Do bullied children get ill, or do ill children get bullied? A prospective cohort study on the relationship between bullying and health-related symptoms

Developmental Relations Between Peer Victimization, Emotional Symptoms, and Disability/Chronic Condition in Adolescence: Are Within- or Between-Person Factors Driving Development?

Although there is a link between peer victimization, emotional symptoms, and disability or chronic condition in adolescence, less is known about the role of stable, individual differences compared to developmental processes. The current study addressed this gap by examining developmental relations between peer victimization, emotional symptoms, and disability or chronic condition. Three waves of self-report panel data on Swedish adolescents at ages 13, 15, and 17 years (n = 734; 51.6% girls) were used. Data were analyzed using random-intercept cross-lagged panel models with invariance tests by sex, disability/chronic condition, and family affluence. Girls and adolescents with a disability or chronic condition showed more heterogeneity in the co-development of peer victimization and emotional symptoms, with girls being more prone than boys to developing emotional symptoms following peer victimization, and particularly in early adolescence. Girls and adolescents with a disability or chronic condition had elevated within-person levels of both peer victimization and emotional symptoms throughout adolescence. Theory and practice may need to pay additional attention to the role of sex, disability, and their intersection, as well as age, regarding the development of peer victimization and emotional symptoms.

The Increase in Early Menarche is Associated With the Increase in Chronic Back Pain in Female Adolescents: The Health Behavior in School-aged Children Study 2002-2014

OBJECTIVE

Research has shown that there has been an increase in the prevalence of chronic back pain (CBP) in adolescents, especially in female adolescents. The purpose of the current study was to test the hypothesis that the observed increase in the prevalence of early menarche in female adolescents is contributing to the increase in the prevalence of CBP over time in this population.

METHODS

Cross-sectional data from 251,390 female adolescents from 27 countries/regions were drawn from the Health Behaviour in School-aged Children questionnaire-based surveys conducted in 2002, 2006, 2010, and 2014. The Karlson-Holm-Breen method was used to examine the explanatory role of the increase in the prevalence of early menarche on the increase in the prevalence of CBP while controlling for socioeconomic status, physical activity, body mass index, and psychological symptoms.

RESULTS

The increase in the prevalence of early menarche between 2002 and 2014 was associated with the increase in the prevalence of CBP ( P < 0.001). The percent of CBP prevalence increase accounted for by the increase in early menarche was 2.2%.

CONCLUSIONS

The increase in the prevalence of CBP in female adolescents observed over the last decade may be explained, in part, by the decrease in the age of menarche. This finding, coupled with research showing a decline in early menarche worldwide, highlights the need to delve deeper into the underlying mechanisms of the association between early menarche and pain-particularly CBP-in female adolescents.

School bullying and peer relationships in children with chronic pain

ABSTRACT

Preliminary evidence suggests that there are significant associations between bullying and chronic pain, as well as between the quality of peer relationships and psychological function in youth with chronic pain. However, these findings have yet to be replicated, and the role that bullying plays in anxiety in children and adolescents with chronic pain has not yet been examined. This study sought to expand our understanding of the associations between measures of bullying and quality of peer relationships and pain-related function domains in a community sample of schoolchildren with chronic pain. One thousand one hundred fifteen schoolchildren participated in this study; 57% were girls, the mean age of the study sample was 11.67 years (SD = 2.47), and 46% reported having chronic pain. Participants completed measures of pain characteristics, pain interference, anxiety, and depressive symptoms, bullying (past and current), and quality of peer relationships. Youth with chronic pain reported a significantly higher percentage of being bullied in the past compared with youth without chronic pain. In the group of youth with chronic pain, the measures of past and current bullying, and quality of peer relationships, were not significantly associated with pain intensity, pain interference, or anxiety. However, having a history of being bullied and the quality of peer relationships were significantly associated with depressive symptom severity. The findings indicate that research to evaluate the potential causal role of bullying and the quality of peer relationships on pain-related function domains in youth with chronic pain is warranted.

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.

Traditional, cyberbullying, and suicidal behaviors in Argentinian adolescents: the protective role of school, parental, and peer connectedness

Introduction

Bullying, both in person and online, is a significant risk factor for a range of negative outcomes including suicidal behaviors among adolescents and it is crucial to explore the protective effects of parental, school, and peer connectedness on suicidal behaviors among victims.

Methods

This study is a secondary analysis of the Argentina Global School-based Student Health Survey (GSHS 2018). Logistic regression analysis, adjusting for age and sex, determines the likelihood of suicidal thoughts and attempts among bullying victims. To explore the modifying effect of school, parental, and peer connectedness on the association between bullying and suicide behaviors, the interaction term was included. Sampling design and weights were applied in all analyses in STATA 17.

Results

The study included 56,783 students in grades 8-12, with over half being female. Adolescents aged 14-15 exhibited the highest prevalence of bullying, cyberbullying, suicidal thoughts, and attempts, with females displaying a higher prevalence in all measured categories. The study found that adolescents who reported being bullied or cyberbullied demonstrated a significantly higher likelihood of experiencing suicidal thoughts and attempting suicide. Furthermore, protective factors such as school, parental, and peer connectedness were found to play a critical role in mitigating the adverse impacts of bullying and cyberbullying on suicidal thoughts and attempts.

Conclusion

The findings underscore the critical prevalence of both bullying and cyberbullying among school-going Argentinian adolescents and their profound association with suicidal behaviors. The study emphasizes the importance of supportive family environments and peer and school connectedness in mitigating the negative effects of bullying and cyberbullying on mental health and suicide risk among adolescents.

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.

Early Behavioral Markers of Anxiety and Reduced Frontal Brain Alpha May Predict High Risk for Bullying Victimization

Bullying victimization has a profound negative impact on a child's emotional, social, and cognitive development. Childhood bullying victimization is reported across various social settings, suggesting common characteristics that increase a child's vulnerability to victimization. It is critical to identify early markers of such vulnerability to design preventative tools. Comprehensive semi-structured clinical interviews from mothers of child-victims and non-engaged control children included assessment of early developmental rituals and behavioral inhibition to social novelty, as potential behavioral correlates of anxiety. Neuropsychological and clinical assessment tools were used, and resting state spectral resting state EEG (rsEEG) was recorded. Increased frequency/severity of early developmental rituals and behaviorally inhibited responses to social novelty were apparent in all child-victims, alongside significantly reduced power of ventral prefrontal brain rsEEG alpha oscillations (8-13 Hz). This triad of findings, in line with prior studies, suggested an elevated early childhood anxiety, which, as current findings indicate, may be a cross-diagnostic marker of increased risk for life-long bullying victimization. Gaining insight into early childhood markers of anxiety may meaningfully complement neuropsychiatric prognosis and preventative efforts.

Bullying experiences before and after the transition from lower to upper secondary school: associations with subsequent mental health in a Swedish cohort

BACKGROUND

Previous research has shown that exposure to bullying is linked to long-term adverse mental health consequences. However, prospective studies examining the persistence of bullying, using information from repeated time points, are limited. The aim of this study was to examine, firstly, the extent to which exposure to bullying among adolescents in Sweden changes between grades 9 (age 15-16) and 11 (age 17-18) (i.e., before and after the transition from lower to upper secondary school); secondly, whether being bullied in grade 9 or 11 is associated with depression and anxiety symptoms at age 20-21; and thirdly, if being bullied in both grade 9 and 11 is linked to an even higher likelihood of subsequent depression and anxiety symptoms. Potential differences by gender were investigated throughout.

