The promotive effects of peer support and active coping on the relationship between bullying victimization and depression among chinese boarding students

Relationship between cumulative peer risk and sense of security among adolescents: a moderated mediation model

Adolescents' sense of security is closely related to their ecological background. Previous studies have shown that single or minority risk factors in peer risk are crucial in adolescents' sense of security. Nevertheless, research into the collective influence of peer-related risk factors on a the sense of security among adolescents is scarce. Furthermore, the moderated mediation processes between cumulative peer risk and a sense of security in adolescents are poorly understood. Therefore, using a cumulative risk model, the present study examined the impact of cumulative peer risk on adolescents' sense of security. Furthermore, based on self-system theory and stress-buffering theory, we examined whether self-efficacy mediated the relationship between cumulative peer risk and adolescents' sense of security and whether perceived social support moderated the adverse effect of cumulative peer risk on adolescents' sense of security. A total of 3037 adolescents (mean age = 14.98 years, SD = 1.72) from three middle schools and two high schools in Henan province, China participated in this study. They completed a set of surveys evaluating demographic characteristics, peer-related risk factors (including peer rejection, peer alienation, peer acceptance, and peer support), self-efficacy, perceived social support, and adolescents' sense of security. Mediation analysis indicated that (a) cumulative peer risk significantly negatively predicted adolescents' sense of security; (b) cumulative peer risk significantly negatively predicted self-efficacy, which in turn reduced adolescents' sense of security; and moderated mediation analysis further demonstrated (c) That the first and second half of the mediation path were moderated differently by perceived social support. High perceived social support could enhance the positive effect of self-efficacy on adolescents' sense of security, but the protective role of perceived social support in adolescents' sense of security is limited, especially when adolescents are exposed to high cumulative peer risk. Taken together, the present study is the first to demonstrate the detrimental impact of cumulative peer risk on adolescents' sense of security, as well as the mediating role of self-efficacy and the moderating role of perceived social support. In addition, we discussed the implications of our findings on improving adolescents' sense of security.

Multiple Risks and Adolescent Depressive Symptoms in Ethnic Regions of China: Analyses Using Cumulative Risk Model, Logistic Regression, and Association Rule Mining

The present study aimed to examine the relationship between multiple risk exposures in family and school settings and the depressive symptoms of Chinese students in early adolescence living in the ethnic regions of Yunnan and Hebei, China, via different multiple risk analytic approaches. A total of 2940 students (47.3% females) in grades 4 to 9 (Mage = 12.08, SD = 2.04) from ethnic minority counties in Yunnan and Hebei participated in the survey. The participants completed the questionnaires and reported family risk, school risk, depressive symptoms, and demographic information. The cumulative risk model and the individual multiple risk models with logistic regression/association rule mining were used to examine the effects of cumulative risk, the relative contributions of individual risks, and combinations of multiple risks. We found that (1) when a cumulative risk model was used, the associations between family cumulative risk and school cumulative risk on depressive symptoms were significant, but the cross-domain interaction effect was not significant. (2) The results of logistic regression indicated that high levels of family conflict, low levels of family cohesion, low levels of teacher support, and low levels of peer support were significantly correlated with a high risk for depression. (3) The results of association rule mining revealed meaningful associations between multiple risk factor combinations and depressive symptoms. In conclusion, the use of association rule mining enhanced the analyses and understanding of the effects of multiple risk exposures. Interpersonal stressors in family and school settings need to be addressed in depression prevention and intervention programs for adolescents.

Bullying victimization and mental health problems of boarding adolescents in rural China: the role of self-esteem and parenting styles

BACKGROUND

The mental health of adolescents is the key to ensure their smooth growth. This study aimed to explore the underlying mechanism between bullying victimization and boarding adolescents' mental health problems in rural China.

METHODS

A total of 2155 boarding adolescents from middle schools (Nboy = 936, Ngirl = 1219, Mage = 13.86, SD = 0.81) participated in this survey and completed four questionnaires on bullying victimization, parenting styles, self-esteem and mental health problems.

RESULTS

Results shown that: (1) In rural China, about one fifth of boarding adolescents were in an unhealthy mental state, and learning anxiety was the most common mental health problem reported by them; (2) Bullying victimization had a significant effect on boarding adolescents' mental health problems, and the more bullied experiences predict more serious mental health problems; (3) Self-esteem played a mediating role in bullying victimization and boarding adolescents' mental health problems, whiles parenting styles played a moderating role.

