Long term economic impact associated with childhood bullying victimisation

Social anxiety moderates the association between adolescent irritability and bully perpetration

BACKGROUND

Preliminary work suggests anxiety moderates the relationship between irritability and bullying. As anxiety increases, the link between irritability and perpetration decreases. We hypothesize that any moderation effect of anxiety is driven by social anxiety symptoms. We sought to explicate the moderating effect of anxiety, while clarifying relations to other aggressive behaviors.

METHODS

A sample of adolescents (n = 169, mean = 12.42 years of age) were assessed using clinician rated assessments of anxiety, parent reports of irritability and bullying behaviors (perpetration, generalized aggression, and victimization). Correlations assessed zero-order relations between variables, and regression-based moderation analyses were used to test interactions. Johnson-Neyman methods were used to represent significant interactions.

RESULTS

Irritability was significantly related to bullying (r = .403, p < .001). Social, but not generalized, anxiety symptoms significantly moderated the effect of irritability on bully perpetration (t(160) = -2.94, b = -.01, p = .0038, ΔR2 = .0229, F(1, 160) = 8.635). As social anxiety symptoms increase, the link between irritability and perpetration decreases.

CONCLUSIONS

Understanding how psychopathology interacts with social behaviors is of great importance. Higher social anxiety is linked to reduced relations between irritability and bullying; however, the link between irritability and other aggression remains positive. Comprehensively assessing how treatment of psychopathology impacts social behaviors may improve future intervention.

Parental Risk and Protective Factors Associated with Bullying Victimization in Children and Adolescents: A Systematic Review and Meta-analysis

The main objective of this meta-analysis was to investigate how modifiable parental factors are related to traditional and cyberbullying victimization in children and adolescents. A systematic literature search of modifiable parental factors associated with bullying victimization was conducted using PubMed, PsycINFO, Scopus, and Web of Science electronic databases. Meta-analyses were performed to assess the mean effect sizes of the associations between the broader categories of parental factors (risk and protective) and bullying victimization (traditional and cyber), as well as between specific parental factors and bullying victimization (traditional and cyber). The differential impact of maternal and paternal factors (risk and protective) was examined. Age and gender were tested as moderators. Out of the 13,171 records identified, 158 studies met the inclusion criteria. Larger evidence was found for the association between parental risk (i.e., authoritarian parenting, aversiveness, inter-parental conflict, over-involvement, permissive parenting, and withdrawal) and protective (i.e., authoritative parenting, autonomy granting, warmth, and monitoring) factors, respectively, and traditional bullying victimization, with parental warmth, aversiveness, and withdrawal being the only common related predictors for traditional and cyberbullying victimization. The effect sizes were generally small. Maternal and paternal factors showed similar patterns of association with both types of bullying victimization. Age had a moderating effect on the association between parental protective factors and cyberbullying victimization. Overall, the present findings suggest that parental factors are relevant in protecting or putting children at risk for bullying victimization, especially in the offline context.

Building Resilience: A Qualitative Analysis of Bullying Among Children with Disabilities on Parental and Teacher's Perspective

Background

Bullying can happen to every human in the community, including children with disability and their families. Children with disabilities, as a vulnerable group in a community, may experience different types of bullying and have different responses to it.

Purpose

This study aimed to identify bullying experiences in children with disabilities based on teachers' and parents' perspectives.

Methods

This study used a qualitative descriptive research design. Participants in this study consisted of two groups, namely parents and teachers in Special Schools, with 18 people (eight parents and ten teachers) in the Pangandaran Regency area, Indonesia, from May to June 2023. The sampling technique chosen was purposive sampling. The data collection process used Focused Group Discussion (FGD) throughout the semi-structured interview. The data was analyzed by thematic analysis. This study applied NVIVO 12 software to assist with data categorization and framework based on participant statements and observations (QSR International).

Results

The data from the discussion were analyzed using thematic analysis methods to find relevant themes were found in the statements expressed by the participants. The results of the data analysis obtained three main themes related to bullying in children with disabilities, namely the type of bullying, the impact of bullying, and the responses to bullying.

Conclusion

A support group is necessary to establish a source of parental coping and increase resilience in caring for children with special needs.

Do classroom relationships moderate the association between peer defending in school bullying and social-emotional adjustment?

Peer defending has been shown to protect bullied peers from further victimization and social-emotional problems. However, research examining defending behavior has demonstrated positive and negative social-emotional adjustment effects for defending students themselves. To explain these mixed findings, researchers have suggested that associations between defending behavior and social-emotional adjustment may be buffered by protective factors (i.e., defender protection hypothesis) or exacerbated by vulnerability or risk factors (i.e., defender vulnerability hypothesis). Consistent with these hypotheses, the present study aimed to investigate whether relationships with teachers and peers would moderate the association between defending behavior and social-emotional adjustment. This three-wave longitudinal study examined the association between peer nominated defending behavior and later self-reported depressive symptoms and self-esteem in 848 Belgian students in Grades 4-6 (53% girls; Mage = 10.61 years, SD = 0.90 at Wave 1). Peer nominated positive and negative teacher-student relationships (i.e., closeness and conflict) and peer relationships (i.e., acceptance and rejection) were included as moderators. Clustered multiple linear regression analyses demonstrated that defending behavior did not predict later depressive symptoms (β = -0.04, p = .80) or self-esteem (β = -0.19, p = .42). The lack of these associations could be explained by the defender protection and vulnerability hypotheses. However, contrary to our expectations, teacher-student closeness and peer acceptance did not play a protective role in the association between defending behavior and social-emotional adjustment (β = -1.48-1.46, p = .24-0.96). In addition, teacher-student conflict and peer rejection did not put defending students at risk for social-emotional maladjustment (β = -1.96-1.57, p = .54-0.97). Thus, relationships with teachers and peers did not moderate the association between defending behavior and later depressive symptoms and self-esteem.

Childhood Adversities and Caregiving for Older Parents: Building Capacity for a Caring Society

OBJECTIVES

This study investigates the relationships between childhood adversities and the provision of informal care for older parents in later life in China.

