Intervening in primary care against childhood bullying: an increasingly pressing public health need

Sibling bullying victimization and subjective well-being among children across 13 countries: The mediating roles of perceived social support and the moderating role of uncertainty avoidance culture

BACKGROUND

While sibling bullying victimization has been recognized as a significant factor detrimentally impacting children's subjective well-being, the underlying mechanisms have yet to be fully elucidated.

OBJECTIVE

This study seeks to investigate the potential mediating role of perceived social support, encompassing support from family, friend, teacher, and neighbor, as well as the moderating influence of uncertainty avoidance culture.

PARTICIPANTS AND SETTING

A sample of 19,328 children was obtained from Wave Three of Children's Worlds: International Survey of Children's Well-being in 13 countries.

METHODS

The structural equation model (SEM) was used to investigate the mediating role of perceived social support in the relationship between sibling bullying victimization and children's subjective well-being. The multiple group analysis was carried out to assess the moderating role of uncertainty avoidance culture.

RESULTS

This study reveals a negative association between sibling bullying victimization and children's subjective well-being (β = -0.138, p < 0.001). Perceived support from family, friend, teacher, and neighbor emerges as a mediating mechanism in this relationship. Uncertainty avoidance culture moderates this relationship, and this association is stronger for children raised in a strong uncertainty avoidance culture (β = -0.085, p < 0.001).

CONCLUSIONS

The results of this study contribute to our comprehension of the nexus between sibling bullying victimization and children's subjective well-being. Moreover, this study extends the current body of knowledge by delving into the cultural disparities spanning various countries.

Attitudes, Self-Confidence, and Knowledge of Primary Care Professionals towards School Bullying

Attitudes, practices, and knowledge about bullying were evaluated in a sample of 274 primary care professionals, including general practitioners, pediatricians, community, pediatric and school nurses, and residents of these specialties. This study was based on a mixed method with a parallel convergent design without dominance between phases, data were collected concurrently, and conversion of the results from both phases was carried out during data interpretation. The quantitative phase had a cross-sectional observational design, using The Healthcare Provider's Practices, Attitudes, Self-confidence, and Knowledge Regarding Bullying Questionnaire as an instrument. Descriptive and bivariate analyses were performed, which showed a positive correlation between higher self-confidence and knowledge scores and a greater predisposition to detect cases. However, although the dimensions of attitudes and knowledge yielded generally high data, low self-confidence was evident in addressing this problem. In addition, a lack of clear guidelines in the workplace was expressed, highlighting the need to create and provide specific resources to intervene in bullying in said context, which could develop an improvement in self-confidence, leading to greater well-being for the educational community regarding bullying.

Bullying victimization in adolescents with hearing impairment

OBJECTIVE

Children with disabilities may face increased social challenges among peers. The purpose of this study was to investigate the association between hearing loss and reports of bullying victimization among adolescents in the United States.

METHODS

The 2021 National Health Interview Survey was a nationally representative cross-sectional survey administered to parents/caregivers of adolescent children ages 12 to 17. The effects of hearing loss on reports of bully victimization were assessed using multivariable logistic regression models, controlling for demographic characteristics including socioeconomic status and health status.

RESULTS

Caregivers of 3207 adolescents completed the survey and their responses represented over 25 million children in weighted analyses. Among all respondents, 21% (95% confidence interval, CI 19%-23%) of caregivers reported that their child had been bullied at least once in the past 12 months. Among children with hearing loss, 34.4% (95% CI 21.1%-47.7%) were bullied. Hearing impairment was associated with increased odds of reporting bullying victimization (odds ratio, OR = 2.04, 95% CI 1.03-4.07, p = 0.04) and children with hearing loss who do not use hearing aids had even greater odds of being bullied (OR = 2.40, 95% CI 1.18-4.86, p = 0.015).

CONCLUSION

In a nationally representative survey of caregivers for U.S. adolescents, hearing impairment among adolescents was associated with increased reported rates of bullying victimization. Further research is needed to investigate how anti-bully interventions can support this at-risk group.