CONCLUSION

Bullying victimization has been shown to decrease self-esteem, which in turn contributes to mental health problems among boarding adolescents. Low-level negative parenting styles further intensify these issues. Consequently, the education department and educators must prioritize addressing school bullying and protecting the mental health of boarding students. Most importantly, collaboration with parents is essential to foster the healthy development of these adolescents.

Resilience as a moderator of the effects of types of workplace bullying and job performance

BACKGROUND

Workplace bullying is a problem that can occur in any occupation or organization and is a stressful and negative experience for employees; resilience helps employees to better resist workplace bullying. The purpose of this study was to examine whether resilience moderates the effects of workplace bullying on job performance and to determine whether this moderating effect differs between three types of bullying: personal, work-related, and physical bullying.

METHODS

A self-administered, paper-based questionnaire was distributed to full-time nurses at three regional hospitals in Taiwan. Cross-sectional data on workplace bullying behaviors, resilience and job performance were collected from 422 nurses using a questionnaire survey. Data were collected using the Job Performance Scale, the Negative Acts Questionnaire, and the Resilience Scale (CD-RISC-10), and the resulting data were analyzed using SPSS 21 and the PROCESS macro.

RESULTS

Resilience moderated the positive relationship between personal, physical bullying and job performance (b = .11, p < .05; b = .17, p < .05), but did not moderate the effects of work-related bullying.

CONCLUSIONS

The findings of this study highlight the need for organizations to be proactive in preventing work-related bullying and to promote and enhance individual resilience. Managers need to be aware of the detrimental effects of work-related bullying, which can damage employees' physical and mental health and contribute to workplace toxicity.

Bullying and depression among adolescents in East Asia: a scoping review on prevalence rates, risk and protective factors

Introduction

Bullying and victimization in adolescence is associated with mental health problems including depression. Depression in East Asian adolescents presents similarities and differences from that in Western adolescents. This review reports on the prevalence and psychosocial associations of bullying and depression in East Asian adolescents.

Methods

Electronic databases (Medline, and Embase) were searched for English language articles on bullying and its associations for a span of 10 years (1st January 2013 to 19th January 2024). Searches were limited to studies conducted in East Asia involving adolescents 10-19 years of age.

Results

Out of 1,231 articles initially identified, 65 full-text articles (consisting of 44 cross-sectional and 21 cohort studies) met the inclusion criteria and were included for qualitative synthesis & analysis. Prevalence rates of bullying ranged from 6.1% - 61.3% in traditional bullying victimization and 3.3% to 74.6% in cyberbullying victimization with higher rates in at-risk groups (e.g., adolescents with internet addiction). Psychosocial associations of bullying and depression which were similarly found in Western cultures include individual factors of coping style and gender; family factors of functioning and sibling relationships; and community factors of friendship and school-connectedness. In contrast, unique East Asian risk factors included being different (i.e., sexual minority status) and teachers as bullies.

Conclusion

Findings of this scoping review suggest that strong relationships within families, peers and the school community coupled with adolescents' positive coping style are protective against the negative effects of bullying. Conversely, poor parent-child attachment in the midst of family dysfunction, poor engagement with peers and the school community together with low self-esteem predispose East Asian adolescents to depressive symptoms as a result of victimization. Similar to Western cultures, adolescents who are bully-victims and poly-victims are most vulnerable to depression. As a significant proportion of bullying occurred in school, future research could focus on a whole-school intervention approach to counter bullying.

Depression Takes a Toll on Academic Performance: Evidence from Rural Students in China

Purpose

Depression is a growing public health concern around the world. For adolescents, depression not only impedes healthy development, but is negatively associated with academic performance. The purpose of this paper is to examine the prevalence of adolescent depressive symptoms in a sample of rural primary and junior high school students. Additionally, we examine various factors to identify subgroups within the sample that may be more vulnerable to depression. Finally, we explore the extent to which depression correlates with academic performance and conduct a series of heterogeneity analyses.

Patients and Methods

We utilize cross-sectional data derived from 30 schools in underdeveloped regions of rural China encompassing primary and junior high school students (n = 1,609).

