Socioeconomic inequality in exposure to bullying during adolescence: a comparative, cross-sectional, multilevel study in 35 countries

Prevalence, patterns, and determinants of multimorbidity in South Africa: Insights from a nationally representative survey

BACKGROUND

Multimorbidity in Sub-Saharan Africa is under researched and includes distinct disease combinations to those seen in high income countries. The aim of this study was to determine the prevalence and distribution of multimorbidity in South Africa, as well as the associated individual, area-level and contextual factors.

METHODOLOGY

Multilevel logistic regression analyses were conducted on nationally representative 2016 South Africa Demographic Health Survey Data. The sample included 5,592 individuals (level 1) living in 691 neighbourhoods (level 2).

PRINCIPAL FINDINGS

Multimorbidity was present in 45.3% of the study population, ranging from 35.6% in Limpopo to 52.1% in Eastern Cape. Hypertension was the most prevalent condition (46.4%) followed by diabetes (22.6%). Individuals aged 65-95 had 11.57 times higher odds (95% CI 8.50-15.74) of multimorbidity compared to those aged 15-24. Women had nearly twice the odds of men (OR 1.95, 95% CI 1.68-1.27). Formerly married individuals had 1.63 times higher odds (95% CI 1.32-2.02) than never married. Compared to Black Africans, White individuals had 44% lower odds (OR 0.56, 95% CI 0.39-0.82) and those of mixed ethnicity had 31% lower odds (OR 0.69, 95% CI 0.51-0.92). Obesity increased the odds by 38% (OR 1.38, 95% CI 1.17-1.64) and occupational smoke exposure by 26% (OR 1.26, 95% CI 1.07-1.49). There was variation in multimorbidity at the neighbourhood level, with 2.9% of the variation attributable to contextual factors in the empty model. The median odds ratio was 1.35, indicating substantially higher odds of multimorbidity if an individual moved to a higher risk neighbourhood.

CONCLUSIONS

This study found a high burden of multimorbidity in South Africa patterned by demographic, socioeconomic, lifestyle and contextual factors. The results highlight the need for multilevel strategies to reduce multimorbidity and its inequities by addressing individual risk factors as well as neighbourhood-level determinants of health.

Early Bullying's Long Shadow: How Victimization in Childhood and Adolescence is Associated with University Students' Mental Health and Loneliness

Bullying victimization in childhood and adolescence is widely acknowledged for its detrimental effects on mental health and loneliness in young adulthood. However, the influence of onset time when bullying happens (in primary and/or secondary school) and of distinct forms of bullying remain underexplored. The study aims to explore the associations between seven forms of victimization (being teased or called nasty names; rumor spreading; physical harm; threat; property damage; robbery; social exclusion) during university students' primary and secondary school years and their current mental health and loneliness in China. A total of 684 university students (mean age = 19.05, SD = 1.56) completed Depression, Anxiety, Stress Scale (DASS-21), UCLA Loneliness Scale, and Retrospective Bullying Questionnaire, which involves recollection of bullying victimization during primary and secondary school years. Stable victim (those who experienced bullying victimization during both primary and secondary school years) was most strongly associated with current higher levels of depression, anxiety, stress, and loneliness. Different forms of bullying victimization in primary and secondary school years were independently associated with mental health and loneliness. Specifically, rumor spreading in secondary school strongly predicted depression, anxiety, and stress, while social exclusion in primary school was closely linked to depression, anxiety, and loneliness. These findings underscore the long-term psychological impact of various forms of bullying victimization experienced in primary and secondary school years and highlight the importance of targeted interventions that address specific types of bullying in primary and secondary school years to mitigate their enduring effects on mental health in young adulthood.

Family affluence and bullying victimisation affect life satisfaction in large-bodied adolescents: Evidence from 37 high-income countries

BACKGROUND

Adolescents with large body sizes often experience bullying which likely affects their overall well-being. Yet, there is limited research on how bullying victimisation affects overall life satisfaction among this cohort of adolescents, and how family affluence moderates this relationship.

OBJECTIVE

This study investigates the moderation effects of family affluence in the association between bullying victimisation and life satisfaction among adolescents with large bodies.

SETTING AND PARTICIPANTS

This research involved 16,240 adolescents with large bodies based on the World Health Organization's Body Mass Index Chart/Classification for ages 13 to 15 years from 37 high-income countries in Europe and North America.

DESIGN

The study used data from the Health Behaviour in School-aged Children (HBSC) survey, a cross-national study of adolescent health and well-being. Hypotheses were assessed through mixed effects binary logit models with random intercepts, accounting for data clustering and variations across regions.

RESULTS

After controlling for covariates, both cyberbullying (AOR = 1.72; 95 % CI = 1.48-2.00) and traditional bullying (AOR = 1.74, 95 % CI: 1.53-1.99) were significantly associated with lower life satisfaction compared with no bullying experience among participants. Family affluence partly moderated these associations, wherein the highest level of affluence reduced the effects of cyberbullying (AOR = 1.57, 95 % CI: 1.09-2.27) and traditional bullying (AOR = 1.41, 95 % CI: 1.02-1.96) on life satisfaction compared to lower levels.

CONCLUSION

Both traditional and cyberbullying significantly reduced life satisfaction among adolescents with large body sizes. However, higher family affluence moderates (reduces) these negative effects, suggesting a protective role of socioeconomic status. These findings highlight the need for targeted interventions to support bullied adolescents, particularly those with large bodies and from lower socioeconomic backgrounds.

The Relationship Between Family Functioning and Defending Behaviors Among Junior High School Students: The Mediating Effect of Empathy and Moderating Effect of Gender

Bystanders play a role in school bullying; more specifically, the defending behaviors of bystanders play an important role in stopping bullying. This study explores the relationship between defending behaviors and family functioning in the context of school bullying from a family perspective. The role played by individual characteristics (empathy and gender) in this relationship was also focused on. The participants were 994 adolescents (average age = 13.34 ± 0.92 years) from the east of China. They completed the McMaster Family Assessment Device, the Basic Empathy Scale, and the Defending Behaviors subscale of the Participant Role Questionnaire. After controlling for residence and age, we found that family functioning significantly and positively influenced defending behaviors, and cognitive empathy rather than affective empathy mediated the relationship between family functioning and defending behaviors. In addition, family functioning influenced defending behaviors in boys more strongly than in girls. This study may increase the likelihood that bystanders will engage in defending behaviors by informing interventions for school bullying.

The healthy context paradox: a cross-country analysis of the association between bullying victimisation and adolescent mental health

Bullying victimisation is an increasing global health problem among adolescents and is associated with short- and long-term adverse mental health outcomes. Investigating whether associations with mental health vary across national contexts and why, can provide insights into mechanisms underlying those associations and inform policy. We used data from 479,685 adolescents participating in the 2018 Program for International Student Assessment (PISA) cross-sectional survey and examined whether the associations between bullying victimisation, psychological distress and life satisfaction vary across 63 countries. We further tested the modifying role of country-level factors - bullying prevalence, income inequality and national wealth, by implementing multilevel cross-country analyses. We found significant associations between bullying victimisation, increased psychological distress (β = 0.181; 95%CI: 0.178, 0.184) and decreased life satisfaction (β = -0.158; 95%CI: -0.162, -0.155). Associations between bullying victimisation, psychological distress and life satisfaction among adolescents were consistent across countries in terms of direction but effect sizes varied substantially. The effects ranged from β = 0.08 in the Philippines to β = 0.40 in South Korea for psychological distress and from β = -0.05 in the Philippines to β = -0.36 in the United Kingdom for life satisfaction. In addition, consistent with the "healthy context paradox" effect, associations between bullying and mental health were larger in countries where the prevalence of bullying was lower, as well as in higher-income countries. Interventions aiming to reduce bullying victimisation should aim to provide additional targeted support for those who still experience bullying after the intervention.

