 3, disagree = 2, and strongly disagree = 1) and summed

to produce the score representing the experience of NP (NP score). To distinguish between

single and multiple experiences of NP, we followed Straus and Savage [33] by presenting sepa-

rate data about the percentage of students who reported three or more experiences of NP,

which was evidence of “pervasive NP.”

Recent health condition

This part of the questionnaire concerned respondents’ self-reported physical and mental health

condition over the past month. The official Japanese version of the 8-item SF-8 Health Survey

was administered (e.g., During the past four weeks, how much did physical health problems

limit your physical activities [such as walking or climbing stairs]? and During the past four

weeks, how much have you been bothered by emotional problems [such as feeling anxious,

depressed, or irritable]?) [34]. Two indicators, the physical condition score (PCS) and mental

condition score (MCS), were calculated as indicators of respondents’ recent health condition.

Subjective happiness

To capture each participant’s subjective well-being, we administered the official Japanese ver-

sion of the Subjective Happiness Scale, a global SH seven-point Likert scale consisting of four

items (e.g., Compared with most of my peers, I consider myself: less happy (1–7) more happy;

Some people are generally very happy. They enjoy life regardless of what is going on, getting

the most out of everything. To what extent does this characterization describe you?) [35,36]. In

the present study, the SH score—the mean score of the four items, assessed on the seven-point

Likert scale—was used as an outcome measure of subjective well-being. The degree of SH rises

as the SH score increases.

Endorsement of parental use of physical punishment on children as a form

of discipline

The Adult Adolescent Parenting Inventory-2 (AAPI-2) was developed to assess the parenting

and child-rearing attitudes of adults and adolescents, regardless of experience in raising their

own children [37]. We obtained permission to translate this instrument into Japanese, and its

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translated contents were confirmed using back-translation. In the present study, our Japanese

version of AAPI-2 Form B was administered. We modified the original five-point Likert scale

to a four-point scale (strongly disagree, disagree, agree, and strongly agree) in this study to

avoid Japanese people’s tendency to choose the “uncertain” response [38].

Following the 2005 edition of the AAPI Online Development Handbook [37], we performed a confirmatory factor analysis for each subscale of AAPI-2 Form B in our sample. We identi-

fied one factor (Cronbach’s α = 0.769) consisting of six items regarding the endorsement of the use of physical punishment (e.g., “Spanking children when they misbehave teaches them

how to behave”). We called this factor the “Endorsement of Physical Punishment as a Form of

Discipline Indicator” (EPP). The response to each EPP item was rated as follows: strongly

agree = 4, agree = 3, disagree = 2, and strongly disagree = 1. Adding the response ratings from

the six EPP items produces the EPP score, which was used as an outcome measure in this

study. The degree of endorsement of physical punishment rises as the EPP score increases.

Statistical methods

First, descriptive analyses were performed to examine respondents’ demographic characteristics

and the frequency distributions of responses to items concerning experience of CP and NP. To

examine the differences between the two groups of responses, t-tests and chi-square tests or Fisher’s exact test were conducted for parametric and non-parametric variables, respectively.

Next, using data of 346 participants (56 men and 290 women), we conducted multiple

regression analyses to detect the independent contributions of the predictors of CP and NP

scores to the EPP score as outcome variable, adjusting for participants’ basic demographic fac-

tors, undergraduate class, recent health condition on SF-8 (PCS, MCS), and with/without the

SH score. As preparation for the multivariate analysis, bivariate correlation analyses were per-

formed to examine the associations among the independent variables, using list-wise case dele-

tion. Variance inflation factors (VIFs) were also used as diagnostic for multicollinearity.

Another multiple regression analysis was conducted using the SH score as an outcome variable

to examine the independent effects of CP and NP scores on the SH score.

For all statistical analyses, SPSS version 24.0 for Windows (IBM Corp., Armonk, NY, USA)

were used. A two-tailed P-value of less than 0.05 was required for statistical significance.

