Annual Research Review: The persistent and pervasive impact of being bullied in childhood and adolescence: implications for policy and practice

Adolescents' Understanding of What Causes Emotional Distress: A Qualitative Exploration in a Non-clinical Sample Using Ideal-Type Analysis

Background: There is increased interest in early intervention and prevention of mental health difficulties during adolescence; thus, we are seeing increased efforts to optimize well-being during this epoch. Positive emotional experiences are a central component of overall well-being. However, research exploring what adolescents perceive to be the cause(s) of their emotional difficulties is lacking. Improving understanding of this issue within non-clinical adolescent groups may provide useful insight into how to develop strategies to support young people as they navigate emotional difficulties.

Objectives: The aim of this research was to explore if meaningful categories of perceived cause(s) for emotional distress exist for non-clinical adolescent groups.

Methods: The data for this study were drawn from interviews across 6 sites in England conducted as part of the 5-year national evaluation of the HeadStart Learning Programme. The sample comprised of 32 young people aged 11–12 years from the first annual wave of qualitative data collection in 2017. Ideal type analysis—a qualitative form of person-centered analysis—was used to construct a typology of adolescents perceived cause(s) for emotional distress.

Findings: We identified five distinct categories of perceived cause: (1) perceived lack of control; (2) unfair treatment; (3) others, their actions and judgements as the catalyst; (4) concerns for self and others; and, (5) self as cause.

Conclusions: Our findings illustrate that distinct categories for perceived cause of emotional distress exist among adolescents considered to be “at risk” of developing mental health difficulties, which provides a foundation for future necessary work seeking to investigate the possible link between perceived cause for emotional distress and help-seeking behavior among sub-clinical groups.

The Potential of Anti-Bullying Efforts to Prevent Academic Failure and Youth Crime. A Case Using the Olweus Bullying Prevention Program (OBPP)

The effectiveness of bullying prevention programs has led to expectations that these programs could have effects beyond their primary goals. By reducing the number of victims and perpetrators and the harm experienced by those affected, programs may have longer-term effects on individual school performance and prevent crime. In this paper, we use Norwegian register data to study the long-term impact of the Olweus Bullying Prevention Program (OBPP) on academic performance, high school dropout, and youth crime for the average student, which we call population-level effects. The OBPP program is widely acknowledged as one of the most successful programs reducing school-level bullying; yet, using a difference-in-difference design, no statistically significant population-level effects of the OBPP were found on any of the long-term outcomes in this study. When studied at the population level, as in the current project, the base rate prevalence of bullying is a major explanatory factor for these results. Earlier studies have shown that OBPP reduces bullying prevalence by 30-50%. This decrease translates into absolute reductions in bullying victimization and perpetration at the population level of "only" four and two percentage points, respectively. Our results suggest the average causal effects of school bullying involvement are too small to translate this reduction in bullying into a sizeable population-level impact on students' long-term outcomes. However, a limited potential of anti-bullying programs to prevent population-level adversity can very well be compatible with substantial program effects for individual bullies and victims. Further, our results do not speak to the main objective of anti-bullying programs of limiting childhood abuse and safeguarding children's human rights.

Longitudinal associations between justice sensitivity, nonsuicidal self-injury, substance use, and victimization by peers

Justice sensitivity (JS), the tendency to perceive and negatively respond to alleged injustice, has been associated with a range of internalizing and externalizing problems and peer victimization; however, it remains unclear if it has an association with self-victimization. Participants (N = 769) reported on their JS longitudinally at 9-19 (T1), 11-21 (T2), and 14-22 years of age (T3). They further reported on nonsuicidal self-injury (NSSI) and illegal substance use as indicators of self-victimization as well as victimization by peers at T2 and T3. A cross-lagged latent model revealed that victim JS at T1 was positively associated with NSSI, substance use, and peer victimization at T2, and victim JS at T2 was positively associated with substance use at T3. Higher observer JS at T2 predicted higher illegal substance use at T3 and higher illegal substance use at T2 predicted higher observer JS at T3. Finally, higher peer victimization at T2 predicted less perpetrator JS at T3 in the total group. Multigroup models further revealed sex-specific effects. Our findings highlight that being sensitive to injustice, particularly the tendency to feel unfairly treated or being taken advantage of, contributes to individuals' vulnerability to both engaging in behaviors reflecting self-victimization and being a target of peer victimization, which in turn have influences on JS.

The Role of Aggressive Peer Norms in Elementary School Children's Perceptions of Classroom Peer Climate and School Adjustment

Although prior research has indicated that peer norms for aggression enhance the spread of aggression in classrooms, it is unclear to date how these norms relate to students’ classroom climate perceptions and school adjustment. Aggressive descriptive norms reflect the average aggression of all students in classrooms, whereas aggressive popularity norms represent the extent to which aggressive behavior relates to popularity among peers. This study examined the role of aggressive descriptive and popularity norms in the classroom climate perceptions (cooperation, conflict, cohesion, isolation) and school adjustment (feelings of belonging; social, academic, and general self-esteem) of popular, well-liked, and victimized children. Self-reported and peer-nominated data were obtained from 1511 children (M_age = 10.60 years, SD = 0.50; 47.2% girls) from 58 fifth-grade classrooms. The results indicated that aggressive descriptive and popularity norms both matter in elementary school, but in diverging ways. Specifically, aggressive descriptive norms—rather than popularity norms—contributed to negative classroom climate perceptions irrespective of students’ social position. In addition, whereas descriptive norms contributed to between-classroom variations in some aspects of school adjustment, aggressive popularity norms related to increased school maladjustment for popular and victimized children specifically. Thus, aggressive descriptive norms and popularity norms matter in complementary ways for children’s classroom climate perceptions and adjustment in elementary education.

Developmental Cascades from Aggression to Internalizing Problems via Peer and Teacher Relationships from Early to Middle Adolescence

Previous research has provided evidence for developmental cascades between externalizing and internalizing problems via mechanisms such as peer and academic problems; however, there remains a need to illuminate other key mediating processes that could serve as intervention targets. This study, thus, evaluated whether developmental associations between aggression and internalizing are mediated by teacher-as well as peer-relationships. Using data from z-proso, a longitudinal study of Swiss youth (n = 1523; 785 males), an autoregressive latent trajectory model with structured residuals (ALT-SR) was fit over ages 11, 13, and 15 to examine within-person developmental links between aggression, internalizing problems, and the mediating role of peer and teacher relationships, while disaggregating between- and within-person effects. Teacher and peer relationships did not play a role in the progression of externalizing to internalizing problems or vice versa, however, teacher and peer relationships showed a protective effect against developing internalizing problems at ages 13. The results suggest that good quality relationships with teachers in early adolescence can help prevent internalizing problems from developing.

Cumulative exposure to socioeconomic and psychosocial adversity and hair cortisol concentration: A longitudinal study from 5 months to 17 years of age

BACKGROUND

Exposure to early adversity has been associated with long-lasting risks for poor health and functioning. Prior research suggests that the hypothalamic-pituitary-adrenal (HPA) axis, and its main end-product glucocorticoid hormone cortisol, may be at play. This study tested whether an index of cumulative socioeconomic and psychosocial adversity assessed prospectively, from infancy to adolescence, was associated with hair cortisol concentration (HCC), and if this association differed by sex.

METHODS

The sample comprised 556 adolescents (42.0% males) who provided hair for cortisol measurement at 17 years of age. Adversity indicators (young and single motherhood, low socioeconomic status (SES), maternal alcohol use, hostile-reactive parenting, and depressive symptoms, as well as peer victimization and neighborhood dangerousness) were repeatedly reported by mothers or youths between the ages of 5 months and 15 years.

RESULTS

Chronic adversity was non-linearly associated with HCC; youth exposed to lower and higher levels of adversity had moderate-to-higher HCC compared to lower HCC noted in participants with moderate levels of adversity, for both males and females. None of the indicators taken separately, except the perception of neighborhood dangerousness, were significantly associated with HCC.

CONCLUSION

Our findings support the hypothesis that HPA axis activity varies according to cumulative adversity, albeit non-linearly, which may bear consequences for later health and functioning.