Socio-Economic Status and Bullying Victimization in India: A Study About Social Misfit and Minority Perception

The Social Misfit Theory, which states that some individuals deviate from what is normative in a community and may therefore be more likely to be victimized, has mostly been studied in Western countries. The current study addresses in a longitudinal sample whether socio-economic minorities (SES) in the classroom (a contextual SES minority) are more likely to become victims of bullying in India, and whether the relation between minority status and victimization is mediated by perception of oneself as a minority. The current study used three waves separated by three month intervals. A sample of youth from Indore India (grades 7 to 9; N = 1238; M-ageT1 = 13.15, SD = 1.16, 24 percent girls) was used. It was found that being a contextual SES minority was related to more victimization, but only when the contextual status was corroborated by the perceived minority status. However, over time, being part of a contextual minority predicted decreased victimization, possibly pointing to normative beliefs and values in the Indian context. The results of this study are in contrast to the Social Misfit Theory, but do support self-perception as a mediator.

A Snapshot of Peer Relationships in Children and Youth: Pre- Versus During COVID-19

Strong peer relationships are an essential component of a healthy, happy, and long lifetime. Given that there is little understanding of the impact of COVID-19 on peer relationships, this study explored the effects of the COVID waves on peer relationships for clinically referred children and youth while controlling for age, sex, and income. 11,281 children and youth between the ages of 4 and 18 years, who were receiving services from mental health agencies across Ontario from January 2018-March 2022, were assessed using the interRAI ChYMH. Chi-square tests of independence and logistic regression analysis was performed. Overall, as expected, there were significantly fewer peer relationship difficulties during COVID-19 compared to the pre-pandemic period. Despite the general decline of peer issues, individuals between the ages of 8-18, particularly males, were more likely to experience peer relationship difficulties compared to those 4-7 years old. Additionally, children from the lowest income households experienced greater peer relationship difficulties during COVID-19 when compared to those from the highest income households. The findings from this study demonstrate the nuanced changes in social behaviours due to the ongoing pandemic for children and youth and highlight those youth who are most in need of social and behavioural interventions.

Association between bullying at school and tooth loss among 15-19-year-olds from southern Brazil

This study aimed to investigate the association between bullying at school and tooth loss in southern Brazilian adolescents. This population-based cross-sectional study included a representative sample of 15-19-year-old students attending high schools in Santa Maria, southern Brazil. Data on sociodemographic and behavioral variables were collected through questionnaires. Contextual data on bullying at school was provided by educational institutions (bullying episodes in the previous year: 'no,' 'sometimes,' or 'often'). Tooth loss was clinically assessed by the M component of the DMFT index, modeled as a discrete variable. Multilevel Poisson regression was used, and rate ratios (RR) and 95% confidence intervals (CI) were estimated. The prevalence of tooth loss was 9.2% (95%CI = 7.5-10.8). Adolescents who attended the schools where bullying events often occurred had 0.39 (95%CI = 0.33-0.45) missing teeth, on average, in contrast to an average of 0.14 (95%CI = 0.08-0.19) among those whose schools did not experience bullying in the previous year. After adjusting for important cofactors, the contextual variable of bullying at school remained significantly associated with the study outcome. Adolescents who attended schools where bullying frequently occurred were 2.49-fold more likely to have an additional missing tooth than those whose school did not experience bullying in the previous year (RR = 2.49, 95%CI = 1.37-4.51, p = 0.003). In conclusion, the frequent bullying episodes at school were associated with more permanent teeth lost due to caries in this population. Hence, improving the school environment may improve the oral health of adolescents.

Perceived Social Support and Health Care Spending as Moderators in the Association of Traditional Bullying Perpetration with Traditional Bullying and Cyberbullying Victimisation among Adolescents in 27 European Countries: A Multilevel Cross-National Study

Existing research has documented the association between bullying perpetration and bullying victimisation. However, it is still unclear how different sources of social support moderate the association between bullying perpetration and bullying victimisation at a cross-national level. Using multilevel binary logistic regression models, this study examined the moderating role of public health care spending and perceived social support (i.e., family and teacher support) in the association between traditional bullying perpetration and victimisation by traditional bullying and cyberbullying among adolescents across 27 European countries. Country-level data were combined with 2017/18 Health Behaviour in School-aged Children (HBSC) survey data from 162,792 adolescents (11-, 13-, and 15-year-olds) in 27 European countries. Results showed that adolescents who perpetrated traditional bullying had a higher likelihood of being victimised by traditional bullying and cyberbullying than adolescents who did not bully others. Results also indicated that the magnitude of the positive association between traditional bullying perpetration and victimisation by traditional bullying and cyberbullying was mitigated among adolescents with more family, teacher, and public health care support. These findings support the notion that multilayered systems of social support could play a vital role in bullying prevention and intervention strategies to address bullying among adolescents.

Screen time, social media use, and weight-related bullying victimization: Findings from an international sample of adolescents

Screen time, social media, and weight-related bullying are ubiquitous among adolescents. However, little research has been conducted among international samples. Therefore, the aim of this study was to determine the association between screen time, social media use, and weight-related bullying victimization among an international sample of adolescents from six countries. Data from the 2020 International Food Policy Study Youth Survey were analyzed (N = 12,031). Multiple modified Poisson regression models were estimated to determine the associations between weekday hours of five forms of screen time, and total screen time, and use of six contemporary social media platforms and weight-related bullying victimization. Analyses were conducted among the overall sample, and stratified by country (Australia, Canada, Chile, Mexico, United Kingdom, United States). Greater hours of weekday screen time and use of each of the six social media platforms were associated with weight-related bullying victimization among the sample. Each additional hour of social media use was equivalent to a 13% (confidence interval [CI] 1.10-1.16) increase in the prevalence of weight-related bullying victimization. The use of Twitter was associated with a 69% (CI 1.53-1.84) increase in the prevalence of weight-related bullying victimization. Associations between hours of weekday screen time, use of six social media, and weight-related bullying victimization differed by country. Findings underscore the associations between screen time, social media, and weight-related bullying among a sample of adolescents from six medium- and high-income countries. Country-specific and global public health and technology efforts are needed to address this burgeoning social problem.