Results

As shown in Table 1, there were no statistically significant gender differences in the sociode-

mographic characteristics or present status of the 536 respondents, except for the variable “has

studied health or welfare at university.”

Experience of parental corporal punishment

Table 2 shows the frequency distribution of the number and percentage of responses to the

two items concerning experience of parental CP. Responses of “strongly agree,” “agree,” or

“disagree” on either or both of the items were considered suggestive of CP, whereas responses

of “agree” or “strongly agree” were considered to indicate pervasive CP.

Overall, 59.5% of students (72.1% of men and 56.5% of women) provided responses sugges-

tive of experience of CP, indicating that they were spanked or hit before the age of 12 by their

parents. Regarding their teenage years, 46.8% of students (61.5% of men and 43.3% of women)

gave responses suggestive of experience of parental CP.

The percentage of respondents who gave answers suggestive of experience of pervasive CP

was 22.8%. There was a significant gender difference, with 36.5% of men and 19.4% of women

(chi-square = 13.932, df = 1, P < 0.001) agreeing or strongly agreeing with either or both items

Child abuse and endorsement of corporal punishment

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concerning experience of CP. There was a strong association between experience of pervasive

CP before the age of 12 and during the teenage years (chi-square = 146.504, df = 1, P < 0.001).

Experiences of neglectful parenting behaviors

Table 2 presents the frequency distribution of responses to each of the eight items used to

assess experience of NP. Emotional and cognitive forms of NP were reported more frequently

than were physical and supervisory forms.

The percentage of respondents who gave answers suggestive of experience of pervasive NP

was 12.2%. There was a significant gender difference, with 22.1% of men compared with 9.7%

of women (chi-square = 12.081, df = 1, P = 0.001) reporting experience of pervasive NP.

Gender differences in predictor and outcome measures

The mean ± SD of the CP score among 346 respondents (56 men and 290 women) was 3.5 ± 1.6 (range: 2–8, median: 3, skewness: 0.886, kurtosis: 0.196); as shown in Table 1, there

Table 1. Characteristics of the study participants (n = 536).

Male (n = 104)

Mean (SD) / n (%)

Female (n = 432)

Mean (SD) / n (%)

P-value�

Socio-demographic variables

Age 19.4 (0.71) 19.5 (0.96) 0.693

Number of siblings †

2.5 (0.75) 2.5 (0.73) 0.785

Birth-order ‡

1.7 (0.79) 1.8 (0.79) 0.670

Mother’s age at birth §

28.1 (4.1) 28.1 (3.9) 0.970

Age difference between mother and father (years) k

-2.9 (4.2) -2.7 (3.5) 0.607

Mother’s years of education ¶

13.2 (1.6) 13.3 (1.6) 0.746

Father’s years of education #

13.8 (2.1) 14.0 (2.0) 0.357

Undergraduate classes

Nursery education 21 (20.2%) 127 (29.4%) 0.059

Health nursing 11 (10.6%) 123 (28.5%) <0.001

Social welfare 51 (49.0%) 49 (11.3%) <0.001

Domestic science 0 62 (14.4%) <0.001

Nutrition 15 (14.4%) 39 (9.0%) 0.101

Psychosociology 6 (5.8%) 32 (7.4%) 0.674

Recent health condition on SF-8

Physical condition score (PCS) 48.9 (7.4) 51.3 (6.4) 0.014

Mental condition score (MCS) 45.9 (8.7) 43.4 (7.3) 0.025

Predictive and outcome measures��

Score representing experience of corporal punishment (CP score) 4.3 (1.6) 3.4 (1.5) <0.001

Score representing experience of neglectful parenting (NP score) 15.1 (2.8) 12.8 (3.3) <0.001

Subjective happiness (SH) score 4.6 (1.1) 4.7 (0.94) 0.836

Endorsement of parental use of physical punishment on children (EPP) score 13.1 (3.4) 12.7 (2.7) 0.413

