Victims of bullying among students with a disability or chronic illness and their peers: a cross-national study between Ireland and France

Psychosocial Factors and Quality of Life of Portuguese Adolescents With Chronic Conditions - Increased Risk for Victims of Bullying

The experience of living with a chronic condition (CC) impacts adolescents' psychological and social adjustment and overall functioning. Considering the increased risk of psychosocial challenges among adolescents with CC, this study aimed to enhance our understanding of the psychological and social factors that impact their quality of life. It also compared the psychological and social variables among (a) adolescents with and without CC and (b) adolescents with CC who are and who are not victims of bullying. The results demonstrated that adolescents with CC showed more psychosocial difficulties than their peers, as they more frequently reported involvement in situations of violence, and demonstrated more difficulties at a psychological and emotional level. Further, being victims of bullying increased the psychosocial vulnerabilities of these adolescents. A better quality of life was associated with the following psychosocial factors: not being a victim of bullying or cyberbullying, having less anxiety and fewer depressive symptoms, liking school, receiving more support from family and friends, having better relationships with peers, and having fewer physical and psychological symptoms. These findings are significant for helping schools develop tools and strategies to address violence and support students with CC, who are at a higher risk of being involved in such situations and require a targeted response.

Barriers to Type 1 Diabetes Adherence in Adolescents

Background: Adolescence is a particularly crucial period of physical, emotional, and social development and adaptation, rendering these formative years rather challenging for individuals with chronic conditions like type 1 diabetes (T1D). Despite rapid improvement in diabetes therapies, adolescents with T1D are characterized by poorer adherence to treatment regimens compared with other pediatric age groups. Insufficient adherence is strongly related to low diabetes control, increasing morbidity, and risk for premature mortality. This study aimed to provide a comprehensive overview of adolescents' most common barriers to T1D adherence, stressing the need for a deep and comprehensive understanding of these barriers. The complexity of these barriers is underscored by the diverse factors contributing to poor T1D adherence in adolescents. Methods: A narrative review was conducted, surveying four databases (PubMed, Scopus, EMBASE, and Web of Science) for full-text articles in the English language published up to June 2024. All studies related to barriers to T1D adherence in adolescents were considered. The literature was selected using selection and exclusion criteria and extracted and organized using Mendeley. Exclusion criteria included studies with insufficient data and non-peer-reviewed articles. This review revealed that adolescents face numerous obstacles to T1D adherence related to psychological factors, flux in family dynamics, perceived social pressures, therapy-related factors, transitioning responsibility, risk-taking behaviors, and pubertal changes. Conclusions: Navigating the adaptations to the different aspects of T1D, from treatment to complications and adolescents' personal growth, effectively requires a thorough understanding of the barriers of a treatment regimen that patients at this critical age face.

Bullying among children with heart conditions, National Survey of Children's Health, 2018-2020

Children with chronic illnesses report being bullied by peers, yet little is known about bullying among children with heart conditions. Using 2018-2020 National Survey of Children's Health data, the prevalence and frequency of being bullied in the past year (never; annually or monthly; weekly or daily) were compared between children aged 6-17 years with and without heart conditions. Among children with heart conditions, associations between demographic and health characteristics and being bullied, and prevalence of diagnosed anxiety or depression by bullying status were examined. Differences were assessed with chi-square tests and multivariable logistic regression using predicted marginals to produce adjusted prevalence ratios and 95% confidence intervals. Weights yielded national estimates. Of 69,428 children, 2.2% had heart conditions. Children with heart conditions, compared to those without, were more likely to be bullied (56.3% and 43.3% respectively; adjusted prevalence ratio [95% confidence interval] = 1.3 [1.2, 1.4]) and bullied more frequently (weekly or daily = 11.2% and 5.3%; p < 0.001). Among children with heart conditions, characteristics associated with greater odds of weekly or daily bullying included ages 9-11 years compared to 15-17 years (3.4 [2.0, 5.7]), other genetic or inherited condition (1.7 [1.0, 3.0]), ever overweight (1.7 [1.0, 2.8]), and a functional limitation (4.8 [2.7, 8.5]). Children with heart conditions who were bullied, compared to never, more commonly had anxiety (40.1%, 25.9%, and 12.8%, respectively) and depression (18.0%, 9.3%, and 4.7%; p < 0.01 for both). Findings highlight the social and psychological needs of children with heart conditions.

The effects of COVID-19 risk, gender, and self-compassion on the workplace cyberbullying and job satisfaction of university faculty

The purpose of this study is to examine workplace cyberbullying (WPCB) in higher education. Specifically, the study examines the relationship between WPCB and several important factors such as self-compassion, job satisfaction, and gender. The cross-sectional study administered a survey to a convenience sample of 179 faculty members. The regression model showed that self-compassion was positively related to job satisfaction, whereas WPCB was negatively related to job satisfaction after controlling for covariates. The path analysis model results showed that gender and COVID-19 risk of severe illness were related to WPCB. Additionally, self-compassion mediated the inverse relationship between WPCB and job satisfaction.

Emotional problems and peer victimization in adolescents born very preterm and full-term: Role of self-control skills in childhood

The aim of the current study was to examine whether self-control skills in childhood moderate the association between very preterm birth (<32 weeks of gestational age) and emotional problems and peer victimization in adolescence. We used data from four prospective cohort studies, which included 29,378 participants in total (N = 645 very preterm; N = 28,733 full-term). Self-control was mother-reported in childhood at 5-11 years whereas emotional problems and peer victimization were both self- and mother-reported at 12-17 years of age. Findings of individual participant data meta-analysis showed that self-control skills in childhood do not moderate the association between very preterm birth and adolescence emotional problems and peer victimization. It was shown that higher self-control skills in childhood predict lower emotional problems and peer victimization in adolescence similarly in very preterm and full-term borns.

Improving visual outcomes in patients with rare paediatric eye diseases

Introduction

Rare paediatric eye diseases (RPEDs) threaten both vision and life. Recently, rare diseases were recognised as a global public health agenda, with children specified as a priority in the World Health Organization's VISION 2020 against avoidable visual loss.

Method

We conducted a review through a query of online databases (PubMed, Embase and Cochrane Library). Articles related to RPEDs were selected based on relevance by 2 authors, with any disagreements adjudicated by the third author.

Results

We synthesise the current state of knowledge regarding RPEDs, barriers to their care, and recommendations for the future. RPEDs often result in significant visual loss, profoundly impacting the way children comprehend and participate in the world. These diseases may also reduce life expectancy and even be life-threatening. Barriers to the care of RPEDs include an unclear definition of "rare diseases", missed or delayed diagnosis, inadequate knowledge and expertise in management, and challenging research environments.

Conclusion

Our findings provide an update on the diagnosis and management of RPEDs, which is of relevance to ophthalmologists, paediatricians, healthcare policymakers and social workers. We propose supportive policies and adequate resource allocation to these diseases, comprehensive and patient-centred care, alongside improved education and training, enhanced research capabilities and continued collaboration across institutions.