Associations between School-Level Disadvantage, Bullying Involvement and Children's Mental Health

Bullying is a modifiable risk factor for poor mental health across childhood and adolescence. It is also socially patterned, with increased prevalence rates in more disadvantaged settings. The current study aimed to better understand whether school-level disadvantage is associated with different types of bullying roles, and whether it is a moderator in the association between bullying and children's mental health. Cross-sectional data were used from 4727 children aged 6-11 years, from 57 primary schools across England and Wales. The child data included previous bullying involvement and bullying role characteristics (bully, victim, bully-victim, reinforcer, defender, outsider), and the teacher-reported data included each child's mental health (emotional symptoms and externalizing) problems. School-level disadvantage was calculated from the proportion of children in the school eligible to receive free school meals (an indicator of disadvantage). Children in more disadvantaged schools were more likely to report being bully perpetrators, bully-victims, and engage less in defending behaviors during a bullying incident. Children from more disadvantaged schools who reported bullying others showed fewer emotional symptoms than those from less disadvantaged schools. There was no other evidence of moderation by school-level disadvantage between bullying roles and emotional and externalizing problems. The findings highlight the potential for school-based interventions targeting children's emotional and social development, targeting bullying, and promoting defending behaviors, particularly in more disadvantaged settings.

Less Computer Access: Is It a Risk or a Protective Factor for Cyberbullying and Face-to-Face Bullying Victimization among Adolescents in the United States?

The present study investigates whether less computer access is associated with an increase or decrease in cyberbullying and face-to-face bullying victimization. Data were derived from the 2009-2010 Health Behavior in School-Aged Children U.S. Study, consisting of 12,642 adolescents aged 11, 13, and 15 years (Mage = 12.95). We found that less computer usage was negatively associated with cyberbullying victimization and face-to-face bullying victimization. The findings from the study have implications for research and practice.

Chronic, increasing, and decreasing peer victimization trajectories and the development of externalizing and internalizing problems in middle childhood

Children's peer victimization trajectories and their longitudinal associations with externalizing and internalizing problems were investigated from Grades 2 to 5. Secondary data analysis was performed with the Early Childhood Longitudinal Study (ECLS-K-2011; n = 13,860, M age = 8.1 years old in the spring of Grade 2; 51.1% male, 46.7% White, 13.2% African-American, 25.3% Hispanic or Latino, 8.5% Asian, and 6.1% other or biracial). Children who experienced high and persistent levels of peer victimization (high-chronic victims) exhibited co-occurring externalizing and internalizing problems. Moreover, among high-chronic victims, boys had a more pronounced increase in their externalizing trajectories, and girls had greater increases in their social anxiety trajectories. In contrast, those with decreasing peer victimization across time exhibited signs of recovery, particularly with respect to their social anxiety. These findings elucidated how chronic, increasing, and decreasing victims exhibited distinct patterns in the co-occurring development of their externalizing and internalizing problems, and how findings varied depending on the form of problem behavior and by child sex.

Recurrent headache, stomachache, and backpain among adolescents: association with exposure to bullying and parents' socioeconomic status

OBJECTIVES

Recurrent pain is a prevalent and severe public health problem among adolescents and is associated with several negative health outcomes. In a representative sample of adolescents this study examined 1) whether exposure to bullying and low socioeconomic status (SES) were associated with recurrent headache, stomachache and backpain, 2) the combined effect of exposure to bullying and low SES on recurrent pain and 3) whether SES modified the association between bullying and recurrent pain.

METHODS

Data derived from the Danish contribution to the international collaborative study Health Behaviour in School-aged Children (HBSC). The study population was students in three age groups, 11-, 13- and 15-year-olds from nationally representative samples of schools. We pooled participants from the surveys in 2010, 2014 and 2018, n=10,738.

RESULTS

The prevalence of recurrent pain defined as pain 'more than once a week' was high: 11.7 % reported recurrent headache, 6.1 % stomachache, and 12.1 % backpain. The proportion who reported at least one of these pains 'almost every day' was 9.8 %. Pain was significantly associated with exposure to bullying at school and low parental SES. The adjusted odds ratio (AOR, 95 % CI) for recurrent headache when exposed to both bullying and low SES was 2.69 (1.75-4.10). Equivalent estimates for recurrent stomachache were 5.80 (3.69-9.12), for backpain 3.79 (2.58-5.55), and for any recurrent pain 4.81 (3.25-7.11).

CONCLUSIONS

Recurrent pain increased with exposure to bullying in all socioeconomic strata. Students with double exposure, i.e., to bullying and low SES, had the highest OR for recurrent pain. SES did not modify the association between bullying and recurrent pain.

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.

The relationship between internet addiction and peer bullying level of sixth and seventh grade secondary school students

PROBLEM

The research aimed to determine the relationship between internet addiction and peer bullying in sixth and seventh-grade students.

METHOD

The population of the study consisted of students in the sixth and seventh grades of secondary schools in a province in eastern Turkey. The data were collected throughout the 2021-2022 academic year from 1201 sixth and seventh graders who voluntered to participate in the research. The data were collected using the Bullying Scale and the Internet Addiction Scale for Adolescents (IAA).

FINDING

It was determined that gender, grade level, status of having a mobile phone, and age influenced children's participation in peer bullying. Also, variables of gender, grade level, and status of having a mobile phone affected internet addiction levels. Furthermore, when the correlation between the two scales was analyzed, a strong positive correlation was determined.

CONCLUSIONS

In line with the findings of this study, interventions that may lower levels of bullying include delivering training on bullying and internet addiction to families, encouraging children to participate in activities that would reduce the amount of time they spend on the internet, and investigating the reasons for bullying.

Association between Community Violence, Disorder and School Environment with Bullying among School Adolescents in Sao Paulo - Brazil

The role of contextual-level factors in bullying is still not clear, and evidence is mostly from high-income countries. Our objective was to investigate the association between community violence, disorder, school environment and bullying among school adolescents. We used data from a representative sample of 9th grade Brazilian adolescents (n = 2108) from the Sao Paulo Project for the social development of children and adolescents (SP - PROSO). Multilevel logistic regression models stratified by sex were used to assess the association between variables at student and school/neighbourhood level and bullying victimization or perpetration. For both sexes, we found that adolescents who perceived high violence between students and high school disorder were more likely to be bullies and victims. Boys who perceived high community violence and disorder in their neighbourhood were more likely to be bullies (OR_3tertile = 2.73 CI95%: 1.57-4.74). Girls attending schools where the principal reported high community violence and disorder in the neighbourhood (OR_high = 10.24 CI95%: 2.11-49.59) and inside the school (OR_high = 6.83 CI95%: 1.48-31.56) were more likely to be bullies. Boys from schools whose principal perceived violence between students were less likely to be victims (OR_high = 0.35 CI95%: 0.16-0.78) and bullies (OR_high = 0.21 CI95%: 0.07-0.64). Girls attending schools with signs or posters about tolerance/gender equality and about violence were less (OR = 0.12 CI95%: 0.03-0.50) and more likely (OR = 25.88 CI95%: 4.28-156.63) to report being bullies, respectively. Community violence, disorder and school environment were associated with bullying victimization and perpetration among adolescents. Sex-specific associations should be further investigated. Prevention and management of school violence in adolescence should consider contextual-level characteristics.