METHODS

The data came from 4 waves of the China Health and Retirement Longitudinal Study (N = 20,047). Using multilevel logistic regression models, we examined the relationships between adverse experiences in childhood and both the propensity and intensity of caregiving for older parents. Drawing on the regression results, we then estimated the total number of caregivers for older parents in China.

RESULTS

Experiencing 1 additional childhood adversity was associated with a decrease of 8% in the odds of providing informal care (p < .001). The association between childhood adversity and caregiving remained significant after sociodemographic factors and later-life outcomes were controlled for. We estimated that 58.3 million middle-aged adults in China were providing care for parents in 2020. Had people experienced 1 fewer adversity in their childhood, there would have been 2.2 million more caregivers in 2020. Had they experienced 2 fewer adversities, there would have been 3.4 million more caregivers.

DISCUSSION

The factors associated with informal caregiving can be traced back to early-life experiences. To address the shortage of informal care supply, it is crucial to foster a caring culture from the very beginning of human development.

From childhood bullying victimization to resilience in emerging adulthood

INTRODUCTION

The aim of this study was to explore how resilience is manifested in the experiences of emerging adults who were subjected to bullying victimization in school and have high levels of psychological functioning in emerging adulthood.

METHODS

Fifteen Swedish emerging adults (Mage = 29.13, SD = 0.52) who, despite experiences of bullying victimization at age 10, had high levels of psychological functioning as emerging adults were interviewed. The interviews focused on experiences of bullying victimization and the long-term outcomes of these experiences. Qualitative methods were used in the analysis, with a specific focus on resilience.

RESULTS/CONCLUSION

The findings illustrate how long-term outcomes of bullying victimization in school, in relation to resilience, comprise a dynamic process between personal agency and social resources in the environmental context.

Bullying at School and Students' Learning Outcomes: International Perspective and Gender Analysis

The present study empirically investigates how school-based bullying victimization affects students' learning outcomes, taking into consideration international and gender perspectives. The main objective of the present research is to provide a better understanding of the consequences of bullying victimization in the learning process of adolescents. We estimate a statistical function that empirically establishes the relationship between the students' outcomes in mathematics, reading, and science (output) and a wide set of explanatory variables (educational factors), one of which is that of being bullied. The present study uses a large sample of 612,004 students between 15 and 16 years old, attending 21,903 schools in 79 countries. The data come from the 2018 round of the Programme for International Student Assessment. The results indicate that bullying victimization is associated with decreases in academic achievement in mathematics, reading, and science. In addition, no relevant differences by gender are observed in reading and science but, other factors being equal, bullied males score less than bullied females in mathematics.

Bullying victimization and bullying perpetration, social anxiety, and social withdrawal in Portuguese adolescents: A reciprocal association model

Further research is needed to clarify the association of the different forms of bullying with social anxiety and social withdrawal over time in adolescents. This two-wave panel study with a 1-year time lag (October 2021-October 2022) examined the cross-lagged relationships between bullying victimization and bullying perpetration, social anxiety (i.e., fear or distress in social situations), and social withdrawal (i.e., consistent, and deliberate social solitude). Participants were 485 middle school students (234 girls) attending the seventh or eighth grade at Time 1 (T1) (Mage = 12.67 years, SD = 1.14 years). Social anxiety and social withdrawal were assessed using subscales of the Social and Emotional Competencies Evaluation Questionnaire. Bullying perpetration and bullying victimization were assessed using the Bullying and Cyberbullying Behavior Questionnaire-Short Form. The within-wave associations between the study variables were similar at T1 and Time 2 (T2), with the exception that the association between bullying perpetration and social anxiety was much weaker at T1 than at T2. The results of the path analysis showed that T1 bullying perpetration predicted T2 social anxiety, and that T1 bullying victimization predicted T2 social withdrawal. We also found a reciprocal relationship between social anxiety and social withdrawal. These findings highlight the importance of preventive and remediation interventions to reduce social anxiety in adolescents who engage in and experience bullying behavior.

The adult consequences of being bullied in childhood

Most studies examining the impact of bullying on wellbeing in adulthood rely on retrospective measures of bullying and concentrate primarily on psychological outcomes. Instead, we examine the effects of bullying at ages 7 and 11, collected prospectively by the child's mother, on subjective wellbeing, labour market prospects, and physical wellbeing over the life-course. We exploit 12 sweeps of interview data through to age 62 for a cohort born in a single week in Britain in 1958. Bullying negatively impacts subjective well-being between ages 16 and 62 and raises the probability of mortality before age 55. It also lowers the probability of having a job in adulthood. These effects are independent of other adverse childhood experiences.

A web-enabled, school-based intervention for bullying prevention (LINKlusive): a cluster randomised trial

Background

There is a need for more sustainable interventions and for assessing the effectiveness of school-based universal anti-bullying programmes in vulnerable populations. We assessed the efficacy of a multicomponent, web-enabled, school-based intervention that aims to improve school climate and reduce bullying (LINKlusive) relative to conventional practices (control condition).

Methods

We conducted a cluster randomised controlled trial in primary and secondary schools in Madrid, Spain. The primary outcome measure was peer-reported bullying victimisation after the 12-week intervention (study endpoint). We analysed data using longitudinal mixed-effects models. The trial was registered with the ISRCTN registry (15719015).

Findings

We included 20 schools (10 in each group); 6542 students participated at baseline; 6403 were assessed at study endpoint. After the intervention, there was a statistically significant reduction in bullying victimisation in both the intervention (OR 0.61, 95% CI [0.41, 0.90]) and control groups (OR 0.69, 95% CI [0.51, 0.92]), with no evidence of differences in the whole sample (OR 0.89, 95% CI [0.58, 1.36]; aOR 0.89, 95% CI [0.58, 1.37]). Subgroup analyses showed a statistically significant effect of LINKlusive on bullying victimisation in primary education (aOR 0.68, 95% CI [0.47, 0.98]). In students with peer-reported bullying victimisation at baseline, LINKlusive showed a statistically significant effect on depression (-1.43, 95% CI [-2.46, -0.40], adjusted standardised mean difference (SMD) -0.41) and quality of life (2.18, 95% CI [0.80, 3.56], adjusted SMD 0.45).