Prevalence and Associated Family Factors of Sibling Bullying Among Chinese Children and Adolescents

Sibling bullying is the most common form of aggression within family worldwide, while the prevalence and correlations of sibling bullying is little known in China. The current research focused on the association between family factors and sibling bullying among Chinese adolescents, and explore sex differences in sibling bullying in the context of Chinese culture. A cross-sectional study was conducted to explore the characteristics of sibling bullying by sampling 6302 children and adolescents who had at least 1 sibling living in the household. Of the participants, 1827 (29.0%) were involved in sibling bullying over the past half year, and pure victims, pure bullies, and bully-victims were 486 (7.7%), 510 (8.1%), and 831 (13.2%), respectively. Family factors of sibling bullying were partly different between boys and girls. Parental absence of both father and mother was a risk factor of being a pure bully and a bully-victim for boys, and of being a pure victim for girls. Parental son preference increased the odds of being a pure victim and a bully-victim for boys, and of being all roles of sibling bullying involvement for girls. Besides, parent–parent violence, parent–child violence, and living with a single parent were risk factors of sibling bullying. The results underline the importance of home environment on sibling relationship, and intervention of sibling bullying should include improving family climate.

Peer Relationship Trajectories in Very Preterm and Term Individuals from Childhood to Early Adulthood

OBJECTIVE

To identify trajectories of peer relationships in very preterm and term-born individuals from 6 to 26 years of age and test early-life predictors of these trajectories.

METHOD

As part of the Bavarian Longitudinal Study, 218 very preterm/very low birth weight (VP/VLBW; <32 weeks' gestation/<1500 grams) and 220 healthy term-born (37-42 weeks' gestation) individuals were followed prospectively from birth to adulthood. Parent and self-reports at 6, 8, 13, and 26 years were combined into comprehensive developmentally appropriate scores across 3 domains: peer acceptance, friendships, and peer problems. Latent profile analyses were used to identify trajectories across these 3 domains. Binary and multinomial logistic regressions were used to test the following potential predictors of trajectories: VP/VLBW status, sex, socioeconomic status, neonatal medical risk, parent-infant relationship at 5 months, child inhibitory control at 20 months, and child cognitive abilities at 20 months.

RESULTS

Three trajectories were identified for peer acceptance and friendships, and 2 trajectories were identified for peer problems. Higher cognitive abilities predicted more optimal trajectories in peer acceptance (odds ratio: 1.03 [95% confidence interval = 1.01-1.05]), friendships (1.03 [1.00-1.05]), and peer problems (1.06 [1.04-1.09]). In addition, good parent-infant relationships predicted lower peer problem trajectories (1.61 [1.03-2.50]).

CONCLUSION

Early cognitive deficits may underlie persistent peer relationship difficulties in VP/VLBW samples. Positive parent-infant relationships may help reduce preterm children's risk for long-term peer problems.

Prädiktion von Mobbing und Viktimisierung

Zusammenfassung. Mobbing unter Schülern ist häufig und stellt ein ernsthaftes Gesundheitsproblem mit langfristigen Folgen dar. Ziele dieser 10-Jahres-Langzeitstudie an N=361 Familien (mittleres Alter der Jugendlichen 14 Jahre; 54 % Jungen) sind zum einen, im Querschnitt die Mobbing-Prävalenzrate und die psychischen Belastungen bei Jugendlichen (erfasst von Müttern, Vätern und Jugendlichen) zu ermitteln. Zum anderen soll längsschnittlich geprüft werden, ob sich Mobbing-Involviertheit auf Grund von familiären Vulnerabilitätsfaktoren, erhoben im Kindergartenalter, vorhersagen lässt. Die Gesamt-Prävalenzrate für Mobbing betrug 23 %. Mobbing-Opfer (MO) zeigten im Vergleich zu Mobbing-Unbeteiligten (MU) eine höhere psychische Gesamtbelastung. MO sind schon im Kindergartenalter psychisch auffällig. Eine binär logistische Regression zeigte, dass vor allem ein dysfunktionales Erziehungsverhalten Mobbing-Erfahrungen signifikant vorhersagt. Präventive Maßnahmen zur Verhinderung von Mobbing-Erfahrungen sollten dysfunktionales Erziehungsverhalten ändern. MO sollten frühzeitig psychotherapeutische Hilfe erhalten, auch um mögliche Spätfolgen zu verhindern.