Chronic health conditions and school experience in school-aged children in 19 European countries

This study investigates chronic conditions (CC) prevalence among children in mainstream schools, their school experience and life satisfaction in Europe. Data were collected from the 2017/2018 HBSC survey, a cross-national study using self-reported questionnaires administered in classrooms. Nationally representative samples of children aged 11, 13, and 15 years in mainstream schools from 19 European countries (n = 104,812) were used. School experience was assessed using four variables: low school satisfaction, schoolwork pressure, low teacher support, and peer-victimization, which were related to life satisfaction. Latent class analysis (LCA) was conducted to identify patterns of school experience among students with CC. The prevalence of CC varied from 8.4 (Armenia) to 28.2% (Finland). Children with CC (n = 17,514) rated their school experience and life satisfaction lower than children without CC. LCA identified three school experience patterns: "negative on all items" (37%), "negative on all items, except school pressure" (40%) and "overall positive" (23%). The distribution of subgroups varied across countries-in countries with a higher proportion of children with CC in mainstream schools, children reported more negative school experiences. Compared to the "overall positive" group, low life satisfaction was highest for students classified as "negative on all items" (relative risk (RR) = 2.9; 95% CI 2.2-3.8) with a lesser effect for "negative on all items, except school pressure" (RR) = 1.8; 95% CI 1.4-2.4). These findings provide cross-national data documenting the diversity in inclusive educational practices regarding school placement and school experiences, and suggest that efforts are still needed to allow a fully inclusive environment.

The Impact of Cybervictimization on the Self-Management of Chronic Conditions: Lived Experiences

BACKGROUND

Cybervictimization of people with long-term conditions is a disturbing phenomenon with a documented impact on health and well-being. These experiences are primarily examined using quantitative methods, focusing on children and young people. However, research centered on the cybervictimization of adults with chronic conditions is scarce, with limited qualitative input from the victims as experts in their own experiences.

OBJECTIVE

This study aims to understand the impact of cybervictimization on the self-management of long-term conditions among adults with chronic conditions and disabilities in the United Kingdom.

METHODS

This paper reports the findings from the qualitative phase of a phenomenologically informed mixed methods study. The biographical disruption concept was used to conceptualize the study. In-depth semistructured interviews were conducted with 13 participants with chronic conditions who experienced cybervictimization. A codebook was developed, and a zigzag approach to thematic analysis was used to define and refine themes. Ethical considerations and risk assessment were ongoing during the research process because of the sensitivity of the topic and cases of harassment.

RESULTS

Cybervictimization has direct and indirect impacts on the self-management of chronic conditions. This impact was verified across 6 overarching themes that emerged from this study. First, biomedical events included overall health deterioration because of existing conditions, new diagnoses, and subjective physical complaints. Second, the impact on mental health was perceived through psychological consequences and psychiatric disorders that developed after or during this traumatic experience. Third, the multilevel impact theme focused on disrupting the strategies for coping with health conditions and involved unplanned changes to victims' health management priorities. Fourth, the impact of complexity reflected the perceived uniqueness in each case, intersectionality, struggle to obtain formal support, and subsequent health complications. Fifth, social network involvement comprised the effects of social isolation, victim blaming, and deception. Finally, the disability discrimination theme focused on prejudice, issues on inclusion, and hostility in society, with subsequent effects on well-being.

CONCLUSIONS

People with long-term conditions experienced different forms of cybervictimization, all disruptive with various effects on health. Disability discrimination was a prominent finding to be further investigated. This paper reports the impact as themes to guide further research and practice, with the recognition that long-term conditions and impairments are not a homogeneous group. Despite the devastating consequences, there are positive points that strengthen potential interventions. Awareness-raising campaigns, training of support channels, and multidisciplinary research are recommended to tackle this issue and initiate change.

Life satisfaction in the context of the COVID-19 pandemic among middle school adolescents in France: findings from a repeated cross-sectional survey (EnCLASS, 2012-2021)

Background and aims

Since the COVID-19 pandemic, several studies have reported a decrease in adolescents' well-being. We aim to describe life satisfaction over the last decade and examine the factors associated with its variations between 2020 and 2021 among French students in their last year of middle school (around 14-15 years old).

Methods

Data were drawn from a repeated biennial cross-sectional national survey conducted in French schools over the last decade (EnCLASS study), using a self-administered questionnaire. After describing life satisfaction trends between 2012 and 2021 using the Cantril ladder, we examined individual changes in life satisfaction between 2020 and 2021 and their associations with housing and studying conditions during the COVID-19 lockdown, using multinomial logistic regression analysis (decrease, increase, no change as reference).

Results

Among the 17,686 survey respondents, an overall slight decrease in the prevalence of adolescents reporting high life satisfaction (i.e., Cantril score ≥6) was observed since 2012 with the lowest proportion reported in 2021 (77.4%). Between 2020 and 2021, 16.3% of French adolescents experienced an improvement in life satisfaction, while 17.7% experienced the opposite. Decrease in life satisfaction between 2020 and 2021 was more likely experienced by adolescents living in reconstructed families [aOR 2.09 (95%CI, 1.58-2.77)], those who did not have their own room [aOR 1.58 (1.16-2.15)], nor access to the Internet to interact with their friends during the lockdown [aOR 1.47 (1.09-1.98)]. Interestingly, more girls than boys were represented in both those reporting increase and decrease in life satisfaction [aOR 1.82 (1.40-2.37) and 1.43 (1.14-1.79), respectively].

Conclusions

This study shows that the way adolescents experienced the first 2020 lockdown in France was not uniform, and that one must consider sex as well as housing and studying conditions when interpreting adolescents' life satisfaction decrease during the COVID-19 pandemic.

Associations between peer experiences and health outcomes among adolescents and young adults with asthma

OBJECTIVE

Although peer relationships become increasingly important across adolescence and early adulthood, research examining links between peer relationships and the health outcomes of young people with asthma is scarce. Using a large sample of adolescents and young adults (AYAs) with asthma, the current study assessed whether positive and negative peer experiences are associated with AYAs' asthma control, asthma self-efficacy, and internalizing symptoms.

METHODS

In this cross-sectional study, a national sample of 440 diverse adolescents and young adults with asthma completed an online survey. Questionnaires assessed general and asthma-specific peer experiences (i.e. peer victimization; peer support; asthma-related peer problems) and health indicators (i.e. asthma control; asthma self-efficacy; internalizing symptoms). Regression analyses were performed to examine associations between peer experiences and health while controlling for participant age, gender, race/ethnicity, and age of asthma diagnosis.

RESULTS

Results from separate regression models indicated that adolescents who experienced greater peer victimization, less peer support, and more asthma-related peer problems also reported worse asthma control, lower asthma self-efficacy, and more severe internalizing symptoms. Follow-up exploratory analyses indicated that peer victimization and asthma-related peer problems were the strongest predictors of asthma control and internalizing, whereas peer support and asthma-related peer problems were the strongest predictors of asthma self-efficacy.

CONCLUSIONS

This study underscores connections between peer relationships and health outcomes among AYAs with asthma. Interventions that leverage peer support and mitigate peer stress may offer a developmentally appropriate approach for mitigating physical and psychological distress among adolescents and young adults with asthma.

Cybervictimization of Adults With Long-term Conditions: Cross-sectional Study

BACKGROUND

People living with chronic conditions and disabilities experience harassment both offline and on the web. Cybervictimization is an umbrella term for negative web-based experiences. It has distressing consequences on physical health, mental well-being, and social relationships. These experiences have mostly been documented among children and adolescents. However, the scope of such experiences is not well documented among adults with long-term conditions, and the potential impact has not been examined from a public health perspective.

OBJECTIVE

This study aimed to examine the scope of cybervictimization among adults living with long-term conditions in the United Kingdom and the perceived impact on self-management of chronic conditions.

METHODS

This paper reports the findings of the quantitative phase of a mixed methods study in the United Kingdom. This cross-sectional study targeted adults aged ≥18 years with long-term conditions. Using a web-based link, the survey was shared on the web via 55 victim support groups, health support organizations, and social media accounts of nongovernmental organizations and activists such as journalists and disability campaigners. People with long-term conditions were asked about their health conditions, comorbidities, self-management, negative web-based experiences, their impact on them, and support sought to mitigate the experiences. The perceived impact of cybervictimization was measured using a set of questions on a Likert scale, frequency tables, and the Stanford Self-Efficacy for Managing Chronic Diseases Scale. Demographic data and the impact on self-management were cross-tabulated to identify the demographic characteristics of the targeted individuals and potential conditions with complications and highlight directions for future research.

