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Sun W, Gu F, Tan B, Tang S, Tang K, Meng J, Shen Y, Gao L, Li J, Shan S, Li S, Xiao W, Zhang R, Song P. Gender differences in the association between bullying victimization and depressive symptoms in Chinese children and adolescents. BMC Public Health 2025; 25:1944. [PMID: 40420087 PMCID: PMC12105365 DOI: 10.1186/s12889-025-23129-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Accepted: 05/09/2025] [Indexed: 05/28/2025] Open
Abstract
BACKGROUND Bullying is a rising social concern and public health challenge, threatening the mental health of the youth. Existing evidence lacks comprehensive insight into the gender disparities in such association. This cross-sectional study aimed to elucidate the gender differences in the association between bullying victimization and depressive symptoms among children and adolescents. METHODS A total of 21,654 fourth-grade and above students were recruited from the annual school-based survey "China Common Disease and Risk Factor Surveillance among Students" in Zhejiang Province, China, conducted in 2021. Six forms of bullying victimization were assessed with a self-administered questionnaire and further categorized into three subtypes, including physical, verbal, and relational bullying victimization. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale. A multilevel generalized linear model was employed to analyze the gender-specific association of bullying victimization (in specific forms, subtypes, and cumulative measures) with depressive symptoms. Gender differences were tested by the girls-to-boys ratios of odds ratios (RORs) and the 95% confidential intervals (CIs). RESULTS The median age of recruited children and adolescents was 15.07 years. All specific forms of bullying victimization were significantly associated with increased odds of depressive symptoms. Girls who were mocked or teased (ROR = 1.27, 95% CI = 1.05-1.56), body-shamed (ROR = 1.39, 95% CI = 1.05-1.85) and experienced the subtype of verbal bullying (ROR = 1.22, 95% CI = 1.01-1.46) exhibited greater depressive symptoms than boys. Concerning cumulative effects, girls who experienced two or more forms of bullying victimization (ROR = 1.42, 95% CI = 1.09-1.84), all three subtypes of bullying victimization (ROR = 1.89, 95% CI = 1.10-3.24) had more prominently increased odds of depressive symptoms than boys. CONCLUSIONS Bullied girls exhibited a higher susceptibility to depressive symptoms than boys with the same experience, especially when exposed to multiple bullying incidents. These findings underscore the need for developing gender-specific strategies to protect children from bullying, with an emphasis on safeguarding girls.
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Affiliation(s)
- Weidi Sun
- Center for Clinical Big Data and Statistics of the Second Affiliated Hospital, School of Public Health, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Fang Gu
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Boren Tan
- Center for Clinical Big Data and Statistics of the Second Affiliated Hospital, School of Public Health, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shanshan Tang
- The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ke Tang
- The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jia Meng
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Yu Shen
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Lei Gao
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Juanjuan Li
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Shiyi Shan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shuting Li
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenhan Xiao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ronghua Zhang
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China.
| | - Peige Song
- Center for Clinical Big Data and Statistics of the Second Affiliated Hospital, School of Public Health, Zhejiang University School of Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Slimovitch R, Lee SY, Vergara-Lopez C, Bublitz MH, Stroud LR. Reactivity to Peer Rejection Moderates the Effect of Victimization on Adolescent Girls' Depressive Symptoms: A Prospective Study. Res Child Adolesc Psychopathol 2024; 52:1901-1912. [PMID: 39287770 PMCID: PMC11624055 DOI: 10.1007/s10802-024-01243-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2024] [Indexed: 09/19/2024]
Abstract
Peer victimization and bullying behaviors are prevalent during adolescence and have been linked to depression. This study examined whether peer rejection reactivity, defined as physiological responses to peer exclusion, moderated the associations of victimization and bullying behaviors with depressive symptoms 12 months later in a sample of female youths (N = 79, Mage = 13.37 ± 2.31). Participants underwent the Yale Interpersonal Stressor-Child, during which systolic and diastolic blood pressure and heart rate were continuously measured. Parent and youth reports of the youth's depressive symptoms were utilized. Our results demonstrate that peer rejection reactivity moderates the relationship between victimization and subsequent depressive symptoms but does not moderate the relationship between bullying behaviors and subsequent depressive symptoms. Higher victimization was associated with increased youth-reported depressive symptoms among girls with high reactivity but decreased depressive symptoms among girls with low reactivity. Future research can explore whether reducing emotional and physiological reactivity to peer rejection, as well as increasing interpersonal effectiveness in peer relationships, can reduce depressive symptoms in adolescent girls experiencing victimization.
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Affiliation(s)
- Rachel Slimovitch
- Department of Epidemiology, School of Public Health, Brown University
| | - Sharon Y. Lee
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
| | - Chrystal Vergara-Lopez
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
| | - Margaret H. Bublitz
- Department of Medicine, Warren Alpert Medical School, Brown University
- Women’s Medicine Collaborative, The Miriam Hospital
| | - Laura R. Stroud
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University
- Center for Behavioral and Preventive Medicine, The Miriam Hospital
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Xue J, Huang H, Zhou C, Feng W, Ge Y, Hu Y. Patterns of adverse childhood experiences and their associations with depression, life satisfaction and short-form video addiction in Chinese college students. CHILD ABUSE & NEGLECT 2024; 158:107091. [PMID: 39454405 DOI: 10.1016/j.chiabu.2024.107091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 09/09/2024] [Accepted: 10/07/2024] [Indexed: 10/28/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are widespread in East Asia, heightening the susceptibility to psychological and behavioral complications in adulthood. OBJECTIVE To identify polyvictimization patterns among Chinese college students and investigate the associations between diverse patterns and symptoms of depression, short-form video addiction (SVA), and life satisfaction. PARTICIPANTS AND SETTING This study encompassed 13,307 college students from four urban centers in China (Mage = 20.2; 46.4 % female). METHODS Latent class analysis (LCA) was employed to discern patterns of ACEs among college students. The three-step method (R3step) was utilized to explore the influence of demographic characteristics on the distribution of latent classes. Additionally, the automatic Bolck-Croon-Hagenaars (BCH) Method was deployed to investigate the latent classes effect on distal outcomes. RESULTS Left-behind experience was the most common ACE among Chinese college students. Four ACEs patterns were identified: 1) No/Very Low ACEs class (N = 8936, 67.2 %); 2) Parental Absence class (N = 430, 3.2 %); 3) Low/Moderate ACEs class (N = 3565, 26.8 %); and 4) High Violence and Left-behind class (N = 376, 2.8 %). The findings revealed a progressive escalation in healthy outcomes associated with the four ACEs patterns. Specifically, from the first class to the fourth, the severity of associated consequences (depression, life satisfaction and SVA) intensified. CONCLUSIONS Distinct ACEs patterns correlate with varying degrees of mental health issues. Compared to participants solely separated from parents, those exposed to abuse and neglect demonstrate more pronounced mental health challenges and addiction susceptibilities.
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Affiliation(s)
- Jiao Xue
- Department of Psychology, Institute of Education, China University of Geosciences, Wuhan, China; Wuhan Mental Health Center, Wuhan, China
| | - Hai Huang
- Department of Psychology, Institute of Education, China University of Geosciences, Wuhan, China; Wuhan Mental Health Center, Wuhan, China.
| | - Chunyan Zhou
- Department of Psychology, Institute of Education, China University of Geosciences, Wuhan, China; Wuhan Mental Health Center, Wuhan, China
| | - Wenting Feng
- Department of Psychology, Institute of Education, China University of Geosciences, Wuhan, China; Wuhan Mental Health Center, Wuhan, China
| | - Yanwei Ge
- Mental Health Education Center, China Jiliang University, Hang Zhou, China
| | - Yue Hu
- Student Mental Health and Counseling Center, Sichuan International Studies University, Chongqing, China
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Lucas R, Talih M, Soares S, Fraga S. Bullying Involvement and Physical Pain Between Ages 10 and 13 Years: Reported History and Quantitative Sensory Testing in a Population-Based Cohort. THE JOURNAL OF PAIN 2024; 25:1012-1023. [PMID: 37914095 DOI: 10.1016/j.jpain.2023.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/06/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023]
Abstract
We aimed to quantify the prospective association between bullying and physical pain in a population-based cohort of adolescents. We assessed 4,049 participants of the 10 and 13 years waves of the Generation XXI birth cohort study in Portugal. Pain history was collected using the Luebeck pain screening questionnaire. A subsample of 1,727 adolescents underwent computerized cuff pressure algometry to estimate pain detection/tolerance thresholds, temporal pain summation and conditioned pain modulation. Participants completed the Bully Scale Survey and were classified as "victim only", "both victim and aggressor", "aggressor only", or "not involved". Associations were quantified using Poisson or linear regression, adjusted for sex and adverse childhood experiences. When compared to adolescents "not involved", participants classified as "victim only" or "both victim and aggressor" at age 10 had higher risk of pain with psychosocial triggers, pain that led to skipping leisure activities, multisite pain, pain of higher intensity, and pain of longer duration, with relative risks between 1.21 (95% confidence interval: .99, 1.49) and 2.17 (1.57, 3.01). "Victims only" at age 10 had lower average pain detection and tolerance thresholds at 13 years (linear regression coefficients: -1.81 [-3.29, -.33] and -2.73 [-5.17, -.29] kPa, respectively), as well as higher pain intensity ratings (.37 [.07, .68] and .39 [.06, .72] mm), when compared with adolescents not involved. No differences were seen for the remaining bullying profiles or sensory measures. Our findings suggest that bullying may have long-term influence on the risk of chronic musculoskeletal pain and may interfere with responses to painful stimuli. PERSPECTIVE: We found prospective evidence that bullying victimization in youth: 1) is more likely to lead to negative reported pain experiences than the reverse, 2) may have long-term influence on adverse pain experiences, and 3) may contribute to pain phenotypes partly by interfering with somatosensory responses to painful stimuli.
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Affiliation(s)
- Raquel Lucas
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal; Department of Population Studies, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Makram Talih
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Sara Soares
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
| | - Sílvia Fraga
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Solis I, Serna L, Stephen JM, Ciesielski KTR. Early Behavioral Markers of Anxiety and Reduced Frontal Brain Alpha May Predict High Risk for Bullying Victimization. Child Psychiatry Hum Dev 2024; 55:71-81. [PMID: 35752998 DOI: 10.1007/s10578-022-01372-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 11/28/2022]
Abstract
Bullying victimization has a profound negative impact on a child's emotional, social, and cognitive development. Childhood bullying victimization is reported across various social settings, suggesting common characteristics that increase a child's vulnerability to victimization. It is critical to identify early markers of such vulnerability to design preventative tools. Comprehensive semi-structured clinical interviews from mothers of child-victims and non-engaged control children included assessment of early developmental rituals and behavioral inhibition to social novelty, as potential behavioral correlates of anxiety. Neuropsychological and clinical assessment tools were used, and resting state spectral resting state EEG (rsEEG) was recorded. Increased frequency/severity of early developmental rituals and behaviorally inhibited responses to social novelty were apparent in all child-victims, alongside significantly reduced power of ventral prefrontal brain rsEEG alpha oscillations (8-13 Hz). This triad of findings, in line with prior studies, suggested an elevated early childhood anxiety, which, as current findings indicate, may be a cross-diagnostic marker of increased risk for life-long bullying victimization. Gaining insight into early childhood markers of anxiety may meaningfully complement neuropsychiatric prognosis and preventative efforts.
