Research Review: Do antibullying interventions reduce internalizing symptoms? A systematic review, meta-analysis, and meta-regression exploring intervention components, moderators, and mechanisms

When Push Comes to Shove: Unravelling the Developmental and Longitudinal Dynamic Relationship between Bullying and Empathy in Chinese School Children

While bullying has significant long-term impacts on mental health, the developmental relationship between empathy and bullying behaviors remains unclear. Specifically, it is uncertain whether bullying perpetration and victimization predict changes in empathy over time or if empathy influences these behaviors. This study addresses this gap by examining the longitudinal dynamic relationship between empathy, bullying perpetration, and victimization. The sample comprised 3337 Chinese school children (Mage = 11.23 years, SD = 1.60; 47.7% female), followed over six waves across three years. Random intercept cross-lagged panel models (RI-CLPMs) were employed to separate between-person and within-person effects. Results indicated that at the between-person level, empathy, bullying perpetration, and victimization followed decreasing trajectories, with initial empathy negatively associated with both bullying perpetration and victimization. At the within-person level, fluctuations in bullying perpetration and victimization predicted subsequent declines in empathy, while empathy did not significantly predict later changes in bullying perpetration and victimization behaviors. These findings suggest that bullying experiences, whether as a perpetrator or victim, can impair empathy development and that empathy alone may not be sufficient to reduce bullying. This challenges current intervention models focused on empathy enhancement and calls for more nuanced approaches that address the complex dynamics between empathy and bullying.

School bullying prevention and intervention strategies in the United Arab Emirates: a scoping review

INTRODUCTION

Schools in the United Arab Emirates (UAE) witnessed an increase of 7% in bullying prevalence since 2005. This review aimed to map antibullying interventions in the UAE.

METHODS

A systematic search was performed in five electronic databases (EMBASE, PubMed, PsycINFO, Scopus and Eric) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review. Studies addressing antibullying interventions and grey literature in the UAE from 2010 to 2021 were included. Interventions were mapped using distribution across key sectors, public health practice levels, and organisation types.

RESULTS

Of the 2122 identified papers, only 2 were included. Both articles were published in 2019 and used qualitative methods. From the search of governmental and non-governmental websites, 22 multilevel interventions were included and presented on the three levels of public health practice across the different sectors and target stakeholders. Eight interventions were at the federal level, and six were by private stakeholders. The government funded 59% of all interventions. Four interventions addressed cyberbullying, and three used multisectoral collaboration.

CONCLUSIONS

Although the UAE is building capacity for bullying prevention, we found limited knowledge of antibullying prevention efforts. Further studies are needed to assess current interventions, strategies and policies.

The Perniciousness and Promise of School-Based Mental Health Service Delivery for Youth

Rates of child and adolescent mental disorder have risen sharply while access to community-based mental health care options continues to be elusive for many families. Substantial and persistent barriers to community-based mental health care have prompted multiple stakeholders to pursue an approach that emphasizes health promotion and intervention practices within the context of ecologically valid and more accessible environments. The most prominent of these environments has been schools that can serve as local and centralized access points to various services, including mental health care. The rapid expansion of school-based mental health service delivery systems, however, carries both risk of perniciousness as well as significant promise with respect to effective and equitable care. This article summarizes key concerns surrounding school-based mental health service delivery systems, including non-beneficence and harm, support disparities, unsustainable implementation, oppressive school climate, and linkage to punitive and discriminatory practices. Broad-based recommendations to help realize the promise of effective and equitable care for students with mental health and behavioral challenges are also presented vis-à-vis each of these concerns. At the same time, natural tensions between various mandates assigned to schools as well as between schools and their surrounding communities will need to be addressed to reach the full potential of school-based mental health service delivery systems.

World Psychiatric Association-Asian Journal of Psychiatry Commission on Public Mental Health

Although there is considerable evidence showing that the prevention of mental illnesses and adverse outcomes and mental health promotion can help people lead better and more functional lives, public mental health remains overlooked in the broader contexts of psychiatry and public health. Likewise, in undergraduate and postgraduate medical curricula, prevention and mental health promotion have often been ignored. However, there has been a recent increase in interest in public mental health, including an emphasis on the prevention of psychiatric disorders and improving individual and community wellbeing to support life trajectories, from childhood through to adulthood and into older age. These lifespan approaches have significant potential to reduce the onset of mental illnesses and the related burdens for the individual and communities, as well as mitigating social, economic, and political costs. Informed by principles of social justice and respect for human rights, this may be especially important for addressing salient problems in communities with distinct vulnerabilities, where prominent disadvantages and barriers for care delivery exist. Therefore, this Commission aims to address these topics, providing a narrative overview of relevant literature and suggesting ways forward. Additionally, proposals for improving mental health and preventing mental illnesses and adverse outcomes are presented, particularly amongst at-risk populations.

