Bullying victimization, mental disorders, suicidality and self-harm among Australian high schoolchildren: Evidence from nationwide data

Traditional bullying and cyberbullying in the digital age and its associated mental health problems in children and adolescents: a meta-analysis

Bullying is a risk factor for the physical and mental health of adolescents. The advent of new technologies has resulted in a brand-new type of bullying, cyberbullying (CB). The co-occurring effects of cyberbullying and traditional bullying(TB) forms of bullying on adolescent mental health are unclear. We performed a meta-analysis to explore the unique and combined effects of CB and TB on adverse psychological outcomes in victims by conducting a joint study of both types of bullying. By doing so, we provide the basis for a comprehensive community bullying prevention program. The database PubMed, PsyclNFO, and Web of Science were searched for studies from 2010 to 2021. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed for data abstraction, and the NIH tool was used to evaluate study-level risk of bias. 42 studies with 266,888 participants were identified. Random-Effect models were used for our study. The moderator analysis was used to explore the moderator of prevalence. Studies with three groups of victims (TB only, CB only, and Both) and two groups of victims (TB and CB) were compared in subgroup analysis. The mean victimization rate was 24.32% (95% CI 20.32-28.83%) for TB and 11.10% (95% CI 9.12-13.44%) for CB. Roughly one-third of TB victims were also victimized by CB. Conversely, only about one-third of CB victims were free from TB. The estimated ORs for depression, suicidal ideation, suicide attempts, and self-harm in the three-group (TB only, CB only and Both) analysis were: depression [TB only: 3.33 (2.22-5.00); CB only: 3.38 (2.57-4.46); Both: 5.30 (2.43-11.56)]; suicidal ideations [TB only: 3.08 (2.12-4.46); CB only: 3.52 (2.38-5.20); Both: 6.64 (4.14-10.64)]; self-harm [TB only: 2.70 (1.86-3.91); CB only: 3.57 (3.20-3.98); Both: 5.57 (2.11-16.00)]; and suicide attempts: [TB only: 2.61 (1.50-4.55); CB only: 3.52 (2.50-4.98); Both: 7.82 (3.83-15.93)]. TB and CB victimization among youth are a matter of public health concern. Victimization appears to be a marker of greater psychopathological severity, particularly suicide-related issues.

Estimation of the Global Disease Burden of Depression and Anxiety between 1990 and 2044: An Analysis of the Global Burden of Disease Study 2019

(1) Background: Depression and anxiety are the most common and severe mental disorders. This research estimated the prevalence and disease burden of depression and anxiety from 1990 to 2044. (2) Methods: Data on disease burden, population, and risk factors were identified and gathered from the Global Health Data Exchange database. The time trends, sex and age differences, key factors, and regional variations in and predictions of depression and anxiety were analyzed based on the age-standardized incidence rate, prevalence rate, and DALY rate. (3) Results: Our findings revealed that the burden of depression and anxiety was heavy. Specifically, the age-standardized DALY rate of depression started to decrease compared with trends related to anxiety disorders. Meanwhile, females bear a heavier burden for both depression and anxiety. Seniors and the middle-aged population carry the highest burden regarding mental disorders. Both high- and low-socio-demographic-index countries were found to be high-risk regions for depressive disorders. The disease burden attributed to childhood sexual abuse, bullying victimization, and intimate partner violence has increased since 1990. Finally, projections regarding depression and anxiety revealed geographic and age variations. (4) Conclusions: Public health researchers, officers, and organizations should take effective age-, sex-, and location-oriented measures.

The Resilience Factor: Examining its Potential to Alleviate Shame and Guilt in School Bullying

School violence, in particular bullying by peers, has become a problem on the public agenda. In the context of bullying, children exposed report high levels of shame and guilt which increase victimization since involves a humiliating experience associated with the lack of acceptance by the peer group and can negatively affect mental health. Both emotions have been previously studied in peer violence context. Now we aim to examine resilience as a potential factor to alleviate shame and guilt in school bullying. We conducted a study to test if resilience mediates the feeling of shame and guilt effect of being exposed to bullying; that is, if resilience entails protective behaviors that favour the dissipation of the risk of feeling shame and guilt when exposed to direct violence in school. First, we adapted to Mexican Spanish the research instrument Short Version of the State Shame and Guilt Scale (SSGS-8, Cavalera et al., 2017)-; then we conducted a quantitative, explanatory, cross-sectional approach study; both were carried out in two different non-urban high schools near the city of Monterrey, Mexico, randomizing groups. We found through a moderated mediation analysis that resilience is a key piece to transform shame and practically alleviate negative school violence consequences the indirect effect of resilience on the relationship between direct violence in school and shame was moderated by gender, better for boys than for girls. As its presence restrain shame in those who have been exposed to direct violence in school, it is important to strengthen resilience in adolescents. Promoting the development of shame resilience in adolescents is crucial to prevent them from questioning whether something is wrong with them when exposed to violence. We must continue making efforts to eradicate violence in schools through prevention programs and public policies.

Cyberbullying Perpetration and Victimization as Risk Factors for Self-Harm: Results From a Longitudinal Cohort Study of 13-14-Year-Olds in England

PURPOSE

Cyberbullying is a crucial issue that affects adolescent mental health, with evidence to suggest that adolescents who are victims of cyberbullying are at higher risk for self-harm. However, longitudinal evidence is lacking, meaning the direction of effects cannot be established. This study investigated longitudinal associations between levels of cyberbullying involvement (bully, victim, or both), frequency, and self-harm a year later in an adolescent sample.

