Socioeconomic inequality in exposure to bullying during adolescence: a comparative, cross-sectional, multilevel study in 35 countries

Roles of fatalism and parental support in the relationship between bullying victimization and bystander behaviors

This article examines how past bullied victims engage two types of bystander behaviors (defender and outsider) when they witness bullying situations.We also investigate if fatalism mediates the relationship between past victimization and two bystander behaviors. Finally, we test if parental support moderates the relationship between fatalism and two bystander behaviors. Based on 3,441 students from 20 middle schools in Taiwan, results support the mediation hypotheses that the relationships of past victimization with defender and outsider behaviors are mediated through fatalism. Furthermore, the results support the moderation hypotheses that parental support is positively associated with defender behavior even when the level of fatalism is high. Future school bullying prevention research and practice may benefit from understanding how to reduce fatalistic belief and strengthen parental support.

The causes of bullying: results from the National Survey of School Health (PeNSE)

OBJECTIVE

to identify the characteristics and reasons reported by Brazilian students for school bullying.

METHOD

this cross-sectional study uses data from an epidemiological survey (National Survey of School Health) conducted in 2012. A total of 109,104 9th grade students from private and public schools participated. Data were collected through a self-applied questionnaire and the analysis was performed using SPSS, version 20, Complex Samples Module.

RESULTS

the prevalence of bullying was 7.2%, most frequently affecting Afro-descendant or indigenous younger boys, whose mothers were characterized by low levels of education. In regard to the reasons/causes of bullying, 51.2% did not specify; the second highest frequency of victimization was related to body appearance (18.6%); followed by facial appearance (16.2%); race/color (6.8%); sexual orientation 2.9%; religion 2.5%; and region of origin 1.7%. The results are similar to those found in other sociocultural contexts.

CONCLUSION

the problem belongs to the health field because it gathers aspects that determine the students' health-disease-care continuum.

No safe haven: locations of harassment and bullying victimization in middle schools

BACKGROUND

Given that adolescent bullying victimization is a significant concern for secondary education and adolescent development, identifying school contexts in which victimization is most likely to occur is salient.

METHODS

An anonymous online survey assessed the prevalence of being harassed or bullied in various locations within 20 middle schools (grades 5-9) in New Jersey and New York (N = 10,668). Seven types of bullying-related victimization (teased in an unfriendly way, called hurtful names, physically abused, excluded from a group to hurt feelings, belongings taken/damaged, threatened to be hurt, and negative rumors spread) were examined in 7 locations where each type of victimization could occur (classroom, lunchroom, hallways, gym, playground, bus, or bathroom).

RESULTS

Prevalence of victimization types ranged from 4% to 38% depending on location. Prevalence of overall victimization was equal or greater in classrooms compared with other school locations (highest prevalence rates in hallways, classrooms, and lunchrooms), regardless of school demographic characteristics. Victimization in classrooms compared with other school settings was most highly associated with feelings of being unsafe.

CONCLUSIONS

Vigilant attention to bullying is needed across all school environments and especially in the classroom context, which may mistakenly be perceived as a more protected area. Indeed, middle school classrooms are not safe havens.

Social emotional learning in a Guatemalan preschool sample: Does socioeconomic status moderate the effects of a school-based prevention program?

Researchers evaluated the effectiveness of a universal social skills program and compared social emotional knowledge on individual skills interviews with 100 Guatemalan preschool children from resource rich ( N = 47) and resource poor ( N = 53) backgrounds. Participant ages ranged from 3- to 6-years-old. SEL was evaluated prior and subsequent to receiving a school-based social emotional educational program. Results were analysed in terms of effectiveness of SEL by error type. Data show that preschool children from both poor and wealthy families made significant gains in social-emotional knowledge as a result of SEL instruction. In order to better understand where SEL might be improved, analyses of incorrect responses provided by children from each SES group were analysed. Findings demonstrated no significant differences between the two groups in terms of incorrect or socially unacceptable responses although, overall, the groups differed in depth of social emotional knowledge. Implications for ‘closing the gap’ between children’s social emotional development in high and low SES groups are discussed.