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Affiliation(s)
- Isabel Solis
- Pediatric Neuroscience Laboratory, Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Loretta Serna
- Department of Special Education, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Julia M Stephen
- Mind Research Network, and Lovelace Biomedical and Environmental Research Institute, 1101Yale Blvd, Albuquerque, NM, 87106, USA
| | - Kristina T R Ciesielski
- Pediatric Neuroscience Laboratory, Psychology Clinical Neuroscience Center, Department of Psychology, University of New Mexico, Albuquerque, NM, 87131, USA.
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149-13th St, Boston, MA, 02 129, USA.
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Yin H, Han Z, Li Y. Traditional bullying, cyberbullying, and quality of life among adolescents in 35 countries: Do cultural values matter? Soc Sci Med 2024; 340:116499. [PMID: 38103495 DOI: 10.1016/j.socscimed.2023.116499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 11/21/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
RATIONALE Substantial evidence indicates that involvement in school bullying has been linked to lower quality of life (QoL). Yet there is little information elucidating the link between bullying involvement and QoL in different cultures. OBJECTIVE This study investigated the associations between different types of bullying involvement and QoL among adolescents. The moderating roles of cultural values in the relationship between bullying involvement and QoL were examined. METHODS This study included representative samples from 35 countries (N = 184,017) using data from the 2017/2018 Health Behavior in School-Aged Children (HBSC) survey and the new 2023 World Cultural Map Scores from the World Values Survey Wave 7 (2017/2021). Multilevel mixed-effects analysis was employed to examine individual-level and country-level effects simultaneously. RESULTS All types of bullying involvement were associated with lower QoL, with being a victim having the lowest QoL. Adolescents in societies that prioritize higher self-expression values exhibited a reduced propensity to engage in school bullying. In countries with higher self-expression values, there was a more pronounced negative association between bullying involvement and QoL. Traditional/Secular-rational values had no significant and consistent moderating effect on the association between bullying involvement and QoL. Those results were quite similar for both traditional bullying and cyberbullying. CONCLUSION These findings imply that cultural values are closely intertwined with adolescent bullying and quality of life. Therefore, prevention and intervention programs should pay more attention to addressing bullying and promoting the QoL of adolescents according to various cultural values.
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Affiliation(s)
- Hui Yin
- School of Political Science and Public Administration, Shandong University, China.
| | - Ziqiang Han
- School of Political Science and Public Administration, Shandong University, China.
| | - Yuhuan Li
- School of Government, Central University of Finance and Economics, China.
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Badger JR, Zaneva M, Hastings RP, Broome MR, Hayes R, Patterson P, Rose N, Clarkson S, Hutchings J, Bowes L. Associations between School-Level Disadvantage, Bullying Involvement and Children's Mental Health. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1852. [PMID: 38136054 PMCID: PMC10741410 DOI: 10.3390/children10121852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023]
Abstract
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.
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Affiliation(s)
- Julia R. Badger
- Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK; (J.R.B.)
- Department of Education, University of Oxford, Oxford OX2 6PY, UK
| | - Mirela Zaneva
- Christ Church College, University of Oxford, Oxford OX1 1DP, UK;
| | - Richard P. Hastings
- School of Education Learning and Communications Sciences, University of Warwick, Coventry CV4 7AL, UK;
| | - Matthew R. Broome
- Institute for Mental Health, University of Birmingham, Birmingham B15 2TT, UK;
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham B4 6NH, UK;
| | - Rachel Hayes
- Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter EX1 2LU, UK;
| | - Paul Patterson
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham B4 6NH, UK;
| | - Naomi Rose
- Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK; (J.R.B.)
| | - Suzy Clarkson
- School of Human and Behavioral Sciences, Bangor University, Bangor LL57 2AS, UK; (S.C.); (J.H.)
| | - Judy Hutchings
- School of Human and Behavioral Sciences, Bangor University, Bangor LL57 2AS, UK; (S.C.); (J.H.)
| | - Lucy Bowes
- Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK; (J.R.B.)
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Nichifor F, Marian AL, Tiţă SM. Predictors of Bullying among Athletes in the Romanian Context. Eur J Investig Health Psychol Educ 2023; 13:2046-2062. [PMID: 37887146 PMCID: PMC10606297 DOI: 10.3390/ejihpe13100145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
The purpose of this study was to examine the explanatory power of a predictive model of bully/perpetrator behaviour in Romanian athletes, consisting of negative pre-competitive emotions (anxiety, sadness, and anger), perception of male gender normativity, and relationships with coaches and teammates. Additionally, we aimed to explore the mediation effect of bully-victim behaviour on the relationship between athletes' connections with their coaches and bully/perpetrator behaviour. The current research involved a nonexperimental, cross-sectional design exploring the presence of bully/perpetrator behaviour in Romanian male and female athletes. The quantitative methodology was used to collect and analyse the data obtained. Researchers translated, adapted and pretested the questionnaire set to the Romanian cultural background (SEQ, MAMS, CART-Q, In-group Ties Scale, BSQ) before distributing it to 448 participants. 58.7% were male participants, and 41.3% were female participants. The mean age was 21.15 (SDage = 2.37, range = 18-32). The research was conducted in the first half of 2023. SPSS (V. 20) and Hayes's PROCESS tool were used to investigate the data. The findings demonstrated that in the case of Romanian male athletes, perception of male gender normativity, anger, and weaker connections with coaches are the most important psychological factors in predicting bully/perpetrator behaviour. In contrast, in the case of Romanian female athletes, only weaker connections with coaches and perception of male gender normativity play an essential role in explaining bully/perpetrator behaviour. Additionally, the study demonstrated that bully-victim behaviour mediates the relationship between athletes' weaker connections with their coaches and bully/perpetrator behaviour. Athletes' weaker connections with their coaches lead to experiencing a high level of bully/perpetrator behaviour by stressing bully-victim behaviour, which also contributes to achieving a high level of bully/perpetrator behaviour.
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Affiliation(s)
- Florin Nichifor
- Faculty of Physical Education and Sport, “Alexandru Ioan Cuza” University of Iasi, Toma Cozma Street, No. 3, 700554 Iasi, Romania;
| | - Andrei-Lucian Marian
- Faculty of Psychology and Educational Sciences, Department for Teacher Training, “Alexandru Ioan Cuza” University of Iasi, Toma Cozma Street, No. 3, 700554 Iasi, Romania;
| | - Silviu-Mihail Tiţă
- Faculty of Economics and Business Administration, Department Management, Marketing and Business Administration, “Alexandru Ioan Cuza” University of Iasi, Carol I Street, No. 22, 700554 Iasi, Romania
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Madsen KM, Holstein BE, Madsen KR. Recurrent headache, stomachache, and backpain among adolescents: association with exposure to bullying and parents' socioeconomic status. Scand J Pain 2023; 23:563-570. [PMID: 37277906 DOI: 10.1515/sjpain-2022-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 05/09/2023] [Indexed: 06/07/2023]
Abstract
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.
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Affiliation(s)
- Klara Merrild Madsen
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | - Bjørn E Holstein
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | - Katrine Rich Madsen
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
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Phillips N, Brown BT, Lin H, Swain MS. Association Between Pain and Bullying in Australian Adolescents: A Secondary Analysis of Cross-Sectional Data From the Australian Child Wellbeing Project. J Manipulative Physiol Ther 2023; 46:377-384. [PMID: 39453302 DOI: 10.1016/j.jmpt.2024.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 08/24/2024] [Accepted: 08/25/2024] [Indexed: 10/26/2024]
Abstract
OBJECTIVE This study aimed to describe the frequency, and the strength of the association, between bullying and pain in Australian schoolchildren. METHODS We used nationally representative data from the 2014 Australian Child Wellbeing Project, comprised students aged 8 to 14 years from 180 schools. Weighted, multiple logistic regression models (adjusting for sex and school year) were constructed to quantify the association between weekly or more frequent bullying and weekly or more frequent pain. Estimates of association for the relationship between bullying and pain were reported as odds ratios (OR). RESULTS The sample was comprised of 5,440 schoolchildren (51.9% female). The prevalence rates of weekly or more frequent pain in the sample were headache (32.3%), backache (23.5%), and stomach ache (21.7%). Between 4.3% and 7.9% of participants reported weekly or more frequent bullying. In schoolchildren reporting bullying, the prevalence of pain ranged from 43.1% to 64.3%. Logistic regression modeling showed moderate-to-strong positive associations (OR, 2.1 [95% CI, 1.8-2.5] to 4.5 [95% CI, 3.7-5.6]) between the experiences of schoolchildren reporting any bullying type and any pain type. CONCLUSION Australian schoolchildren who reported bullying were more likely to experience headache, stomach ache, and backache. The moderate-to-strong positive association is consistent with previous international studies that have examined the association between bullying and pain in young people. These findings have significant implications for clinicians who provide care for young people, as well as educators and healthcare policymakers, highlighting the important role of coexisting psychosocial factors in the management of adolescents who report pain.
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Affiliation(s)
- Nichole Phillips
- Department of Chiropractic, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
| | - Benjamin T Brown
- Department of Chiropractic, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Huan Lin
- School of Mathematical and Physical Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
| | - Michael S Swain
- Department of Chiropractic, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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Newman KL, Alexander DS, Rovers JP. Sadness, hopelessness and suicide attempts in bullying: Data from the 2018 Iowa youth survey. PLoS One 2023; 18:e0281106. [PMID: 36791058 PMCID: PMC9931156 DOI: 10.1371/journal.pone.0281106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/15/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Bullying in schools is a common problem that can have significant consequences on the mental health of both bullies and victims of bullying. Some estimates suggest that 30% of American youth are bullied. Self-reported incidence of depression, anxiety, and suicide attempts has been correlated with bullying. Victims may also suffer from a variety of somatic complaints such as headache, sleep disorders, and others. Youth surveys undertaken by Education or Public Health Departments in most US states are an underutilized resource in evaluating the problem and any consequences. OBJECTIVE The objective of this study was to explore the association of being involved in bullying either as a victim and/or a bully on mental health and suicide ideation by analyzing data from the 2018 Iowa Youth Survey. The results will then be applied to the published anti-bullying literature to make suggestions for how anti-bullying programs may be designed. METHODS Data were obtained from the 2018 Iowa Youth Survey (IYS), which is a cross-sectional survey of 6th, 8th and 11th grade students. We chose two mental health questions as dependent variables and used a multivariable logistic regression analysis to evaluate the correlation between the two dependent variables and ten types of bullying included in the IYS. Since some respondents in the IYS were prescribed psychotropic medications to help with feeling angry, anxious, nervous, or sad, we adjusted for the use of psychotropic medication in our analysis. Similarly, the literature suggests that some students are both bullies and victims (bully-victims). Accordingly, we also adjusted for bully-victims. RESULTS Unadjusted Odds Ratios (ORs) showed that not all forms of bullying were correlated with a significant risk of mental distress. Physical bullying had comparatively little association (ORs < 1 or overlapped 1), while identity bullying on sexual orientation or gender identity or sexual joking was consistently correlated with significant ORs for feeling sad or hopeless and attempting suicide (ORs 1.40-2.84). Cyberbullying (ORs 1.32-1.70) and social bullying (ORs < 1-2.21) were correlated with mental distress with ORs generally between physical and identity bullying. When adjusting for medication use or bully-victim status, adjusted ORs (aORs) were generally lower than unadjusted ORs. CONCLUSIONS Not all types of bullying were significantly correlated with feeling sad or hopeless or attempting suicide. Being able to evaluate the specific associations of different types of bullying may have implications for teachers or policy makers hoping to implement bullying mitigation strategies in their schools.