METHODS

Data were collected from Year 9 students (13-14-year-olds; N = 1,195) enrolled in 19 schools in Southwest England using an online questionnaire with a 1-year follow-up period (October 2019-October 2020). Multivariable logistic regression analysis was conducted to test for associations between different levels of cyberbullying involvement at baseline and the likelihood of self-harm a year later, adjusting for key covariates. A secondary regression analysis also explored the associations between the frequency of cyberbullying involvement at baseline and subsequent self-harm.

RESULTS

Compared to those with no cyberbullying involvement, individuals who were both victims and perpetrators (adjusted odds ratio = 2.94, 95% confidence interval: 1.99-4.34) as well as victims only (adjusted odds ratio = 2.81, 95% confidence interval: 1.95-4.04) showed an increased risk of subsequent self-harm. In terms of frequency, associations were found between frequent and occasional cyberbullying and self-harm for both victims and perpetrators; however, associations for the perpetrator group attenuated to the null following adjustment for covariates.

DISCUSSION

Our findings highlight cyberbullying in early adolescence as a risk factor for subsequent self-harm. Cyberbullying prevention should be a priority for school mental health interventions, with consideration that most perpetrators of cyberbullying may also be victims.

Association between sports-related concussions and the risk of self-injury thoughts and behaviors: Who, and under what circumstances?

BACKGROUND

Understanding the association between sport-related concussions and the risk of suicidal and non-suicidal self-injury thoughts and behaviors (SITBs), including non-suicidal self-injury (NSSI), suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA), is crucial for suicide prevention. We aimed to identify the circumstances in which individuals with or without a concussion are vulnerable to SITBs.

METHODS

The cross-sectional study included 85,469 students from 63 Chinese university with a mean age of 19.6 years. Firstly, propensity score matching, and inverse probability of treatment weighting (IPTW) were used to match the concussion and non-concussion group based on a range of biological, social, and psychological factors. Subsequently, multivariable logistic regression and a decision tree algorithm were employed to evaluate the interaction and cumulative impact of these risk factors and concussion on the probability of SITBs.

RESULTS

In the unmatched sample, concussion exposures were associated with all SITBs, with NSSI (OR, 1.41), SI (OR, 1.10), SP (OR, 1.23), and SA (OR, 1.28). However, the matched and weighted sample only had a significant association with NSSI and SI. The decision tree model revealed that, in the unmatched sample, among individuals without depressive symptoms or childhood emotional abuse, the risk of concussion on SITBs increased from 45.5 % to 65.2 % (χ2, 9.370; adjusted P = .002) after experiencing sexual abuse and verbal bullying. In the matched sample, the risk increased from 46.2 % to 64.6 % (χ2, 6.848; adjusted P = .009).

CONCLUSION

Our study revealed that individuals who suffered concussions exhibited a significantly higher risk of SITBs.

Cyberbullying and Non-Suicidal Self-Injury (NSSI) in Adolescence: Exploring Moderators and Mediators through a Systematic Review

(1) Objective: This systematic review explores the intricate relationship between cyberbullying and non-suicidal self-injury (NSSI) in adolescents, acknowledging the dynamic nature of these phenomena in the evolving landscape of technology and social norms. (2) Methods: PubMed/MEDLINE, Web of Science, and EMBASE were searched, and 14 studies were selected based on the eligibility criteria, focusing on participants aged 10 to 19, cyberbullying roles, and NSSI as the predictor and outcome variables, respectively. (3) Results: Internalizing symptoms, specifically depression and anxiety, emerged as the most prominent mediators. However, factors such as externalizing symptoms, stress, and negative emotional responses (emotion reactivity, negative emotions) were also identified to play a significant role in the relationship between cyberbullying and NSSI. On the other hand, protective factors against the negative impact of cyberbullying on NSSI risk, such as strong peer connections and school engagement, were identified. (4) Discussions: This review underscores the multidimensional nature of the cyberbullying-NSSI association, emphasizing the roles of potential risk factors such as internalizing and externalizing symptoms, stress, and negative emotional response. Internalizing symptoms played a central role as pathways between cyberbullying victimization and NSSI. Additionally, social factors, including peer connections and school engagement, were found to act as protective elements. (4) Conclusion: Continuous investigation is crucial in order to adapt interventions to the evolving technological and social landscape. The study advocates for targeted interventions that prioritize positive social connections to mitigate the impact of cyberbullying on adolescent well-being.