RESULTS

Data from 152 participants showed that almost 1 in every 2 adults with chronic conditions was cybervictimized (69/152, 45.4%). Most victims (53/69, 77%) had disabilities; the relationship between cybervictimization and disability was statistically significant (P=.03). The most common means of contacting the victims was Facebook (43/68, 63%), followed by personal email or SMS text messaging, each accounting for 40% (27/68). Some participants (9/68, 13%) were victimized in web-based health forums. Furthermore, 61% (33/54) of victims reported that experiencing cybervictimization had affected their health condition self-management plan. The highest impact was on lifestyle changes such as exercise, diet, avoiding triggers, and avoiding excessive smoking and alcohol consumption. This was followed by changes to medications and follow-ups with health care professionals. Most victims (38/55, 69%) perceived a worsened self-efficacy on the Self-Efficacy for Managing Chronic Diseases Scale. Formal support was generally rated as poor, with only 25% (13/53) of victims having disclosed this experience to their physicians.

CONCLUSIONS

Cybervictimization of people with chronic conditions is a public health issue with worrying consequences. This triggered considerable fear and negatively influenced the self-management of different health conditions. Further context- and condition-specific research is needed. Global collaborations to address inconsistencies in research are recommended.

Exploring the linkage between family financial struggle and children's bullying victimization: Implications for nursing and psychotherapeutic practices

PURPOSE

A few studies have found that children whose families are economically disadvantaged and financially struggling are at an elevated risk of victimization by their peers. However, extant research is largely descriptive. To address this gap, this study empirically tested the proposed pathways from family financial struggle to children's bullying victimization, including the role of barriers to healthcare access in this association using a nationally representative sample.

DESIGN AND METHODS

The study utilizes the 2016 National Survey of Children's Health, a survey of a cross-sectional, weighted probability sample of US children (ages 0-17 years) living in 50 states and the District of Columbia, and their caregivers. The sample used for the current study included 14,374 racially and ethnically diverse caregivers of children, aged 6-11 years.

RESULTS

Positive significant associations between family financial struggle and children's bullying victimization, and between financial struggle and barriers to healthcare access were found. Barriers to healthcare access mediated the association between family financial struggle and bullying victimization.

PRACTICE IMPLICATIONS

Given the documented effects of bullying victimization on children, findings point to the importance of developing psychotherapeutic practices that are appropriate for children who are flagged as "high-risk."

Bullies, victims, and meanies: the role of child and classmate social and emotional competencies

This study used a personal oriented approach to identify distinct combinations of children’s experiences of bullying and victimisation in the Irish primary school context. The study investigated the social and emotional characteristics that predicted those profiles at individual and classroom levels. The sample of 2,062 participants was drawn from the Irish national cohort study Children’s School Lives. We analysed teacher reports of individual children’s strengths and difficulties and neglect, and child reports of experiences of bullying, victimisation, and care from classmates. Latent profile analysis revealed five main profiles of bullying and victimisation in Irish primary schools. Approximately 40% of the children were distributed in the atypical profiles (i.e., bullies, meanies, victims, and bully-victims) with the other 60% of children reporting very low levels of bullying and victimisation. Multilevel modelling predicted the profile membership from a set of social and emotional predictors from individual and classroom levels. At the individual level, being a bully was predicted by higher child neglect, hyperactivity, conduct problems, and peer problems; being a meanie was predicted by hyperactivity, peer problems, and less caring classmates; being a victim was predicted by child neglect, conduct problems, and less caring classmates; and being a bully-victim was predicted by conduct problems and less caring classmates. At the classroom level, being a victim was predicted by being in a classroom comprised of younger children, and in classrooms where children were less caring on average. Theoretical and psycho-educational implications are discussed.

The association between violent video game exposure and sub-types of school bullying in Chinese adolescents

BACKGROUND

School bullying among adolescents has been a worldwide public health issue. It has been observed that adolescents who are exposed to violent video games (VVGs) are often more aggressive. However, research on the association between violent video game exposure (VVGE) and different types of school bullying is limited in the Chinese context.

OBJECTIVE

The purpose of this study was to explore whether VVGE is linked to school bullying behaviors among Chinese adolescents and to examine the relationship between different levels of violent game exposure and four sub-types (physical, verbal, relational, and cyber) of school bullying involvement.

METHODS

This was a cross-sectional study of 1,992 Chinese students (55.02% boys and 44.98% girls) with the average age of 15.84 ± 1.62 years. Sub-types of school bullying victimization and perpetration, Internet addiction, and VVGE were measured by using a self-administrated questionnaire. The association was examined by multiple logistic regression analysis, adjusting for covariates.

RESULTS

Physical, verbal, relational, and cyber school bullying victimization were reported by 18.12, 60.34, 11.75, and 12.05% of the adolescents, and physical, verbal, relational, and cyber school bullying perpetration were reported by 16.62, 54.62, 21.49, and 8.23% of them. Of the students, 1,398 (70.18%) were normal Internet users, 514 (25.80%) showed moderate Internet addictive behaviors, and 31 (1.56%) of the students showed severe Internet addictive behaviors. The prevalence of no VVGE, low-level VVGE, medium-level VVGE, and high-level of VVGE were 27.70, 24.10, 24.20, and 24.00%, respectively. The risk of physical victimization and physical perpetration significantly increased with the increasing degree of violent video game exposure (P for trend < 0.001), with the highest adjusted odds ratios (ORs) of 2.251 (95% CI 1.501-3.375) and 2.554 (95% CI 1.685-3.870), when comparing high-level VVGE with no VVGE.

CONCLUSION

These findings highlight the specific association between different sub-types of school bullying involvement and violent video game exposure. Physical school bullying prevention and intervention programs should be conducted after adolescents are exposed to violent video games.

The Prevalence of Bullying Among Pediatric Orthopaedic Patients

BACKGROUND

Bullying is destructive and pervasive. Although the literature suggests children with chronic health conditions are at higher risk of being bullied, there is minimal research regarding the prevalence of bullying among children with orthopaedic conditions. Our study aimed to assess the prevalence of bullying among pediatric orthopaedic outpatients and evaluate the association of orthopaedic conditions and use of orthopaedic devices with perceptions of bullying.

METHODS

Patients in outpatient pediatric orthopaedic clinics, ages 10 to 17 and their parents were surveyed using the Child-Adolescent Bullying Scale-9. Basic demographic, information about the child's orthopaedic condition, and parent's perception of their child being subject to bullying were also collected. Children were asked if they had used any orthopaedic devices in the last 3 months, whether they were bullied because of their device, and if bullying affected their compliance with device use. The analysis utilized a t test or analysis of variance to compare mean Child-Adolescent Bullying Scale-9 scores across different groups.

RESULTS

Among the 198 patients surveyed, 61% (N=121) perceived no-to-minimal exposure to bullying, 36% (N=72) moderate exposure, and 3% (N=5) severe exposure. Children ages 10 to 13 (N=100) and children ages 14 to 17 (N=98) reported similar rates of bullying (P=0.97). Higher rates of moderate to severe bullying were reported by patients with foot deformity (80%), multiple orthopaedic diagnoses (55%), chronic pain (39%), fracture/acute injury (37%), and scoliosis (33%). Moderate to severe bullying was reported by 37% of patients who wore a cast, 40% who wore a brace/orthotic, and 52% who used multiple orthopaedic devices. Parental concern that their child was being bullied was highly correlated with their child's bullying score (P=0.0002).

