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Physical punishment and lifelong outcomes in low‑ and middle‑income countries: a systematic review and multilevel

Jorge Cuartas1,2,3, Elizabeth T Gershoff4,5, Drew H Bailey6

  • 1Department of Applied Psychology, New York University, New York, NY, USA. j.cuartas@nyu.edu.

Nature Human Behaviour
|May 5, 2025
PubMed

Insights

Physical punishment of children is linked to negative outcomes in low- and middle-income countries (LMICs). This meta-analysis confirms detrimental effects on mental health, relationships, and behavior, highlighting the need for global prevention efforts.

Area of Science:

  • Child Development
  • Global Health
  • Psychology

Background:

  • Research in high-income nations links physical punishment to adverse child outcomes.
  • Generalizability of these findings to low- and middle-income countries (LMICs) remains largely unexamined.

Purpose of the Study:

  • To conduct a meta-analysis on the associations between childhood physical punishment and individual outcomes in LMICs.
  • To synthesize evidence on the impact of physical punishment on children in diverse global contexts.

Main Methods:

  • Systematic search of 11 databases in six languages (April-August 2021, June-July 2024).
  • Inclusion of 189 studies (1,490 effect sizes) from 92 LMICs.
  • Random-effects multilevel meta-analyses to assess associations.

Main Results:

  • Physical punishment is associated with detrimental outcomes including mental health problems, poor parent-child relationships, substance use, impaired social-emotional development, negative academic outcomes, and increased externalizing behaviors.
  • Subgroup analyses showed consistent detrimental effects across various contexts.
  • Findings were specific to physical punishment and psychological aggression, not other non-violent discipline methods.

Conclusions:

  • Physical punishment is demonstrably linked to negative individual outcomes for children in LMICs.
  • Evidence supports the need for global policies and interventions to prevent child physical punishment.
  • Further research is crucial for effective intervention and policy development worldwide.

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