Results

We find a high prevalence of depression, with 23% and 9% of students experiencing general depression (depression score ≥ 14) and severe depression (depression score ≥ 21), respectively. Female gender, elevated stress and anxiety levels, boarding at school, exposure to bullying, and having depressed caregiver(s) are positively correlated with depressive symptoms, while high social support exhibits a negative association. Importantly, our analyses consistently show a significantly negative link between depression and academic performance, which is measured using standardized math tests. For instance, transitioning from a non-depressed state to a state of general depression (depression score ≥ 14) is linked to a decline of 0.348-0.406 standard deviations in math scores (p < 0.01). Heterogeneity analyses reveal that this adverse relationship is more pronounced for male students, boarding students, those with lower social support, individuals with more educated mothers, and those with lower family assets.

Conclusion

Our findings underscore the high prevalence of depression in rural schools and the detrimental impact on academic performance. We advocate for the implementation of policies aimed at reducing student depression, particularly within vulnerable populations and subgroups.

The relationship between adverse childhood experiences and depressive symptoms in rural left-behind adolescents: A cross-sectional survey

Objective

We assessed the current status of depressive symptoms and the associated factors in rural left-behind adolescents. Moreover, we investigated the relationship between adverse childhood experiences and depressive symptoms.

Methods

Students from two rural junior high schools in Huaihua City were enrolled from July to September 2022. Before distributing the questionnaires, guardians of the students were contacted, and consent was obtained from the students themselves. The questionnaires were filled out anonymously and collected on-site.

Results

The prevalence of depressive symptoms among the 325 left-behind teenagers was 23.40%; the rate of emotional abuse in adverse childhood experiences was 17.50%, physical abuse was 15.70%, sexual abuse was 9.50%, emotional neglect was 24.60%, while physical neglect was 27.70%. The five dimensions of adverse childhood experiences were associated with depressive symptoms (r = 0.597, 0.395, 0.410, 0.498, 0.741, p < 0.01).

Conclusions

Depressive symptoms were common among rural left-behind adolescents. Adverse childhood experiences were associated with depressive symptoms in rural left-behind adolescents. Occurrence of adverse childhood experiences should be reduced to improve on depressive symptoms.

Resilience mediates the effect of peer victimization on quality of life in Chongqing adolescents: from a perspective of positive childhood experiences

Background

Peer victimization is a harmful experience that contributed to one's psychological problems, physical health deterioration, and so on. Quality of life (QoL) is an important indicator of adolescent health assessment. To identify potential pathways of positive experiences in preventing peer victimization's detrimental effects and then provide intervention ideas for adolescent health, this study was conducted to examine the relationship between peer victimization and QoL in Chongqing adolescents and discover whether resilience plays a mediating role and positive childhood experiences (PCEs) act as a moderating role in the relationship.

Methods

Data were the first follow-up of a cohort study conducted in four complete middle schools in two districts of Chongqing, China. Self-designed peer victimization items, the Connor-Davidson Resilience Scale, the Adolescent Quality of Life Scale, and the Benevolent Childhood Experiences Scale were used. We investigated the differences and correlations in peer victimization, QoL, and resilience between the two PCEs groups. Mplus version 8.3 was used to analyze the mediating role of resilience and the moderating role of PCEs in peer victimization and QoL.

Results

Peer victimization, resilience, and QoL differed between the two PCEs groups (P < 0.001). Peer victimization negatively correlated with QoL and resilience, while resilience positively correlated with QoL (P < 0.001). In the models with total QOL as the dependent variable, the indirect effect was -0.431 (8.08% of the total effect) in the low-PCEs group vs. -2.077 (41.97% of the total effect) in the high-PCEs group. In the models with four dimensions of QOL as the dependent variable, the indirect effects ranged from -0.054 to -0.180 (6.07-12.95% of the total effects) in the low-PCEs group and from 0.295 to -0.823 in the high-PCEs group (35.89-68.76% of the total effects). Both total and indirect effects were significant (P < 0.05). In addition, the differences in indirect effects were significant between the two PCEs groups (P < 0.05), while differences in total and direct effects were almost not apparent.

Conclusion

Resilience partially mediated the effect of peer victimization on QoL in Chongqing adolescents, and PCEs moderated this mediation. Schools, families, and society should focus on resilience intervention and prioritize the enhancement of PCEs for improving adolescent QoL.

