Bullying victimisation, self harm and associated factors in Irish adolescent boys

Depression and dissociation mediate the association between bullying victimization and self-cutting

BACKGROUND

Bullying victimization is experienced by more than 10% of children and adolescents worldwide and has been associated with numerous negative mental health consequences, such as depression and dissociation.

AIMS

We investigated the association between bullying victimization and self-cutting in a Finnish adolescent population and whether depression and dissociation act as mediators in this association.

METHODS

We used cross-sectional questionnaire data from Finnish students (age 13-18; N = 3345; boys n = 1454; girls n = 1891). Logistic regression and mediation analyses were performed.

RESULTS

Bullying victimized adolescents were younger, more likely to be afraid to go to school, had fewer friends, felt lonelier, and had a poorer relationship with family members, as well as higher level of depressive and dissociative symptoms compared to non-bullied adolescents. According to logistic regression analysis, the association between bullying and self-cutting remained significant despite all other adjustments besides those for depressive symptoms. In serial mediation analysis, depressive and dissociative symptoms mediated the effect of bullying victimization on self-cutting, regardless of their order in the model.

CONCLUSIONS

Self-cutting is more common among bullying victimized adolescents than their peers. The association is mediated by depressive and dissociative symptoms. More studies are needed to clarify the exact mechanisms via which depressive and dissociative symptoms interact with the association between bullying and self-harm.

Assessment of Plasma-Endogenous Opioid Neuropeptide Levels and Psychometric Properties of Non-Suicidal Self-Injury in Adolescents

OBJECTIVE

Non-suicidal self-injury (NSSI) is one of the most common mental health problems and growing public-health issues, coupled with a significant population-level burden among adolescents in both developed and developing countries. We aimed to assess the role of endogenous opioid system-emotion regulation circuitry in NSSI through measurement of plasma beta-endorphin (β-EP), met-enkephalin (MENK) levels, and determination of psychometric features of Turkish adolescent subjects.

METHOD

In this research, we measured plasma β-EP and MENK levels of 49 adolescents with NSSI and 39 control subjects without NSSI between the ages of 12-18 years. All adolescent subjects were observed in the outpatient clinic, and their clinical and sociodemographic characteristics were examined. All subjects were assessed using the Brief Symptom Inventory (BSI) and Inventory of Statements About Self Injury (ISAS).

RESULTS

Plasma β-EP levels were statistically lower in adolescents with NSSI than control group, whereas there was no statistically significant difference in MENK levels. β-EP levels showed a negative correlation with depression severity. The data obtained from BSI and ISAS were not found to be associated with both β-EP and MENK levels, while subscale scores exhibited versatile correlations.

CONCLUSION

Our findings supported the salient role of β-EP in NSSI behavior. Also, decreased plasma β-EP could be assessed as a reliable indicator for NSSI. However, it is possible that measurement of basal plasma levels of neuropeptides might also bring many confounders and could cause bias. Therefore, repeated measurements of plasma-endogenous opioid neuropeptides in a time-dependent manner-concomitant to engage of NSSI behavior-might give more reliable results.

Exploring Social Media Rumination: Associations With Bullying, Cyberbullying, and Distress

In this study, we examined students' perceptions of peer aggression occurring within their school environment and how these perceptions are interconnected with both social media rumination and distress. Social media usage is associated with a range of negative mental health and interpersonal outcomes for adolescents. Social media use can increase youth's vulnerability to peer victimization and psychosocial difficulties. In addition, ruminating when sad or stressed has been linked to elevated distress for youth experiencing peer aggression. Yet rumination specifically regarding social media activities has not been investigated in relation to peer aggression and distress, nor has the degree to which students perceive peer aggression occurring at school been included in these investigations. Participants were 169 high school students (age, M = 15.89, SD = .87), largely identifying as Black/African American and female, who completed surveys as part of a larger program working with at-risk youth in a Midwestern, urban city. We found that social media rumination mediated the relationship between perceptions of bullying at school and feelings of distress, but mediation was not supported when examining student perceptions of cyberbullying frequency and youth distress. In the case of bullying, rumination may disrupt other forms of coping-such as positive cognitive distractions-that would ameliorate symptoms of distress. Furthermore, we present evidence that social media rumination is experienced by, and has different influences on, youth. We highlight the need for differentiated intervention and prevention efforts regarding these two forms of peer aggression. Future research may be justified to examine these possibilities.

Fighting Bullying and Cyberbullying

The Internet's design and raison d'être are complete freedom, but complete freedom might lead to anarchy and to harmful and anti-social activities. In this paper I address the concepts of moral and social responsibility, applying them to the Internet realm in considering the most troubling phenomenon of cyberbullying that results in loss of life. Specifically, I probe the moral and social responsibilities of Internet users (agents), of parents and of the education system in fighting cyberbullying. Balance needs to be struck between two most important principles: freedom of expression and social responsibility. Illustrative examples in which this disturbing and harmful phenomenon of cyberbullying had cost young life are mentioned. It is argued that all relevant stakeholders need to think of the consequences of their conduct, that Internet abusers should be accountable for their wrongdoing and be penalized, and that people who have the ability to stop or at least reduce the risk of cyberbullying should take proactive steps, exhibiting zero tolerance to cyberbullying.