Using decision tree to predict non-suicidal self-injury among young adults: the role of depression, childhood maltreatment and recent bullying victimization

Importance: Non-suicidal self-injury (NSSI) is a significant mental health issue requiring a deeper understanding of its underlying causes, such as childhood maltreatment, adult bullying victimization, and depression. Previous studies have not adequately addressed the cumulative risks of these factors on NSSI among college students. This population-based study investigates these cumulative risk factors.Design, setting, and participants: The cross-sectional study included 63 university's college students with a mean age of 19.6 years (N = 95,833).Main outcomes and measures: Two Chi-Square Automatic Interaction Detection (CHAID) decision tree models were used to classify subgroups based on childhood maltreatment and adult bullying victimization experiences and to investigate their cumulative risks of NSSI. Recursive partitioning algorithms determined each predictor variable's relative importance.Results: The CHAID model accurately predicted NSSI behaviours with an overall accuracy rate of 77.8% for individuals with clinically relevant depressive symptoms and 97.2% for those without. Among depressed individuals, childhood emotional abuse was the strongest NSSI predictor (Chi-Square, 650.747; adjusted P < .001), followed by sexual and physical abuse. For non-depressed individuals, emotional abuse in childhood was the strongest NSSI predictor (Chi-Square, 2084.171; adjusted P < .001), with sexual and verbal bullying in the past year representing the most significant proximal risks.Conclusions and relevance: Emotional abuse during childhood profoundly impacts individuals, increasing the risk of NSSI in both depressed and non-depressed individuals. Clinically relevant depressive symptoms have a moderating effect on the relationship between childhood maltreatment, adult bullying victimization, and NSSI. Identifying these factors can inform targeted interventions to prevent NSSI development among young adults.

The Effect of Bullying Victimization on Adolescent Non-Suicidal Self-Injury: The Mediating Roles of Alexithymia and Self-Esteem

Background & Aim

Non-suicidal self-injury (NSSI) in adolescents is a serious public health issue influenced by the interaction of multiple factors. The purpose of this study was to investigate the multiple mediating roles of alexithymia and self-esteem in the association between bullying victimization and NSSI in a sample of Chinese adolescents.

Methods

A survey of 1299 adolescents from two public middle schools in Henan Province, China, was undertaken. Data were collected using the Chinese version of the Delaware bullying victimization scale-student (DBVS-S), the Toronto Alexithymia-20 Scale (TAS-20-C), the Rosenberg self-esteem scale (RSES), and the adolescent self-injury questionnaire. Besides, we performed a structural equation modeling (SEM) with latent variables using AMOS 26.0 to examine the relationship between variables and the mediating effects.

Results

The SEM analysis found that not only can bullying victimization directly impact NSSI, but that alexithymia and self-esteem have a chain mediating effect in the association between bullying victimization and NSSI. This mediating effect contributed 22.47% to the total effect.

Conclusion

These findings validate bullying victimization, alexithymia, and low self-esteem are important variables that affect NSSI among Chinese adolescents. Educators need to implement some prevention and intervention strategies to ameliorate the campus atmosphere and adolescents' mental health aimed at avoiding NSSI behavior in adolescence.

The burden and trend of diseases and their risk factors in Australia, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND

A comprehensive understanding of temporal trends in the disease burden in Australia is lacking, and these trends are required to inform health service planning and improve population health. We explored the burden and trends of diseases and their risk factors in Australia from 1990 to 2019 through a comprehensive analysis of the Global Burden of Disease Study (GBD) 2019.

METHODS

In this systematic analysis for GBD 2019, we estimated all-cause mortality using the standardised GBD methodology. Data sources included primarily vital registration systems with additional data from sample registrations, censuses, surveys, surveillance, registries, and verbal autopsies. A composite measure of health loss caused by fatal and non-fatal disease burden (disability-adjusted life-years [DALYs]) was calculated as the sum of years of life lost (YLLs) and years of life lived with disability (YLDs). Comparisons between Australia and 14 other high-income countries were made.

FINDINGS

Life expectancy at birth in Australia improved from 77·0 years (95% uncertainty interval [UI] 76·9-77·1) in 1990 to 82·9 years (82·7-83·1) in 2019. Between 1990 and 2019, the age-standardised death rate decreased from 637·7 deaths (95% UI 634·1-641·3) to 389·2 deaths (381·4-397·6) per 100 000 population. In 2019, non-communicable diseases remained the major cause of mortality in Australia, accounting for 90·9% (95% UI 90·4-91·9) of total deaths, followed by injuries (5·7%, 5·3-6·1) and communicable, maternal, neonatal, and nutritional diseases (3·3%, 2·9-3·7). Ischaemic heart disease, self-harm, tracheal, bronchus, and lung cancer, stroke, and colorectal cancer were the leading causes of YLLs. The leading causes of YLDs were low back pain, depressive disorders, other musculoskeletal diseases, falls, and anxiety disorders. The leading risk factors for DALYs were high BMI, smoking, high blood pressure, high fasting plasma glucose, and drug use. Between 1990 and 2019, all-cause DALYs decreased by 24·6% (95% UI 21·5-28·1). Relative to similar countries, Australia's ranking improved for age-standardised death rates and life expectancy at birth but not for YLDs and YLLs between 1990 and 2019.

INTERPRETATION

An important challenge for Australia is to address the health needs of people with non-communicable diseases. The health systems must be prepared to address the increasing demands of non-communicable diseases and ageing.

FUNDING

Bill & Melinda Gates Foundation.

Cyberbullying Victimization and Nonsuicidal Self-Injury in Early Adolescents: A Moderated Mediation Model of Social Anxiety and Emotion Reactivity

This study examined the mediating role of social anxiety in the relation between cyberbullying victimization and nonsuicidal self-injury (NSSI), as well as the moderating role of emotion reactivity in those associations. Participants included 2,864 adolescents (M_age = 12.46, SD = 1.36, 47.1 percent girls). Results of path analysis showed that cyberbullying victimization was significantly related to NSSI, and social anxiety plays a mediating role in the relation between them. Emotion reactivity strengthened the effect of cyberbullying victimization on NSSI and of social anxiety on NSSI. The results further showed that the mediating effect of social anxiety was more prominent for youths who have higher levels of emotion reactivity. Interventions to reduce adolescent social anxiety and emotion reactivity may interrupt the pathway from cyberbullying victimization to NSSI.