School bullying among Chinese third to fifth grade primary school students in a cross-sectional study: The protective effect of psychological resilience

School bullying is a major concern for school-aged youth and has great impacts on children's health and well-being, and an increasing number of school bullying cases have been reported in China. Many studies have indicated that psychological resilience may have a well-established association with school bullying. However, only a limited number of studies have explored this association, especially among primary school students. The present study aimed to investigate the relationship between school bullying and psychological resilience among primary school students from a Chinese city. The participants were 6,011 primary school students aged 7-14 years who were recruited in a cross-sectional survey in Luzhou, China. The statistical significance of differences between groups was tested using the χ2 test or t test. Binary logistic regression analyses were conducted to explore the association between psychological resilience and school bullying. The incidence rates of bullies and victims were 30.00% (1803/6011; 95% CI: 28.84%-31.16%) and 69.89% (4201/6011; 95% CI: 68.73%-71.05%), respectively. Psychological resilience was a protective factor of school bullying among primary school students (for bullying perpetrators, OR = 0.76, 95%CI:0.62-0.93, and for bully victims OR = 0.74, 95%CI:0.61-0.90), especially among female students (for bullying perpetrators, OR = 0.63, 95%CI: 0.47-0.85, and for bully victims, OR = 0.69, 95%CI: 0.53-0.90). School bullying among primary school students in Luzhou City was highly prevalent. High levels of psychological resilience might be a protective factor in preventing primary students from being involved in school bullying, especially among females.

Earned Income Tax Credit and Youth Violence: Findings from the Youth Risk Behavior Surveillance System

Family- and neighborhood-level poverty are associated with youth violence. Economic policies may address this risk factor by reducing parental stress and increasing opportunities. The federal Earned Income Tax Credit (EITC) is the largest cash transfer program in the US providing support to low-income working families. Many states have additional EITCs that vary in structure and generosity. To estimate the association between state EITC and youth violence, we conducted a repeated cross-sectional analysis using the variation in state EITC generosity over time by state and self-reported data in the Youth Risk Behavior Surveillance System (YRBSS) from 2005 to 2019. We estimated the association for all youth and then stratified by sex and race and ethnicity. A 10-percentage point greater state EITC was significantly associated with 3.8% lower prevalence of physical fighting among youth, overall (PR: 0.96; 95% CI 0.94-0.99), and for male students, 149 fewer (95% CI: -243, -55) students per 10,000 experiencing physical fighting. A 10-percentage point greater state EITC was significantly associated with 118 fewer (95% CI: -184, -52) White students per 10,000 experiencing physical fighting in the past 12 months while reductions among Black students (75 fewer; 95% CI: -176, 26) and Hispanic/Latino students (14 fewer; 95% CI: -93, 65) were not statistically significant. State EITC generosity was not significantly associated with measures of violence at school. Economic policies that increase financial security and provide financial resources may reduce the burden of youth violence; further attention to their differential benefits among specific population subgroups is warranted.

Status of Iranian schools' psycho-social environment: cultural adaptation and validation of the Persian version of the W.H.O profile to create Child-Friendly Schools

Background

Creating an environment for emotional and social well-being is an important responsibility of Health-Promoting and Child-Friendly Schools. Thus, the present study aimed to assess cultural adaptation and validation of the Persian version of the Psycho-Social Environment (PSE) Profile. The second purpose of this study was to survey the psycho-social environment of schools among a local sample of Iranian school staff.

Methods

This study was conducted in two phases, including cultural adaptation and validation of a culturally adapted scale. The cultural adaptation process followed the procedure suggested by Beaton et al. Then, the culturally adapted scale was administered to a local sample of Iranian school staff including managers (21.9%), teachers (57.4%), support staff (4%), and other school staff (16.7%) in a cross-sectional study. The participants’ mean age was 39.98 ± 8.11 years and they were mostly female (62.8%). The psychometric properties of the culturally adapted version of the questionnaire were tested using a confirmatory factor analysis (n = 265), and a test of internal consistency. Finally, the status of schools’ psycho-social environment was assessed using descriptive and analytical statistics.

Results

Confirmatory factor analysis indicated an overall good fit for the 7-factor profile (χ2/df: 1.906, PNFI: 0.62, TLI: 0.78, CFI: 0.79, RMSE: 0.059). The test of internal consistency showed an acceptable reliability (α = 0. 98).

Conclusions

The Persian version of the PSE profile was culturally adapted for use in Iranian schools. Certainly, this culturally adapted version of PSE profile could be useful to determine the school psycho-social environment and to make any changes that can promote a friendly school climate for all participants, and to enhance learning and development.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14260-z.

Individual Risk, Country-Level Social Support, and Bullying and Cyberbullying Victimization Among Youths: A Cross-national Study

This study examined the relationships between three life domains-physical health, risky/deviant lifestyle, and psychosocial adjustment-and traditional bullying and cyberbullying victimization among youths in 23 countries.

METHODS

We first estimated logistic regression models that examined the relationships between indicators of physical health, risky/deviant lifestyle, and psychosocial adjustment using 23 distinct national samples. This analysis also allowed us to observe patterns of similarity and dissimilarity across countries regarding the correlates of for traditional bullying and cyberbullying victimization. Next, we estimated multilevel models of bullying victimization that combined data across 21 countries and estimated the effects of a country-level indicator of quality of human development (IHDI) in interaction with individual-level indicators of physical health, risky/deviant lifestyle, and psychosocial adjustment.

RESULTS

There were both cross-country similarities and differences regarding the individual-level correlates of traditional bullying and cyberbullying victimization. Additionally, countries that had relatively greater quality of human development tended to exhibit lower prevalence of traditional and cyberbullying victimization. Finally, country-level quality of human development conditioned relationships between individual level factors and both traditional and cyberbullying victimization.

CONCLUSIONS

Findings suggest that student-level bullying-prevention programs should address risk/protective factors across three student life domains, with some risk/protective factors seemingly universally relevant. Moreover, cross-level interactions suggest that enhancing country-level quality of human development can also play an important role in youth bullying prevention.

Challenging the "'Mean Kid"' Perception: Boys' and Girls' Profiles of Peer Victimization and Aggression from 4th to 10th Grades

Student involvement in peer aggression is assumed to include the uninvolved, victims, aggressors, and victim-aggressor groups. Yet, evidence supporting this four-group configuration is equivocal. Although most studies report the four groups, several of the aggressor groups could have been labeled as moderate victim-aggressors. This study first reviews studies identifying subgroups of students involved in verbal, relational, and physical aggression. The study then assesses students' perceived involvement in elementary (n = 2,071; Grades 4-6) and secondary school (n = 1,832; Grades 7-10), as well as the associations with outcomes (school belonging, depressive thoughts, and perceived school violence). Latent profile analysis identified three profiles (uninvolved, victim-only, and victim-aggressor) across all grades and genders. In primary school, the uninvolved, victim, and victim-aggressor respectively included 54.56%, 37.51%, and 7.83% of the girls, and 44.23%, 31.92%, and 23.85% of the boys. In secondary school, the uninvolved, victim, and victim-aggressor respectively included 80.16%, 14.93% and 4.91% of the girls, and 64.31%, 22.95% and 12.74% of the boys. Victims and victim-aggressors reported poorer adjustment than uninvolved students. Victims and victim-aggressors reported lower levels of school belonging and higher levels of depressive thoughts than uninvolved students. Also, victim-aggressors perceived more violence in their school than victims and uninvolved students, and victims perceived more violence than uninvolved students. These findings question the existence of an aggressor-only profile, at least, according to student perception, suggesting the need for a new perspective when intervening with students involved in peer aggression.