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Affiliation(s)
- Kaela L. Newman
- College of Arts and Sciences, Drake University, Des Moines, Iowa, United States of America
| | - Daniel S. Alexander
- College of Arts and Sciences, Drake University, Des Moines, Iowa, United States of America
| | - John P. Rovers
- College of Pharmacy & Health Sciences, Drake University, Des Moines, Iowa, United States of America
- * E-mail:
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Hasan MM, Fatima Y, Cleary A, McDaid L, Munir K, Smith SS, Dias S, Baxter J, Mamun A. Geographical variations in the prevalence of traditional and cyberbullying and its additive role in psychological and somatic health complaints among adolescents in 38 European countries. J Psychosom Res 2023; 164:111103. [PMID: 36521322 DOI: 10.1016/j.jpsychores.2022.111103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To explore geographical variations in the prevalence of traditional and cyberbullying and their individual and additive role on psychological and somatic health issues of adolescents. METHODS We used cross-sectional data from 188,003 adolescents (50.9% females; mean age 13.6 years) from the nationally representative Health Behaviour in School-aged Children 2014 survey in 38 European countries. Multivariable linear regression analyses were conducted to explore the role of bullying on health outcomes whilst meta-analyses were conducted to generate pooled regression coefficients. RESULTS Overall, the prevalence of traditional bullying was 26.9%, ranges from 8.8% in Armenia to 49.7% in Latvia, and cyberbullying was 15.8%, ranges from 5.8% in Greece to 38.3% in Greenland. 1 in 10 (8.4%) adolescents reported experiencing both forms of bullying, with the prevalence ranging from 2.5% (Greece) to 21.0% (Greenland). Meta-analytic estimates suggest a significant role of both traditional and cyberbullying in poor somatic and psychological health issues. The additive effect of both forms of bullying was more prominent on psychological health issues (β 0.70, 95% CI 0.66-0.74) than on somatic health issues (β 0.50, 95% CI 0.47-0.53). These associations varied across countries. CONCLUSION The prevalence of traditional and cyberbullying varied significantly across European countries while their individual and additive links with an increased risk of poor psychological and somatic health issues remain common in majority countries. To ensure both forms of bullying are prevented, a multifaceted approach and particular attention to mental health issues in bullying victims are needed in countries with high prevalence of bullying.
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Affiliation(s)
- Md Mehedi Hasan
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland 4068, Australia; ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland 4068, Australia.
| | - Yaqoot Fatima
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland 4068, Australia; ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland 4068, Australia; Centre for Rural and Remote Health, James Cook University, Queensland, Australia
| | - Anne Cleary
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland 4068, Australia
| | - Lisa McDaid
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland 4068, Australia
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Simon S Smith
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland 4068, Australia; ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland 4068, Australia
| | - Shannon Dias
- Jamieson Trauma Institute, Metro North Hospital and Health Service, Queensland, Australia
| | - Janeen Baxter
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland 4068, Australia; ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland 4068, Australia
| | - Abdullah Mamun
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Queensland 4068, Australia; ARC Centre of Excellence for Children and Families over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland 4068, Australia
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13
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Ding H, Cao L, Xu B, Li Y, Xie J, Wang J, Su P, Wang G. Involvement in bullying and sleep disorders in Chinese early adolescents. Front Psychiatry 2023; 14:1115561. [PMID: 37181869 PMCID: PMC10172573 DOI: 10.3389/fpsyt.2023.1115561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 04/11/2023] [Indexed: 05/16/2023] Open
Abstract
Background School bullying may cause sleep disorders in early adolescents. Here, we determined the relationship between school bullying (considering all the features of bullying involvement) and sleep disorders, which are the common problems in Chinese early adolescents. Materials and methods We conducted a questionnaire survey among 5,724 middle school students from Xuancheng, Hefei, and Huaibei cities in Anhui province, China. The self-report questionnaires included the Olweus Bully/Victim Questionnaire and Pittsburgh Sleep Quality Index. We used latent class analysis to identify the potential subgroups of bullying behavior. Logistic regression analysis was used to investigate the association between school bullying and sleep disorders. Results Active participants in bullying interactions, including the bullies and victims, reported higher levels of sleep disorders compared with the non-active participants [Bully: physical (aOR = 2.62), verbal (aOR = 1.73), relational (aOR = 1.80), and cyber (aOR = 2.08); Victim: physical (aOR = 2.42), verbal (aOR = 2.59), relational (aOR = 2.61), and cyber (aOR = 2.81)]. A dose-response relationship was observed between the number of school bullying types and sleep disorders. In the context of bullying roles, bully-victims had the highest risk of reporting sleep disorders (aOR = 3.07, 95% CI: 2.55-3.69). We identified four potential categories of school bullying behaviors: low involvement in bullying, verbal and relational victims, medium bully-victims, and high bully-victims, and the highest frequency of sleep disorders was observed in the high bully-victims group (aOR = 4.12, 95% CI: 2.94-5.76). Conclusion Our findings indicate a positive correlation between bullying roles and sleep disorders in early adolescents. Therefore, targeted intervention for sleep disorders should include an evaluation of bullying experiences.
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Affiliation(s)
- Han Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Leilei Cao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Baoyu Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Jinyu Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Jun Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Puyu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, Anhui, China
- *Correspondence: Puyu Su,
| | - Gengfu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, Anhui, China
- Gengfu Wang,
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Huang J, Huebner ES, Tian L. Stability and Changes in Traditional and Cyberbullying Perpetration and Victimization in Childhood: The Predictive Role of Depressive Symptoms. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP17300-NP17324. [PMID: 34182827 DOI: 10.1177/08862605211028004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Childhood bullying is a public health concern. The stability and changes in children's bullying profiles should provide useful information about specific risk groups and their developmental patterns. The current longitudinal study examined the stability and changes in bullying involvement in children along with the predictive roles of depressive symptoms in bullying subgroup memberships and transitions. A total of 4,321 Chinese children (55.1% male, Mage = 9.93) participated in self-report assessments at three time points with six-month intervals. Bullying subgroups were identified based on physical, relational, and cyberbullying using latent profile analysis. The transitions patterns were modeled using latent transition analysis. Depressive symptoms were added as a covariate in bullying subgroup memberships and transitions. Five bullying subgroups were found at Time 1 and Time 2: traditional bully-victims, traditional victims, (cyber) bully-victims, (cyber) victims, and noninvolved children, whereas four bullying subgroups were found at Time 3: traditional bully-victims, traditional victims, (cyber) bully-victims, and noninvolved children. Findings suggested that (a) childhood bullying involvement showed varying levels of stability, with noninvolved children displaying the most stability and cyberbullying-involved children displaying the least stability; (b) children reporting more severe depressive symptoms manifested a higher risk of bullying involvement; (c) initially noninvolved children showing depressive symptoms were at a higher risk for becoming traditional victims; and (d) children reporting depressive symptoms found it more difficult to escape from bullying than children without depressive symptoms. The findings offer support for both the cumulative continuity and interactional models of development. The findings also highlight the important the role of depressive symptoms in preventing and ameliorating children's bullying.
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Affiliation(s)
- Jingyi Huang
- School of Psychology, South China Normal University, Guangzhou, China
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - E Scott Huebner
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Lili Tian
- School of Psychology, South China Normal University, Guangzhou, China
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
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15
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Gong Z, Reinhardt JD, Han Z, Ba Z, Lei S. Associations between school bullying and anxiety in children and adolescents from an ethnic autonomous county in China. Psychiatry Res 2022; 314:114649. [PMID: 35643051 DOI: 10.1016/j.psychres.2022.114649] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 05/17/2022] [Accepted: 05/21/2022] [Indexed: 11/16/2022]
Abstract
School bullying is a widespread public health issue that negatively impacts the mental health of children and adolescents. This study aimed to investigate associations between school bullying involvement and anxiety of children and adolescents. A survey covering all types of pre-college schools (primary, middle, high, and vocational school) was conducted in an ethnic autonomous county in China. 1,943 students participated in this study. Being a victim of verbal (OR=3.08, 95%CI = [2.43,3.91]), physical (OR=3.24, 95%CI = [2.46,4.27]), relational (OR=3.72, 95%CI = [2.90,4.76]), or cyberbullying (OR=3.47, 95%CI = [2.61,4.61]) were associated with increased symptoms of generalized anxiety. Similarly, being a perpetrator of verbal (OR=2.12, 95%CI = [1.45,3.10]), physical (OR=1.85, 95%CI = [1.22,2.79]), relational (OR=1.78, 95%CI = [1.15,2.74]), or cyber-bullying (OR=1.59, 95%CI = [1.08,2.33]) were related to a higher degree of anxiety. Moreover, in both victims and perpetrators higher levels of anxiety were associated with a greater number of types of bullying they were involved in, suggesting a dose-response relation between school bullying involvement and anxiety. Therefore, both bullying victims and perpetrators need mental health support and anti-bullying strategies should address different forms of bullying evenhandedly.
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Affiliation(s)
- Zepeng Gong
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China; Shenzhen Institute for Advanced Study, University of Electronic Science and Technology of China, Shenzhen, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China; Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Ziqiang Han
- School of Political Science and Public Administration, Shandong University, Qingdao, China
| | - Zhanlong Ba
- School of Sociology, Beijing Normal University, Beijing, China
| | - Shangqing Lei
- School of Public Administration, Sichuan University, Chengdu, China.
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16
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Kim J, Lee Y, Jennings WG. A Path from Traditional Bullying to Cyberbullying in South Korea: Examining the Roles of Self-Control and Deviant Peer Association in the Different Forms of Bullying. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:5937-5957. [PMID: 35259313 DOI: 10.1177/08862605211067022] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Despite a recent growth in studies on cyberbullying, extant knowledge on the underlying mechanisms of cyberbullying remain limited. The objective of the present study is to explore the dynamics of cyberbullying via traditional bullying, self-control, and delinquent peer association. Specifically, the following hypotheses guide the present study: (1) traditional bullying, low self-control, and delinquent peer association are predictive of cyberbullying, respectively, (2) the interaction between traditional bullying and low self-control has a significant impact on cyberbullying, and (3) the interaction between traditional bullying and delinquent peer association has a significant impact on cyberbullying. The present study relies on five waves of the Korean Youth Panel Survey (KYPS), a representative sample of South Korean adolescents. Data collection occurred annually and respondents were 14 years old at the first wave in 2003. KYPS is an almost gender-equal and racially/ethnically homogenous sample. Results of cross-lagged dynamic panel models show (1) significant effects of traditional bullying on cyberbullying with and without low self-control and delinquent peer affiliation, (2) the respective roles of self-control and delinquent peer association in the prediction of cyberbullying, and (3) an interaction effect between low self-control and traditional bullying on cyberbullying. These findings demonstrate the theoretical validity of self-control theory and social learning theory in online delinquent behavior as well as confirm their cross-cultural generalizability in a non-Western sample. The findings also highlight the importance of investing in early life-course prevention/intervention programs and policies to prevent and/or reduce the occurrence of bullying, regardless of whether it is being perpetrated face-to-face or online, and these programs and policies should also target components to improve self-control and reduce delinquent peer associations.
