Family dynamics and young children's sibling victimization

A longitudinal study of sibling bullying and mental health in autistic adolescents: The role of self-esteem

Sibling bullying is associated with poor mental health in autistic adolescents. The reasons for this remain unknown. In the current study, we attempted to replicate the existing findings on the direct associations between sibling bullying and mental health in autistic adolescents and expand knowledge by focusing on the indirect associations through self-esteem. We made use of existing data from the Millennium Cohort Study, a nationally representative UK-based birth cohort study. We fitted a mediation model to longitudinal data from a sample of 416 autistic adolescents aged 11, 14, and 17 years old who had at least one sibling. We found that sibling bullying was prevalent in the lives of autistic adolescents, especially in those who were late-diagnosed, had a shared bedroom, and lived in a low-income household. Additionally, increased sibling bullying in early adolescence was a significant predictor of reduced self-esteem in mid-adolescence; in turn, reduced self-esteem predicted poorer mental health and wellbeing in late adolescence. Our findings indicate that sibling bullying in early adolescence may indirectly lead to poorer mental health and wellbeing in late adolescence through a reduction in self-esteem in mid-adolescence in autistic adolescents. We discuss the implications of these findings further.

Antecedents of sibling aggression and bullying victimization: The parallel and serial contributions of depressive symptoms and substance use

PURPOSE

Sibling aggression has received attention as a common form of family violence. However, further research is needed to elucidate several antecedents of sibling aggression perpetration and bullying victimization, such as substance use and depressive symptoms. Additionally, more studies are needed to identify the mediating paths of depressive symptoms and substance use, which could explain the association between bullying victimization and sibling aggression perpetration on the one hand and the association between sibling aggression victimization and bullying victimization on the other hand, while controlling for exposure to family violence and demographic variables. The current study tested two separate mediational models guided by the displaced aggression theory and self-medication hypothesis.

METHOD

The present study used the Bullying, Sexual, and Dating Violence Trajectories From Early to Late Adolescence in the Midwestern United States, 2007-2013 dataset. The original sample consisted of 1162 middle school students who were initially surveyed and followed into three high schools. For the current study, the first wave was used, which included a sample of 1101 adolescents. Structural equation modeling (SEM) was conducted to first examine whether bullying victimization was associated with sibling aggression perpetration. Then another model was conducted to test whether sibling aggression victimization was associated with bullying victimization.

RESULTS

In the first model, results suggest bullying victimization is positively associated with sibling aggression. Mediation results indicated depressive symptoms and substance use serially mediated the relation between bullying victimization and sibling aggression. In the second model, results suggest that sibling aggression victimization is positively associated with bullying victimization. Parallel mediation results indicated that depressive symptoms alone and not substance use individually explained the association between sibling aggression victimization and bullying victimization. Finally, serial mediation results indicated that depressive symptoms and substance use serially mediate the association between sibling aggression victimization and bullying victimization.

LIMITATIONS

Limitations include self-report measures and cross-sectional design; therefore, we could not estimate casual relationships.

CONCLUSION

The implications of these findings suggest the need for continued attention to school-based bully prevention efforts and family relations interventions. Such efforts might be associated with reductions in bullying victimization and sibling aggression.

Depression and Substance Use as Consequences of Exposure to Family Violence: A Moderation Mediation and Self-Medication Hypothesis Study

Ample evidence exists suggesting that exposure to family violence leads to substance use and this relationship is moderated by gender; however, much is still unknown of the underlying mechanism of this relationship. Thus, the current study first examined whether exposure to family violence was associated with substance use. Then consistent with the self-medication hypothesis, we tested whether depressive symptoms mediated the relations between exposure to family violence and substance use. Finally, we examined the moderating effect of gender on the relationships among exposure to family violence and depressive symptoms/substance use (N = 1,850). Results suggest that exposure to family violence positively associated with substance use. Mediation results revealed that depressive symptoms explained the relationship between exposure to family violence and substance use. Moderation results indicated that males who were exposed to family violence were more likely to endorse depressive symptoms and more likely to use substances while controlling for sibling aggression victimization. This study provides new insight into the internalizing and externalizing symptoms of exposure to family violence, specifically for male adolescents. Implications are discussed.

