Examining the association between bullying victimization and prescription drug misuse among adolescents in the United States

Pathways From Bullying Victimization to Suicidal Thoughts Among Urban African American Adolescents: Applying the General Strain Theory

ABSTRACT

The present study explores the relationship between bullying victimization and suicidal thoughts among African American adolescents in urban neighborhoods. The study, which was guided by the general strain theory, proposed and tested potential pathways that link bullying victimization with suicidal thoughts through the mediators including emotional distress, low future orientation, hopelessness, and drug use. The study sample included 414 African American adolescents who were between ages 12 and 22 years and residing in low-income Chicago's South Side neighborhoods. Descriptive statistics, bivariate correlation, and path analyses were conducted. Bullying victimization was not significantly related to suicidal thoughts, although it was positively associated with emotional distress and drug use. The association between low future orientation and hopelessness was bidirectional. The study findings have implications for practice, which is important as resources to assist adolescents who are affected by violence tend to be limited.

Chronic Pain and Childhood Adversity Experiences Among U.S. Military Personnel

INTRODUCTION

Chronic pain in a military population is prevalent, is costly, and can limit daily activities and affect soldier readiness. It has been associated with childhood adversity (CA) within the veteran, adult, and pediatric populations. Given the need to maximize soldier resiliency, an examination of the link between CA and chronic pain in an active duty population for a better understanding that informs treatment options is warranted.

MATERIALS AND METHODS

The analytic sample comprised 32 men and 8 women drawn from a retrospective review of 203 intake assessments at an interdisciplinary pain management center. We identified a group (CA) of 20 patients who reported a history of pre-adolescent sexual abuse or living in an "abusive" childhood home and compared it with a control group (no-CA) of 20 patients, matched for age, gender, pain history duration, and pain problem. Validated measures were used to assess pain intensity, interference in functioning and well-being, emotional sequelae of pain as reflected in symptoms of depression and anxiety, and pain-related catastrophic thinking. Data were analyzed using descriptive statistics and independent samples t-test analyses.

RESULTS

Differences in current, worst, and average pain ratings were non-significant between groups. The CA group reported significantly greater effect of pain on mood (mean: 6.20 versus 4.25, P < .02) and showed a trend toward higher pain interference in functioning (mean: 17.70 versus 15.05, P = .053). The CA patients had significantly more serious depression (mean: 12.65 versus 4.50, P < .001) and anxiety symptoms (mean: 10.60 versus 2.35, P < .001) and significantly higher pain catastrophizing tendency (mean: 30.05 versus 20.50, P < .03).

CONCLUSIONS

Overall, the findings suggest that childhood trauma should be considered by providers when treating depression and anxiety in soldiers with chronic pain. Being mindful of trauma-informed care may have implications, perhaps, for cases perceived as treatment resistant.

Investigating the co-occurrence of marijuana use and prescription opioid misuse with multiple suicide attempts among adolescents with a history of suicidal ideation

This study investigated the co-occurrent association of marijuana use and prescription opioid misuse with multiple suicide attempts among adolescents with a history of suicidal ideation. Data came from the 2019 Youth Risk Behavior Survey. The sample was comprised of adolescents ages 14-18 who reported suicidal ideation during the past year (n = 2,562). Multinomial logistic regression was used to examine the co-occurring association of marijuana use and prescription opioid misuse with multiple suicide attempts. Of the 2,562 adolescents who experienced suicidal ideation, 19.2 % also attempted suicide multiple times during the past year and 19.0 % reported ever using marijuana and misusing prescription opioids, 8.8 % misused prescription opioids only, and 33.3 % used marijuana only. In the multivariate model, for adolescents who used marijuana and misused prescription opioid, the risk of attempting suicide once was 1.77 times higher (RRR = 1.77, 95 % CI = 1.22-2.59) and the risk of multiple suicide attempts was 3.23 times higher (RRR = 3.23, 95 % CI = 1.95-5.33) when compared to adolescents who had never used marijuana nor misused prescription opioid. The risk of multiple suicide attempts was greater for bisexual and racial/ethnic minority adolescents and adolescents who felt sad or hopeless. Interventions that prevent prescription opioid misuse among adolescents may be effective in mitigating suicide attempts.