Using a Mixed-Methods Approach to Analyze Traumatic Experiences and Factors of Vulnerability Among Adolescent Victims of Bullying

A number of studies have analyzed the bullying phenomenon among adolescent victims. Relatively few studies, however, have specifically addressed the associated post-traumatic stress disorder (PTSD). Our clinical practice and therapeutic encounters with adolescents reveal that the majority of bullied adolescents suffer from high levels of PTSD. The objective of this study is to further explore bullied adolescents' traumatic experiences. In an attempt to analyze these experiences, this article presents a mixed-methods approach. Such an approach will allow to analyze the PTSD that results from bullying as well as subjects' psychic and family-relevant vulnerabilities. First, bullying will be defined in the context of adolescence. Then the main studies on bullying will be presented. The objectives, tools and methods of analysis will be presented. The interviews will be analyzed according to the Interpretative Phenomenological Analysis (IPA) method. Projective tools, family drawings, Rorschach and Thematic Apperception Test (TAT), will be analyzed using a psychoanalytic interpretation method. Each qualitative tool will be used alongside a validated quantitative tool. The Clinical Administered PTSD Scale (CAPS-CA-5 questionnaire) and the interviews conducted will thus allow to analyze PTSD and traumatic experiences. The Family Assessment Device (FAD) and the family drawing test will enable to assess family functioning; lastly, the Symptom Check List (SCL-90) that will be used alongside Rorschach and TAT tests will allow to analyze individual psychological vulnerabilities. This approach will increase data validity. The originality of this research study is based on a mixed-methods approach, our methodology which is based on clinical psychology, and the choice of certain research tools which have received little attention to date. Ultimately, this study may help improve how bullying is identified and could contribute toward the reinforcement or revision of the criteria that characterize bullying. Lastly, it may help us explore various unexamined dimensions of bullying. A possible limitation is the complexity associated with such a protocol.

Pathways to Suicide Among People With a Diagnosed Mental Illness in Victoria, Australia

Background: People who have mental illness are at increased risk of suicide. Therefore, identifying "typical" trajectories to suicide in this population has the potential to improve the effectiveness of suicide prevention strategies. Aim: The aim of this study was to explore the pathways to suicide among a sample of Victorians with a diagnosed mental illness. Method: Victorian Suicide Register (VSR) data were used to generate life charts and identify typical life trajectories to suicide among 50 Victorians. Results: Two distinct pathways to suicide were identified: (1) where diagnosis of mental illness appeared to follow life events/stressors; and (2) where diagnosis appeared to precede exposure to life events/stressors. Some events acted as distal factors related to suicide, other events were more common as proximal factors, and still others appeared to act as both distal and proximal factors. Limitations: The data source might be biased because of the potential for incomplete information, or alternatively, the importance of some factors in a person's life may have been overstated. Conclusion: Strategies to reduce suicide need to consider the chronology of exposure to stressors in people's lives and clearly need to be different depending on whether proximal or distal risk factors are the target of a given strategy or intervention.

Bi-directional longitudinal associations between different types of bullying victimization, suicide ideation/attempts, and depression among a large sample of European adolescents

BACKGROUND

The association between bullying victimization and depression, suicide ideation and suicide attempts has been studied mainly in cross-sectional studies. This study aims to test the bidirectional effect and the chronicity versus sporadic effect of physical, verbal, and relational bullying victimization on suicidal ideation/attempts and depression.

METHODS

Longitudinal assessments with an interval of 3- and 12-months were performed within a sample of 2,933 adolescents (56.1% females; mean age 14.78, SD = .89) from 10 European countries, participating in the Saving and Empowering Young Lives in Europe (SEYLE) school-based multicenter control sample. Multilevel Structural Equation Models were used, controlling for sociodemographic variables. Victimization was considered chronic when a student was victimized in the first two time points and sporadic when it was reported only at one point but not in another.

RESULTS

Bidirectional prospective association between all types of victimization and depression were found. Among participants, who reported victimization once (but not twice), physical victimization, but not verbal and relational, was associated with later suicidal ideation and attempts. Chronic victimization of any type increased likelihood for later depression compared with sporadic and no-victimization. Chronic relational victimization increased the likelihood of later suicidal ideation, and chronic physical victimization increased the likelihood for suicidal attempts.

CONCLUSIONS

The results support the bidirectional effect of victimization and depression and indicate that there are complex longitudinal associations between victimization and suicidal ideation/attempts. Physical victimization may especially carry effect on suicidal risk over time. Interventions should focus on victimization as a cause of distress but also aim to prevent vulnerable adolescents from becoming targets of victimization.

Risk profile of young people admitted to hospital for suicidal behaviour in Melbourne, Australia

AIM

Self-harm and suicidal behaviour is most prevalent during adolescence, but little is known about the risk profile of adolescents admitted to hospital for suicidal behaviour. Young people who self-harm are at an increased risk of mortality compared to those who do not self-harm; adolescents admitted to hospital for suicidal behaviour are particularly at risk. The aim of this study was to generate a risk profile of adolescents admitted to hospital with suicidal behaviour.