Cyber-Victimization and Its Effect on Depression in Adolescents: A Systematic Review and Meta-Analysis

The difference in participants' characteristics between samples and the inconsistency in the methodology have led to variability in both direction and magnitude of association between cyber-victimization and depression in adolescents. This systematic review and meta-analysis investigates the relationship between cyber-victimization and depression in adolescents. Primary studies on cyber-victimization and depression among adolescents (10-19 years of age based on WHO definition) on PubMed and EMBASE databases were included. The forward and backward snowballing searching method was also used to explore more publications. The main effect estimate extracted from eligible studies was the odds ratio which was synthesized based on the random-effect model. The protocol of this study was prospectively registered on PROSPERO database (registration number: CRD42020185700). Among 1,008 research articles identified, 17 were eligible which comprised a total sample of 79,202 adolescents. The odds of depression among cyber-victims was almost three-fold higher (OR = 2.73; 95% CI 2.25-3.31) compared to non-cyber-victims. The overall effect estimate remained positive irrespective of differences in sample and method characteristics (study location, female percentage, sampling procedures, the use of single vs. multiple items, and elaboration of cyber-bullying definition). The presence of traditional bullying items was found to be important moderator of this relationship. However, none of the anticipated moderators had a clear impact on this relationship. Moreover, absence of publication bias was confirmed. This study confirms findings from the literature about the significant association between cyber-victimization and depression in adolescents across settings and populations. More efforts should be made to address this issue rigorously and to a greater extent.

Meta-analysis of the relationship between bullying and depressive symptoms in children and adolescents

Childhood and adolescence are critical periods for physical and mental development; thus, they are high-risk periods for the occurrence of mental disorders. The purpose of this study was to systematically evaluate the association between bullying and depressive symptoms in children and adolescents. We searched the PubMed, MEDLINE and other databases to identify studies related to bullying behavior and depressive symptoms in children and adolescents. A total of 31 studies were included, with a total sample size of 133,688 people. The results of the meta-analysis showed that the risk of depression in children and adolescents who were bullied was 2.77 times higher than that of those who were not bullied; the risk of depression in bullying individuals was 1.73 times higher than that in nonbullying individuals; and the risk of depression in individuals who bullied and experienced bullying was 3.19 times higher than that in nonbullying-bullied individuals. This study confirmed that depression in children and adolescents was significantly associated with being bullied, bullying, and bullying-bullied behavior. However, these findings are limited by the quantity and quality of the included studies and need to be confirmed by future studies.

Cyberbully victimization and its association with residual depressive symptoms among clinically stable adolescents with psychiatric disorders during the COVID-19 pandemic: A perspective from network analysis

Objective

This study examined the prevalence of cyberbullying and its relationship with residual depressive symptoms in this patient population during the COVID-19 outbreak using network analysis.

Methods

This was a multicenter, cross-sectional study. Adolescent patients attending maintenance treatment at outpatient departments of three major psychiatric hospitals were included. Experience of cyberbullying was measured with a standard question, while the severity of Internet addiction and depressive symptoms were measured using the Internet Addiction Test and the Patient Health Questionnaire-9, respectively. The network structure of depression and cyberbully were characterized and indices of "Expected Influence" was used to identify symptoms central to the network. To identify particular symptoms that were directly associated with cyberbully, the flow function was used.

Results

Altogether 1,265 patients completed the assessments. The overall prevalence of cyberbullying was 92.3% (95% confidence interval (CI): 90.8-93.7%). Multiple logistic regression analysis revealed that male gender (p = 0.04, OR = 1.72, 95%CI: 1.04-2.85) was significantly associated with higher risk of cyberbullying, while a relapse of illness during the COVID-19 pandemic was significantly associated with a lower risk of cyberbullying (p = 0.03, OR = 0.50, 95%CI: 0.27-0.93). In the network of depression and cyberbully, "Sad mood," "Anhedonia" and "Energy" were the most central (influential) symptoms. Furthermore, "Suicidal ideation" had the strongest negative association with cyberbully followed by "Guilt".

Conclusion

During the COVID-19 pandemic, the experience of cyberbullying was highly prevalent among clinically stable adolescent psychiatric patients, particularly male patients. This finding should raise awareness of this issue emphasizing the need for regular screening and interventions for adolescent patients. Central symptoms (e.g., "Sad mood," "Anhedonia" and "Energy") identified in this study should be targeted in interventions and preventive measures.

Influence of academic stress and school bullying on self-harm behaviors among Chinese middle school students: The mediation effect of depression and anxiety

Objective

The purpose of this study was to explore the relationship between academic stress, school bullying and self-harm behaviors among Chinese middle school students and to further explore the impact of anxiety and depression on this relationship.

Methods

The students (aged 12-16 years) in a middle school in Changsha city were invited to respond to a questionnaire through an online platform. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess the severity of anxiety and depressive symptoms, respectively. The experience of being bullied, academic stress, and self-harm behaviors were assessed using several questions on the basis of previous studies.