Personality and Psychopathology in Adults with Noonan Syndrome

This is the first controlled study regarding personality and psychopathology in adults with Noonan syndrome (NS). Anxiety, depression, alexithymia and symptoms of Attention Deficit-Hyperactivity Disorder and Autism Spectrum Disorder, have been previously described in NS. More information regarding personality and psychopathology in NS could improve mental health care for this population. Therefore, scores on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), a widely used self-report questionnaire of personality and psychopathology, were compared between patients with NS (n = 18) and matched, healthy controls (n = 18). Furthermore, correlations between MMPI-2-RF scores and alexithymia, measured by the Toronto Alexithymia Scale-20, were investigated. Patients with NS showed significantly higher scores, with medium effect sizes, on MMPI-2-RF scales reflecting infrequent responses (F-r), somatic and cognitive complaints (FBS-r and RBS-r), internalizing problems (EID), demoralization (RCd) and introversion (INTR-r), although the overall profile in both groups was within the non-clinical range. Alexithymia correlated with internalizing problems and negative emotionality in the patient group. In conclusion, patients with NS showed higher levels of introversion, which may predispose them to internalizing problems. These problems were indeed more frequent in patients with NS, especially higher levels of demoralization. Patients may benefit from psychological interventions aimed to decrease internalizing problems, introversion and alexithymia.

Links Between Early Personal Characteristics, Longitudinal Profiles of Peer Victimization in School and Victimization in College or at Work

This study used a longitudinal design from age six through age 19 (N = 1206 (603 girls)) to examine the associations between anxious-withdrawal and reactive aggression during childhood, distinct profiles of peer victimization from kindergarten to grade 11 and victimization in college or at work in emerging adulthood. In particular, it was tested whether the predictive effect of personal characteristics on victimization in emerging adulthood would be mediated via chronic peer victimization experiences during the school years. Teachers evaluated children's personal characteristics, whereas peer nominations and self-reports were used to assess victimization. Control variables included sex, parent-reported harsh parenting and SES. Longitudinal latent profile analysis revealed four distinct profiles of peer victimization during the school years: Consistently-Low (39.7%), Low-Moderate (42.8%), High-Decreasing (8.8%) and High-Increasing-Decreasing (8.7%). A subsequent 3-step regression-based path analysis supported the mediation hypothesis - albeit differently for different profiles of peer victimization. Specifically, compared to a Consistently-Low profile of peer victimization in school, a High-Decreasing profile was predicted by reactive aggression, but not anxious-withdrawal. In contrast, a High-Increasing-Decreasing profile was predicted by reactive aggression and anxious-withdrawal. In turn, elevated peer victimization profiles were associated with higher levels of later victimization in college or at work. The indirect effects linking the childhood behaviors to later victimization in college or at work - via elevated peer victimization profiles during childhood and adolescence - were significant. These results highlight the need for tailored interventions to optimize reactively aggressive or anxious-withdrawn children's response strategies to challenging and potentially threatening peer interactions.

Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled Trial

BACKGROUND

Schools increasingly prioritize social-emotional competence and bullying and cyberbullying prevention, so the development of novel, low-cost, and high-yield programs addressing these topics is important. Further, rigorous assessment of interventions prior to widespread dissemination is crucial.

OBJECTIVE

This study assesses the effectiveness and implementation fidelity of the ACT Out! Social Issue Theater program, a 1-hour psychodramatic intervention by professional actors; it also measures students' receptiveness to the intervention.

METHODS

This study is a 2-arm cluster randomized control trial with 1:1 allocation that randomized either to the ACT Out! intervention or control (treatment as usual) at the classroom level (n=76 classrooms in 12 schools across 5 counties in Indiana, comprised of 1571 students at pretest in fourth, seventh, and tenth grades). The primary outcomes were self-reported social-emotional competence, bullying perpetration, and bullying victimization; the secondary outcomes were receptiveness to the intervention, implementation fidelity (independent observer observation), and prespecified subanalyses of social-emotional competence for seventh- and tenth-grade students. All outcomes were collected at baseline and 2-week posttest, with planned 3-months posttest data collection prevented due to the COVID-19 pandemic.

RESULTS

Intervention fidelity was uniformly excellent (>96% adherence), and students were highly receptive to the program. However, trial results did not support the hypothesis that the intervention would increase participants' social-emotional competence. The intervention's impact on bullying was complicated to interpret and included some evidence of small interaction effects (reduced cyberbullying victimization and increased physical bullying perpetration). Additionally, pooled within-group reductions were also observed and discussed but were not appropriate for causal attribution.

CONCLUSIONS

This study found no superiority for a 1-hour ACT Out! intervention compared to treatment as usual for social-emotional competence or offline bullying, but some evidence of a small effect for cyberbullying. On the basis of these results and the within-group effects, as a next step, we encourage research into whether the ACT Out! intervention may engender a bystander effect not amenable to randomization by classroom. Therefore, we recommend a larger trial of the ACT Out! intervention that focuses specifically on cyberbullying, measures bystander behavior, is randomized by school, and is controlled for extant bullying prevention efforts at each school.

TRIAL REGISTRATION

Clinicaltrials.gov NCT04097496; https://clinicaltrials.gov/ct2/show/NCT04097496.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/17900.

Developmental relations between ADHD symptoms and bullying perpetration and victimization in adolescence

It has previously been hypothesized that individuals with elevated attention deficit hyperactivity disorder (ADHD) symptoms are at greater risk of bullying perpetration and victimization. Using autoregressive latent trajectory models with structured residuals (ALT-SR) and four waves (ages 11, 13, 15, and 17) of longitudinal data from the normative z-proso study (n = 1526, 52% male), we evaluated the developmental relations between ADHD and bullying using both self- and teacher-reported ADHD symptom data. Analyses suggested that ADHD symptoms primarily increase the risk of bullying perpetration, with a within-person effect of ADHD symptoms on bullying perpetration symptoms identified across ages 13-15 (β = .13) and ages 15-17 (β = .19) based on self-reported ADHD symptoms and a similar effect identified across ages 11-13 (β = .24) and 13-15 (β = .29) based on teacher-reported inattention symptoms. There were also some indications of reciprocal effects and effects involving victimization that merit further exploration in future research. Results imply that the content of bullying intervention and prevention programs should take account of ADHD symptoms to ensure that those with elevated symptoms can benefit as much as their typically developing peers. This will involve addressing bullying perpetration that may reflect impulsive/reactive aggression and impaired social skills rather than instrumental aggression. Further, programs should go beyond classical curriculum/classroom-based delivery to ensure that individuals with elevated ADHD symptoms can be successfully engaged.

Efficacy of a Web-Enabled, School-Based, Preventative Intervention to Reduce Bullying and Improve Mental Health in Children and Adolescents: Study Protocol for a Cluster Randomized Controlled Trial

Introduction: Bullying is a major preventable risk factor for mental disorders. Available evidence suggests school-based interventions reduce bullying prevalence rates. This study aims to test the efficacy of a web-enabled, school-based, multicomponent anti-bullying intervention to prevent school bullying and to assess its effects on mental health and quality of life. Methods and analysis: Cluster randomized controlled trial conducted in 20 publicly funded primary and secondary schools in Madrid, Spain. Schools are randomly allocated to either the intervention arm (n = 10) or conventional practices arm (n = 10). The web-enabled intervention (LINKlusive) lasts ~12 weeks and consists of three main components: (i) an online training program for teachers and parents, (ii) a web-guided educational program for students, focusing on promoting respect for diversity, empathy, and social skill development, and (iii) a web-guided, teacher-delivered, targeted intervention program for bullying situations identified based on peer-support strategies and individual intervention for those involved (i.e., bullying victims and perpetrators). The primary objective is to compare differences between peer-reported bullying victimization in the intervention and control arms at the end of the intervention. Secondary outcome measures are additional measures of bullying victimization and perpetration, mental health symptoms, self-esteem, and quality of life. A follow-up assessment is conducted 1 year after the end of the intervention. Treatment effects will be tested using multilevel mixed models, adjusting for school-, classroom-, and student-related covariates. Considering the increased bullying rates in children with special educational needs, a specific subgroup analysis will test the efficacy of the intervention on bullying prevalence, mental health, and quality of life in this particularly vulnerable population. Ethics and Dissemination: The Deontology Commission of the School of Psychology, Universidad Complutense in Madrid, Spain reviewed the study protocol and granted ethical approval on 21st January 2019. The results of the trial will be disseminated in relevant peer-reviewed journals and at conferences in the field. Trial Registration Number: ISRCTN15719015.