�Continuous variable: t-test; Categorical variable: chi-square test or Fisher’s exact test

†n = 530 (104 males and 426 females)

‡n = 521 (103 males and 418 females)

§n = 462 (74 males and 388 females)

kn = 437 (70 males and 367 females)

¶n = 476 (87 males and 389 females)

#n = 461 (85 males and 376 females)

��n = 346 (56 males and 290 females).

https://doi.org/10.1371/journal.pone.0206243.t001

Child abuse and endorsement of corporal punishment

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was a significant gender difference in the mean CP score (P < 0.001).The mean ± SD of the NP score among them was 13.1 ± 3.4 (range: 8–24, median: 13, skewness: 0.427, kurtosis: −- 0.215); as shown in Table 1, there was a significant gender difference in mean NP scores

(P < 0.001). The mean ± SD of the SH score among them was 4.6 ± 0.97 (range: 2–7, median: 4.5, skewness: 0.083, kurtosis: −0.151); as shown in Table 1, there was no significant gender dif- ference in mean SH scores (P = 0.836).The mean ± SD of the EPP score among 346 respon- dents (56 men and 290 women) was 12.8 ± 2.8 (range: 6–21, median: 13, skewness: −0.028; kurtosis: 0.269); as shown in Table 1, there was no significant gender difference in mean EPP

scores (P = 0.413).

Associations between predictor and outcome variables

As shown in Table 3, a few variables were significantly correlated with EPP or SH scores, but

no multicollinearity was detected among the study variables by VIFs. Hence, we included

some non-significant variables into the regression models based on the previous evidence. As

shown in Table 4, by multiple regression analysis, the CP score had a significantly positive

effect on the EPP score, whereas the NP score had no significant effect on the EPP score. The

robustness of the standardized partial regression coefficient of the CP score was demonstrated

by controlling for respondents’ basic demographic factors, the NP score, undergraduate clas-

ses, and PCS and MCS (adjusted R 2

= 0.135). Subsequently, after the inclusion of the SH score

in the model, the results did not change (ΔR2 = 0.001) and the CP score had a significantly pos- itive effect on the EPP score (β = 0.310, P < 0.001). Another independent variable with

Table 2. Frequency distribution of responses to each question on experience of parental corporal punishment and neglectful parenting in childhood and adoles-

cence (n = 536: 104 men and 432 women).

Corporal punishment item Strongly disagree

n (%)

Disagree

n (%)

Agree

n (%)

Strongly agree

n (%)

When I was less than 12 years old, I was spanked or hit a lot by my mother or father. Men 29 (27.9) 40 (38.5) 29 (27.9) 6 (5.8)

Women 188 (43.5) 165 (38.2) 57 (13.2) 22 (5.1)

When I was a teenager, I was hit a lot by my mother or father. Men 40 (38.5) 46 (44.2) 14 (13.5) 4 (3.8)

Women 245 (56.7) 151 (35.0) 28 (6.5) 8 (1.9)

Revised MNBS-AS item (sub-category of neglect) Strongly disagree Disagree Agree Strongly agree

My parents helped me when I had trouble understanding something. 1

Men 2 (1.9) 18 (17.3) 63 (60.6) 21 (20.2)

(cognitively) Women 10 (2.3) 61 (14.1) 247 (57.2) 114 (26.4)

My parents did not comfort me when I was upset. Men 15 (14.4) 56 (53.8) 27 (26.0) 6 (5.8)

(emotionally) Women 121 (28.0) 211 (48.8) 80 (18.5) 20 (4.6)

My parents helped me when I had problems. 1

Men 3 (2.9) 29 (27.9) 52 (50.0) 20 (19.2)

(emotionally) Women 7 (1.6) 73 (16.9) 230 (53.2) 122 (28.2)

My parents did not care if I did things like shoplifting. Men 60 (57.7) 30 (28.8) 11 (10.6) 3 (2.9)

(supervisory) Women 320 (74.1) 104 (24.1) 7 (1.6) 1 (0.2)