Interpretation

LINKlusive could be effective in reducing bullying victimisation in primary school students. Sustainable whole-school interventions to promote mental health and reduce risk factors are warranted to improve outcomes in young people, especially in the early years of education.

Funding

Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation.

The Differential Effects of Childhood and Chronic Bullying Victimization on Health and Risky Health Behaviors

We examine the heterogeneous effects of childhood bullying victimization and chronic bullying victimization on a wide range of outcomes using data from the National Longitudinal Survey of Youth in the United States. Bullying victimization is categorized as childhood or chronic depending on the duration of victimization. We find that bullying victimization negatively affects the physical and mental health of youths, and increases the likelihood of engaging in risky behaviors, such as, smoking and marijuana use. The adverse effects tend to increase in magnitude with chronic bullying victimization. In addition, chronic bullying victimization increases the likelihood of utilizing mental health services and experiencing life-disrupting emotional problems in adulthood.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-023-00542-0.

Association of childhood bullying victimisation with suicide deaths: findings from a 50-year nationwide cohort study

BACKGROUND

Bullying victimisation has been associated with increased risk of suicide ideation and attempt throughout the lifespan, but no study has yet examined whether it translates to a greater risk of death by suicide. We aimed to determine the association of bullying victimisation with suicide mortality.

METHODS

Participants were drawn from the 1958 British birth cohort, a prospective follow-up of all births in 1 week in Britain in 1958. We conducted logistic regressions on 14 946 participants whose mothers reported bullying victimisation at 7 and 11 years with linked information on suicide deaths through the National Health Service Central Register.

RESULTS

Fifty-five participants (48 males) had died by suicide between the age 18 and 52 years. Bullying victimisation was associated with suicide mortality; a one standard deviation increases in bullying victimisation linked to an increased odds for suicide mortality [odds ratio (OR) 1.29; 1.02-1.64] during adulthood. The OR attenuated by 11% after adjustment for individual (e.g. behavioural and emotional problems) and familial characteristics (e.g. adverse childhood experiences, 1.18; 0.92-1.51). Analysis of bullying victimisation frequency categories yields similar results: compared with individuals who had not been bullied, those who had been frequently bullied had an increased odds for suicide mortality (OR 1.89; 0.99-3.62).

CONCLUSION

Our study suggests that individuals who have been frequently bullied have a small increased risk of dying by suicide, when no other risk factors is considered. Suicide prevention might start in childhood, with bullying included in a range of inter-correlated vulnerabilities encompassing behavioural and emotional difficulties and adverse experiences within the family.

A Systematic Review of Resilience Factors for Psychosocial Outcomes During the Transition to Adulthood Following Childhood Victimisation

Exposure to childhood victimisation (i.e. abuse, neglect, domestic violence or bullying) can detrimentally impact later psychosocial adjustment. However, this is not the case for all victimised children; some do well despite their experiences and are considered to be resilient. Understanding the factors associated with such resilience is important to inform interventions to support better psychosocial outcomes among victimised children. This review provides an overview of the extant research examining resilience factors for psychosocial outcomes during the transition to adulthood following exposure to childhood victimisation. Studies were identified through a systematic literature search of Embase, PsychINFO and Ovid MEDLINE databases. The 26 included studies spanned a range of psychosocial outcomes between ages 18-25, including education and work, housing and independent living, criminal behaviour, victimisation, and social and psychological adjustment. For each outcome, a variety of putative resilience factors had been investigated including those related to the individual, their family and the wider community within which they lived. However, because few studies had comparable resilience factors and psychosocial outcomes, it is difficult to draw conclusions about which factors are consistently associated with resilience to a particular psychosocial outcome. Additionally, this review revealed that the included studies were of variable methodological quality - many were limited by cross-sectional designs with retrospective self-reports of childhood victimisation, and convenience or unrepresentative samples. In this review, we also highlight gaps in knowledge about the co-occurring impact of multiple resilience factors in combination and the need for studies conducted in non-Western and low- and middle-income countries.

Childhood family risks and mental health of older adults in China: The moderating effect of age

Introduction

Childhood family risks (CFRs) are believed to have long-arm effects on people's mental health. However, it is unclear whether age can alleviate these long-arm effects.

Aim

This study aimed to explore the relationship between CFRs and the mental health of older adults (mean [M] = 62.10, standard deviation [SD] = 8.02) in China and investigate whether age could moderate this relationship.

Methods

This cross-sectional, survey-based study used data from the Chinese General Social Survey conducted in 2015, and the data of 4,237 respondents were included in the final analysis. Mental health was measured by two items, namely negative and positive emotions. The step-by-step regression procedure and moderation analysis technique were used.

Results

For older adults in China, CFRs were significantly negatively associated with their mental health (β = -0.046, t = -2.690, p < 0.01), age was positively correlated with their mental health (β = 0.115, t = 7.157, p < 0.01), and age significantly moderated the relationship between CFRs and mental health (β = 0.277, t = 2.172, p < 0.05). As age increases, the correlation between CFRs and mental health decreases, and when age is one SD above the M, CFRs are no longer significantly associated with the mental health level (b _simple = -0.01, t = -0.077, p > 0.05).

Conclusion

This study showed that CFRs were negatively associated with the mental health level of older Chinese adults, and age could significantly moderate the association. Therefore, it is essential to take preventive measures in advance to protect people's mental health and teach older adults to use emotion-regulation techniques to weaken the association between CFRs and mental health.

Parents' Self-reported Changes in Concern About Children's Bullying-Fall ConsumerStyles and Estilos Surveys, United States, 2020

Bullying is a type of youth violence and an adverse childhood experience that can result in trauma and have immediate and long-term consequences for all involved. It can happen at school or elsewhere - including online entertainment and social and learning environments. Some children are at increased risk for bullying victimization, such as those targeted because of their racial/ethnic background or cultural identity. This study assessed U.S. parents and caregivers' self-reported changes in concern about their children's involvement in bullying during Fall 2020 compared to the prior year, which was marked by extraordinary historical circumstances (e.g., COVID-19 pandemic, heightened awareness of racial inequities, schools transitioning to virtual learning). Secondary analyses of data from the 2020 Fall ConsumerStyles and Estilos online panel surveys - designed to be representative of U.S. adults overall and U.S. Hispanic adults, respectively - were conducted. Differences by children's type of school attendance (i.e., physically at school or not) and parents' sociodemographic characteristics were explored. While findings suggest that U.S. parents' concern for their children being bullied during Fall 2020 compared to the prior year did not change, significant differences were found by the children's type of school attendance and the parents' race/ethnicity - with increased concern among parents of children who physically attended school, non-Hispanic Black parents and Hispanic parents. Among parents who reported being less concerned during Fall 2020 about their children being bullied compared to the prior year, not being physically at school is noted as the main reason why. Parents who reported being more concerned frequently noted racism as the reason why. It is imperative to understand what parents think about bullying, to best inform efforts to support their key role in bullying prevention.

