"I Didn't Even Know You Cared About That Stuff": Youths' Perceptions of Health Care Provider Roles in Addressing Bullying

They are my worries, so it's me the doctor should listen to-adolescent males' experiences of consultations with general practitioners

BACKGROUND

Many adolescent males visit a general practitioner regularly, yet many report unmet health needs and negative experiences. This indicates a gap between provided healthcare and the needs of adolescent males. In order to improve adolescent males' possibilities to discuss their health concerns with general practitioners, the study's aim was to explore and describe how adolescent males understand and assign meaning to their experiences of consultations with general practitioners.

METHODS

This qualitative study was conducted at two healthcare centres in mid-Sweden in 2022. Nine males 15 to 19 years old described their experiences in semi-structured interviews immediately after consulting a general practitioner, regardless of reason for the consultation and whether or not accompanied by a parent. The analysis was guided by thematic analysis according to Braun & Clarke and reflective lifeworld theory's concepts of openness and sensitivity.

RESULTS

One overarching theme, To be listened to, and three themes were developed: To handle insecurity and uneasiness, To be understood and cared for, and To get parental support on his terms. In a good appointment, the general practitioner cares about him, listens attentively, and takes him seriously. More importantly, the general practitioner's understanding permeates the consultation, so that all aspects of it is adapted to him. The adolescent males doubted their ability to express themselves and to understand what would happen in the consultation, and therefore feared being dismissed without receiving any help. Such difficulties may be due to unfinished neurocognitive development and inexperience. They struggled with embarrassment, partly due to notions of masculinity, and strived to balance their needs of parental support, privacy, and being the one that the doctor listens to.

CONCLUSIONS

We argue that adolescent males are particularly vulnerable due to on-going neurocognitive and emotional development, inexperience, and notions of masculinity. However, good experiences can be generated through rather simple means. Adolescent males need individual adaptations demonstrating that they are cared for, understood and taken seriously. Furthermore, they need an unhurried pace to facilitate understanding, verbal affirmations to mitigate embarrassment, and help in navigating parental involvement.

Surviving Cyberbullying: A Thematic Analysis of Online Videos

The Internet offers a wealth of convenience and nearly unlimited connectivity for sharing news, demonstrating talents, and voicing opinions. However, technology and the cyber world also bring new risks to technology users, including cyberbullying. Adolescents are particularly at risk and it is imperative that the dynamics of cyberbullying be fully explored and effective coping strategies for cyberbullying be identified. This study sought to answer the following questions: 1) How do creators of online videos cope with or manage adolescent cyberbullying victimization? 2) What motivates adolescent victims of cyberbullying to share their stories of victimization in the same place where they were victimized? This study presents the findings of a thematic analysis of 40 video stories of adolescent cyberbullying posted online. Three themes were revealed for coping with cyberbullying victimization: 1) Internalizing Behaviors; 2) Disconnecting; and 3) Needing Support. An additional theme of Offering Support was identified as the motivation for why victims share their stories online and risk additional victimization. These findings have implications for health care professionals in self-reflection, identifying and responding to cyberbullying, and offering support and education to adolescents and their allies.

Cognitive-Behavioral Skills Building to Alleviate the Mental Health Effects of Bullying Victimization in Youth

Bullying is a long-standing problem with relatively few intervention options for individual youth who have experienced it and have adverse mental health concerns. Depression, anxiety, and suicidal ideation are major consequences of bullying victimization. Although few evidence-based interventions have been put forth to address bullying victimization at the individual level, cognitive-behavioral therapy (CBT) and cognitive-behavioral skills building (CBSB) have been well researched for mental health concerns in youth. The purpose of the current article is to examine the theoretical framework of cognitive theory for individuals who have experienced bullying. Previous work that has addressed CBT for bullying interventions is described. Specific examples of how CBSB components could be applied to a bullying intervention program for youth are discussed. Ultimately, providing a theoretical framework to address this public health concern sets the stage for future intervention research. [Journal of Psychosocial Nursing and Mental Health Services, 59(5), 15-20.].

Caring for the Digital Generation: Understanding Electronic Aggression

We live in a technology-saturated world, evidenced by widespread, global use of the Internet and other forms of technology. Technology offers nearly limitless connectivity, information-sharing, and communication. Unfortunately, with these opportunities come risks, especially for children, and pediatric healthcare providers have a responsibility to be aware and informed of these risks and how to respond. This article provides a breakdown of the broad phenomenon of electronic aggression and offers practice implications for healthcare providers.

Childhood Bullying: Screening and Intervening Practices of Pediatric Primary Care Providers

INTRODUCTION

Many adverse outcomes related to childhood bullying are treated in primary care, although little is known about how often providers are screening for, and intervening in, bullying.

METHODS

A descriptive survey on the practices, attitudes, self-confidence, and knowledge of health care providers was sent to pediatric primary care providers in the state of Ohio.

RESULTS

One hundred and two health care providers responded to the survey. More than half of the providers reported screening their patients for bullying. Interventions frequently used were providing counseling to the patient, referring patients to mental health, and documenting bullying in the chart. Providers with stronger attitudes and self-efficacy scores were more likely to screen for bullying, whereas knowledge was not related to screening for bullying.