Results

A total of 1,313 middle school students completed the study, and 3.40% and 4.10% of them reported suicide attempts (SAs) and non-suicidal self-injury (NSSI), respectively. Univariate logistic regression analysis revealed that anxiety symptoms (OR = 1.23, 95% CI: 1.18-1.28; OR = 1.25, 95% CI: 1.19-1.31), depressive symptoms (OR = 1.20, 95% CI: 1.16-1.25; OR = 1.26, 95% CI: 1.20-1.31), school bullying (OR = 3.8, 95% CI: 2.11-6.89; OR = 2.76, 95% CI: 1.39-5.47), and academic stress (OR = 2.20, 95% CI: 1.27-3.80; OR = 3.80, 95% CI: 1.20-7.25) were common factors of NSSI and SAs. In addition, depressive symptoms showed a mediating effect on the association of school bullying and academic stress with SAs or NSSI, and anxiety symptoms showed a mediating effect on the association of school bullying and academic stress with NSSI only.

Conclusion

Appropriate strategies are needed to reduce academic pressure and prevent school bullying. Meanwhile, negative emotions such as depression and anxiety should be evaluated and intervened in to prevent self-harm behaviors among middle school students.

Cyberbullying among college students in a Chinese population: Prevalence and associated clinical correlates

Objectives

Cyberbullying is quite common in adolescents and college students, and it influences mental health in many aspects. The purpose of this study was to investigate the prevalence of cyberbullying in Chinese college students and to look for related factors.

Methods

Eight thousand and ninety-eight college students aged 17-26 were enrolled in this cross-sectional study. We collected information of their sociodemographic data, depression (evaluated by Self-Rating Depression Scale), anxiety (evaluated by Self-Rating Anxiety Scale), lifetime suicidal behaviors (including suicidal ideation, suicidal plans, and suicide attempts), and experiences of cyberbullying for the past 12 months by online questionnaires.

Results

The prevalence of cyberbullying for the past 12 months was 7.82% (633/8,098) among college students. Binary logistic regression analysis showed that sex (odds ratio, OR = 0.522, 95%CI = 0.433-0.629, p < 0.001), suicide attempts (OR = 2.164, 95%CI = 1.589-2.948, p < 0.001), depression (OR = 2.372, 95%CI = 1.602-3.512, p < 0.001), and anxiety (OR = 1.911, 95%CI = 1.305-2.800, p = 0.001) were independently associated with cyberbullying.

Conclusion

Cyberbullying is very common among college students in Hunan Province, China. Besides, being male, suicide attempts, depression and anxiety were independently associated with cyberbullying, which highlights the importance of paying attention to cyberbullying and addressing anxiety, depression, and suicidal behaviors among college students to better improve their mental health and prevent suicide.

The impact of gender and age on bullying role, self-harm and suicide: Evidence from a cohort study of Australian children

There has been limited longitudinal investigation to date into the association between bullying, self-harm, and suicidality in Australia and the impact of specific demographic differences on this relationship. This is despite the continued rise in the incidence of bullying, self-harm, and suicide. As such, the current study draws on data from the Longitudinal Survey of Australian children (LSAC) to examine the association between bullying, self-harm, and suicidality and explore the impact of demographic differences across three bullying related behaviors (being bullied, bullying others and being both bullied and bullying others). The evidence indicates that bully-victims exhibit the highest risk of self-harm and suicidality in Australia. When considering demographic differences, it was identified that females and adolescents aged 16-17-years-of-age had the highest risk of self-harm and suicidality. Further, a direct curvilinear relationship between age and the categories of self-harm was identified with an inflection point around 16-17 years. The study supports the need for further investigation into the association between bullying, self-harm, and suicidality longitudinally with a particular focus on other moderators.

Global trends and regional differences in the burden of anxiety disorders and major depressive disorder attributed to bullying victimisation in 204 countries and territories, 1999-2019: an analysis of the Global Burden of Disease Study

AIM

This study aimed to analyse the temporal and spatial trends in the burden of anxiety disorders and major depressive disorder related to bullying victimisation on global, regional and country scales.

METHODS

Data were from the 2019 Global Burden of Disease (GBD) Study. We assessed the global disability-adjusted life years (DALYs, per 100 000 population) of anxiety disorders and major depressive disorder attributable to bullying victimisation by age, sex and geographical location. The percentage changes in age-standardised rates of DALYs were used to quantify temporal trends, and the annual rate changes across 204 countries and territories were used to present spatial trends. Furthermore, we examined the relationship between the sociodemographic index (SDI) and the burden of anxiety disorders as well as major depressive disorder attributable to bullying victimisation and its spatial and temporal characteristics globally.

RESULTS

From 1990 to 2019, the global DALY rates of anxiety disorders and major depressive disorder attributable to bullying victimisation increased by 23.31 and 26.60%, respectively, with 27.27 and 29.07% for females and 18.88 and 23.84% for males. Across the 21 GBD regions, the highest age-standardised rates of bullying victimisation-related DALYs for anxiety disorders were in North Africa and the Middle East and for major depressive disorder in High-income North America. From 1990 to 2019, the region with the largest percentage increase in the rates of DALYs was High-income North America (54.66% for anxiety disorders and 105.88% for major depressive disorder), whereas the region with the slowest growth rate or largest percentage decline was East Asia (1.71% for anxiety disorders and -25.37% for major depressive disorder). In terms of SDI, this study found overall upward trends of bullying-related mental disorders in areas regardless of the SDI levels, although there were temporary downward trends in some stages of certain areas.