Educational achievement and bullying: The mediating role of psychological difficulties

BACKGROUND

Bullying has a profound and enduring impact on academic achievement. However, there is a lack of clarity surrounding the specific mechanisms of this relationship.

AIMS

This study examined the link between bullying at age 9 and Numeracy/Literacy achievement at age 15 to determine if this relationship is partially or fully explained by psychological difficulties at age 13.

SAMPLE

Secondary data analysis was completed on waves 1, 2 and 3 of child cohort (Cohort'98) of the Growing Up in Ireland (GUI) study, respectively, at 9 years (N = 8568), 13 years (N = 7527) and 15 years of age (N = 6216).

RESULTS

Longitudinal path mediation model was conducted with bullying at age 9 as the predictor, total (emotional and behavioural) difficulties at age 13 as the mediator and Numeracy/Literacy scores at age 15 as outcomes revealing significant indirect effects of bullying on achievement, via psychological difficulties.

CONCLUSIONS

We discuss the impact of bullying on the student's psychological well-being, the relationship between bullying and academic attainment and how this may be tackled to avoid consequences throughout education and later in life.

EDUCATIONAL IMPACT AND IMPLICATIONS

This study emphasizes the need for schools to address the emotional and behavioural difficulties occurring as a result of bullying in order to improve the overall educational experience of a child. Existing interventions can be built upon by focusing on the continuous remediation of such psychological difficulties.

How does the school built environment impact students' bullying behaviour? A scoping review

RATIONALE

School bullying is a public health concern affecting the physical and mental health of children and young people. While school-based interventions to prevent bullying have been developed internationally, the effectiveness of many interventions has been mixed and modest. Despite a growing recognition that the school built environment may impact bullying behaviour, few anti-bullying interventions have addressed the built environment.

OBJECTIVE

This systematic scoping review explored existing literature for evidence that the school built environment influences bullying behaviour in school students.

METHODS

The review was guided by Arksey and O'Malley's methodological framework for scoping reviews. A search of six databases (Medline, PsycINFO, ERIC, EMBASE, CINAHL Plus and The Cochrane Library) identified studies addressing primary, middle and secondary school students, bullying, school bullying locations, and school built environments. Peer-reviewed journal articles published in English prior to July 19, 2021, were included.

RESULTS

In total, 7568 documents were screened by title and abstract. Following a full-text review, 61 studies (63 articles) were selected; 43 studies identified school bullying locations, and 19 studies linked features of the school built environment to bullying behaviour. Classrooms, playgrounds, and corridors were identified as common bullying locations. Features of the school built environment linked to bullying behaviour included security cameras, architectural design, aesthetics, seating, and vandalism.

CONCLUSIONS

This review identified key school settings for anti-bullying interventions and identified gaps in existing built environment and bullying literature. Further analyses of published studies will inform anti-bullying policy and practice.

School Built Environments and Bullying Behaviour: A Conceptual Model Based on Qualitative Interviews

Interest in how the school built environment impacts bullying behaviour has gained momentum in recent years. While numerous studies have identified locations within schools where bullying frequently occurs, few studies have investigated the potential conceptual pathways linking school locations to bullying behaviour. This study aimed to (i) identify school built environment factors that may prevent or facilitate bullying behaviour in primary and secondary schools; and (ii) develop a conceptual model of potential pathways between the school built environment and bullying behaviour for future anti-bullying intervention research. Seventy individual semi-structured interviews were conducted between May and December 2020, with policymakers (n = 22), school staff (n = 12), parents (n = 18), and students (n = 18). School staff, parents and students, were recruited from six metropolitan primary and secondary schools in Perth, Western Australia. Interviews were conducted online and face-to-face using semi-structured interview guides. A thematic analysis was undertaken. Participants identified school bullying locations (e.g., locker areas, bathrooms, corridors) and built environment factors linked to bullying behaviour via (i) visibility and supervision; (ii) physical and psychological comfort and safety; and (iii) social-emotional competencies. The findings have policy and practice implications regarding the design of school built environments to prevent bullying behaviour.

The Adverse Childhood Experiences - International Questionnaire (ACE-IQ) in community samples around the world: A systematic review (part I)

BACKGROUND

The Adverse Childhood Experiences International Questionnaire (ACE-IQ) collects additional data (e.g., witness community violence/terrorism) than the previous version. Despite ACE-IQ is widely used and validated in several languages, no reviews focus on this measure.

OBJECTIVE

The main goals are to: 1) synthesize the ACE-IQ prevalence rates and average means among community samples, both for total ACE and single dimensions (e.g., intrafamily abuse, bullying); 2) discuss these data in light of the characteristics of studies and samples; 3) identify main research lines of the field.

PARTICIPANTS AND SETTING

The search for studies using the ACE-IQ with community participants was conducted on seven academic databases, including retrieval of grey literature. The screening process led to include 63 documents.

METHODS

A systematic review following the PRISMA guidelines was performed.

RESULTS

1) On average, 75% of community respondents experienced ACEs, with a mean of three, primarily emotional abuse and bullying. 2) Males experienced more ACEs, but they were underrepresented, as well as children and adolescents. Most studies were conducted in Asia or Africa, and different geographical areas showed different pathways of prevalence in subdimensions. 3) Most research focused on prevalence and relationships between ACE-IQ scores and respondents' mental and physical health, suicide and parenting, focusing on intrafamily ACEs more than on those outside the household.