My parents did not help me to do my best. Men 24 (23.1) 56 (53.8) 17 (16.3) 7 (6.7)

(cognitively) Women 220 (50.9) 188 (43.5) 20 (4.6) 4 (0.9)

My parents gave me enough clothes to keep me warm. 1

Men 2 (1.9) 8 (7.7) 52 (50.0) 42 (40.4)

(physically) Women 8 (1.9) 16 (3.7) 147 (34.0) 261 (60.4)

My parents did not keep me clean. Men 46 (44.2) 47 (45.2) 7 (6.7) 4 (3.8)

(physically) Women 297 (68.8) 120 (27.8) 9 (2.1) 6 (1.4)

My parents did not care if I got into trouble in school. Men 51 (49.0) 42 (40.4) 10 (9.6) 1 (1.0)

(supervisory) Women 284 (65.7) 131 (30.3) 11 (2.5) 6 (1.4)

1: reverse-scored item

https://doi.org/10.1371/journal.pone.0206243.t002

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Child abuse and endorsement of corporal punishment

PLOS ONE | https://doi.org/10.1371/journal.pone.0206243 October 26, 2018 8 / 16

significant coefficients was “having studied nursery education,” which showed a significant

inverse effect on the EPP score (β = −0.239 in the final model, P < 0.001). As shown in Table 5, by simple regression analysis, the NP score had a significantly negative

effect on the SH score, whereas the CP score had no significant effect on the SH score. The

robustness of the standardized partial regression coefficient of NP score was demonstrated by

controlling for respondents’ basic demographic factors, the CP score, undergraduate classes,

and PCS and MCS (adjusted R 2

= 0.142). Other independent variables with significantly posi-

tive coefficients were MCS, PCS, birth-order, and mother’s years of education.

Discussion

The present results indicate that a sizable proportion of the undergraduate student participants

had experienced pervasive parental CP and NP, and more men than women reported both

types of experience (36.5% vs. 19.4% for CP; 22.1% vs. 9.7% for NP). This result is especially

interesting given that we targeted an apparently healthy and academically successful popula-

tion of young people. In a previous Japanese survey [39], it was reported that 21% of junior

high school students and 26% of high school students experienced CP from fathers, which is

similar with the current findings. To the best of our knowledge, however, the present study

shows the first internationally comparable Japanese data on experiences of CP and/or NP tar-

geting young people in a non-clinical setting.

Table 4. The results of multiple regression analysis (Dependent variable: Degree of students’ endorsement of

physical punishment by parents, EPP score; n = 346).

Unadjusted β Adjusted

Independent variable B (95%CI) Β (constant) 13.904 (6.175, 21.632)

Score representing experience of corporal punishment (CP

score)

0.320��� 0.564 (0.373, 0.754) 0.311����

Score representing experience of neglectful parenting (NP

score)

0.122 0.012 (-0.078, 0.101) 0.014

Gender −0.044 0.200 (-0.611, 1.012) 0.026 Age 0.018 −0.051 (-0.360, 0.259) −0.017 Number of siblings −0.015 0.276 (-0.210, 0.762) 0.067 Birth-order −0.048 −0.431 (-0.930, 0.067) −0.116 Mother’s age at birth 0.022 0.074 (-0.017, 0.165) 0.100

Age difference between mother and father −0.068 −0.08 (-0.163, 0.003) −0.102 Mother’s years of education −0.057 −0.015 (-0.210, 0.181) −0.008 Father’s years of education −0.040 −0.053 (-0.208, 0.101) −0.039 Studied nursery education −0.181�� −1.574 (-2.370,

-0.778)

−0.239����

Studied health and nursing/social welfare −0.017 −0.686 (-1.388, 0.016) −0.120 Physical condition score (PCS) −0.071 −0.039 (-0.083, 0.005) −0.092 Mental condition score (MCS) −0.048 −0.024 (-0.063, 0.014) −0.065