Moderating Effects of Mindfulness in the Relation between Bullying Victimization and Sleep Disturbance in Chinese Children: Sex Differences

Bullying victimization is associated with sleep disturbance. The present study aimed to investigate the impact of bullying victimization on sleep disturbance, and the moderating effect of mindfulness on this association, also exploring differences across sex. A sample of 420 Chinese children (Mage = 9.60, SD age = 1.11, 48.10% girls) in grade 3 to grade 6 were recruited to complete the revised Bully/Victim Questionnaire, the Chinese version of Pittsburg Sleep Quality Index, the Child and Adolescent Mindfulness Measure, as well as the Family Affluence Scale. Results showed that bullying victimization was positively associated with sleep disturbance (β = 0.20, p < 0.001). And the effect of bullying victimization on sleep disturbance was moderated by mindfulness (β = -0.16, p < 0.001), and the effect was invalid for children with high mindfulness (β = 0.04, p > 0.05). Subgroup analyses indicated the buffering effect of mindfulness only existed among boys (β = -0.19, p < 0.01) but not girls (β = -0.11, p > 0.05), suggesting that mindfulness may buffer this association, mainly for boys.

Longitudinal associations between traditional and cyberbullying victimization and depressive symptoms among young Chinese: A mediation analysis

BACKGROUND

The impacts of bullying victimization on psychological health are long-lasting. However, the longitudinal mediating processes of the association between being bullied (traditionally and in a cyber context) and depressive symptoms of Chinese youth remain underexplored, including across the sexes.

OBJECTIVE

This study investigated the longitudinal association between bullying victimization and depressive symptoms, including the mediating effects of physical health, healthy lifestyles, sleep quality, and academic achievements. Different pathways from traditional bullying and cyberbullying victimization regarding depressive symptoms were also explored, with a comparison across the sexes.

PARTICIPANTS AND SETTING

Data were obtained from the China Education Panel Survey, and ninth graders aged approximately 15 years constituted the baseline cohort.

METHODS

The baseline data and longitudinal data at two- and five-year follow-ups, respectively, were evaluated to estimate structural equation models.

RESULTS

Baseline traditional bullying and cyberbullying victimization significantly predicted subsequent depressive symptoms at both follow-ups (P < 0.001). Being bullied also predicted worse healthy lifestyles, poorer sleep quality, and lower academic achievements (P < 0.05), all significantly correlated with the development of depressive symptoms (P < 0.001) regarding both bullying victimizations. Physical health was the mediator of the traditional bullying victimization-depressive symptoms linkage (P < 0.05). Female victims have a relatively higher risk of depression versus male victims, with different mediating pathways from victimization to depressive symptoms.

CONCLUSIONS

Our findings strengthen the evidence of a longitudinal association between bullying victimization and depressive symptoms, provide new explanations for mechanisms of mediation, and highlight the importance of long-term comprehensive mental health interventions for victims of bullying.

Did the prevalence of traditional school bullying increase after COVID-19? Evidence from a two-stage cross-sectional study before and during COVID-19 pandemic

BACKGROUND

COVID-19 has had a range of adverse effects on the behavior and mental health of adolescents globally, including bullying, anxiety and depression. However, there is a lack of comparative studies on the changes of school bullying before and during COVID-19 pandemic.

OBJECTIVE

To examine the changes in traditional bullying before and during COVID-19 pandemic and reveal the related risk factors in Shantou, China.

PARTICIPANTS AND SETTING

Two samples of secondary school students were collected in 2018 and 2021 in Shantou, respectively.

METHODS

Bullying history and risk behaviors of students were measured in the past six months. The χ² test was used to analyze differences in baseline information and bullying types. The binary logistic regression with Forward LR method was used to analyze factors that affect the risk of bullying victimization and perpetration before and during COVID-19.

RESULTS

A total of 5782 secondary school students were included, 3071 before COVID-19 pandemic and 2711 during COVID-19. The prevalence of different types of victimization and perpetration all increased during COVID-19 (P < 0.001). Boarding, being a lower secondary school student (as opposed to upper secondary school), being male (as opposed to female), drinking, and playing violent video games were shared risk factors for bullying victimization and perpetration. Living in an urban (as opposed to rural and island) was a risk factor for perpetration. Smoking was a risk factor for perpetration. All differences were statistically significant (P < 0.05).

CONCLUSIONS

We found that the prevalence of bullying victimization as well as perpetration increased during COVID-19. It suggests that we need to pay more attention to traditional school bullying prevention and control in China in the pandemic context.