METHODS

We conducted a 12-month retrospective audit of adolescent admissions to the mental health inpatient unit at a tertiary children's hospital in Melbourne, Australia. Routinely collected data were used to generate a risk profile.

RESULTS

We found that 212 of 271 (78.2%) admissions were due to suicidal behaviour. Of these, 107 (51%) adolescents were diagnosed with one or more mental disorders at discharge, most commonly major depressive disorder. Beyond known distal determinants of health risk, the proximal risk profile of these adolescents included factors relating to gender, substance use, prior mental health diagnoses and prior admission to hospital. Poor sleep was also a risk factor, with 159 (75%) reporting a recent history of sleeping problems.

CONCLUSIONS

The very high proportion of admissions to the mental health inpatient unit due to suicidal behaviour reinforces the importance of finding effective methods of identification of the risk processes underpinning suicidal behaviours to reduce the unnecessary waste of young lives by suicide.

The Association between Deliberate Self-Harm and School Bullying Victimization and the Mediating Effect of Depressive Symptoms and Self-Stigma: A Systematic Review

BACKGROUND

Identifying deliberate self-harm in the young and its relationship with bullying victimization is an important public health issue.

METHODS

A systematic review was performed to explore evidence of the association between deliberate self-harm and school bullying victimization in young people, as well as the mediating effect of depressive symptoms and self-stigma on this association. An advanced search in the following electronic databases was conducted in January 2018: PubMed/Medline; CINAHL; PsycINFO; PsycARTICLES; Science Direct; Scopus, and Cochrane Library. Studies that fulfilled the inclusion criteria were further assessed for their methodological integrity. The Norwegian Knowledge Centre for Health Services tool was applied for cross-sectional studies and the Critical Appraisal Skills Programme instrument for the cohort studies. Only empirical quantitative studies published in the English language in peer reviewed journals during the last decade (2007-2018) aimed at exploring the association between deliberate self-harm and school bullying victimization in community-based schoolchildren with a mean age of under 20 years were included.

RESULTS

The reviewed cross-sectional and cohort studies (22) revealed a positive association between school bullying victimization and deliberate self-harm, including nonsuicidal self-injury, which remained statistically significant when controlled for the main confounders. The mediating role of depressive symptoms in the association between deliberate self-harm and school bullying victimization was confirmed. A dose-response effect was shown in the association between nonsuicidal self-injury and school bullying victimization, whilst the mediating effect of depressive symptoms needs to be further explored. No studies were found directly exploring the mediating effect of self-stigma in the association between deliberate self-harm and bullying victimization.

CONCLUSION

Targeted interventions aimed at eliminating victimization behaviours within the school context are therefore proposed, as well as interventions to promote healthy parenting styles for the parents of schoolchildren. Moreover, school healthcare professionals should screen students involved in bullying for self-injury, and vice versa.

[Bullying and psychoactive substance use during adolescence: a systematic review]

Bullying and psychoactive substance abuse are prevalent phenomena among adolescents and identified as health problems that may jeopardise the development of all those involved. This systematic review of the literature aims to identify the extent to which involvement in bullying and psychoactive substance use during adolescence are associated, as well as check for differences regarding the social roles of bullying. From the search for empirical articles published between January 2009 and December 2014 in seven electronic databases, 585 records were identified. After the criteria for inclusion and exclusion were applied, the remaining 40 studies were analyzed based on the design, characteristics of the sample and results of the relationship between bullying and psychoactive substance use. Most studies are quantitative and cross-sectional, and they showed mixed samples of boys and girls in the school environment, which was the place where the phenomena are studied by preference. The association between the perpetration of bullying and psychoactive substance use for adolescents of both sexes is revealed. In relation to victimization by bullying, it was not possible to determine the direction and characterization of the relationship with psychoactive substance use.

Multi-modal neuroimaging of adolescents with non-suicidal self-injury: Amygdala functional connectivity

BACKGROUND

Non-suicidal self-injury (NSSI) is a significant mental health problem among adolescents. Research is needed to clarify the neurobiology of NSSI and identify candidate neurobiological targets for interventions. Based on prior research implicating heightened negative affect and amygdala hyperactivity in NSSI, we pursued a systems approach to characterize amygdala functional connectivity networks during rest (resting-state functional connectivity [RSFC)]) and a task (task functional connectivity [TFC]) in adolescents with NSSI.

METHOD

We examined amygdala networks in female adolescents with NSSI and healthy controls (n = 45) using resting-state fMRI and a negative emotion face-matching fMRI task designed to activate the amygdala. Connectivity analyses included amygdala RSFC, amygdala TFC, and psychophysiological interactions (PPI) between amygdala connectivity and task conditions.

RESULTS

Compared to healthy controls, adolescents with NSSI showed atypical amygdala-frontal connectivity during rest and task; greater amygdala RSFC in supplementary motor area (SMA) and dorsal anterior cingulate; and differential amygdala-occipital connectivity between rest and task. After correcting for depression symptoms, amygdala-SMA RSFC abnormalities, among others, remained significant.