Interventions targeting social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews

Globally, mental disorders account for almost 20% of disease burden and there is growing evidence that mental disorders are socially determined. Tackling the United Nations Sustainable Development Goals (UN SDGs), which address social determinants of mental disorders, may be an effective way to reduce the global burden of mental disorders. We conducted a systematic review of reviews to examine the evidence base for interventions that map onto the UN SDGs and seek to improve mental health through targeting known social determinants of mental disorders. We included 101 reviews in the final review, covering demographic, economic, environmental events, neighborhood, and sociocultural domains. This review presents interventions with the strongest evidence base for the prevention of mental disorders and highlights synergies where addressing the UN SDGs can be beneficial for mental health.

Upholding the Human Rights and Well-Being of Refugee Children Through Effective Clinical Care

Refugee children are often exposed to adversities and traumatic experiences that can harm the mental health and well-being of refugee children. These include human trafficking and exploitation and dangers in detention centers and refugee camps. All these adverse events can be traumatic and contribute to poor mental health, including posttraumatic stress, anxiety, depression, and substance use disorders. Therefore, the assessment of refugee children and adolescents should include screening and identification for these experiences, provision of evidence-based trauma treatment, and social supports to promote their well-being and thriving.

Bullying Involvement and Physical Pain Between Ages 10 and 13 Years: Reported History and Quantitative Sensory Testing in a Population-Based Cohort

We aimed to quantify the prospective association between bullying and physical pain in a population-based cohort of adolescents. We assessed 4,049 participants of the 10 and 13 years waves of the Generation XXI birth cohort study in Portugal. Pain history was collected using the Luebeck pain screening questionnaire. A subsample of 1,727 adolescents underwent computerized cuff pressure algometry to estimate pain detection/tolerance thresholds, temporal pain summation and conditioned pain modulation. Participants completed the Bully Scale Survey and were classified as "victim only", "both victim and aggressor", "aggressor only", or "not involved". Associations were quantified using Poisson or linear regression, adjusted for sex and adverse childhood experiences. When compared to adolescents "not involved", participants classified as "victim only" or "both victim and aggressor" at age 10 had higher risk of pain with psychosocial triggers, pain that led to skipping leisure activities, multisite pain, pain of higher intensity, and pain of longer duration, with relative risks between 1.21 (95% confidence interval: .99, 1.49) and 2.17 (1.57, 3.01). "Victims only" at age 10 had lower average pain detection and tolerance thresholds at 13 years (linear regression coefficients: -1.81 [-3.29, -.33] and -2.73 [-5.17, -.29] kPa, respectively), as well as higher pain intensity ratings (.37 [.07, .68] and .39 [.06, .72] mm), when compared with adolescents not involved. No differences were seen for the remaining bullying profiles or sensory measures. Our findings suggest that bullying may have long-term influence on the risk of chronic musculoskeletal pain and may interfere with responses to painful stimuli. PERSPECTIVE: We found prospective evidence that bullying victimization in youth: 1) is more likely to lead to negative reported pain experiences than the reverse, 2) may have long-term influence on adverse pain experiences, and 3) may contribute to pain phenotypes partly by interfering with somatosensory responses to painful stimuli.

Bullying fosters interpersonal distrust and degrades adolescent mental health as predicted by Social Safety Theory

Social Safety Theory predicts that socially threatening experiences such as bullying degrade mental health partly by fostering the belief that others cannot be trusted. Here we tested this prediction by examining how peer bullying in childhood impacted adolescent mental health, and whether this effect was mediated by interpersonal distrust and several other commonly studied mediators-namely diet, sleep and physical activity-in 10,000 youth drawn from the UK's Millennium Cohort Study. Youth bullied in childhood developed more internalizing, externalizing and total mental health problems in late adolescence, and this effect was partially mediated by interpersonal distrust during middle adolescence. Indeed, adolescents who developed greater distrust were approximately 3.5 times more likely to subsequently experience clinically significant mental health problems than those who developed less distrust. Individual and school-based interventions aimed at reducing the negative impact of bullying on mental health may thus benefit from bolstering youths' sense of trust in others.

Current evidence and opportunities in child and adolescent public mental health: a research review

BACKGROUND

A public mental health lens is increasingly required to better understand the complex and multifactorial influences of interpersonal, community and institutional systems on the mental health of children and adolescents.

METHODS

This research review (1) provides an overview of public mental health and proposes a new interactional schema that can guide research and practice, (2) summarises recent evidence on public mental health interventions for children and adolescents, (3) highlights current challenges for this population that might benefit from additional attention and (4) discusses methodological and conceptual hurdles and proposes potential solutions.

RESULTS

In our evidence review, a broad range of universal, selective and indicated interventions with a variety of targets, mechanisms and settings were identified, some of which (most notably parenting programmes and various school-based interventions) have demonstrated small-to-modest positive effects. Few, however, have achieved sustained mental health improvements.