CONCLUSIONS

More than one third of our pediatric orthopaedic outpatients (39%) experience moderate to severe levels of bullying, which is higher than the general population's reported rates of 20% to 35%. Exposure to bullying may be higher in certain diagnoses or with use of certain orthopaedic devices. Further research is needed to delineate who is at highest risk.

LEVEL OF EVIDENCE

Level IV.

The Characteristics of Targets of Bullying Among Chinese Youth Attending Key Versus Non-Key Schools: A Mixed-Methods Analysis

The current study examined the characteristics of targets of bullying using a sample of students from two distinct school types (key vs. non-key), wherein key middle schools are defined as having better teaching resources and higher performing students than non-key middle schools. Open-ended, self-report surveys were collected from 322 Chinese students in sixth to 11th grades. Two cycle coding methods analyses generated 3,566 original codes in which 21 main categories and 77 subcategories were extracted. Five major themes emerged: multiple deviant personalities; prominent puniness and imperfect body characteristics accompanied by polarization of appearance; polarization school engagement and academic performance; psychological and behavioral problems; and problematic family and social contexts. Results of chi-square analysis indicated characteristics of targets of bullying were significantly different between key and non-key school in 12 main categories. Implications for ecological systems theory and person-group dissimilarity theory as well as bullying prevention approaches in schools are discussed.

Stigma Moderates the Relation Between Peer Victimization, Thwarted Belongingness, and Depressive Symptoms in Youth with Inflammatory Bowel Disease

PURPOSE

The stigmatizing nature of IBD symptoms may place youth at risk for being targets of peer victimization, potentially resulting in a decreased sense of social belongingness and poorer emotional adjustment. The present study tested a series of mediation and moderated mediation models examining the associations among peer victimization, thwarted social belongingness, and depressive symptoms, as well as the moderating role of IBD stigma in these associations. We hypothesized peer victimization would have an indirect effect on youth depressive symptoms through thwarted belongingness, and this effect would be amplified for youth endorsing greater IBD stigma.

DESIGN AND METHODS

Seventy-five youth (10-18 yrs.) diagnosed with IBD were recruited from a pediatric gastroenterology clinic. Participants completed self-report measures of IBD stigma, peer victimization, thwarted belongingness, and depressive symptoms.

RESULTS

As anticipated, mediation analyses revealed a significant peer victimization → thwarted belongingness → depressive symptoms indirect path. Moderated mediation analyses indicated that this indirect effect was moderated by IBD stigma and was significantly greater among youth reporting higher IBD stigma.

CONCLUSIONS

Youth who experience higher levels of IBD-related stigma are at increased risk for depressive symptoms as a function of the socially isolating effects of peer victimization.

PRACTICE IMPLICATIONS

Our findings highlight the need for routine screening and identification of the socioemotional challenges faced by youth with IBD. Clinical interventions that incorporate coping strategies aimed at minimizing youths' stigmatizing self-perceptions and improving overall social skills and social engagement may lessen the negative impact of peer victimization on youths' social and emotional adjustment.

Caregiver's difficulty paying child's healthcare bills and bullying victimization of adolescents with physical disabilities

Guided by the ecological systems perspective, the objective of the study was to examine whether caregivers' difficulty paying their child's health-care bills is associated with bullying victimization directly and indirectly through the mediating mechanisms of caregivers' frustration, adolescents' internalizing problems, and social difficulty focusing on adolescents with physical disabilities. The 2019 National Survey of Children's Health dataset, which collected data on adolescents' and caregivers' demographic characteristics and health and well-being, was used. The study sample consisted of 368 caregivers of adolescents, 12-17 years of age with physical disabilities. No direct association between caregivers' difficulty paying their child's health-care bills and bullying victimization was found. However, caregivers' frustration and adolescents' internalizing problems were shown to have an indirect association with bullying victimization, which was mediated by difficulty making friends. In addition, adolescents' difficulty making friends was positively associated with bullying victimization. Practitioners working with adolescents with physical disabilities are encouraged to foster collaborative processes across various ecological systems of the adolescent and family to address caregivers' frustration and promote positive social and emotional development of the adolescent with physical disabilities, which can decrease their risk of bullying victimization.

Coeliac disease is associated with depression in children and young adults with type 1 diabetes: results from a multicentre diabetes registry

AIMS

To analyse the association between coeliac disease (CD) and depression in children, adolescents, and young adults with type 1 diabetes (T1D).

METHODS

We included 79,067 T1D patients aged 6-20 years, with at least six months of diabetes duration, and treatment data between 1995 and 2019 were documented in the diabetes patient follow-up registry. We categorized patients into four groups: T1D only (n = 73,699), T1 + CD (n = 3379), T1D + depression (n = 1877), or T1D + CD + depression (n = 112).

RESULTS

CD and depression were significantly associated (adjusted OR: 1.25 [1.03-1.53]). Females were more frequent in both the depression and the CD group compared with the T1D only group. Insulin pumps were used more frequently in T1D + CD and T1D + depression compared with T1D only (both p < .001). HbA1c was higher in T1D + depression (9.0% [8.9-9.0]), T1D + CD + depression (8.9% [8.6-9.2]), both compared with T1D only (8.2% [8.2-8.2], all p < .001). We found comorbid autism, attention deficit hyperactivity disorder, anxiety, schizophrenia, and eating disorders more frequently in the T1D + CD + depression group compared with T1D only (all p < .001).

CONCLUSIONS

CD and depression are associated in young T1D patients. The double load of T1D and CD may lead to an increased risk for depression. Depression was associated with additional psychological and neurological comorbidities. Aside from imperative CD screening after T1D diagnosis and regular intervals, depression screening might be helpful in routine care, especially in patients with diagnosed CD.

Creating Learning Environments Free of Violence in Special Education Through the Dialogic Model of Prevention and Resolution of Conflicts

Violence suffered by children is a violation of human rights and a global health problem. Children with disabilities are especially vulnerable to violence in the school environment, which has a negative impact on their well-being and health. Students with disabilities educated in special schools have, in addition, more reduced experiences of interaction that may reduce both their opportunities for learning and for building protective social networks of support. This study analyses the transference of evidence-based actions to prevent violence in schools - the dialogic model of prevention and resolution of conflicts (DMPRC) - in the context of a special school, and its impact on the reduction of violence, the creation of egalitarian relationships, and the prevention of bullying. A case study with a communicative approach was conducted including in-depth interviews and communicative focus groups with the diverse participants to analyze the process of transformation carried out in the school and the main actions that give students a voice in the management and creation of egalitarian non-violent relationships. The results show that the inclusion of the students' voices in the resolution and prevention of conflicts reduces violence, empowers special education students, strengthens friendship relationships, caring behavior, and active positioning among the community. The positive impact of the transference of the DMPRC to special schools contributes to students' well-being and healthy development by offering safe and protective educational spaces and quality emotional education, also contributing to the achievement of the Sustainable Development Goals related to the elimination of all forms of violence in childhood.