LIMITATIONS

This study's limitations include its cross-sectional design and its absence of a psychiatric control group.

CONCLUSIONS

Using a multi-modal approach, we identified widespread amygdala circuitry anomalies in adolescents with NSSI. While deficits in amygdala-frontal connectivity (driven by depression symptoms) replicates prior work in depression, hyperconnectivity between amygdala and SMA (independent of depression symptoms) has not been previously reported. This circuit may represent an important mechanism underlying the link between negative affect and habitual behaviors. These abnormalities may represent intervention targets for adolescents with NSSI.

Psychiatric disorders and suicide attempts among adolescents victimized by school bullying

OBJECTIVE

We conducted a cross-sectional school-based study to investigate psychiatric disorders and suicide risk among adolescents victimized by bullying.

METHOD

The study was designed in two stages. In the screening stage, 33,038 middle school students were screened for psychopathology. Next, in the face-to-face interview stage, 1196 participants were assessed for psychiatric disorders using a structured diagnostic instrument. We also collected information about the participants' experiences of bullying and history of suicidal ideation/attempts.

RESULTS

The results indicate that adolescents with a history of bullying victimization were more likely to be diagnosed with depression and psychosis than those without such a history. Multivariate logistic regression models revealed that bullying victimization was significantly associated with suicide attempts even after adjusting for demographic characteristics, depression and psychosis.

CONCLUSIONS

Bullying victimization is a risk factor for depression, psychosis, and suicide ideation and attempts. The findings warrant an early intervention and suicide prevention program for victimized students and anti-bullying policies in schools.

Bullying and cyberbullying studies in the school-aged population on the island of Ireland: A meta-analysis

BACKGROUND

Bullying research has gained a substantial amount of interest in recent years because of the implications for child and adolescent development.

AIM AND SAMPLE

We conducted a meta-analysis of traditional and cyberbullying studies in the Republic and North of Ireland to gain an understanding of prevalence rates and associated issues (particularly psychological correlates and intervention strategies) among young people (primary and secondary school students).

METHOD

Four electronic databases were searched (PsychArticles, ERIC, PsychInfo and Education Research Complete) for studies of traditional bullying and cyberbullying behaviours (perpetrators, victims or both) published between January 1997 and April 2016.

RESULTS

A final sample of 39 articles fit our selection criteria. CMA software was used to estimate a pooled prevalence rate for traditional/cyberbullying victimization and perpetration. A systematic review on the psychological impacts for all types of bullying and previously used interventions in an Irish setting is also provided.

CONCLUSIONS

The results demonstrate the influence moderating factors (e.g., assessment tools, answer scale, time frame) have on reported prevalence rates. These results are discussed in light of current studies, and points for future research are considered.

Prevalence and Associated Factors of Peer Victimization (Bullying) among Grades 7 and 8 Middle School Students in Kuwait

Background. Peer victimization (bullying) is a universal phenomenon with detrimental effects. The aim of this study is to determine the prevalence and factors of bullying among grades 7 and 8 middle school students in Kuwait. Methods. The study is a cross-sectional study that includes a sample of 989 7th and 8th grade middle school students randomly selected from schools. The Revised Olweus Bully/Victim Questionnaire was used to measure different forms of bullying. After adjusting for confounding, logistic regression identified the significant associated factors related to bullying. Results. Prevalence of bullying was 30.2 with 95% CI 27.4 to 33.2% (3.5% bullies, 18.9% victims, 7.8% bully victims). Children with physical disabilities and one or both non-Kuwaiti parents or children with divorced/widowed parents were more prone to be victims. Most victims and bullies were found to be current smokers. Bullies were mostly in the fail/fair final school grade category, whereas victims performed better. The logistic regression showed that male gender (adjusted odds ration = 1.671, p = 0.004), grade 8 student (adjusted odds ratio = 1.650, p = 0.004), and student with physical disabilities (adjusted odds ratio = 1.675, p = 0.003), were independently associated with bullying behavior. Conclusions. There is a need for a school-wide professional intervention program and improvement in the students' adjustment to school environment to control bullying behavior.

The differences in level of trait anxiety among girls and boys aged 13-17 years with myopia and emmetropia

Background

A significant increase in myopia among children and teenagers can be observed all over the world. Yet at the same time, there is still an insignificant number of studies concerning this health problem.

The aim of this study was to assess the level of trait anxiety among myopic group of teenagers in comparison to teenagers with emmetropia, and to confirm whether the level of trait anxiety relates to age and gender.

Methods

Two hundred thirty-nine students aged 13–17 years were included in the study. The study group comprised 114 persons with myopia (81 girls and 33 boys), while the control group comprised 125 persons without refractive error (79 girls and 46 boys). Volunteers completed a set of questionnaires including: personal data, State-Trait Anxiety Inventory for Children (STAIC) (13–14 year-olds), or State-Trait Anxiety Inventory (STAI) (15–17 year-olds). The trait anxiety subscales were thus analyzed.