CONCLUSIONS

There is an opportunity to re-think how public mental health interventions are designed, evaluated and implemented. Deliberate design, encompassing careful consideration of the aims and population-level impacts of interventions, complemented by measurement that embraces complexity through more in-depth characterisation, or 'phenotyping', of interpersonal and environmental elements is needed. Opportunities to improve child and adolescent mental health outcomes are gaining unprecedented momentum. Innovative new methodology, heightened public awareness, institutional interest and supportive funding can enable enhanced study of public mental health that does not shy away from complexity.

The impact of bullying in childhood and adolescence

PURPOSE OF REVIEW

Bullying is a common adversity affecting many children and adolescents. It has been shown to negatively impact the psychological well being not only of targets of bullying, but also that of bullying perpetrators and those witnessing bullying. Bullying is linked to depression and poorer mental health and functioning among children and adolescents. Given the high prevalence of bullying among children and adolescents and the negative mental health sequelae of bullying, this is an area of urgent public health concern. This narrative review brings forth recent research findings in this arena, which could help shape public health policies for addressing and preventing bullying.

RECENT FINDINGS

Recent findings demonstrate an association of bullying among children and adolescents with depression, nonsuicidal self-injury, sleep loss, reduced health-related quality of life, poorer rates of graduation from high school and later mental health problems. A recent systematic review also showed an association of peer-victimization among children and adolescents with activation of amygdala, left parahippocampal gyrus and fusiform gyrus, and alterations in other brain areas.

SUMMARY

Evidence indicates that bullying in childhood and adolescence is associated with higher odds of developing mental health problems; therefore, early identification and timely intervention is crucial.

Do no harm: can school mental health interventions cause iatrogenic harm?

In recent years, there have been extensive efforts in secondary schools to prevent, treat and raise awareness of adolescent mental health problems. For some adolescents, these efforts are essential and will lead to a reduction in clinical symptoms. However, it is also vital to assess whether, for others, the current approach might be causing iatrogenic harm. A growing body of quantitative research indicates that some aspects of school-based mental health interventions increase distress or clinical symptoms, relative to control activities, and qualitative work indicates that this may be partly due to the interventions themselves.

What Happens to Children's Mental Health and Peer Relationships During Periods of Restricted and Unrestricted Social Interactions? Results From the Co-SPACE Study in Primary School-Aged Children

Objective

Children's experiences of peer victimization and peer aggression are strongly linked to their mental health. However, we do not know how this relationship is influenced by periods of restricted and unrestricted social interactions. In this study, we investigated the following: (1) the bidirectional association between children's peer problems and mental health; (2) individual differences in the joint development of peer victimization, peer aggression, and mental health; and (3) factors associated with joint trajectories over 13 months during the COVID-19 pandemic in the United Kingdom.

Method

Our sample consisted of 2,160 children 4 to 10 years of age for whom parents or carers/caregivers completed a baseline and at least 1 follow-up online survey between March 2020 and May 2021 as part of the COVID-19: Supporting Parents, Adolescents and Children during Epidemics (Co-SPACE) study. We used generalized linear models to examine bidirectional associations, group-based trajectory modeling to map joint trajectories, and multinomial logistic regressions to identify factors associated with trajectories.

Results

Experiencing mental health difficulties during school closures increased the risk of experiencing peer victimization, but not peer aggression on return to school. Experiencing any peer problems during school closures did not predict subsequent mental health difficulties. The majority of children followed joint trajectories of low exposure to peer problems and mental health; however 16% to 17% of our sample followed joint trajectories of high exposure to peer problems and mental health. Low family income, family conflict, parental distress, special educational needs, and lack of friendships were associated with high exposure mental health and peer problem trajectories.

Conclusion

Increasing children's mental health support during periods of isolation may not only reduce concurrent and future mental health problems but may also prevent subsequent peer problems for both vulnerable and non-vulnerable children.

Study preregistration information

Co-SPACE (Covid-19: Supporting Parents, Adolescents and Children during Epidemics); https://osf.io/.

The Association between Internalizing Symptoms and Witnessing School Bullying and Defending Behavior: An Analysis of Gender Differences among Elementary and Middle School Students

Bullying is a significant public health concern that begins as early as elementary school and peaks in middle school. Although researchers have demonstrated the relationship between internalizing symptoms and being a target of bullying, there is limited research examining the association between internalizing symptoms and witnessing school bullying and defending targets or gender differences in these relationships. In this cross-sectional study, we examined gender as a moderator of the relationships between internalizing symptoms (e.g., depressive symptoms and social anxiety) and witnessing school bullying and defending behavior in a sample of elementary and middle school students (N = 126; 51.6% female; 3rd-8th grade). Results demonstrated that witnessing school bullying was a significant predictor of depressive symptoms. For social anxiety, the gender x witnessing school bullying interaction was significant for social avoidance and distress (SAD), such that among female students, SAD was positively related to witnessing school bullying. In contrast, the gender x defending behavior interaction was significant for fear of negative evaluation (FNE), such that among male students, FNE was positively related to defending behavior. Findings suggest bullying prevention should incorporate bystander training programs that include a focus on gender differences in social anxiety associated with being a bullying bystander.