Prevalence and Associated Family Factors of Sibling Bullying Among Chinese Children and Adolescents

Sibling bullying is the most common form of aggression within family worldwide, while the prevalence and correlations of sibling bullying is little known in China. The current research focused on the association between family factors and sibling bullying among Chinese adolescents, and explore sex differences in sibling bullying in the context of Chinese culture. A cross-sectional study was conducted to explore the characteristics of sibling bullying by sampling 6302 children and adolescents who had at least 1 sibling living in the household. Of the participants, 1827 (29.0%) were involved in sibling bullying over the past half year, and pure victims, pure bullies, and bully-victims were 486 (7.7%), 510 (8.1%), and 831 (13.2%), respectively. Family factors of sibling bullying were partly different between boys and girls. Parental absence of both father and mother was a risk factor of being a pure bully and a bully-victim for boys, and of being a pure victim for girls. Parental son preference increased the odds of being a pure victim and a bully-victim for boys, and of being all roles of sibling bullying involvement for girls. Besides, parent–parent violence, parent–child violence, and living with a single parent were risk factors of sibling bullying. The results underline the importance of home environment on sibling relationship, and intervention of sibling bullying should include improving family climate.

Exposure to parent assault on a sibling as a childhood adversity

BACKGROUND

Children's exposure to parental violence against another parent has been widely studied as an adverse childhood experience and source of childhood trauma. Exposure to parental violence against a sibling could be equally as traumatizing, but the literature on this exposure is sparse, by comparison. We examined the frequency of exposure to parental assault on a sibling (EPAS) and its demographic distributions. We also investigated the links between EPAS and symptoms of distress.

METHOD

From three combined surveys of the National Survey on Children's Exposure to Violence, based on telephone interviews with parents, and in the case of those 10-17 years old, adolescents, we examined children living with a juvenile sibling (N = 7, 029; 49% female).

RESULTS

Lifetime EPAS was 3.7%, and sibling assault was more common by fathers (70%) than by mothers (30%). Exposure was greatest for boys and adolescents, highest for those whose parents had some college education, and for those living with other non-parental adults, single parents, and stepfamilies. Rates did not differ by ethnicity. Most exposed youth felt afraid (83%), and fear was greater when witnessing fathers than mothers assaulting a sibling. Controlling for child maltreatment and exposure to interparental violence, those exposed to EPAS showed higher current levels of mental distress (anger, depression, and anxiety; F (10, 6146) = 140.44, p = .001; R² = 0.19).

CONCLUSIONS

Clinical work and parent education programs should address the occurrence of EPAS and the adverse association between EPAS and mental health to reduce its potential negative impact.

A systematic review and meta-analysis of the associations between interparental and sibling relationships: Positive or negative?

According to family systems theory, a family is regarded as an organized whole and relations within this system are interconnected. However, it is not clear to date whether the interparental and the sibling relationship are associated and, if such an association exists, whether it is positive or negative. Previous findings on the associations between the interparental and sibling relationships are inconsistent and there is as yet no pertinent review or meta-analysis. Therefore, this systematic review and meta-analysis set out (1) to aggregate previous studies investigating the links between the interparental and sibling relationships and (2) to examine potential moderators in this link. Based on 47 studies reporting 234 effect sizes (N = 29,746 from six nations; 6-12 years; 49% boys), meta-analytic results suggest a small positive correlation between interparental and sibling relationship quality (r = .14). Only the percentage of male children in the sample moderated this effect. Sex composition of sibling dyad and source of publication affected whether positive or negative associations were found. The findings support a growing consensus that family relations do not function in isolation, but are mutually interdependent, which should be considered in clinical practice.