Results

Among younger adolescents (13–14 years of age) with myopia there was a significantly higher incidence of pathological intensification of anxiety as a constant trait. After taking into account the distribution of gender, there was a higher level of trait anxiety in the group of boys with myopia than in the control group aged 13–17 years and 13–14 years. There was also a higher level of trait anxiety detected in males than in females.

Conclusions

Myopia may affect the level of trait anxiety among 13–14-year-olds. In both age groups of girls, a higher percentage of patients with high level of anxiety was discovered (≥7 sten), as compared to their peers without vision defects. Our results can contribute to a more accurate analysis of young teenagers’ psychological problems, especially among boys diagnosed with myopia.

‘Keeping my mind strong’: enabling children to discuss and explore issues relating to their perceptions of positive mental health through the arts

Background

The ramifications of mental ill health are enduring and potentially disabling. This research study focuses on using art to explore children’s understanding and awareness of mental health issues.

Aims

To explore the medium of ‘drawing’ as a method of communication by young people for expressing feelings and thoughts about what keeps their minds strong and what makes them happy as children.

Method

Arts-based research was used as a primary mode of inquiry to collect data and conduct analysis.

Sample

A total of 16 schools participated, with 10 from the primary school sector (children aged 5–11 years) and six from the post-primary sector (11 + to 18 years). A total of 358 posters were submitted.

Findings

Emergent themes suggested the existence of the awareness of stigma, which accompanied mental health issues and social isolation. In addition, perceptions of what makes children happy were also apparent, for example, family and friends. Similarities existed in the relationship between genders of a similar age group, and some differentiations presented between primary and post-primary educational sectors.

Implications

Arts-based research offers children an opportunity to recognise and express their feelings. Early identification of a child’s mental health problems may enable mental health nurses to engage in early intervention strategies to promote positive health functioning.

Conceptualizing the neurobiology of non-suicidal self-injury from the perspective of the Research Domain Criteria Project

Non-suicidal self-injury (NSSI) commonly starts in adolescence and is associated with an array of negative outcomes. Neurobiological research investigating NSSI is in its early stages and most studies have examined this behavior within the context of specific diagnoses. However, the Research Domain Criteria (RDoC) initiative encourages researchers to examine brain-behavior relationships across diagnoses. This review on the neurobiology associated with NSSI is organized using the domains proposed by RDoC: Negative Valence, Positive Valence, Cognitive, Social Processes, and Arousal/Regulatory Systems. Evidence of neurobiological anomalies is found in each of these domains. We also propose future research directions, especially in regard to human development. Future NSSI studies should address this behavior independent of diagnosis, examine relevant constructs across multiple units of analysis, and assess how systems change across development and course of illness. These advances will be essential for guiding neurobiologically informed intervention and prevention strategies to target NSSI. In doing so, we may prevent the associated negative outcomes across the lifespan.

Bullying behaviors among Chinese school-aged youth: a prevalence and correlates study in Guangdong Province

Bullying among school-aged youth is a common issue worldwide and is increasingly being recognized as an important problem affecting both victims and perpetrators. Most of the bullying studies have been conducted in western countries, and their implications in other regions are limited due to different cultural contexts. The goal of our study is to identify the prevalence of bullying and its correlates school-aged youth in Guangdong province. In total, 1098 (7.1%) students reported having bullied other students, 744 (4.8%) students reported having been bullied by other students and 396 (2.6%) students reported having both bullied other students and been bullied by other students. There was a strong association between bullying others as well as being bullied and suicidal ideations, suicidal attempts, and self-harm behaviors. The prevalence of bullying and its associations with delinquent behaviors warrant the importance of school facility based preventive intervention taking into account both victims and perpetrators.

Risk and Protective Factors of Suicidal Ideation and Attempt among Adolescents with Different Types of School Bullying Involvement

Suicide has been found to be prevalent among adolescents involved in bullying; however, there has been a lack of research examining whether the risk and protective factors of suicidal ideation and attempt are different among adolescents with different types of bullying involvement. The aims of this study were to examine the risk and protective factors of suicidal ideation and attempt among adolescents with different experiences of bullying involvement, victimization, and perpetration. A total of 4,533 adolescents participated in this study. Different groups of bullying involvement, victimization, and perpetration were determined through use of the Chinese version of the School Bullying Experience Questionnaire. The associations of suicidal ideation and attempt with possible risk factors (domestic violence, overweight, depression, anxiety, and alcohol abuse) and protective factors (family support and self-esteem) were examined using logistic regression analysis. Pure victims, pure perpetrators, and victim-perpetrators were more likely to report suicidal ideation and attempt than the neutral group. The risk and protective factors of suicidal ideation and attempt were different across adolescents with different experiences of bullying involvement, victimization, and perpetrators. The risk of suicide should be monitored among adolescents who are involved in any type of bullying. The risk and protective factors of suicide identified in this study should be taken into consideration in prevention and intervention programs for suicide in adolescents involved in bullying.