����: p < 0.001 ���: p < 0.01 ��: p < 0.05 Gender was coded as man = 0 and woman = 1. Studied nursery education and studied health and nursing/social

welfare were coded as yes = 1 and no = 0. PCS: Physical condition score on SF-8; MCS: Mental condition score on

SF-8

https://doi.org/10.1371/journal.pone.0206243.t004

Child abuse and endorsement of corporal punishment

PLOS ONE | https://doi.org/10.1371/journal.pone.0206243 October 26, 2018 9 / 16

In our study, male respondents were more likely than their female counterparts to have

experienced CP and NP as children and teenagers. Externalizing problems were reported to be

more critical in boys, while internalizing symptoms were more apparent among girls [40].

Such gender differences may partially explain why males were more likely to have experienced

child maltreatment. There is a need to explore the gendered norms and values around child-

rearing that may influence this outcome. Oshio and Umeda [41] reported that the intergenera-

tional impact of parents’ experience of childhood abuse on problem behavior in children

between the ages of 2 and 18 was largely characterized by same-gender linkages: daughters’

problem behavior was more closely associated with childhood abuse of mothers than of

fathers, and sons’ problem behavior was more closely associated with their fathers’ experiences.

Thus, there is a need to consider gender when developing interventions to address their par-

enting skills, and attempts to ameliorate the impact of childhood maltreatment may also

require gender-sensitive approaches.

CP has been shown to be an ineffective tool for improving child behaviors [27]. Regardless

of culture, religion, location, or country, from a human rights perspective, CP of children

should be avoided [42,43]. However, despite legal restrictions on the use of CP in school set-

tings, CP is still widely endorsed among the general population. For example, the Japanese

General Social Survey 2000/2001 reported that more than half of 5,656 randomly sampled

adults approved of the use of CP as a means of discipline, not only by parents but also by

school teachers [44]. In addition, the use of CP by Japanese teachers in the context of extracur-

ricular activities has recently emerged as a controversial issue in the media on several

Table 5. The results of multiple regression analysis (Dependent variable: Degree of students’ subjective happiness,

SH score; n = 346).

Unadjusted β Adjusted

Independent variables B (95%CI) β (constant) 1.606 (-1.020, 4.232)

Score representing experience of corporal punishment (CP

score)

-0.027 0.029 (-0.036, 0.094) 0.047

Score representing experience of neglectful parenting (NP

score)

-0.232���� -0.073 (-0.103,

-0.042)

-0.253����

Gender 0.011 -0.079 (-0.355, 0.197) -0.03

Age 0.037 0.044 (-0.061, 0.149) 0.044

Number of siblings -0.024 -0.151 (-0.317, 0.014) -0.108

Birth order 0.106�� 0.175 (0.005, 0.344) 0.138��

Mother’s age at birth 0.072 0.003 (-0.028, 0.034) 0.013

Age difference between mother and father 0.009 -0.008 (-0.036, 0.020) -0.03

Mother’s years of education 0.150��� 0.07 (0.004, 0.136) 0.117��

Father’s years of education 0.055 -0.027 (-0.080, 0.025) -0.059

Studied nursery education -0.041 -0.025 (-0.295, 0.245) -0.011

Studied health and nursing/social welfare 0.029 -0.045 (-0.283, 0.194) -0.023

Physical condition score (PCS) 0.073 0.018 (0.003, 0.033) 0.126��

Mental condition score (MCS) 0.269���� 0.037 (0.023, 0.050) 0.286����

����: p < 0.001 ���: p < 0.01 ��: p < 0.05. Gender was coded as man = 0 and woman = 1. Studied early nursery education and studied health and nursing/social

welfare were coded as yes = 1 and no = 0. PCS: Physical condition score on SF-8; MCS: Mental condition score on

SF-8

https://doi.org/10.1371/journal.pone.0206243.t005

Child abuse and endorsement of corporal punishment

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occasions. CP’s wide acceptance as a disciplinary tool by the general population may explain

the high reported incidence of CP among the respondents in our study—a relatively privileged

group of young people. There is a need to create community-wide structures to support posi-

tive parenting [43,45].