Association Between Sub-types of Sibling Bullying and Mental Health Distress Among Chinese Children and Adolescents

Sibling bullying is a common phenomenon in childhood and adolescence worldwide and has a significant association with mental health distress. However, there have been few studies that have examined the associations between any specific sub-type of sibling bullying and depression as well as anxiety. Besides, the association between sibling bullying and psychological well-being was never explored among the Chinese population. The purpose of this cross-sectional study was to examine the associations between the number of sub-types of sibling bullying involvement and depression as well as anxiety among Chinese children and adolescents. Multi-stage stratified cluster sampling was used to recruit 5,926 participants aged 10 to 18 who had at least one sibling living in the household. Different sub-types of sibling bullying involvement were determined by using Olweus Bully/Victim Questionnaire (OBVQ). The nine-item Patient Health Questionnaire (PHQ-9) and the seven-item Generalized Anxiety Disorder Scale (GAD-7) were used to screen clinical ranges of major depression and generalized anxiety disorder, respectively. Of the participants, 1,235 (20.8%) were bullied by siblings, and 1,230 (20.8%) perpetrated bullying behavior against siblings over the past 6 months. After controlling potential confounders, adjusted model of logistic regression analyses indicated that all three sub-types of sibling victimization and perpetration were significantly associated with both depression and anxiety. There were linear associations between the number of sub-types of sibling bullying victimization and depression (adjusted OR = 1.49, 95% CI 1.32 to 1.68) as well as anxiety (adjusted OR = 1.68, 95% CI 1.48 to 1.90). Besides, linear trends were found between the number of sub-types of sibling bullying perpetration and depression (adjusted OR = 1.44, 95% CI 1.26 to 1.64) as well as anxiety (adjusted OR = 1.63, 95% CI 1.42 to 1.87). The findings underline dose-response relationships between the number of sub-types of sibling bullying involvement and mental health distress. Intervention programs should be conducted to focus on developing mental health status of those children and adolescents who are involved in multiple sub-types of sibling victimization or perpetration.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

DISCUSSION

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

GP views on their role in bullying disclosure by children and young people in the community: a cross-sectional qualitative study in English primary care

BACKGROUND

Bullying among children and young people (CYP) is a major public health concern that can lead to physical and mental health consequences. CYP may disclose bullying, and seek help from a GP. However, there is currently little research on GPs' views on and perceptions of their role in dealing with disclosures of bullying in primary care.

AIM

To explore GPs' views about their role in dealing with CYPs' disclosures of being bullied, especially factors that have an impact on GPs' roles.

DESIGN AND SETTING

In this cross-sectional qualitative study, semi-structured interviews were conducted with GPs in primary care in England from October to December 2017.

METHOD

Purposive sampling was used to achieve variation in GP age, professional status in practice, profile of the patients served by the practice, practice size and location, and whether the GPs considered themselves to be actively in research or teaching.

RESULTS

Data from 14 semi-structured interviews revealed three main themes: remaining clinically vigilant; impact of bullying in schools; and training and guidance on dealing with bullying and cyberbullying. GPs felt that dealing with disclosures of bullying and cyberbullying came down to their clinical experience rather than guideline recommendations, which do not currently exist, and that bullying was a precipitating factor in presentations of CYPs' mental health issues.

CONCLUSION

GPs feel they have a role to play in managing and supporting the health of CYP who disclose being bullied during consultations. However, they feel ill-equipped to deal with these disclosures because of lack of professional development opportunities, and guidance on treating and managing the health consequences of being bullied.