Pattern of lifestyle behaviors and associated risk of being bullied at schools: A latent class analysis of 25,379 adolescents in Jiangsu Province of China

School bullying is a worldwide problem. Although previous studies examined the association between different lifestyle behaviors and bullying victimization, the complex co-occurrence of these behaviors was not identified, and their association with the risk of being bullied remains unclear. We aimed to identify the behavioral patterns of adolescents and to explore their association with bullying victimization. This cross-sectional study employed data from the "Surveillance for Common Diseases and Health Risk Factors among Students" project implemented in Jiangsu Province of China in 2019, and a total of 25,379 school-enrolled students were included. We used a latent class analysis to identify behavioral patterns and a regression mixture model to explore various demographic characteristics, such as age, sex, and family structure in relation to bullying victimization across different patterns. We considered respondents having targeted behaviors, including smoking, alcohol consumption, illicit drug use, sugar consumption, no fruit consumption, low physical activity, electronic media use, and insufficient sleep. Four behavioral patterns were identified, including the "adolescents without apparent targeted behaviors" (19.65%), "substance and electronic media users" (12.76%), "typical electronic media users" (54.49%), and "typical substance users" (8.10%). The risk of being bullied was the highest in the "substance and electronic media users" (probability: 0.33), tripled that in "adolescents without apparent targeted behaviors" (odds ratio: 3.60, 95% confidence interval: 3.01-4.30). Risk of being bullied was reduced for those "substance and electronic media users" living with a nuclear family. Behavioral patterns and their association with being bullied differ between groups of school-aged adolescents. To better inform decision-making based on the current real-world findings, the implementation of bullying prevention programs could target specific behavioral patterns.

Non-prescribed pharmaceutical stimulants use among adolescents: A way to self-care or peer success?

BACKGROUND

the use of pharmaceutical stimulants without a medical prescription (PSWMP) among adolescents is considered an established public health issue. The present study aimed to investigate the potential links between different patterns of non-medical use of pharmaceutical stimulants, psycho-social factors, and other risky behaviours (e.g. psychoactive substance use).

METHODS

For this purpose, data from a sample of 14,685 adolescents aged 15-19 participating in the ESPAD®Italia 2019 study were analysed by conducting descriptive analyses and multinomial logistic regressions.

RESULTS

The findings highlight the key role of psycho-social factors and engagement in other risky behaviours in either reducing or promoting the risk of PSWMP use. Particularly, being satisfied with peer relationships and with oneself is significantly associated with lower use of PSWMP. Conversely, the consumption of other psychoactive substances (both legal and illegal) and engagement in other risky behaviours (e.g., gambling and cyberbullying) may increase this phenomenon.

CONCLUSIONS

Considering their representativeness, the results of the present study could be used as groundwork for the development of effective and targeted prevention programs and interventions.

Perceived racial discrimination and polysubstance use among racial/ethnic minority adolescents in the United States

OBJECTIVE

Polysubstance use among adolescents is a significant public health concern, yet most studies on adolescent substance use focus on a singular substance. This study is one of the first to investigate the association between perceived racial discrimination (PRD) in school and polysubstance use among racial/ethnic minority adolescents using a nationally representative sample.

METHODS

Data was from the 2021 Adolescent Behaviors and Experiences Survey. The sample included 4145 racial/ethnic minority adolescents (52.8% female). Hierarchical binary logistic regression was used to examine the association between PRD in school and polysubstance use among racial/ethnic minority adolescents.

RESULTS

About 12% of racial/ethnic minority adolescents engaged in polysubstance use and 23.4% reported experiencing PRD in school sometimes/most of the time/always. Controlling for other factors, experiencing PRD in school sometimes/most of the time/always was associated with 1.52 times higher odds of polysubstance use when compared to adolescents who never experienced PRD in school (OR=1.52, p=.044, 95% CI=1.01-2.30). Cyberbullying victimization, symptoms of depression, and being emotionally abused by a parent during COVID-19 were also associated with polysubstance use.

CONCLUSION

Controlling for demographic characteristics and psychosocial stressors, PRD in school was significantly associated with higher odds of polysubstance use among racial/ethnic minority adolescents. The findings of this study could inform clinicians and policymakers of the association between PRD in school and polysubstance use, which could contribute to early identification of polysubstance use among racial/ethnic minority adolescents.

Typologies of child maltreatment and peer victimization and the associations with adolescent substance use: A latent class analysis

BACKGROUND

Child maltreatment and peer victimization are pervasive public health problems associated with adolescent substance use. Although child maltreatment has been identified as a risk factor for peer victimization, few studies have investigated their co-occurrence (i.e., polyvictimization). The study objectives were to: examine sex differences in the prevalence of child maltreatment, peer victimization, and substance use; identify polyvictimization patterns; and examine the associations between the identified typologies and adolescent substance use.

METHODS

Data were self-reported from a sample of adolescents aged 14 to 17 years (n = 2910) who participated in the provincially-representative 2014 Ontario Child Health Study. Latent class analysis with distal outcomes was conducted to identify typologies of six types of child maltreatment and five types of peer victimization and examine the associations between the polyvictimization typologies and use of cigarettes/cigars, alcohol, cannabis, and prescription drugs.