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Affiliation(s)
- Jihoon Kim
- Department of Criminology and Criminal Justice, 8063The University of Alabama, Tuscaloosa, AL, USA
| | - Yeungjeom Lee
- School of Economic, Political and Policy Sciences, 12335The University of Texas at Dallas, Richardson, TX, USA
| | - Wesley G Jennings
- Department of Criminal Justice & Legal Studies, 8083The University of Mississippi University, University Park, MS, USA
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17
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Hong JS, Yan Y, Espelage DL, Tabb KM, Caravita SCS, Voisin DR. Peer Victimization and Adverse Psychosocial Wellbeing of Black/White Biracial Adolescents: Is Ease of Talking With Family a Protective Buffer? SCHOOL PSYCHOLOGY REVIEW 2022. [DOI: 10.1080/2372966x.2022.2034474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chui WH, Weng X, Khiatani PV. Associations among Bullying Victimization, Family Dysfunction, Negative Affect, and Bullying Perpetration in Macanese Adolescents. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:28-49. [PMID: 33357082 DOI: 10.1177/0306624x20983741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Bullying has become one of the most significant problem behaviors that school-aged adolescents face. The current study examines the strain-delinquency relationship by employing General Strain Theory as a guiding framework. "Strain" was operationalized as bullying victimization and family dysfunction, "delinquency" was operationalized as bullying perpetration, and "negative affect" was operationalized as anxiety and depression. Analyses were carried out based on a group of 2,139 Macanese schoolchildren. Using a structural equation modeling technique, the results revealed that exposure to family dysfunction and bullying victimization was associated with adolescents' negative affect, such as anxiety and depression. Contrary to our expectations, the indirect effect of victimization on bullying through negative affect was negative, though the mediation effect was relatively small and only significant in boys. In addition, gender analyses of invariance showed that male adolescents who experienced more family conflict and parental control were less likely to engage in bullying. This study could lead to further anti-bullying interventions and practical efforts designed to improve positive parenting and adolescents' interpersonal skills.
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Affiliation(s)
- Wing Hong Chui
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Xue Weng
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Paul Vinod Khiatani
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
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Xu S, Ren J, Li F, Wang L, Wang S. School Bullying Among Vocational School Students in China: Prevalence and Associations With Personal, Relational, and School Factors. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP104-NP124. [PMID: 32338115 DOI: 10.1177/0886260520907360] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study poses the following research questions: What is the prevalence of bullying in vocational schools in China? What are the differences between different genders and professions? How should individuals, families, and schools do to affect school bullying? What can we do to improve and to respond school bullying, to reduce its occurrence and consequences? This cross-sectional study was conducted in 2018 with 95,873 students from 85 vocational schools. The main outcome indicators were self-reported involvement in bullying (perpetrator, victim, perpetrator-victim, or uninvolved). Multinomial logistic regression analyses were conducted, with personal characteristics, relational characteristics, and school climate as predictors. A total of 30.4% of participants reported being bullied, 2.9% reported bullying others, and 21.7% reported being bullied and bullying others. Majors related to primary and secondary industries are more likely to involvement in bullying than majors related to tertiary industries. Boys were more involved in physical or verbal bullying, whereas girls were more involved in relational bullying and cyberbullying. Sex, history of fighting, and emotional/mental state were the strongest individual factors associated with bullying. Having friends was inversely associated with bullying involvement; moreover, a positive relationship with parents and a good parenting style (warmth, democracy, and mutual concern) protected students from bullying others as well as being bullied. School bullying programs, happiness at school, and insecurity at school were strong negative predictors of bullying. Bullying is prevalent among vocational school students in China. An appropriate response to school bullying requires strengthening student capacity to correctly understand and deal with bullying, identifying victims and vulnerable groups, developing school-based interventions, involving parents in prevention programs, and enhancing students' sense of responsibility in supervision, reporting, and creating a friendly environment.
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Affiliation(s)
- Shuqing Xu
- China University of Mining and Technology, Xuzhou, China
- Jiangsu Union Technical Institute, Nanjing, China
| | - Jun Ren
- Fudan University, Shanghai, China
| | | | - Lei Wang
- Jiangsu Union Technical Institute, Nanjing, China
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20
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Bullying perpetration and victimization among adolescents: A diathesis-stress model of depressive symptoms. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2021. [DOI: 10.1016/j.appdev.2021.101350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Doumas DM, Midgett A, Myers V, Buller MK. Usability of a Technology-Based Bystander Bullying Intervention for Middle School Students in Rural, Low-Income Communities: Mixed Methods Study. JMIR Form Res 2021; 5:e32382. [PMID: 34582355 PMCID: PMC8579223 DOI: 10.2196/32382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Students who are targets of bullying and who witness bullying are at high risk for negative mental health outcomes. Bystander training is essential to reduce bullying and the negative associated consequences for targets and bystanders. Resources necessary for program delivery, however, pose significant barriers for schools, particularly those in rural, low-income communities. Technology-based programs can reduce health disparities for students in these communities through cost-effective, easy-to-disseminate programming. OBJECTIVE The aim of this study is to conduct usability testing of a bystander bullying web app prototype, STAC-T (technology-based STAC, which stands for the 4 bystander strategies Stealing the Show, Turning it Over, Accompanying Others, and Coaching Compassion) as an initial step in the development of a full-scale STAC-T intervention. Objectives include assessing usability and acceptability of the STAC-T prototype, understanding school needs and barriers to program implementation, and assessing differences in usability between school personnel and students. METHODS A sample of 16 participants, including school personnel and students recruited from 3 middle schools in rural, low-income communities, completed usability testing followed by a qualitative interview. Descriptive statistics, 2-tailed independent sample t tests, and consensual qualitative research were used to assess usability and program satisfaction and to extract themes related to acceptability, feasibility, needs, barriers, and feedback for intervention development. RESULTS Usability testing indicated that the app was easy to use, acceptable, and feasible. Both school personnel (mean rating 89.6, SD 5.1) and students (mean rating 91.8, SD 7.0) rated the app well above the standard cutoff score for above-average usability (ie, 68), and both school personnel (mean rating 5.83, SD 0.41) and students (mean rating 6.10, SD 0.57) gave the app high user-friendliness ratings (0-7 scale, with 7 as high user-friendliness). The overall ratings also suggested that school personnel and students were satisfied with the program. Of the 6 school personnel who said they would recommend the program, 1 (17%), 4 (66%), and 1 (17%) rated the program as 3, 4, and 5 stars, respectively; 80% (8/10) of students said they would recommend the program; and 60% (6/10) and 40% (4/10) rated the program as 4 stars and 5 stars, respectively. Qualitative data revealed that school personnel and students found the STAC-T app to be useful, user-friendly, and relevant, while providing feedback related to the importance of digital learning activities that engage the user. Data from school personnel also indicated positive perceptions regarding program feasibility and probability of program adoption, with the most significant barrier being cost, suggesting the importance of considering the financial resources available to schools in rural, low-income communities when setting the price point for the full-scale STAC-T intervention. CONCLUSIONS This study provides support for the full-scale development of the STAC-T app and provides key information for revision to enhance used engagement. TRIAL REGISTRATION ClinicalTrials.gov NCT04681495; https://clinicaltrials.gov/ct2/show/NCT04681495.
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Affiliation(s)
- Diana M Doumas
- Institute for the Study of Behavioral Health and Addiction, Boise State Universtiy, Boise, ID, United States
- Department of Counselor Education, Boise State University, Boise, ID, United States
| | - Aida Midgett
- Institute for the Study of Behavioral Health and Addiction, Boise State Universtiy, Boise, ID, United States
- Department of Counselor Education, Boise State University, Boise, ID, United States
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Gao X, Vaca FE, Haynie D, Simons-Morton B, Li K. Trajectories of risky driving among emerging adults with their mental and psychosomatic health predictors in the 12th grade. TRAFFIC INJURY PREVENTION 2021; 22:S14-S20. [PMID: 34379555 PMCID: PMC8792148 DOI: 10.1080/15389588.2021.1949003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To identify trajectory classes of risky driving among emerging adults and examine predictive associations of depressive and psychosomatic symptoms in the 12th grade with the identified trajectory classes. METHODS Data were from the last year in high school (12th-Grade - Wave 3 [W3]) and years 1-4 after high school (Waves 4-7 [W4-7]) of the NEXT Generation Health Study, a nationally representative study starting with 10th grade (2009-2010). We measured risky driving with the 21-item Checkpoints Self-Reported Risky Driving Scale (C-RDS). Using C-RDS data from W3-7, the latent class growth modeling (LCGM) was used to identify risky driving trajectory classes. Independent variables were W3 depressive symptoms and W3 psychosomatic symptoms. Covariates included family affluence and urbanicity. The LCGM was conducted with SAS PROC Traj. The multinomial logistic regressions were used to examine the associations between the trajectory classes and independent variables, taking complex survey sampling features into account. RESULTS Three risky driving trajectories were identified: low (N = 583, 21.43%, weighted and hereafter), medium (N = 1423, 59.22%), and high (N = 389, 19.35%) risky driving classes. Compared to the low risky driving class, one unit increase in W3 depressive symptoms was significantly associated with a higher likelihood of belonging to the medium (adjusted odds ratio [AOR] = 1.04, 95% CI 1.01, 1.07) and the high (AOR = 1.05, 95% CI 1.02, 1.08) risky driving classes, respectfully, when controlling for the covariates. Likewise, compared to the low risky driving class, one unit increase in W3 psychosomatic symptoms was significantly associated with a higher likelihood of belonging to the medium (AOR = 1.06, 95% CI 1.00, 1.13) and the high (AOR = 1.10, 95% CI 1.04, 1.16) risky driving classes, respectively, when controlling for the covariates. CONCLUSIONS High school students with depressive and psychosomatic symptoms were at higher risk of engaging in risky driving in the immediate years after leaving high school. These findings suggest that prevention programs that incorporate screening, referral to treatment, and treatment of mental and psychosomatic symptoms in high school may be important opportunities to reduce risky driving among youth as they transition from adolescence to emerging adulthood.
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Affiliation(s)
- Xiang Gao
- Department of Health & Exercise Science, Colorado State University
| | - Federico E. Vaca
- Department of Emergency Medicine, Yale University School of Medicine
- Yale Developmental Neurocognitive Driving Simulation Research Center (DrivSim Lab)
| | - Denise Haynie
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development
| | - Bruce Simons-Morton
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development
| | - Kaigang Li
- Department of Health & Exercise Science, Colorado State University
- Department of Emergency Medicine, Yale University School of Medicine
- Yale Developmental Neurocognitive Driving Simulation Research Center (DrivSim Lab)
- Colorado School of Public Health
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Georgiou SN, Charalambous K, Stavrinides P. The mediating effects of adolescents’ internalizing and externalizing problems on the relationship between emotion regulation, mindfulness and bullying/victimization at school. SCHOOL PSYCHOLOGY INTERNATIONAL 2021. [DOI: 10.1177/01430343211035420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was two-fold: to investigate the relationship between emotion regulation, dispositional mindfulness and bullying/victimization experiences at school, and to examine the mediating effects of internalizing and externalizing problems on this relationship. Self-reports measuring the above variables were completed by 444 adolescents (mean age 15.3) who attended high school in Cyprus. Data were collected at three points in time. Specifically, data were collected during the second week of October, 2018 (T1), the third week of January, 2019 (T2) and the first week of June, 2019 (T3). It was found that mindfulness at T1 had a significant negative effect on both internalizing and externalizing symptoms and through these variables, it had an indirect negative effect on both bullying and victimization at T3. Similarly, adaptive emotion regulation at T1 had an indirect effect on victimization, fully mediated by internalizing problems. In contrast, maladaptive emotion regulation had a positive, direct effect on both bullying and victimization.