Self-harm in young offenders

The prevalence and correlates of self-harm and suicidal behavior in 515 young offenders (mean age 17.3 years, SD = 1.7) serving community-based orders (CBOs; n = 242) or custodial sentences (n = 273) in Victoria, Australia, are described. Results from structured interviews showed that 83 (16.1%) participants reported self-harming in the previous 6 months, and this was more common among those serving custodial sentences than those serving CBOs (19.4% vs. 12.4%; OR 3.10, 95% CI: 1.74-5.55). Multiple incidents were more common in females and 24% (95% CI: 19-39) of participants who had self-harmed reported having done so with suicidal intent. Self-harm was associated with recent bullying victimization, expulsion from school, past year violent victimization, cannabis dependence, and risk-taking behavior in the preceding year. The epidemiological profile of self-harm in this population appears to be distinct from that seen in the general population. Young offenders who self-harm are a vulnerable group with high rates of psychiatric morbidity, substance misuse problems, and social risk factors. They may benefit from targeted psychological interventions designed specifically to address impulsivity, delivered both within-and during the transition from-the youth justice system.

Risk and protective factors for peer victimization: a 1-year follow-up study of urban American students

This study examined whether internalizing problems, parental warmth and teacher support were associated with adolescents' experience of future peer victimization in school. Data were drawn from two rounds of the longitudinal Social and Health Assessment (SAHA). Study subjects comprised 593 US urban adolescents (aged 13.8 ± 0.8 years; 56 % female). Results showed that there was a substantial degree of continuity in peer victimization over a 1-year period. The presence of internalizing (anxiety, depressive and somatic) symptoms at baseline was associated with an increased risk of peer victimization over time. Both parental warmth and teacher support were uniquely associated with a lower risk for peer victimization. Implications of these findings for prevention efforts are discussed.

The relationship between elder mistreatment and suicidal ideation in rural older adults in China

OBJECTIVE

The aim of this study was to examine the association of elder mistreatment subtypes and suicidal ideation in adults age 60 years and older residing in a Chinese rural community.

METHODS

We conducted a population-based cross-sectional survey in 2010 and 2,039 adults age 60 and older, living in Macheng city of Hubei province, China, were interviewed face-to-face using a structured questionnaire. Multivariate logistic regression analyses were used to determine the independent effect of elder mistreatment to suicidal ideation among older adults.

RESULTS

Older adults who endorsed mistreatment had a significantly higher rate of suicidal ideation than those without elder mistreatment both in men (17.4% versus 2.4%; χ(2) = 58.04, p <0.01) and women (15.8% versus 4.0%; χ(2) = 50.24, p <0.01). After adjusting for potential confounding factors, psychological mistreatment (OR: 5.0; 95% CI: 2.5-9.8) and financial mistreatment (OR: 4.1; 95% CI: 1.2-14.7) were positively associated with suicidal ideation. Among men, psychological mistreatment (OR: 5.4; 95% CI: 2.6-11.2) and financial mistreatment (OR: 4.2; 95% CI: 1.1-16.2) were positively associated with suicidal ideation. Among women, physical mistreatment (OR: 4.5; 95% CI: 2.2-9.2) and psychological mistreatment (OR: 2.6; 95% CI: 1.5-4.4) were positively associated with suicidal ideation.

CONCLUSION

This is the first study that demonstrates that elder adults who experienced mistreatment are at increased risk for suicidal ideation. Our findings suggest that clinicians need to consider mistreatment exposure in older patients who have suicidal ideation. Victims of elder mistreatment should be the targets for suicide monitoring and prevention programs.

Exposure to bullying among students with autism spectrum conditions: A multi-informant analysis of risk and protective factors

Research has consistently shown that children and young people with autism spectrum conditions are more likely to be bullied than those with other or no special educational needs. The aim of this study was to examine risk and protective factors that could help to explain variation in exposure to bullying within this group. A sample of 722 teachers and 119 parents reported on their child’s experience of being bullied. This response variable was regressed onto a range of explanatory variables representing individual and contextual factors. The teacher- and parent-rated regression models were statistically significant, explaining large proportions of variance in exposure to bullying. Behaviour difficulties and increased age were associated with bullying in both models. Positive relationships and attending a special school were associated with a decrease in bullying in the teacher model, with use of public/school transport predicting an increase. In the parent model, special educational needs provision at School Action Plus (as opposed to having a Statement of Special Educational Needs) was a significant risk factor, and higher levels of parental engagement and confidence were associated with reductions in bullying. These findings are discussed in relation to the autism spectrum conditions literature, and opportunities for intervention are considered.

Being bullied during childhood and the prospective pathways to self-harm in late adolescence

OBJECTIVE

To assess whether being bullied between 7 and 10 years of age is directly associated with self-harm in late adolescence when controlling for previous exposure to an adverse family environment (domestic violence, maladaptive parenting); concurrent internalizing and externalizing behavior; and subsequent psychopathology (borderline personality disorder and depression symptoms).

METHOD

A total of 4,810 children and adolescents in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort were assessed to ascertain bullying exposure (between 7 and 10 years of age) and self-harm at 16 to 17 years.

RESULTS

A total of 16.5% of 16- to 17-year-olds reported self-harm in the previous year. Being bullied was associated with an increased risk of self-harm directly, and indirectly via depression symptoms in early adolescence. The association between an adverse family environment (exposure to maladaptive parenting and domestic violence) and self-harm was partially mediated by being bullied.

