Victims of Bullying and Tobacco Use Behaviors in Adolescents: Differences Between Bullied at School, Electronically, or Both

Effects of racial teasing on adolescent marijuana use and nicotine vaping: An analysis of the Virginia Youth Risk Behavior Surveillance System

BACKGROUND

Despite adverse effects of tobacco and marijuana use on the adolescent brain, its use among youth remains high. Previous research shows associations between bullying and risks of substance use; less is known about racial teasing. This study examines associations of racial teasing, marijuana and/or electronic vapor products (EVP) use among adolescents, using 2021 Virginia Youth Risk Behavior Surveillance System (VYRBSS).

METHODS

VYRBSS is a self-reported survey which collects information on experiences with racial teasing and substance use. This analysis included 3,083 high school students ≥ 12 years old. Descriptive analysis and logistic regression models were performed for categorical variables. Multivariable models were adjusted for confounders.

RESULTS

Racial teasing was associated with marijuana (AOR 1.89; CI 1.43-2.48) and EVP use (AOR 2.52; CI 1.91-3.31). Compared to Whites; Asians, Blacks, and Latinos were more likely to report racial teasing. Older heterosexual females reported higher use of marijuana and EVP. Blacks reported greater use of marijuana, whereas Whites were more likely to use EVP. EVP use was higher in females (AOR 1.73, CI 1.34-2.23), bisexual youth (AOR 1.68, CI 1.23, 2.30) and poor mental health (AOR 1.49, CI 1.16, 1.92). Marijuana use was associated with bisexuality (AOR 1.75, CI 1.28-2.39) and poor mental health (AOR 1.62, CI 1.27-2.07) as well.

CONCLUSIONS

Every effort should be made by public health professionals in Virginia to prevent racial teasing among adolescents because it increases the odds of substance use, particularly in older females, youth who identify as bisexual, and those reporting poor mental health.

Prevalence and Determinants of Current Cigarette Smoking Among Adolescents in Thailand: Evidence From 2021 Global School-Based Health Survey

BACKGROUND

Adolescent cigarette smoking remains a concern globally, including in Thailand. This research aimed to elucidate the prevalence and determinants of cigarette smoking among Thai adolescents. Study Design: A cross-sectional study.

METHODS

A cross-sectional analysis of data from the 2021 Thailand Global School-Based Health Survey with 5545 adolescents aged 13-17 with complete information was conducted on their cigarette smoking status. Bivariate analysis and multivariable logistic regression were performed to discern the determinants of tobacco smoking among adolescents.

RESULTS

The overall weighted prevalence of cigarette smoking was 11.5% (95% confidence interval [CI]=9.7%, 13.5%), with adolescent males at 18.2% (95% CI=15.3%, 21.4%) and adolescent females at 5.6% (95% CI=4.2%, 7.4%). The multivariable logistic regression also revealed that males were more likely to be smokers (Adjusted Odd Ratio [AOR]=1.58; 95% CI=1.02, 2.45, P=0.040) compared to females. The presence of smokers in their vicinity significantly increased the odds of smoking (AOR=2.21, 95% CI=1.46, 3.36, P<0.001). Current alcohol use (AOR=3.37, 95% CI=2.21-5.14, P<0.001) and current marijuana use (AOR=4.53, 95% CI=2.06, 9.99, P<0.001) were both significant determinants of smoking. Notably, early initiation of cigarette use (before age 14) was associated with a lower likelihood of current smoking (AOR=0.54, 95% CI=0.33, 0.92, P=0.022).

CONCLUSION

With an overall prevalence of smoking among adolescents at 11.5%, our study highlights a significant public health concern. The positive determinants of the identified tobacco smoking include being male, having smokers in their vicinity, and currently using alcohol, and marijuana, while early initiation of cigarette use before age 14 is identified as an inverse determinant.