RESULTS

Four typologies were identified: Low victimization (76.6 %), Violent home environment (16.0 %), High verbal/social peer victimization (5.3 %), and High polyvictimization (2.1 %). The Violent home environment and High verbal/social peer victimization typologies were associated with increased odds of adolescent substance use (adjusted odds ratio range: 2.06-3.61). The High polyvictimization typology showed increased, but non-significant, odds of substance use.

CONCLUSIONS

Adolescent-serving health and social services professionals should be aware of polyvictimization patterns and the impact on substance use. For some adolescents, polyvictimization may include exposure to multiple child maltreatment and peer victimization types. Upstream strategies to prevent child maltreatment and peer victimization are needed, which may also contribute to reductions in adolescent substance use.

Regular cannabis use is associated with history of childhood and lifetime trauma in a non-clinical community sample

Higher rate of substance use, including cannabis, has been reported in individuals with a history of childhood trauma, but less is known about the association between cannabis use with lifetime history of trauma and chronic stress, and potential gender differences in this association. This study systematically examined this association in a cross-sectional study of 841 individuals recruited between 2007 and 2012 from the community in New Haven, Connecticut. The Cumulative Adversity Index (CAI) was used to measure cumulative lifetime major life events, life trauma, and recent life events and chronic stress. Childhood Trauma Questionnaire (CTQ) was used to measure childhood trauma. Current and regular use of drugs were assessed using self-report questionnaires and objectively verified with urine drug testing. Higher rates of childhood trauma as well as lifetime trauma, and major life events were found in cannabis users, compared to non-users. The association between cannabis use with childhood trauma (total CTQ scores) was significant after controlling for age, gender, ethnicity and regular use of alcohol or cocaine. In logistic regression analysis, cannabis use had a significant positive association with major life events and lifetime trauma, but not with chronic stress, controlling for confounding factors including age, gender, ethnicity, and regular use of alcohol and cocaine. When analyzed separately, only in women the association between cannabis use and childhood trauma was significant. These associations point to further assessment of the impact of these gender differences on neurobiology of stress and cannabis misuse risk.

Association between Sexual Violence Victimization and Electronic Vaping Product Use among Adolescents: Findings from a Population-based Study

BACKGROUND

Although studies have investigated the association between sexual violence (SV) victimization and substance use, few studies have examined the association between SV victimization and electronic vaping product (EVP) use among adolescents in the United States. The objective of this study was to examine the cross-sectional association between SV victimization and EVP use among adolescents.

METHODS

Data were pooled from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 28,135 adolescents (51.2% female) was analyzed using binary logistic regression. The outcome variable investigated was EVP use, and the main explanatory variable was SV victimization.

RESULTS

Of the 28,135 adolescents, the prevalence of past 30-day EVP use and SV victimization was 22.7% and 10.8%, respectively. Controlling for other factors, adolescents who experienced SV had 1.52 times higher odds of being EVP users when compared to their counterparts who did not experience SV (AOR = 1.52, p < .001, 95% CI = 1.27-1.82). Other factors associated with EVP use included cyberbullying victimization, symptoms of depression, and current use of cigarettes, alcohol, and marijuana.

CONCLUSIONS

Experiencing SV was associated with EVP use. Future studies that employ longitudinal designs may offer more insight into the mechanisms underlying the association between SV victimization and EVP use. In addition, school-based interventions that focus on sexual violence prevention and reducing substance use among adolescents are warranted.

Effect of prosocial behavior on school bullying victimization among children and adolescents: Peer and student-teacher relationships as mediators

INTRODUCTION

In this study, we examined the relationship between prosocial behavior and school bullying victimization in children and adolescents. We also tested the mediating effects of peer alienation and student-teacher closeness, as well as the moderating effect of the educational stage.

METHODS

In total, 538 children and adolescents were recruited from three suburban schools in Beijing, China (252 boys, 286 girls; mean age = 12.47; 237 elementary school students, 101 middle school students, and 200 high school students). The participants were asked to complete the measures of prosocial behavior, peer alienation, and student-teacher closeness at the initial time point and reported school bullying victimization 3 months later.

RESULTS

We found that prosocial behavior was directly and negatively associated with traditional bullying victimization (i.e., physical, nonphysical, and relational); however, it had no direct association with cyberbullying victimization. Prosocial behavior was indirectly associated with school bullying victimization (except in the relational dimension) via peer alienation, but no indirect effect of student-teacher closeness was found. Besides, the associations between prosocial behavior, peer alienation, student-teacher closeness, and bullying victimization were found equally among elementary, middle, and high school students.