Family Dynamics and Young Adults' Well-Being: The Mediating Role of Sibling Bullying

Although a common form of family violence, sibling bullying is often viewed as harmless by families and society. Consequently, it has not received as much attention in research compared with peer bullying or other types of family violence, such as interpartner violence, child abuse, and elder abuse. Considering that sibling relationships have lasting effects on children's development, this retrospective study focused on the antecedents and outcomes of sibling bullying. Grounded in family system theory and social learning theory, it explored whether sibling bullying during childhood and adolescence mediated the relationship between negative family dynamics (i.e., sibling rivalry, interparental hostility, and parental hostility) and young adults' well-being (i.e., sense of competence, internalized problems, self-esteem, and satisfaction with life). Data from 216 respondents were analyzed using structural equation modeling. Results revealed that young adults who reported higher levels of sibling rivalry and interparental hostility were more likely to be victims of sibling bullying. In turn, sibling bullying was associated with lower sense of competence, self-esteem, and life satisfaction, as well as more internalized problems. Parents' hostile behaviors toward their children were not associated with sibling bullying but were negatively associated with well-being in early adulthood. Our work underlines the importance of harmonious family dynamics and the need for sibling bullying to be taken more seriously by parents and family members. From a clinical point of view, our findings suggest that clinicians and human service workers should adopt a family-level approach when trying to reduce sibling bullying and its negative outcomes by educating parents about the interdependence of family relationships.

Physical and Emotional Sibling Violence in the Time of COVID -19

The COVID-19 pandemic has impacted families in a variety of ways with much being written on the potential impact of sheltering in place and quarantining on intimate partner violence and parent-to-child abuse. One area that has received scant attention is that of physical and emotional sibling violence. While physical and emotional sibling violence is a predominant form of family violence, discussion of violence between siblings in the time of COVID-19 has not received the attention it warrants. This article examines the potential for family stress to place siblings at risk for engaging in physical and emotional sibling violence and how this is exacerbated in the time of COVID-19. Also discussed is the the connection between physical and emotional sibling violence and other forms of family violence including intimate partner violence and parent-to-child abuse and neglect which underwrites the need to place physical and emotional sibling violence on the radar of practitioners, policy makers, and researchers. Finally, implications for practice, policy, and research on physical and emotional sibling violence in the context of COVID-19 are discussed.

Aggression in Children Exposed to Intimate Partner Violence: A Comparison of Maternal, Sibling, and Observer Perspectives

The negative effects of exposure to intimate partner violence (IPV) on children have been well documented, including externalizing difficulties such as aggression. Although aggressive behavior is a common concern for these children, sibling aggression in children exposed to IPV has rarely been studied. Our purpose was to investigate similarities and differences in multiple informant reports of aggression by siblings exposed to IPV, and to examine how exposure to IPV was linked to these differing perspectives. Forty-seven sibling dyads and their mothers were recruited from the community. Aggression was assessed by observers, by mothers, and by the siblings themselves, whereas IPV was assessed by both maternal and child report. Informants had very differing views on aggression. Regression results indicated that children's reports of their own exposure to IPV accounted for significant variance in observed aggression between siblings, as well as in the maternal reports of aggression by both siblings. Aggression did not vary by sibling age, sex, or age spacing. Results were discussed within a risk and resilience framework.