Recognizing the Frequency of Exposure to Cyberbullying in Children: The Results of the National HBSC Study in Serbia

Nowadays, children are able to enrich their reality via the Internet. Unfortunately, this may increase their risk of becoming victims of cyberbullying. We analyzed the health characteristics and risk behavior of two cohorts of children in Serbia; those who reported being exposed to cyberbullying and those who did not. The statistical differences and logistic regression models were applied to the data on 3267 students collected from 64 schools participating in the 2017 Serbian Study on health behavior in school-age children (HBSC). Children exposed to cyberbullying reported having the following health problems on a daily basis: headache (18.5%), back pain (19.5%), depression (21.6%), irritability or bad mood (17.7%), nervousness (16.0%), sleep problems (16.1%), and dizziness (21.2%). As for the different types of risk behavior, cigarette smoking ranging from six to nine days ever was the most prevalent (26.9%). It was followed closely by getting drunk more than 10 times ever (24.1%). Compared to non-victims, victims were found to be at a higher risk of perceived back pain (OR = 2.27), depression (OR = 1.43), irritability or bad mood (OR = 2.07), nervousness (OR = 2.23), and dizziness (OR = 2.43) as well as being injured once or twice (OR = 1.98) or three or more times (OR = 4.09). Victims were associated with further risk factors: having smoked more than five cigarettes ever in life (OR = 1.73) and having gotten drunk two to three times (OR = 1.71) or four or more times (OR = 1.65). As the number of school-age children using social media continues to rise, we must prioritize educating them about self-help and community resources for addressing related health issues with greater speed and intensity. The findings from Serbia suggest that while children may be aware of their health issues, they may be unaware of their link to cyberbullying, which could hinder their ability to address these issues promptly. The respondents' attention to the health implications of cyberbullying could be increased by reformulating the survey questions used in the HBSC study.

Adolescent smoking patterns: Associations with sociodemographic factors, cyberbullying, and psychiatric diagnoses in an outpatient clinical sample

There is a scarcity of research on smoking in adolescents within a clinical (outpatient) sample, and there is no existing knowledge on the relationship between cyberbullying and smoking in this population. The primary aim of this study is to determine the prevalence of smoking among adolescents in a clinical sample. Additionally, it aims to examine the potential associations between smoking status and factors such as socioeconomic characteristics, psychiatric diagnoses, and cyberbullying levels. A cross-sectional study was performed on 200 adolescents who visited a tertiary child and adolescent psychiatry outpatient clinic. Participants were assessed using the DSM-5 based psychiatric evaluation, the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-DSM-5 Turkish Adaptation (K-SADS-PL-DSM-5-T), the Revised Cyber Bullying Inventory-II, and the Fagerström Test for Nicotine Dependence. The study found that 21% of the sample consisted of regular smokers, with a higher prevalence observed among older adolescents. The prevalence of depression and disruptive behavior disorders was significantly greater in the smoking group compared to other groups (p:0.043, p < 0.001, respectively). There was a significant difference in the scores for the cyberbullying bully subdimension among smokers (p = 0.013). The results of the multinomial logistic regression analysis indicated significant associations between smoking and age, maternal smoking status, friends smoking status, and a diagnosis of disruptive behavior disorder (p < 0.05 for all variables). This study reveals a significant prevalence of adolescent smoking in an outpatient clinic. These findings highlight the necessity of implementing focused smoking cessation interventions for this specific population.

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.

Smoking Susceptibility in Canadian Adolescent Electronic-Cigarette Users

Background: E-cigarette use is increasing among Canadian youth, with experimentation especially prevalent among never-smoking youth. Among this group, there is concern e-cigarette use contributes to future initiation of smoking through a gateway effect. However, e-cigarette use and smoking share many common risk factors; a postulated mechanism to explain the apparent causal pathway from e-cigarette use to smoking initiation in previously smoking-naïve youth. A better understanding of the relationships between smoking susceptibility and e-cigarette use among never-smoking youth is needed. Purpose/objectives: The primary aim of this study was to gain a deeper understanding of the risk factors associated with smoking susceptibility in youth who have recently used e-cigarettes. Methods: This study used data (n = 40,363) from the 2018/2019 Canadian Student Tobacco Alcohol and Drug Use Survey (CSTADS) to compare the risk factor profiles of susceptible and non-susceptible never-smoking e-cigarette users, as well as susceptible and non-susceptible never-smoking youth who have never used an e-cigarette. Results: E-cigarette use, independent of susceptibility status, was associated with a sociodemographic and behavioral risk factor profile likely to confer a higher risk of initiating smoking. Among e-cigarette users, smoking susceptibility was associated with more smoking risk factors. Conclusions/importance: Study findings support a common risk-factor model, rather than e-cigarette use itself, to explain differences in the likelihood of smoking initiation among e-cigarette users. E-cigarette use and smoking initiation may be interchangeable outcomes amongst those with smoking risk factors. The risks of e-cigarette use, and their regulatory status, need to be balanced with their potential as harm reduction tools.

