The relation between bullying and subclinical psychotic experiences and the influence of the bully climate of school classes

The Cross-Sectional and Longitudinal Effects of Cumulative Multi-Contextual Risk on Psychotic-Like Experiences among Chinese Rural Adolescents

Psychotic-like experiences (PLEs) are common among adolescents and are associated with an increased risk of psychotic disorders and other mental health issues in adulthood. However, research on PLEs in rural adolescents is limited. Therefore, this study sought to investigate the cross-sectional and longitudinal effects of multiple contextual risk factors on PLEs among 1210 Chinese rural adolescents (45.6% boys; Mage = 13.70 years, SD = 0.81) across a one-year period, utilizing a cumulative risk model. Results revealed that bullying victimization, borderline personality feature (BPF), psychache, depression, and sleep problems were significant risk factors for PLEs. Furthermore, these risk factors demonstrated a cumulative effect on the development of PLEs across time. Additionally, no significant sex differences were observed in the cumulative risk model of PLEs. These findings provide valuable insights into the identification of at-risk adolescents and contribute to the effective implementation of comprehensive preventive measures and interventions targeting PLEs among rural adolescents.

Variation of subclinical psychosis across 16 sites in Europe and Brazil: findings from the multi-national EU-GEI study

BACKGROUND

Incidence of first-episode psychosis (FEP) varies substantially across geographic regions. Phenotypes of subclinical psychosis (SP), such as psychotic-like experiences (PLEs) and schizotypy, present several similarities with psychosis. We aimed to examine whether SP measures varied across different sites and whether this variation was comparable with FEP incidence within the same areas. We further examined contribution of environmental and genetic factors to SP.

METHODS

We used data from 1497 controls recruited in 16 different sites across 6 countries. Factor scores for several psychopathological dimensions of schizotypy and PLEs were obtained using multidimensional item response theory models. Variation of these scores was assessed using multi-level regression analysis to estimate individual and between-sites variance adjusting for age, sex, education, migrant, employment and relational status, childhood adversity, and cannabis use. In the final model we added local FEP incidence as a second-level variable. Association with genetic liability was examined separately.

RESULTS

Schizotypy showed a large between-sites variation with up to 15% of variance attributable to site-level characteristics. Adding local FEP incidence to the model considerably reduced the between-sites unexplained schizotypy variance. PLEs did not show as much variation. Overall, SP was associated with younger age, migrant, unmarried, unemployed and less educated individuals, cannabis use, and childhood adversity. Both phenotypes were associated with genetic liability to schizophrenia.

CONCLUSIONS

Schizotypy showed substantial between-sites variation, being more represented in areas where FEP incidence is higher. This supports the hypothesis that shared contextual factors shape the between-sites variation of psychosis across the spectrum.

The effects of peer bullying and poverty on suicidality in Chinese left behind adolescents: The mediating role of psychotic-like experiences

AIM

This study investigated the influence of childhood adversity, such as peer bullying and socioeconomic status, on the suicidal behaviour of left-behind Chinese adolescents to determine whether psychotic-like experiences (PLEs) mediated the associations between these childhood adversities and suicidality; suicidal ideation (serious thoughts about taking one's own life), suicide plans, and suicide attempts.

METHODS

A representative group of rural adolescents (n = 3346) was recruited from 16 rural high schools in China. Suicidality was assessed using the suicide module from the Mini International Neuropsychiatric Interview Kid. Participants also completed questionnaires on bullying, socioeconomic status, left-behind characteristics, and PLEs. Structural equation modelling was then employed to explore the relationships between these variables.

RESULTS

Peer bullying, poverty, and left-behind status were all found to significantly increase adolescent suicide risk, the relationships between which were mediated by PLEs. Peer bullying was found to play the most significant role in the PLEs and suicidality, with the risk of suicide increasing with the length of time a child had been left behind.

CONCLUSION

Adverse life events can lead to a high risk of PLEs, which in turn can increase the risk of suicide. These results could assist in identifying individuals at risk of suicidality and the design of appropriate interventions. The results also highlighted the role PLEs play in suicidality and highlighted the need for further research in this area.

Bidirectional associations among school bullying, depressive symptoms and sleep problems in adolescents: A cross-lagged longitudinal approach

BACKGROUND

Adolescence is a life stage with a high risk of depression, sleep disorders and school bullying. The aim of this study is to examine the longitudinal relationships between school bullying (bullying victimization and bullying perpetration), depressive symptoms and sleep problems among adolescents and to consider whether the direct pathways vary by gender.