What Do We Know about Bullying in Schoolchildren with Disabilities? A Systematic Review of Recent Work

Bullying is a serious problem that particularly affects schoolchildren with disabilities. However, studies in this group have been carried out on smaller cohorts and the results obtained are, therefore, less representative and sometimes inconclusive. The purpose of this paper is to perform a systematic review of the work carried out in recent years, including the analysis of several variables related to the sample, the methodology applied and the type of bullying. The guidelines set down by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement were followed in three phases. The total sample consisted of 55 children who fulfilled the inclusion criteria. The results reveal that half the studies were conducted in cohorts of less than 250 schoolchildren and drew no distinctions between the different types of disabilities. Furthermore, there is no consensus regarding the methodology used, and no specialized instruments were used. Hardly any specific interventions have been performed into the type of bullying investigated, in which victimization is the predominant mode. We concluded that there is an urgent need to increase the number of studies, including a larger number of individuals and using specialized instruments, in order to obtain more solid results. Such studies will allow us to create specific prevention and intervention programs to address the bullying of schoolchildren with disabilities.

Efficacy of a Web-Enabled, School-Based, Preventative Intervention to Reduce Bullying and Improve Mental Health in Children and Adolescents: Study Protocol for a Cluster Randomized Controlled Trial

Introduction: Bullying is a major preventable risk factor for mental disorders. Available evidence suggests school-based interventions reduce bullying prevalence rates. This study aims to test the efficacy of a web-enabled, school-based, multicomponent anti-bullying intervention to prevent school bullying and to assess its effects on mental health and quality of life. Methods and analysis: Cluster randomized controlled trial conducted in 20 publicly funded primary and secondary schools in Madrid, Spain. Schools are randomly allocated to either the intervention arm (n = 10) or conventional practices arm (n = 10). The web-enabled intervention (LINKlusive) lasts ~12 weeks and consists of three main components: (i) an online training program for teachers and parents, (ii) a web-guided educational program for students, focusing on promoting respect for diversity, empathy, and social skill development, and (iii) a web-guided, teacher-delivered, targeted intervention program for bullying situations identified based on peer-support strategies and individual intervention for those involved (i.e., bullying victims and perpetrators). The primary objective is to compare differences between peer-reported bullying victimization in the intervention and control arms at the end of the intervention. Secondary outcome measures are additional measures of bullying victimization and perpetration, mental health symptoms, self-esteem, and quality of life. A follow-up assessment is conducted 1 year after the end of the intervention. Treatment effects will be tested using multilevel mixed models, adjusting for school-, classroom-, and student-related covariates. Considering the increased bullying rates in children with special educational needs, a specific subgroup analysis will test the efficacy of the intervention on bullying prevalence, mental health, and quality of life in this particularly vulnerable population. Ethics and Dissemination: The Deontology Commission of the School of Psychology, Universidad Complutense in Madrid, Spain reviewed the study protocol and granted ethical approval on 21st January 2019. The results of the trial will be disseminated in relevant peer-reviewed journals and at conferences in the field. Trial Registration Number: ISRCTN15719015.

Blockchain and IoMT against Physical Abuse: Bullying in Schools as a Case Study

By law, schools are required to protect the well-being of students against problems such as on-campus bullying and physical abuse. In the UK, a report by the Office for Education (OfE) showed 17% of young people had been bullied during 2017–2018. This problem continues to prevail with consequences including depression, anxiety, suicidal thoughts, and eating disorders. Additionally, recent evidence suggests this type of victimisation could intensify existing health complications. This study investigates the opportunities provided by Internet of Medical Things (IoMT) data towards next-generation safeguarding. A new model is developed based on blockchain technology to enable real-time intervention triggered by IoMT data that can be used to detect stressful events, e.g., when bullying takes place. The model utilises private permissioned blockchain to manage IoMT data to achieve quicker and better decision-making while revolutionising aspects related to compliance, double-entry, confidentiality, and privacy. The feasibility of the model and the interaction between the sensors and the blockchain was simulated. To facilitate a close approximation of an actual IoMT environment, we clustered and decomposed existing medical sensors to their attributes, including their function, for a variety of scenarios. Then, we demonstrated the performance and capabilities of the emulator under different loads of sensor-generated data. We argue to the suitability of this emulator for schools and medical centres to conduct feasibility studies to address sensor data with disruptive data processing and management technologies.

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

OBJECTIVE

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

DESIGN

This study is a qualitative mixed study.

PARTICIPANTS

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

FINDINGS

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

IMPLICATION FOR PSYCHOSOCIAL PROVIDERS

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

Adolescents with asthma reported more peer victimization, more anger repression, and less anger expression

Objective: The aim of this study was to investigate the peer victimization and anger expression in adolescents with asthma. The relationship between asthma control and psychological features was also examined.Methods: The study was a cross-sectional study with a healthy control group. The sample of the study was composed of 61 adolescents who were previously diagnosed by a physician with asthma of various intensities. Sixty adolescents with no chronic disorders were enrolled as the control group. Peer victimization was examined using the Multidimensional Peer Victimization Scale (MPVS). The State-Trait Anger Expression Inventory (STAXI) was used to assess anger expression styles. Emotional and behavioral symptoms of the adolescents were measured using the Strengths and Difficulties Questionnaire (SDQ).Results: Adolescents with asthma reported more peer victimization in the subscales of physical, social, verbal, attacks on property, and frightening in the MPVS; and having more problems in emotional, social, and peer relations areas in the SDQ (p < .001 for all subscales) compared to the control group. The results were similar between the groups regarding the conduct problems and hyperactive behaviors. The adolescents with asthma reported more anger repression and less anger expression than the control group (p < .001 for both subscales).Conclusions: The results indicated that the adolescents with asthma were subjected to more peer victimization and experienced more difficulties in anger expression than the controls. Based on the findings of this study, we suggest that these psychological factors should be kept in mind during the management of asthma in adolescents.

Preliminary Study on Psychometric Properties of an Anxiety Scale in Down Syndrome with Anxiety Symptoms

BACKGROUND

anxiety remains one of the most common disorders in typically developing children and young adults. Adolescents with Down syndrome (DS) lack diagnostic tests for evaluation.

METHODS

this study evaluated the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders inventory in its self-report version in 63 adolescents with anxiety symptoms with DS. The inclusion criteria for the studies were trisomy 21 and a chronological age between 8 and 17 years. Psychometric properties arestrictly evaluated with the sample exceeding a cutoff point in anxiety symptomatology. A confirmatory factorial analysis tested two models for the new evaluation test.

RESULTS

both models confirmed a four-factor structure (somatic/panic, social phobia, generalized anxiety, and separation anxiety). Model 2, nevertheless, had fewer items and a better fit, and it also showed a high correlation with other anxiety detection measures and adequate internal consistency.

CONCLUSIONS

the importance of validating psychopathological anxiety tests for children and young people with DS in order to build good mental health is discussed, emphasizing the need to provide easy and short-term tests on cognitive and emotional aspects in people with intellectual disabilities.

Relationship between bullying and type 1 diabetes mellitus in children and adolescents: a systematic review

OBJECTIVE

To carry out a systematic review on the relationship of bullying with type 1 diabetes in children and adolescents.

METHODS

Systematic review, according to the PRISMA methodology, in which the databases PubMed, Web of Science, Scopus, Thomson Reuters, Eighteenth Century Collections Online, Begell House Digital Library, LILACS, and SciELO were searched using the terms "bullied", "aggression", "peer victimization", "victimization", "school violence", "diabetes mellitus", "type 1 diabetes mellitus", "autoimmune diabetes", "children" and "adolescents." The authors included original studies, involving bullying associated with type 1 diabetes, with children and adolescents, without language restriction and publication period, with texts available in full.

RESULTS

Of the 32 articles found, four studies met the selection criteria. Of these studies 85.7% identified occurrence of victimization in diabetics or found a higher frequency in diabetic children and adolescents when compared with young people with other chronic conditions or with healthy peers. Association between bullying and worse glycemic control was observed in two studies, and all the studies mention the fact that type 1 diabetes is a limiting factor for socialization related to diabetes, with less social support and difficulties for the management of the disease in public environments, such as school. The type of bullying suffered varied, including physical, verbal, social, psychological, and sexual.