CONCLUSIONS

Several issues emerged in terms of lack of reporting prevalence or means, lack of studies in Europe, America and Oceania, and no attention to collective/community/peer violence, plus a lack of consensus toward the dimensions of the ACE-IQ.

The UK stand together trial: protocol for a multicentre cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of KiVa to reduce bullying in primary schools

Background

Reducing bullying is a public health priority. KiVa, a school-based anti-bullying programme, is effective in reducing bullying in Finland and requires rigorous testing in other countries, including the UK. This trial aims to test the effectiveness and cost-effectiveness of KiVa in reducing child reported bullying in UK schools compared to usual practice. The trial is currently on-going. Recruitment commenced in October 2019, however due to COVID-19 pandemic and resulting school closures was re-started in October 2020.

Methods

Design: Two-arm pragmatic multicentre cluster randomised controlled trial with an embedded process and cost-effectiveness evaluation.

Participants: 116 primary schools from four areas; North Wales, West Midlands, South East and South West England. Outcomes will be assessed at student level (ages 7–11 years; n = approximately 13,000 students).

Intervention: KiVa is a whole school programme with universal actions that places a strong emphasis on changing bystander behaviour alongside indicated actions that provide consistent strategies for dealing with incidents of bullying. KiVa will be implemented over one academic year.

Comparator: Usual practice.

Primary outcome: Student-level bullying-victimisation assessed through self-report using the extensively used and validated Olweus Bully/Victim questionnaire at baseline and 12-month follow-up.

Secondary outcomes: student-level bullying-perpetration; student mental health and emotional well-being; student level of, and roles in, bullying; school related well-being; school attendance and academic attainment; and teachers’ self-efficacy in dealing with bullying, mental well-being, and burnout.

Sample size: 116 schools (58 per arm) with an assumed ICC of 0.02 will provide 90% power to identify a relative reduction of 22% with a 5% significance level.

Randomisation: recruited schools will be randomised on 1:1 basis stratified by Key-Stage 2 size and free school meal status.

Process evaluation: assess implementation fidelity, identify influences on KiVa implementation, and examine intervention mechanisms.

Economic evaluation: Self-reported victimisation, Child Health Utility 9D, Client Service Receipt Inventory, frequency of services used, and intervention costs. The health economic analysis will be conducted from a schools and societal perspective.

Discussion

This two-arm pragmatic multicentre cluster randomised controlled trial will evaluate the KiVa anti-bullying intervention to generate evidence of the effectiveness, cost-effectiveness and scalability of the programme in the UK. Our integrated process evaluation will assess implementation fidelity, identify influences on KiVa implementation across England and Wales and examine intervention mechanisms. The integrated health economic analysis will be conducted from a schools and societal perspective. Our trial will also provide evidence regarding the programme impact on inequalities by testing whether KiVa is effective across the socio-economic gradient.

Trial registration

Trials ISRCTN 12300853 Date assigned 11/02/2020.

Sibling, Peer, and Cyber Bullying Among Children and Adolescents: Co-occurrence and Implications for Their Adjustment

Bullying across the sibling, peer, and cyber context has consistently been associated with a range of long-term health and well-being consequences for children and adolescents. Although research examining different bullying forms simultaneously in the same study are emerging, it remains unclear to what extend sibling, peer, and cyber bullying co-occur and in what ways they are associated. Moreover, previous work has demonstrated that children and adolescents who experience multiple forms of victimization are at a particular risk of adverse outcomes. However, whether different constellations of co-occurring bullying forms have differential impacts has not yet been investigated sufficiently. The aim of the present study was to examine the frequencies of isolated and co-occurring sibling, peer, and cyber bullying as well as to explore their independent and cumulative relationships with child adjustment. This study was based on a sample of 329 children and adolescents aged between 9 and 15. Bullying experiences across the sibling, peer, and cyber context in the previous 6 months were assessed via self-report. Youth further reported on emotional problems, conduct problems, sleep problems, and academic achievement via an online questionnaire. Sibling, peer, and cyber bullying were uniquely associated with child outcomes. A cumulative relationship between bullying victimization across contexts and emotional problems, conduct problems, and sleep problems could be identified, while bullying perpetration across contexts was only linked to more conduct problems in a cumulative manner. The findings have important practical implications arguing for the adoption of a holistic approach toward bullying in prevention and intervention.

Childhood adversity and healthy ageing: a study of the Chinese older population

This study examines the relationship between childhood adversities and healthy ageing in the Chinese older population. The data come from the China Health and Retirement Longitudinal Survey (CHARLS), a national survey that collected life history and ageing-related information on 9248 older people aged over 60 in 2014 and 2015. The analysis of healthy ageing focuses on seven indicators: IADL limitations, ADL limitations, cognitive functioning, depressive symptoms, life satisfaction, self-reported health, and chronic illness. Using k-means clustering, an unsupervised learning technique, we identified four qualitatively different groups according to their achievement in healthy ageing. We studied 17 types of childhood adversities and found that experiencing multiple childhood adversities is associated with a lower probability of achieving healthy ageing. This relationship is moderated by age and gender. Women are more vulnerable than men to the negative impacts of childhood adversities. The threat of childhood adversities to healthy ageing is greatly attenuated among people aged over 80. We argue that the policy response to healthy ageing should not be confined to those services and programmes that directly target older people. Instead, healthy ageing can be better addressed by concerted efforts in different areas of social policy.

Bullying behaviours and other conduct problems: longitudinal investigation of their independent associations with risk factors and later outcomes

PURPOSE

Bullying behaviours and other conduct problems often co-occur. However, we do not yet know whether bullying behaviours are associated with early factors and later poor outcomes independently of conduct problems. While there are differing, specific interventions for bullying behaviours and for conduct problems, it is unclear if such specificity is justified given parallels between both behaviours.

METHODS

We used prospective data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative sample of 2232 children. Mothers and teachers reported on children's bullying behaviours and conduct problems at ages 7 and 10. We collected measures of risk factors, including temperament and family factors, when children were age 5. We assessed behavioural, emotional, educational and social problems when participants reached the ages of 12 and 18.