CONCLUSIONS

The number and rates of DALYs of anxiety disorders and major depressive disorder attributable to bullying victimisation increased from 1990 to 2019. Effective strategies to eliminate bullying victimisation in children and adolescents are needed to reduce the burden of anxiety disorders and major depressive disorder. Considering the large variations in the burden by SDI and geographic location, future protective actions should be developed based on the specific cultural contexts, development status and regional characteristics of each country.

Emotional processing in bullying: an event-related potential study

Bullying is a subtype of violence that leads to maladaptive behaviors and emotional responses, with implications for social competence, emotions, and empathy. The present study compared the time course of emotional processing in children who were involved in the dynamics of bullying (i.e., as victims, bullies, and observers) by evaluating event-related potentials [early posterior negativity and late positive potential (LPP)] in different brain regions during a passive visualization task that involved positive, neutral, and negative social pictures. High-density electroencephalograms were recorded in 45 children, 8-12 years old (M = 9.5 years, SD = 1.3), while they observed emotional and neutral social pictures that we selected from the International Affective Picture System. Late positive potential had higher amplitudes in the victim group, especially in posterior and anterior regions. In the central region, LPP was greater toward neutral social pictures in bullying victims. The greater amplitude of LPP in victims was observed during and after the stimulus. The results showed a consistent response with a higher intensity in response to emotional stimuli in the victim group, suggesting a tendency toward hypervigilance that could interfere with emotional regulation.

The gap between perceived mental health needs and actual service utilization in Australian adolescents

Despite being highly prevalent, adolescent mental health problems are undertreated. To better understand the mental health treatment gap, we assessed the prevalence and correlates of help-seeking, including perceived need for care and access to that care. Data were drawn from Young Minds Matter (YMM) survey-the second Australian child and adolescents survey of mental health and wellbeing. Parent-reported data and self-reported child data were combined into one dataset to analyse 2464 Australian adolescents aged 13-17 years. We employed bivariate and multivariate logistic regression models to assess the correlation between independent variables (professionally assessed with mental disorders only, self-reported self-harm/suicidality only and both) and their distribution over outcome variables (perceived need and service use). Mental disorders include depression, anxiety, ADHD and conduct disorder. Our study revealed 15.0%, 4.6% and 7.7% had professionally assessed with mental disorders only, self-reported self-harm/suicidality only and both, respectively. Overall, 47.4% and 27.5% of adolescents respectively perceived need for care and used services in the past-12-months. While among those only who perceived the need, only 53% of adolescents used any services. Professionally assessed with mental disorders only, self-reported self-harm/suicidality only and both were associated with higher likelihood of perceived need and service use (p < 0.001 for all). However, adolescents who self-reported self-harm/suicidality only were not found to be significantly associated with service use among those who perceived the need for care. Adolescents who perceived the need for mental health care but did not seek care represent a treatment gap. Our results suggest the importance of reducing the wide treatment gap that exists between need and care.

Depression and anxiety have a larger impact on bullied girls than on boys to experience self-harm and suicidality: A mediation analysis

BACKGROUND

The mechanism underlying the correlation between bullying victimization, self-harm and suicidality by gender are not well understood. This study, therefore, aimed to investigate whether the mediating effect of mental disorder (depression and anxiety) on the association between bullying victimization, and self-harm and suicidality vary across boys and girls.

METHODS

Overall, 2522 Australian adolescents aged 12-17-year-olds were analyzed from a nationally representative cross-sectional survey: Young Minds Matter. A series of logistic regressions were employed using Baron and Kenny's approach to test the mediating effect of each mental disorder on the relationship between bullying victimization, and self-harm and suicidality across gender. Further, the Sobel test was used to estimate the indirect effect.

RESULTS

Out of 784 (31.1%) bullied victims, 53.2% were girls and 46.8% were boys. A higher proportion of girls compared to boys experienced depression, anxiety, self-harm and suicidality (p < 0.001 for all). The relationships between bullying victimization, and self-harm and suicidality were mediated by depression (p < 0.05) in both boys and girls. While anxiety disorder mediated the association only in girls (p < 0.05).

LIMITATIONS

Cross-sectional study design does not imply causality. Self-reported data about self-harm and suicidality may be susceptible to social desirability bias.

CONCLUSION

Girls were more affected by bullying, self-harm and suicidality than boys. Depression mediated the correlation between bullying, and self-harm and suicidality in both boys and girls. While anxiety influenced only bullied girls to experience self-harm and suicidality. These findings warrant the need for gender-specific prevention programs to combat bullying and subsequently self-harm and suicidality in adolescents.

Empowering teachers to screen, guide, and refer schoolchildren with behavioral and mental health problems. A pilot study to promote mental health in Iran

BACKGROUND

Schools are ideal for promoting the mental health of school-age children, but the teachers' current knowledge is insufficient to play an influential role in mental health services at schools. Fortunately, however, teachers have a high sense of responsibility, interest, and talent to receive knowledge and the ability to participate in this field. This study aimed to examine whether a protocol focused on the role of teachers could identify, guide, and care for school-age children with behavioral and mental health problems.