Disclosure of Sibling Sexual Abuse by Hospitalized Adolescent Girls: Three Case Reports

Although sibling sexual abuse (SSA) may be the most common type of intrafamilial sexual abuse, it has not been widely studied. The lack of studies makes it very difficult for clinicians to create a comprehensive framework about this complex phenomenon, particularly in comparison with other forms of intrafamilial sexual abuse, such as father-daughter incest. SSA is still underrecognized and underdisclosed but it has the potential to be every bit as harmful as sexual abuse by a parent. The topic rarely finds its way into the more general psychiatry or social work literature. It is imperative to increase healthcare practitioners' awareness of this complex subject to improve their ability to listen to, detect, and manage the disclosures of SSA in adolescent populations. This paper presents vignettes of three 13-to-15-year-old adolescent girls who disclosed SSA during inpatient hospitalization in an adolescent psychiatric and medicine department. These cases illustrate the complexity of SSA, which has been associated with a wide spectrum of both mental and physical symptoms. Adolescent victims of SSA experience serious distress, with various and numerous psychiatric manifestations, including but not limited to depression and suicide attempts, addictive behaviors, post-traumatic stress symptoms, and eating disorders. Physical symptoms should also alert practitioners: adolescent survivors are more likely to be affected by somatic complications such as sexually transmitted diseases, chronic pain, urogenital symptoms, and nutritional disorders. We offer some recommendations to improve the detection and support of distressed adolescents disclosing SSA. Listening to them and offering a protective multidisciplinary response can limit the lasting damage and contribute to the repair process.

Precursors of sibling bullying in middle childhood: Evidence from a UK-based longitudinal cohort study

BACKGROUND

There is increasing evidence that sibling bullying is associated with various social, emotional, and mental health difficulties. It is, however, unclear which factors predict sibling bullying in middle childhood and whether child-level individual differences make some children more susceptible to sibling bullying involvement.

OBJECTIVE

To investigate the precursors of sibling bullying in middle childhood in a UK based population sample.

PARTICIPANTS AND SETTING

Existing data from the prospective Millennium Cohort Study (N = 16,987) were used. Primary caregivers reported on precursors (child age 7 years or earlier) whilst children self-reported on sibling bullying (child age 11 years).

ANALYSIS

A series of multinomial logistic regression models were fitted. First, testing for crude associations between sibling bullying and the precursors individually. Culminating in a final model with the significant predictors from all of the previous models.

RESULTS

Structural family-level characteristics (e.g. birth order, ethnicity, and number of siblings) were found to be the strongest predictors of sibling bullying involvement followed by child-level individual differences (e.g. emotional dysregulation and sex). Parenting and parental characteristics (e.g. primary caregiver self-esteem and harsh parenting) predicted sibling bullying, but to a lesser extent.

CONCLUSIONS

These findings suggest that structural family characteristics and child-level individual differences are the most important risk factors for sibling bullying. If causality can be established in future research, they highlight the need for interventions to be two-pronged: aimed at parents, focusing on how to distribute their time and resources appropriately to all children, and the children themselves, targeting specific sibling bullying behaviors.

Cross-lagged model of bullying victimization and mental health problems in children with autism in middle to older childhood

LAY ABSTRACT

Youth with autism spectrum disorders are disproportionately at risk for bullying victimization compared to typically developing children and adolescents. While internalizing and externalizing mental health problems have been linked to victimization experiences, few studies have examined the longitudinal effects bullying victimization experiences may have on youth mental health outcomes. The present study investigated longitudinal associations between bullying victimization and mental health problems in a sample of children with autism in middle childhood to early adolescence (aged 5 to 12 years). Findings from our study suggest that youth with autism who experienced bullying victimization (versus no victimization) were older in age, had more severe autism symptoms, and higher levels of internalizing and externalizing mental health problems at study onset. Though externalizing mental health problems at study onset (Time 1) did not relate to change in the likelihood of being bullied one year later (Time 2), experiences of bullying victimization did relate to an increase in parent reports of internalizing mental health problems. This study expanded on previous cross-sectional studies by including two waves of data in a relatively large sample of youth with autism and highlights important information that may be helpful in adapting approaches to intervention at the individual level. Moreover, our findings support the need for bullying programs that may need to focus particular attention to subgroups of youth with autism who may be most at-risk for bullying victimization such as those with more autism symptoms and those with past experiences of victimization (given the chronic nature of bullying).