METHODS

Data was derived from the Swedish cohort study Futura01 involving individuals attending grade 9 in the school year 2016/17 (n = 2323). We utilised self-reported information from three survey waves conducted in 2017, 2019, and 2022, and linked registry information on sociodemographic characteristics. Bullying was assessed using a single item in waves 1 and 2. Depression and anxiety symptoms were measured using the Patient Health Questionnaire-4 (PHQ-4) in wave 3. Gender stratified binary logistic regressions were performed.

RESULTS

Among those who were bullied in grade 9, 22.6% of males and 35.8% of females continued to experience bullying in grade 11. For females, exposure to bullying in grade 9 or 11 was associated with an increased likelihood of reporting depression and anxiety symptoms at age 20-21, with the highest odds for those bullied at both time points. For males, only one statistically significant association was identified - specifically, between being bullied in grade 9 and subsequent depression symptoms.

CONCLUSIONS

For a majority of adolescents who experience bullying in lower secondary school, but not all, the transition to upper secondary school proves to be beneficial as the bullying typically does not persist. However, bullying can have long-term health effects, in particular for females. These findings emphasise the importance of effective measures to address bullying within schools.

Association Between Peer Victimization, Gender Diversity, Mental Health, and Recurrent Headaches in Adolescents: A Canadian Population-Based Study

BACKGROUND AND OBJECTIVES

It is unknown whether bullying and gender diversity are associated with increased headache frequency in adolescents. Our study aimed to assess the association between peer victimization, gender diversity, and frequent recurrent headaches in adolescents, while controlling for age, sex, socioeconomic status, and potential confounders (mood and anxiety disorders, suicidality).

METHODS

This was a cross-sectional observational study of adolescents aged 12-17 years using data from a Canadian population-based health survey. Headache frequency was dichotomized into "≤once/wk" or ">once/wk" (i.e., frequent recurrent headaches). Logistic regression was used to quantify the association between frequent peer victimization (overt or relational), gender diversity (female sex at birth + male gender, male sex at birth + female gender, or gender diverse), mood/anxiety disorder, suicidality, and the odds of frequent recurrent headaches. The fully adjusted multivariable logistic regression model included all exposures and was controlled for age, sex, and socioeconomic status. Bootstrap replicate weighting was used to account for survey design effects.

RESULTS

There were an estimated 2,268,840 eligible participants (weighted sample size) (mean age = 14.4 years, 48.8% female, 0.5% gender diverse), and 11.2% reported frequent recurrent headaches. Frequent recurrent headaches were associated with older age (odds ratio [OR] = 1.26 per year of age, 95% CI 1.20-1.31), female sex (OR = 2.89, 95% CI 2.47-3.37), and being gender diverse (OR = 3.30, 95% CI 1.64-6.63, adjusted for age/sex). Youth with frequent headaches had higher odds of experiencing both overt and relational bullying compared with peers (OR = 2.69, 95% CI 2.31-3.14, and OR = 3.03, 95% CI 2.58-3.54, adjusted for age/sex). In the fully adjusted model, frequent headaches were no longer associated with gender diversity (OR = 1.53, 95% CI 0.63-3.69) but were still associated with frequent overt and relational peer victimization (OR = 1.82, 95% CI 1.41-2.34, and OR = 1.54, 95% CI 1.17-2.03, respectively), suicidality (OR = 1.83, 95% CI 1.44-2.32), and having a mood or anxiety disorder (OR = 1.50, 95% CI 1.01-2.21, and OR = 1.74, 95% CI 1.24-2.45, respectively). In a model adjusted for age, sex, and mood/anxiety disorders, the risk of suicidality increased incrementally with headache frequency.

DISCUSSION

Peer victimization and suicidality may be associated with higher headache frequency in adolescents with headaches, independently of mood and anxiety symptoms. Gender-diverse adolescents may have a higher risk of experiencing frequent headaches when compared with cisgender peers, and this may be explained by associated psychosocial factors (anxiety, depression, suicidality, and peer victimization).

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.

The Contribution of Bullying Involvement and Alexithymia to Somatic Complaints in Preadolescents

Somatic complaints during preadolescence are connected to individual and contextual factors, and extant research highlights the relevance of alexithymia and bullying involvement. In this cross-sectional study, we explored the joint and unique influence of bullying involvement-as perpetrators, victims, or outsiders-and alexithymia on somatic complaints in a sample of 179 Italian middle-school students (aged 11-15). Findings revealed an indirect association between bullying perpetration and victimization complaints through alexithymia. We also found a significant direct association between victimization and somatic complaints. No significant association between outsider behavior and somatization was found. Our results revealed that bullying perpetration and victimization could increase youths' risk for somatic complaints and clarify one of the processes underlying this association. The current findings further emphasize the relevance of emotional awareness for youths' well-being and propose that implementing social-emotional skills might prevent some of the adverse consequences of being involved in bullying episodes.

Socioeconomic Differences in the Association Between Bullying Behaviors and Mental Health in Canadian Adolescents

BACKGROUND

Bullying and poverty are each associated with poor health in adolescents. We examined socioeconomic differences in the association of bullying and health.

METHODS

The 2017/2018 Canadian Health Behaviour of School-aged Children study surveyed 21,750 youth (9-18 years). We used linear regression models to investigate interactive effects of bullying involvement (traditional and cyberbullying) and socioeconomic position (SEP) on self-reported life satisfaction, psychological symptoms, and physical symptoms.

RESULTS

Involvement in either form of bullying, as a perpetrator or a target, was associated with worse health and well-being compared to uninvolved youths. Associations of victimization via conventional bullying with low life satisfaction (b = -.33 [-.61, .05]), more psychological symptoms (b = .83 [.27, 1.38]), and more somatic symptoms (b = .56 [.14, .98]) were stronger at lower SEP.

CONCLUSION

Socioeconomic disadvantage intensifies the association between bullying victimization and poor health. The intersections of victimization and poverty pose a significant health risk to adolescents.

Geographical variations in the prevalence of traditional and cyberbullying and its additive role in psychological and somatic health complaints among adolescents in 38 European countries

OBJECTIVES

To explore geographical variations in the prevalence of traditional and cyberbullying and their individual and additive role on psychological and somatic health issues of adolescents.

METHODS

We used cross-sectional data from 188,003 adolescents (50.9% females; mean age 13.6 years) from the nationally representative Health Behaviour in School-aged Children 2014 survey in 38 European countries. Multivariable linear regression analyses were conducted to explore the role of bullying on health outcomes whilst meta-analyses were conducted to generate pooled regression coefficients.

RESULTS

Overall, the prevalence of traditional bullying was 26.9%, ranges from 8.8% in Armenia to 49.7% in Latvia, and cyberbullying was 15.8%, ranges from 5.8% in Greece to 38.3% in Greenland. 1 in 10 (8.4%) adolescents reported experiencing both forms of bullying, with the prevalence ranging from 2.5% (Greece) to 21.0% (Greenland). Meta-analytic estimates suggest a significant role of both traditional and cyberbullying in poor somatic and psychological health issues. The additive effect of both forms of bullying was more prominent on psychological health issues (β 0.70, 95% CI 0.66-0.74) than on somatic health issues (β 0.50, 95% CI 0.47-0.53). These associations varied across countries.