Individual, Peer, and Family Correlates of Depressive Symptoms among College Students in Hong Kong

In this study, an ecological model and developmental psychopathology theory focusing on an ontogenic system (hopelessness) and microsystems (peer alienation and childhood abuse and trauma) was adopted to examine the individual, peer, and family correlates of depressive symptoms among college Chinese students in Hong Kong, China. A cross-sectional survey research design with a convenience sampling procedure was used to examine a sample of college students (n = 786) aged 18 to 21 years old in Hong Kong. Among them, 352 respondents (44.8%) reported having depressive symptoms, with a Beck Depression Inventory-II (BDI-II) score of 14 or above. The results of this study indicated that childhood abuse and trauma, peer alienation, and hopelessness were positively related to depressive symptoms. The underlying arguments and implications were discussed. The study results provided further support for the ecological model and the developmental psychopathology theory on the predictive roles of individual, peer, and family correlates of adolescent depression.

Bullying Victimization Moderates the Association between Social Skills and Self-Esteem among Adolescents: A Cross-Sectional Study in International Schools

Background. Bullying is a major school problem. Victims of bullying often experience low self-esteem, whereas social skills are positively associated with the level of self-esteem. This research examined whether the victim's condition impacted their social skills and self-esteem. Methods. International school students in Thailand aged 13 to 18 years old completed the Olweus bullying questionnaire, social capital questionnaire (SC), social skills questionnaire (SS), adolescent discrimination index (ADDI), and the Rosenberg self-esteem scale (RSES). Moderation analyses and visual presentations were carried out using IBM SPSS ver. 22 and PROCESS, ver. 4.0. Results. A total of 102 students participated (63% female). The mean age of the participants was 16.57 (SD = 1.42). The number of victims was 16 (15.7%), the mean (SD) for the SC, SS, ADDI, and RSES was 7.82 (2.37), 44.45 (9.40), 12.33 (9.82), and 27.85 (5.31), respectively. As predicted, those with high social skills reported greater self-esteem when they had never been bullied. The moderation effect was significant: B = 0.458, standard error = 0.203, 95% CI = -0.836 to -0.054. Additionally, the ADDI and SC were found to predict self-esteem. Conclusions. The significant moderation effect suggests the importance of identifying the victim's condition when the association between social skills and self-esteem is not observed (as expected) among school adolescents. A longitudinal study to confirm the causal relationship should be encouraged. Further research on providing appropriate interventions along with social skill training for the victim group is warranted.

Resilience in the face of peer victimization and perceived discrimination: The role of individual and familial factors

BACKGROUND

Peer victimization and discrimination are two related forms of social victimization. However, the majority of studies only focus on one form or the other. This study investigates resilience in victims of both these forms of violence.

OBJECTIVE

To identify individual and family level factors that foster, or hinder, resilience in the face of both peer victimization and perceived discrimination.

PARTICIPANTS

In a sample of 2975 high-school students, 22% (n = 644) met the criteria for substantial social victimization. The sample's mean age was 16.5 years, 57% were girls, 19% were in vocational courses, 12% were from an ethnic minority background, and 5% were lesbian, gay, or bisexual.

METHOD

A measure of resilience was created by regressing the mean levels of current mental health, self-esteem, and life satisfaction on the frequency of lifetime peer victimization and past year perceived discrimination. Regression analyses were conducted to identify correlates of resilience considering protective and vulnerability factors, including sociodemographic information, anxious personality, empathy, coping strategies, familial optimism, and the relationship with their mother and father.

RESULTS

Resilience was associated with low anxious personality, four coping strategies (active, use of humor, low self-blame, low substance use), and satisfaction with the relationship with the mother.

CONCLUSIONS

Resilience is related to both behavioral and meaning-making coping strategies, personality traits, and satisfaction in relationships. This study's findings can be used to tailor interventions to foster resilience in adolescents exposed to social victimization.

Coping with Relationship Stress in Adolescence: A Decade in Review

At a moment in history when stress levels among adolescents are high and coping capacities are taxed, it seems timely and important to review a decade's accomplishments in elucidating how, and with what effects, adolescents cope with relationship stress. We provide an update on research about coping with parent, peer, and romantic stress and discuss the effectiveness of coping strategies across cultures, developmental periods, and levels of social stress. We explore relations between coping and other automatic and reflective responses to stress and highlight innovations in lab-based and ambulatory assessments. We recommend studies of variability in the success of coping at different intensities of relationship stress and research with real-time and repeated assessments to capture the process of coping.