CONCLUSIONS

Being bullied during childhood increases the risk of self-harm in late adolescence via several distinct pathways, for example, by increasing the risk of depression and by exacerbating the effects of exposure to an adverse family environment; as well as in the absence of these risk exposures. Health practitioners evaluating self-harm should be aware that being bullied is an important potential risk factor.

Weight, body image and bullying in 9-year-old children

AIM

To explore the association between weight and bullying; considering victims and perpetrators as two aspects of bullying, and subjective perception and objective measurement as two aspects of weight.

METHODS

This study is based on the first wave of data collection from Growing Up in Ireland - the National Longitudinal Study of Children. The two-stage sample design included a sample of 910 primary schools in Ireland, from which a sample of 8568 nine-year-old children and their families was randomly selected. Analysis is based on statistically reweighted data to ensure that it is representative of all 9-year-olds in Ireland.

RESULTS

Significantly (P < 0.001) more girls were overweight or obese (33.1%: 23.1% overweight and 10% obese) than boys (25.2%: 18.3% and 6.9%). Children who were body mass index (BMI) classified as overweight or obese were significantly (P < 0.001) more likely to be victimised when compared with children whose BMI was not classified as overweight or obese. BMI-classified thinness was not significantly associated with victimisation; however, the body image of being skinny or very skinny was significantly (P = 0.015) associated with being victimised. Bullying perpetration was not associated with BMI-derived weight classification but was significantly (P < 0.001) associated with the child's own self-description of weight.

CONCLUSIONS

Overall body image was found to have a stronger association with victimisation and bullying perpetration than objective BMI-derived weight classification. Further research investigating the mediating role of body image in the relationship between weight, victimisation and bullying is necessary to better understand this association.

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.

Peer physical aggression and its association with aggressive beliefs, empathy, self-control, and cooperation skills among students in a rural town of China

This study explored the prevalence of peer physical aggression (PPA) and its association with aggressive beliefs, empathy, self-control, and cooperation skills among 1,719 7th-to-9th-grade students in a rural town in the central China province of Henan. The data were collected by the self-administered questionnaire anonymously. Results showed that 17.9% of the students reported that they had one or more times of physical aggressive behaviors toward their peers in the past 12 months. The reported rate of PPA was significantly higher in boys (24.7%) than in girls (10.7%). After adjusting the factors of gender and grade, result of logistic regression analysis showed that having a higher level of aggressive beliefs was PPA risk factor; a higher level of self-control was protective factor, but there were no significant association between PPA and the factors of empathy and cooperation skills. These results indicated that helping students to decrease their aggressive beliefs and to improve their self-control skill would aid in the prevention of youth violence.

Lifetime polytraumatization in adolescence and being a victim of bullying

The purposes of this study were to examine the mental health consequences of having been a victim of bullying and to investigate whether the impact of bullying was dependent on the co-occurrence of other potentially traumatic events, noninterpersonal traumas, interpersonal traumas, as well as adverse childhood circumstances. A community sample of participants (n = 462; 216 males and 246 females) aged 15 to 20 years completed the self-administered Linkoping's Youth Life Experience Scale about lifetime exposure to a range of traumatic and other adverse events and circumstances and the Trauma Symptom Checklist for Children (TSCC). The results showed that those who reported being a victim of bullying reported significantly higher scores on all TSCC clinical scales as well as significantly more other traumatic and adverse family exposures. Multiple linear regression analyses indicated that the impact of bullying on mental health was explained, to a considerable degree, by the accumulation of other adverse and traumatic exposures, particularly in the females.

Effects of poly-victimization on self-esteem and post-traumatic stress symptoms in Spanish adolescents

This study aims to provide evidence concerning the effects of experiencing multiple forms of victimization (poly-victimization) on self-esteem and post-traumatic stress symptoms in Spanish adolescents. A total of 722 adolescents were recruited from seven secondary schools in Catalonia, Spain. The Rosenberg Self-Esteem Scale, the Youth Self Report and the Juvenile Victimization Questionnaire were employed to assess self-esteem, post-traumatic stress symptoms and victimization, respectively. Participants were divided into three groups (non-victim, victim and poly-victim groups) according to the total number of different kinds of victimization experienced. Results showed that 88.4 % of adolescents had been exposed to at least one kind of victimization. Poly-victimization was associated with a higher number of post-traumatic stress symptoms in both boys and girls. Also, self-liking was significantly lower in the poly-victim group, whereas self-competence was equivalent across the three victimization groups. Girls were approximately twice as likely to report child maltreatment (OR = 1.92) and sexual victimization (OR = 2.41) as boys. In conclusion, the present study adds evidence on the importance of taking account of the full burden of victimizations suffered when studying victimization correlates. Also, it highlights the importance of prevention policies to focus particularly on preserving adolescents' sense of social worth.

Bullying victimisation and risk of self harm in early adolescence: longitudinal cohort study

OBJECTIVES

To test whether frequent bullying victimisation in childhood increases the likelihood of self harming in early adolescence, and to identify which bullied children are at highest risk of self harm.