Victimization by traditional bullying and cyberbullying and the combination of these among adolescents in 13 European and Asian countries

There has been a lack of studies on bullying in non-western low-income and middle-income countries. This study reported the prevalence of traditional victimization, cybervictimization, and the combination of these, in 13 European and Asian countries, and explored how psychiatric symptoms were associated with victimization. The data for this cross-sectional, school-based study of 21,688 adolescents aged 13-15 were collected from 2011 to 2017. The main outcomes were traditional and cybervictimization obtained from student self-reports. The Strengths and Difficulties Questionnaire was used to assess psychiatric symptoms. Generalized estimating equation and logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). The mean prevalence of any victimization was 28.9%, of traditional victimization only, this was 17.7%, and for cybervictimization only this was 5.1%. Cybervictimization occurred both independently, and in combination with, traditional victimization. The mean prevalence of combined victimization was 6.1%. The mean proportion of those who were cyberbullied only among those who were either cyberbullied only or bullied both traditionally and in cyber was 45.1%. The rates of prevalence varied widely between countries. In the total sample, those who experienced combined victimization, reported the highest internalizing symptoms (girls, OR 1.25, 95% CI 1.22-1.29; boys, OR 1.29, 95% CI 1.25-1.33). The study findings suggest that anti-bullying interventions should include mental health components and target both traditional and cyberbullying. Due to the overlap between these, targeting bullying should primarily focus on how to reduce bullying behavior rather than just focusing on where bullying takes place.

Ragging, a Form of University Violence in Sri Lanka-Prevalence, Self-Perceived Health Consequences, Help-Seeking Behavior and Associated Factors

Ragging is an initiation ritual practiced in Sri Lankan universities for generations, although research is scarce. This practice has several adverse consequences such as physical, psychological, and behavioral effects and increased university dropouts. The aim of this study was to investigate the prevalence of different types of ragging: emotional/verbal, physical and sexual ragging, self-perceived health consequences, help-seeking behavior, and factors associated with the experience of ragging. A cross-sectional study was conducted among 623, second- and third-year students from the medical, and technology faculties in Jaffna University. Bivariate associations were assessed using chi-squared tests. Logistic regression was used to evaluate factors associated with any type of ragging. Ragging was experienced by 59% of the students, emotional/verbal ragging being the most common. A total of 54% of students suffered one or more health consequences and mainly sought help from friends and family, with few seeking formal help. Factors associated with any type of ragging were faculty and year of study. This study emphasizes the urgent need to address this public health problem. It is important that there are adequate student support services, planning and implementation of effective interventions, as well as ensuring that existing policies are strengthened, to reduce or eliminate ragging in Sri Lanka.

Lower Subjective Socioeconomic Status Is Associated With Increased Risk of Reporting Negative Experiences on Social Media. Findings From the "LifeOnSoMe"-Study

Objectives

To investigate the association between subjective socioeconomic status (SES) and a) frequency and daily duration of social media use, and b) self-reported negative experiences on social media platforms.

Methods

The present study is based on the cross-sectional school-based "LifeOnSoMe"-study (N = 3,415) recruiting high school students aged 16 years or more in Bergen, Norway. Subjective SES was the independent variable and measured by perceived family affluence. The dependent variables included self-reported amount of social media use, and eight different types of negative experiences on social media. Self-reported age, gender, country of birth and type study were used as covariates. Statistical analyses included multinomial logistic regression and negative binomial regression models.

Results

For amount of social media use, we only found relatively weak and inconsistent associations with SES. In contrast, the associations between SES and separate variables gauging negative experiences were robust in crude models as well as in models adjusted for age and gender. The number of different negative experiences were increased by 1.25 times for those with low and by 1.10 times for those with medium socioeconomic status, compared to those with high socioeconomic status in fully adjusted models. For composite measures of "negative acts and exclusion" and "unwanted attention from others," the difference between low and high SES was equivalent to a small-to-moderate effect size even after adjustments for age, gender, country of birth, type of study and amount of social media use.

Conclusions

In the present study, we found consistent and strong support for an association between SES and negative experiences on social media even after adjustments for age, gender, country of birth, type of study, and amount of social media use. The potential link between SES and negative experiences on social media as reported in this study is likely to have a public health impact. As the reported findings are novel, they need to be replicated in forthcoming studies based on other study populations. Future research should also focus on other aspects of SES and negative experiences, as well as endeavor to investigate potential longitudinal associations.

Prevalence of school bullying and its relationship with attention deficit-hyperactivity disorder and conduct disorder: a cross-sectional study

Background

School bullying is the most widespread form of violence among adolescents. It has been identified as a critical problem for students and has evolved into a public health issue and global crisis. The study aims to assess the prevalence of school bullying among primary school students and its relationship with attention deficit hyperactive disorder (ADHD) and conduct disorders. Among the 280 primary school students those aged 10-12 years were recruited. All participants were assessed by parent interview, the Arabic version of the bullying behavior scale for children and adolescents and the Arabic version of the Conners' Teacher Rating Scale-28.

Results

We found that the prevalence rate of bullying behavior was 12.5% among students. In bullying students' group, males were higher percentage (15.8%) than females (9%). Also, they had the highest mean scores regarding verbal bullying and social bullying, followed by psychological and physical bullying. Regarding Conners', the higher mean scores of conduct problem, passive-inattentive, and hyperactivity index were associated with bullying students in compared to students without bullying.

Conclusions

The prevalence of school bullying among primary school students was 12.5%. Also, there was significant association between bullying students and having attention deficit hyperactive disorder (ADHD) and/or conduct disorder.

Risk factors of school bullying and its relationship with psychiatric comorbidities: a literature review

Background

School bullying is described as violence to other people. It is perpetrated at schools or other activities when the power of a student or a group of students is used to injure others or other groups.

Main body

The prevalence of school bullying is varied from one country to another. There are many types of bullying, such as physical, verbal, social relations, psychological, sexual, and cyber-bullying. Many risk factors could affect school bullying, especially individual, peer and parent factors. Researches found that adults who had school bullying are more vulnerable to develop future psychiatric disorders.

Conclusions

School bullying is one of the crucial problems among pupils. The wide range of the prevalence of school bullying may be due to different methodologies and the presence of many risk factors. It is recommended to have long-term researches about the student with bullying behavior. Also, prevention programs are required to increase knowledge and early detection of affected students to prevent future psychiatric disorders.

Bullying Victims in Rural Primary Schools: Prevalence, Correlates, and Consequences

School bullying is a widely recognized problem in developed countries, but remains under-investigated in developing countries, especially in remote rural areas. In this paper, we examine the prevalence, correlates, and consequences of bullying victimization and its relation to educational performance and creative attitudes. Using data from 10,528 students across 120 primary schools in rural China, we find an alarmingly high prevalence of bullying victimization and that several individual, family, and school characteristics are correlated with bullying victimization. Analyses indicate students who are bullied frequently score lower in Chinese, reading, and math tests and creative attitudes. Taken together, the results demonstrate a need for further research and policy interventions to reduce bullying in schools.