The cost incurred by victims of bullying from a societal perspective: estimates based on a German online survey of adolescents

Being a victim of bullying is linked to various social, emotional and behavioral problems potentially leading to a reduced quality of life. Furthermore, victims of bullying may cause extensive costs for society, for example by an above-average need for healthcare services. The present study was designed to quantify the costs and the loss of quality of life attributable to bullying by comparing victims with a control group of non-bullied students. A cross-sectional sample of 1293 adolescents (mean age 14.07, SD = 1.36) and their parents reported on bullying victimization, quality of life (adolescents' self-report), and annual direct (medical and non-medical) as well as indirect costs (parents' self-report) from a societal perspective (all expressed in €, year 2014 and 2015). For frequent (20.6% of our sample; costs: €8461.80 p.a.) but not occasional (13.3%; costs: €2850.06) bullying, victimization was associated with significantly higher costs compared to non-bullied adolescents (costs: €3138.00; annual difference between frequently bullied students and controls: €5323.01 p.a.; p = 0.008). Cost drivers included increased direct medical costs, but mostly indirect costs caused by productivity losses of the parents. Self-reported quality of life of frequent victims was considerably reduced (T = - 10.96; p < 0.001); also occasional bullying showed significantly reduced values in global quality of life (T = - 5.73; p < 0.001). The present findings demonstrate that frequent bullying is associated with substantial cost to society and reduced quality of life of victims. This observation underscores the need for effective school-based bullying prevention and suggests a high potential of effective programs to be cost effective as well.

Cyberbullying prevention: Insight and recommendations from youths, parents, and paediatricians

BACKGROUND

The purpose of this study was to identify injunctive norms for cyberbullying prevention among youths, parents, and primary care providers, as well as barriers to preventive behaviours.

METHODS

Semi-structured interviews on the topic of cyberbullying were conducted with 29 adolescents, 13 paediatricians, and 15 parents recruited from 3 primary care sites. Transcripts were coded for themes related to various stakeholders' perceived roles in cyberbullying prevention and barriers to preventive behaviours.

RESULTS

Participants reported perceptions that youths should intervene in the moment and get outside help for others. Fear of repercussions emerged as a significant barrier to these behaviours. Participants believed that parents should communicate with their children and monitor and supervise youths' online activities. Barriers included perception of priority and low parental efficacy or naiveté. Participants believed that providers should provide education and resources and ask screening questions; the most frequently identified barrier to those behaviours was the perception of providers' role.

CONCLUSIONS

Youths and providers may not be aware of their potential to prevent cyberbullying before it occurs. Educating youths, parents, and providers about cyberbullying prevention is warranted.

How Well Do We Understand the Long-Term Health Implications of Childhood Bullying?

Once dismissed as an innocuous experience of childhood, bullying is now recognized as having significant psychological effects, particularly with chronic exposure. Victims of bullying are at risk for a number of psychiatric disturbances, and growing evidence suggests that the pathophysiological effects of bullying, as with other forms of trauma and chronic stress, create additional health risks. We review the literature on the known sequelae of bullying, including psychiatric and physiological health effects, with a focus on implications for the victim. In addition, since it is now well established that early and chronic exposure to stress has a significant negative impact on health outcomes, we explore the implications of this research in relation to bullying and victimization in childhood. In particular, we examine how aspects of the stress response, via epigenetic, inflammatory, and metabolic mediators, have the capacity to compromise mental and physical health, and to increase the risk of disease. Research on the relevant mechanisms associated with bullying and on potential interventions to decrease morbidity is urgently needed.

Bullying and Cyberbullying: Their Legal Status and Use in Psychological Assessment

Bullying and cyberbullying have severe psychological and legal consequences for those involved. However, it is unclear how or even if previous experience of bullying and cyberbullying is considered in mental health assessments. Furthermore, the relevance and effectiveness of current legal solutions has been debated extensively, resulting in a desire for a specific legislation. The purpose of this study is to investigate the psychological and legal components of bullying and cyberbullying. This is a qualitative research that includes interviews with five practitioner psychologists and four lawyers in the United Kingdom (UK). Thematic analysis revealed three main themes. One theme is related to the definition, characteristics, and impact of bullying and cyberbullying and the need for more discussion among the psychological and legal professions. Another theme is related to current professional procedures and the inclusion of questions about bullying and cyberbullying in psychological risk assessments. The third theme emphasised the importance of intervention through education. Two key messages were highlighted by the lawyers: ample yet problematic legislation exists, and knowledge will ensure legal success. The study recommends the necessity of performing revisions in the clinical psychological practices and assessments, and the legal policies regarding bullying and cyberbullying. In addition to improving legal success, this will reduce bullying prevalence rates, psychological distress, and psychopathology that can be comorbid or emerge as a result of this behaviour.