DISCUSSION

Despite national calls to screen for bullying, many providers do not routinely carry out screening. When bullying is suspected, many interventions are used in lieu of a paucity of evidence-based interventions.

Item Generation and Content Validity of the Child-Adolescent Bullying Scale

BACKGROUND

Healthcare providers do not uniformly screen young patients for exposure to bullying, and no screening instruments have been developed for widespread use in clinical settings.

OBJECTIVES

The objectives of this study were to (a) generate scale items by identifying and eliciting concepts relevant to youths with potential exposure to bullying as well as to professionals who work with bullied youths and (b) assess the content validity of the new Child-Adolescent Bullying Scale (CABS) instrument.

METHODS

A mixed-methods design was used to develop an initial pool of 52 items. The study was conducted in four phases: (I) comprehensive review of the existing literature; (II) concept elicitation through the conduct of focus groups with school-age youths and professionals who work with bullied youths; (III) concept selection and item construction; and (IV) content validation assessment of relevance, clarity, and dimension of each item by a panel of 30 international bullying and measurement experts through completion of an online survey.

RESULTS

An initial pool of 52 potential items was developed during Phases I-III of the study. During Phase IV, item- and scale-level content validity indices were calculated and were used to refine the item pool. These strategies resulted in a new, 22-item tool, with scale-level content validity indices of .954 for clarity and .920 for representativeness.

DISCUSSION

Evaluation of the CABS tool with a sample of youths drawn from healthcare settings will be necessary to assess the performance of the CABS items, further evaluate its psychometric properties, and further refine the tool.

Expanding Concepts of Youth Adversity: Relationships With a Positive Patient Health Questionnaire-2

INTRODUCTION

Research suggests that diverse examples of adverse childhood experiences (ACEs) may link to health. This study examines relationships between conventional (abuse, neglect, household dysfunction) and expanded examples (bullying, safety perceptions) of ACEs and adolescent mental health among youth participating in a statewide school-based survey.

METHODS

Logistic regression was used to determine whether 10 types of conventional ACEs and 11 types of additional ACEs were associated with the odds of youth meeting cutoff scores for a positive Patient Health Questionnaire-2 (PHQ-2) after adjustment for demographic covariates and known mental health problems.

RESULTS

Individual and cumulative measures for conventional and expanded ACEs were significantly associated with youth odds of meeting criteria for a positive PHQ-2. Increasing frequency of bullying harassment was associated with a 1.5- to 5-fold increase in the odds of a positive PHQ-2.

DISCUSSION

Findings support consideration of broad concepts for adversity as relevant for youth mental health.

Adolescent Victims Emerging From Cyberbullying

Cyberbullying is a pervasive public health issue, affecting 10% to 50% of adolescents and resulting in significant negative health outcomes. Due to the relative newness of cyberbullying, there are many elements of the phenomenon that are not understood. Fifteen adolescents and young adults who had experienced cyberbullying as adolescents, participated in one-on-one, semi-structured interviews. A grounded theory and model, Emerging From Cyberbullying, was constructed to describe the process of being a victim of cyberbullying. The process began by Being Targeted and a cycle of Being Cyberbullied, Losing Oneself, and Attempting to Cope followed. Once out of the cycle, victims could begin the process of Resolving and Finding Oneself. This theory can be used to inform cyberbullying prevention efforts and adolescent providers can utilize this theory to understand the process of being a victim of cyberbullying, promote open discussions with adolescents about cyberbullying, and offer suggestions for effective methods to cope.

The Child Adolescent Bullying Scale (CABS): Psychometric evaluation of a new measure

While youth bullying is a significant public health problem, healthcare providers have been limited in their ability to identify bullied youths due to the lack of a reliable, and valid instrument appropriate for use in clinical settings. We conducted a multisite study to evaluate the psychometric properties of a new 22-item instrument for assessing youths' experiences of being bullied, the Child Adolescent Bullying Scale (CABS). The 20 items summed to produce the measure's score were evaluated here. Diagnostic performance was assessed through evaluation of sensitivity, specificity, predictive values, and area under receiver operating characteristic (AUROC) curve. A sample of 352 youths from diverse racial, ethnic, and geographic backgrounds (188 female, 159 male, 5 transgender, sample mean age 13.5 years) were recruited from two clinical sites. Participants completed the CABS and existing youth bullying measures. Analyses grounded in classical test theory, including assessments of reliability and validity, item analyses, and principal components analysis, were conducted. The diagnostic performance and test characteristics of the CABS were also evaluated. The CABS is comprised of one component, accounting for 67% of observed variance. Analyses established evidence of internal consistency reliability (Cronbach's α = 0.97), construct and convergent validity. Sensitivity was 84%, specificity was 65%, and the AUROC curve was 0.74 (95% CI: 0.69-0.80). Findings suggest that the CABS holds promise as a reliable, valid tool for healthcare provider use in screening for bullying exposure in the clinical setting.