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Bentivegna E, Luciani M, Paragliola V, Baldari F, Lamberti PA, Conforti G, Spuntarelli V, Martelletti P. Recent advancements in tension-type headache: a narrative review. Expert Rev Neurother 2021; 21:793-803. [PMID: 34128449 DOI: 10.1080/14737175.2021.1943363] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Tension-type headache (TTH) is the most common primary headache disorder with a prevalence of up to 78% in general population and huge expenses in terms of health service. Despite its high incidence and impact on life's quality the knowledge on the pathophysiology and efficacious treatment of TTH was still limited. AREAS COVERED In recent years, a series of studies highlighted the heterogeneous nature of this pathology that seems to be determined by a complex interaction between genetic, environmental, and neuromuscular factors, which result in nociceptive system activation. In this setting, alongside the simple analgesic therapies used during the acute attack, a series of therapeutic options based on newly acquired experiences have taken hold. EXPERT REVIEW Not having a single substrate or a typical site of pathophysiology, TTH must be analyzed in a global and multidisciplinary way. Herein, we perform a narrative review of the most recent advancement stimulating the concept of this disease as the tip of the iceberg of a more complex individual malaise secondary to different alterations. Strategies based solely on symptomatic drugs should therefore be avoided by experienced personnel and treatment should aim at taking charge of the patient considering the processes behind this complex pathology.
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Affiliation(s)
- Enrico Bentivegna
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | | | - Vincenzo Paragliola
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Francesco Baldari
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Piera A Lamberti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Giulia Conforti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Valerio Spuntarelli
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Department of clicinal and molecular medicine, Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
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Social Anxiety in Victimization and Perpetration of Cyberbullying and Traditional Bullying in Adolescents with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115728. [PMID: 34073617 PMCID: PMC8198472 DOI: 10.3390/ijerph18115728] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 11/17/2022]
Abstract
Victimization and perpetration of cyberbullying and traditional bullying are prevalent among adolescents with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The aims of this study were to examine the role of social anxiety in victimization and perpetration of cyberbullying and traditional bullying in adolescents with ASD and ADHD in Taiwan. A total of 219 adolescents with ASD and 287 adolescents with ADHD aged 11–18 years and their caregivers were recruited from the child psychiatry outpatient clinics into this study. The associations of social anxiety with victimization and perpetration of cyberbullying and traditional bullying were examined using logistic regression analysis. The results indicated that after the effects of sex, age, and autistic social impairment were controlled, social anxiety increased the risk of being a victim of cyberbullying (Odds Ratios (OR) = 1.048; 95% Confidence Interval (CI): 1.013–1.084), a victim of traditional bullying (OR = 1.066; 95% CI: 1.036–1.097), and a perpetrator of traditional bullying (OR = 1.061; 95% CI: 1.027–1.096) in adolescents with ASD. After the effects of sex, age, and ADHD symptoms were controlled for, social anxiety increased the risk of being a victim of traditional bullying in adolescents with ADHD (OR = 1.067; 95% CI: 1.039–1.096). Social anxiety was significantly associated with several forms of bullying involvement in adolescents with ASD and ADHD and warrants being considered into prevention and intervention programs for bullying involvement.
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26
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Baiden P, Tarbet Z, Chakravarty S, LaBrenz CA, Okumu M. Functional difficulties mediate the association between exposure to adverse childhood experiences and headaches among children: Findings from a population-based study. Headache 2021; 61:673-682. [PMID: 33891349 DOI: 10.1111/head.14098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/15/2021] [Accepted: 02/08/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are commonly observed in the general population and often have lasting neurological and physiological effects. Previous studies have found links between exposure to ACEs, headaches, and functional difficulties in adults. However, little is known about the mechanisms through which exposure to ACEs is associated with headaches among children. OBJECTIVE To examine the association between exposure to ACEs and headaches in children, and whether functional difficulties mediate this association. METHODS Data for this cross-sectional secondary analysis study came from the 2017-2018 National Survey of Children's Health. The sample analyzed in this study was 40,953 children who were between ages 3 and 17 years. We adjusted for the complexity of the sampling design and used structural equation modeling to examine the mediating effect of functional difficulties in the association between exposure to ACEs and headaches. RESULTS Based on parent reports, we found that 4.1% (1697/40,953) of the children reported frequent or severe headaches, and 9.5% (3906/40,953) were exposed to three or more ACEs. About one in four children (23.4%; 9601/40,953) had at least one functional difficulty. The results show that exposure to ACEs was directly positively associated with functional difficulties (β = 0.16, p < 0.001, 95% CI = 0.15-0.17), and functional difficulties were in turn positively associated with headaches (β = 0.17, p < 0.001, 95% CI = 0.12-0.22). The Sobel test of indirect effect showed that functional difficulties partially mediated the association between exposure to ACEs and headaches (β = 0.027, p < 0.001, 95% CI = 0.022-0.029). Also, older children and children with brain injury were more likely to report experiencing headaches. CONCLUSIONS The findings from this study suggest an association between exposure to ACEs and headaches among children, and functional difficulties partially mediate this association.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Zachary Tarbet
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | | | - Catherine A LaBrenz
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Moses Okumu
- University of North Carolina, at Chapel Hill, School of Social Work, Chapel Hill, NC, USA
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27
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Eyuboglu M, Eyuboglu D, Pala SC, Oktar D, Demirtas Z, Arslantas D, Unsal A. Traditional school bullying and cyberbullying: Prevalence, the effect on mental health problems and self-harm behavior. Psychiatry Res 2021; 297:113730. [PMID: 33486274 DOI: 10.1016/j.psychres.2021.113730] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 01/14/2021] [Indexed: 01/22/2023]
Abstract
Bullying is widely recognized as a major psychosocial problem with substantial negative consequences. The current study aimed to estimate the prevalence of traditional school bullying and cyberbullying and reciprocal associations between bullying involvement and mental health problems. The sample of the study consisted of 6202 middle and high school students (age 11-18, M= 14.4 ±1.9 years, 54% boy). Bullying involvement, self-harm behavior, anxiety, depression, and psychosocial difficulties were assessed by self-report questionnaire. The prevalence of traditional school bullying and cyberbullying victimization was 33% (95% CI 32.1-34.5%) and 17% (95% CI 16.3-18.2%), respectively. The prevalence of traditional school bullying and cyberbullying perpetration was 22.4% (95% CI 21.3-23.4%) and 10.4% (95% CI 9.7-11.3%), respectively. Bullying involvement -as a victim, perpetrator, or both- was associated with anxiety, depression, psychosocial difficulties, and self-harm behavior. Girls were more likely to be affected than boys in mental health outcomes. A significant association between bullying victimization and negative mental health outcomes were also observed. These findings provide evidence to intervention strategies need to target both traditional and cyberbullying involvement. Understanding the risk profile will help create useful and appropriate interventions, which will reduce the early effect of bullying on mental health and modify the clinical course.
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Affiliation(s)
- Murat Eyuboglu
- Eskisehir Osmangazi University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Eskisehir, Turkey.
| | - Damla Eyuboglu
- Eskisehir Osmangazi University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Eskisehir, Turkey
| | - Seval Caliskan Pala
- Eskisehir Osmangazi University Faculty of Medicine, Department of Public Health, Eskisehir, Turkey
| | - Didem Oktar
- Eskisehir Osmangazi University Faculty of Medicine, Department of Public Health, Eskisehir, Turkey
| | - Zeynep Demirtas
- Eskisehir Osmangazi University Faculty of Medicine, Department of Public Health, Eskisehir, Turkey
| | - Didem Arslantas
- Eskisehir Osmangazi University Faculty of Medicine, Department of Public Health, Eskisehir, Turkey
| | - Alaettin Unsal
- Eskisehir Osmangazi University Faculty of Medicine, Department of Public Health, Eskisehir, Turkey
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Esteban-Gonzalo S, Esteban-Gonzalo L, González-Pascual JL, Esteban-Cornejo I, Izquierdo-Gómez R, Conde-Caveda J, Castro-Piñero J, Veiga OL. A longitudinal gender perspective of well-being and health in spanish youth: the UP&DOWN study. Appl Psychol Health Well Being 2021; 13:282-298. [PMID: 33554480 DOI: 10.1111/aphw.12247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 01/07/2023]
Abstract
Previous studies have observed a link between gender and well-being and health in young populations. The purpose of this research was twofold: (1) to analyse the cross-sectional relationship between gender status with well-being indicators and self-perceived health in adolescents at baseline and at 2-year follow-up and (2) to evaluate the prospective associations between gender at baseline and well-being indicators/self-perceived health assessed at 2-year follow-up. Well-being was measured using the KIDSCREEN-10 questionnaire (as a measure of health-related quality of life (HR-QoL)), the Children's Hope Scale and the Positive and Negative Affect Schedule. Health status of the adolescents was assessed using self-perceived health. Multilevel mixed-effects linear/logistic regression models were carried out to assess the associations between gender status and well-being and health of a sample of 1590 Spanish adolescents. Adolescent girls were shown to have lower HR-QoL scores and higher negative affect scores, and had a higher risk of reporting poor health than boys, in both cross-sectional and longitudinal analyses. Adolescent girls seem to be more vulnerable to poorer well-being and self-reported health than boys. When looking at hedonic and eudemonic well-being separately, longitudinal differential evolution of boys and girls seems to indicate greater deterioration of hedonic well-being among girls as compared to boys. Overall, gender may have a relevant impact on mental and physical health during adolescence.
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Affiliation(s)
- Sara Esteban-Gonzalo
- Faculty of Biomedicine, Psychology Department, Universidad Europea de Madrid, Madrid, Spain
| | - Laura Esteban-Gonzalo
- Faculty of Biomedicine, Nursing Department, Universidad Europea de Madrid, Madrid, Spain.,Faculty of Medicine, Nursing Department, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Irene Esteban-Cornejo
- PROFITH 'PROmoting FITness and Health through Physical Activity' Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Rocío Izquierdo-Gómez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain.,Research Department, Faculty of Education, Universidad Central de Chile, Santiago de Chile, Chile
| | - Julio Conde-Caveda
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - José Castro-Piñero
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Oscar L Veiga
- EstiLIFE Research Group. Department of Physical Education, Sports and Human Movement, Autonomous University of Madrid, Madrid, Spain
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29
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Li K, Vaca FE, Courtney J, Haynie DL, Simons-Morton B. Associations of mental health with driving while impaired and risky driving in emerging adults. TRAFFIC INJURY PREVENTION 2021; 22:114-119. [PMID: 33497268 PMCID: PMC8428797 DOI: 10.1080/15389588.2020.1852225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/13/2020] [Accepted: 11/13/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Examined cross-sectional associations of driving while impaired (DWI) and risky driving with mental and psychosomatic health among U.S. emerging adults. METHODS Data were from years 1-4 after high school (waves 4-7) of the NEXT Generation Health Study, a nationally representative study starting with 10th grade (2009-2010). Outcome variables were DWI (dichotomous variable: ≥ 1 day vs. 0 days in the last 30 days) and risky driving Checkpoints Self-Reported Risky Driving Scale (C-RDS). Independent variables included depressive symptoms and psychosomatic symptoms. Multivariate logistic and linear regressions were conducted with complex survey features considered. RESULTS Higher depressive and psychosomatic symptoms were associated with modestly higher likelihood of DWI (Adjusted odds ratio [AOR] ranged from 1.02 to 1.03 and from 1.04 to 1.05, respectively) and higher C-RDS scores (b ranged from 0.06 to 0.12 and from 0.08 to 0.23, respectively) in years 1-4 after high school. CONCLUSIONS Depressive and psychosomatic symptoms were associated with greater DWI and risky driving in all 4 years after high school. Negative mental and psychosomatic health should be targeted components of DWI and risky driving prevention to lower fatal motor vehicle crashes among emerging adults.