CONCLUSION

Most of the studies showed an association between bullying and type 1 diabetes when compared to individuals with no such condition. Knowledge of this association has become essential for the follow-up of these patients and the implementation of preventive programs.

Cyber-Victimization of People With Chronic Conditions and Disabilities: A Systematic Review of Scope and Impact

The victimization of individuals with chronic conditions or disabilities is prevalent with severe impact at psychological and physiological levels. With the increasing use of technology these experiences were further reshaped. This systematic review aimed at scoping the experiences of cyber-victimization of people living with chronic conditions or disabilities and examine the documented impact on them. Following a four-stage search strategy in several databases including MEDLINE, Embase, PsychINFO, CINAHL, Cochrane and snowballing of references, a total of 2,922 studies were scanned and 10 studies were eventually included. Quality assessment was done in two phases using tools specific to observational studies and cyber-victimization research. A narrative synthesis of reported results covered a total of 3,070 people. Sample size ranged between 42 and 823 participants, and the age range was 6-71 years with a majority of White ethnic backgrounds. Most studies (n=9) were cross sectional. The prevalence range of cyber-victimization was 2%-41.7% based on variable definitions, duration and methods. Targeted conditions included physical impairments, intellectual disabilities and specific chronic diseases. The most common documented impact was psychological/psychiatric, mainly depression followed by anxiety and distress. Somatic health complaints and self-harm were also reported. We concluded that people with chronic conditions and disabilities were consistently at higher risk of victimization with devastating health complications. Research gaps were identified such as the need to address more conditions and acknowledge differences between heterogeneous health conditions. Other recommendations include allowing flexibility and accountability to patients/victims in research design, education on victimization and health consequences, and improving primary care.

Victimisation in a French population of children and youths with autism spectrum disorder: a case control study

BACKGROUND

Children and youths with autism spectrum disorder (ASD) have behavioural characteristics and severe social disabilities that make them vulnerable to victimisation. The current study explores the prevalence of peer victimisation in this population in France.

METHODS

We used the Juvenile Victimization Questionnaire-Screener Sum Version in a French sample of 39 children and youths with ASD and 53 typically developing (TD) children and youths and tested the association of the victimisation with socio-demographic factors and clinical factors of anxiety and post-traumatic stress.

RESULTS

The results indicate that 72% of the subjects with ASD had been victimised during the previous year and 94.9% during their entire lifetime. Of all students victimised at least once over the course of their lives, 75% had been victimised at school. Their peer victimisation score was significantly higher than in the TD group and was correlated to clinical factors such as a deficit in social skills and the severity of post-traumatic symptoms. Symptoms of anxiety were reported by parents of children and youths with ASD in 80% of cases.

CONCLUSIONS

Children and youths with ASD are particularly vulnerable to victimisation at school. Discussion focuses on the importance of considering the impacts and needs of school integration of this population in France in order to prevent these phenomena and their consequences.

Improving medication adherence in the pediatric population using integrated care of companion animals

Medication non-adherence occurs in more than half of children with chronic conditions. Unfortunately, most strategies for improving adherence have had limited success in the pediatric population highlighting the need for novel interventions that establish healthy self-management habits for children and adolescents. In this paper we discuss innovative strategies to improve adherence by embedding a medical regimen within a pet care routine, thereby capitalizing on the benefits of a structured habit while providing opportunities for development of autonomy in children and fostering collaborative parent interactions.

Gender, parental education, and experiences of bullying victimization by Australian adolescents with and without a disability

BACKGROUND

This study sought to compare the prevalence of bullying victimization between adolescents with and without a disability and between adolescents with and without borderline intellectual functioning or intellectual disability (BIF/ID). We also sought to assess whether the relationships between either disability or BIF/ID and bullying victimization vary by gender and parental education.

METHODS

The sample included 3,956 12- to 13-year-old adolescents who participated in Wave 5 of the Longitudinal Study of Australian Children. Three indicators of bullying were used: physical bullying victimization, social bullying victimization, and "any bullying victimization." We used Poisson regression to obtain the prevalence risk ratios (PRR) of bullying by disability status adjusting for potential confounders.

RESULTS

In adjusted models, we found evidence that social bullying victimization was more prevalent among adolescents with a disability than those without a disability (PRR 1.29, 95% confidence interval [CI] 1.06-1.42) and between adolescents with BIF/ID than those without (PRR 1.24, 95% CI 1.07-1.44). Adolescents with BIF/ID were also more likely to experience "any bullying victimization"(PRR 1.10, 95% CI 1.00-1.22). Having a disability and living in a family with low parental education were associated with an elevated risk of social bullying victimization BIF/ID.

CONCLUSIONS

Adolescents with disabilities and BIF/ID are at elevated risk of social bullying victimization. School-based antibullying initiatives should concentrate on enhancing the inclusion of adolescents with disabilities, with an emphasis on adolescents from disadvantaged backgrounds.

Well-Being and Resilience in Children With Speech and Language Disorders

PURPOSE

Children with speech and language disorders are at risk in relation to psychological and social well-being. The aim of this study was to understand the experiences of these children from their own perspectives focusing on risks to their well-being and protective indicators that may promote resilience.

METHOD

Eleven 9- to 12-year-old children (4 boys and 7 girls) were recruited using purposeful sampling. One participant presented with a speech sound disorder, 1 presented with both a speech and language disorder, and 9 with language disorders. All were receiving additional educational supports. Narrative inquiry, a qualitative design, was employed. Data were generated in home and school settings using multiple semi-structured interviews with each child over a 6-month period. A total of 59 interviews were conducted. The data were analyzed to identify themes in relation to potential risk factors to well-being and protective strategies.

RESULTS

Potential risk factors in relation to well-being were communication impairment and disability, difficulties with relationships, and concern about academic achievement. Potential protective strategies were hope, agency, and positive relationships.

CONCLUSION

This study highlights the importance of listening to children's narratives so that those at risk in relation to well-being can be identified. Conceptualization of well-being and resilience within an ecological framework may enable identification of protective strategies at both individual and environmental levels that can be strengthened to mitigate negative experiences.

Saúde do escolar: uma revisão integrativa sobre família e bullying

Resumo O “bullying” é um problema de saúde pública e, nesta revisão, objetivou-se avaliar a relação entre o contexto familiar e a ocorrência do fenômeno. Sua contribuição original é a abordagem ampliada sobre esse tipo de violência. Utilizou-se a estratégia SPIDER na construção do estudo que foi guiado pela questão norteadora: qual o papel da família no desenvolvimento, manutenção e prevenção do “bullying”? Foram consultadas as bases PsycInfo e Lilacs, e a biblioteca virtual SciELO, a partir dos cruzamentos 1. “bullying and Family” e 2. “bullying and parents”, e seus correlatos em português e espanhol. A qualidade metodológica dos estudos foi avaliada segundo critérios de nível de evidência. Foram incluídos 27 artigos, publicados entre 2009 e 2013, nos idiomas inglês, espanhol e português, com prevalência de evidências entre forte e moderada. Nos estudos, o delineamento predominante foi o transversal e a maioria não indicou o referencial teórico adotado. Aspectos qualitativos do contexto familiar, características sociodemográficas e experiências de violência em casa foram associados com o envolvimento de escolares em situações de “bullying”. Revelou-se que o “bullying” requer intervenções intersetoriais e são estimuladas investigações com foco não apenas nas características individuais dos estudantes, mas também nos contextos.

