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Tsomokos DI, Slavich GM. Bullying fosters interpersonal distrust and degrades adolescent mental health as predicted by Social Safety Theory. NATURE MENTAL HEALTH 2024; 2:328-336. [PMID: 38682098 PMCID: PMC11052587 DOI: 10.1038/s44220-024-00203-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/08/2024] [Indexed: 05/01/2024]
Abstract
Social Safety Theory predicts that socially threatening experiences such as bullying degrade mental health partly by fostering the belief that others cannot be trusted. Here we tested this prediction by examining how peer bullying in childhood impacted adolescent mental health, and whether this effect was mediated by interpersonal distrust and several other commonly studied mediators-namely diet, sleep and physical activity-in 10,000 youth drawn from the UK's Millennium Cohort Study. Youth bullied in childhood developed more internalizing, externalizing and total mental health problems in late adolescence, and this effect was partially mediated by interpersonal distrust during middle adolescence. Indeed, adolescents who developed greater distrust were approximately 3.5 times more likely to subsequently experience clinically significant mental health problems than those who developed less distrust. Individual and school-based interventions aimed at reducing the negative impact of bullying on mental health may thus benefit from bolstering youths' sense of trust in others.
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Affiliation(s)
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Yang R, Chen J, Wang R, Li D, Hu J, Wan Y, Fang J, Zhang S. The effect of bullying victimization on sleep quality among Chinese medical students: Timing, duration, and patterns. J Affect Disord 2024; 344:25-32. [PMID: 37802327 DOI: 10.1016/j.jad.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/02/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Bullying victimization (BV) is a potential factor to sleep quality, but the role of BV characteristics in this association remains unclear. This study aimed to investigate correlation between the timing, duration, and patterns of BV and sleep quality among Chinese medical students. METHODS 4035 participants (mean age of 19.2 ± 1.0) were recruited. BV patterns from pre-school to college were estimated using latent class analysis. Multinomial logistic regression was conducted to evaluate the odds ratio (OR) and 95 % confidence interval (CI) between sleep quality and BV. E values were used to assess unmeasured confounding. RESULTS Three patterns of BV were identified as follows: persistent BV (6.2 %), moderate BV (10.5 %), and low BV (83.3 %). BV during pre-school, elementary school, junior high school, senior high school, and college were all positively associated with poor sleep quality. The ORs were 2.30 (1.43-3.70), 3.00 (2.28-3.95), 2.71 (2.14-3.43), 3.34 (2.57-4.33) and 4.13 (3.19-5.36), respectively. The E value were 4.03 (2.21-NA), 5.45 (3.99-NA), 4.86 (3.70-NA), 6.14 (4.58-NA), 7.73 (5.83-NA), respectively. Those who experienced more periods of BV were more strongly associated with poor sleep quality, presenting a dose-response relationship [OR = 1.78, 95 % CI: 1.63-1.95, E value: 2.96 (2.64-NA)]. Those who experienced moderate BV [OR = 2.58, 95 % CI: 1.99-3.35; E value: 4.60 (3.39-NA)] and persistent BV [OR = 4.01, 95 % CI: 2.95-5.46; E value: 7.48(5.35-NA)] had higher odds of poor sleep quality. LIMITATIONS Retrospective design may introduce recall bias. CONCLUSION BV was positively related to poor sleep quality and chronic exposure to BV had a cumulative effect on poor sleep quality.
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Affiliation(s)
- Rong Yang
- School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui Province, PR China
| | - Jin Chen
- School of Medical Technology, Anhui Medical College, 632th Furong Road, Hefei 230601, Anhui Province, PR China
| | - Rong Wang
- Community Health Service Center of Xiyuan Street, 77th Hezuohua South Road, Hefei 230031, Anhui Province, PR China
| | - Danlin Li
- School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui Province, PR China
| | - Jie Hu
- School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui Province, PR China
| | - Yuhui Wan
- School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui Province, PR China
| | - Jun Fang
- School of Public Health, Anhui Medical University, 81th Meishan Road, Hefei 230032, Anhui Province, PR China; Faculty of Pharmaceutical Science, Sojo University, Ikeda 4-22-1, Kumamoto 860-0082, Japan; Department of Preventive Medicine, School of Public Health and Health Management, Anhui Medical College, 632th Furong Road, Hefei 230601, Anhui Province, PR China.
| | - Shichen Zhang
- Department of Preventive Medicine, School of Public Health and Health Management, Anhui Medical College, 632th Furong Road, Hefei 230601, Anhui Province, PR China; MOE Key Laboratory of Population Health Across Life Cycle, 81th Meishan Road, Hefei 230032, Anhui Province, PR China.