CONCLUSION

The prevalence of traditional and cyberbullying varied significantly across European countries while their individual and additive links with an increased risk of poor psychological and somatic health issues remain common in majority countries. To ensure both forms of bullying are prevented, a multifaceted approach and particular attention to mental health issues in bullying victims are needed in countries with high prevalence of bullying.

Bullying victimization and suicide attempts among adolescents in 41 low- and middle-income countries: Roles of sleep deprivation and body mass

Background

Suicide is the fourth leading cause of death for adolescents, and globally, over 75% of completed suicides occur in low- and middle-income countries (LMICs). Bullying has been proven to be closely related to suicide attempts. However, further understanding of the mechanisms underlying the relationship between bullying and adolescents' suicide attempts is urgently needed.

Methods

We used data from the Global School-based Student Health Survey (GSHS) (2010-2017) from 41 LMICs or regions. This study was based on questions assessing bullying victimization, suicide attempts, sleep deprivation, and body mass. Chi-square tests were used to explore the correlations among the main variables. The mediating role of sleep deprivation and the moderating role of body mass index (BMI) were analyzed using PROCESS.

Results

The results showed a positive association between bullying victimization and suicide attempts. Sleep deprivation partially mediated the relationship between the frequency of being bullied and suicide attempts. In addition, sleep deprivation played a full or partial mediating role in the relationship between different types of bullying and suicide attempts. BMI moderated the relationships between the frequency of being bullied and suicide attempts, between being made fun of about one's body and sleep deprivation, and between sleep deprivation and suicide attempts.

Conclusion

Being bullied has a positive effect on suicide attempts, which is mediated by sleep deprivation and moderated by body mass. The results of this study are consistent with the stress-diathesis model of suicide, suggesting that being bullied is one of the stressors of suicide in adolescents, while sleep deprivation and body mass are susceptibility diatheses of suicide. The results are conducive to identifying adolescents at a high risk of suicide, suggesting that there is a need to pay more attention to bullied adolescents, especially their sleep quality and body mass, and design effective intervention measures to improve the current situation of adolescent suicide in LMICs.

Association between Child Abuse, Depression, and School Bullying among Chinese Secondary School Students

INTRODUCTION

School bullying is a serious social and public health problem. This article aims to explore the association between experiences of childhood abuse and involvement in school bullying, especially considering the mediating effects of depression.

METHODS

The sample of this study was 3059 students (1584 males and 1475 females) aged from 12 to 20, in eleven Chinese secondary schools, which included six middle schools, four high schools, and one vocational high school in both urban and rural areas. The multinomial logit regression and linear regression were conducted by the two gender groups, to determine the mediating effect of depression in the association between child abuse experiences and involvement in school bullying.

RESULTS

This study indicated that female students were less likely to be involved in school bullying. Male students were more represented in the bully-victim group and experienced more physical and mental abuse during childhood. Depression was a mediator between childhood abuse and involvement in school bullying. Nevertheless, there was a gender difference in that depression fully mediated the relationship between the two variables among female students, while it only partially meditated such a relationship for male students.

CONCLUSIONS

These findings indicate that more school-based service interventions and evidence-based research are needed to more thoroughly investigate school bullying and its predictors in China.

Association between weight status and bullying experiences among children and adolescents in schools: An updated meta-analysis

BACKGROUND

The association between weight status and bullying experience is well established, but little is known about the association between overweight or obesity and bullying behaviors among children and adolescents.

OBJECTIVE

The aim of this study was to provide updated evidence on the association between weight status and exposure to bullying among school children and adolescents.

METHODS

All literature published not later than December 12, 2019 was obtained from PubMed, Web of Science, Embase, and PsycINFO databases. The odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) were used to measure the effect size. Results were combined using random-effects or fixed-effects meta-analysis, and sensitivity analysis was conducted to explore potential heterogeneity moderator factors.

RESULTS

This meta-analysis included 26 studies on the association between obesity overweight and bullying. Overall, children and adolescents with obesity had greater odds of experiencing bullying than their counterparts with healthy weight. Children and adolescents with obesity (OR = 1.46, 95 % CI:1.31-1.62), and overweight (OR = 1.24, 95 % CI: 1.17-1.32) were more likely to experience bullying than their normal weight peers. With regards to gender, boys with obesity experienced an increased risk of bullying behaviors than girls with obesity (OR = 1.40, 95 % CI: 1.30-1.50). Similarly, boys with overweight experienced an increased risk of bullying behaviors than girls with overweight (OR = 1.19, 95 % CI:1.06-1.34).

CONCLUSIONS

The present results suggest that children and adolescents must be protected from bullying, especially those that are children and adolescents with obesity overweight and effective strategies are needed to reduce bullying behaviors among children and adolescents in schools.

Gender-Specific Significance of Peer Abuse during Childhood and Adolescence on Physical and Mental Health in Adulthood-Results from a Cross-Sectional Study in a Sample of Hospital Patients

Peer abuse (PA) is a widespread and gender-sensitive form of Adverse Childhood Experiences (ACEs). However, research on its influence on physical and mental health in adulthood remains scarce. The aim of this study was to investigate gender-specific associations between PA and physical and mental health in adulthood in a sample of general hospital patients. A cross-sectional study at the University Hospital of Innsbruck was conducted. Data on ACEs, physical and mental health were collected using self-report questionnaires. We compared patients with no ACEs, PA only, ACEs without PA, and ACEs with PA using gender-specific binary logistic regressions to investigate the association of PA with physical and mental health. A total of 2,392 patients were included in the analyses. Women reported more emotional PA (13.1% vs. 9.4%; p = 0.006), while men reported more physical PA (8.3% vs. 5.2%; p = 0.003). PA was associated with a higher likelihood for depression (OR = 2.6), somatization (OR = 2.1), as well as worse physical health (OR = 2.1) in women but not in men. This study is the first to present data on the gender-specific detrimental effect of PA on physical and mental health in adulthood. Especially for women, PA poses a significant health risk. Thus, we should be aware of these effects and offer adequate support for affected individuals.

Prevalence and impact of peer victimisation among youth seeking treatment at a tertiary psychiatric institution in Singapore: a cross-sectional study

BACKGROUND

Peer victimization is common among adolescents and leads to negative consequences. However, few studies have examined the extent of peer-victimization and its correlates among adolescent patients in a psychiatric setting. The current study aimed to examine the prevalence and correlates of peer victimisation among youth with mental illness and to examine its association with depressive symptoms and health-related quality of life (HRQOL).

METHODS

A sample of 239 youths aged 15-24 years were recruited from the outpatient clinics of a tertiary psychiatric hospital in Singapore using convenience sampling. All participants were administered the Multidimensional Peer Victimisation Scale (MPVS), Short Form 12 (SF-12) questionnaire and the Patient Health Questionnaire-8 (PHQ-8). The effect of MPVS  total and subscores on depression scores, quality of life subscores and quality of life total scores were examined using multiple linear regression analyses.

RESULTS

The majority of the patients reported that they had experienced at least one form of peer victimisation (95.8%, n = 229) during their school years. Higher levels of 'verbal victimisation', 'attacks on property' and higher total MPVS scores were significantly associated with lower social functioning; additionally, higher levels of 'verbal victimisation' were significantly associated with lower mental component summary scores in the quality of life assessment. Higher scores on all four subscales as well as higher total scores on the MPVS were significantly associated with more severe depressive symptoms.