The revised MNBS-AS has been shown to be reliable and valid in diverse cultural settings

(33 universities in 17 countries), including Asian countries such as Hong Kong, Korea, and

Singapore. Straus and Savage [33] reported that the proportion of Korean university students

with experience of NP was the highest among these three countries. They found that the per-

centage of those reporting NP was considerably higher for women than for men (41.2% vs.

28.1%). Interestingly, this pattern of gender difference was reversed in our study, with men

reporting a higher incidence of NP than women. This difference in findings indicates that,

even among culturally close East Asian (Confucian) cultures, there may be considerable diver-

sity in the effects of NP on men and women. These parenting deficits include the use of coer-

cive and punitive parenting strategies that intensify and perpetuate child behavioral problems,

thereby increasing the likelihood of further child maltreatment in the family.

The present study revealed the long-term impacts of experience of parental CP and/or NP

behaviors. We presented two clear findings. First, undergraduate students who had experi-

enced CP positively endorsed the use of parental CP of children as a form of discipline. This

finding is in line with the findings of previous international studies [46,47]. Furthermore,

experiencing child maltreatment has been associated with greater use of intimate partner vio-

lence later in life [48]. However, in the present study, it should be noted that subjective happi-

ness as well as mental and physical health status were not significantly associated with a

reduction in the endorsement of the use of CP on children, which suggests that the endorse-

ment of CP as an acceptable parenting strategy is not affected by subjectively perceived well-

being or health conditions.

In terms of preventing intergenerational continuity of tolerant attitudes toward violent

behaviors, an important finding of the present study was that respondents who had studied

nursery education were significantly less likely to approve of CP of children as a disciplinary

tool. Developmental psychology included in the nursery education course may be effective for

prevention of CP. This result points to the possibility of educational interventions to sensitize

students to problems associated with using CP to discipline children. As per a publication

from the World Health Organization Regional Office for Europe [49], “school-based safety

education programs aim to teach children to recognize potentially harmful situations and to

distinguish between appropriate and inappropriate forms of touching” and “education cam-

paigns, other proactive initiatives can be used to challenge norms that support or justify hitting

a child”; however, “the need for school teachers to receive good quality specialist training to

deliver these programs should not be underestimated.” There is evidence of improvements in

protective behaviors and knowledge among children exposed to school-based programs,

regardless of the type of program [50]. The corrective capability of university child-nurturing

and educational interventions should be noted.

The second main finding was that the SH score was inversely correlated with the score of

experience of parental NP after adjusting for gender, birth order, mother’s and father’s years of

education, and both mental and physical health status in the previous month. To the best of

our knowledge, in Japan, this is the first study to demonstrate the association between experi-

ences of neglectful behaviors by parents and SH among apparently healthy university students.

This result was consistent with those of two previous studies. Milevsky et al. [51], examining

the association between parenting styles in adolescence and indices of adolescent psychological

well-being, showed that high school students who had experienced neglectful parenting styles

scored lower on self-esteem than did students with a parent or parents implementing an

Child abuse and endorsement of corporal punishment

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authoritative or permissive parenting style. Oshio et al. [52] demonstrated that the experience

of childhood adversity had a substantial negative impact on adulthood subjective well-being

among Japanese community residents; the participants’ age range was older and wider (25–50

years). Another study in Japan [53] showed that neglect, emotional abuse, and sexual maltreat-

ment predicted borderline personality traits and depression among university students.

Although this previous study did not directly evaluate SH, the findings are generally consistent

with ours. In addition, children who were left behind by parents who migrated to urban areas

were reported to have poorer SH than those who were not left behind in China [54], which is

also consistent with our results.