Predictors of Bully Victimization in Students With Disabilities

Longitudinal data from the Special Education Elementary Longitudinal Study (SEELS) national data set were used to examine risk of bully victimization in a sample of 4,155 students in special education. Results indicated that prior history of victimization was the greatest predictor of victimization risk across time, followed by the display of elevated internalizing and externalizing behaviors. Children with attention deficit hyperactivity disorder (ADHD) experienced the greatest risk of victimization compared with all other children with disabilities, followed by children with emotional disturbance (ED). Overall, the results suggest that all children with disabilities are highly vulnerable to bully victimization. Implications for educational policy and future research are discussed.

Socioeconomic status and bullying: a meta-analysis

We examined whether socioeconomic status (SES) could be used to identify which schools or children are at greatest risk of bullying, which can adversely affect children's health and life. We conducted a review of published literature on school bullying and SES. We identified 28 studies that reported an association between roles in school bullying (victim, bully, and bully-victim) and measures of SES. Random effects models showed SES was weakly related to bullying roles. Adjusting for publication bias, victims (odds ratio [OR] = 1.40; 95% confidence interval [CI] = 1.24, 1.58) and bully-victims (OR = 1.54; 95% CI = 1.36, 1.74) were more likely to come from low socioeconomic households. Bullies (OR = 0.98; 95% CI = 0.97, 0.99) and victims (OR = 0.95; 95% CI = 0.94, 0.97) were slightly less likely to come from high socioeconomic backgrounds. SES provides little guidance for targeted intervention, and all schools and children, not just those with more socioeconomic deprivation, should be targeted to reduce the adverse effects of bullying.

Elder abuse and socioeconomic inequalities: a multilevel study in 7 European countries

OBJECTIVES

To compare the prevalence of elder abuse using a multilevel approach that takes into account the characteristics of participants as well as socioeconomic indicators at city and country level.

METHODS

In 2009, the project on abuse of elderly in Europe (ABUEL) was conducted in seven cities (Stuttgart, Germany; Ancona, Italy; Kaunas, Lithuania, Stockholm, Sweden; Porto, Portugal; Granada, Spain; Athens, Greece) comprising 4467 individuals aged 60-84 years. We used a 3-level hierarchical structure of data: 1) characteristics of participants; 2) mean of tertiary education of each city; and 3) country inequality indicator (Gini coefficient). Multilevel logistic regression was used and proportional changes in Intraclass Correlation Coefficient (ICC) were inspected to assert explained variance between models.

RESULTS

The prevalence of elder abuse showed large variations across sites. Adding tertiary education to the regression model reduced the country level variance for psychological abuse (ICC=3.4%), with no significant decrease in the explained variance for the other types of abuse. When the Gini coefficient was considered, the highest drop in ICC was observed for financial abuse (from 9.5% to 4.3%).

CONCLUSION

There is a societal and community level dimension that adds information to individual variability in explaining country differences in elder abuse, highlighting underlying socioeconomic inequalities leading to such behavior.

Traditional and cyberbullying victimization as correlates of psychosocial distress and barriers to a healthy lifestyle among severely obese adolescents--a matched case-control study on prevalence and results from a cross-sectional study

Background

Obese youth are at increased risk for peer victimization, which may heighten their risk of psychosocial problems and physical activity avoidance, and lower the effectiveness of professional and lifestyle weight-loss initiatives. Little is known about obese adolescents’ risk for victimization from cyber-bullying and how this relates to psychosocial functioning and healthy lifestyle barriers. The purpose of the study was to assess traditional and cyber-victimization among adolescents with severe obesity and its relation to psychosocial distress and barriers to healthy lifestyles.

Methods

A sample of 102 obese adolescents (mean age = 15.32 ±1.71) in residential treatment was matched with 102 normal-weight youngsters from the Health Behavior in School-aged Children (HBSC) study (mean age = 15.30 ±1.73).

Results

Adolescents with obesity were significantly more often cyber-victimized than normal-weight peers. Obese youth victimized by traditional bullying experienced lower quality of life, lower motivation for physical activity and higher avoidance and emotional coping towards healthy lifestyles than those non-victimized. Obese cyber-victims experienced significantly higher suicidal ideation.