METHODS

The study included 1687 7th grade students (60.4% boys) recruited from a middle school in southeastern China. We collected self-reports of school bullying, depressive symptoms and sleep problems from 2019 (T1) and 2020 (T2) among adolescents. A series of gender-specified cross-lagged paths in a structural equation model was used for the primary analysis.

RESULTS

The models revealed evidence for bidirectional associations between school bullying, depressive symptoms and sleep problems. Among girls, higher bullying perpetration at T1 predicted fewer sleep problems and depressive symptoms at T2, while bullying victimization significantly predicted poor quality of sleep and severe depressive symptoms. Furthermore, sleep problems at T1 positively predicted bullying perpetration and victimization at T2 in boys but not in girls. For both boys and girls, severe depressive symptoms significantly predicted more victimization and sleep problems, and sleep problems were positively associated with depressive symptoms.

LIMITATIONS

The sample is unrepresentative, as it is from only one middle school.

CONCLUSIONS

Our findings highlight that school bullying, depressive symptoms and sleep problems were interrelated across time and that acknowledging gender differences is important.

The ethnic density effect in psychosis: a systematic review and multilevel meta-analysis

BACKGROUND

An 'ethnic' or 'group' density effect in psychosis has been observed, whereby the risk of psychosis in minority group individuals is inversely related to neighbourhood-level proportions of others belonging to the same group. However, there is conflicting evidence over whether this effect differs between minority groups and limited investigation into other moderators.

AIMS

To conduct a comprehensive systematic review and meta-analysis of the group density effect in psychosis and examine moderators.

METHOD

Four databases were systematically searched. A narrative review was conducted and a three-level meta-analysis was performed. The potential moderating effect of crudely and specifically defined minority groups was assessed. Country, time, area size and whether studies used clinical or non-clinical outcomes were also tested as moderators.

RESULTS

Thirty-two studies were included in the narrative review and ten in the meta-analysis. A 10 percentage-point decrease in own-group density was associated with a 20% increase in psychosis risk (OR = 1.20, 95% CI 1.09-1.32, P < 0.001). This was moderated by crudely defined minority groups (F6,68 = 6.86, P < 0.001), with the strongest associations observed in Black populations, followed by a White Other sample. Greater heterogeneity was observed when specific minority groups were assessed (F25,49 = 7.26, P < 0.001).

CONCLUSIONS

This is the first review to provide meta-analytic evidence that the risk of psychosis posed by lower own-group density varies across minority groups, with the strongest associations observed in Black individuals. Heterogeneity in effect sizes may reflect distinctive social experiences of specific minority groups. Potential mechanisms are discussed, along with the implications of findings and suggestions for future research.

The victim-bully cycle of sexual minority school adolescents in China: prevalence and the association of mood problems and coping strategies

AIMS

Compared to their heterosexual peers, youth who identify as lesbian, gay or bisexual (LGB) tend to suffer higher rates of peer victimisation from bullying. However, studies of LGB adolescents' participation as bullies are scarce. We aimed to examine the possible association of sexual minority identity and the heightened risk of not only being bullied but bullying others as well. We also explored the effect of one's sexual identity on their involvement in bullying through the mediation of coping strategies and mood states.

METHODS

A total of 12 218 students were recruited from 18 secondary schools in China. The demographic information, positive and negative coping strategies, mood state (anxiety, depression and hypomania) and information related to bullying and being bullied were collected. Multinomial regression was used to assess the heightened risk of sexual minority groups in comparison to their heterosexual adolescents' counterparts. A structural equation model (SEM) was used to test the mediating role of coping strategy and mood state between one's sex, sexual identity and bullying experience.

RESULTS

Two trends could be observed: (1) LGB groups reported heightened risks of being bullied and bullying others at school than heterosexual peers. However, being a sexual-undeveloped girl seemed to have a protective effect on bullying-related problems. (2) Birth-assigned males were more likely to be bullied as well as bullying others at school when compared to birth-assigned females. SEM analysis revealed that being a sexual minority was directly associated with a higher frequency of being bullied (B = 0.16, 95% CI [0.10, 0.22], p < 0.001) but not bullying others (B = 0.02, 95% CI [-0.02, 0.06], p = 0.398) when compared to the heterosexual group. Negative coping, hypomania, anxiety and depression were associated with a higher frequency of being bullied, while positive coping was associated with a lower frequency of being bullied. Moreover, negative coping, hypomania and depression were associated with a higher frequency of bullying others, while positive coping was associated with a reduced likelihood of bullying others. In addition, being bullied and bullying others were significantly correlated in the SEM model.