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Affiliation(s)
- Kaigang Li
- Department of Health & Exercise Science, Colorado State University, Moby B Complex, Fort Collins, CO 80523
- Colorado School of Public Health, Sage Hall, 700 South Mason St., Fort Collins, CO 80523
- Yale Developmental Neurocognitive Driving Simulation Research Center (DrivSim Lab), Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Avenue, Suite 260, New Haven, Connecticut, 06519
| | - Federico E. Vaca
- Yale Developmental Neurocognitive Driving Simulation Research Center (DrivSim Lab), Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Avenue, Suite 260, New Haven, Connecticut, 06519
| | - Jimikaye Courtney
- Department of Health & Exercise Science, Colorado State University, Moby B Complex, Fort Collins, CO 80523
| | - Denise L. Haynie
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, 6710B Rockledge MSC 7000 Bethesda, MD 20892-7000
| | - Bruce Simons-Morton
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, 6710B Rockledge MSC 7000 Bethesda, MD 20892-7000
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30
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Gong Z, Han Z, Zhang H, Zhang G. Weight Status and School Bullying Experiences in Urban China: The Difference Between Boys and Girls. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:2663-2686. [PMID: 31583944 DOI: 10.1177/0886260519880170] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This article examined the associations between weight status (body mass index [BMI] and perceived weight measures) and school bullying experiences (being bullied and bullying others) of children and adolescents in urban China. A national representative sample (n = 3,675) of all types of pre-college schools from seven Chinese cities was employed for the analysis. Students from all grades in high school, vocational school, middle school, and primary grades 4 to 6 were surveyed. Height, weight, perceived weight status, and experiences of being bullied and bullying others were obtained. The results demonstrated that the objective weight status (BMI) was neither associated with being bullied overall by others nor associated with bullying others, but the subjective/perceived weight status was significantly related to being bullied. Regarding the specific forms of being bullied, underweight (measured by BMI) students were less likely to be cyberbullied, whereas obese (measured by BMI) students were more likely to be cyberbullied. Students who perceived themselves as slightly fat and too fat were more likely to be verbally bullied. Overweight and obese students were more likely to bully others physically and relationally, and the students who perceived themselves as too thin were positively associated with physically bullying others. Moreover, BMI had a role in the involvement in school bullying for boys, whereas perceived weight status had a role in school bullying involvement in girls. These results indicate that school bullying prevention and intervention should consider weight status, as well as gender differences.
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31
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Yang Y. Aggression and Somatic Symptoms: the Role of Emotion Regulation and Distress Tolerance. Int J Behav Med 2020; 27:466-474. [DOI: 10.1007/s12529-020-09885-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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32
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Bilodeau F, Brendgen M, Vitaro F, Côté SM, Tremblay RE, Petit D, Montplaisir J, Boivin M. Association Between Peer Victimization and Parasomnias in Children: Searching for Relational Moderators. Child Psychiatry Hum Dev 2020; 51:268-280. [PMID: 31535251 DOI: 10.1007/s10578-019-00928-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This cross-sectional study examined the moderating role of support from three key figures (mothers, teachers, friends) in the association between peer victimization and parasomnias in childhood. The sample consisted of 1150 children aged 8 years who attended elementary school. Controlling for potential confounders, hierarchical multiple regressions revealed that peer victimization was associated with a higher level of parasomnias, equally for both girls and boys. However, for girls, the predictive association of peer victimization with parasomnias was moderated by the level of support in relationships with either their parents, their teachers, or their friends. The findings suggest that somatic symptoms such as sleep problems may be a first indicator that a child is being bullied. Because parents, teachers as well as friends can play a key role in preventing the development of parasomnias, it may be useful to help bullied children develop strong bonds within at least one of these relationships.
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Affiliation(s)
| | - Mara Brendgen
- University of Quebec at Montreal, Montreal, Canada.
- Psychology Department, University of Quebec at Montreal, Case Postale 8888, Succursale Centre-ville, Montreal, QC, H3C 3P8, Canada.
| | | | - Sylvana M Côté
- University of Montreal, Montreal, Canada
- INSERM U1219, University of Bordeaux, Bordeaux, France
| | - Richard E Tremblay
- University of Montreal, Montreal, Canada
- University College Dublin, Dublin, Ireland
| | - Dominique Petit
- Center of Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
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Guo J, Li M, Wang X, Ma S, Ma J. Being bullied and depressive symptoms in Chinese high school students: The role of social support. Psychiatry Res 2020; 284:112676. [PMID: 31727440 DOI: 10.1016/j.psychres.2019.112676] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 10/20/2019] [Accepted: 11/02/2019] [Indexed: 12/23/2022]
Abstract
The aims of this study were to: 1) examine the relationship between being bullied and depressive symptoms; 2) explore whether the three mentioned sources of social support moderated this association; and 3) examine gender differences in the moderating effects of social support on bullying-associated depressive symptoms among Chinese high school students. A total of 1252 students were selected from three high schools in Zhenping County of Henan Province in China. The results suggest that bullying victimization is significantly associated with depressive symptoms among high school students. In addition, we found that only school-type social support had a moderating effect on depressive symptoms. Those who had been bullied but who had high levels of school support had lower levels of depressive symptoms than those with less school support. However, moderating effects of this support were only found for girls, not for boys. This study empirically supports that programs aimed at boosting social support for students from teachers and classmates, could help protect high school students from depressive symptoms.
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Affiliation(s)
- Jing Guo
- School of Public Health, Peking University, Beijing, 100191, PR China
| | - Min Li
- School of Sociology, Huazhong University of Science and Technology, Wuhan, 430074, PR China
| | - Xiaohua Wang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing 100875, PR China.
| | - Shuang Ma
- School of Management, Beijing University of Chinese Medicine, Beijing 100029, PR China
| | - Juanjuan Ma
- Community Health Service Center, Huazhong University of Science and Technology, Wuhan, 430074, PR China
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Radoman M, Akinbo FD, Rospenda KM, Gorka SM. The impact of startle reactivity to unpredictable threat on the relation between bullying victimization and internalizing psychopathology. J Psychiatr Res 2019; 119:7-13. [PMID: 31520836 PMCID: PMC6876702 DOI: 10.1016/j.jpsychires.2019.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/07/2019] [Accepted: 09/05/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Being bullied has detrimental effects on mental health functioning. Individuals who are highly reactive to unpredictable threats (U-threat) may be particularly vulnerable to the negative consequences of being bullied. For them, persistent, unpredictable bullying likely elicits chronic anticipatory anxiety and depression. The aim of the present study was to examine the main and interactive effects of aversive reactivity to U-threat and past-year bullying victimization on current anxiety and depressive symptoms. METHODS Seventy-one young adults (ages 17-19) completed a well-validated threat-of-shock task used to probe reactivity to both U-threat and predictable threat (P-threat). Startle eyeblink potentiation was recorded to index aversive responding. RESULTS We found a main effect of bullying, such that individuals with more bullying experience exhibited greater anxiety and depressive symptoms than individuals with less bullying experience. There was also a bullying by U-threat reactivity interaction such that among individuals with high reactivity to U-threat, more bullying experience was associated with more anxiety and depressive symptoms. Among individuals with low U-threat reactivity, there was no association between bullying and internalizing symptoms. There were no main or interactive effects involving reactivity to P-threat. CONCLUSIONS Together, these results suggest that among individuals who are bullied, those who are sensitive to U-threat are particularly vulnerable to depression and anxiety in young adulthood. These individuals may represent a high-risk group for the development of internalizing psychopathology.
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Affiliation(s)
- Milena Radoman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL,Department of Anatomy and Cell Biology, and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL
| | - Fikayo D. Akinbo
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
| | | | - Stephanie M. Gorka
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL,Department of Psychology, University of Illinois at Chicago, Chicago, IL
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Ceballos-Ospino G, Suárez-Colorado YP, Campo-Arias A. Asociación entre matoneo escolar, síntomas depresivos e ideación suicida. ACTA ACUST UNITED AC 2019. [DOI: 10.21615/cesp.12.3.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
El objetivo de la presente investigación fue estimar la relación entre matoneo escolar (ME), síntomas depresivos con importancia clínica (SDIC) y alto nivel de ideación suicida (ANIS) en adolescentes estudiantes de la ciudad de Santa Marta, Colombia. Se diseñó un estudio transversal en el que participaron estudiantes entre 10 y 17 años, de sexto a undécimo grado escolar, quienes diligenciaron una versión de cinco ítems del Cuestionario de Intimidación Escolar Abreviado, CIE-A; la versión de diez ítems de la Escala del Centro de Estudios Epidemiológicos de la Depresión, CES-D-10; y la Escala de Okasha para Suicidalidad, EOS. Participaron 350 estudiantes (M=13,3; DE=1,8), 188 mujeres y 162 hombres, 236 estudiantes de básica secundaria y 114 en media vocacional. Un total de 58 (16,6%) informó ME, 59 (16,9%) SDIC y 33 (9,4%) ANIS. El ME se asoció significativamente a ANIS (OR=3,1; IC95% 1,3-7,9), después de controlar por SDIC y sexo. Se evidencia la relevancia de evaluar SDIC en víctimas de ME, y las posibilidades de reducir el riesgo de ANIS a partir de la identificación y realización de programas de intervención en adolescentes con SDIC.
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Garmy P, Hansson E, Vilhjálmsson R, Kristjánsdóttir G. Bullying and Pain in School-Aged Children and Adolescents: A Cross-Sectional Study. SAGE Open Nurs 2019; 5:2377960819887556. [PMID: 33415258 PMCID: PMC7774399 DOI: 10.1177/2377960819887556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/22/2019] [Accepted: 10/18/2019] [Indexed: 11/23/2022] Open
Abstract
Bullying is defined as repeated and unwanted aggressive behavior involving a
power imbalance and hurt children and adolescents’ socioemotional functioning.
The aim is to investigate associations between pain (headache, stomach pain,
backache, and neck/shoulder pain) and bullying among school-aged children and
adolescents. This cross-sectional school-based survey comes from the Icelandic
data set in the international research network Health Behaviour in School-Aged
Children. The study population included all Icelandic students in Grades 6, 8,
and 10 (ages 11, 13, and 15 years, respectively; participation rate, 84%;
n = 10,626). An anonymous standardized questionnaire was
distributed and completed by students in their classrooms. About every 8 in 10
bullied students reported weekly pain (79%), compared with little over half of
nonbullied students (57%). The prevalence of pain was significantly higher among
bullied students compared with their nonbullied peers. Being a bullying victim
was associated with an increased frequency of experiencing headaches,
stomachaches, and back pain, in addition to neck or shoulder pain. It is
important for mental health nurses and health professionals to ask about pain
when meeting with children and adolescents as well as to inquire about their
peer relationships.