Conclusions

Traditional and cyber-victimization may hinder treatment effectiveness and healthy lifestyle change in adolescents with obesity. Health professionals should pro-actively address peer victimization and psychosocial functioning during multidisciplinary obesity treatment. Schools could contribute to a better physical and psychosocial health of obese youth by implementing multi-behavioral health-promotion programs.

Peer victimization in fifth grade and health in tenth grade

BACKGROUND AND OBJECTIVES

Children who experience bullying, a type of peer victimization, show worse mental and physical health cross-sectionally. Few studies have assessed these relationships longitudinally. We examined longitudinal associations of bullying with mental and physical health from elementary to high school, comparing effects of different bullying histories.

METHODS

We analyzed data from 4297 children surveyed at 3 time points (fifth, seventh, and tenth grades) in 3 cities. We used multivariable regressions to test longitudinal associations of bullying with mental and physical health by comparing youth who experienced bullying in both the past and present, experienced bullying in the present only, experienced bullying in the past only, or did not experience bullying.

RESULTS

Bullying was associated with worse mental and physical health, greater depression symptoms, and lower self-worth over time. Health was significantly worse for children with both past and present bullying experiences, followed by children with present-only experiences, children with past-only experiences, and children with no experiences. For example, 44.6% of children bullied in both the past and present were at the lowest decile of psychosocial health, compared with 30.7% of those bullied in the present only (P = .005), 12.1% of those bullied in the past only (P < .001), and 6.5% of those who had not been bullied (P < .001).

CONCLUSIONS

Both chronic and current bullying are associated with substantially worse health. Clinicians who recognize bullying when it first starts could intervene to reverse the downward health trajectory experienced by youth who are repeated targets.

Individual and social network predictors of physical bullying: a longitudinal study of Taiwanese early adolescents

This study followed 125 7th-grade students in Taiwan for the entire school year and analyzed the individual and social network factors predicting their involvement in physical bullying over 5 waves of data. Using self-reports of bullying experiences, 20 classroom-level networks of bullying and friendship were constructed for 4 classrooms and 5 temporal points, from which 4 individual-level network measures were calculated. They included bully and victim centrality, popularity, and embeddedness in friendship networks. A series of mixed models for repeated measures were constructed to predict students' bully and victim centrality in bullying network at time t + 1. Compared to girls, boys were more likely to be both the bullies and victims. Lower self-esteem and higher family economic status contributed to victim centrality. Having parents married and living together predicted lower bully centrality. Higher educational level of parents predicted lower victim and bully centrality. Regarding the social network factors, students' bully centrality at t positively predicted their bully centrality at t + 1, whereas victim centrality predicted their subsequent victim centrality. Interaction effects between friendship network and bullying network were observed. Embeddedness in friendship network reduced victim centrality at t + 1 except for those students with low victim centrality at t. For those with high victim centrality at t, popularity increased their risk of physical victimization over time. Implications for research and practice are discussed.

Inequalities in Croatian pupils' risk behaviors associated to socioeconomic environment at school and area level: a multilevel approach

The socioeconomic inequality in pupils' risk behaviors has been the topic of many studies with quite contradictory findings. Furthermore, the role of socioeconomic environment has been analyzed much less often than the role of individual socioeconomic status (SES). This study examined the association between school/area-level socioeconomic environment and Croatian pupils' risk behaviors (tobacco use, drunkenness, cannabis use, early sexual initiation and fighting). Data from the WHO-Collaborative 'Health Behavior in School-aged Children' study conducted in Croatia in 2006 (1601 secondary schools' pupils, aged 15) and census data were used. Multilevel logistic regression analyses, adjusted by gender, were performed. The individual level of SES explained the majority of differences in all risk behaviors among adolescents. Differences in tobacco use, early sexual initiation and fighting were more closely attributed to school level than area level, which was more closely associated with differences in adolescent drunkenness and cannabis use. At the individual level, high individual SES was associated with higher probability for tobacco use and drunkenness compared to low individual SES. Furthermore, school heterogeneity (compared to school homogeneity) and medium school-level SES (compared to low school-level SES) were associated with higher probability for cannabis use. Compared to the most advanced schools (gymnasiums), attending the least advanced schools (industrial and crafts schools) was associated with higher probability for fighting. Compared to low area-level SES, medium area-level SES was associated with higher probability for cannabis use and fighting. Conclusively, it was found that low SES at individual, school and area levels, school homogeneity and advanced school attendance play a protective role against risk behaviors. To reduce inequalities in pupils' risk behaviors, there is a need for community and school-based programs that take into consideration not only individual SES but also school- and area-level socioeconomic circumstances.