Sibling Bullying in Middle Childhood is Associated with Psychosocial Difficulties in Early Adolescence: The Case of Individuals with Autism Spectrum Disorder

Sibling bullying is associated with various psychosocial difficulties. We investigated this in 231 individuals with Autism Spectrum Disorder (ASD) and 8180 without ASD between middle childhood (age 11 years) and early adolescence (age 14 years). On the whole, self-reported sibling bullying decreased from middle childhood to early adolescence. Despite this, individuals with ASD continued to report more sibling bullying as both perpetrator and victim in early adolescence than those without ASD. We found that self-report sibling bullying in middle childhood was associated with psychosocial difficulties in early adolescence. Moreover, individuals with ASD were more likely to report being bullied by both siblings and peers in middle childhood and this pattern of victimisation was associated with concurrent and longitudinal psychosocial difficulties.

Predictors of sibling victimization and associations with self-perception and relationship attachment in adolescence

Research has shown that sibling victimization may be as detrimental to adolescent outcomes as peer victimization. However, many questions remain unanswered with regard to potential protective parenting factors and consequences sibling victimization among adolescents. This study tested a mediation model of sibling victimization with parental monitoring, a positive parenting factor, as a predictor and parent and peer-adolescent attachment as mediated by adolescent self-perceptions as potential outcomes. A three path mediation from parental monitoring → sibling victimization → adolescent self-perceptions → peer/parent-adolescent attachment was also tested. Structural Equation Modeling revealed that parental monitoring was negatively associated with sibling victimization only for girls. Sibling victimization had negative direct and indirect effects on parent- and peer-adolescent attachment via adolescent self-perceptions of social competence and self-worth. Findings suggest that parental monitoring may be important in the prevention of sibling victimization and self-perceptions may be an important point of intervention adolescents experiencing sibling victimization.

The Prevalence and Psychopathological Correlates of Sibling Bullying in Children with and without Autism Spectrum Disorder

Using data from a prospective population based study, the prevalence and psychopathological correlates of sibling bullying in children with and without autism spectrum disorder (ASD) were estimated. There were 475 children with ASD and 13,702 children without ASD aged 11 years. Children with ASD were more likely to be bullied by their siblings compared to those without ASD. They were also more likely than those without ASD to both bully and be bullied by their siblings, which was associated with lower prosocial skills as well as more internalizing and externalizing problems compared to those not involved in any sibling bullying. Interventions to improve social and emotional outcomes in children with ASD should focus on both the affected and the unaffected sibling.

Continuation of domestic violence and changes in the assessment of family functioning, health, and social support in Finland

Our aim in this comparison study was to describe the continuation of domestic violence and to assess changes in the association among family functioning, health, and social support for participants who have or have not experienced violence for the years 2012 and 2015. We collected the data using a family functioning, health, and social support (FAFHES) questionnaire. We collected the baseline questionnaires (N = 188) from patients who visited a Finnish central hospital and mailed the follow-up survey (N = 71). The prevalence of violence remained constant. However, the violence varied and changed. Our findings should encourage health care professionals to better identify and intervene in violence.

The Combination of Sibling Victimization and Parental Child Maltreatment on Mental Health Problems and Delinquency

This study examined how the combination of sibling victimization and parental child maltreatment is related to mental health problems and delinquency in childhood and adolescence. Co-occurrence, additive associations, and interactive associations of sibling victimization and parental child maltreatment were investigated using a sample of 2,053 children aged 5-17 years from the National Survey of Children's Exposure to Violence. The results provide primarily evidence for additive associations and only suggest some co-occurrence and interactive associations of sibling victimization and child maltreatment. Evidence for co-occurrence was weak and, when controlling for the other type of maltreatment, only found for neglect. Sibling victimization was related to more mental health problems and delinquency over and above the effect of child abuse and neglect. Moderation by sibling victimization depended on child age and was only found for the relation between both types of child maltreatment by parents and delinquency. For mental health, no interactive associations were found. These results highlight the unique and combined associations between sibling victimization on child development.