Predicting the severity of peer victimization and bullying perpetration among youth with interpersonal problems: A 6-month prospective study

INTRODUCTION

Peer victimization is prevalent and associated with adverse outcomes. In this prospective study of youth who self-reported interpersonal problems, we examined school connectedness, school behavioral difficulties, academic difficulties, and internalizing problems (social anxiety, self-esteem, depression) as predictors of peer victimization and bullying perpetration severity. We also examined the moderating effects of gender.

METHODS

Participants were 218 youth (66.5% female), ages 12-15 years (M = 13.5, SD = 1.1), who screened positive for peer victimization, bullying perpetration, and/or low social connectedness using self-report measures. Youth were recruited from an emergency department in the United States as part of an intervention trial. Youth identified primarily as African American (53.7%) and Caucasian (31.7%). Youth completed a 6-month follow-up assessment (75% retention). Separate Bayesian regression models were used to examine the effects of baseline school connectedness, school behavioral difficulties, academic difficulties, and internalizing problems on the severity of 6-month peer victimization and bullying perpetration.

RESULTS

Baseline depression was positively related to both peer victimization and bullying perpetration severity. Baseline behavioral problems were positively related to bullying perpetration severity. Interactions indicated that gender moderated the relationship between school connectedness and peer victimization.

CONCLUSIONS

Given the adverse outcomes linked with peer victimization and bullying perpetration, an improved understanding of factors that predict victimization and perpetration severity may be helpful in defining intervention targets.

Work-Family Reconciliation and Children's Well-Being Disparities across OECD Countries

Socioeconomic inequalities in health and well-being are large, beginning early in childhood and accumulating over the life course, but they also vary widely across rich developed nations. Despite this well-known cross-national variation, research has yet to examine why children's health disparities might be larger or smaller based on national policy contexts and macroeconomic conditions. Parental health and well-being suffer under high work-family or economic strain, which may directly impact children's health inequalities by family social class. These childhood health disadvantages, if not substantially improved, compound to even larger adult inequalities. To examine the role of national work-family reconciliation in children's health, we merge country-level policy data with 2006 and 2010 World Health Organization child-level data on mental and physical well-being and family economic disadvantage. Based on adjusted estimates, we find greatly narrowed disparities in children's self-rated health as work flexibility and vacation-sick leave mandates become more generous. However, cash transfer policies including family benefits spending and childcare costs were not associated with the size of children's health disparities. Taken together, our results suggest the distinctive value of better work-family accommodations, rather than any generic cash allowances, for lessening family-based inequalities in children's health and human capital development.

Wealth Inequalities in Different Types of Violence Among Brazilian Adolescents: National Survey of School Health 2015

Studies have assessed inequalities in violence by economic status, but few studies have been done with adolescents from middle-income countries. Our objective was to analyze inequalities in verbal bullying, family physical violence, sexual violence, and fights with weapons among Brazilian adolescents in school according to wealth and stratified by sex and skin color. We used data from the Brazilian National Survey of School Health (Pesquisa Nacional de Saúde do Escolar [PeNSE]), carried out in 2015, with a representative sample of Brazilian adolescents attending ninth grade in public and private schools. We created a wealth index based on questions about access to goods and services through principal component analysis; this index was later divided into quintiles. We calculated the slope index of inequality (SII), the concentration index (CIX), and simple measures of inequality, such as ratio and difference. To identify statistically significant differences in sex and skin color inequality, we used the t test. We found high prevalence values of verbal bullying and family physical violence, 23.9% and 14.5%, respectively. In general, when comparing the types of violence according to SII and CIX, we observed a higher prevalence of violence among adolescents in the lower income quintiles, for both sexes and skin colors. We observed higher wealth inequality in sexual violence among girls (CIX = -14.89) when compared with boys (CIX = -4.63) (p = .001). We also observed higher wealth inequality in sexual violence among Whites (CIX = -15.55) when compared with Brown (CIX = -6.23) (p = .009). Wealth inequality aggravates the occurrence of violence among poorer Brazilian adolescents. Also, the identification of vulnerable groups may contribute to target public policies for fighting violence.

Bullying victimisation in adolescence: prevalence and inequalities by gender, socioeconomic status and academic performance across 71 countries

BACKGROUND

Bullying victimisation is of global importance due to its long-term negative consequences. We examined the prevalence of victimisation and its inequalities in 15-year-olds across 71 countries.

METHODS

Data were from the Programme for International Student Assessment (March-August 2018). Students reported frequencies of relational, physical, and verbal victimisation during the last 12 months, which were analysed separately and combined into a total score. Prevalence of frequent victimisation (> a few times a month) was estimated, followed by mean differences in total score by gender, wealth and academic performance quintiles in each country. Meta-analyses were used to examine country differences.

FINDINGS

Of 421,437 students included, 113,602 (30·4%) experienced frequent victimisation, yet this varied by country-from 9·3% (Korea) to 64·8% (Philippines). Verbal and relational victimisation were more frequent (21·4%, 20.9%, respectively) than physical victimisation (15·2%). On average, boys (vs girls +0·23SD, 95%CI: 0·22-0·24), students from the lowest wealth (vs highest +0·09SD, 0·08-0·10) and with lowest academic performance (vs highest +0·49SD, 0·48-0·50) had higher scores. However, there was substantial between-country heterogeneity in these associations (I²=85%-98%). Similar results were observed for subtypes of victimisation-except relational victimisation, where gender inequalities were smaller.

INTERPRETATION

Globally, bullying victimisation was high, although the size, predominant subtype and strength of associations with risk factors varied by country. The large cross-country differences observed require further replication and empirical explanation, and suggest the need to and the large scope for reducing bullying victimisation and its inequity in the future.

FUNDING

Japan Foundation for Pediatric Research.

The Impact of Formal School Entry on Children's Social Relationships with Parents, Siblings, and Friends

The normative transition to formal schooling confronts children with social challenges but also opportunities. Longitudinal research on how school entry impacts children's family and friend-ship relationships is scarce. This study investigated social relationship qualities with parents, siblings, and friends among 1110 children (49.9% female) from the prospective, population-based Bavarian Longitudinal Study at 6 years (before school entry) and 8 years using a forced-choice card-sorting task. Multivariate analyses of variance revealed significant effects of age (i.e., school entry) on social relationship qualities with mothers (Pillai's Trace (PT) = 0.28, F(9, 1101) = 47.73, p < 0.001), fathers (PT = 0.14, F(9, 1101) = 19.47, p < 0.001), siblings (PT = 0.27, F(9, 1101) = 46.14, p < 0.001), and friends (PT = 0.21, F(9, 1101) = 32.57, p < 0.001). On average, children reported higher levels of parental comfort after school entry. Companionable qualities increased in relationships with friends, whereas sibling relationships became more conflictual from preschool to early school age. Findings provide unique insights into how social relationships develop from preschool to early school age, supporting evidence of the growing importance of friends. Conflict was predominant and increasing in sibling relationships and should be considered more in future research.