Effects of an emotional literacy intervention for students identified with bullying behaviour

The effectiveness of a 12-week, small group emotional literacy (EL) intervention in reducing bullying behaviour in school was evaluated. Participants were 50 primary school pupils identified through peer nomination as engaging in bullying behaviours. The intervention was implemented in schools already engaged with a universal social and emotional learning initiative, including an anti-bullying component. Within schools, participants were randomly assigned to an intervention or a wait-list comparison group. Response to the intervention was found to be dependent on baseline levels of EL. Only children whose baseline level was low showed a significant reduction in peer-rated bullying behaviour. No effect of the intervention was detected on victimisation or adjustment scores, although positive changes in adjustment were associated with increased EL.

Prevalence of school bullying among secondary students in Taiwan: Measurements with and without a specific definition of bullying

Estimates of bullying and bullying victimization rates vary depending on how these rates are measured. The current study used survey methods of the World Health Organisation (WHO) to investigate the prevalence of school bullying among secondary students in Taiwan. We also examined whether results differed between surveys with and without definitions of bullying. Olweus-type global items and the timeframe, response categories, and cut-off point adopted in the WHO’s Health Behaviour in School-Aged Children study were used in this study. Surveys were administered to secondary students in Taiwan (grades 7–12), with 3,554 students receiving surveys with a definition of bullying and 793 receiving surveys without a definition of bullying. The following results were obtained: (1) In the survey with bullying defined, the self-reported prevalence rates of bullying, victimization, witness to bullying, and bully/victims were 10.9%, 10.7%, 29.9%, and 5.5% respectively; (2) male students were more involved in school bullying than females; (3) no significant difference in prevalence rates was found between the two survey versions. International bullying prevalence rates, gender differences, and the effects of a bullying definition are discussed.

Neighborhood, family and individual influences on school physical victimization

Few studies on the correlates of school violence include school and neighborhood influences. We use ecological systems theory and social disorganization theory to simultaneously incorporate neighborhood (e.g., concentrated poverty, residential instability, and immigrant concentration), school, family, and individual predictors of physical school victimization longitudinally among a large socio-economically and ethnically diverse (49 % Hispanic; 34 % African American) sample of 6 and 9 year olds (49 % female) from the Project on Human Development in Chicago Neighborhoods. These children were followed up at Wave II at ages 8 and 11 (n = 1,425). Results of Hierarchical Generalized Linear Models reveal neighborhood residential instability increases school victimization net of family and individual correlates. Furthermore, cross-level interactions were also supported where residential family mobility has a stronger risk influence in areas of high residential instability. Also, the influence of residential family mobility is decreased in areas with higher levels of immigrant concentration. We also found cross-context connections where parent-to-child aggression in the home is connected to a higher risk of victimization at school. The role of neighborhood and family residential instability on victimization warrants further research.

Bullying of extremely low birth weight children: associated risk factors during adolescence

BACKGROUND

Preterm children have many risk factors which may increase their susceptibility to being bullied.

AIMS

To examine the prevalence of bullying among extremely low birth weight (ELBW, <1 kg) and normal birth weight (NBW) adolescents and the associated sociodemographic, physical, and psychosocial risk factors and correlates among the ELBW children.

METHODS

Cohort study of self-reports of bullying among 172 ELBW adolescents born 1992-1995 compared to 115 NBW adolescents of similar age, sex and sociodemographic status. Reports of being bullied were documented using the KIDSCREEN-52 Questionnaire which includes three Likert type questions concerning social acceptance and bullying. Multiple linear regression analyses adjusting for sociodemographic factors were used to examine the correlates of bullying among the ELBW children.