RESULTS

Bullying behaviours and conduct problems co-occurred in childhood. Our findings indicated that bullying behaviours and other conduct problems were independently associated with the same risk factors. Furthermore, they were associated with the same poor outcomes at both ages 12 and 18. Despite this, bullying behaviours were uniquely associated with behavioural, emotional, educational and social problems at age 18.

CONCLUSIONS

Our findings suggest that anti-bullying programmes and interventions aimed at reducing conduct problems could benefit from greater integration. Furthermore, our study highlights the mental health problems children who bully may face in later years and the need to consider those in intervention plans.

A Large-Scale Replication of the Effectiveness of the KiVa Antibullying Program: a Randomized Controlled Trial in the Netherlands

This study evaluates the effectiveness of the KiVa antibullying program in the Netherlands through a randomized controlled trial of students in grades 3-4 (Dutch grades 5-6). The sample involved 98 schools who volunteered to participate in the research, with 245 classes and 4383 students at the baseline (49% girls; M age = 8.7 years), who participated in five measurement waves, collected in three consecutive school years. After the baseline, two-thirds of the schools were assigned to the intervention condition (KiVa or KiVa+, the latter included an additional intervention component of network feedback to teachers) and one-third to the control condition (waiting list, care as usual) with a stratified randomization procedure. The effects of the intervention on self-reported victimization and bullying were tested using cross-classified ordered multinomial models and binomial logistic regression models. These longitudinal models showed that self-reported victimization and bullying reduced more strongly in KiVa-schools compared with control schools, with stronger effects after two school years than after one school year of implementation. The results showed that for students in control schools, the odds of being a victim were 1.29-1.63 higher, and the odds of being a bully were 1.19-1.66 higher than for KiVa students. No significant differences between KiVa and KiVa+ emerged. Overall, the findings provide evidence of the effectiveness of the KiVa program in the Netherlands.

Early childhood parenting and adolescent bullying behavior: Evidence from a randomized intervention at ten-year follow-up

RATIONALE

Bullying in education is a significant public health problem with long-run life cycle consequences, but efforts to reduce bullying were met with mixed results. We ask whether improving early childhood parenting can reduce subsequent bullying behavior by the children.

METHOD

We analyze ten-year follow-up of a randomized intervention where the parents of preschool children received a training aimed at improving parenting techniques, such as disciplinary strategies. 280 parents in 17 preschools were cluster-randomized at the preschool level (intervention group, cluster = 11, n = 186 vs. control group, cluster = 6, n = 94). Their children were followed ten years later, at ages between 12 and 16, with overall attrition rate of 12.5%. Ordinary least squares is used to estimate the intent-to-treat effects, controlling for the baseline characteristics of the child and the mother. Multiple imputation and inverse probability weighting are used to account for attrition and wild-cluster bootstrap test is used for statistical inference with few clusters. We estimate treatment-on-the-treated effects using two-stage least squares to account for noncompliance in the intervention group. Finally, we examine the associations between bullying and externalizing behavior.

RESULTS

Adolescent children are significantly less likely to bully their peers if their parents received the parenting training when their children were in preschools. The effects are stronger for boys and for aggressive forms of bullying such as 'beating' and 'threatening'. Treatment-on-the-treated effects are greater in magnitude and more significant than intent-to-treat effects, suggesting that the effects are driven by program participants. No effect is found for cyberbullying and for victimization. The results were robust to using multiple imputation and inverse probability weighting. We also find suggestive evidence that the effects on bullying are not explained by changes in externalizing behavior.

CONCLUSION

We show that improving early childhood parenting can have important public health benefits through reduction in adolescent bullying behavior.

Assessment of School Anti-Bullying Interventions: A Meta-analysis of Randomized Clinical Trials

IMPORTANCE

Bullying is a prevalent and modifiable risk factor for mental health disorders. Although previous studies have supported the effectiveness of anti-bullying programs; their population impact and the association of specific moderators with outcomes are still unclear.

OBJECTIVE

To assess the effectiveness of school anti-bullying interventions, their population impact, and the association between moderator variables and outcomes.

DATA SOURCES

A search of Ovid MEDLINE, ERIC, and PsycInfo databases was conducted using 3 sets of search terms to identify randomized clinical trials (RCTs) assessing anti-bullying interventions published from database inception through February 2020. A manual search of reference lists of articles included in previous systematic reviews and meta-analyses was also performed.

STUDY SELECTION

The initial literature search yielded 34 798 studies. Included in the study were articles that (1) assessed bullying at school; (2) assessed the effectiveness of an anti-bullying program; (3) had an RCT design; (4) reported results; and (5) were published in English. Of 16 707 studies identified, 371 met the criteria for review of full-text articles; 77 RCTs were identified that reported data allowing calculation of effect sizes (ESs). Of these, 69 independent trials were included in the final meta-analysis database.

DATA EXTRACTION AND SYNTHESIS

Random-effects and meta-regression models were used to derive Cohen d values with pooled 95% CIs as estimates of ES and to test associations between moderator variables and ES estimates. Population impact number (PIN), defined as the number of children in the total population for whom 1 event may be prevented by an intervention, was used as an estimate of the population impact of universal interventions targeting all students, regardless of individual risk.

MAIN OUTCOMES AND MEASURES

The main outcomes are the effectiveness (measured by ES) and the population impact (measured by the PIN) of anti-bullying interventions on the following 8 variable categories: overall bullying, bullying perpetration, bullying exposure, cyberbullying, attitudes that discourage bullying, attitudes that encourage bullying, mental health problems (eg, anxiety and depression), and school climate as well as the assessment of potential assocations between trial or intervention characteristics and outcomes.

RESULTS

This study included 77 samples from 69 RCTs (111 659 participants [56 511 in the intervention group and 55 148 in the control group]). The weighted mean (range) age of participants in the intervention group was 11.1 (4-17) years and 10.8 (4-17) years in the control group. The weighted mean (range) proportion of female participants in the intervention group was 49.9% (0%-100%) and 50.5% (0%-100%) in the control group. Anti-bullying interventions were efficacious in reducing bullying (ES, -0.150; 95% CI, -0.191 to -0.109) and improving mental health problems (ES, -0.205; 95% CI, -0.277 to -0.133) at study end point, with PINs for universal interventions that target the total student population of 147 (95% CI, 113-213) and 107 (95% CI, 73-173), respectively. Duration of intervention was not statistically significantly associated with intervention effectiveness (mean [range] duration of interventions, 29.4 [1 to 144] weeks). The effectiveness of anti-bullying programs did not diminish over time during follow-up (mean [range] follow-up, 30.9 [2-104] weeks).