Associations between developmental trajectories of peer victimization, hair cortisol, and depressive symptoms: a longitudinal study

BACKGROUND

Peer victimization has been associated with long-lasting risks for mental health. Prior research suggests that stress-related systems underlying adaptation to changing environments may be at play. To date, inconsistent findings have been reported for the hypothalamic-pituitary-adrenal (HPA) axis, and its end product cortisol. This study tested whether peer victimization was associated with hair cortisol concentrations (HCC), and whether this association varied according to sex, timing, and changes in exposure. We also examined whether peer victimization differentially predicted depressive symptoms according to HCC.

METHODS

The sample comprised 556 adolescents (42.0%; 231 males) who provided hair for cortisol measurement at 17 years of age. Peer victimization was reported at seven occasions between the ages of 6 and 15 years.

RESULTS

Peer victimization was nonlinearly associated with HCC for boys only, whereas changes in peer victimization were related to HCC for boys and girls. Peer victimization predicted more depressive symptoms for all participants, except those with lower HCC.

CONCLUSIONS

Our findings provide further support for persistent dysregulation of the HPA axis following exposure to chronic adversity, of which the expression may change according to sex and the severity of victimization.

The Role of Defending Norms in Victims' Classroom Climate Perceptions and Psychosocial Maladjustment in Secondary School

Victims of bullying are at increased risk of developing psychosocial problems. It is often claimed that it helps victims when others stand up against the bullying and when defending is typical (descriptive norm) or rewarded with popularity (popularity norm) in classrooms. However, recent work on the healthy context paradox suggests that victims – paradoxically – tend to do worse in more positive classrooms. Therefore, it is possible that defending norms are counterproductive and exacerbate victims’ adjustment difficulties, possibly because social maladjustment is more apparent in classrooms where everybody else is doing well. The current study examined whether descriptive and popularity norms for defending predicted victims’ classroom climate perceptions and psychosocial adjustment. Using data of 1,206 secondary school students from 45 classrooms (M_age = 13.61), multi-level analyses indicated that descriptive norms for defending increased rather than decreased negative classroom climate perceptions and maladjustment of victimized youths. In contrast, popularity norms for defending positively predicted all students’ classroom climate perceptions and feelings of belonging, except victims’ self-esteem. Interventions may benefit more from promoting popularity norms for defending rather than descriptive norms for defending in secondary schools.

Perceived Teacher Responses to Bullying Influence Students' Social Cognitions

Teachers’ responses to bullying incidents are key in bullying intervention at school. Scholars have suggested that teacher responses can predict student cognitions that are associated with their bullying behaviors. However, little is known about whether and how teacher responses affect these cognitions. Therefore, the current study investigated the effects of four immediate teacher responses on four bullying-related student cognitions, using an experimental vignette design. Additionally, it was examined whether students’ own participant role behaviors in actual bullying moderated these effects. The investigated teacher responses were non-response, comforting the victim, correcting the bully, and a combination of comforting the victim and correcting the bully. The investigated student cognitions were perceived teacher attitudes toward bullying, perceived teacher moral disengagement regarding bullying, student willingness to report bullying to the teacher and student expectations regarding bullying participant role behaviors in the classroom. Fourth-to-sixth grade students (N = 910; 47% boys; M_age = 11.04 years, SD = 0.91) read a vignette describing a hypothetical teacher’s response to a same bullying incident, following random assignment to one of eight conditions (i.e., four teacher responses × two genders of bully and victim in the vignette). Afterward, students completed questionnaires about their social cognitions and manipulation checks. ANOVA demonstrated that students perceived stronger teacher anti-bullying attitudes and less teacher moral disengagement when the hypothetical teacher displayed an active response. These effects were even stronger when the teacher corrected the bully compared to when only the victim was comforted. Further, students were more willing to report bullying when the teacher corrected the bully than when the teacher only comforted the victim. Finally, students expected less pro-bullying behaviors, more defending and less victimization in the vignette’s classroom following active teacher response compared to non-response. The effects of teacher responses on student cognitions were not moderated by students’ own participant roles in bullying. Taken together, these findings emphasize the importance of active teacher responses to bullying, and especially, responses that clearly show that bullying is not tolerated. Teachers are encouraged to be aware that students can deduce beliefs from teacher responses which can, in turn, affect bullying processes in the classroom.

Psychological maltreatment: An international challenge to children's safety and well being

BACKGROUND

Child psychological maltreatment (PM), also known as emotional abuse and neglect, mental violence, and emotional maltreatment, is the least recognized and addressed of the four major forms of child maltreatment.

OBJECTIVES

This article provides an 1) the history of PM and its relationship to children's rights, 2) an overview of the current state of knowledge, 3) implications of diversity for the topic of PM, 4) an example of a topic-relevant intervention, and 5) a vision for further progress in addressing this form of child maltreatment.

PARTICIPANTS AND SETTINGS

NA.

METHOD

Literature review, intervention description of fabricated or induced illness, and expert opinion.

RESULTS

PM is directly implicated in seven of the articles of the Convention. PM is common, reliable definitions of PM exist and need to be applied to practice and public health surveillance, harmfulness has been empirically established but is not fully appreciated, and countries vary dramatically in terms of incidence.

CONCLUSIONS

PM is a human rights issue that must be addressed through child protection and promotion of child wellbeing. Adoption of reliable definitions of the different aspects of PM for Child Protective Service practice is a top policy goal. The development of empirically supported curricula on PM for training professionals and parents and culturally sensitive interventions to change social norms on the use of psychologically aggressive disciplinary practices and other forms of PM are critical research needs. Well-validated interventions to support quality parent-child relationships and support families exist and need to be widely adopted. Individual child protective measures should be confined to cases of ongoing serious PM when interventions have failed to reduce harm to the child.

Relative age is associated with bullying victimisation and perpetration among children aged eight to nine

AIM

To assess whether relative age was associated with bullying involvement and whether the associations were independent of child psychiatric symptoms.

METHODS

Bullying was assessed among 8576 children in the second grade, aged 8 years, by using four cross-sectional population-based studies with identical methodology completed by children, parents and teachers in 1989 (response rate 97%), 1999 (93%), 2005 (90%) and 2013 (86%). The main outcomes were bullying victimisation and perpetration. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated with the relatively oldest as the reference group and adjusted for child psychiatric symptoms.

RESULTS

The relatively youngest children, born September to December, were compared with the relatively oldest, born January to April. The youngest children had increased odds of being victims according to child (OR 1.2, 95% CI 1.1-1.4) and parent reports (OR 1.2 95% CI 1.008-1.4). The youngest also had decreased odds of being perpetrators according to child (OR 0.8, 95% CI 0.7-0.96) and teacher reports (OR 0.8, 95% CI 0.7-0.95). These findings were independent of psychiatric symptoms.

CONCLUSION

The relative age effects which were found in bullying involvement were independent of psychiatric symptoms. Considering this newly recognised risk factor for victimisation is important within anti-bullying practices.

[Bullying experiences in outpatients of a child and adolescent psychotherapy centre - A particularly vulnerable group?]

Bullying experiences in outpatients of a child and adolescent psychotherapy centre - A particularly vulnerable group? Abstract. Objective: Bullying has both short- and long-term effects on physical and mental health. Thus, more victimized children might tend to be found in clinical samples. This is the first study to examine the prevalence of bullying roles and modes in children/adolescents in a psychotherapeutic outpatient setting in Germany. Method: 298 outpatients being treated in a child/adolescent psychotherapy centre (6-20 years, 50.7 % female) completed a questionnaire concerning their bullying experiences over the last 6 months. Results: 24.5 % of the patients reported from a victim's perspective, independent of being perpetrators of bullying. 19.1 % reported solely as victims, 5.4 % as victims who also bullied (bully-victims), and 2.0 % as bullies. More than one-third of those with victim or bully-victim experiences had been polyvictimized, 86.2 % were victims solely of traditional bullying, and 1.4 % solely of cyberbullying. The exploratory comparison to general-population school samples seems to show significantly more patients with victim experiences and significantly less patients who bullied others. There seem to be no significant effects for bully-victims. Compared to an inpatient sample, significantly fewer adolescent patients seem to state being victims or bully-victims. Conclusions: Bullying is a topic of particular importance in the context of psychotherapy. These findings have implications for the psychotherapeutic practice as well as training settings.