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Affiliation(s)
- Pernilla Garmy
- Faculty of Health Sciences, Kristianstad University, Sweden.,Faculty of Medicine, Clinical Health Promotion Centre, Lund University, Sweden
| | - Erika Hansson
- Faculty of Education, Kristianstad University, Sweden
| | | | - Gudrún Kristjánsdóttir
- Faculty of Nursing, University of Iceland, Reykjavik, Iceland.,Landspitali University Hospital, Reykjavik, Iceland
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Zhang H, Chi P, Long H, Ren X. Bullying victimization and depression among left-behind children in rural China: Roles of self-compassion and hope. CHILD ABUSE & NEGLECT 2019; 96:104072. [PMID: 31319239 DOI: 10.1016/j.chiabu.2019.104072] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/25/2019] [Accepted: 07/03/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Bullying victimization among school-aged children is an important public health issue that may affect their well-being and mental health. However, few studies have been conducted on left-behind children in rural China, who are defined as the children who stay in rural areas for more than six months and have one or both parents migrating to urban areas for work. The mechanisms through which bullying victimization will influence depression have disproportionally adopted a psychopathological perspective, and the protective factors are understudied. OBJECTIVE This study aims at investigating the factors that might contribute to breaking up the vicious circle between bullying victimization and developmental problems, focusing on the protective role of self-compassion and hope in the association between bullying victimization and depression. METHODS Using questionnaires, data were collected from a sample of 1091 school-aged left-behind children from west and central China. RESULTS Compared with rural children living with their parents, left-behind children reported a higher level of bullying victimization. Bullying victimization was positively associated with depression through decreased self-compassion and hope, and self- compassion played a more crucial role than hope in the linkage between bullying victimization and depression. CONCLUSIONS Our study's findings suggest that it is necessary to incorporate self-compassion and hope in mental health prevention and intervention programs targeting left-behind children with bullying victimization experiences.
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Affiliation(s)
- Huiping Zhang
- Center for Studies of Sociological Theory and Method, China; The School of Sociology and Population Studies, Renmin University of China, China.
| | - Peilian Chi
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China.
| | - Haili Long
- The School of Sociology and Population Studies, Renmin University of China, China.
| | - Xiaoying Ren
- The School of Sociology and Population Studies, Renmin University of China, China.
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Albaladejo-Blázquez N, Ferrer-Cascales R, Ruiz-Robledillo N, Sánchez-SanSegundo M, Fernández-Alcántara M, Delvecchio E, Arango-Lasprilla JC. Health-Related Quality of Life and Mental Health of Adolescents Involved in School Bullying and Homophobic Verbal Content Bullying. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2622. [PMID: 31340496 PMCID: PMC6678093 DOI: 10.3390/ijerph16142622] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 07/19/2019] [Accepted: 07/20/2019] [Indexed: 11/19/2022]
Abstract
Bullying has been traditionally related to a significant reduction in well-being and Health-Related Quality of Life (HRQoL) of adolescents. This negative impact on HRQoL seems to be modulated by the developed role in bullying (uninvolved, bully, victim or bully-victim). However, no studies have identified if these negative results are the same when other types of bullying, such as homophobic bullying, are evaluated. The main aim of the present study was to analyze the prevalence of different roles of bullying and homophobic bullying and the relationship between these roles in both types of bullying with HRQoL, depression and anxiety levels in a sample of 1723 Spanish adolescents. Although results exhibited lower prevalence of homophobic bullying roles when compared to traditionally bullying in general, in the case of victims, the prevalence was high in the case of homophobic bullying. When differences between roles in HRQoL, depression and anxiety were evaluated, in both types of bullying, uninvolved adolescents showed the best results and bully-victim adolescents the worst. The obtained results suppose an improvement in the understanding of the negative effects of different types of bullying on HRQoL and mental health in adolescents. Future research could advance in this comprehension, analyzing possible differences with other types of bullying, such as cyberbullying.
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Affiliation(s)
| | - Rosario Ferrer-Cascales
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain.
| | - Nicolás Ruiz-Robledillo
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain
| | - Miriam Sánchez-SanSegundo
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain
| | - Manuel Fernández-Alcántara
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain
| | - Elisa Delvecchio
- Department of Philosophy, Social Sciences and Education; Università degli Studi di Perugia, 06123 Perugia, Italy
| | - Juan Carlos Arango-Lasprilla
- BioCruces Bizkaia Health Research Institute, Cruces University Hospital Barakaldo, 48903 Bizkaia, Spain
- IKERBASQUE, Basque Foundation for Science, 48013 Bilbao, Spain
- Department of Cell Biology and Histology, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
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Magno MB, de Paiva Cabral Tristão SK, Jural LA, Aguiar Sales Lima SO, Coqueiro RDS, Maia LC, Pithon MM. Does dental trauma influence the social judgment and motivation to seek dental treatment by children and adolescents? Development, validation, and application of an instrument for the evaluation of traumatic dental injuries and their consequences. Int J Paediatr Dent 2019; 29:474-488. [PMID: 30735589 DOI: 10.1111/ipd.12479] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 11/20/2019] [Accepted: 01/07/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND One's smile clearly plays a significant role in the perception and judgment that others have of one's appearance and personality. AIM We sought to develop and validate a questionnaire related to the social judgment of children and adolescents and to evaluate, through its application, the perceptions and judgment of children and adolescents regarding their view of different traumatic dental injuries and their consequences (TDIs-Cs) as well as the motivation to seek dental treatment. DESIGN The aspects of acceptability, discriminative properties, internal consistency, test-retest reliability, and construct validity were evaluated in the developed questionnaire. A cross-sectional study was conducted involving 100 boys and girls aged 10-15 years. Images of an adolescent male and female were either manipulated or not (control) to create different types of TDI-C (eg, enamel fracture, enamel and dentin fracture, crown colour change, and tooth loss/avulsion). These images were analysed by the participants, using a previously validated questionnaire with a six-positive-point and six-negative-point scale, in relation to their social physical and psychosocial characteristics. The data were analysed with the Friedman, Wilcoxon, and Mann-Whitney tests (P < 0.05). RESULTS The developed questionnaire presented high acceptability, strong discriminative properties, satisfactory internal consistency, and satisfactory test-retest reliability, but weak construct validity. The presence of TDI-C had a negative effect on all characteristics evaluated (P < 0.001). Tooth loss had the highest level of rejection. Additionally, the presence of TDI-C had a greater negative impact on the aspects of 'starting fights', 'being given a nickname', and 'being ashamed to smile' in males than in females (P < 0.05). Children and adolescents with TDI-C were judged as needing to seek dental treatment (P < 0.001). CONCLUSION The questionnaire developed showed properties of validity and reliability in its administration in a child and adolescent population. TDIs-Cs have a negative influence on the social judgment of children and adolescents.
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Affiliation(s)
- Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Lucas Alves Jural
- School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Matheus Melo Pithon
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Southwest Bahia State University UESB, Jequié, Bahia, Brazil
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Yeh YC, Huang MF, Wu YY, Hu HF, Yen CF. Pain, Bullying Involvement, and Mental Health Problems Among Children and Adolescents With ADHD in Taiwan. J Atten Disord 2019; 23:809-816. [PMID: 28836888 DOI: 10.1177/1087054717724514] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this study was to examine the relationships of pain and pain-induced functional impairment with bullying involvement, as well as the relationships between pain and mental health problems among 474 children and adolescents with ADHD. METHOD The levels of pain, pain-induced functional impairment, involvement in bullying, depression, anxiety, ADHD symptoms, and sleep quality were assessed. RESULTS Both victims of verbal and relational bullying and victims of physical bullying were more likely to have pain and pain-induced functional impairment than nonvictims. The perpetrators of verbal and relational bullying were more likely to have pain than the nonperpetrators. Participants with pain and pain-induced functional impairment experienced more severe depression and anxiety and worse sleep quality than did those without pain or pain-induced functional impairment. CONCLUSION Clinical and educational professionals should consider the possibility of involvement in bullying and comorbid depression, anxiety, and poor sleep quality among ADHD children and adolescents with pain problems.
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Affiliation(s)
- Yi-Chun Yeh
- 1 Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan.,2 School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Mei-Feng Huang
- 1 Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan.,2 School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Yu-Yu Wu
- 3 YuNing Psychiatry Clinic, Taipei, Taiwan
| | - Huei-Fan Hu
- 4 Department of Psychiatry, Tainan Municipal Hospital, Taiwan
| | - Cheng-Fang Yen
- 1 Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan.,2 School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
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Agostini A, Lushington K, Dorrian J. The relationships between bullying, sleep, and health in a large adolescent sample. Sleep Biol Rhythms 2018. [DOI: 10.1007/s41105-018-0197-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Bayer JK, Mundy L, Stokes I, Hearps S, Allen N, Patton G. Bullying, mental health and friendship in Australian primary school children. Child Adolesc Ment Health 2018; 23:334-340. [PMID: 32677138 DOI: 10.1111/camh.12261] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Frequent bullying predicts adolescent mental health problems, particularly depression. This population-based study with young Australian primary school children aimed to determine the frequency and mental health correlates of bullying, and whether friendship could be protective. METHOD Participants were a population-based sample of 1221 children aged 8-9 years attending 43 primary schools in metropolitan Melbourne, Australia. Children were taking part in the Childhood to Adolescence Transition Study. Children completed online questionnaires at school to measure peer relations and emotional well-being. Parents reported on their child's mental health in questionnaires sent to the home. RESULTS One in three children (29.2%) reported experiencing frequent bullying, defined as at least once a week. This included physical bullying alone (13.8%), verbal bullying alone (22.7%) and the combination (7.4%). Children who reported being frequently bullied self-reported higher internalising symptoms compared with children who did not report frequent bullying (M (SD) 1.6 (0.9) vs. 1.1 (0.8), p < .001). This difference was confirmed by parents' reports of their child's internalising symptoms (M (SD) 2.4 (2.3) vs. 2.1 (2.0), p = .026, respectively). Amongst children who reported frequent bullying, those with a group of friends had better emotional well-being. CONCLUSIONS A substantial proportion of children report experiencing bullying on a weekly basis early in primary school. Given the prevalence of bullying in primary school and its relationship to children's mental health, we recommend effective school-wide antibullying programmes. Further research can explore whether intervention to foster a group of friends around bullied children can improve their emotional well-being.
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Affiliation(s)
- Jordana K Bayer
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Lisa Mundy
- Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
| | - Isobel Stokes
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Stephen Hearps
- Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Nicholas Allen
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - George Patton
- Murdoch Children's Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Vic., Australia
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Leader H, Singh J, Ghaffar A, de Silva C. Association between bullying and pediatric psychiatric hospitalizations. SAGE Open Med 2018; 6:2050312117750808. [PMID: 29326819 PMCID: PMC5758959 DOI: 10.1177/2050312117750808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 12/06/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives: Bullying is a serious public health issue. We sought to demonstrate an association between bullying victimization and hospital admissions for acute psychiatric problems. We described the demographics and types of bullying in a sample of hospitalized patients in Staten Island, NY, and compared bullying victimization scores with psychiatric versus medical admissions. Methods: Patients in grades 3–12 were recruited from the Staten Island University Hospital Inpatient Pediatrics unit and emergency department. Patients completed the validated Olweus Bully/Victim Questionnaire (OBQ) was analyzed to formulate a report of bullying in our sample as well as a sub-score measurement of bullying victimization. Pediatric residents simultaneously documented whether the subject was a medical versus an in-patient psychiatry admission. Statistical analysis was performed to look for an association between the victimization sub-score and a psychiatric indication for admission. Results: A total of 185 surveys were analyzed. Peak bullying occurred in 7th and 8th grades. Demographics and types of bullying in our sample were described. A strong association between bullying victimization and hospitalization for in-patient psychiatry was demonstrated. Association between bullying victimization and suicidal ideation, psychiatry, and social work consults was also shown. Concern for an association between hospitalization for psychogenic illness and bullying victimization was also raised. Conclusions: There is a significant association between bullying victimization and psychiatric hospital admissions. This raises the specter of the serious consequences of bullying as it is the first study to prospectively link hospital admissions to bullying. Studies using a valid measure of psychogenic illness to look for an association with bullying victimization are needed.