Estimating income-related and area-based inequalities in mental health among nationally representative adolescents in Australia: The concentration index approach

Despite the awareness of the importance of mental health problems among adolescents in developed countries like Australia, inequality has not been widely researched. This study, is therefore, aimed to measure and compare household income-related and area-based socioeconomic inequalities in mental health problems (bullying victimization, mental disorders-single and multiple, self-harm and suicidality-ideation, plan and attempt) among Australian adolescents aged 12-17 years. Young Minds Matter (YMM)-the 2nd national cross-sectional mental health and well-being survey involving Australian children and adolescents conducted in 2013-14, was used in this study to select data for adolescents aged 12-17 years (n = 2521). Outcome variables included: bullying, mental disorders, self-harm, and suicidal ideation, plan and attempt. The Erreygers's corrected concentration index (CI) approach was used to measure the socioeconomic inequalities in mental health problems using two separate rank variables-equivalised household income quintiles and area-based Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) quintiles. The prevalence of mental health problems in the previous 12-months among these study participants were: bullying victimization (31.1%, 95% CI: 29%-33%), mental disorder (22.9%, 95% CI: 21%-24%), self-harm (9.1%, 95% CI: 8%-10%), suicidal ideation (8.5%, 95% CI: 7%-10%), suicidal plan (5.9%, 95% CI: 5%-7%) and suicidal attempt (2.8%, 95% CI: 2%-3%). The concentration indices (CIs) were statistically significant for bullying victimization (CI = -0.049, p = 0.020), multiple mental disorders (CI = -0.088, p = <0.001), suicidal ideation (CI = -0.023, p = 0.047) and suicidal attempt (CI = -0.021, p = 0.002), implying pro-poor socioeconomic inequalities based on equivalized household income quintiles. Similar findings revealed when adolescents mental health inequalities calculated on the basis of area based IRSAD (Index of Relative Socio-economic Advantage and Disadvantage) quintiles. Overall, adolescents from economically worse-off families experienced more mental health-related problems compared to those from economically better-off families. This has implications for prevention strategies and government policy in order to promote mental health and provide equitable healthcare facility.

Prevalence of bullying victimisation among primary school children in South Africa: a population-based study

Objectives

Bullying victimisation (BV) among children in South Africa has been identified as a major public health concern. While several studies report on the prevalence rates of BV, there is currently a dearth of research that reports on the prevalence of BV among a national sample of primary school children. This study determines the prevalence rates of BV among a nationally representative sample of school-going children in South Africa across provinces, age, and gender. The sample comprised 7067 children (boys = 45.6%; girls = 54.4%) between the ages of 10–12-years attending 61 primary schools across the nine provincial regions of South Africa.

Results

In terms of ‘being hit’ by other children, percentages range from 22.55% (North West) to 33.34% (Free State). Children in Gauteng (33.59%) and Limpopo (38.54%) had the highest percentage of children being ‘left out’ or excluded. Additionally, across all provinces more than 30% of children reported that they had been ‘called unkind names’. Across gender, boys are more likely to experience all three forms of BV (being hit, left out, and called unkind names). The findings further indicate that 10-year-olds reported being ‘hit’ and ‘left out’, whereas a greater percentage of 12-year-olds reported ‘being called unkind names’ (44.28%).

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-021-05747-w.

The Importance of Pedagogical and Social School Climate to Bullying: A Cross-Sectional Multilevel Study of 94 Swedish Schools

BACKGROUND

Bullying is a public health issue with long-term effects for victims. This study investigated if there was an association between pedagogical and social school climate and student-reported bullying victimization, which dimensions of pedagogical and social school climate were associated with bullying, and if these associations were modified by individual-level social factors.

METHODS

The study had a cross-sectional multilevel design with individual-level data on bullying from 3311 students nested in 94 schools over 3 consecutive school years. School climate was measured with student and teacher questionnaires, aggregated at the school level. The association between school climate and bullying victimization was estimated with multilevel mixed-model logistic regression.

RESULTS

In schools with the most favorable school climate, fewer students reported being bullied. This was especially evident when school climate was measured with the student instrument. Students in schools with favorable climate had an adjusted odds ratio of bullying of 0.74 (95% CI: 0.55-1.00) compared to students in schools with the worst climate. Results from the teacher instrument were in the same direction, but less consistent.

CONCLUSIONS

Improvement in school climate has the potential to affect students both academically, and socially, as well as decrease the prevalence of bullying.

Violence at School and Bullying in School Environments in Peru: Analysis of a Virtual Platform

BACKGROUND

School violence and bullying are prevalent problems that affect health in general, especially through the development of emotional and behavioral problems, and can result in the deterioration of the academic performance of the student victim. The objective of this study was to determine the prevalence rates of aggressive behaviors according to types of school violence and bullying, sociodemographic characteristics, and variation by department, region, and time in the period between 2014 and 2018 in Peru.

METHODS

The design was observational and cross-sectional based on data from the Specialized System for Reporting Cases of School Violence (Sistema Especializado en Reporte de Casos sobre Violencia Escolar-SíseVe) in Peru, which covers a population of 23,641 students at the initial, primary, and secondary levels of Basic Regular Education [Educación Básica Regular (EBR)], for the 2014-2018 period. The prevalence rates of the different types of school violence and bullying, the sociodemographic characteristics, and the variation by department, region, and time in the period between 2014 and 2018 were estimated.

RESULTS

Psychological violence/bullying occurred at higher prevalence rates (185.8 and 62.6 per 100,000 residents). Women from public institutions reported greater sexual violence, mostly by teachers (67.8%) than by other students (32.2%). The Selva region had the highest prevalence rate of sexual violence (10.1 per 100,000 residents). The departments of Tacna and Piura had the highest and lowest rates of psychological/verbal violence and bullying in 2018 (95.79 and 25.31 per 100,000 residents).

CONCLUSION

Psychological/verbal violence and bullying is highly prevalent among students; women report being victims of sexual violence by administrative personnel of public institutions. The Selva region had the highest rate of sexual violence, and Piura and Tacna had the highest and lowest rates of violence and psychological/verbal bullying. Based on these results, it is suggested to conduct evidence-based prevention programs in Peruvian schools to reduce these social problems.

Recurrent abdominal pain among adolescents: trends and social inequality 1991-2018

OBJECTIVES

The association between socioeconomic status and recurrent abdominal pain (RAP) among adolescents is an understudied issue. No study has examined whether such an association changes over time. The aim was to examine trends in RAP among adolescents in Denmark from 1991 to 2018, to examine whether there was social inequality in RAP and whether this inequality varied over time.

METHODS

The study used data from the Danish part of the international Health Behaviour in School-aged Children (HBSC) study of nationally representative samples of 11-, 13- and 15-year-olds. This study pooled data from eight comparable surveys from 1991 to 2018, overall participation rate 88.0%, n=30,048. The definition of RAP was self-reported stomach-ache daily or several days per week during the past six months. We reported absolute inequality as prevalence difference in RAP between low and high socioeconomic status and relative inequality as odds ratio for RAP by socioeconomic status.

RESULTS

In the entire study population, 5.6% reported RAP, 3.1% among boys and 7.8% among girls. There was a significant increase in RAP from 1991 to 2018 among boys and girls, test for trend, p<0.0001. The prevalence of RAP was significantly higher in low than high socioeconomic status, OR=1.63 (95% CI: 1.42-1.87). The absolute social inequality in RAP fluctuated with no consistent increasing or decreasing pattern.