A longitudinal twin study of victimization and loneliness from childhood to young adulthood

The present study used a longitudinal and discordant twin design to explore in depth the developmental associations between victimization and loneliness from mid-childhood to young adulthood. The data were drawn from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2,232 individuals born in England and Wales during 1994-1995. Diverse forms of victimization were considered, differing across context, perpetrator, and timing of exposure. The results indicated that exposure to different forms of victimization was associated with loneliness in a dose-response manner. In childhood, bullying victimization was uniquely associated with loneliness, over and above concurrent psychopathology, social isolation, and genetic risk. Moreover, childhood bullying victimization continued to predict loneliness in young adulthood, even in the absence of ongoing victimization. Within-twin pair analyses further indicated that this longitudinal association was explained by genetic confounds. In adolescence, varied forms of victimization were correlated with young adult loneliness, with maltreatment, neglect, and cybervictimization remaining robust to controls for genetic confounds. These findings indicate that vulnerability to loneliness in victimized young people varies according to the specific form of victimization in question, and also to the developmental period in which it was experienced.

Exploring gender differences in the longitudinal association between bullying and risk behaviours with Body Mass Index among COMPASS youth in Canada

The purpose of this study was to identify gender differences in the association between bullying and Body Mass Index (BMI) longitudinally. Longitudinal data (2013-2015) from 4510 youth (Ontario, Canada) were used to model BMI with consecutive bullying status prospectively, adjusting for previously identified gender-specific health risk behaviour latent classes. To assess for gender differences, these mixed-effects models were stratified by gender. Youth who were victims of bullying (VoB) were more active, engaged in more substance use and reported higher BMI than their non-victim of bullying (NVoB) peers. The gender-specific mixed-models showed that there are gender differences in the association between bullying and BMI. Among females, repeated bullying was associated with higher odds of having overweight/obesity [by 51% (95% C.I. = 1.03, 2.23)] at follow-up. Among male youth, being a VoB at the previous wave only, was associated with higher odds of having overweight/obesity [by 60% (95% C.I. = 1.11, 2.29)] at follow-up. In contrast with previous literature that measured BMI during adulthood (i.e., years after school victimization), our study adds a unique contribution to the literature that across one year (while youth are still in secondary school), bullying is associated with higher odds of weight status and BMI among female and male youth. Since this increase occurs during secondary school, school-based programs aimed at decreasing youth bullying behaviours and addressing increases in BMI before youth leave school are of paramount importance.

Correlates of bullying victimization among school adolescents in Nepal: Findings from 2015 Global School-Based Student Health Survey Nepal

BACKGROUND

Bullying is an emerging risk factor for poor mental health outcomes adversely affecting children and adolescents. However, it has rarely caught the attention of the health and education sector due to lack of evidence in many countries including Nepal. This study aimed to assess the prevalence and factors associated with bullying behavior among adolescent students in Nepal.

METHODS

We used nationally representative data from the Nepal Global School-Based Student Health Survey that involved two-stage cluster sampling design with the use of a standard set of self-administered questionnaires. Complex sample analysis was done to determine the prevalence and correlates of bullying among 6529 students of 68 schools studying in grade 7 to 11 using descriptive analysis and multivariable logistic regression.

RESULTS

The overall prevalence of bullying among Nepalese school adolescents was 51% (55.67% in male and 46.17% in female). Bullied adolescents more commonly reported mental health problems with higher risk of loneliness (aOR 1.36, 95% CI: 1.12, 1.64), anxiety (aOR 2.04, 95% CI: 1.65, 2.52), suicide attempt (aOR 2.08, 95% CI: 1.54, 2.81), school absenteeism due to fear (aOR 1.72, 95% CI: 1.34, 2.21) and school truancy (aOR 1.48, 95% CI: 1.17, 1.87). A significant association was seen between bullying victimization and negative health behaviors like involvement in physical fights (aOR 3.64, 95% CI: 2.94, 4.51) and tobacco use (aOR 2.05, 95% CI: 1.15, 3.65).

CONCLUSION

School bullying is significantly associated with mental health factors like loneliness, anxiety, suicide attempt, school absenteeism and risky behavioral factors like smokeless tobacco use and involvement in physical fight. The insights provided by these findings have important implications for planning anti-bullying strategies in school settings in the Nepalese context.

The effects of social deprivation on adolescent development and mental health

Adolescence (the stage between 10 and 24 years) is a period of life characterised by heightened sensitivity to social stimuli and the increased need for peer interaction. The physical distancing measures mandated globally to contain the spread of COVID-19 are radically reducing adolescents' opportunities to engage in face-to-face social contact outside their household. In this interdisciplinary Viewpoint, we describe literature from a variety of domains that highlight how social deprivation in adolescence might have far-reaching consequences. Human studies have shown the importance of peer acceptance and peer influence in adolescence. Animal research has shown that social deprivation and isolation have unique effects on brain and behaviour in adolescence compared with other stages of life. However, the decrease in adolescent face-to-face contact might be less detrimental due to widespread access to digital forms of social interaction through technologies such as social media. The findings reviewed highlight how physical distancing might have a disproportionate effect on an age group for whom peer interaction is a vital aspect of development.

Cybervictimization in adolescence and its association with subsequent suicidal ideation/attempt beyond face-to-face victimization: a longitudinal population-based study

BACKGROUND

Cross-sectional associations have been documented between cybervictimization and suicidal risk; however, prospective associations remain unclear.

METHODS

Participants were members of the Quebec Longitudinal Study of Child Development (QLSCD), a prospective birth cohort of 2,120 individuals followed from birth (1997/98) to age 17 years (2014/15). Cybervictimization and face-to-face victimization experienced since the beginning of the school year, as well as serious suicidal ideation and/or suicide attempt were self-reported at ages 13, 15 and 17 years.

RESULTS

In cross-sectional analyses at 13, 15 and 17 years, adolescents cybervictimized at least once had, respectively, 2.3 (95% CI = 1.64-3.19), 4.2 (95% CI = 3.27-5.41) and 3.5 (95% CI = 2.57-4.66) higher odds of suicidal ideation/attempt after adjusting for confounders including face-to-face victimization, prior mental health symptoms and family hardship. Sensitivity analyses suggested that cybervictimization only and both cyber- and face-to-face victimization were associated with a higher risk of suicidal ideation/attempt compared to face-to-face victimization only and no victimization; however, analyses were based on small n. In prospective analyses, cybervictimization was not associated with suicidal ideation/attempt 2 years later after accounting for baseline suicidal ideation/attempt and other confounders. In contrast, face-to-face victimization was associated with suicidal ideation/attempt 2 years later in the fully adjusted model, including cybervictimization.

CONCLUSIONS

The cross-sectional association between cybervictimization and suicidal ideation/attempt is independent from face-to-face victimization. The absence of a prospective association suggested short-term effects of cybervictimization on suicidal ideation/attempt.

The effects of social deprivation on adolescent development and mental health

Adolescence (the stage between 10 and 24 years) is a period of life characterised by heightened sensitivity to social stimuli and the increased need for peer interaction. The physical distancing measures mandated globally to contain the spread of COVID-19 are radically reducing adolescents' opportunities to engage in face-to-face social contact outside their household. In this interdisciplinary Viewpoint, we describe literature from a variety of domains that highlight how social deprivation in adolescence might have far-reaching consequences. Human studies have shown the importance of peer acceptance and peer influence in adolescence. Animal research has shown that social deprivation and isolation have unique effects on brain and behaviour in adolescence compared with other stages of life. However, the decrease in adolescent face-to-face contact might be less detrimental due to widespread access to digital forms of social interaction through technologies such as social media. The findings reviewed highlight how physical distancing might have a disproportionate effect on an age group for whom peer interaction is a vital aspect of development.