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Associations of sleep problems with non-physical bullying perpetration and victimization among adolescents: A cross-lagged panel study. Sleep Health 2022; 9:144-150. [PMID: 36402728 DOI: 10.1016/j.sleh.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/09/2022] [Accepted: 10/19/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The current study attempted to explore the possible temporal direction of the relationship between sleep problems and non-physical bullying perpetration as well as non-physical bullying victimization among adolescents. DESIGN The study used a longitudinal panel survey design with a 6-month interval. SETTING A cluster random sampling method was conducted to recruit students from junior high schools in Northern Taiwan. PARTICIPANTS Eight hundred twenty-two students (46.6% were boys) completed a survey at 2 waves. MEASUREMENT Adolescents reported their sleep problems, non-physical bullying perpetration, and non-physical bullying victimization in both waves. RESULTS The results from cross-lagged panel models revealed that sleep problems at time 1 significantly predicted non-physical bullying victimization at time 2, but not in the opposite direction. In addition, non-physical bullying perpetration at time 1 significantly predicted sleep problems at time 2, but not in the opposite direction. No significant differences emerged between male and female adolescents in the cross-lagged model of sleep problems with non-physical bullying perpetration and non-physical bullying victimization. CONCLUSION This study advances the literature by revealing that sleep problems may be a consequence, not a precursor, of adolescent non-physical bullying perpetration and a precursor, not a consequence, of non-physical bullying victimization. Intervention programs aimed at preventing adolescents from being non-physically bullied may consider improving their sleep quality. Reducing adolescents' non-physical bullying perpetration may also improve sleep quality along the way.
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Miskimon K, Jenkins LN, Kaminski S. Direct and Indirect Effects of Bullying Victimization on Academic Performance and Mental Health Among Secondary School Students. SCHOOL MENTAL HEALTH 2022. [DOI: 10.1007/s12310-022-09545-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chang FC, Chiu CH, Chen PH, Chiang JT, Miao NF, Chuang HY, Huang WQ, Tseng CC. Smartphone addiction and victimization predicts sleep problems and depression among children. J Pediatr Nurs 2022; 64:e24-e31. [PMID: 35101352 DOI: 10.1016/j.pedn.2022.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND In this study we examined the phenomena of smartphone addiction, online harassment, and school bullying/victimization to predict the prospective influence these could have on the onset and persistence of sleep problems and depression among children. METHODS Responses from 2155 fifth-grade children recruited from 30 primary schools in Taipei were assessed, and a follow-up was performed in the 6th grade. Self-administered questionnaires were collected for each year. FINDINGS Children who reported smartphone addictions, online harassment, and school bullying/victimization coupled with an increase in those factors were more likely to experience the onset and persistence of sleep problems. In addition, children who reported smartphone addiction, online harassment, school bullying/victimization, and poor sleep quality were more likely to experience the onset and persistence of depression. IMPLICATIONS School nurses or pediatric nurses should be able to assess children's Internet use and risks to understand potential influences on sleep quality and mental status and provide recommendations for children, parents and schools.
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Affiliation(s)
- Fong-Ching Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan.
| | - Chiung-Hui Chiu
- Graduate Institute of Information and Computer Education, National Taiwan Normal University, Taiwan.
| | - Ping-Hung Chen
- The Graduate Institute of Mass Communication, National Taiwan Normal University, Taiwan.
| | | | - Nae-Fang Miao
- College of Nursing, Taipei Medical University, Taiwan.
| | - Hung-Yi Chuang
- Department of Public Health, Kaohsiung Medical University, Taiwan.
| | - Wei-Quan Huang
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan.
| | - Chie-Chien Tseng
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan.