Adolescent bullying victimization and psychosomatic symptoms: Can relationship quality with fathers buffer this association?

The present study explored racial/ethnic and sex differences in fathers' awareness and perceived ease of communication with fathers and how they are related to adolescent bullying victimization and psychosomatic symptoms. Data were drawn from the 2009 to 2010 Health Behavior in School-Aged Children study in the United States. The sample consists of 5,121 White, 1,497 African American, and 1,850 Hispanic adolescents in grades 5 to 10. For all three racial and ethnic groups, bullying victimization was positively associated with psychosomatic symptoms. A higher level of the child's perception of their father's awareness was found to be positively associated with lower levels of bullying victimization for White and Hispanic adolescents. African American, White, and Hispanic adolescents who perceived their fathers as easy to communicate with had a lower risk of bullying victimization. The child's perception of their father's awareness buffered the positive association between bullying victimization and psychosomatic symptoms for Hispanic adolescents. A higher child's perception of their father's awareness was related to lower bullying victimization for adolescents of both sexes. The child's perception of their father's awareness and their perceived ease of communication with their father were found to be associated with a decreased risk of psychosomatic symptoms for both sexes. Overall, the results support the importance of relationship quality with fathers as a protective factor against bullying victimization.

Perceived friend support buffers against symptoms of depression in peer victimized adolescents: Evidence from a population-based cohort in South Korea

BACKGROUND

Peer victimization is associated with an increased risk for depression, but there is less evidence on how certain factors such as friend support can buffer this association. This study investigated the associations between friend support and depressive symptoms among victimized and non-victimized adolescent girls and boys from South Korea.

METHODS

Participants includes 2258 students from the Korean Children and Youth Panel Survey, a nationally representative sample of middle school students in South Korea. Self-reported perceived friend support, depressive symptoms and peer victimization were measured using validated scales during middle school year 3 (mean age= 15.7 years).

RESULTS

The association between peer victimization and depressive symptoms varied by sex (p for sex by peer victimization interaction<0.05). Peer victimization was more strongly associated with same year depressive symptoms in girls (β=0.55) than boys (β=0.24). After controlling for key confounders, including prior year mental health symptoms, higher levels of friend support were found to attenuate the association between peer victimization and depressive symptoms (p for friend support by peer victimization interaction <0.05). Peer victimization was associated with more depressive symptoms for adolescents with low and moderate friend support, but not those with high friend support.

LIMITATIONS

Peer victimization, depressive symptoms, and friend support, were self-reported and measured the same year.

CONCLUSIONS

Friend support protects victimized South Korean adolescents from the negative effect of peer victimization on depressive symptoms, hence contributes to closing the gap in depression between victimized and non-victimized adolescents.

Parental Behavioral Control and Bullying and Victimization of Rural Adolescents in China: The Roles of Deviant Peer Affiliation and Gender

Bullying and victimization (BAV) have been widely studied, but the potential mechanism of parental behavioral control (PBC) on bullying and victimization in Chinese adolescents has not been explored. This study aimed to examine a moderated mediation model for the association between PBC and BAV mediated by deviant peer affiliation (DPA) and moderated by gender. A total of 3779 adolescents (N_boy = 1679, M_age = 14.98 years, SD = 0.95) from southwest China has completed the Peer Bullying, Peer Victimization, PBC, and DPA questionnaires. The results indicated that: (1) PBC significantly predicted adolescents’ BAV (−12%); (2) DPA mediated the effect of PBC on BAV only for those adolescents who were both bullies and victims; (3) the mediating role of DPA was moderated by gender only in the relationship between PBC and victimization, with a relatively stronger effect in girls than in boys.