Bullying: What the PNP Needs to Know

Despite generations of doubt about the true impact of bullying, it is now clear that childhood bullying can have significant lifelong consequences for victims and bullies alike. Recent school shootings and suicides by students who have been victims of bullying have helped to solidify public awareness of the gravity of the problem of childhood bullying. Adults who were frequently bullied in childhood have an increased frequency of psychiatric disorders, including anxiety, depression, and suicidality, extending into middle age (Arseneault, 2017). In fact, frequent bullying in childhood may impact victims similar to experiencing multiple adverse childhood experiences (Takizawa, Maughan, & Arseneault, 2014). Bullying also has a detrimental effect on young perpetrators (Zuckerman, 2016). Bullying is clearly a pediatric health care problem. This continuing education article will explore bullying in terms of definitions, epidemiology, types, risk factors, resilience factors, consequences, and implications for practice.

Aggression by Children Exposed to IPV: Exploring the Role of Child Depressive Symptoms, Trauma-Related Symptoms, & Warmth in Family Relationships

Multi-informant reports of aggression by siblings in families with and without a history of IPV were compared. Associations between aggressive behavior and child depressive and trauma-related symptoms, as well as maternal and sibling warmth were also explored. Mothers, observers and the siblings themselves reported on aggressive behaviour. Mothers reported on child trauma-related symptoms while children provided self-report on depressive symptoms and mother-child and sibling warmth. The frequency of observed aggression did not differ across groups on average, although more sibling dyads exposed to IPV engaged in aggression than those not exposed. Child reports of sibling aggression did not differ across groups but mothers reported significantly less aggressive behavior by children exposed to IPV than those not exposed. Regression results indicated that depressive and trauma-related symptoms were significant risk factors for aggression, while the role of mother-child and sibling warmth was more complex. Results were discussed within a developmental psychopathology framework.

Risk of maltreatment for siblings: Factors associated with similar and different childhood experiences in a dyadic sample of adult siblings

Siblings share the same environment and thus potentially a substantial number of risk factors for child maltreatment. Furthermore, the number of siblings and the sibling constellation itself might pose a risk for child maltreatment. Little is known about the likelihood that more than one child in a family is maltreated and which factors increase the risk. This study sought to investigate similarities and differences in maltreatment in siblings and risk factors associated with the maltreatment of more than one child from the same family. Data on maltreatment during childhood and adolescence, family background, and sibling constellation were collected from 870 pairs of siblings. In the dyadic analyses, siblings reported similar maltreatment experiences, especially when any type of maltreatment was considered. Parents' mental health problems were significant predictors for maltreatment of at least one sibling. Father's mental health problems were predictive of maltreatment of both or only the younger sibling, mother's mental health problems of both or only the older sibling. Closeness in age and same gender of siblings did not emerge as a consistent predictor. The increasing number of siblings was a risk factor for any type of maltreatment of both siblings. The results highlight the need for preventive measures for families with a large number of children and with parents with mental health problems as well as a repeated risk assessment of all siblings in a family when one sibling was maltreated.

The State of Interventions for Sibling Conflict and Aggression: A Systematic Review

Sibling conflict and aggression is often a pervasive part of family life that parents want help managing and can have negative effects on children's well-being. The purpose of this systematic review is to evaluate current research regarding programs to reduce sibling conflict and aggression and promote positive sibling relationships. Online databases, reference lists, and Google Scholar were searched using key words and inclusion/exclusion criteria were applied. The search located five unique studies of programs focused on school-aged children. Heterogeneity of the studies precluded meta-analysis, but characteristics of the studies were systematically described. Three interventions were aimed at directly improving children's social skills and two interventions trained parents on mediation techniques to use during sibling conflicts. Overall, of the four studies that included assessment of children's social skills, the results were positive. Two of the three studies that evaluated sibling relationship quality demonstrated improved sibling interactions compared with the control group. With further research and evidentiary support, these programs have promise to modify sibling behaviors as part of current parenting education programs or as a stand-alone program to address sibling conflict and aggression.