Factors Associated with Cyberbullying Victimisation among Colombian High-School Adolescents

The study's purpose was to examine the prevalence and explore some factors associated with cyberbullying in high-school adolescents at ​​Santa Marta, Colombia. A cross-sectional study was designed, which participated in students between 13 and 17 years. Participants completed the item for being a victim of cyberbullying of the Youth Risk Behavior Survey for high school students designed by the Center for Disease Control of the United States. A total of 1462 students answered the questionnaire (M = 14.4 years, SD = 0.8). 19.6% (n = 287) reported lifetime cyberbullying victimisation. Cyberbullying victimisation was associated with post-traumatic stress disorder risk (OR = 2.05, 95%CI 1.51-2.79), lifetime cigarette smoking (OR = 1.91, 95%CI 1.42-2.57), female gender (OR = 1.68, 95%CI 1.25-2.26), family dysfunction (OR = 1.68, 95%CI 1.18-2.41), and poor-fair health condition (OR = 1.45, 95%CI 1.08-1.95). Being a victim of cyberbullying is frequent among Colombian high-school adolescents. It is associated with post-traumatic stress disorder risk, cigarette smoking, female gender, family dysfunction, and poor-fair general health condition. Longitudinal investigations are needed to measure better the dynamics of cyberbullying and the nature of such associations.

Correlates of bullying victimization among school adolescents in Nepal: Findings from 2015 Global School-Based Student Health Survey Nepal

BACKGROUND

Bullying is an emerging risk factor for poor mental health outcomes adversely affecting children and adolescents. However, it has rarely caught the attention of the health and education sector due to lack of evidence in many countries including Nepal. This study aimed to assess the prevalence and factors associated with bullying behavior among adolescent students in Nepal.

METHODS

We used nationally representative data from the Nepal Global School-Based Student Health Survey that involved two-stage cluster sampling design with the use of a standard set of self-administered questionnaires. Complex sample analysis was done to determine the prevalence and correlates of bullying among 6529 students of 68 schools studying in grade 7 to 11 using descriptive analysis and multivariable logistic regression.

RESULTS

The overall prevalence of bullying among Nepalese school adolescents was 51% (55.67% in male and 46.17% in female). Bullied adolescents more commonly reported mental health problems with higher risk of loneliness (aOR 1.36, 95% CI: 1.12, 1.64), anxiety (aOR 2.04, 95% CI: 1.65, 2.52), suicide attempt (aOR 2.08, 95% CI: 1.54, 2.81), school absenteeism due to fear (aOR 1.72, 95% CI: 1.34, 2.21) and school truancy (aOR 1.48, 95% CI: 1.17, 1.87). A significant association was seen between bullying victimization and negative health behaviors like involvement in physical fights (aOR 3.64, 95% CI: 2.94, 4.51) and tobacco use (aOR 2.05, 95% CI: 1.15, 3.65).

CONCLUSION

School bullying is significantly associated with mental health factors like loneliness, anxiety, suicide attempt, school absenteeism and risky behavioral factors like smokeless tobacco use and involvement in physical fight. The insights provided by these findings have important implications for planning anti-bullying strategies in school settings in the Nepalese context.

Bullying Victimization and e-Cigarette Use among Middle and High School Students

BACKGROUND

Bullying has been associated with several adverse health outcomes, including substance use. However, little is known about the association between bullying and e-cigarette use. This study examined the association between bully victimization and the frequency of e-cigarette use.

METHODS

Data from the 2016-2017 Canadian Student Tobacco, Alcohol and Drugs Survey were used (N = 49,543). The target population consists of Canadian students enrolled in grades 7-12. Multivariable logistic regression models were used to examine the association between bullying victimization status and e-cigarette use.