DESIGN

The Environmental Risk (E-Risk) longitudinal study of a nationally representative UK cohort of 1116 twin pairs born in 1994-95 (2232 children).

SETTING

England and Wales, United Kingdom.

PARTICIPANTS

Children assessed at 5, 7, 10, and 12 years of age.

MAIN OUTCOME MEASURES

Relative risks of children's self harming behaviour in the six months before their 12th birthday.

RESULTS

Self harm data were available for 2141 children. Among children aged 12 who had self harmed (2.9%; n=62), more than half were victims of frequent bullying (56%; n=35). Exposure to frequent bullying predicted higher rates of self harm even after children's pre-morbid emotional and behavioural problems, low IQ, and family environmental risks were taken into account (bullying victimisation reported by mother: adjusted relative risk 1.92, 95% confidence interval 1.18 to 3.12; bullying victimisation reported by child: 2.44, 1.36 to 4.40). Victimised twins were more likely to self harm than were their non-victimised twin sibling (bullying victimisation reported by mother: 13/162 v 3/162, ratio=4.3, 95% confidence interval 1.3 to 14.0; bullying victimisation reported by child: 12/144 v 7/144, ratio=1.7, 0.71 to 4.1). Compared with bullied children who did not self harm, bullied children who self harmed were distinguished by a family history of attempted/completed suicide, concurrent mental health problems, and a history of physical maltreatment by an adult.

CONCLUSIONS

Prevention of non-suicidal self injury in young adolescents should focus on helping bullied children to cope more appropriately with their distress. Programmes should target children who have additional mental health problems, have a family history of attempted/completed suicide, or have been maltreated by an adult.

Distinguishing adolescents who think about self-harm from those who engage in self-harm

BACKGROUND

Adolescent self-harm is a major public health concern, yet little is known about the factors that distinguish adolescents who think about self-harm but do not act on these thoughts from those who act on such thoughts.

AIMS

Within a new theoretical model, the integrated motivational-volitional model, we investigated factors associated with adolescents having thoughts of self-harm (ideators) v. those associated with self-harm enaction (enactors).

METHOD

Observational study of school pupils employing an anonymous self-report survey to compare three groups of adolescents: self-harm enactors (n = 628) v. self-harm ideators (n = 675) v. those without any self-harm history (n = 4219).

RESULTS

Enactors differed from ideators on all of the volitional factors. Relative to ideators, enactors were more likely to have a family member/close friend who had self-harmed, more likely to think that their peers engaged in self-harm and they were more impulsive than the ideators. Enactors also reported more life stress than ideators. Conversely, the two self-harm groups did not differ on any of the variables associated with the development of self-harm thoughts.

CONCLUSIONS

As more adolescents think about self-harm than engage in it, a better understanding of the factors that govern behavioural enaction is crucial in the effective assessment of the risk of self-harm.

Education and depression

This article is intended to assist educators in the medical field in promoting competency among medical students and trainees on the key issues in child and adolescent depression, including approach, understanding, and management. Using clinical vignettes, up-to-date research, and expert opinion and referencing accessible guidelines, resources, and tools, the authors' goal is to create information that is engaging and useful. It is designed to reach a broad audience with emphasis on trainees who are early in their career path (eg, medical students or interns) and/or who are going into primary care.

Opfer von Bullying in der Schule

Der Leidensdruck durch schulisches Bullying ist enorm, sowohl auf Opfer- als auch auf Täterseite wird das Risiko für emotionale Störungen und Verhaltensauffälligkeiten erhöht sowie die schulische Entwicklung erheblich beeinträchtigt. Es wird der Zusammenhang von Bullying und Depression, Suizidalität und selbstverletzendem Verhalten diskutiert. Hierfür wurden 303 Schüler befragt, von denen 20.8 % angaben, in den letzten Monaten ein Opfer von Bullying geworden zu sein. Das Risiko zur Ausbildung der genannten emotionalen Störungen zeigte sich für viktimisierte Schüler deutlich erhöht (Odds Ratios von 2.4 bis 3.0). Der notwendige Ausbau von schulbezogenen Bullying-Präventionsprogrammen in Deutschland würde demnach mit hoher Wahrscheinlichkeit auch zur Prävention ernsthafter emotionaler Störungen bei Kindern und Jugendlichen beitragen.

Violence and Men’s Health

Although violence affects everyone, men’s health is disproportionately affected. To better understand the etiology of men’s violence, it is essential to comprehensively examine the factors influencing the development and trajectories of violence perpetration and victimization. This review offers a broad perspective on the burden of violence for men and the characteristics of individuals, relationships, communities, and society that combine to influence men’s experience with interpersonal violence, including child maltreatment, youth violence, intimate partner violence, and sexual violence. Men’s experience with violence is influenced by physiological, emotional, and behavioral factors; relationships with family and peers; and social norms. In collaboration with professionals from other sectors, health professionals can help prevent or intervene in male’s perpetration of violence across the lifespan through identification of factors that place men at risk and referral of male patients to evidence-based prevention and intervention resources.