CONCLUSIONS

This novel research investigated the dynamic nature of the interaction between victim and bullying of LGB school adolescents in China, with a specific exploration of the psychological mechanism behind the pattern of being bullied and bullying others. School-level interventions aimed at teaching positive coping strategies to lower psychological distress are recommended to support sexual minority students.

The Mediating Effect of Regulatory Emotional Self-Efficacy on the Association between Self-Esteem and School Bullying in Middle School Students: A Cross-Sectional Study

School bullying is negatively associated with self-esteem, but psychological mediators of bullying have yet to be clarified. We examined regulatory emotional self-efficacy (RESE) as a possible mediator in the association between self-esteem and school bullying. A cross-sectional study of 995 adolescents was conducted in two middle schools of Xi'an. All of the participants completed the Chinese version of the School Bullying Experience Questionnaire (C-SBEQ), Self-Esteem Scale (SES), and Regulatory Emotional Self-Efficacy Scale (RESE). Descriptive statistics analysis, the bias corrected percentile Bootstrap CI method, and structural equation modelling were used to analyze the data. The results showed that 418 students (42.0%) reported that they were involved in school bullying in the past year. Self-esteem was negatively associated with school bullying (total effect: β = -0.275, 95% CI = -0.381⁻-0.034), and RESE mediated the association between self-esteem and school bullying (indirect effect: β = -0.136, 95% CI = -0.245⁻-0.037). Furthermore, self-esteem had an indirect effect through perceived self-efficacy in managing negative affect, while self-esteem had no indirect effect through self-efficacy in the expression of positive affect. The present study suggests that school authorities and the related education departments should not only focus on improving students' self-esteem, but should also pay more attention to students' RESE, in order to mitigate, and potentially reduce, the occurrence of bullying.

Bullying victimisation and psychosis: The interdependence and independence of risk trajectories

A number of studies have noted an association between being the victim of bullying and psychotic symptoms. We offer an overview of the topic, focusing especially on a developmental perspective. We highlight the results of the latest studies on psychosis across the continuum and its relationship with bullying. Then we summarise the three main explanatory models investigated: developmental, biological and cognitive. We recommend that bullying in psychosis requires careful study of the developmental trajectories involved, and that research should now focus on how personal, social and biological factors interact.

LEARNING OBJECTIVES

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Relationship between the experience of being a bully/victim and mental health in preadolescence and adolescence: a cross-sectional study

BACKGROUND

Several studies have proven that the experiences of being bullied or bullying others are associated with poor mental health among adolescent youths. Our study aims to investigate the relationship between the experience of the bully/victim and mental health among preadolescents and adolescents.

METHODS

Subjects were the Japanese fifth and sixth grade elementary school students (preadolescents: mean age = 11.3 years; n = 338) and junior high school students (adolescents: mean age = 13.8 years; n = 486). A self-report questionnaire was administered containing items concerning the experience of being a bully/victim and the Youth Self Report (YSR).

RESULTS

Four groups relating to the experience of being a bully/victim were formed: "Victim Only," "Bully Only," "Victim and Bully," and "Neither." Approximately 65% of preadolescents and approximately 25% of adolescents engaged in bullying behaviors. Of these, the rate of participants in the "Bully Only" group was low, and that in the "Victim and Bully" group was high. Regarding the relationship between the experience of being a bully/victim and mental health, both preadolescents and adolescents of the "Victim Only" group had significantly higher scores on the YSR's internalizing problems compared with the "Neither" group. Moreover, both preadolescents and adolescents of the "Bully Only" group had significantly higher scores on the YSR's externalizing problems compared with the "Neither" group. Regarding the relationship between the experience of being a bully/victim and suicidal ideation for both preadolescent and adolescent girls, the relative risks of suicidal ideation were significantly higher in the "Victim and Bully" group than in the "Neither" group.

CONCLUSIONS

Preadolescents indicated a higher rate of bullying behaviors than adolescents. In both preadolescents and adolescents, different effect patterns on mental health were found for the "Victim Only," "Bully Only," and "Victim and Bully" groups. The prevention and intervention methods for mental health should be tailored according to the type of experience associated with being a bully/victim and according to the developmental stages of preadolescence or adolescence.