CONCLUSIONS

The prevalence of RAP increased from 1991 to 2018. The prevalence was significantly higher among girls than among boys, and significantly higher in low socioeconomic status families. Professionals should be aware of RAP as common and potentially serious health problems among children and adolescents. In addition to clinical examination it is important to focus on improving the child's quality of life, reduce parents' and children's concerns about the seriousness of the condition, and consider supplements to medicine use.

Prevalence and correlates of bullying perpetration and victimization among school-going adolescents in Chandigarh, North India

OBJECTIVES

Bullying among adolescents is one of the important but neglected health concerns, especially in low- and middle-income countries. The objective of this study was to estimate the prevalence and correlates of bullying among Indian adolescents.

STUDY DESIGN

This was a cross-sectional study.

MATERIALS AND METHODS

The prevalence of self-reported involvement in any kind of bullying was assessed among sixth to tenth class students (n = 667, mean age 13 years), across government (n = 359) and private (n = 308) schools using Olweus Bully-Victim Questionnaire in Chandigarh, a North Indian union territory. Self-esteem and emotional and behavioral difficulties of the participants were measured by using standard Rosenberg Self Esteem Scale and Strengths and Difficulties Questionnaire, respectively. Multinomial logistic regression was done to determine the predictors of bullying.

RESULTS

Prevalence of any kind of bullying was 25.6% (16% victimization, 5.2% perpetration, and 4.3% being bully-victim). Verbal bullying was the most common (55.1%), followed by physical (32.7%) and relational (25.2%) bullying. The prevalence of cyberbullying was 2.7%. Around 44% of students reported that adults in school never did anything to stop bullying. Bully-victims had the highest mean difficulty score (16.07). Significant predictors of bullying were being male (odds ratio [OR] = 2.5 [1.5-4.2], P < 0.001); studying in government school (OR = 0.63 [0.41-0.99], P = 0.048); having abnormal emotions (OR = 2.24 [1.1-4.7], P = 0.035); and poor peer relations (OR = 2.77 [1.44-5.35], P = 0.002).

CONCLUSIONS

One in four adolescents experience some form of bullying in schools in a North Indian city. Bullying perpetration and victimization is associated with gender, type of school, and abnormal difficulties (emotional and behavioral problems).

Childhood cancer patients' baseline for social affiliation as a determining factor for the self-reported impact of person-based exclusion

OBJECTIVE

Childhood cancer patients experience a challenging reentry to social activities after diagnosis. This study aims to generate knowledge about the challenges experienced by childhood cancer patients with peers during and after treatment.

DESIGN

This study is a qualitative mixed study.

PARTICIPANTS

The study included 70 children - 34 boys and 36 girls - aged 3 to 17 years who are affiliated with a pediatric oncology unit in Denmark.

FINDINGS

Childhood cancer patients experience two types of exclusion: (1) unavoidable diagnosis-related exclusion and (2) person-based exclusion from teachers, peers, and peers' parents. Person-based exclusion is manifested through the perceived insecurity of peers, misconceptions, and bullying. The impact and degree of these interactions partly depend on the patients' social affiliation prior to cancer.

IMPLICATION FOR PSYCHOSOCIAL PROVIDERS

There is a need to understand the exclusion experiences of childhood cancer patients and identify particularly vulnerable children to reduce the self-reported impact of person-based exclusion.

Lifestyle behaviors predict adolescents bullying victimization in low and middle-income countries

BACKGROUND

In this study we aimed to provide a global perspective of the association between different lifestyle behaviors and bullying in school adolescents and to ascertain whether or not the Human Development Index moderated those associations.

METHODS

Data from the Global school-based Student Health Survey were analyzed in 273 121 from 82 countries. Logistic regression was applied to determine country-specific bullying victimization probability from meeting the recommended guidelines for physical activity, excessive sitting time, physical education attendance and active transport. Meta-analysis was then undertaken to ascertain pooled global effect estimates of the relationship between these behaviors and bullying victimization. Linear regression was used to study the relationship between odds of bullying from meeting the lifestyle guidelines and the Human Development Index.

RESULTS

Our estimates indicate that excessive sitting time [1.38 (1.34,1.41)], attendance to physical education [0.87 (0.85,0.89)], and active transport [0.94 (0.91,0.97)] but not overall physical activity [1.01 (0.99,1.04)] were associated with bullying in the study sample.

LIMITATIONS

The present study is limited by its cross-sectional nature. Also, only two countries were surveyed from the European region CONCLUSIONS: Active commuting and attendance to physical education play a protective role for bullying, while physical activity does not.

Psychometric Properties of the Spanish Version of the Homophobic Content Agent Target Scale Among Adolescent Students

This study examined the psychometric properties and factor structure of the Spanish version of the Homophobic Content Agent Target (HCAT) scale in a sample of 1848 high school students. Participants completed an online survey including measures of homophobic bullying, depression, and anxiety. The factor structure showed adequate fit indices in Spanish adolescents similar to the original scale. An exploratory factor analysis showed a simple factor solution of two related factors strongly correlated describing the extent to which students use homophobic language (agent) and the extent to which students are called homophobic epithets (target) due to sexual orientation. The Spanish HCAT scale showed high Cronbach's alpha coefficient at the subscale score levels, as well as good convergent validity. This study contributes a Spanish-language validated measure of homophobic victimization to be used among adolescents. Implications for understanding homophobic bullying in adolescents are discussed.

Mental health disorders and adolescent peer relationships

RATIONALE

Mental health disorders often arise during adolescence, with disruptive behavior disorders and anxiety disorders among the most common. Given the salience of peer relationships during adolescence, and research suggesting that mental health disorders negatively impact social functioning, this study uses novel methodology from social network analysis to uncover the social processes linking disruptive behavior disorders and anxiety disorders with adolescent friendships. In particular, the study focuses on peer withdrawal, peer popularity, and peer homophily in relation to both disorders.

METHODS

Data come from 15-year old students in four Scottish secondary schools (N = 602). Diagnoses of disruptive behavior disorders and anxiety disorders were produced using the Diagnostic Interview Schedule for Children, and peer relationship data were obtained through a friendship nomination survey. Exponential random graph models were used to estimate the probability of peer withdrawal, peer popularity, and peer homophily based on each disorder.

RESULTS

Results demonstrated that adolescents with disruptive behavior disorders were more popular than their peers without disruptive behavior disorders (OR: 1.47, CI: 1.20, 1.87). Friendship was also more likely between two adolescents both with or both without disruptive behavior disorders (OR: 1.26, CI: 1.07, 1.47), demonstrating peer homophily. There was no evidence that anxiety disorders were related to adolescent peer relationships.

CONCLUSIONS

Findings from this study suggest that disruptive behavior disorders may be socially rewarded (e.g., peer popularity) and socially clustered (e.g., homophily), whereas anxiety disorders show no such trends. Thus, intervention efforts must account for the peer social status that may be gained from engaging in disruptive behavior during this developmental period. Further, given that similarity in DBD status is associated with an increased likelihood of friendship, adolescents are likely to be surrounded by peers who reinforce their behaviors.