Bullying Victimization among Mexican Adolescents: Psychosocial Differences from an Ecological Approach

This transversal study over a random representative sample of 1687 Mexican students attending public and private secondary schools (54% girls, 12-17 years old, M = 13.65. DT = 1.14) aimed to analyze psychosocial differences between victims and non-victims of bullying from the bioecological model. It included individual variables (ontosystem), familiar, community, and scholar factors (microsystem), and gender (macrosystem) to perform a multivariate discriminant analysis and a logistic regression analysis. The discriminant analysis found that psychological distress, offensive communication with mother and father, and a positive attitude toward social norms transgression characterized the high victimization cluster. For the non-victims, the discriminant variables were community implication, positive attitude toward institutional authority, and open communication with the mother. These variables allowed for correctly predicting membership in 76% of the cases. Logistic regression analysis found that psychological distress, offensive communication with the father, and being a boy increased the probability of high victimization, while a positive attitude toward authority, open communication with the mother, and being a girl decrease this probability. These results highlight the importance of open and offensive communication between adolescents and their parents on psychological distress, attitude toward authority, community implication, and bullying victimization.

The Effectiveness of the KiVa Bullying Prevention Program in Wales, UK: Results from a Pragmatic Cluster Randomized Controlled Trial

The study evaluated the implementation fidelity and effectiveness of KiVa, an evidence-based program that aims to prevent and address bullying in schools, with a particular emphasis on changing the role of bystanders. The study was a two-arm waitlist control cluster randomized controlled trial in which 22 primary schools (clusters) (N = 3214 students aged 7-11) were allocated using a 1:1 ratio to intervention (KiVa; 11 clusters, n = 1588 students) and a waitlist control (usual school provision; 11 clusters, n = 1892 children)). The trial statistician (but not schools or researchers) remained blind to allocation status. The outcomes were as follows: student-reported victimization (primary outcome) and bullying perpetration; teacher-reported child behavior and emotional well-being; and school absenteeism (administrative records). Implementation fidelity was measured using teacher-completed online records (for class lessons) and independent researcher observations (for school-wide elements). Outcome analyses involved 11 intervention schools (n = 1578 children) and 10 control schools (n = 1636 children). There was no statistically significant effect on the primary outcome of child-reported victimization (adjusted intervention/control OR 0.76; 95% CI 0.55 to 1.06; p = 0.11) or on the secondary outcomes. The impact on victimization was not moderated by child gender, age, or victimization status at baseline. Lesson adherence was good but exposure (lesson length) was lower than the recommended amount, and there was considerable variability in the implementation of whole school elements. The trial found insufficient evidence to conclude that KiVa had an effect on the primary outcome. A larger trial of KiVa in the UK is warranted, however, with attention to issues regarding implementation fidelity. Trial registration: Current Controlled Trials ISRCTN23999021 Date 10-6-13.

Emotion Recognition and Adverse Childhood Experiences in Individuals at Clinical High Risk of Psychosis

OBJECTIVE

To investigate the association between facial affect recognition (FAR) and type of adverse childhood experiences (ACEs) in a sample of clinical high risk (CHR) individuals and a matched sample of healthy controls (HCs).

METHODS

In total, 309 CHR individuals and 51 HC were recruited as part of an European Union-funded multicenter study (EU-GEI) and included in this work. During a 2-year follow-up period, 65 CHR participants made a transition to psychosis (CHR-T) and 279 did not (CHR-NT). FAR ability was measured using a computerized version of the Degraded Facial Affect Recognition (DFAR) task. ACEs were measured using the Childhood Experience of Care and Abuse Questionnaire, the Childhood Trauma Questionnaire, and the Bullying Questionnaire. Generalized regression models were used to investigate the relationship between ACE and FAR. Logistic regressions were used to investigate the relationship between FAR and psychotic transition.

RESULTS

In CHR individuals, having experienced emotional abuse was associated with decreased total and neutral DFAR scores. CHR individuals who had experienced bullying performed better in the total DFAR and in the frightened condition. In HC and CHR, having experienced the death of a parent during childhood was associated with lower DFAR total score and lower neutral DFAR score, respectively. Analyses revealed a modest increase of transition risk with increasing mistakes from happy to angry faces.

CONCLUSIONS

Adverse experiences in childhood seem to have a significant impact on emotional processing in adult life. This information could be helpful in a therapeutic setting where both difficulties in social interactions and adverse experiences are often addressed.

Revealing the Transactional Associations among Teacher-Child Relationships, Peer Rejection and Peer Victimization in Early Adolescence

Peer victimization is a persistent problem in early adolescents' peer relationships that is related to various difficulties in the short and long run. Previous studies have investigated whether relationships with peers and teachers predict victimization, but to date, few studies have examined the simultaneous contribution of both classroom-based relationships to victimization over time. Therefore, this study investigated how peer rejection and teacher-child relationships uniquely predict peer victimization over the course of one school year in upper elementary school. The transactional associations among teacher-child relationships, peer rejection, and relational and physical victimization were examined in a sample of 692 children (36 classes; M_age = 10.28; range: 7.92-13.14; 48.4% female). Teacher-child relationship quality and peer victimization were measured by student self-report, peer rejection by peer-report. Cross-lagged analyses showed that rejection predicted victimization from wave 1 to wave 2. In turn, more victimization predicted more rejection throughout the whole school year. More supportive teacher-child relationships predicted less victimization. Additionally, more victimization (wave 1) predicted less supportive relationships with teachers (wave 2). Peer rejection and teacher-child relationships were found to have unique, additive effects on victimization in early adolescence over time. Therefore, to effectively intervene in victimization processes, relationships with both peers and teachers need to be considered.

The relationship between bullying victimization and depression in adolescents: multiple mediating effects of internet addiction and sleep quality

Various studies have found that bullying victimization is an important factor affecting depression. However, few studies have explored the underlying mechanism of this effect.  The purpose of this study was to examine the effects of bullying victimization on depression, as well as the mediating roles of internet addiction and sleep quality. The participants were 2022 Chinese junior high school students who completed questionnaires regarding bullying victimization, internet addiction, sleep quality and depression. Correlation analysis indicated that bullying victimization, poor sleep quality, internet addiction, and depression have significant, positive correlations with each other. Hayes' PROCESS macro revealed that internet addiction and sleep quality played multiple mediation roles in the relationship between bullying victimization and depression. These results suggested that effective strategies focusing on improving problematic internet use along with sleep quality may contribute to reducing the negative effect of bullying victimization on depressive symptoms.

Broader impacts of an intervention to transform school environments on student behaviour and school functioning: post hoc analyses from the INCLUSIVE cluster randomised controlled trial

BACKGROUND

We have previously reported benefits for reduced bullying, smoking, alcohol and other drug use and mental health from a trial of 'Learning Together', an intervention that aimed to modify school environments and implement restorative practice and a social and emotional skill curriculum.

OBJECTIVES

To conduct post hoc theory-driven analyses of broader impacts.

DESIGN

Cluster randomised trial.

SETTINGS

40 state secondary schools in southern England.

PARTICIPANTS

Students aged 11/12 years at baseline.

OUTCOMES

Student self-reported measures at 24 and 36 months of: cyberbullying victimisation and perpetration; observations of other students perpetrating aggressive behaviours at school; own perpetration of aggressive behaviours in and outside school; perceived lack of safety at school; participation in school disciplinary procedures; truancy and e-cigarette use.

RESULTS

We found evidence of multiple impacts on other health (reduced e-cigarette use, cyberbullying perpetration, perpetration of aggressive behaviours) and educational (reduced participation in school disciplinary procedures and truancy) outcomes.

CONCLUSION

These analyses suggested that the intervention was effective in bringing about a broader range of beneficial outcomes, adding to the evidence that the intervention is a promising approach to promote adolescent health via an intervention that is attractive to schools.

TRIAL REGISTRATION NUMBER

ISRCTN10751359.

Sensitive periods for the effect of bullying victimization on suicidal behaviors among university students in China: The roles of timing and chronicity

OBJECTIVE

To examine whether timing and chronicity of bullying victimization (BV) play a significant role in linking exposure to BV to suicidal behaviors in university students.

METHODS

A multistage stratification sampling method was used to select a sample of 4034 university students (18-23 years, mean age 20.38±1.35 years, 41.9% female). We used latent class analysis and developmental-stage-based characterizations of BV timing and chronicity to explore the sensitive periods for the effect of BV on suicidal behaviors.