CONCLUSIONS

The findings suggest that prosocial behavior is an important factor associated with decreased school bullying victimization, and peer relationships play a mediating role in this association. Our study extends the current understanding of prosocial behavior primarily as a consequence of child and adolescent development to an antecedent (of school bullying victimization), which contributes to a more comprehensive view of prosocial behavior.

Combined Race and Gender Trend Disparities in Depressive Symptoms among U.S. High School Students: 1999-2019

In 2019, over 3.2 million adolescents in the U.S. reported depressive symptoms-a number that continues to increase annually. Not only can depression negatively impact an adolescent's academic performance, social development, and cognitive function, but it is also the most common condition associated with suicide. Previous studies have reported prevalence rates and statistical trends by either gender or race. We conducted an in-depth analysis of the current racial and gender trend disparities in adolescent depressive symptoms by examining linear and quadratic trends from the Youth Behavior Risk Survey (N = 158,601) over two decades (1999-2019), stratified by gender and race subgroups, both separately and combined. This novel quantitative method allows for a more nuanced approach when exploring social and cultural influences on adolescent depressive symptoms. We found a significant difference in the prevalence of depressive symptoms between males and females among Black, Hispanic, and multiracial adolescents in each separate year of pooled data. However, an increased prevalence trend over the 20-year period was only seen among the females of these three racial categories. White and Asian female adolescents also exhibited a statistical increase in prevalence of depressive symptoms over time. The only group of males with a significant trend increase over time were White adolescents. Understanding the intersection of gender and race in adolescent depressive symptoms trends enhances evidence for nurses and other healthcare professionals when developing and implementing targeted, effective prevention and intervention measures.

Bullying victimization and nicotine and marijuana vaping among Florida adolescents

PURPOSE

Previous research links bullying victimization with the use of illicit substances in adolescence. In addition, recent research has linked bullying victimization with vaping. Very limited research, however, has explored how different forms of bullying may be linked with nicotine and marijuana vaping specifically.

PROCEDURES

This study addresses this gap in the literature by utilizing logistic regression to examine the relationships between verbal, physical, and cyber bullying victimization and nicotine and marijuana vaping in a sample of Florida adolescents.

FINDINGS

Our findings reveal that all three forms of bullying victimization are linked with recent nicotine vaping, and these associations differ somewhat by youth gender. In addition, our findings indicate that cyber bullying victimization is linked with marijuana vaping.

CONCLUSIONS

In conclusion, our findings suggest that bullying victimization is linked with greater odds of vaping activity in adolescents. The implications of these findings for future research and policy are discussed.

Racial/Ethnic Bullying Subtypes and Alcohol, Tobacco, and Marijuana Use Among US Adolescents

BACKGROUND

The study examines the rate of alcohol, tobacco, and marijuana use among White, African American, and Latino adolescents and whether racial/ethnic bullying subtypes (victim-only, bullies-only, and bully/victim) are related to alcohol, tobacco, and marijuana use.

METHODS

We used data from the 2009-2010 Health Behaviour in School-aged Children study (n = 9863) to examine differences in alcohol, tobacco, and marijuana use among White, African American, and Latino adolescents in the USA, and assessed whether racial/ethnic bullying involvement was associated with alcohol, tobacco, and marijuana use among these adolescents. Adolescents were categorized into four groups based on whether they had experienced racial bullying perpetration, victimization, both perpetration, and victimization, or neither perpetration nor victimization. Descriptive statistics were conducted to examine the distributions of the study variables and describe the samples. Spearman's rank-order correlation analyses were used to examine the relationships among the variables. Multinomial logistic regression was conducted to examine alcohol, tobacco, and marijuana use among the racial bully victimization, perpetration, and victimization-perpetration groups compared to the non-involved group by race/ethnicity.

RESULTS

The White victim-only group was more likely to use alcohol but less likely to use tobacco. The African American victim-only group was more likely to use alcohol, and the bully/victim group was more likely to use marijuana. The Latino victim-only group was more likely to use alcohol, whereas the bully/victim group was more likely to use tobacco.

CONCLUSION

Our findings have implications for the development and implementation of prevention and intervention programs across different racial/ethnic adolescent groups.

Subtypes of Bullying and Types of Substance Use among Urban African American Adolescents: Who Is Likely to Use What?

The present study examined the types of drugs likely to be used by bullies, victims, and bully/victims. Participants comprise African American adolescents from three high schools, one youth church group, two community youth programs, and four public venues in low-income communities in Chicago's Southside. A series of logistic regression analyses and latent class analyses were employed. Victims are likely to use alcohol, marijuana, and lean/krokodil. Bullies were likely to use alcohol and marijuana. Bully/victims were not at risk of any of the substances. Our LCA findings revealed a lower occurrence of substance use among victims although 30% used alcohol and marijuana; more than half of bullies showed high levels of alcohol, marijuana, and lean/krokodil use; a diverse pattern of drug use was shown among bully/victims although their lean/krokodil and crack/cocaine use was higher than other subgroups of bullying. The drugs of choice for African American bullies, victims, or bully/victims are variable.