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Palamarchuk IS, Vaillancourt T. Integrative Brain Dynamics in Childhood Bullying Victimization: Cognitive and Emotional Convergence Associated With Stress Psychopathology. Front Integr Neurosci 2022; 16:782154. [PMID: 35573445 PMCID: PMC9097078 DOI: 10.3389/fnint.2022.782154] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/15/2022] [Indexed: 12/14/2022] Open
Abstract
Bullying victimization is a form of psychological stress that is associated with poor outcomes in the areas of mental health and learning. Although the emotional maladjustment and memory impairment following interpersonal stress are well documented, the mechanisms of complex cerebral dysfunctions have neither been outlined nor studied in depth in the context of childhood bullying victimization. As a contribution to the cross-disciplinary field of developmental psychology and neuroscience, we review the neuropathophysiology of early life stress, as well as general psychological stress to synthesize the data and clarify the versatile dynamics within neuronal networks linked to bullying victimization. The stress-induced neuropsychological cascade and associated cerebral networks with a focus on cognitive and emotional convergence are described. The main findings are that stress-evoked neuroendocrine reactivity relates to neuromodulation and limbic dysregulation that hinder emotion processing and executive functioning such as semantic cognition, cognitive flexibility, and learning. Developmental aspects and interacting neural mechanisms linked to distressed cognitive and emotional processing are pinpointed and potential theory-of-mind nuances in targets of bullying are presented. The results show that childhood stress psychopathology is associated with a complex interplay where the major role belongs to, but is not limited to, the amygdala, fusiform gyrus, insula, striatum, and prefrontal cortex. This interplay contributes to the sensitivity toward facial expressions, poor cognitive reasoning, and distress that affect behavioral modulation and emotion regulation. We integrate the data on major brain dynamics in stress neuroactivity that can be associated with childhood psychopathology to help inform future studies that are focused on the treatment and prevention of psychiatric disorders and learning problems in bullied children and adolescents.
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Bao Z, Jiang Y, Zhu J, Zhang W. School connectedness and deviant peer affiliation among Chinese adolescents: the mediating role of sleep problems. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00731-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dantchev S, Zemp M. Sibling, Peer, and Cyber Bullying Among Children and Adolescents: Co-occurrence and Implications for Their Adjustment. Front Psychol 2021; 12:761276. [PMID: 35002854 PMCID: PMC8728088 DOI: 10.3389/fpsyg.2021.761276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/02/2021] [Indexed: 12/04/2022] Open
Abstract
Bullying across the sibling, peer, and cyber context has consistently been associated with a range of long-term health and well-being consequences for children and adolescents. Although research examining different bullying forms simultaneously in the same study are emerging, it remains unclear to what extend sibling, peer, and cyber bullying co-occur and in what ways they are associated. Moreover, previous work has demonstrated that children and adolescents who experience multiple forms of victimization are at a particular risk of adverse outcomes. However, whether different constellations of co-occurring bullying forms have differential impacts has not yet been investigated sufficiently. The aim of the present study was to examine the frequencies of isolated and co-occurring sibling, peer, and cyber bullying as well as to explore their independent and cumulative relationships with child adjustment. This study was based on a sample of 329 children and adolescents aged between 9 and 15. Bullying experiences across the sibling, peer, and cyber context in the previous 6 months were assessed via self-report. Youth further reported on emotional problems, conduct problems, sleep problems, and academic achievement via an online questionnaire. Sibling, peer, and cyber bullying were uniquely associated with child outcomes. A cumulative relationship between bullying victimization across contexts and emotional problems, conduct problems, and sleep problems could be identified, while bullying perpetration across contexts was only linked to more conduct problems in a cumulative manner. The findings have important practical implications arguing for the adoption of a holistic approach toward bullying in prevention and intervention.