RESULTS

The prevalence rates of suicidal ideation, plans and attempts among our study participants were 9.9%, 3.0% and 1.3%, respectively. BV during primary school (OR = 2.12, 95% CI: 1.55-2.90) and secondary school (OR = 2.65, 95% CI: 1.80-3.90) was associated with suicidal ideation among university students. We identified four classes of life-course BV experiences (low BV, 73.8%; moderate BV, 18.6%; secondary school BV, 4.4% and persistent BV, 3.2%). Persistent BV was associated with 2.50 times (95% CI: 1.56-3.98), 2.98 times (95% CI: 1.48-6.02), and 6.13 times (95% CI: 2.48-15.14) higher risk of suicide ideation, plans, and attempts, respectively. Both moderate BV (OR = 1.75, 95% CI: 1.35-2.26) and secondary school BV (OR=2.01, 95% CI: 1.29-3.12) were positively correlated with suicidal ideation. Furthermore, there was a dose-response relationship between the number of periods of BV and suicidal behaviors.

LIMITATIONS

This study was a cross-sectional study based on self-reported measures, especially BV experiences in each school stage.

CONCLUSIONS

This study identifies sensitive periods for the effect of BV on suicidal behaviors among university students in China.

Early Childhood Factors Associated With Peer Victimization Trajectories From 6 to 17 Years of Age

OBJECTIVES

To describe (1) the developmental trajectories of peer victimization from 6 to 17 years of age and (2) the early childhood behaviors and family characteristics associated with the trajectories.

METHODS

We used data from 1760 children enrolled in the Quebec Longitudinal Study of Child Development, a population-based birth cohort. Participants self-reported peer victimization at ages 6, 7, 8, 10, 12, 13, 15, and 17 years. Participants' behavior and family characteristics were measured repeatedly between ages 5 months and 5 years.

RESULTS

We identified 4 trajectories of peer victimization from 6 to 17 years of age: low (32.9%), moderate-emerging (29.8%), childhood-limited (26.2%), and high-chronic (11.1%). Compared with children in the low peer victimization trajectory, children in the other 3 trajectories were more likely to exhibit externalizing behaviors in early childhood, and those in the high-chronic and moderate-emerging trajectories were more likely to be male. Paternal history of antisocial behavior was associated with moderate-emerging (odds ratio [OR] = 1.54; 95% confidence interval [CI] = 1.09-2.19) and high-chronic (OR = 1.93; 95% CI = 1.25-2.99) relative to low peer victimization. Living in a nonintact family in early childhood was associated with childhood-limited (OR = 1.48; 95% CI = 1.11-1.97) and high-chronic (OR = 1.59; 95% CI = 1.09-2.31) relative to low peer victimization.

CONCLUSIONS

Early childhood externalizing behaviors and family vulnerabilities were associated with the development of peer victimization. Some children entered the cascade of persistent peer victimization at the beginning of primary school. Support to these children and their families early in life should be an important component of peer victimization preventive interventions.

A Novel Approach to Tackling Bullying in Schools: Personality-Targeted Intervention for Adolescent Victims and Bullies in Australia

OBJECTIVE

To examine the secondary effects of a personality-targeted intervention on bullying and harms among adolescent victims and bullies.

METHOD

Outcomes were examined for victims and bullies in the Climate and Preventure study, Australia. Participants completed self-report measures at baseline and four follow-up assessments (6, 12, 24, and 36 months). Thirteen intervention schools (n = 1,087) received Preventure, a brief personality-targeted cognitive-behavioral therapy intervention for adolescents with high-risk personality types (hopelessness, anxiety sensitivity, impulsivity, sensation seeking). Thirteen control schools (n = 1,103) received health education as usual. Bullying was examined for high-risk victims (n = 143 in Preventure schools versus n = 153 in control schools) and bullies (n = 63 in Preventure schools versus n = 67 in control schools) in the total sample. Harms were examined for high-risk victims (n = 110 in Preventure schools versus n = 87 in control schools) and bullies (n = 50 in Preventure schools versus n = 30 in control schools) in independent schools.

RESULTS

There was no significant intervention effect for bullying victimization or perpetration in the total sample. In the subsample, mixed models showed greater reductions in victimization (b = -0.208, 95% CI -0.4104 to -0.002, p < .05), suicidal ideation (b = -0.130, 95% CI -0.225 to -0.034, p < .01), and emotional symptoms (b = -0.263, 95% CI -0.466 to -0.061, p < .05) among high-risk victims in Preventure versus control schools. Conduct problems (b = -0.292, 95% CI -0.554 to -0.030, p < .05) showed greater reductions among high-risk bullies in Preventure versus control schools, and suicidal ideation showed greater reductions among high-risk female bullies in Preventure versus control schools (b = -0.820, 95% CI -1.198 to -0.442, p < .001).

CONCLUSION

The findings support targeting personality in bullying prevention.

CLINICAL TRIAL REGISTRATION INFORMATION

The CAP Study: Evaluating a Comprehensive Universal and Targeted Intervention Designed to Prevent Substance Use and Related Harms in Australian Adolescents; http://www.anzctr.org.au/; ACTRN12612000026820.

Bullying and psychotic symptoms in youth with bipolar disorder

BACKGROUND

Childhood trauma is associated with psychosis in adults with bipolar disorder (BD). Although bullying represents a widespread form of childhood trauma, no studies thus far have investigated the association of bullying and psychosis in pediatric bipolar disorder (PBD). We aim to examine the association between psychosis in PBD with bullying victimization.

METHODS

We included 64 children and adolescents (age± mean= 12±3.43) outpatients with BD spectrum disorders. Psychiatric diagnoses were assessed with the semi- structured interview Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime (KSADS-PL) version with additional depression and manic symptom items derived from the Washington University in St. Louis Kiddie Schedule for Affective Disorders (WASH-U-KSADS). Bullying, demographic, and clinical variables were assessed during the clinical interview.

RESULTS

A lifetime history of psychotic symptoms was associated with bullying (p = 0.002), suicidal behavior (p = 0.006), low socioeconomic status (p = 0.04), and severity of PBD (p = 0.02). Only bullying (OR = 7.3; 95%CI = 2-32) and suicidal behavior (OR = 7.6; 95%CI = 1.5-47.8) remained significant after adjustment for confounders. In a supplementary analysis, we developed a model using supervised machine learning to identify the most relevant variables that differentiated participants with psychotic symptoms, which included bullying, Clinical Global Impression-Severity scale (CGI-S), and suicidal behavior (accuracy = 75%, [p = 0.03]; sensitivity = 77.91%; specificity = 69.05%; area under the curve [AUC] = 0.86).

LIMITATIONS

Small sample, cross-sectional design, and generalizability of findings beyond the outpatient clinical sample.

CONCLUSIONS

Findings underscore the importance of assessing bullying in PBD participants. Future longitudinal studies with larger samples are needed to replicate our findings and determine causality.

Early pathways to bullying: A prospective longitudinal study examining the influences of theory of mind and social preference on bullying behaviour during the first 3 years of school

Research has focused on the role of theory of mind (ToM) for positive social behaviour, while the association between ToM and negative social behaviours is less well understood. This longitudinal study compares two mediation models examining the role of ToM and peer-rated social preference at ages 5 and 6 for bullying at age 7. Participants were 114 children (58 boys, M_age  = 67 months) at entry to primary school (T1). At Time 2 (T2), 106 children and, at Time 3 (T3), 96 children remained. Teacher-rated externalizing problems and children's language ability were controlled at T1. Poor ToM was found to indirectly predict later bullying via poor social preference, while for boys only, greater earlier ToM directly predicted greater bullying 2 years later. These results suggest that there are different pathways to bullying via ToM and social preference, which has implications for interventions to prevent the development of bullying behaviour.

Bullying Victimization and Trauma

Bullying victimization and trauma research traditions operate quite separately. Hence, it is unclear from the literature whether bullying victimization should be considered as a form of interpersonal trauma. We review studies that connect bullying victimization with symptoms of PTSD, and in doing so, demonstrate that a conceptual understanding of the consequences of childhood bullying needs to be framed within a developmental perspective. We discuss two potential diagnoses that ought to be considered in the context of bullying victimization: (1) developmental trauma disorder, which was suggested but not accepted as a new diagnosis in the DSM-5 and (2) complex post-traumatic stress disorder, which has been included in the ICD-11. Our conclusion is that these frameworks capture the complexity of the symptoms associated with bullying victimization better than PTSD. We encourage practitioners to understand how exposure to bullying interacts with development at different ages when addressing the consequences for targets and when designing interventions that account for the duration, intensity, and sequelae of this type of interpersonal trauma.