CONCLUSIONS AND RELEVANCE

Despite the small ESs and some regional differences in effectiveness, the population impact of school anti-bullying interventions appeared to be substantial. Better designed trials that assess optimal intervention timing and duration are warranted.

The social ecology of childhood and early life adversity

An increasing prevalence of early childhood adversity has reached epidemic proportions, creating a public health crisis. Rather than focusing only on adverse childhood experiences (ACEs) as the main lens for understanding early childhood experiences, detailed assessments of a child's social ecology are required to assess "early life adversity." These should also include the role of positive experiences, social relationships, and resilience-promoting factors. Comprehensive assessments of a child's physical and social ecology not only require parent/caregiver surveys and clinical observations, but also include measurements of the child's physiology using biomarkers. We identify cortisol as a stress biomarker and posit that hair cortisol concentrations represent a summative and chronological record of children's exposure to adverse experiences and other contextual stressors. Future research should use a social-ecological approach to investigate the robust interactions among adverse conditions, protective factors, genetic and epigenetic influences, environmental exposures, and social policy, within the context of a child's developmental stages. These contribute to their physical health, psychiatric conditions, cognitive/executive, social, and psychological functions, lifestyle choices, and socioeconomic outcomes. Such studies must inform preventive measures, therapeutic interventions, advocacy efforts, social policy changes, and public awareness campaigns to address early life adversities and their enduring effects on human potential. IMPACT: Current research does not support the practice of using ACEs as the main lens for understanding early childhood experiences. The social ecology of early childhood provides a contextual framework for evaluating the long-term health consequences of early life adversity. Comprehensive assessments reinforced with physiological measures and/or selected biomarkers, such as hair cortisol concentrations to assess early life stress, may provide critical insights into the relationships between early adversity, stress axis regulation, and subsequent health outcomes.

Understanding practitioners' and young people's views of a risk calculator for future psychopathology and poor functioning in young people victimised during childhood

BACKGROUND

Although children who are exposed to victimisation (including abuse, neglect, domestic violence and bullying) have an increased risk of later psychopathology and functional impairment, not all go on to develop these outcomes. Risk calculators that generate individualised probabilities of a victimised child developing future psychopathology and poor functioning have the potential to help practitioners identify the most vulnerable children and efficiently target preventive interventions.

AIM

This study explored the views of young people and practitioners regarding the acceptability and feasibility of potentially using a risk calculator to predict victimised children's individual risk of poor outcomes.

METHODS

Young people (n = 6) with lived experience of childhood victimisation took part in two focus groups. Health and social care practitioners (n = 13) were interviewed individually. Focus groups and interviews were audio-recorded, transcribed and thematically analysed.

RESULTS

Ten themes were identified, organised according to the three main topics of discussion: (i) identifying risk (risk factors, current practice, accuracy, implementation, response); (ii) protective factors and prevention (individual, environment, preventative intervention); and (iii) communication of research (stakeholders, methods).

CONCLUSION

Risk calculators have the potential to enhance health and social care practice in the United Kingdom, but we highlight key factors that require consideration for successful implementation.

Mapping community, social, and economic risks to investigate the association with school violence and bullying in Italy

BACKGROUND

School violence and bullying are a pandemic issue. The academic literature underlined the need to investigate social-contextual risk factors. The United Nations called for more comprehensive and disaggregated data to inform prevention strategies.

OBJECTIVE

The present study comprises a set of secondary analyses on Italian data from the International Civic and Citizenship Study 2016. We adopted an innovative 'bottom-up' approach to identify the level of disaggregation for national data. The researchers focused on community, social, and economic risk indicators at school-level, and investigated whether it was possible to aggregate schools in different classes, depending on their risk profile.

PARTICIPANTS AND SETTINGS

Analyses were implemented on a nationally representative sample of 170 Principals of lower secondary schools, 2,527 teachers and 3,766 students at grade 8.

METHODS AND ANALYSES

A Latent Class Analyses was conducted on risk indicators and four classes of risk were identified: No Risk, Community Risk, Socio-economic Risk, Multi-Risk (entropy = .786). No significant differences were found across classes in relation to urban/rural location, school size, and geographical macro-partition. On the contrary, significant differences emerged when considering teachers' perception of bullying, social problem, and students' behavior at school. Furthermore significant differences were found for the quality of relationship with teachers as reported by students.

CONCLUSIONS

Results a) suggested a potential gradient of increasing risk moving across the classes; b) provided a contribution to address the gap in the investigation of contextual factors and bullying; c) offered a new lens to tailor interventions to prevent school violence and bullying.

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.

Parent Communication and Bullying Among Hispanic Adolescent Girls

In this article, we report findings regarding parent communication and daughter's experiences of bullying and victimization in a sample of Hispanic families with seventh-grade daughters. About 57% of daughters reported experiencing any form of victimization and 37% reported engaging in some type of bullying behavior. Overall, the most common type of victimization reported was verbal/emotional bullying (36%). Nearly all parents agreed they had spoken with their daughters about the dangers of bullying perpetration (95%) and how to handle being victimized (96%), but there was no association between the frequency with which parents spoke with their daughters about bullying perpetration and their child's victimization experiences. Additionally, the gap between parent and child acculturation did not appear to moderate this association. The high incidence of self-reported bullying perpetration and victimization experiences underscores the need for school nurses, parents, and school personnel to address bullying behavior.

Cyber bullying victimization and adolescent mental health: The differential moderating effects of intrapersonal and interpersonal emotional competence

INTRODUCTION

Individuals who experience bullying victimization are at increased risk for future health and social problems. Despite this, studies show that not all bullying victims are in ill health, suggesting the importance of investigating protective factors that could counteract the adverse effects. The present study focused on investigating the moderating effects of emotional competence (EC) in the relationship between cyber-bullying victimization (CV) and mental health among adolescents.