Cyber-Victimization Experience among Higher Education Students: Effects of Social Support, Loneliness, and Self-Efficacy

Most of the research literature on cyberbullying (CB) has focused on adolescents, but due to their intensive, unsupervised use of Information Communication Technologies (ICT), higher education students are at high risk of being involved in CB. The current study examined the nature of CB among 1004 higher education students. In addition, we explored the relationships between cyber-victimization, social support, loneliness, and self-efficacy. For that purpose, we applied a path analysis model (PA) to explain the effect of each variable on the cyber-victimization experience, expecting that high levels of loneliness and low levels of self-efficacy will predict cyber-victimization, but might be moderated and reduced by high levels of social support. Results revealed that social support moderated the relationships between these socio-emotional variables and cyber-victimization, and might serve as a protective factor. These findings on young adults may contribute to the understanding of the nature of cyber-victimization throughout the life cycle. Nowadays, academic institutions are facing an uphill effort in trying to restrain online misbehavior. In view of the findings, higher education policy could help facilitate coping with CB through student support and focused intervention programs.

Use of electronic vaping products and mental health among adolescent high school students in the United States: The moderating effect of sex

Although studies have investigated the association between conventional tobacco smoking and mental health outcomes among adolescents in the United States, few studies have examined the association between electronic vaping products (EVPs) and mental health among adolescents. This study aimed to investigate the cross-sectional association between EVPs use, symptoms of depression, and suicidal behaviors among adolescents. Data were pooled from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 14,285 adolescents (50.3% female) was analyzed using binary logistic regression. The outcome variables investigated were symptoms of depression, suicidal ideation, suicide plan, and suicide attempts, and the main explanatory variable was EVPs use. Of the 14,285 adolescents, 22.2%, 19.2%, and 58.8% were current, former and never users of EVPs, respectively. Controlling for other factors, current users of EVPs were significantly more likely to report having symptoms of depression (AOR = 1.82, 95% CI = 1.58-2.09), having suicidal ideation (AOR = 1.55, 95% CI = 1.30-1.86), making a suicide plan (AOR = 1.62, 95% CI = 1.34-1.97), or attempting suicide (AOR = 1.75, 95% CI = 1.41-2.18) when compared to never users of EVPs. Gender moderated the association between EVPs use, symptoms of depression, suicidal ideation, and suicide plan. Racial minority identity, sexual minority identity, sexual violence victimization, victim of school and cyberbullying, alcohol use, and cigarette smoking were all significantly associated with depression and suicidal behaviors. Study findings support the association between EVPs use and adolescent mental health. Future studies that employ longitudinal designs may offer more insight into the mechanisms underlying this association.

Sports- and Physical Activity-Related Concussions, Binge Drinking and Marijuana Use among Adolescents: The Mediating Role of Depression and Suicidal Ideation

BACKGROUND

Although past studies have examined the adverse impact of sports- and physical activity-related concussions (SPACs) on health and mental health outcomes, there is a dearth of research investigating the association between SPACs and binge drinking and marijuana use.

OBJECTIVE

The objective of this study is to examine the cross-sectional association between SPACs and binge drinking and marijuana use among adolescents and whether symptoms of depression and suicidal ideation mediate this association.

METHODS

Data for this study came from the 2017 and 2019 National Youth Risk Behavior Survey. An analytic sample of 17,175 adolescents aged 14-18 years (50.2% male) was analyzed using binary logistic regression.

RESULTS

Of the 17,175 adolescents, 13.7% engaged in binge drinking and 19.3% used marijuana 30 days preceding the survey date. Approximately one in seven (14.1%) adolescents had SPACs during the past year. Upon controlling for the effects of other factors, adolescents who had SPACs had 1.74 times higher odds of engaging in binge drinking (AOR = 1.74, p<.001, 95% CI = 1.47-2.06) and 1.42 times higher odds of using marijuana (AOR = 1.42, p<.001, 95% CI = 1.24-1.62) than those who did not have SPACs. Symptoms of depression and suicidal ideation explained 12% of the association between SPACs and binge drinking, and 19% of the association between SPACs and marijuana use.

CONCLUSIONS

Understanding the association between SPACs and substance use and mental health could contribute to early identification of adolescents who may engage in substance use.

Association Between Bully Victimization and Vaping Among Texas High School Students

INTRODUCTION

Bullying and vaping among adolescents in Texas is a major public health concern. Bully victimization has been associated with substance use in adolescents; however, research examining the association between bully victimization and vaping in adolescents is sparse. This study aims to examine the independent association between bully victimization and vaping among Texas high school students.