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Affiliation(s)
- Hadassa Leader
- Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, NY, USA.,Department of Pediatrics, Hofstra-Northwell School of Medicine, Hempstead, NY, USA
| | - Jasmine Singh
- Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, NY, USA
| | - Ayesha Ghaffar
- Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, NY, USA
| | - Cheryl de Silva
- Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, NY, USA.,Department of Pediatrics, Hofstra-Northwell School of Medicine, Hempstead, NY, USA
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Li P, Huang Y, Guo L, Wang W, Xi C, Lei Y, Luo M, Pan S, Deng X, Zhang WH, Lu C. Is sexual minority status associated with poor sleep quality among adolescents? Analysis of a national cross-sectional survey in Chinese adolescents. BMJ Open 2017; 7:e017067. [PMID: 29282258 PMCID: PMC5770949 DOI: 10.1136/bmjopen-2017-017067] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Recent studies have suggested that sexual minorities are more likely to have poor sleep quality. This study aims to explore sleep quality among sexual minority adolescents and examines the association between sexual minority status and sleep quality. DESIGN Cross-sectional survey. SETTING A total of 506 high schools in seven Chinese provinces. PARTICIPANTS A total of 150 822 students in grades 7-12 completed the questionnaires, and 123 459 students who reported being aware of their sexual orientation were included in analyses. MAIN OUTCOME MEASURES The Pittsburgh Sleep Quality Index, sexual attraction and school bullying victimisation. RESULTS Of the 123 459 students who were analysed, 5.00% self-reported as sexual minorities. Only 26.67% of sexual minority students slept 8 or more hours/day, which is less than their heterosexual peers (35.70%; χ2=130.04, P<0.001). Of the total sample, 22.41% of the students reported poor sleep quality, and this prevalence was significantly higher in sexual minority students than in heterosexual students (32.56% vs 21.87%; χ2=281.70, P<0.001). After controlling for social demographics, lifestyle and depressive symptoms, sexual minority students had higher odds of poor sleep quality (adjusted OR=1.41, 95% CI 1.31 to 1.51) than their heterosexual peers. The indirect effect of school bullying victimisation (standardised β estimate=0.007, 95% CI 0.006 to 0.009) was significant, indicating that school bullying victimisation partially mediated the association between sexual minority status and sleep quality. CONCLUSIONS Our study suggested that poor sleep quality was common in sexual minority adolescents, and more attention should be paid to sleep problems in this population. Conducting interventions to reduce school bullying behaviours is an important step to improving sleep quality in sexual minority adolescents. Further, studies are warranted that focus on the risk factors and mechanisms of and interventions for sleep problems in sexual minority adolescents.
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Affiliation(s)
- Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yeen Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chuhao Xi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yiling Lei
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Min Luo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Siyuan Pan
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Wei-hong Zhang
- Epidemiology, Biostatistics and Clinical Research Center, School of Public Health, Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
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Heithaus JL, Twyman KA, Braddock BA. Ostracism and Peer Victimization in Adolescents With and Without Mental Health Diagnoses in a Public Middle School Setting. Clin Pediatr (Phila) 2017; 56:1301-1311. [PMID: 28056556 DOI: 10.1177/0009922816682745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To better understand adolescents experiencing peer victimization, ostracism, and emotional health problems, this study aimed to describe a cohort of middle school students identified as having school peer-related social difficulties as 2 groups: those with mental health diagnoses (MHDs; n = 17) and those without diagnoses (n = 8). Participants were administered a test battery to examine communication ability, social responsiveness, social activity, ostracism, victimization, and emotional health. Results showed that adolescents with MHDs, relative to those without, scored significantly lower on measures of communication ability, social responsiveness, and social activity but similarly on measures of victimization, ostracism, and internalizing/externalizing factors. Results suggest that adolescents with and without MHDs can endure ostracism and peer victimization to a similar extent. Because ostracism and victimization have serious morbidity in adolescents, physicians and caregivers must look for signs in all adolescents, irrespective of MHD. Recommendations for appropriate primary care management are discussed.
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Hinduja S, Patchin JW. Cultivating youth resilience to prevent bullying and cyberbullying victimization. CHILD ABUSE & NEGLECT 2017; 73:51-62. [PMID: 28945996 DOI: 10.1016/j.chiabu.2017.09.010] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 08/30/2017] [Accepted: 09/09/2017] [Indexed: 05/05/2023]
Abstract
In an effort to better prevent and respond to bullying and cyberbullying, schools are recognizing a need to focus on positive youth development. One often-neglected developmental construct in this rubric is resilience, which can help students successfully respond to the variety of challenges they face. Enhancing this internal competency can complement the ever-present efforts of schools as they work to create a safe and supportive learning environment by shaping the external environment around the child. Based on a national sample of 1204 American youth between the ages of 12 and 17, we explore the relationship between resilience and experience with bullying and cyberbullying. We also examine whether resilient youth who were bullied (at school and online) were less likely to be significantly impacted at school. Results show resilience is a potent protective factor, both in preventing experience with bullying and mitigating its effect. Implications for school and community-based interventions are offered.
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Affiliation(s)
- Sameer Hinduja
- Florida Atlantic University, 5353 Parkside Drive, Jupiter, FL 33458-2906, USA.
| | - Justin W Patchin
- University of Wisconsin-Eau Claire, 105 Garfield Avenue, Eau Claire, WI 54702-4004, USA.
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47
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Yin XQ, Wang LH, Zhang GD, Liang XB, Li J, Zimmerman MA, Wang JL. The promotive effects of peer support and active coping on the relationship between bullying victimization and depression among chinese boarding students. Psychiatry Res 2017. [PMID: 28623769 DOI: 10.1016/j.psychres.2017.06.037] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
We examined the relationship between bully victimization experience and depression in rural adolescents and analyzed the moderating roles of peer support and active coping in male and female students. The sample comprised N=755 adolescents (376 females) with a mean age of 13.52 years. Through structural model and multi-group analysis, the results indicated: (1) a significant gender difference on the positive association between bullying victimization and depression; (2) peer support had a directly negative effect on depression among all boarding adolescents; and (3) significant moderating effect of active coping on the association between victimization and depression, without significant gender difference. We discuss enhancing active coping and peer support as a prevention strategy to reduce adverse mental health outcomes in adolescents due to bullying victimization.
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Affiliation(s)
- Xue-Qin Yin
- Center for Mental Health Education, School of Psychology, Southwest University, Chongqing 400715, China
| | - Li-Hui Wang
- Center for Mental Health Education, School of Psychology, Southwest University, Chongqing 400715, China
| | - Guo-Dong Zhang
- School of Physical Education, Southwest University, Chongqing 400715, China
| | - Xiao-Bing Liang
- Center for Mental Health Education, School of Psychology, Southwest University, Chongqing 400715, China
| | - Jason Li
- Stanford University, Stanford 94305, CA, USA
| | - Marc A Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor 48109-2029, MI, USA
| | - Jin-Liang Wang
- Center for Mental Health Education, School of Psychology, Southwest University, Chongqing 400715, China.
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Koh JB, Wong JS. Survival of the Fittest and the Sexiest: Evolutionary Origins of Adolescent Bullying. JOURNAL OF INTERPERSONAL VIOLENCE 2017; 32:2668-2690. [PMID: 26160858 DOI: 10.1177/0886260515593546] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The central idea of evolutionary psychology theory (EPT) is that species evolve to carry or exhibit certain traits/behaviors because these characteristics increase their ability to survive and reproduce. Proponents of EPT propose that bullying emerges from evolutionary development, providing an adaptive edge for gaining better sexual opportunities and physical protection, and promoting mental health. This study examines adolescent bullying behaviors via the lens of EPT. Questionnaires were administered to 135 adolescents, ages 13 to 16, from one secondary school in metro Vancouver, British Columbia. Participants were categorized into one of four groups (bullies, victims, bully/victims, or bystanders) according to their involvement in bullying interactions as measured by the Olweus Bully/Victim Questionnaire. Four dependent variables were examined: depression, self-esteem, social status, and social anxiety. Results indicate that bullies had the most positive scores on mental health measures and held the highest social rank in the school environment, with significant differences limited to comparisons between bullies and bully/victims. These results lend support to the hypothesis that youth bullying is derived from evolutionary development. Implications for approaching anti-bullying strategies in schools and directions for future studies are discussed.
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Affiliation(s)
- Jun-Bin Koh
- 1 Simon Fraser University, Burnaby, British Columbia, Canada
| | - Jennifer S Wong
- 1 Simon Fraser University, Burnaby, British Columbia, Canada
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Bullying Behaviors among Macanese Adolescents-Association with Psychosocial Variables. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080887. [PMID: 28783110 PMCID: PMC5580591 DOI: 10.3390/ijerph14080887] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/02/2017] [Accepted: 08/04/2017] [Indexed: 01/07/2023]
Abstract
Bullying is a widespread public health problem among school students. Using a large sample of Macanese school adolescents, the present study examines psychosocial conditions and demographic characteristics in discriminating the following four subgroups of students: victims; bullies; bully-victims; and a comparison group of adolescents. Participants included 2288 adolescents from 13 primary and secondary schools in Macau whose ages ranged from 10 to 20 years. Statistical results revealed significant differences among the groups and indicated that adolescents who are involved in school bullying experience worse psychosocial adjustment. Specifically, among the four subgroups of students, bully-victims reported the strongest feelings of anxiety, depression, and negative affectivity, and expressed the lowest satisfaction with life. Compared with students who were not involved in bullying and victimization, bullies experienced more anxiety and depression and victims had lower levels of satisfaction with life. In addition, boys were more likely to engage in bullying behaviors and younger students had a greater probability of being victimized by their peers at school. Implications for future research and practice on bullying perpetration and the prevention of peer victimization are discussed.
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Anxiety, depression, suicidal ideation, and stressful life events in non-cardiac adolescent chest pain: a comparative study about the hidden part of the iceberg. Cardiol Young 2017; 27:1098-1103. [PMID: 27830640 DOI: 10.1017/s1047951116002109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Chest pain in adolescents is rarely associated with cardiac disease. Adolescents with medically unexplained chest pain usually have high levels of anxiety and depression. Psychological stress may trigger non-cardiac chest pain. This study evaluated risk factors that particularly characterise adolescence, such as major stressful events, in a clinical population. The present study was conducted on 100 adolescents with non-cardiac chest pain and 76 control subjects. Stressful life events were assessed by interviewing patients using a 36-item checklist, along with the Children's Depression Inventory and Spielberger's State-Trait Anxiety Inventory for children, in both groups. Certain stressful life events, suicidal thoughts, depression, and anxiety were more commonly observed in adolescents with non-cardiac chest pain compared with the control group. Moreover, binary logistic regression analysis showed that trouble with bullies, school-related problems, and depression may trigger non-cardiac chest pain in adolescents. Non-cardiac chest pain on the surface may point to the underlying psychosocial health problems such as depression, suicidal ideas, or important life events such as academic difficulties or trouble with bullies. The need for a psychosocial evaluation that includes assessment of negative life events and a better management have been discussed in light of the results.
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