CONCLUSIONS

Given the high prevalence of peer victimisation in our sample and its associations with more severe depressive symptoms and lower quality of life, it is vital to implement interventions that prevent peer victimisation in educational and other social settings and to provide youth with strategies to more effectively manage instances of peer victimisation.

Peer victimization, environmental and psychological distress, and academic performance among children in China: A serial mediation model moderated by migrant status

BACKGROUND

Despite robust evidence indicating the adverse academic, psychological, and school-related impacts of being victimized, the ways in which peer victimization indirectly affects children's academic performance by psychological and environmental distress remain poorly understood, especially in China.

OBJECTIVE

We sought to investigate how peer victimization negatively impacts academic performance via the serial mediation effects of environmental and psychological distress among migrant versus non-migrant children in China.

PARTICIPANTS AND SETTING

Participants were selected by multistage stratified cluster sampling, and data were collected with a cross-sectional survey administered in Nanjing and Guangzhou, China. The sample included 1747 students in Grades 4 to 9 (boys = 54.7 %, mean age = 11.7 years).

METHODS

Structural equation modeling and group comparison analysis were conducted to examine the hypothesized model.

RESULTS

Children's experiences with peer victimization significantly affected their academic performance and in relationships partially mediated by environmental distress (i.e., perception of school safety), followed by psychological distress (i.e., anxiety) (95 % CI: [-0.010, -0.001], B = -0.005, p < .01). The serial mediation model applied to non-migrant children only (95 % CI: [-0.026, -0.001], B = -0.008, p < .05), however, whereas environmental distress exerted a single mediating effect on the association between peer victimization and academic performance among migrant children only (95 % CI: [-0.125, -0.044], B = -0.076, p < .001).

CONCLUSION

Environmental and psychological distress exerted serial mediating effect on the association between peer victimization and academic performance. School-based comprehensive intervention programs designed for migrant versus non-migrant children are recommended.

Method of Nursing Interventions to Reduce the Incidence of Bullying and Its Impact on Students in School: A Scoping Review

The bullying of students in schools can have a negative impact on students. The impact of bullying can take the form of anxiety, low psychological well-being, low social adjustment, psychological distress, and risk of suicide. Incidents of bullying are still considered normal, and there has not been a focus on reducing their incidence and impact. The purpose of this study is to describe nursing interventions to reduce the incidence of bullying and its impact on students at school. This study used the scoping review method and literature reviews via CINAHL, PubMed, and ProQuest databases. The keywords used in English were "bullying OR cyberbullying OR aggression" AND "students OR school students" AND "school OR schools" AND "nursing intervention". The criteria for articles in this study were: full texts, student populations and samples, randomized control trials or quasi-experiment research designs, use of the English language, and the publication period of the last 10 years (2013-2022). We found 11 articles discussing nursing interventions to reduce the incidence of bullying and its impact on students in schools. There are four types of interventions that can be provided to students, namely, prevention programs, activities programs, peer group programs, and resilience programs. Most of the articles used randomized control trials and quasi-experiment designs. The samples in the articles analyzed were in the range of 50-7121 students. These four types of interventions can reduce the incidence of bullying and its impact on students at school, and in addition, they can improve the social skills and mental health of students, for example, by increasing their self-efficacy, resilience, and adaptive coping. There are four nursing interventions to reduce the incidence of bullying and its impact on students in schools, namely, the prevention program, activities program, peer group program, and resilience program.

Psychological disorders, adverse childhood experiences and parental psychiatric disorders in children affected by headache: A systematic review

BACKGROUND

Pediatric headaches have been linked to adverse life events or psychological factors in children and their families, with a complex and bidirectional association. Moreover, it is well-known that psychological stress can trigger headaches.

METHODS

We searched three databases for studies focusing on headaches and adverse events or psychological factors in children up to 12 years old or in their caregivers.

RESULTS

We included 28 studies. Child psychological factors, including internal and external symptoms, were commonly associated with all types of headaches. Sleep disturbances showed a positive association with headaches in 3 out of 5 studies. Family conflict and unhappiness were frequently found in children suffering with headaches, while single-parent families and divorce were not associated. Stressful environments and adverse life events, particularly bullying, were also found to be linked with headaches.

CONCLUSIONS

Childhood headaches represent an alarm bell for clinicians to investigate and treat psychological or psychiatric disorders in children and their family. Further studies are needed to elucidate the role of early-life adverse events in children and their families.

The association between the social environment of childhood and adolescence and depression in young adulthood - A prospective cohort study

BACKGROUND

Good social relationships with parents and peers protect children and adolescents from developing mental disorders in adulthood while several negative experiences increase the risk of depression in later life.

METHODS

We used population-based cohort data from the Northern Finland Birth Cohort (NFBC) 1986. Participants (n = 6147), their teachers and parents reported factors associated with the social environment of children and adolescents. Diagnoses of depression of cohort members were derived from Finnish nationwide registers. We conducted regression analyses to assess which factors of the social environment of childhood and adolescence were associated with depression in young adulthood.

RESULTS

Bullying victimization in adolescence was the strongest predictor of depression in young adulthood among girls (OR 2.23: 95% CI 1.47-3.39) and boys (OR 2.44: 95% CI 1.49-4.00). Loneliness and bullying behavior in childhood were associated with depression in boys only. Loneliness in adolescence (OR 1.63: 95% CI 1.30-2.04) was associated with depression among both genders. Spending with the family seemed to protect against the negative impact of bullying and loneliness.

LIMITATIONS

We used single-item study questions to measure social relationships. These questions do not necessarily describe the phenomena as accurately as the measures validated for them.

CONCLUSION

Problems in social relationships with peers in childhood and adolescence are associated with depression in young adulthood. Time spent with the family is emphasized in situations in which adolescents have problems in peer-relationships.

A Path from Traditional Bullying to Cyberbullying in South Korea: Examining the Roles of Self-Control and Deviant Peer Association in the Different Forms of Bullying

Despite a recent growth in studies on cyberbullying, extant knowledge on the underlying mechanisms of cyberbullying remain limited. The objective of the present study is to explore the dynamics of cyberbullying via traditional bullying, self-control, and delinquent peer association. Specifically, the following hypotheses guide the present study: (1) traditional bullying, low self-control, and delinquent peer association are predictive of cyberbullying, respectively, (2) the interaction between traditional bullying and low self-control has a significant impact on cyberbullying, and (3) the interaction between traditional bullying and delinquent peer association has a significant impact on cyberbullying. The present study relies on five waves of the Korean Youth Panel Survey (KYPS), a representative sample of South Korean adolescents. Data collection occurred annually and respondents were 14 years old at the first wave in 2003. KYPS is an almost gender-equal and racially/ethnically homogenous sample. Results of cross-lagged dynamic panel models show (1) significant effects of traditional bullying on cyberbullying with and without low self-control and delinquent peer affiliation, (2) the respective roles of self-control and delinquent peer association in the prediction of cyberbullying, and (3) an interaction effect between low self-control and traditional bullying on cyberbullying. These findings demonstrate the theoretical validity of self-control theory and social learning theory in online delinquent behavior as well as confirm their cross-cultural generalizability in a non-Western sample. The findings also highlight the importance of investing in early life-course prevention/intervention programs and policies to prevent and/or reduce the occurrence of bullying, regardless of whether it is being perpetrated face-to-face or online, and these programs and policies should also target components to improve self-control and reduce delinquent peer associations.