RESULTS

Group differences revealed a non-significant trend of higher mean bullying scores among ELBW vs. NBW children (1.56 vs. 1.16, p=0.057). ELBW boys had significantly higher bullying scores than NBW boys (1.94 vs. 0.91, p<0.01), whereas ELBW and NBW girls did not differ (1.34 vs. 1.30, p=0.58). Bullying of ELBW children was significantly associated with subnormal IQ, functional limitations, anxiety and ADHD, poor school connectedness, less peer connectedness, less satisfaction with health and comfort, and less risk avoidance.

CONCLUSION

ELBW boys, but not girls, are more likely to be victims of bullying than NBW boys. School and health professionals need to be aware of the risk of bullying among ELBW male adolescents.

Assessment and management of bullied children in the emergency department

Bullying is an important public health issue in the United States. Up to 30% of children report exposure to such victimization. Not only does it hurt bully victim, but it also negatively impacts the bully, other children, parents, school staff, and health care providers. Because bullying often presents with accompanying serious emotional and behavioral symptoms, there has been an increase in psychiatric referrals to emergency departments. Emergency physicians may be the first responders in the health care system for bullying episodes. Victims of bullying may present with nonspecific symptoms and be reluctant to disclose being victimized, contributing to the underdiagnosis and underreporting of bully victimization. Emergency physicians therefore need to have heightened awareness of physical and psychosocial symptoms related to bullying. They should rapidly screen for bullying, assess for injuries and acute psychiatric issues that require immediate attention, and provide appropriate referrals such as psychiatry and social services. This review defines bullying, examines its presentations and epidemiology, and provides recommendations for the assessment and evaluation of victims of bullying in the emergency department.

Does neighbourhood social capital aid in levelling the social gradient in the health and well-being of children and adolescents? A literature review

Background

Although most countries in the European Union are richer and healthier than ever, health inequalities remain an important public health challenge. Health-related problems and premature death have disproportionately been reported in disadvantaged neighbourhoods. Neighbourhood social capital is believed to influence the association between neighbourhood deprivation and health in children and adolescents, making it a potentially interesting concept for policymakers.

Methods

This study aims to review the role of social capital in health inequalities and the social gradient in health and well-being of children and adolescents. A systematic review of published quantitative literature was conducted, focussing on (1) the mediating role of neighbourhood social capital in the relationship between socio-economic status (SES) and health-related outcomes in children and adolescents and (2) the interaction between neighbourhood social capital and socio-economic characteristics in relation to health-related outcomes in children and adolescents. Three electronic databases were searched. Studies executed between 1 January 1990 and 1 September 2011 in Western countries (USA, New Zealand, Australia and Europe) that included a health-related outcome in children or adolescents and a variable that measured neighbourhood social capital were included.

Results

Eight studies met the inclusion criteria for the review. The findings are mixed. Only two of five studies confirmed that neighbourhood social capital mediates the association between neighbourhood deprivation and health and well-being in adolescents. Furthermore, two studies found a significant interaction between neighbourhood socio-economic factors and neighbourhood social capital, which indicates that neighbourhood social capital is especially beneficial for children who reside in deprived neighbourhoods. However, two other studies did not find a significant interaction between SES and neighbourhood social capital. Due to the broad range of studied health-related outcomes, the different operationalisations of neighbourhood social capital and the conceptual overlap between measures of SES and social capital in some studies, the factors that explain these differences in findings remain unclear.

Conclusions

Although the findings of this study should be interpreted with caution, the results suggest that neighbourhood social capital might play a role in the health gradient among children and adolescents. However, only two of the included studies were conducted in Europe. Furthermore, some studies focussed on specific populations and minority groups. To formulate relevant European policy recommendations, further European-focussed research on this issue is needed.

Child and parental reports of bullying in a consecutive sample of children with food allergy

OBJECTIVE

The social vulnerability that is associated with food allergy (FA) might predispose children with FA to bullying and harassment. This study sought to quantify the extent, methods, and correlates of bullying in a cohort of food-allergic children.

METHODS

Patient and parent (83.6% mothers) pairs were consecutively recruited during allergy clinic visits to independently answer questionnaires. Bullying due to FA or for any cause, quality of life (QoL), and distress in both the child and parent were evaluated via questionnaires.