METHOD

The current research was a "before and after" pilot quasi-experimental study conducted in three elementary, secondary, and high schools. The main intervention consisted of a 5-h workshop based on a ready-to-use booklet for teachers conducted separately in each school. A total of 58 teachers and 872 school-age children were included using a judgmental sampling technique.

RESULTS

The pre-and post-workshop mean scores of teachers' knowledge about common mental disorders in school-age children were 6.21 ± 4.58 and 12.50 ± 7.27, respectively. According to the Strengths and Difficulties Questionnaire (SDQ), the teachers made 127 referrals, of whom 102 school-age children had problems. Consultants diagnosed 114 school children who reflected 90% of all teachers' recommendations needing psychological care and counseling. Finally, only 50 diagnosed school-age children were followed up and attended therapy sessions at counseling centers. The sensitivity and specificity of this brief intervention in detecting school-age children with psychological problems were respectively 80.3 and 98.0%.

CONCLUSIONS

This study's results support teacher empowerment training's effectiveness in identifying and guiding school-age children needing mental health care. Psychological counseling programs in schools in various quantitative and qualitative dimensions, including responding to school-age children's needs and psychological problems, should be adequately evaluated, and appropriate measures should be taken to promote mental health services. Collaboration between health systems and the education department will increase the effectiveness of mental health programs' promotion and drug abuse prevention. These pilot data lead the way to designing scientifically sound follow-up studies that will concretely ascertain the benefit of this program.

The consequences of cyberbullying and traditional bullying victimization among adolescents: Gender differences in psychological symptoms, self-harm and suicidality

This study aimed to examine the effects of different types of bullying victimization (direct, relational, and cyber) on psychological symptoms, self-harm, and suicidality (including suicidal ideation and attempts) among adolescents, and to explore whether these effects may vary by gender. The data were obtained from a cross-sectional study of adolescents (n = 11,248, 46.7% females) with a mean age of 13.83 years from grade 5 to 12 in Henan, China. A series of binary logistic regression models were conducted to estimate the associations between different types of bullying victimization and psychological symptoms, self-harm, suicidal ideation, and suicidal attempts, after adjusting for demographic covariates. All three types of bullying victimization were significantly associated with psychological symptoms, self-harm, suicidal ideation, and suicidal attempts. Adolescents who suffered from cyberbullying victimization were more likely to commit self-harm and suicidal attempts as compared to direct and relational victimization. Female adolescents who suffered from relational bullying tend to have a higher risk of suicidal attempts than male adolescents. The current study demonstrated the negative effect of bullying victimization on adolescents' adverse psychological outcomes and gender difference need to be taken into account in developing targeted intervention strategies to address bullying victimization.

Estimating income-related and area-based inequalities in mental health among nationally representative adolescents in Australia: The concentration index approach

Despite the awareness of the importance of mental health problems among adolescents in developed countries like Australia, inequality has not been widely researched. This study, is therefore, aimed to measure and compare household income-related and area-based socioeconomic inequalities in mental health problems (bullying victimization, mental disorders-single and multiple, self-harm and suicidality-ideation, plan and attempt) among Australian adolescents aged 12-17 years. Young Minds Matter (YMM)-the 2nd national cross-sectional mental health and well-being survey involving Australian children and adolescents conducted in 2013-14, was used in this study to select data for adolescents aged 12-17 years (n = 2521). Outcome variables included: bullying, mental disorders, self-harm, and suicidal ideation, plan and attempt. The Erreygers's corrected concentration index (CI) approach was used to measure the socioeconomic inequalities in mental health problems using two separate rank variables-equivalised household income quintiles and area-based Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) quintiles. The prevalence of mental health problems in the previous 12-months among these study participants were: bullying victimization (31.1%, 95% CI: 29%-33%), mental disorder (22.9%, 95% CI: 21%-24%), self-harm (9.1%, 95% CI: 8%-10%), suicidal ideation (8.5%, 95% CI: 7%-10%), suicidal plan (5.9%, 95% CI: 5%-7%) and suicidal attempt (2.8%, 95% CI: 2%-3%). The concentration indices (CIs) were statistically significant for bullying victimization (CI = -0.049, p = 0.020), multiple mental disorders (CI = -0.088, p = <0.001), suicidal ideation (CI = -0.023, p = 0.047) and suicidal attempt (CI = -0.021, p = 0.002), implying pro-poor socioeconomic inequalities based on equivalized household income quintiles. Similar findings revealed when adolescents mental health inequalities calculated on the basis of area based IRSAD (Index of Relative Socio-economic Advantage and Disadvantage) quintiles. Overall, adolescents from economically worse-off families experienced more mental health-related problems compared to those from economically better-off families. This has implications for prevention strategies and government policy in order to promote mental health and provide equitable healthcare facility.

The association between bullying and eating disorders: A case-control study

OBJECTIVE

Childhood bullying is associated with a range of adverse mental health outcomes, and here we investigated the association between bullying exposure and eating disorders (EDs).

METHOD

In this case-control study, we compared bullying history in individuals with EDs with community controls. Participants (n = 890, mean age = 29.50 ± 10.60) completed an online self-report battery assessing bullying history and lifetime history of bulimia nervosa (BN), binge-eating disorder (BED), and anorexia nervosa (binge-eating/purging (AN-BP) or restrictive (AN-R) subtype). Logistic regressions were performed to estimate odds ratios (ORs).