Cyberbullying Prevention and Intervention Efforts: Current Knowledge and Future Directions

Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents' use of social media, and online communication platforms have exposed adolescents to another mode of bullying- cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided.

Young people who are being bullied - do they want general practice support?

Background

Childhood bullying is a major risk factor for health, education and social relationships, with effects persisting into adulthood. It affects half of all children at some point, with 10–14 % experiencing bullying that lasts for years. With the advent of cyberbullying, it can happen at all times and places. There have been calls for GPs to take a more active role in identifying and supporting young people who are being bullied. This paper explores young people’s and parents’ opinions about whether general practice should be involved in identifying and supporting young people who are being bullied.

Methods

Two hundred six young people (85.9 % female, mean ± sd age 16.2 ± 3.2 years) and 44 parents were recruited through established bullying charity websites and their social media channels to complete an online questionnaire comprising multiple-choice questions and unlimited narrative responses. Questionnaire responses were analysed by age and gender using descriptive statistics. A descriptive analysis of the narrative responses was undertaken and key themes identified.

Results

Young people (90.8 %) and parents (88.7 %) thought it was important for GPs to be better able to recognise and help young people who are being bullied. Most recognised the link between bullying and health. The doctor’s independence was seen as advantageous. Young people preferred completing a screening questionnaire to disclose experience of being bullied than being asked directly. They expressed concerns about how questions would be asked and whether information would be shared with parents/guardians. Parents were supportive of the use of a screening questionnaire, and most expected their child’s disclosure to be shared with them.

Conclusion

Young people and parents recruited through anti-bullying websites and social media would welcome greater GP involvement in identifying and supporting young people who are being bullied and their families, provided it is offered in a caring, compassionate and confidential manner.

Bullying in the family: sibling bullying

Sibling relationships have a substantial and lasting effect on children's development. Many siblings experience some occasional conflict, however, up to 40% are exposed to sibling bullying every week, a repeated and harmful form of intrafamilial aggression. We review evidence on the precursors, factors relating to peer bullying, and mental health consequences of sibling bullying. Parenting quality and behaviour are the intrafamilial factors most strongly associated with bullying between siblings. Sibling bullying increases the risk of being involved in peer bullying, and is independently associated with concurrent and early adult emotional problems, including distress, depression, and self-harm. The effects appear to be cumulative, with those children bullied by both siblings and peers having highly increased emotional problems compared with those bullied by siblings or peers only, probably because they have no safe place to escape from bullying. The link between sibling and peer bullying suggests interventions need to start at home. Health professionals should ask about sibling bullying and interventions are needed for families to prevent and reduce the health burden associated with sibling bullying.

Long-term effects of bullying

Bullying is the systematic abuse of power and is defined as aggressive behaviour or intentional harm-doing by peers that is carried out repeatedly and involves an imbalance of power. Being bullied is still often wrongly considered as a 'normal rite of passage'. This review considers the importance of bullying as a major risk factor for poor physical and mental health and reduced adaptation to adult roles including forming lasting relationships, integrating into work and being economically independent. Bullying by peers has been mostly ignored by health professionals but should be considered as a significant risk factor and safeguarding issue.

Bullying of preterm children and emotional problems at school age: cross-culturally invariant effects

OBJECTIVE

To investigate whether adolescents who were born extremely preterm (<26 weeks gestation), very preterm (<32 weeks gestation), or with very low birth weight (<1500 g) are more often bullied, and whether this contributes to higher emotional problem scores.