RESULTS

Of 251 families who completed the surveys, 45.4% of the children and 36.3% of their parents indicated that the child had been bullied or harassed for any reason, and 31.5% of the children and 24.7% of the parents reported bullying specifically due to FA, frequently including threats with foods, primarily by classmates. Bullying was significantly associated with decreased QoL and increased distress in parents and children, independent of the reported severity of the allergy. A greater frequency of bullying was related to poorer QoL. Parents knew about the child-reported bullying in only 52.1% of the cases. Parental knowledge of bullying was associated with better QoL and less distress in the bullied children.

CONCLUSIONS

Bullying is common in food-allergic children. It is associated with lower QoL and distress in children and their parents. Half of the bullying cases remain unknown to parents. When parents are aware of the bullying, the child's QoL is better. It is important to proactively identify and address cases in this population.

Trends and socioeconomic correlates of adolescent physical fighting in 30 countries

BACKGROUND AND OBJECTIVES

No recent international studies provide evidence about its prevalence, trends, or social determinants of physical fighting in adolescents. We studied cross-national epidemiologic trends over time in the occurrence of frequent physical fighting, demographic variations in reported trends, and national wealth and income inequality as correlates.

METHODS

Cross-sectional surveys were administered in school settings in 2002, 2006, and 2010. Participants (N = 493874) included eligible and consenting students aged 11, 13, and 15 years in sampled schools from 30 mainly European and North American countries. Individual measures included engagement in frequent physical fighting, age, gender, participation in multiple risk behaviors, victimization by bullying, and family affluence. Contextual measures included national income inequality, absolute wealth and homicide rates. Temporal measure was survey cycle (year).

RESULTS

Frequent physical fighting declined over time in 19 (63%) of 30 countries (from descriptive then multiple Poisson regression analyses). Contextual measures of absolute wealth (relative risk 0.96, 95% confidence interval 0.93-0.99 per 1 SD increase in gross domestic product per capita) but not income inequality (relative risk 1.01, 95% confidence interval 0.98-1.05 per 1 SD increase) related to lower levels of engagement in fighting. Other risk factors identified were male gender, younger age (11 years), multiple risk behaviors, victimization by bullying, and national homicide rates.

CONCLUSIONS

Between 2002 and 2010, adolescent physical fighting declined in most countries. Specific groups of adolescents require targeted violence reduction programs. Possible determinants responsible for the observed declines are discussed.

Overweight and obese teenagers: why is adolescence a critical period?

This paper discusses the critical period of adolescence and its potential role in the development and persistence of obesity. The adolescent years are characteristic of changes in body composition (location and quantity of body fat), physical fitness and decreased insulin sensitivity during puberty. This period of growth and maturation is also marked with behavioural changes in diet, physical activity, sedentary behaviour and psychological health. Physical activity and sport participation decline during adolescence especially in teenage girls, while sedentary behaviour, risk for depression and body esteem issues increase during the teenage years. These physiological and behavioural changes during adolescence warrant the attention of health practitioners to prevent the onset and continuation of obesity throughout the lifespan.

Prevalence of bullying and victimization among children in early elementary school: do family and school neighbourhood socioeconomic status matter?

BACKGROUND

Bullying and victimization are widespread phenomena in childhood and can have a serious impact on well-being. Children from families with a low socioeconomic background have an increased risk of this behaviour, but it is unknown whether socioeconomic status (SES) of school neighbourhoods is also related to bullying behaviour. Furthermore, as previous bullying research mainly focused on older children and adolescents, it remains unclear to what extent bullying and victimization affects the lives of younger children. The aim of this study is to examine the prevalence and socioeconomic disparities in bullying behaviour among young elementary school children.

METHODS

The study was part of a population-based survey in the Netherlands. Teacher reports of bullying behaviour and indicators of SES of families and schools were available for 6379 children aged 5-6 years.

RESULTS

One-third of the children were involved in bullying, most of them as bullies (17%) or bully-victims (13%), and less as pure victims (4%). All indicators of low family SES and poor school neighbourhood SES were associated with an increased risk of being a bully or bully-victim. Parental educational level was the only indicator of SES related with victimization. The influence of school neighbourhood SES on bullying attenuated to statistical non-significance once adjusted for family SES.