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The association of sleep quality and aggression: A systematic review and meta-analysis of observational studies. Sleep Med Rev 2021; 59:101500. [PMID: 34058519 DOI: 10.1016/j.smrv.2021.101500] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/23/2022]
Abstract
Poor sleep quality is closely related to aggression, but despite the promise of new therapeutic possibilities, a systematic synthesis of observational research on the association between sleep quality and aggression is lacking. This systematic review and meta-analysis examined the association between sleep quality and aggression, using the academic databases PubMed and PsycINFO. Subjective and objective measures of sleep quality were included, as well as multiple measures of aggression, assessing aggressive and externalizing behavior, anger, hostility and irritability. Ninety-two observational articles, containing 96 studies, encompassing a total of 58.154 children, adolescents and adults were sourced out of 7161 references identified. Methodological quality was moderate or strong in 76% of studies. Data for meta-analysis was available from 74 studies. Poorer sleep quality was associated with higher aggression in 80.8% of studies. Pooled results showed a correlation of 0.28 (95%CI 0.25-0.31; I2 = 90.1%) and odds ratio of 3.61 (95%CI 1.13-11.51; I2 = 88.3%). Effect estimates and heterogeneity varied according to population type and measurement instruments, but not according to article quality or age group. Our findings confirm that poor sleep quality is consistently associated with higher aggression. As most evidence is cross-sectional, more prospective and high-quality experimental evidence is required to elucidate cause-effect and optimize prevention and treatment of aggression.
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Carvalho F, Vilaça J, Carvalho AL, Pontes T, Carvalho S. Sleep quality and bullying - prevalence in a cohort of Portuguese students. Int J Adolesc Med Health 2020; 34:163-169. [PMID: 32549176 DOI: 10.1515/ijamh-2020-0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 02/04/2020] [Indexed: 11/15/2022]
Abstract
Objectives The involvement of adolescents in violent behaviors is becoming an important public health problem that is concerning physicians as it is associated with a decrease in adult life quality. In this context, bullying is a type of aggressive behavior that occurs repeatedly in interpersonal relationship where power imbalance exists increasing the risk of physical and psychosocial problems in all its intervenient. Prevalence of bullying in Portuguese adolescents is estimated to be ranging from 16.2 to 27.5%. Sleep disorders are a well-known problem related to bullying situations, either as a consequence or a risk factor; estimated prevalence in adolescence is 25% worldwide. In the present study we aimed to investigate the association between sleep quality and the involvement in school bullying in Portuguese adolescents in two high schools. Methods Data collected from a cross-sectional survey addressing questions on bullying behaviors and sleep quality was analyzed using SPSS 22.0. A two-tailed p-value of less than 0.05 was considered significant for all tests. Results We have included 171 adolescents, mean age of 14.39 ± 1.149 years, 59.6% were boys; prevalence of bullying behaviors was 28.1%. Among the students 15.2% were identified as "pure victims", 8.8% as "pure bullies", 4.1% as "bully-victims" and 71.9% as "neutrals". "Pure bullies" and "bully-victims" present higher Athens Insomina Scale (AIS) scores (p = 0.004) and higher prevalence of insomnia (p = 0.004). The prevalence of insomnia was significantly higher in the group involved in bullying behaviors comparing with the neutrals (58.3% vs 30%, p = 0.001). We verified that 65.4% of the reported bullying situations took place inside the school and 8.8% of those teachers did nothing to help the victim and in 17.5% school staff took the same attitude. Conclusions We found a prevalence of bullying behaviors higher than the one reported in previous studies and a prevalence of insomnia of 38.0%, proving that bullying and sleep disturbances are two major problems in adolescence which may increase future risk for psychiatric symptoms, involvement in criminal activities, hyperactive, and inattentive behaviors. We verified a strong relation between insomnia and involvement in bullying situations with those who are involved reporting difficulties in sleep induction. The group of "bully-victims" was identified as potentially being the one with the most troubled adolescents since they combine characteristics of both bullies and victims. The authors conclude that there should be an investment in school-based interventions that help recognize and reduce school bullying and change lifestyle behaviors that may negatively influence adolescents' development.