RESULTS

Among the students included in the study, 14.1% were bullied less than once a week. Bullying victimization was statistically significantly associated with higher odds of any e-cigarette use in the last 30 days. Likewise, those bullied daily or almost daily were more likely to use e-cigarettes more frequently compared to students not bullied. We found a statistically significant difference in analysis stratified by sex, with female bullying victims having higher odds of all measures of e-cigarette use.

CONCLUSIONS

Bullying victims were significantly more likely to use an e-cigarette, and findings appeared to vary by sex. Female bullying victims had a higher likelihood of e-cigarette use.

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

BACKGROUND

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

OBJECTIVE

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

PARTICIPANTS AND SETTING

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

METHODS

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

RESULTS

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

CONCLUSION

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

Self-reported history of concussions is associated with risk factors for suicide completion among high school students

BACKGROUND

Suicide is the third leading cause of death among adolescents. While research has found concussions to be a risk factor for suicide in adults, this relationship is not well studied in nationally representative samples of youth. This study examines the relationship between self-reported history of sports-related concussion and five risk factors for suicide completion.

METHODS

Data were obtained from the 2017 Youth Risk Behavior Surveillance Survey (n=13,353). Multivariate logistic regression models assessed the relationship between self-reported, sports-related concussion and five risk factors for suicide completion. Analyses controlled for sex, race/ethnicity, grade, bullying victimization, and sexual orientation. Subsample analyses were conducted stratified by sex. Interaction models examined biological sex as a possible effect modifier.

RESULTS

Overall, 15.0% of high school students reported a sports-related concussion in the past 12-months. Self-reported, sports-related concussion was significantly associated with greater odds of feeling sad/hopeless (Adj OR: 1.20; 95% CI:1.02-1.42), suicidal ideations (Adj OR: 1.25; 95% CI:1.02-1.55), suicide attempt (Adj OR: 1.60; 95% CI:1.31-1.96), and suicide attempt treated by a doctor/nurse (Adj OR: 2.35; 95% CI:1.68-3.29), adjusting for covariates. Stratified analyses demonstrated differences by sex, however, no direct evidence of effect modification was observed in interaction models.

LIMITATIONS

Data are cross-sectional, prohibiting causal inferences. Measures were assessed via self-report. No pre-concussion measures of mental health.

CONCLUSION

Self-reported sports-related concussion was associated with risk factors for suicide completion. No direct evidence of effect modification was observed but stratified analyses suggest biological sex may impact the observed relationship.

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

BACKGROUND

Although studies have examined the association between bullying victimization and adolescent substance behaviors, there is a dearth of research investigating the association between bullying victimization and prescription drug misuse. The objective of this study was to examine the cross-sectional association between bullying victimization and prescription drug misuse among adolescents.

METHODS

Data for this study came from the 2017 Youth Risk Behavior Survey. A sample of 9974 adolescents aged 14-18 years (50.1% female) were analyzed using binary logistic regression with prescription drug misuse as the outcome variable and bullying victimization as the main explanatory variable.

RESULTS

Of the 9,974 adolescents, 13.1% misused prescription drugs. One in ten adolescents were victims of both school bullying and cyberbullying, 5.1% were victims of only cyberbullying, 9% were victims of only school bullying, and 75.8% experienced neither school bullying nor cyberbullying victimization. In the binary logistic regression model, adolescents who experienced both school bullying and cyberbullying victimization had 1.66 times higher odds of misusing prescription drugs (AOR = 1.66, p < .001, 95% CI = 1.34-2.06) and adolescents who experienced only school bullying victimization had 1.30 times higher odds of misusing prescription drugs (AOR = 1.30, p < .05, 95% CI = 1.02-1.64). Being lesbian, gay, or bisexual; feeling sad or hopeless; cigarette smoking; binge drinking; cannabis use; and illicit drug use were statistically significantly associated with prescription drug misuse.

CONCLUSIONS

Understanding the association between bullying victimization and prescription drug misuse could contribute to early identification of adolescents who may misuse prescription drugs.