METHODS

Responses from 6403 adolescents aged 12 to 18 (1925 male, 4478 female, M_age = 16.35, SD = 1.46) with no missing data were used for analysis. The cross-sectional data analyzed in the present study was a part of a large longitudinal online survey conducted by the University of Tokyo in Japan. Participants were recruited among adolescent users of a social networking service widely used in Japan for communication.

RESULTS

Results of regression analysis showed significant direct effects of CV on psychological distress/self-esteem, confirming the adverse effects of victimization. Results also suggested that high intrapersonal EC weakened the relationship between CV and psychological distress, whereas high interpersonal EC strengthened the relationship. There were no significant interactions between CV and EC in predicting self-esteem.

CONCLUSIONS

Intrapersonal and interpersonal EC may play differential moderating roles in the relationship between CV and psychological distress, the former by buffering the effect and the latter by exacerbating it. Interventions targeting abilities to handle one's own emotions may help decrease distress among adolescents with CV experiences.

Economics and mental health: the current scenario

Economics and mental health are intertwined. Apart from the accumulating evidence of the huge economic impacts of mental ill-health, and the growing recognition of the effects that economic circumstances can exert on mental health, governments and other budget-holders are putting increasing emphasis on economic data to support their decisions. Here we consider how economic evaluation (including cost-effectiveness analysis, cost-utility analysis and related techniques) can contribute evidence to inform the development of mental health policy strategies, and to identify some consequences at the treatment or care level that are of relevance to service providers and funding bodies. We provide an update and reflection on economic evidence relating to mental health using a lifespan perspective, analyzing costs and outcomes to shed light on a range of pressing issues. The past 30 years have witnessed a rapid growth in mental health economics, but major knowledge gaps remain. Across the lifespan, clearer evidence exists in the areas of perinatal depression identification-plus-treatment; risk-reduction of mental health problems in childhood and adolescence; scaling up treatment, particularly psychotherapy, for depression; community-based early intervention and employment support for psychosis; and cognitive stimulation and multicomponent carer interventions for dementia. From this discussion, we pull out the main challenges that are faced when trying to take evidence from research and translating it into policy or practice recommendations, and from there to actual implementation in terms of better treatment and care.

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.

Development of an individualized risk calculator for poor functioning in young people victimized during childhood: A longitudinal cohort study

BACKGROUND

Childhood victimization elevates the average risk of developing functional impairment in adulthood. However, not all victimized children demonstrate poor outcomes. Although research has described factors that confer vulnerability or resilience, it is unknown if this knowledge can be translated to accurately identify the most vulnerable victimized children.

OBJECTIVE

To build and internally validate a risk calculator to identify those victimized children who are most at risk of functional impairment at age 18 years.

PARTICIPANTS

We utilized data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative birth cohort of 2232 UK children born in 1994-95.

METHODS

Victimization exposure was assessed repeatedly between ages 5 and 12 years along with a range of individual-, family- and community-level predictors. Functional outcomes were assessed at age 18 years. We developed and evaluated a prediction model for psychosocial disadvantage and economic disadvantage using the Least Absolute Shrinkage and Selection Operator (LASSO) regularized regression with nested 10-fold cross-validation.

RESULTS

The model predicting psychosocial disadvantage following childhood victimization retained 12 of 22 predictors, had an area under the curve (AUC) of 0.65, and was well-calibrated within the range of 40-70% predicted risk. The model predicting economic disadvantage retained 10 of 22 predictors, achieved excellent discrimination (AUC = 0.80), and a high degree of calibration.

CONCLUSIONS

Prediction modelling techniques can be applied to estimate individual risk for poor functional outcomes in young adulthood following childhood victimization. Such risk prediction tools could potentially assist practitioners to target interventions, which is particularly useful in a context of scarce resources.

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.

Aggression and its predictors among elementary students

Background:

Aggression is the most significant psychopathological risk factor. It is a multifaceted construct and can affect students’ social, mental and physical health. The present study was conducted to investigate factors associated with aggression among elementary school girls and boys using the theoretical framework of Social Cognitive Theory in Kermanshah city, Iran.

Methods:

The cross-sectional study was conducted on 900 students, including 445 girls and 455 boys, 563 parents and 104 elementary school teachers in the fourth, fifth and sixth educational grades in Kermanshah city in 2018. The proportionate stratified random sampling was used. The Adolescent Peer Relations Instrument (APRI) was used to measure aggression. To measure the variables of social cognitive theory, a researcher-made questionnaire was used. Data analysis was conducted using descriptive and inferential statistics via the SPSS software.

Results:

It was showed that 29% and 10% of the students had moderate and high levels of aggression, respectively. Also, 30.6% of them were moderate victims and 45.6% were intense victims. Self-efficacy (p less than 0.001), perceived social norms (p=0.011), observational learning (p less than 0.001), outcome expectations (p=0.027), outcome expectancies (p=0.028) and per-ceived situational (p less than 0.001) were reported as the significant predictors of aggressive behaviors in the students based on the Social Cognitive Theory constructs. In total, they explained for 37.3% of changes in aggressive behaviors. Parents’ knowledge (p=0.005), parents’ attitude (p=0.012), teachers’ attitude (p less than 0.001), and teachers’ self-efficacy (p=0.021) had statistically significant relationships with aggression in the students.

Conclusions:

Aggression among children and adolescents is getting alarmingly prevalent. The Social Cogni-tive Theory is the appropriate framework for the prediction of aggression behaviors in children and adolescents. Therefore, designing and implementing educational interventions based on this theory can help with the management of aggression in children and adolescents.

The Economic Case for the Prevention of Mental Illness

Poor mental health has profound economic consequences. Given the burden of poor mental health, the economic case for preventing mental illness and promoting better mental health may be very strong, but too often prevention attracts little attention and few resources. This article describes the potential role that can be played by economic evidence alongside experimental trials and observational studies, or through modeling, to substantiate the need for increased investment in prevention. It illustrates areas of action across the life course where there is already a good economic case. It also suggests some further areas of substantive public health concern, with promising effectiveness evidence, that may benefit from economic analysis. Financial and economic barriers to implementation are then presented, and strategies to address the barriers and increase investment in the prevention of mental illness are suggested.