Depression, anxiety and associated factors among Chinese adolescents during the COVID-19 outbreak: a comparison of two cross-sectional studies

The 2019 coronavirus disease (COVID-19) is a public health emergency of international concern. In China, all schools were shut down and students were home quarantined to prevent disease spread; these steps could have potential negative effects on mental health of adolescents. This study aimed to examine changes in depression and anxiety among Chinese adolescents during the COVID-19 epidemic, and explore factors associated with depression and anxiety. Two survey administrations were conducted among Chinese adolescents between February 20 and February 27 and between April 11 and April 19, 2020, respectively. The Center for Epidemiological Studies-Depression Scale (CES-D) and the 7-item Generalized Anxiety Disorder (GAD-7) scale were used to assess depressive symptoms and anxiety symptoms, respectively. A total of 9554 and 3886 adolescents participated in the first and second surveys. During the initial survey, the prevalence of depression was 36.6% (95% CI: 35.6-37.6%) while the prevalence of anxiety was 19% (95% CI: 18.2-19.8%). Rates of depression and anxiety increased to 57.0% (95% CI: 55.4-58.6%) and 36.7% (95% CI: 35.2-38.2%), respectively, in the second survey. Multivariable logistic regression analyses revealed that group membership in the second survey, female gender, senior secondary school enrollment, and concerns about entering a higher grade were positively associated with both depression and anxiety. Conversely, a sleep duration of ≥6 h/day, an exercise duration ≥30 min/day, having the same as typical or higher study efficiency during the COVID-19 outbreak, and living in provinces with 1000-9999 confirmed COVID-19 cases were negatively associated with depression and anxiety. In conclusion, compared to figures reported during the COVID-19 outbreak, the prevalence of depression and anxiety in Chinese adolescents significantly increased after the initial outbreak. Regular screening and appropriate interventions are urgently needed to reduce the risk for emotional disturbances among adolescents during and after the initial COVID-19 outbreaks.

Association of Childhood Intrafamilial Aggression and Childhood Peer Bullying With Adult Depressive Symptoms in China

IMPORTANCE

Childhood intrafamilial aggression, a series of aggressive behaviors inflicted by family members, and adulthood mental health are associated with childhood peer bullying (eg, in the neighborhood or in school). However, few studies have been able to identify the contribution of childhood peer bullying to the association between childhood intrafamilial aggression and adult depression.

OBJECTIVE

To examine the mediating role of childhood peer bullying in the association between childhood intrafamilial aggression and depression in adulthood.

DESIGN, SETTING, AND PARTICIPANTS

This population-based cross-sectional study used data from the China Health and Retirement Longitudinal Study (CHARLS). Middle-aged and older adults (≥45 years) participated in a CHARLS wave from July 1 to September 30, 2015, and the CHARLS life history survey from June 1 to December 31, 2014, with complete data. A 4-step mediation model with logistic regression was run to test the mediating role of peer bullying. Data analysis was performed from October 1 to 30, 2019.

EXPOSURES

Childhood intrafamilial aggression, including parental physical maltreatment and sibling aggression, and peer bullying.

MAIN OUTCOMES AND MEASURES

Depressive symptoms measured by a categorical variable derived from the Center for Epidemiologic Studies Depression Scale, based on a cutoff score of 12.

RESULTS

Among the 15 450 respondents (mean [SD] age, 59.5 [9.9] years; 7987 women [51.7%]), 4422 (28.6%) were exposed to parental physical maltreatment; 986 (6.4%), to sibling aggression; and 2504 (16.2%), to peer bullying in childhood. Respondents experiencing intrafamilial aggression were more likely to be bullied by peers (parental physical maltreatment odds ratio [OR], 2.53 [95% CI, 2.25-2.83]; sibling aggression OR, 3.05 [95% CI, 2.46-3.78]). Children with these adverse experiences were at a higher risk of adult depression symptoms (parental physical maltreatment OR, 1.28 [95% CI, 1.15-1.42]; sibling aggression OR, 1.40 [95% CI, 1.13-1.74]; peer bullying OR, 1.78 [95% CI, 1.56-2.01]). Peer bullying mediated 30% (95% CI, 19%-42%) of the association between childhood parental maltreatment and adult depression and 35% (95% CI, 15%-54%) of the association between sibling aggression and depression symptoms in adulthood.

CONCLUSIONS AND RELEVANCE

This study found that being bullied by peers was a mediator of the association between childhood intrafamilial aggression and depression in adulthood. The findings have important implications to mitigate the effect of early-life stress and promote life-course mental health through dealing with childhood intrafamilial aggression and peer bullying experiences coordinately.