CONCLUSIONS

Bullying and victimization are already common problems in early elementary school. Children from socioeconomically disadvantaged families, rather than children visiting schools in disadvantaged neighbourhoods, have a particularly high risk of involvement in bullying. These findings suggest the need of timely bullying preventions and interventions that should have a special focus on children of families with a low socioeconomic background. Future studies are necessary to evaluate the effectiveness of such programs.

High School Anti-Bullying Interventions: An Evaluation of Curriculum Approaches and the Method Of Shared Concern in Four Hong Kong International Schools

The challenge for high schools to adopt effective measures to reduce bullying has been underscored by international media coverage highlighting the consequences of school bullying. Despite whole-school anti-bullying programs being accepted as the best evidence-based approaches to intervention, research continues to yield ambiguous findings, and only a limited number of studies have been conducted in secondary schools to systematically evaluate the components of this approach. The aim of this study was to investigate the effectiveness of anti-bullying interventions in four international secondary schools in Hong Kong. Schools were randomly assigned to: (a) a whole-school intervention, (b) a curriculum and Shared Concern intervention at Year 7, (c) a Shared Concern intervention at Year 7 and (d) a control school. Year 7 students in the four schools anonymously completed a bullying questionnaire at the beginning (N = 545) and end of the school year (N = 549). A highly significant main effect for schools was found between pre-test and post-test composite bullying scores (F = 7.70, p < .001). Results showed the most significant reductions occurred when a whole-school intervention was used (F = 10.73, p < .001). The research provides strong support for use of whole-school preventative/management interventions and the effective components of this approach are discussed.

Bullying behaviour in schools, socioeconomic position and psychiatric morbidity: a cross-sectional study in late adolescents in Greece

BACKGROUND

Bullying is quite prevalent in the school setting and has been associated with the socioeconomic position and psychiatric morbidity of the pupils. The aim of the study was to investigate the association between bullying and socioeconomic status in a sample of Greek adolescents and to examine whether this is confounded by the presence of psychiatric morbidity, including sub-threshold forms of illness.

METHODS

5,614 adolescents aged 16-18 years old and attending 25 senior high schools were screened and a stratified random sample of 2,427 were selected for a detailed interview. Psychiatric morbidity was assessed with a fully structured psychiatric interview, the revised Clinical Interview Schedule (CIS-R), while bullying was assessed with the revised Olweus bully/victim questionnaire. The following socio-economic variables were assessed: parental educational level and employment status, financial difficulties of the family and adolescents' school performance. The associations were investigated using multinomial logit models.

RESULTS

26.4% of the pupils were involved in bullying-related behaviours at least once monthly either as victims, perpetrators or both, while more frequent involvement (at least once weekly) was reported by 4.1%. Psychiatric morbidity was associated with all types of bullying-related behaviours. No socioeconomic associations were reported for victimization. A lower school performance and unemployment of the father were significantly more likely among perpetrators, while economic inactivity of the mother was more likely in pupils who were both victims and perpetrators. These results were largely confirmed when we focused on high frequency behaviours only. In addition, being overweight increased the risk of frequent victimization.

CONCLUSIONS

The prevalence of bullying among Greek pupils is substantial. Perpetration was associated with some dimensions of adolescents' socioeconomic status, while victimization showed no socioeconomic associations. Our findings may add to the understanding of possible risk factors for bullying behaviours in adolescence.

The lifelong effects of early childhood adversity and toxic stress

Advances in fields of inquiry as diverse as neuroscience, molecular biology, genomics, developmental psychology, epidemiology, sociology, and economics are catalyzing an important paradigm shift in our understanding of health and disease across the lifespan. This converging, multidisciplinary science of human development has profound implications for our ability to enhance the life prospects of children and to strengthen the social and economic fabric of society. Drawing on these multiple streams of investigation, this report presents an ecobiodevelopmental framework that illustrates how early experiences and environmental influences can leave a lasting signature on the genetic predispositions that affect emerging brain architecture and long-term health. The report also examines extensive evidence of the disruptive impacts of toxic stress, offering intriguing insights into causal mechanisms that link early adversity to later impairments in learning, behavior, and both physical and mental well-being. The implications of this framework for the practice of medicine, in general, and pediatrics, specifically, are potentially transformational. They suggest that many adult diseases should be viewed as developmental disorders that begin early in life and that persistent health disparities associated with poverty, discrimination, or maltreatment could be reduced by the alleviation of toxic stress in childhood. An ecobiodevelopmental framework also underscores the need for new thinking about the focus and boundaries of pediatric practice. It calls for pediatricians to serve as both front-line guardians of healthy child development and strategically positioned, community leaders to inform new science-based strategies that build strong foundations for educational achievement, economic productivity, responsible citizenship, and lifelong health.