METHODS

Pooled data from the 2017 and 2019 Texas Youth Risk Behavior Survey (N=3,486) were analyzed in July 2020. Past-year bully victimization was categorized into 4 mutually exclusive groups: no bully victimization, school bully victimization only, cyberbully victimization only, and both school bully and cyberbully victimization. Current vape use was measured as a binary variable. Multivariable logistic regression was used to examine the association.

RESULTS

In the total sample, the past-year prevalence of school bully victimization only, cyberbully victimization only, and both school bully and cyberbully victimization was 8.3%, 4.6%, and 7.7%, respectively. Approximately 1 in 7 students (14.5%) reported vaping during the past 30 days. Female students who experienced both school bullying and cyberbullying had 68% greater odds of vaping than female students who did not experience bullying (AOR=1.68, 95% CI=1.02, 3.41). Bully victimization was not significantly associated with vaping in male students.

CONCLUSIONS

Female Texas high school students who are victims of both school bullying and cyberbullying have a greater likelihood of vaping. Healthcare providers, school counselors, and educators should be aware of the association and sex differences that exist while developing intervention programs to address bullying and vaping in high school students.

Age at first alcohol use and weapon carrying among adolescents: Findings from the 2019 Youth Risk Behavior Survey

BACKGROUND

Although studies have investigated the association between alcohol use and violent behaviors such as weapon carrying, few studies have examined the association between age at first alcohol use and weapon-carrying among adolescents. The objective of this study was to investigate the association between age at first alcohol use and weapon carrying among adolescents.

METHODS

Data for this study came from the 2019 Youth Risk Behavior Survey. An analytic sample of 13,442 adolescents aged 14-18 years old (51% female) was analyzed using binary logistic regression. The outcome variable investigated in this study was weapon carrying during the past 30 days, and the main explanatory variable investigated was age at first alcohol use.

RESULTS

Of the 13,442 adolescents, 13.5% carried a weapon during the past 30 days, and 15.4% reported having their first alcoholic drink before age 13. In the multivariable logistic regression, adolescents who reported having alcohol before age 13 had more than double the odds of carrying a weapon when compared to those who never had alcohol before age 13 (AOR = 2.32, p < .001, 95% CI = 1.87-2.89). Other significant factors associated with weapon carrying include male gender, victim of bullying, teen dating violence, sexual violence, suicidal ideation, and history of substance use. Adolescents who self-identified as Black/African American or Hispanic were significantly less likely to carry a weapon when compared to adolescents who self-identified as non-Hispanic White.

CONCLUSION

The findings of this study underscore the importance of developing age appropriate intervention strategies to curb early initiation of alcohol use and weapon carrying among adolescents.

Association between bullying victimization and e-cigarette use among German students

This study examined the association between bullying victimization and e-cigarette use. Data from a 2019-2020 German student survey were used (N = 16,476). The target population consisted of students enrolled in grades 5-10, with a mean age of 13.1 years (SD = 1.8), and equal gender distribution (49.5% female). Mixed-effect multivariable logistic regression models were used to examine the association between bullying victimization (attacked physically, assaulted verbally, experienced relational bullying, sexual harassment, cyberbullying) and current e-cigarette use. The multivariable analysis controlled for age, sex, sensation-seeking, socioeconomic status, school performance, type of school attended, and substance use (current cigarette smoking, hookah smoking, and alcohol drinking). Overall 510 (3.7%) students reported current use of e-cigarettes. The odds for using e-cigarettes increased each step of being bullied from "never," "rarely," "sometimes," "once a week," to "several times a week" by 2.03 (95% confidence interval [CI]: 1.81, 2.29) in the unadjusted model, and by 1.46 (95% CI: 1.24, 1.71) in the covariate-adjusted model. Data indicate an empirical association between victimization and e-cigarette use among German students. Design limitations prevent the conclusion of a causal relationship, calling for well-designed longitudinal studies to investigate the temporal sequence between victimization and e-cigarette use.