Association of child maltreatment and bullying victimization among Chinese adolescents: The mediating role of family function, resilience, and anxiety

BACKGROUND

Among adolescents, child maltreatment is linked to being bullied at school. Nevertheless, little is known about the mediating mechanisms underlying this association. Therefore, our research aimed to explore and evaluate the potential mediators of the relationship between child maltreatment and bullying victimization among Chinese adolescents.

METHODS

From October to December 2020, a population-based cross-sectional survey was conducted among 6247 adolescents (3401 males, 2846 females) in Anhui Province, China. The subjects of the survey were elementary and middle school students from grades 4 to 9. The data were collected through self-report questionnaires. Pearson correlation and linear regression were used to examine the relationships among child maltreatment, bullying victimization, family function, resilience, and anxiety. Structural equation modeling (SEM) was employed to conduct mediation analyses.

RESULTS

The results indicated that child maltreatment positively predicted the later bullying victimization of adolescents. Resilience and anxiety were each shown to separately mediate this relationship. Moreover, the sequential mediating effects of family function, resilience, and anxiety also mediated the predictive effect of child maltreatment on bullying victimization.

CONCLUSIONS

Resilience and anxiety were both shown to be important independent mediators for the relationship between child maltreatment and bullying victimization. Furthermore, the combined mediating effects of family function, resilience, and anxiety were also of great significance. These findings provide additional evidence that family and individual factors are critical to understanding bullying victimization. Effective prevention and intervention strategies for school bullying should target family and individual vulnerabilities in adolescents.

Association of aggressivity at adolescence and criminality to severe assault exposure among former adolescent psychiatric inpatients

This study investigated the associations of adolescent aggression, and criminality, to severe hospital-treated assault exposures among young adults (n = 508) with a history of adolescent psychiatric inpatient treatment between 2001-2006. Participants were interviewed during hospitalization using K-SADS-PL to assess psychiatric disorders, and to obtain information on aggressivity. Data on crimes committed were obtained from the Finnish Legal Register Centre, and the treatment episodes for assault exposures from the Finnish National Care Register for Health Care, up to end of 2016. Predictors for severe assault exposure were male sex (OR = 2.1), short temperedness (OR = 2.4), non-violent offending (OR = 2.6), and violent offending (OR = 4.8). These results indicate that the participants most vulnerable to severe assaults were those suffering from a continuum of aggressivity across their lifetime. Our findings can be utilized to identify adolescents at risk of severe assault exposure, and to reduce this risk by focusing on appropriate treatments for these vulnerable adolescents.

The Long-Term Effects of Bullying, Victimization, and Bystander Behavior on Emotion Regulation and Its Physiological Correlates

Bullying at school is a serious social problem that influences the wellbeing of everyone involved, that is, victims, perpetrators, and bystanders. Among the many health and psychological problems that these individuals may develop, emotion dysregulation appears to be a common marker. To date, however, it remains unclear whether bullying experienced during the school years is associated with emotion dysregulation also in adulthood. In this study, by adopting a retrospective approach, we investigated whether involvement in bullying at school-either as a bully, victim, or bystander-could put these individuals at risk of presenting deficits in emotion regulation in adulthood, as assessed with behavioral (explicit) and physiological (implicit) indexes (i.e., skin conductance), and whether the association between the involvement in bullying and emotion regulation was direct or mediated by other factors, such as somatic complaints and sensation seeking. A total of 58 young adults were asked to control their emotional reactions in front of images with strong emotional content, and to explicitly evaluate them with ratings, while their arousal was measured through skin conductance. They also responded to questionnaires about retrospective involvement in bullying, somatic complaints, and sensation seeking. Results revealed that victimization and bystander behavior were directly and negatively associated with emotion regulation as assessed with skin conductance, whereas bullying was positively associated with implicit emotion regulation through the mediation of sensation seeking. Interestingly, emotion regulation as assessed with explicit ratings was not associated with any of the characteristics of the participants. Our study suggests that being directly (as victim) but also indirectly (as bystander) involved in bullying at school time is associated with difficulties in emotional wellbeing in adulthood. Furthermore, it reveals that behavioral and physiological indexes associated with emotion regulation dissociate, suggesting that subtle physiological changes may remain hidden from explicit behavior.

The light and the dark side of social media use: Depression, anxiety, and eating attitudes among adolescents

In the current study, we explored the links between social networking activity, eating attitudes (EA), anxiety, and depression among adolescents. We used a cross-sectional design. Our sample consisted of 532 males and females, aged 12 to 15 (M = 13.55, SD = 0.90), from the Eastern side of Romania. We analyzed our data using three different pathways to explore these relationships on the overall sample, as well as the at-risk for eating disorders (ED) group (n = 134), and the non-ED-risk (n = 398) samples. The results suggested that depressive and anxiety symptoms partially mediated the relationship between social networking and eating attitudes in the overall group and in the not-at-risk for ED group, but not in the at-risk for ED sample. When controlling for gender, social networking use partially mediated the relationship between anxiety and depressive symptoms and eating attitudes in the overall group and the not-at-risk for ED group, and a total mediating effect within this relationship in the at-risk ED sample was also found. In adolescents with symptoms of potential ED, social networking use seemed to have a protective role compared to the not-at-risk sample. The present study suggested that social networking use might increase the chances of developing unhealthy eating attitudes in adolescents who are not-at risk to develop an eating disorder, but, at the same time, it might play a protective role (instead of a harmful one) for adolescents who already developed such symptoms. Results are discussed concerning their clinical and practical implication for adolescents? physical and mental health, especially during the COVID?19 pandemic, and the potential protective role of social media use for adolescents with ED symptoms.

From Bully Victimization to Aggressive Behavior: Applying the Problem Behavior Theory, Theory of Stress and Coping, and General Strain Theory to Explore Potential Pathways

Studies have documented that some bully victims fall into a subcategory of bullying called "bully victims" in which the victim becomes the aggressor. However, studies to date have not examined the pathways linking bully victimization and aggressive behavior. To address this research gap, this study applies the problem behavior theory, theory of stress and coping, and general strain theory to explore possible pathways from bully victimization to aggressive behavior by examining the mediating effects of low life satisfaction, drug use, and exposure to peer deviance. Structural equation modeling was used to examine the path model from a sample of 1,676 adolescents, aged 13 to 17 years. Data were derived from the Health Behavior in School-Aged Children (HBSC) survey. Findings revealed that bully victimization was positively associated with aggressive behavior. Moreover, bully victims displayed lower levels of life satisfaction. In addition, bully victims who were frequently exposed to peer deviance and drug use were likely to engage in bullying. These findings support the problem behavior theory and general strain theory and have implications for research, practice, and policy.