RESULTS

In the combined ED sample, individuals with a history of any ED were significantly more likely than controls to have experienced bullying victimization during childhood or adolescence (ORs = 1.99-3.30), particularly verbal, indirect, and digital bullying. Bullying prior to ED onset was also significantly more common than bullying within the same time frame for controls (ORs = 1.75-2.16). Further analysis showed that these effects were due to individuals with BN or BED reporting significantly more lifetime (p < .001) and premorbid bullying (p = .002) than controls, while individuals in the other diagnostic subgroups did not differ significantly from controls.

DISCUSSION

Our results confirm an association between bullying and binge-eating/purging ED subtypes. Prospective studies are needed to establish bullying as a risk factor for EDs.

Childhood trauma and bullying-victimization as an explanation for differences in mental disorders by sexual orientation

Sexual minority individuals are more likely to have mental disorders, including mood, anxiety, and substance use disorders, compared to heterosexual individuals. Whether experiencing trauma or bullying-victimization during childhood explains these differences is currently unclear. We used a psychiatric epidemiological general population-based study to assess whether childhood trauma severity and bullying-victimization before age 16 explains the difference by sexual attraction in mental disorders. Data from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; N = 6392) were used to examine (1) whether same/both-sex attraction and predominantly other-sex attraction is linked to self-reports of childhood trauma (types and severity) and bullying-victimization, and (2) whether these experiences explain differences between these groups in lifetime and 12-month prevalence of DSM-IV disorders assessed by the Composite International Diagnostic Interview 3.0. Same/both-sex attracted individuals reported a higher childhood trauma severity score compared to exclusively other-sex attracted individuals (B = 0.93, SE = 0.20, p < .001), and were more likely to report bullying-victimization (OR = 2.51 95%CI[1.68, 3.74]). DSM-IV disorders were more prevalent among same/both-sex attracted individuals than among exclusively other-sex attracted individuals (ORs ranged from 1.57 to 4.68). There were no differences in DSM-IV disorders for predominantly other-sex attracted individuals. Childhood trauma severity explained between 9.0% and 57.0% of significant indirect associations between same/both-sex attraction and DSM-IV disorders. Sexual minority individuals experience more types of, and more severe childhood trauma, and are more likely to experience bullying-victimization. These negative experiences partly explained disparities in mental disorders.

Prejudice Against Citizens with Right-aligned Political Views in Western Cosmopolitan Cities, and Possible Interventions

Prejudice against citizens with right-aligned political views in western cosmopolitan cities was explored, and possible interventions proposed. Literature and theories were reviewed, with social psychological and sociological theories compiled that explain the reasons for this prejudice and an intervention to solve this problem. Scientific research in social sciences is dominated by bias from left-aligned researchers in social psychology and psychology. Dysfunctional scientific processes prominent in this area of sciences are due to the sacralization of social science. A significantly small percent of social and personality psychologists identify as politically conservative. A significant amount of errors and distortions were found in sociology textbooks. Media and corporation biases toward left-aligned political views were found, and right-aligned individuals are out-group members in cosmopolitan cities. Inoculation by media assignments and critical literacy education is proposed, that could prevent school students from being influenced by stealth messages and propaganda. Media campaigns targeting the full spectrum of political views is proposed, that could help reduce biases of citizens. A family and community health class is proposed, that could improve student’s psychological, family, and social health. Youth and adult clubs are proposed, that could help reduce animosity between social groups, and promote solidarity and community health.

Mental Health Among School-Going Adolescents in Greater London: A Cross-Sectional Study

Objectives: Mental health problems are among the leading causes of health-related disability among children and adolescents worldwide. However, there is still a global challenge in terms of gathering consistent epidemiological information about the issue. The present study was designed to describe various mental health issues and factors associated with negative feelings among adolescents in Greater London. Methods: This is a cross sectional study, using a self-administered questionnaire (Cronbach's alpha = 0.742). A convenience sampling strategy was used to recruit participants who were school/college-attending adolescents, aged 11-19. A minimum sample size of 199 was required (95% confidence interval, 5% margin of error, and 15.3% population proportion). The study was conducted between February and April 2016 in Greater London. Descriptive statistics and inferential statistics including chi square, Spearman correlation, and binary logistic regression were used to identify the key findings. Data analysis was performed using SPSS v21. Results: A total of 526 out of 1,920 surveys were collected across 18 secondary schools and two colleges, giving a response rate of 27.4%. More than half of the adolescents reported to be either neutral (41.4%), sad (7.8%), or very sad (2.8%), whereas 48% reported to be either happy (35%) or very happy (13%). Difficulties in relationships and hectic schedules were among the most stressful situations affecting adolescents' mental health. Discrimination was identified as the main predicting factor with five-fold increase in odds of having negative mental health symptomatology. Other significant risk factors identified were age, gender, smoking, and health comorbidities. Conclusion: Discrimination was identified as the most predictive factor influencing negative symptomatology among the study cohort. The study had several limitations, most notably the use of a non-validated surrogate measure for mental health, in addition to the exclusion of adolescents aged 10-11 years, school/college dropouts and non-school-going adolescents. A similar study on a national scale is highly recommended to determine the real magnitude of the problem, which would be the starting point toward proper tackling of mental health issues and associated complexities among the adolescent population across England.