Childhood bullying victimization, self-labelling, and help-seeking for mental health problems

PURPOSE

Previous research found sustained high levels of mental health service use among adults who experienced bullying victimization during childhood. This could be due to increased psychopathology among this group, but other factors, such as self-perception as having a mental health problem, might contribute to increased service use. Additionally, the relationship between informal help-seeking for mental health problems and bullying victimization is incompletely understood.

METHODS

The present study examined associations between the frequency of bullying victimization and both formal service use and informal help-seeking for mental health problems independent from psychopathology. Data on bullying victimization, service use, informal help-seeking for mental health problems, psychopathology, and self-labelling as a person with mental illness were collected among 422 young people aged 13-22 years.

RESULTS

In logistic regression models, controlling for past and current psychopathology and using no bullying victimization as the reference category, we identified a greater likelihood of mental health service use among persons who experienced frequent bullying victimization, as well as a greater likelihood of seeking informal help among persons who experienced occasional victimization. Increased self-identification as a person with mental illness completely mediated the positive association between frequent bullying victimization and mental health service use.

CONCLUSIONS

Our findings suggest that services to support persons who experienced frequent bullying victimization should focus on improving empowerment and self-perception. Additionally, there might be unserved need for formal support among those who experienced occasional bullying victimization.

What Counts?: A Qualitative Study of Adolescents' Lived Experience With Online Victimization and Cyberbullying

OBJECTIVE

To inform development of cyberbullying interventions that are both accurate and meaningful to all adolescents, this qualitative analysis examines experiences of online peer victimization among a sample of predominately minority and low-income youth.

METHODS

Adolescents ages 13 to 17 years who reported past-year cyberbullying on a previously validated survey were recruited from an urban pediatric clinic to complete semistructured interviews. Interview topics included definitions of cyberbullying, prior cyberbullying experiences, and strategies to reduce cyberbullying and its consequences. Interviews were audio-recorded and transcribed verbatim. Using thematic analysis, study team members applied both structural and emergent codes to transcripts.

RESULTS

Saturation was reached after 23 interviews (mean age 14.8 years; 65% female, 47.8% Hispanic, 35% Black, 74% low socioeconomic status). Four main themes emerged: 1) Teens avoided the term "cyberbullying," due to its association with suicidality and severe depression; they preferentially described experiences (even those meeting criteria for repetition, power differential, etc.) as "online conflict". 2) In-person bullying categories (bully, victim, bully victim, bystander) apply to online conflict. Few identify purely as victims. 3) Cyberbullying is part of a larger continuum of peer violence, including physical fights and in-person bullying. 4) Teens want to help victims of cyberbullying; they desire more guidance in so doing.

CONCLUSIONS

These youth rarely acknowledge presence of cyberbullying; instead, they describe online conflict as part of a larger spectrum of peer violence. Clinicians may consider prevention of a range of conflict-related behaviors (rather than focusing exclusively on cyberbullying), and may consider engaging adolescent bystanders in prevention of online conflict.

Do social support and eating family meals together play a role in promoting resilience to bullying and cyberbullying in Scottish school children?

This study investigates if cyberbullying is associated with wellbeing independently of traditional bullying and if social support and eating family meals together promotes resilience by buffering adolescents against the consequences of both types of bullying. Data for 5286 eleven, thirteen and fifteen year olds participating in the cross-sectional 2018 Scottish Health Behaviour in School-aged Children study were analysed. Adolescent self-report measures were used to assess traditional bullying, cyberbullying, classmate and teacher support and frequency of family meals together. Psychological wellbeing was assessed with the 5-item World Health Organization Wellbeing index. Analyses were conducted separately by gender with multilevel models, adjusting for sociodemographic factors. Resilience to bullying and cyberbullying was operationalised using statistical interactions. For both genders, cyberbullying and traditional bullying measures were associated with reduced wellbeing and all social support indicators were associated with increased wellbeing. In models containing both bullying measures, frequent traditional bullying victimisation was associated with a 7.2 (95% CI: 3.4-10.1) reduction in wellbeing score for boys and a 7.2 (95% CI: 4.5-10.0) reduction for girls, while cyberbullying was associated with 10.5 (95% CI: 5.8-15.1) reduction in wellbeing score for boys and 11.1 (95% CI: 6.7-15.5) reduction for girls. For both genders adjusting for classmate support explained away the relationships between traditional bullying and wellbeing, but cyberbullying was associated negatively with wellbeing independent of social support. Only one of 12 interaction tests provided any evidence of resilience. Cyberbullying was associated with a 7.8 (95% CI: 0.2-15.4) reduction in wellbeing score for girls who ate with their family every day, and 17.3 (95% CI: 10.5-24.1) reduction for girls who ate with their families less than weekly. In conclusion, cyberbullying is a strong, albeit rare, threat to adolescent wellbeing. Social support is important for wellbeing, but its ability to buffer adolescents against the consequences of bullying may be limited.

Victimization In Childhood Affects Depression In Adulthood Via Neuroticism：A Path Analysis Study

BACKGROUND

Adverse experiences, such as low care, overprotection, or abuse in childhood increase the likelihood of depression via their effects on personality traits. Similarly, being victimized in childhood may affect the likelihood of depression via personality traits. In this case-control study, we hypothesized that being victimized in childhood is associated with depression in adulthood via its effect on neuroticism, and verified this hypothesis using path analysis.

SUBJECTS AND METHODS

Eighty-two major depressive disorder (MDD) patients and 350 age-and-sex matched healthy controls completed self-administered questionnaires of demographic data, Patient Health Questionnaire-9, neuroticism, and victimization. The association between victimization, neuroticism, and depressive symptoms or having major depression was investigated by path analysis.

RESULTS

Multiple group path analysis, in which depressive symptoms were considered as dependent variables, showed that the direct effect of victimization in childhood on depressive symptoms was not statistically significant in either healthy controls or MDD patients (standardized path coefficient: 0.079 and 0.084, respectively), but their indirect effects via neuroticism were statistically significant (standardized path coefficient: 0.059 and 0.141, respectively). Path analysis, in which the distinction between healthy controls and MDD patients was a dependent variable, showed that both direct effects and indirect effects of victimization in childhood via neuroticism on the distinction between healthy controls and MDD patients were statistically significant (standardized path coefficient: 0.186 and 0.164, respectively).

LIMITATIONS

Recall bias and the relatively small number of MDD patients are limitations of this study. Because it was a case-control survey, this study could not make any conclusions regarding causal associations.

CONCLUSION

This study suggests the possibility of causal associations between victimization in childhood and depressive symptoms or MDD in adulthood, and the mediation of this association by neuroticism.

Modifying the secondary school environment to reduce bullying and aggression: the INCLUSIVE cluster RCT

Background

Bullying, aggression and violence among children and young people are some of the most consequential public mental health problems.

Objectives

The INCLUSIVE (initiating change locally in bullying and aggression through the school environment) trial evaluated the Learning Together intervention, which involved students in efforts to modify their school environment using restorative approaches and to develop social and emotional skills. We hypothesised that in schools receiving Learning Together there would be lower rates of self-reported bullying and perpetration of aggression and improved student biopsychosocial health at follow-up than in control schools.

Design

INCLUSIVE was a cluster randomised trial with integral economic and process evaluations.

Setting

Forty secondary schools in south-east England took part. Schools were randomly assigned to implement the Learning Together intervention over 3 years or to continue standard practice (controls).

Participants

A total of 6667 (93.6%) students participated at baseline and 5960 (83.3%) students participated at final follow-up. No schools withdrew from the study.

Intervention

Schools were provided with (1) a social and emotional curriculum, (2) all-staff training in restorative approaches, (3) an external facilitator to help convene an action group to revise rules and policies and to oversee intervention delivery and (4) information on local needs to inform decisions.

Main outcome measures

Self-reported experience of bullying victimisation (Gatehouse Bullying Scale) and perpetration of aggression (Edinburgh Study of Youth Transitions and Crime school misbehaviour subscale) measured at 36 months. Intention-to-treat analysis using longitudinal mixed-effects models.