Pre-vaccination vulnerability and suspected adverse events following HPV vaccination. A case-control study nested in the Danish national birth cohort

Previous studies have indicated that girls experiencing suspected adverse events (AE) following HPV vaccination were more vulnerable prior to vaccination. However, no study has previously investigated differences in vulnerability using prospectively collected self-reported measures of vulnerability. The objective of this study therefore was to describe the distribution of biological and psychosocial indicators of vulnerability in girls referred to a hospital setting due to suspected adverse events and compare it with a sample of non-referred HPV vaccinated girls. The study was conducted as a case control study based within the Danish National Birth Cohort. Cases were defined as HPV vaccinated girls referred to a hospital setting between 2015 and 2017 due to suspected adverse events (n = 80), and 5 controls were randomly selected from the remaining source population, matched to cases on age at vaccination, region of residence and year of vaccination. The final study population consisted of 480 girls. Prior exposures were based on information gathered from an 11 year follow up of the DNBC and included information on self-rated health, frequent health complaints, medication use, bullying, stressful life events and physical activity. Conditional logistic regression analysis was used to estimate the association between each exposure and referral. The percentage of individuals in the exposed category of each exposure was generally higher for cases than controls. Particularly, the odds of being referred were higher for those with low self-rated health compared to high (OR [95%-CI] 2.43 [1.07-5.5]1), those being bullied (OR 3.19 [1.17-8.73]), and those who had taken medication (OR 2.22 [1.32-3.67]). Overall, these results indicated that girls experiencing suspected AE following HPV vaccination were more vulnerable prior to vaccination.

The relationship between social and academic outcomes and anxiety for children and adolescents on the autism spectrum: A systematic review

Anxiety is the most common co-occurring condition in children on the autism spectrum but the potential impacts of anxiety on social and academic outcomes of children on the autism spectrum have not been systematically examined. In this review, 50 studies were identified that explore the relationship between anxiety and scores on social or academic measures in children on the autism spectrum. Social competence was frequently measured, and the findings of these studies were mixed. While other social constructs have received little attention, associations were found between anxiety and victimisation, and anxiety and social relationships. Only three studies focused on the impact of anxiety on scores on academic measures, highlighting the need for further research in this area. Anxiety was most frequently measured using subscales from broader behavioural instruments, which may not capture the range of anxiety symptoms of children on the autism spectrum. Future studies that include multi-informant methodologies and proportional representation of females and children with intellectual disability will further knowledge of the impact of anxiety in children on the spectrum.

Construction and Psychometric Properties of a Short Form of the Personal Experiences Checklist

Peer victimization is a significant problem concerning young people. However, there are few brief measures that cover the key domains of victimization, including cyber victimization. Therefore, the objective of the present study was to construct and validate a short form version of the Personal Experiences Checklist (PECK) to be able to measure victimization efficiently and effectively. The PECK was originally developed to measure a young person's experience of victimization and provides scores for four subscales (relational-verbal, cyber, physical, and victimization in relation to culture) as well as a total score. A sample of N = 1,040 school students from Grades 4 to 9 (mean age = 12.2 years) derived from two studies was used to construct and cross-validate the structure of a Personal Experiences Checklist Short Form (PECK-SF) using confirmatory factor analysis and item response theory analysis. Based on discriminative ability and consideration of item content, 14 items were selected to form the PECK-SF, which demonstrated good internal consistency (Cronbach's α = .83). Given the small number of items, the use of subscales is not advised. However the PECK-SF total scale represents a potential alternative to the long form of the PECK and provides a brief and general index of victimization.

School Bullying and Association with Somatic Complaints in Victimized Children

OBJECTIVE

To examine the relationship between peer victimization and psychosomatic symptoms among school-going children.

METHODS

A total of 213 school-going children (Mean = 11.49 y, SD = 1.44) studying in grades 5 to 8 were recruited from 2 schools from a north Indian city. The children were administered the California Bullying Victimization Scale (CBVS), Pre-Adolescent Adjustment Scale (PAAS), and the Children's Somatization Inventory (CSI). The total score on the somatization inventory and the total number of psychosomatic symptoms endorsed were used as the main outcome measures.

RESULTS

Out of the 213 students, 42.7% were involved in bullying either as victims or as perpetrators. A little more than one-fourth (26.8%) were victims. A consistent positive association between victimization and somatic complaints was found. The most common physical symptoms reported by victims included headache (60.7%), chest pain (35.7%), stomach pain (33.9%), weakness (30.4%), and pain in arms and legs (19.6%). Stepwise multiple regression analysis revealed that 22.6% of the variance in the total CSI scores was accounted by the total victimization score, self-reported adjustment with school teachers, and academic performance (F = 20.97, P = 0.0001). The total number of functional somatic symptoms were predicted by the total victimization score, academic performance, and age of the child (F = 16.03, P = 0.0001). These variables together predicted 18% of the variance in the total number of symptoms.

CONCLUSIONS

Primary health care clinicians and pediatricians need to consider bullying as one of the potential risk factors when they encounter physical symptoms among pediatric patients in their clinical practice.

Bullying and Its Associated Individual, Peer, Family and School Factors: Evidence from Malaysian National Secondary School Students

Adolescents involved in bullying can be at risk of developing behavioural problems, physical health problems and suicidal ideation. In view of this, a quantitative research design using a cross-sectional study was conducted to determine the prevalence of bullying and associated individual, peer, family and school factors. The study involved 4469 Malaysian public-school students who made up the response rate of 89.4%. The students were selected using a randomized multilevel sampling method. The study found that 79.1% of student respondents were involved in bullying as perpetrators (14.4%), victims (16.3%), or bully-victims (48.4%). In a multivariate analysis, the individual domain showed a significant association between students' bullying involvement and age (OR = 1.38; 95% CI 1.12-1.70), gender (OR = 1.73; 95% CI 1.47-0.91), ethnicity (OR = 0.66; 95% CI 0.47-0.91), duration of time spent on social media during the weekends (OR = 1.43; 95% CI 1.09-1.87) and psychological distress level (OR = 2.55; 95% CI 1.94-3.34). In the peer domain, the significantly associated factors were the number of peers (OR = 0.69; 95% CI 0.56-0.86) and frequency of quarrels or fights with peers (OR = 2.12; 95% CI 1.24-3.26). Among the items in the school domain, the significantly associated factors were students being mischievous in classrooms (OR = 1.52; 95% CI 1.06-2.06), student's affection towards their teachers (OR = 1.53; 95% CI 1.06-2.20), frequency of appraisal from teachers (OR = 1.49; 95% CI 1.16-1.94), frequency of friends being helpful in classrooms (OR = 1.92; 95% CI 1.09-3.38) and frequency of deliberately skipping class (OR = 2.91; 95% CI 2.90-1.72). As a conclusion, the study revealed high levels and widespread bullying involvement among students in Malaysia. As such, timely bullying preventions and interventions are essential, especially in terms of enhancing their mental health capacity, which substantially influences the reduction in the prevalence rates of bullying involvement among students in Malaysia.

A Systematic Review of the Prospective Relationship Between Bullying Victimization and Pain

Objective

This systematic review synthesized evidence about the relationship between childhood bullying victimization and chronic pain, with a focus on the temporal nature of the relationship and moderating factors, such as the type and intensity of victimization.

Method

We included prospective cohort studies that examined the relationship between childhood bullying victimization and pain measured at least three months later. We conducted electronic searches of Medline, EMBASE, PsycINFO, and CINAHL up to June 30, 2019. Standard methodological procedures consistent with Cochrane reviews of prognosis studies were used (PROSPERO record ID 133146).