Pathways and mechanisms in adolescence contribute to adult health inequalities

AIMS

This paper presents a model that encompasses pathways and mechanisms working over adolescence that contribute to adult health inequalities. We review evidence on the four mechanisms: socially differential exposure, tracking, socially differential tracking, and socially differential vulnerability.

METHODS

We conducted literature searches in English-language peer-reviewed journals using PubMed (from 1966 to May 2009) and PsycINFO, and combined these with hand-searches of reference lists, journals, and authors of particular relevance.

RESULTS

Most health indicators are socially patterned in adolescence and track into adulthood, with higher risks of adverse outcomes among individuals from lower socioeconomic positions. Adolescent health behaviours track into adulthood. Smoking, physical activity, and especially fruit and vegetable intake are socially patterned, while evidence for social patterning of alcohol use is less consistent. Relational dimensions like lone parenthood and bullying are socially patterned and track over time, and there are indications of a socially differential vulnerability to the effects of these types of relational strain. Very little research has investigated the social patterning of the above indicators over time or studied social vulnerability of these indicators from adolescence to adulthood. However, all four mechanisms seem to be active in establishing social differences in adult educational attainment.

CONCLUSIONS

We find the Adolescent Pathway Model useful for providing an overview of what elements and mechanisms in adolescence may be of special importance for adult health inequalities. There is a lack of knowledge of how social patterns of health, health behaviours, and social relations in adolescence transfer into adulthood and to what extent they reflect themselves in adult health.

Negative school perceptions and involvement in school bullying: a universal relationship across 40 countries

Cross-national analyses explore the consistency of the relationship between negative school experiences and involvement in bullying across 40 European and North American countries, using the 2006 (40 countries n = 197,502) and 2002 (12 countries, n = 57,007) WHO-HBSC surveys. Measures include two Cumulative Negative School Perception (CNSP) scales, one based on 6 mandatory items (2006) and another including an additional 11 items (2002). Outcome measures included bullying perpetration, victimization and involvement as both bully and victim. Logistic regression analyses suggested that children with only 2-3 negative school perceptions, experience twice the relative odds of being involved in bullying as compared with children with no negative school perceptions. Odds Ratios (p < 0.001) increase in a graded fashion according to the CNSP, from about 2.2 to over 8.0. Similar consistent effects are found across gender and almost all countries. Further research should focus on the mechanisms and social context of these relationships.

Income inequality and school bullying: multilevel study of adolescents in 37 countries

PURPOSE

To examine the association between income inequality and school bullying in an international sample of preadolescents and to test for mediation of this association by the availability of social support from families, peers, and schools.

METHODS

The study used economic data from the 2006 United Nations Development Program Human Development Report and survey data from the 2005/2006 Health Behavior in School-aged Children (HBSC) study which included 66,910 11-year-olds in 37 countries. Ecological correlations tested associations between income inequality and bullying among countries. Multilevel linear and ordinal regression analyses tested the effects of income inequality on perceived social support and bullying others at school.

RESULTS

Income inequality was associated with rates of bullying among the 37 countries (r = .62). Multilevel analyses indicated that each standard deviation increase in income inequality corresponded with more frequent bullying by males (odds ratio = 1.17) and females (odds ratio = 1.24), less family support and school support but more peer support. Social support from families and schools was associated with less bullying after differences in wealth were taken into account; however, social support did not account for the association between income inequality and bullying.

CONCLUSIONS

Countries with high income inequality have more school bullying among preadolescents than countries with low income inequality. Further study is needed to understand the mechanisms that account for this association. Findings suggest that adolescents in areas of wide income inequality-not only those in deprived schools and neighborhoods- should be a focus of anti-bullying campaigns.