Effect of personal characteristics, victimization types, and family- and school-related factors on psychological distress in adolescents with intellectual disabilities

The purpose of this study was to determine the prevalence of bullying victimization among adolescents with intellectual disabilities and the influence of victimization experience on their mental health in Taiwan. Data on 706 adolescents from the 2011 Special Needs Education Longitudinal Study were analyzed. Multivariate regression analysis was applied to variables comprising 7 items of psychological distress, 4 types of bullying victimization, and family-, school-, and peer-related factors. Approximately 70% of the survey respondents had experienced at least one type of victimization, and 44% of them had experienced at least two types of victimization. Exclusion (50%) and verbal bullying (70%) were the most commonly reported types. In addition, exclusion and verbal bullying were found to be significantly associated with psychological distress in these adolescents. Our findings suggest that victimization is a common experience among adolescents with disabilities, and a notable risk factor for the psychological well-being of adolescents with intellectual disabilities. However, a good relationship with parents and peers can relieve psychological distress and its effect on mental health.

Substance misuse and sexual function in adolescents with chronic diseases

Objective:

To evaluate alcohol/tobacco and/or illicit drug misuse in Chronic Diseases (CDs).

Methods:

A cross-sectional study with 220 CDs adolescents and 110 healthy controls including: demographic/anthropometric data; puberty markers; modified questionnaire evaluating sexual function, alcohol/smoking/illicit drug misuse and bullying; and the physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk.

Results:

The frequencies of alcohol/tobacco and/or illicit drug use were similar in both groups (30% vs. 34%, p=0.529), likewise the frequencies of bullying (42% vs. 41%, p=0.905). Further analysis solely in CDs patients that used alcohol/tobacco/illicit drug versus those that did not use showed that the median current age [15 (11–18) vs. 14 (10–18) years, p <0.0001] and education years [9 (5–14) vs. 8 (3–12) years, p <0.0001] were significant higher in substance use group. The frequencies of Tanner 5 (p <0.0001), menarche (p <0.0001) and spermarche (p=0.001) were also significantly higher in patients with CDs that used alcohol/tobacco/illicit, likewise sexual activity (23% vs. 3%, p <0.0001). A trend of a low frequency of drug therapy was observed in patients that used substances (70% vs. 82%, p=0.051). A positive correlation was observed between CRAFFT score and current age in CD patients (p=0.005, r=+0.189) and controls (p=0.018, r=+0.226).

Conclusions:

A later age was evidenced in CDs patients that reported licit/ilicit drug misuse. In CDs adolescent, substance use was more likely to have sexual intercourse. Our study reinforces that these patients should be systematically screened by pediatricians for drug related health behavioral patterns.

Bullying in Brazilian school children: analysis of the National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE

To describe the victimization and bullying practice in Brazilian school children, according to data from the National Adolescent School-based Health Survey and to compare the surveys from 2009 and 2012.

METHODS

This is a cross-sectional study with univariate and multivariate analyzes of the following variables: to have been treated badly by colleagues, to have been bullied and to have bullied other children. The following independent variables were analyzed: age, sex, race/color, type of school, maternal education. Prevalence rates were compared between the editions of 2009 and 2012 of the survey.

RESULTS

Of all the adolescents analyzed, 27.5% have not been treated well by peers at school, with greater frequency among boys (OR = 1.50), at the age of 15 years (OR = 1.29) and 16 (OR = 1.41), public school students (OR = 2.08), black (OR = 1.18) and whose mothers had less education; 7.2% reported having been bullied, with a greater chance in younger students (13 years old), male (OR = 1.26), black (OR = 1.15) and indigenous (OR = 1.16) and whose mothers had less education; 20.8% reported to have bullied other children, with a greater chance for older students, at the age of 14 (OR = 1.08) and 15 years (OR = 1.18), male (OR = 1.87), black (OR = 1.14) and yellow (OR = 1.15), children of mothers with higher education, private school students. There was an increase of bullying in the Brazilian capitals, from 5.4 to 6.8%, between 2009 and 2012.

DISCUSSION

The occurrence of bullying reveals that the Brazilian school context is also becoming a space of reproduction of violence, in which it is crucial to act intersectorally and to articulate social protection networks, aiming to face this issue.

Physical Conditions and Special Needs as Risk Factors of Peer Victimization Among School Children in Taiwan

Students with physical symptoms and diseases may be at an increased risk of peer victimization. This study examined the associations of several medical conditions (obesity, asthma, allergy, epilepsy, and diabetes) with experience of physical, verbal, and relational victimization among children. A sample of 6,233 fourth-grade students from 314 elementary schools in Taiwan was recruited for the analysis. The mean age of the sample was 10.5, with an even distribution of gender (50.3% male and 49.7% female). Children with asthma, allergy, and epilepsy reported higher frequencies of peer victimization. Those who took daily medications or received treatment were also at a higher risk of being victimized. Diabetes and obesity were not found to be associated with peer victimization. The findings highlighted that children with physical conditions suffer maltreatment from peers. Sensitivity training should be provided to school health professionals, so they can evaluate the risk of victimization among students with special needs during assessment.

Bullying in medically fragile youth: a review of risks, protective factors, and recommendations for medical providers

Bullying is a common child and adolescent phenomenon that has concurrent and long-term implications for victims' psychological, psychosomatic, social, and academic functioning. Youth with chronic illnesses are at increased risk for being bullied, but few studies have evaluated specific risk and protective factors for medically fragile youth. Despite recommendations by the American Academy of Pediatrics and the Society for Adolescent Medicine that pediatric health care providers should contribute to bullying prevention and intervention efforts, researchers also have yet to identify the best ways for providers to intervene with medically fragile youth. In this article, the authors review risk and protective factors for bullying among healthy samples. Then, the authors specifically address the ways in which these risk and protective factors are likely to apply to children with fragile medical conditions, and they provide summaries of extant bullying research for selected examples of medically fragile pediatric populations. Finally, the authors present recommendations for intervening with medically fragile youth and suggest several areas in which additional research is needed.

Mental health problems and social resource factors among bullied children in the Nordic countries: a population based cross-sectional study

This study estimated internalising and externalising mental health problems among bullied-, unclear if bullied- and not bullied children aged 4-16 in the Nordic countries, and identified resource factors to bullied children's mental health. Data comes from the cross-sectional NordChild survey 2011 and the Strength and Difficulties Questionnaire, including 6,214 children in the analyses. Mental health problems were most prevalent among children parent-reported as bullied (29.2-44.3 %), followed by children with unclear status if bullied (13.0-25.6 %) and not bullied children (5.3-7.9 %). Externalising problems were more prevalent in all groups except among bullied girls aged 7-16, where internalising problems were more prevalent. Ten potential resource factors to bullied children's mental health were analyzed, finding that (1) children with at least three close friends had higher odds to be mentally healthy than children with fewer close friends and (2) bullied boys had higher odds to be mentally healthy if they regularly practiced sport.