Results

We included four longitudinal studies (6275 participants) in this review. The mean age of participants at baseline ranged from 10 to 14 years and the follow-up periods ranged from 6 months to 12 years. Two of the four studies were judged as having high risk of bias. Meta-analysis of results from four studies revealed increased risk of pain among victimized compared to non-victimized youth (adjusted OR [95% CI] = 1.45 [1.06-1.97], but the effect size was small and not clinically important. Only one study examined the inverse association (ie, from pain to victimization), and there was not enough evidence to conduct a meaningful analysis of the proposed moderators.

Conclusions

Study findings were limited by few prospective studies. Meta-analytic findings suggested that victimization may incur some risk for later pain, although the evidence was judged to be very low quality. High-quality studies that measure and report the nuances of bullying victimization are needed to test the proposed moderator models.

Risk and Protective Pathways to Peer Victimization from Infancy to Adolescence: Role of Fathers

This study examined the developmental pathways from fathers' psychopathology in early childhood to child peer victimization (bullying and cyber victimization) in late adolescence via family relationships and early adolescent psychosocial functioning (anxiety, emotion regulation, social problems). A conceptual model with pathways through inter-parental aggression and fathers' parenting (harshness and sensitivity) was tested. Participants were 227 families (51% female children recruited as infants) who participated in a longitudinal study examining the role of parental alcohol problems and associated risks on developmental and family processes from infancy to late adolescence. Multi-method (observational, parent report, adolescent report) assessments of family processes and child outcomes were conducted across all time points. Fathers' alcohol problems and depressive symptoms in early childhood was prospectively associated with inter-parental aggression in middle childhood and social problems in early adolescence. For boys only, early adolescent social problems were predictive of bullying victimization. Fathers' antisocial behavior in early childhood was associated with less sensitive parenting in middle childhood. Fathers' sensitivity in middle childhood was protective, being associated with lower cyber victimization in late adolescence. Fathers' sensitivity was also associated with higher emotion regulation in early adolescence; however, counter to expectations, higher emotion regulation was associated with more bullying and cyber victimization. Findings shed light on differences in the etiological pathways to bullying and cyber victimization, as well as how distinct forms of paternal psychopathology in early childhood associate with family relationships, child adjustment, and vulnerability to peer victimization in late adolescence.

Patterns of Aggressive Behaviors Across Mental Health in Sixth Graders

School-based violence is a current public concern in the United States. One factor that can impact school-based violence that has gained much attention is mental health status. To better inform public perceptions, this study provides new evidence concerning the association between mental health status and acting out violence in school-aged populations. We examined a diverse sample of sixth graders across 14 schools in Texas in 2011-2012 (N = 721) who completed a self-administered survey assessing mental health symptoms and frequency of perpetration and/or receipt of different types of aggressive behaviors. Multinomial regression models tested whether adolescents with mental health symptoms (overall and by symptom types) are more predisposed to be actors only, recipients only, or both, of physical, verbal, and relational aggression. Across aggressive behavior types, symptomatic versus nonsymptomatic adolescents had consistently increased odds of being exclusively a recipient of aggression. When symptomatic adolescents did act out aggression, they participated concurrently as both an actor and recipient. Rarely were symptomatic adolescents more likely to be exclusively an actor of aggression. Moreover, symptomatic versus nonsymptomatic adolescents had five times the odds of being threatened by a weapon including a gun or knife. Compared to those who do not, youth who perceive having a mental health issue had twice the odds of being an actor only of verbal and relational aggression. These findings provide evidence for the need to change how the public associates mental health problems with aggressive behaviors among youth especially following national tragic events. Communities at large may benefit from evidence- and school-based interventions that improve awareness of and tolerance to mental health conditions among youth.

Violent Victimization, Stressful Events, and Depression: A Longitudinal Study of Young Adults in the U.S

We surveyed a sample of young adults in the United States to determine (1) whether/how depression is affected by violent victimization during childhood and/or by recent stressful events, as well as (2) whether any observed links between depression and violent victimization and/or stressful events would be uniform across racial/ethnic groups. Using data from the National Longitudinal Survey of Youth 1997 cohort, we measured respondent depression in 5 interview waves dating 2004-2015. Our final sample for analysis numbered 22,549 person-waves. Our study showed that violent victimization in childhood, and recent stressful events, as well, alike exacerbated depression. Moreover, as we analyzed, in turn, the data for each ethnic subsample, we observed differential patterns in depression's associations with victimization. Childhood violent victimization-and also recently encountered stress-has a significant role in the development of depression in adulthood; this role appears to be moderated by race/ethnicity.

Critical Evaluation of the Case for Pausing California's School-based Fitness Testing

Objective

We undertook a literature review to evaluate the evidence for an association among school-based fitness testing and bullying, weight-based teasing (WBT), and/or gender discrimination.

Methods

We searched the peer-reviewed literature using PubMed, ERIC and GOOGLE Scholar to identify articles related to school-based physical fitness testing (K-12) on the one hand and bullying, WBT, and/or gender discrimination on the other.

Results

We identified 12 studies on the impact of school-based physical fitness testing (PFT) on bullying and WBT. These studies do not support the assertion that PFT places students at elevated risk for bullying and/or WBT as compared to other school settings. There is a dearth of studies investigating an association between PFT and gender discrimination.

Conclusions

The concerns about PFT as a widespread cause of bullying and WBT are not supported by the evidence. It is likely that school climate is a stronger determinant overall of these negative student interactions and that more rigorous teacher training would ameliorate student concerns about fitness testing. Nevertheless, more rigorous research is warranted to determine with confidence that PFT does not elevate students' risks for bullying and WBT and to examine the risks for students with non-binary gender.

Victimization in traditional and cyberbullying as risk factors for substance use, self-harm and suicide attempts in high school students

Background:

Traditional bullying (or peer bullying) is considered a common and unpleasant experience among students and has serious consequences such as mental health problems and unhealthy behavior. In recent years, another type of bullying named cyberbullying has emerged as a growing problem with negative effects on school achievement, physiology, and mental health of its victims.

Objective:

The purpose of this research is to examine and compare the roles of traditional and cyberbullying victimization in substance use, self-harm and suicide attempts.

Methods:

This was a cross-sectional study and conducted in 2019. A total of 425 high school students were selected for the study in Kermanshah, Iran. For conducting the survey, a multi-stage cluster randomized procedure was used and 18 classes in six different high schools in three urban areas were selected. A total of 400 students (mean age 16.61 years, 53.2% girls) responded to the survey, and it provided usable information for the research. Data were analyzed through binary logistic regression analyses.

Results:

The analysis results revealed that 54.2% of students (n = 217) have experienced traditional or cyber victimization. Any kind of victimization was associated with self-harm. Cyber victimization alone and the combination of cyber plus traditional victimization showed significant association with suicide and substance use. Risk of substance use, self-harm, and suicide was higher when students experienced both types of bullying than when they experienced just one kind of bullying alone.

Conclusions:

The results of this study suggest that traditional and cyber victims may require immediate intervention to reduce the negative effects of victimization. Also, prevention programs should consider the possible relationship between traditional and cyber victimization and substance use, self-harm, and suicide.