Our study has several limitations. First, it had a cross-sectional design; therefore, we cannot

discuss causality between the predictors and outcomes. Additionally, because the respondents

of the present study were not recruited randomly, our findings cannot be considered directly

generalizable to Japanese young adults, especially for low-education and low-income sectors of

the population. Second, the predictor measures were retrospectively collected and based on

self-reported data, which are susceptible to respondents’ recall bias and their tendency to

choose more socially desirable answers. However, the validity of self-report approaches to

studying child abuse and neglect has been examined [55–57], with findings indicating that this

approach is valid because official records are likely to underestimate the prevalence of child

abuse. Third, students who were exposed to positive forms of parenting and teaching or those

who are interested in children may be more likely to study nursery education as well as less

likely to endorse CP as an acceptable parenting strategy. In this study, we did not collect infor-

mation on which our participants were exposed to positive forms of parenting in their child-

hood, but such participants seem more likely to study an undergraduate course in nursery

education. Such factors other than studying nursery education may explain the inverse associa-

tion between studying nursery education and endorsement of CP.

Moreover, the Japanese-translated version of revised MNBS-AS used in our study has not

yet been standardized, since this is the first exploratory study applying MNBS to a Japanese

population. To address cross-cultural translation issues in the present questionnaires, at a pre-

liminary research stage, we back-translated the items and checked their reliability according to

the methodology recommended by Acquadro et al. [30]. Moreover, we regarded “disagree”

responses as suggestive of CP, as mentioned earlier, because participants were asked to report

whether they had been hit or spanked “a lot” in the past. However, there might have been dif-

ferences in interpretation of this phrase among the participants (i.e., some participants might

consider “a lot” to mean weekly, whereas others might interpret it to mean daily).

Conclusion

The high proportion of reports of experience of CP and/or NP in a population of apparently

healthy undergraduate students should not be ignored. We clarified that the experience of

parental CP in childhood and adolescence was positively associated with undergraduate stu-

dents’ endorsement of CP as a disciplinary tool to use on children. We also confirmed that

experiences of NP were associated with lower levels of SH. However, neither SH nor good

mental/physical health conditions significantly reduced endorsement of parental CP to disci-

pline children, indicating that people who endorse parental physical punishment do not always

have a mental illness. In addition, at university age, studying nursery education was signifi-

cantly associated with a reduction in participants’ endorsement of CP; this may suggest the

possibility of intervention to stop intergenerational continuity of CP. Future studies could

investigate the effects of a nursing education program on beliefs and practices in a longitudinal

manner.

Child abuse and endorsement of corporal punishment

PLOS ONE | https://doi.org/10.1371/journal.pone.0206243 October 26, 2018 12 / 16

In terms of health promotion and the promotion of non-violent forms of parenting, this

study presents the possibility of educational interventions that include teaching about child

development and effective parenting or nurturing skills. However, the current study was

exploratory. Given our results, further investigation using internationally comparable method-

ologies, especially in prospective cohort studies, is warranted, not only in Japan but also in

other Asian countries.

Acknowledgments

We are most grateful to the undergraduate students who responded to our questionnaire. We

would like to express our great appreciation to Drs. Yoshiki Hirose (Osaka Aoyama Univer-

sity), Yoko Kato (Ryutsu Science University), Miyoko Utsumi (Wakayama Medical Univer-

sity), Kokoro Shirai (Osaka University), and Takayoshi Kusago (Kansai University) for their

part in data collection. We appreciate Professor Toru Kikkawa (Osaka University) for his

thoughtful review and comments on the Ph.D. thesis that served as the foundation for this

manuscript.

Author Contributions

Conceptualization: Naomi Kitano, Yasuhide Nakamura.

Formal analysis: Naomi Kitano, Kouichi Yoshimasu.

Investigation: Naomi Kitano.

Methodology: Naomi Kitano.

Supervision: Yasuhide Nakamura.

Writing – original draft: Naomi Kitano.

Writing – review & editing: Naomi Kitano, Kouichi Yoshimasu, Beverley Anne Yamamoto.

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