Using a Mixed-Methods Approach to Analyze Traumatic Experiences and Factors of Vulnerability Among Adolescent Victims of Bullying

A number of studies have analyzed the bullying phenomenon among adolescent victims. Relatively few studies, however, have specifically addressed the associated post-traumatic stress disorder (PTSD). Our clinical practice and therapeutic encounters with adolescents reveal that the majority of bullied adolescents suffer from high levels of PTSD. The objective of this study is to further explore bullied adolescents' traumatic experiences. In an attempt to analyze these experiences, this article presents a mixed-methods approach. Such an approach will allow to analyze the PTSD that results from bullying as well as subjects' psychic and family-relevant vulnerabilities. First, bullying will be defined in the context of adolescence. Then the main studies on bullying will be presented. The objectives, tools and methods of analysis will be presented. The interviews will be analyzed according to the Interpretative Phenomenological Analysis (IPA) method. Projective tools, family drawings, Rorschach and Thematic Apperception Test (TAT), will be analyzed using a psychoanalytic interpretation method. Each qualitative tool will be used alongside a validated quantitative tool. The Clinical Administered PTSD Scale (CAPS-CA-5 questionnaire) and the interviews conducted will thus allow to analyze PTSD and traumatic experiences. The Family Assessment Device (FAD) and the family drawing test will enable to assess family functioning; lastly, the Symptom Check List (SCL-90) that will be used alongside Rorschach and TAT tests will allow to analyze individual psychological vulnerabilities. This approach will increase data validity. The originality of this research study is based on a mixed-methods approach, our methodology which is based on clinical psychology, and the choice of certain research tools which have received little attention to date. Ultimately, this study may help improve how bullying is identified and could contribute toward the reinforcement or revision of the criteria that characterize bullying. Lastly, it may help us explore various unexamined dimensions of bullying. A possible limitation is the complexity associated with such a protocol.

Family acceptance, peer support, and HIV serostatus disclosure of MSM-PLWHA in Medan, Indonesia

OBJECTIVE

This study was conducted to determine the correlation between family acceptance and HIV serostatus disclosure, and the correlation between peer support and HIV serostatus disclosure.

METHODS

This was a quantitative study with a cross-sectional design involving 176 MSM-PLWHA (Men who have sex with men-people living with HIV and AIDS). Instruments used in this study is Brief Scale of HIV disclosure, perceived acceptance scale, and peer group caring interaction scale.

RESULTS

The analysis showed a significant correlation between peer support and HIV serostatus disclosure (p-value 0.011), but there was no significant correlation between family acceptance and HIV serostatus disclosure (p-value 0.979).

CONCLUSION

Peer support affects HIV serostatus disclosure in MSM-PLWHA. Peer group interventions need to be improved. Providing systematic peer group support for MSM-PLWHA and integrating intervention with peer support might need to be done for the next care plan for MSM-PLWHA in Medan, Indonesia.

Adolescent non-suicidal self-injury and its relationships with school bullying and peer rejection

The central goal of this study was to examine the associations of school bullying and peer rejection with non-suicidal self-injury (NSSI), as well as their interactive role in a sample of non-clinical adolescents. Six hundred and forty adolescents (253 Males, M_age = 15.60, SD = 1.65) self-reported measures of school bullying and NSSI and provided sociometric ratings of peer rejection. The results showed that being involved in bullying (as bullies, victims, or bully-victims) increases the likelihood to engage in NSSI; being rejected by peers amplifies the probability, for victims and bully-victims, of using NSSI at least once. The findings support the hypothesis that peer relationships play a key-role in determining NSSI and the importance to implement programs aimed to improve the school climate in order to avoid maladjusted behaviors in adolescence.

Poor Dietary Habits in Bullied Adolescents: The Moderating Effects of Diet on Depression

The prevalence of bullying has increased dramatically during recent years, with numerous negative consequences for the health and quality of life of bullied adolescents. Although negative psychological consequences of this type of situation have been widely investigated, no previous research has evaluated the effects of bullying victimization on dietary habits, and its relationship with psychological outcomes, such as depression. For this reason, the main aim of the present study was to evaluate the association between bullying, dietary habits, and depression in a sample of 527 Spanish adolescents. The results obtained showed that being bullied was correlated negatively with healthy dietary habits and positively with depression. Moderation analysis revealed dietary habits as moderator of the association between bullying and depression. These results underline the relevance of diet in the phenomenon of bullying, especially in victims, as could be related to the high levels of depression characteristic of this population. The inclusion of nutritional education in intervention programs oriented to victims of bullying might significantly improve their efficacy, reducing depression levels.