STUDY DESIGN

We used 2 whole population samples: the German Bavarian Longitudinal Study (BLS) (287 very preterm/very low birth weight and 293 term comparison children) and the UK EPICure Study (183 extremely preterm and 102 term comparison children). Peer bullying was assessed by parent report in both cohorts at school years 2 and 6/7. The primary outcome was emotional problems in year 6/7. The effects of prematurity and bullying on emotional problems were investigated with regression analysis and controlled for sex, socioeconomic status, disability, and preexisting emotional problems.

RESULTS

Preterm-born children were more often bullied in both cohorts than term comparisons (BLS: relative risk, 1.27; 95% CI, 1.07-1.50; EPICure: relative risk, 1.69; 95% CI, 1.19-2.41). Both preterm birth and being bullied predicted emotional problems, but after controlling for confounders, only being bullied at both ages remained a significant predictor of emotional problem scores in both cohorts (BLS: B, 0.78; 95% CI, 0.28-1.27; P < .01; EPICure: B, 1.55; 95% CI, 0.79-2.30; P < .001). In the EPICure sample, being born preterm and being bullied at just a single time point also predicted emotional problems.

CONCLUSION

Preterm-born children are more vulnerable to being bullied by peers. Those children who experience bullying over years are more likely to develop emotional problems. Health professionals should routinely ask about peer relationships.

Long term follow up of high risk children: who, why and how?

BACKGROUND

Most babies are born healthy and grow and develop normally through childhood. There are, however, clearly identifiable high-risk groups of survivors, such as those born preterm or with ill-health, who are destined to have higher than expected rates of health or developmental problems, and for whom more structured and specialised follow-up programs are warranted.

DISCUSSION

This paper presents the results of a two-day workshop held in Melbourne, Australia, to discuss neonatal populations in need of more structured follow-up and why, in addition to how, such a follow-up programme might be structured. Issues discussed included the ages of follow-up, and the personnel and assessment tools that might be required. Challenges for translating results into both clinical practice and research were identified. Further issues covered included information sharing, best practice for families and research gaps.

SUMMARY

A substantial minority of high-risk children has long-term medical, developmental and psychological adverse outcomes and will consume extensive health and education services as they grow older. Early intervention to prevent adverse outcomes and the effective integration of services once problems are identified may reduce the prevalence and severity of certain outcomes, and will contribute to an efficient and effective use of health resources. The shared long-term goal for families and professionals is to work toward ensuring that high risk children maximise their potential and become productive and valued members of society.

Bullying and parasomnias: a longitudinal cohort study

BACKGROUND AND OBJECTIVES

Environmental factors such as serious trauma or abuse and related stress can lead to nightmares or night terrors. Being bullied can be very distressing for children, and victims display long-term social, psychological, and health consequences. Unknown is whether being bullied by peers may increase the risk for experiencing parasomnias such as nightmares, night terrors, or sleepwalking.

METHODS

A total of 6796 children of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort were interviewed at elementary school age (8 and 10 years) about bullying experiences with a previously validated bullying interview and at secondary school age (12.9 years) about parasomnias such as nightmares, night terrors and sleepwalking by trained postgraduate psychologists.

RESULTS

Even after adjusting for pre-existing factors related to bullying and parasomnias, being bullied predicted having nightmares (8 years odds ratio [OR], 1.23; 95% confidence interval [CI], 1.05-1.44; 10 years OR, 1.62; 95% CI, 1.35-1.94) or night terrors (8 years OR, 1.39; 95% CI, 1.10-1.75; 10 years OR, 1.53; 95% CI, 1.18-1.98) at age 12 to 13 years. Especially being a chronic victim was associated with both nightmares (OR, 1.82; 95% CI, 1.46-2.27) and night terrors (OR, 2.01; 95% CI, 1.48-2.74). Being a bully/victim also increased the risk for any parasomnia at ages 8 or 10 years (8 years OR, 1.42; 95% CI, 1.08-1.88; 10 years OR, 1.75; 95% CI, 1.30-2.36). In contrast, bullies had no increased risk for any parasomnias.

CONCLUSIONS

Being bullied increases the risk for having parasomnias. Hence, parents, teachers, school counselors, and clinicians may consider asking about bullying experiences if a child is having parasomnias.