Prevalence and correlates of being bullied among adolescents in Indonesia: results from the 2015 Global School-based Student Health Survey

Introduction Violence against adolescents is prevalent in the world, yet this issue is neglected especially in developing countries. Bullying among adolescents negatively affects the victims in relation to emotional, physical, social and overall health status. This study was conducted to understand bullying and its associated factors in school-going adolescents in Indonesia. Methods This study was a correlational design with a cross-sectional approach. Data were obtained from the 2015 Indonesia Global School-based Health Survey (GSHS). As many as 9969 adolescents in schools were selected by probability proportional to size method and systematic sampling. Variables analyzed on this study were age, sex, smoking behavior, alcohol consumption, close friends and feeling of loneliness. The research instrument used the GSHS 2015 questionnaire. Chi-square (χ2) analysis and multiple logistic regression tests were conducted to determine the significance of each variable. Results A total of 19.9% of adolescents in Indonesian schools were victims of being bullied. Being bullied was associated with ≤14 years old [adjusted odds ratio (AOR) 1.30, 95% confidence interval (CI) 1.17-1.45], being male (AOR 1.43, 95% CI 1.28-1.59), being a smoker (AOR 1.46, 95% CI 1.23-1.73), consuming alcohol (AOR 2.07, 95% CI 1.64-2.62), having no close friends (AOR 1.27, 95% CI 0.95-1.70) and feeling lonely (AOR 2.29, 95% CI 2.05-2.55). Conclusion Indonesian in-school adolescents report a relatively high prevalence of having been bullied. Being bullied is related to various factors depending on personal and environmental factors. School communities and health professionals' attention to adolescents should be sensitized and this issue discussed, developing strategies and minimizing the negative effect on the adolescents. Policy makers need to consider developing a social platform among adolescents to facilitate students' interaction.

Increasing cultural competence with LGBTQ patients

Many nurses practicing today lack basic education about LGBTQ (lesbian, gay, bisexual, transgender, queer) patient care. How can they better prepare to care for this population? This article provides insight on LGBTQ people, their health risks and disparities, and how nurses can work with LGBTQ patients to improve outcomes.

Autism Spectrum Disorder and School Bullying: Who is the Victim? Who is the Perpetrator?

While a growing number of studies indicate associations between experiences of bullying and autism spectrum disorder (ASD), it is not clear what roles comorbid behavioral problems may play. We investigated the experiences of children with ASD as victims and/or perpetrators of bullying. Children with ASD epidemiologically ascertained participated in a cross-sectional study. Although children with ASD showed significantly increased risk for bullying involvement compared to community children, after controlling for comorbid psychopathology and other demographic factors, increased risks for being perpetrators or victim-perpetrators disappeared while risk for being bullied/teased continued to be significantly elevated. This finding will help guide medical, educational and community personnel to effectively identify children with ASD at risk for school bullying and develop interventions.

The gender discrepancy in high-risk behaviour outcomes in adolescents who have experienced cyberbullying in Indonesia

OBJECTIVE

Adolescent cyberbullying and high-risk behaviour outcomes has been a major concern in the last few years. Gender discrepancy is an important component that predicts the outcomes. This study aimed to elaborate and identify the association between cyberbullying experience and high-risk behaviour outcomes based on gender differences among adolescents in Indonesia.

METHOD

A cross sectional study that involved junior and senior high schools in Jakarta. There were 2917 adolescents who took part in this study. The cyberbullying questionnaire was used to identify the cyberbullying experienced. High-risk behaviour included in this study was tobacco smoking, alcohol consumption, and self-harm behaviour. Chi-Square test and odds ratio analysis were applied through SPSS for Mac.

RESULTS

The highest proportion in this study was composed of adolescents of both genders who acted as victim/perpetrator (52.25%). Adolescent males who indulged in cyberbullying showed an increased risk for cigarette smoking (OR = 2.97); male adolescents who were victims and victim/perpetrator of cyberbullying had a higher risk to consume alcohol (OR = 2.96 & OR = 6.93). Meanwhile, the risk of self-hurting behaviour increased for both female and male with cyberbullying victimization (OR = 3.68 & OR = 2.97). Female adolescents who acted as victim/perpetrator had a higher risk of suicidal thoughts and attempting suicide (OR = 1.90 & OR = 2.11); and they were also at risk of consuming alcohol (OR = 2.84).

CONCLUSION

Cyberbullying returned negative impacts on both genders of adolescents. Boys showed a greater tendency to externalize while girls showed a greater tendency to internalize. Mental health promotion that is designed specifically for both genders might address the adolescents' needs.