Sibling sexual abuse: why don't we talk about it?

AIMS AND OBJECTIVES

To explore two hypotheses for explaining why there is little written about sibling sexual abuse and to raise awareness of the subject in order better to protect children and to facilitate sensitive patient care.

BACKGROUND

While there is no universal agreement over its definition, sibling sexual abuse is acknowledged internationally as a prevalent form of child sexual abuse but tends not to be recognised by health professionals. It is also under-represented within the literature in comparison with other forms of intrafamilial sexual abuse. Understanding why this is may help to illuminate the potential barriers to effective professional responses. Two explanations which emerge strongly are the existence of a sibling incest taboo and a prevailing belief that sibling sexual behaviour is largely harmless.

DESIGN

Discursive position paper.

METHOD

The paper examines the two hypotheses through exploration of the extant literature on sibling incest and sibling sexual abuse.

CONCLUSIONS

Sibling sexual abuse accounts for a significant minority of child sexual abuse and has the potential to be as harmful as sexual abuse by a parent. An abhorrence at the thought of sibling sexual activity and a prevailing view of its harmlessness may hinder nurses' detection of and appropriate responses to sibling sexual abuse, but do not provide convincing explanations for the dearth of literature. Instead, a deeply held perspective of sibling relationships as non-abusive offers a more profound explanation.

RELEVANCE TO CLINICAL PRACTICE

A knowledge of sibling sexual abuse and its consequences are important both for the effective protection of children and the sensitive and appropriate treatment of patients who present with a variety of physical and mental health concerns. A perspective that sibling relationships are non-abusive provides a deeper level of understanding of the powerful obstacles to raising awareness of and responding appropriately to this form of abuse.

The Transmission of Gun and Other Weapon-Involved Violence Within Social Networks

Fatal and nonfatal injuries resulting from gun violence remain a persistent problem in the United States. The available research suggests that gun violence diffuses among people and across places through social relationships. Understanding the relationship between gun violence within social networks and individual gun violence risk is critical in preventing the spread of gun violence within populations. This systematic review examines the existing scientific evidence on the transmission of gun and other weapon-related violence in household, intimate partner, peer, and co-offending networks. Our review identified 16 studies published between 1996 and 2015 that suggest that exposure to a victim or perpetrator of violence in one's interpersonal relationships and social networks increases the risk of individual victimization and perpetration. Formal network analyses find high concentrations of gun violence in small networks and that exposure to gun violence in one's networks is highly correlated with one's own probability of being a gunshot victim. Physical violence by parents and weapon use by intimate partners also increase risk for victimization and perpetration. Additional work is needed to better characterize the mechanisms through which network exposures increase individual risk for violence and to evaluate interventions aimed at disrupting the spread of gun and other weapon violence in high-risk social networks.

Bullying in the family: sibling bullying

Sibling relationships have a substantial and lasting effect on children's development. Many siblings experience some occasional conflict, however, up to 40% are exposed to sibling bullying every week, a repeated and harmful form of intrafamilial aggression. We review evidence on the precursors, factors relating to peer bullying, and mental health consequences of sibling bullying. Parenting quality and behaviour are the intrafamilial factors most strongly associated with bullying between siblings. Sibling bullying increases the risk of being involved in peer bullying, and is independently associated with concurrent and early adult emotional problems, including distress, depression, and self-harm. The effects appear to be cumulative, with those children bullied by both siblings and peers having highly increased emotional problems compared with those bullied by siblings or peers only, probably because they have no safe place to escape from bullying. The link between sibling and peer bullying suggests interventions need to start at home. Health professionals should ask about sibling bullying and interventions are needed for families to prevent and reduce the health burden associated with sibling bullying.