Meta-analytic results of ethnic group differences in peer victimization

Research on the prevalence of peer victimization across ethnicities indicates that no one group is consistently at higher risk. In the present two meta-analyses representing 692,548 children and adolescents (age 6-18 years), we examined ethnic group differences in peer victimization at school by including studies with (a) ethnic majority-minority group comparisons (k = 24), and (b) White and Black, Hispanic, Asian, and Aboriginal comparisons (k = 81). Methodological moderating effects (measure type, definition of bullying, publication type and year, age, and country) were examined in both analyses. Using Cohen's d, results indicated a null effect size for the ethnic majority-minority group comparison. Moderator analyses indicated that ethnic majority youth experienced more peer victimization than ethnic minorities in the US (d = .23). The analysis on multiple group comparisons between White and Black (d = .02), Hispanic (d = .08), Asian (d = .05), Aboriginal (d = -.02) and Biracial (d = -.05) groups indicated small effect sizes. Overall, results from the main and moderator analyses yielded small effects of ethnicity, suggesting that ethnicity assessed as a demographic variable is not an adequate indicator for addressing ethnic group differences in peer victimization. Although few notable differences were found between White and non-White groups regarding rates of peer victimization, certain societal and methodological limitations in the assessment of peer victimization may underestimate differences between ethnicities. Aggr. Behav. Aggr. Behav. 42:149-170, 2015. © 2014 Wiley Periodicals, Inc.

Assessing the bullying and victimisation experiences of children with special educational needs in mainstream schools: Development and validation of the Bullying Behaviour and Experience Scale

Children with special educational needs (SEN) are more likely to experience victimisation at school and there is some evidence to suggest that these children are also more likely to engage in bullying behaviours; however, no measure of bullying experiences has been designed specifically for use with these children. The Bullying Behaviour and Experiences Scale (BBES) was specifically developed as a self-report measure of victimisation and bullying behaviour for children with SEN. This study examines the initial psychometric properties of the BBES using a sample of 348 children (67 of which had SEN, mean age=10 years), and compares the incidence of both victimisation and bullying in children with SEN to their peers, controlling for behavioural and emotional difficulties. Overall, the BBES showed favourable psychometric properties using multi-group confirmatory factor analyses and differential item functioning. Comparing the frequency of victimisation and bullying using the BBES showed that children with SEN were not more likely to experience victimisation compared to their peers but when extant behavioural and emotional difficulties were controlled for then they were significantly more likely to report victimisation. Conversely, children with SEN were more likely to report bullying compared to their peers, but this effect disappeared when extant behavioural and emotional difficulties were controlled. Overall, the BBES appears to be a promising measure of victimisation and bullying for children with SEN. This study also highlights the need to consider SEN status independently of behavioural and emotional problems to help understand the nature and extent of bullying and victimisation in this important population of children.

Peer victimization as a mediator of the relationship between disability status and psychosocial distress

BACKGROUND

Youth with disabilities experience greater levels of peer victimization and psychosocial distress than non-disabled youth. However, the extent to which exposure to peer victimization mediates the relationship between disability status and psychosocial distress is unknown.

OBJECTIVE

To determine whether the relationship between disability status and psychological distress was mediated by exposure to peer victimization, and if so, whether the mediation effects of peer victimization on psychosocial distress was moderated by sex.

METHODS

This cross-sectional study involved a series of regressions to test for mediation and moderated mediation using complex survey data from 6664 Oregon 11th graders.

RESULTS

Peer victimization partially mediated the relationship between disability status and psychosocial distress. Sex, however, did not significantly moderate the mediating effects of peer victimization on psychosocial distress.

CONCLUSION

Exposure to peer victimization mediated the relationship between disability status and psychosocial distress; there was little support for sex as a moderator.

Are students with asthma at increased risk for being a victim of bullying in school or cyberspace? Findings from the 2011 Florida youth risk behavior survey

BACKGROUND

Adolescents with asthma are at risk for psychological and behavioral problems. The aim of this study was to determine whether high school students with asthma are at increased risk for bullying in school and cyberspace, and to explore the role of depressive symptoms in moderating this association.

METHODS

A secondary data analysis was completed with the 2011 Florida Youth Risk Behavior Survey. Participant included a random sample of adolescents in grades 9 through 12 who attended public high schools in Florida. Descriptive and inferential statistics were conducted using SPSS software.

RESULTS

We examined data from 6212 high school adolescents and found a significant relationship between current asthma and cyberbullying in adolescents. Of the sample diagnosed with asthma, 15.6% reported bullying and 17% cyberbullying (versus 10.2% and 11% of nonasthmatics). We further examined data using depressive symptoms as a mediating and moderating variable and found significance on all accounts.

CONCLUSIONS

Adolescents with asthma are at increased risk for being victims of bullying in school and cyberspace. Our findings suggest that adolescents with asthma who also report depressive symptoms are particularly at high risk for bullying than adolescents with asthma who did not report depressive symptoms. Efforts to increase education and decrease all types of bullying at the high school level for both students with and without asthma are warranted.

Factors Associated with the Persistence of Bullying Victimization From 10th grade to 13th Grade: A Longitudinal Study

Background:

Bullying among adolescents represents a major public health challenge. The aim of this study was to map the stability of bullying victimization across the transitional phase from lower to upper secondary school, and to describe the sociodemographic, academic and health-related characteristics of those bullied during the transition.

Method:

3674 Norwegian adolescents were followed longitudinally from the age of 15/16 until the age of 18/19, answering questionnaires about health, academic achievements, life events, lifestyle and sociodemography. The 337 participants reporting exposure to bullying victimization at age 15/16 were the target group, as we made comparisons between those reporting victimization only at the age of 15/16 (n=289) with the participants for whom the bullying had continued into later adolescence (n = 48).

Results:

14% of those victimized at age 15/16, reported continuation of bullying victimization into upper secondary school. These adolescents were significantly more likely to report having divorced parents, low parental educational level, poor self-perceived economy, muscle and skeletal pain, symptoms of mental distress, lower school marks in Norwegian and higher body-mass index (BMI) when group differences at age 18/19 were assessed through basic inferential statistical tests. However, the multivariate logistic regression analyses only revealed statistically significantly increased adjusted odds ratios for the variables mental distress and school-marks in Norwegian.

Conclusion:

The persistence of exposure to bullying from 10th grade to 13th grade is associated with mental health complaints and poor school performance. Preventive measures to take care of students being continuously bullied should be in place in secondary schools.

Differences in Social Vulnerability among Individuals with Autism Spectrum Disorder, Williams Syndrome, and Down Syndrome

Although individuals with disabilities are at increased risk of victimization, few studies examine persons with different disability conditions to determine whether distinctive cognitive-behavioral profiles are associated with different levels of social vulnerability. To determine the differences in social vulnerability and experiences of victimization, caregiver responses to a Social Vulnerability Questionnaire were examined for 103 caregivers of individuals with autism spectrum disorder (ASD), Williams syndrome (WS), and Down syndrome (DS). Although all three groups experienced similar rates and types of victimization, the specific correlates of social vulnerability differed by disability. Individuals with ASD displayed less risk awareness and had less social protection; those with WS were rated higher on risk factors related to perceived vulnerability and parental independence; and those with DS had less risk awareness and were perceived to be more vulnerable. Safety interventions should be tailored to address each group's specific correlates of social vulnerability.

Assessment and management of bullied children in the emergency department

Bullying is an important public health issue in the United States. Up to 30% of children report exposure to such victimization. Not only does it hurt bully victim, but it also negatively impacts the bully, other children, parents, school staff, and health care providers. Because bullying often presents with accompanying serious emotional and behavioral symptoms, there has been an increase in psychiatric referrals to emergency departments. Emergency physicians may be the first responders in the health care system for bullying episodes. Victims of bullying may present with nonspecific symptoms and be reluctant to disclose being victimized, contributing to the underdiagnosis and underreporting of bully victimization. Emergency physicians therefore need to have heightened awareness of physical and psychosocial symptoms related to bullying. They should rapidly screen for bullying, assess for injuries and acute psychiatric issues that require immediate attention, and provide appropriate referrals such as psychiatry and social services. This review defines bullying, examines its presentations and epidemiology, and provides recommendations for the assessment and evaluation of victims of bullying in the emergency department.