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Affiliation(s)
- Fábia Carvalho
- Pediatrics Department of Hospital de Braga, Braga, Portugal
| | - Joana Vilaça
- Pediatrics Department of Hospital de Braga, Braga, Portugal
| | | | - Teresa Pontes
- Unit of Adolescent Medicine in Pediatrics, Department of Hospital de Braga, Braga, Portugal
| | - Susana Carvalho
- Unit of Adolescent Medicine in Pediatrics, Department of Hospital de Braga, Braga, Portugal
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Kliewer W, Robins JL, Borre A. Community Violence Exposure, Sleep Disruption, and Insulin Resistance in Low-Income Urban Adolescents. Int J Behav Med 2019; 26:437-442. [PMID: 31264100 DOI: 10.1007/s12529-019-09801-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Exposure to violence, which is experienced at disproportionally higher levels by black versus white youth, is associated with disruptions in sleep and elevated cardiovascular risk. Further, poor sleep hygiene is associated with insulin resistance. However, research to date examining disruptions in sleep and cardiovascular risk in African-American adolescents has not taken the impact of exposure to violence into account, nor considered how gender might affect patterns of association. The present study addressed this gap by testing a path model linking exposure to community violence, sleep disruption, and insulin resistance in a sample of African-American adolescents and evaluating model fit across gender. METHOD African-American adolescents (N = 107; 56% female; Mage = 14.29, SD = 1.17) completed structured interviews at home and provided a blood sample after fasting overnight. RESULTS The model fit connecting exposure to violence with sleep disruption and insulin resistance, adjusting for depressive symptoms and body mass index z score, was excellent. Multiple group analysis indicated gender differences in model fit. Path analysis revealed significant positive associations between exposure to violence and sleep disruption and sleep disruption and insulin resistance for females but not males. CONCLUSION These data indicate that low-income, urban African-American female adolescents who witness violence and experience sleep disruptions may already be at elevated risk for health problems compared with their male counterparts. Additional research should attempt to replicate and explicate the underlying reasons for the gender differences observed here, with the goal of improving health and disrupting the path leading to health disparities.
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Affiliation(s)
- Wendy Kliewer
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA, 23284-2018, USA.
| | - Jo Lynne Robins
- Department of Family and Community Health, School of Nursing Box 980567, Virginia Commonwealth University, Richmond, VA, 23298-0567, USA
| | - Alicia Borre
- Psychology Department, Hampton University, MLK Building, Room 238, Hampton, VA, 23668, USA
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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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Chang LY, Chang HY, Lin LN, Wu CC, Yen LL. Transitions in sleep problems from late adolescence to young adulthood: A longitudinal analysis of the effects of peer victimization. Aggress Behav 2018; 44:69-82. [PMID: 28857191 DOI: 10.1002/ab.21725] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 12/24/2022]
Abstract
Adolescence is a developmental period with high vulnerability to sleep problems. However, research identifying distinct patterns and underlying determinants of sleep problems is scarce. This study investigated discrete subgroups of, changes in, and stability of sleep problems. We also examined whether peer victimization influenced sleep problem subgroups and transitions in patterns of sleep problems from late adolescence to young adulthood. Sex differences in the effects of peer victimization were also explored. In total, 1,455 male and 1,399 female adolescents from northern Taiwan participated in this longitudinal study. Latent transition analysis was used to examine changes in patterns of sleep problems and the effects of peer victimization on these changes. We identified three subgroups of sleep problems in males and two in females, and found that there was a certain level of instability in patterns of sleep problems during the study period. For both sexes, those with greater increases in peer victimization over time were more likely to change from being a good sleeper to a poor sleeper. The effects of peer victimization on baseline status of sleep problems, however, was only significant for males, with those exposed to higher levels of peer victimization more likely to be poor sleepers at baseline. Our findings reveal an important role of peer victimization in predicting transitions in patterns of sleep problems. Intervention programs aimed at decreasing peer victimization may help reduce the development and escalation of sleep problems among adolescents, especially in males.
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Affiliation(s)
- Ling-Yin Chang
- Institute of Population Health Sciences; National Health Research Institutes; Zhunan Town Miaoli County Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences; National Health Research Institutes; Zhunan Town Miaoli County Taiwan
| | - Linen Nymphas Lin
- Department of Psychiatry; En Chu Kong Hospital; New Taipei Taiwan
- Department of Psychology; Chung Yuan Christian University; Taoyuan Taiwan
| | - Chi-Chen Wu
- Institute of Population Health Sciences; National Health Research Institutes; Zhunan Town Miaoli County Taiwan
| | - Lee-Lan Yen
- Institute of Population Health Sciences; National Health Research Institutes; Zhunan Town Miaoli County Taiwan
- Institute of Health Policy and Management; College of Public Health; National Taiwan University; Taipei Taiwan
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Body mass index and depressive symptoms in adolescents in Taiwan: testing mediation effects of peer victimization and sleep problems. Int J Obes (Lond) 2017. [DOI: 10.1038/ijo.2017.111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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