Parental stress and adolescent bullying perpetration and victimization: The mediating role of adolescent anxiety and family resilience

Although past research suggests that parental stress can heighten adolescents' risk for bullying perpetration and victimization, the mechanisms underlying such a potential link and that may involve child psychological wellbeing remain unclear. Parental stress may heighten adolescents' risk for bullying involvement by elevating adolescents' anxiety and interfering with family functioning. Therefore, the current study investigated the role of adolescent anxiety and family resilience as mediators linking parental stress with adolescent bullying involvement. Sex differences in these associations were also explored. Analyses relied on data collected from 11,244 parents who participated in the 2019 National Survey of Children's Health. Parents completed surveys assessing parental stress, adolescent anxiety, family resilience, and adolescents' involvement in bullying perpetration as well as victimization. Results from structural equation models indicated that a higher level of parental stress was related to greater bullying perpetration and victimization among both male and female adolescents. Moreover, parental stress was indirectly related to bullying victimization via elevated adolescent anxiety for both girls and boys, whereas parental stress was indirectly related to bullying perpetration via reduced family resilience for boys but not girls. The findings highlight connections between adolescents' family and peer contexts and implicate adolescent anxiety and family resilience as putative mechanisms linking parental stress and bullying involvement.

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

OBJECTIVE

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

METHOD

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

RESULTS

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

LIMITATIONS

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

CONCLUSIONS

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

Examining the intersection of race/ethnicity and sexual orientation on suicidal ideation and suicide attempt among adolescents: Findings from the 2017 Youth Risk Behavior Survey

Although some studies have examined factors associated with suicidal behaviors, few studies have examined the intersection of sexual orientation and race/ethnicity on suicidal behaviors among adolescents. The objective of this study is to examine the intersection of sexual orientation and race/ethnicity on suicidal ideation and suicide attempt. We hypothesized that controlling for the effects of known risk factors for suicidal behaviors, there will be an interaction effect between sexual orientation and race/ethnicity on suicidal behaviors. Data for this study came from the 2017 Youth Risk Behavior Surveillance System. A sample of 13,697 adolescents aged 14-18 years (51.8% female) was analyzed using binary logistic regression. Of the 13,697 adolescents, 17.7% reported suicidal ideation and 7.7% made at least one suicide attempt during the past 12 months. In the multivariate logistic regression models, non-White sexual minority adolescents are less likely to report suicidal ideation. However, Hispanic lesbian/gay adolescents had 1.71 times higher odds of making a suicide attempt. Odds of suicide attempt are 1.2 times higher for Black or African American bisexual adolescents and American Indian/Native Hawaiian/Pacific Islander bisexual adolescents had 2.44 times higher odds of making a suicide attempt. Other significant predictors of suicidal behaviors include a history of sexual assault, a victim of bullying, depression, cigarette smoking, misuse of prescription pain medication, and illicit drug use. The findings of the present study extend past research on the intersection of sexual orientation and race/ethnicity on mental health problems among adolescents including suicidal behaviors.

The Impact of Emotional Symptoms and Family Support on the Association Between Homophobic Bullying and Sedative/Hypnotic Use among Gay and Bisexual Men in Taiwan: A Moderated Mediation Model

Sedative/hypnotic use and homophobic bullying have become a big mental health concern for gay and bisexual men. However, few studies have investigated the mediators and moderators of the association between them. The current study aimed to build a conceptual model to estimate the mediating effect of emotional symptoms and the moderating effect of family support on this association among gay and bisexual men in Taiwan. A total of 500 gay or bisexual men were recruited for the study. Their history of homophobic bullying, their experience of sedative/hypnotic use, their perceived family support, and their current emotional symptoms were evaluated using self-reporting questionnaires. A moderated mediation model was developed to test the mediating effect of emotional symptoms and the moderating effect of family support. A higher level of homophobic bullying was significantly associated with sedative/hypnotic use among gay and bisexual men and this was mediated by a higher severity of emotional symptoms. A moderating effect of family support was identified, wherein the mediating effect of emotional symptoms was weaker when there was a higher level of perceived family support, thus revealing the protective effect of family support. The significant impact of emotional symptoms and family support on the association between homophobic bullying and sedative/hypnotic use was identified. Timely interventions for emotional symptoms and the enhancement of family support are crucial for gay and bisexual men.

Association between insufficient sleep and suicidal ideation among adolescents

The objective of this study was to examine the association between insufficient sleep and suicidal ideation among adolescents. Data for this study came from the 2017 Youth Risk Behavior Surveillance System. A sample of 13,659 adolescents aged 14-18 years (51.8% female) were analyzed using logistic regression with suicidal ideation as the outcome variable and insufficient sleep as the main explanatory variable. Of the 13,659 adolescents, 2,409 representing 17.6% experienced suicidal ideation during the past 12 months and three out of four adolescents (75.2%) had insufficient sleep on an average school night. Controlling for all other predictors, the odds of experiencing suicidal ideation were 1.35 times higher for adolescents who had insufficient sleep relative to those who had sufficient sleep on an average school night (AOR = 1.35, 95% CI = 1.16-1.58). Other factors associated with suicidal ideation include female gender, sexual minority, history of traditional bullying and cyberbullying victimization, feeling sad or hopeless, being slightly or very overweight, and substance use. Physical activity was inversely associated with suicidal ideation. School counselors, clinicians, and practitioners should consider adequate sleep as an important intervention in suicide prevention.