Results

Primary outcomes – Gatehouse Bullying Scale scores were significantly lower among intervention schools than among control schools at 36 months (adjusted mean difference –0.03, 95% confidence interval –0.06 to 0.00). There was no evidence of a difference in Edinburgh Study of Youth Transitions and Crime scores. Secondary outcomes – students in intervention schools had higher quality of life (adjusted mean difference 1.44, 95% confidence interval 0.07 to 2.17) and psychological well-being scores (adjusted mean difference 0.33, 95% confidence interval 0.00 to 0.66), lower psychological total difficulties (Strengths and Difficulties Questionnaire) score (adjusted mean difference –0.54, 95% confidence interval –0.83 to –0.25), and lower odds of having smoked (odds ratio 0.58, 95% confidence interval 0.43 to 0.80), drunk alcohol (odds ratio 0.72, 95% confidence interval 0.56 to 0.92), been offered or tried illicit drugs (odds ratio 0.51, 95% confidence interval 0.36 to 0.73) and been in contact with police in the previous 12 months (odds ratio 0.74, 95% confidence interval 0.56 to 0.97). The total numbers of reported serious adverse events were similar in each arm. There were no changes for staff outcomes. Process evaluation – fidelity was variable, with a reduction in year 3. Over half of the staff were aware that the school was taking steps to reduce bullying and aggression. Economic evaluation – mean (standard deviation) total education sector-related costs were £116 (£47) per pupil in the control arm compared with £163 (£69) in the intervention arm over the first two facilitated years, and £63 (£33) and £74 (£37) per pupil, respectively, in the final, unfacilitated, year. Overall, the intervention was associated with higher costs, but the mean gain in students’ health-related quality of life was slightly higher in the intervention arm. The incremental cost per quality-adjusted life year was £13,284 (95% confidence interval –£32,175 to £58,743) and £1875 (95% confidence interval –£12,945 to £16,695) at 2 and 3 years, respectively.

Limitations

Our trial was carried out in urban and periurban settings in the counties around London. The large number of secondary outcomes investigated necessitated multiple statistical testing. Fidelity of implementation of Learning Together was variable.

Conclusions

Learning Together is effective across a very broad range of key public health targets for adolescents.

Future work

Further studies are required to assess refined versions of this intervention in other settings.

Trial registration

Current Controlled Trials ISRCTN10751359.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 7, No. 18. See the NIHR Journals Library website for further project information. Additional funding was provided by the Educational Endowment Foundation.

Genetic and Environmental Influences on Different Forms of Bullying Perpetration, Bullying Victimization, and Their Co-occurrence

Bullying comes in different forms, yet most previous genetically-sensitive studies have not distinguished between them. Given the serious consequences and the high prevalence of bullying, it is remarkable that the aetiology of bullying and its different forms has been under-researched. We present the first study to investigate the genetic architecture of bullying perpetration, bullying victimization, and their co-occurrence for verbal, physical and relational bullying. Primary-school teachers rated 8215 twin children on bullying perpetration and bullying victimization. For each form of bullying, we investigated, through genetic structural equation modelling, the genetic and environmental influences on being a bully, a victim or both. 34% of the children were involved as bully, victim, or both. The correlation between being a bully and being a victim varied from 0.59 (relational) to 0.85 (physical). Heritability was ~ 70% for perpetration and ~ 65% for victimization, similar in girls and boys, yet both were somewhat lower for the relational form. Shared environmental influences were modest and more pronounced among girls. The correlation between being a bully and being a victim was explained mostly by genetic factors for verbal (~ 71%) and especially physical (~ 77%) and mostly by environmental factors for relational perpetration and victimization (~ 60%). Genes play a large role in explaining which children are at high risk of being a victim, bully, or both. For victimization this suggests an evocative gene-environment correlation: some children are at risk of being exposed to bullying, partly due to genetically influenced traits. So, genetic influences make some children more vulnerable to become a bully, victim or both.

Policy Evolution in the Chinese PPP Market: The Shifting Strategies of Governmental Support Measures

Much attention has been paid world-wide to the advancement of policy with regard to public–private partnerships (PPPs). Though PPPs continue to play a major role in the development of China’s national economy, capital projects and infrastructure upgrade, little work has been done to understand the evolution of Chinese governmental policy with regard to PPPs. This paper addresses this lack and sets out the trajectory of Chinese PPP policy maturation over the period of 1986 to 2018. Policy documents were retrieved from official government websites, such as the Ministry of Finance and National Development and Reform Commission, with some 205 policy statements deemed relevant to PPPs. These were then classified by type and submitted to regression analysis. Five major instruments in support of PPPs were identified, including fiscal, financial, taxation, land and operations support. Moreover, four historical policy phases can be identified in the Chinese PPP market, including ‘try’, ‘explore’, ‘expand’ and ‘consolidate’. While governmental policy may now be considered sophisticated, deficiencies remain, including insufficient policy coordination between departments, lack of financial incentives and poor transparency and disclosure supervision. These observations will inform policy makers as they look to continue advancement of PPP policy measures, and help practitioners in assessing the pitfalls of operating in the Chinese PPP market.

Is Bullying Victimization in Childhood Associated With Mental Health in Old Age

Objective

This study investigates the relationship between bullying victimization in childhood and mental health in old age.

Methods

The study uses data from a nationally representative sample of 9,208 older people aged 60 and older collected through the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2014 and 2015.

Results

Older people who were bullied in childhood have more severe depressive symptoms and are more likely to be dissatisfied with life than those without the experience of bullying victimization. The negative impacts remain significant after childhood confounders (15 types of familial adversities), four groups of contemporary confounders (demographic, health, social support, and socioeconomic factors), and community-level unobserved heterogeneity are all controlled for. The negative impacts of bullying victimization on mental health are attenuated among people in very old age, which confirms the socioemotional selectivity theory.

Discussion

The consequences of bullying victimization for mental health are comparable to, or even greater than those of familial adversities and contemporary risk factors. The factors threatening mental health vary considerably for older people in different age groups. Effective anti-bullying schemes in childhood and personalized support in later life can make a substantial contribution to healthy aging.

Defend, Stand By, or Join In?: The Relative Influence of Moral Identity, Moral Judgment, and Social Self-Efficacy on Adolescents' Bystander Behaviors in Bullying Situations

In bullying situations, adolescent bystanders may help bullied others, just stand by, or join in the antisocial behavior. Current studies have yet to fully examine the moral and social factors motivating these varied responses to bullying encounters. Extending from pertinent developmental theories, the present study investigated the relative contributions of moral identity (i.e., viewing moral qualities as central to the self), moral judgment, and social self-efficacy to adolescents' bystander behaviors vis-à-vis bullies. Also investigated were the interactions among these variables. Three hundred and thirty-seven adolescents (M age = 13 years, 56.1% female) who self-identified as Caucasian (90.2%), Hispanic-American (2.1%), Asian-American (0.9%), African-American (3.9%), or Other/Unknown (2.9%) participated in the study. Students completed questionnaires assessing moral identity, moral judgment, social self-efficacy, and how they would respond if they observed a peer being bullied. Moral identity predicted more prosocial action, particularly for adolescents high in social self-efficacy. Moral identity related positively to moral judgment, and both predicted less antisocial (joining in) behavior. Interestingly, moral judgment maturity primarily diminished antisocial behavior when moral identity was relatively low. Social self-efficacy predicted less passive bystanding. Overall, moral identity strongly relates to defending behavior, and-as does moral judgment maturity-predicts less antisocial behavior among bystanders.

Self-Perceptions and Factors Associated With Being Put Down at School Among Middle and High School Students

This study assessed the prevalence of verbally being put down by others and intrapersonal and normative factors associated with being put down by others among middle and high school students. Students (N = 1,027) completed the Adolescent Health Risk Behavior Survey. Over 16% of participants reported being put down at school. Students who identified with the negative words confused, unattractive, dull, and careless and identified less with the positive words popular, smart, considerate, cool, and self-confident reported being put down by others. High school students were less likely to be put down. As students scored higher on the Negative Self-Description Scale, their odds of being put down increased. As students scored higher on the Positive Self-Description Scale, their odds of being put down decreased. Students who perceived their friends drinking alcohol regularly were less likely to be put down. Strategies to enhance self-perceptions to raise self-awareness and form healthy/positive identities are needed.