The social withdrawal and social anxiety feedback loop and the role of peer victimization and acceptance in the pathways

Social withdrawal and social anxiety are believed to have a bidirectional influence on one another, but it is unknown if their relationship is bidirectional, especially within person, and if peer experiences influence this relationship. We investigated temporal sequencing and the strength of effects between social withdrawal and social anxiety, and the roles of peer victimization and acceptance in the pathways. Participants were 2,772 adolescents from the population-based and clinically referred cohorts of the Tracking Adolescents' Individual Lives Survey. Self- and parent-reported withdrawal, and self-reported social anxiety, peer victimization, and perceived peer acceptance were assessed at 11, 13, and 16 years. Random-intercept cross-lagged panel models were used to investigate within-person associations between these variables. There was no feedback loop between withdrawal and social anxiety. Social withdrawal did not predict social anxiety at any age. Social anxiety at 11 years predicted increased self-reported withdrawal at 13 years. Negative peer experiences predicted increased self- and parent-reported withdrawal at 13 years and increased parent-reported withdrawal at 16 years. In turn, self-reported withdrawal at 13 years predicted negative peer experiences at 16 years. In conclusion, adolescents became more withdrawn when they became more socially anxious or experienced greater peer problems, and increasing withdrawal predicted greater victimization and lower acceptance.

Violence Victimization Among Adolescents from Culturally or Ethnically Diverse South Korean Families

This study compared the prevalence of violence victimization requiring hospital treatment among adolescents that are culturally or ethnically diverse and those that are South Korean living in South Korea. This study used a nationally representative data set of 63,376 adolescents obtained from the Korean Youth Risk Behavior Web-based Survey conducted in 2015 by the Korea Centers for Disease Control and Prevention. Hierarchical multivariable logistic regression was conducted to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for violence victimization in each group of culturally diverse adolescents compared to that of adolescents with South Korean parents. The analysis showed that adolescents whose parents are both culturally or ethnically diverse had ORs of 18.64 (95% CI 11.28-30.81) for violent experience. To decrease the violent victimization of culturally diverse adolescents with a culturally or ethnically diverse parent, specific government policies and school strategies are needed.

School Mental Health Curriculum Effects on Peer Violence Victimization and Perpetration: A Cluster-Randomized Trial

BACKGROUND

Addressing school violence is an important public health goal. To assess the role of school mental health curricula in violence prevention, we evaluated effects of an anti-stigma curriculum on violence victimization/perpetration.

METHODS

An ethnically/socioeconomically diverse sample of 751 sixth-graders (mean age 11.5 years) across 14 schools in Texas were block-randomized by school (2011-2012) to receive singly or in combination: (1) a mental illness anti-stigma curriculum; (2) contact with 2 young adults with mental illness; or (3) merged control (printed materials/no intervention). Pre- and post-test assessments were self-completed during health education classes; prior to randomization, 484 (64.5%) agreed to 2-year, home-based longitudinal assessments. Statistical models tested short- and long-term effects on physical, verbal, and relational/social violence victimization/perpetration.

RESULTS

At 1-month post-test, students who received the curriculum versus control made fewer verbal threats (p < .05). Those with high-level mental health symptoms in the curriculum group versus control used less violence overall and received fewer verbal threats from peers short-term (p < .05). Curriculum effects of reducing violence perpetration sustained long-term among adolescents with high-symptoms (p < .01). The comparator contact intervention was ineffective short- and long-term.

CONCLUSIONS

Implementing efficacious mental health curricula can serve as a multi-pronged strategy with anti-bulling efforts to prevent violence and improve mental health.

Bullying, health complaints, and self-rated health among school-aged children and adolescents

Objective

The aim of the current study was to examine whether health complaints and self-reported health were associated with bullying victimization in a large cohort of Icelandic children and adolescents.

Methods

In this study, we used data from a school-based cross-sectional survey, specifically, the Icelandic contribution to the international research network Health Behavior in School-aged Children (HBSC). The study population included all students throughout Iceland in grades 6, 8, and 10 (mean age 13 years, standard deviation 1.61). The participation rate was 84% (N = 11,018). Participating students completed an anonymous standardized questionnaire in their classrooms.

Results

Bullying victimization was associated with feeling depressed (odds ratio 2.61), having difficulty falling asleep, dizziness, and low self-reported health. No differences were found between sex and age groups.

Conclusions

Children and adolescents who are bullied appear to more often experience depression, difficulties falling asleep, dizziness, and poor health; however, health complaints were also relatively high among non-bullied children and adolescents. Bullying prevention measures must be implemented in children’s and adolescents’ social environments. In addition to assessing bullying interventions, further research should focus on methods of enhancing resilience in this population.

Association between aggressive and non-fatal suicidal behaviors among U.S. high school students

OBJECTIVE

This study quantified the association between aggressive and non-fatal suicidal behaviors (NFSB) among U.S. high school students and examined whether the association could be explained by substance use, bullying and sexual/dating violence victimization, and other potential risk factors.

METHOD

Data were based on self-reports from 14,765 students who responded to the 2017 National Youth Risk Behavior Survey. Confirmatory latent class analysis (LCA) identified two distinct, dichotomous latent class variables manifested by indicators of past-year NFSB (i.e., ideation, plan, and attempt) and aggressive behavior (i.e., physical fighting in general and on school property). The structural model estimated the odds ratios between NFSB, aggressive behavior, and their potential risk factors.

RESULTS

Without adjusting for covariates, the confirmatory LCA estimated an odds ratio (OR) of 2.55 (95% confidence interval [CI]: 1.93, 3.37) between two latent class variables for violence against self (NFSB) and others (physical fighting). The net association, however, was rendered nonsignificant (OR = 1.08 [95% CI: 0.88, 1.31]) when adjusted for covariates. Significant common risk factors included exposure to physical dating violence, being bullied on school property and/or electronically, being threatened or injured by someone with a weapon on school property, and lifetime illegal drug use and prescription opioid misuse.

LIMITATIONS

Cross-sectional data do not allow assessment of causal relationships.

CONCLUSIONS

Findings elucidated the association between NFSB and aggressive behavior, with serious implications for prevention and intervention. Targeting substance use, bullying, and sexual and dating violence will protect students from engaging in both types of violent behaviors.

Freeze-like responses to pain in humans and its modulation by social context

Background

Maladaptive defensive responses such as excessive avoidance behavior have received increasing attention as a main mechanism for the development and maintenance of chronic pain complaints. However, another defensive response which is commonly studied in animals as a proxy for fear is freezing behavior. No research to date has investigated human freezing behavior in the context of pain. In addition, there is an increasing realization that social context can affect pain-relevant processes such as pain experience and pain behavior but less is known about the effects of social context on defensive responses to pain. Hence, this study investigated freezing behavior and facial pain expression in the context of pain, and their modulation by social context.

Methods

Healthy, pain-free participants (N = 39) stood on a stabilometric force platform in a threatening or safe social context, which was manipulated using angry or happy facial stimuli. In some trials, an auditory cue (conditioned stimulus; CS) predicted the occurrence of painful electrocutaneous stimulus (unconditioned stimulus; pain-US). We assessed body sway (an index of freezing), heart rate, facial pain expression, self-reported pain intensity, unpleasantness, and pain-US expectancy during the CS and the context alone (no CS).

Results

The results were mixed. Neither the anticipation of pain, nor social context affected body sway. Heart rate and painful facial expression were reduced in the threatening social context at high anxiety levels. A threatening social context also elicited higher pain-US expectancy ratings. In sum, a threatening social context increases the expectation of pain, but reduces the facial expression of pain and lowers heart rate in highly anxious individuals.

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

AIMS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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