Investigating the association between bullying victimization and suicidal ideation among adolescents: Evidence from the 2017 Youth Risk Behavior Survey

BACKGROUND

Suicide among adolescents in the United States is the second leading cause of death. Bullying victimization has also been identified as a growing public health concern. Although studies have examined the association between bullying victimization and mental health outcomes, there is a dearth of research investigating the association between bullying victimization and suicidal ideation among adolescents.

OBJECTIVE

The objective of this study is to investigate the association between bullying victimization and suicidal ideation among adolescents.

PARTICIPANTS AND SETTING

Data for this study came from the 2017 National Youth Risk Behavior Survey.

METHODS

An analytic sample of 14,603 adolescents aged 14-18 years (52 % female) was analyzed using binary logistic regression.

RESULTS

About 18 % of adolescents experienced suicidal ideation during the past 12 months. About one in ten adolescents (9.1 %) were victims of both school bullying and cyberbullying. Bullying victimization was associated with suicidal ideation whereby, adolescents who experienced both school bullying and cyberbullying victimization had 3.26 times higher odds of experiencing suicidal ideation (AOR = 3.26, p < .001, 95 % CI=3.10-3.43), adolescents who experienced school bullying victimization had 2.15 times higher odds of experiencing suicidal ideation (AOR = 2.15, p < .001, 95 % CI=2.04-2.27), and adolescents who experienced cyberbullying victimization had twice the odds of experiencing suicidal ideation (AOR = 2.00, p < .001, 95 % CI=1.87-2.14). Other factors significantly associated with suicidal ideation include forced sexual intercourse, depressive symptoms, cigarette smoking, alcohol use, cannabis use, and illicit drug use.

CONCLUSION

Understanding the association between bullying victimization and suicidal ideation could contribute to early identification of adolescents who may be at risk for suicide.

Factors Affecting Painkillers, Sedatives/Hypnotics, Nicotine, and Unhealthy Alcohol Use Among Gay and Bisexual Men in Taiwan

Substance use has become a major health problem globally for sexual minorities. However, few studies have explored multi-dimensional factors associated with smoking, drinking, and prescription drug use. We aimed to investigate the factors affecting painkiller, sedative/hypnotic, nicotine and unhealthy alcohol use among gay and bisexual men in Taiwan. We recruited 500 gay or bisexual men and assessed their experiences of using painkillers, sedatives/hypnotics, nicotine, alcohol and multi-dimensional factors with self-reported questionnaires. Multivariate logistic regression with a forward stepwise model was used to verify the factors associated with substance use. Overall, 9.4%, 5.4%, and 13.8% of the participants reported using painkillers, sedatives/hypnotics, and nicotine, respectively, and 5.6% reported unhealthy alcohol use. Victims of traditional homophobic bullying in childhood and adolescence were more likely to report nicotine use, sedative/hypnotic use, and unhealthy alcohol use in early adulthood than non-victims. Missing classes or truancy at senior high school was associated with painkiller and sedative/hypnotic use in early adulthood. Traditional homophobic bullying and missing classes or truancy in childhood and adolescence predicted substance use in early adulthood among the gay and bisexual men in this study. Timely preventions and interventions for substance use are crucial for gay and bisexual men, especially for those who experience homophobic bullying and missing classes or truancy.

The association between excessive screen-time behaviors and insufficient sleep among adolescents: Findings from the 2017 youth risk behavior surveillance system

Although studies have examined the association between television viewing and poor sleep quality, few studies have considered the association between excessive screen-time behaviors and insufficient sleep among adolescents drawing on a large nationally representative sample. The objective of this study was to examine the association between excessive screen-time behaviors and insufficient sleep among adolescents. Data for this study came from the 2017 Youth Risk Behavior Survey. A sample of 14,603 adolescents aged 14-18 years (51.5% female) was analyzed using logistic regression with insufficient sleep as the outcome variable and excessive screen-time behaviors as the main explanatory variable. Of the 14,603 adolescents, almost three out of four (74.8%) had less than 8 h of sleep on an average school night, and about 43% engaged in excessive screen-time behaviors on an average school day. Controlling for all other predictors, odds were 1.34 times higher for adolescents who engaged in excessive screen-time behaviors to have insufficient sleep when compared to adolescents who did not engage in excessive screen-time behaviors (AOR = 1.34, p < .001, 95% CI = 1.22-1.48). School-based behavior interventions that focus on reduction in excessive screen-time and sedentary behaviors might be beneficial in reducing excessive screen-time behaviors and consequently improve sleep quality among adolescents.