Correlates of bullying perpetration among Lebanese adolescents: a national study

Adverse Childhood Experiences and Bullying: Findings from the Growing Up in Scotland Cohort

Adverse childhood experiences (ACEs) are defined as stressful or traumatic events occurring within a child's family environment during their first 18 years of life. Research examining the associations between exposure to ACEs in childhood and bullying experiences in adolescence is sparse. To address this gap, data from the first 10 sweeps of the Growing Up in Scotland prospective cohort study was used to evaluate the relationship between 6 different ACEs and the risk of being bullied or engaging in bullying others at age 14 among a sample of 2,669 adolescents. Multiple univariable logistic regression models were fitted to explore independent associations between each of the six ACEs measured, 1+ ACE and 3+ ACEs and bullying perpetration and victimization, respectively. Results showed that a high proportion of young people in Scotland experience bullying victimization (31%) and a very high percentage reported exposure to at least one type of adversity (73.6%). Young people whose parents reported drug or alcohol misuse and females whose parents had divorced or separated had higher odds of engaging in bullying others. Having a parent who had mental health problems was the only ACE that predicted higher odds of experiencing bullying. Substance misuse in the family predicted a higher risk of bullying victimization for females. Logistic regression analyses further showed that females with greater exposure to ACEs were more likely to engage in bullying in mid-adolescence. Our findings underscore the importance of understanding bullying perpetration as a maladaptive way to manage life stressors.

Bullying and self-harming behavior in universities - A cross-sectional study of a sample of 327 university students

INTRODUCTION

Bullying is a widespread public health issue, found in different contexts (e.g. schools, universities, workplaces, families), and it has negative consequences on both the perpetrator and the victim. There is a lack of studies addressing bullying among university students in Arab countries and more specifically in Lebanon. The objective of our study was to determine the prevalence of bullying among a sample of university students in Lebanon, its forms, and associated factors.

METHODS

The study consists of a cross-sectional online survey addressed to university students in Lebanon that evaluates sociodemographic data, presence and type of bullying, history of bullying during childhood, adverse childhood experiences, daily life functioning, and mental health status (reported psychiatric disorders, substance use, self-harming behaviors, and suicidal attempts). Chi-Square and Fisher's exact tests were used to compare the results between victims of bullying and the rest of the sample.

RESULTS

Three hundred and twenty-seven university students participated in this study. The prevalence of bullying was 14.1%. The main forms of reported bullying were verbal (58.7%) and social bullying (65.2%). The main associated factors were being a witness of bullying at university (84.8% vs. 56.2% - P<.001) and history of cyberbullying (13% vs. 4.6% - P=.024). Among students who reported current bullying, 28.3% had a psychiatric diagnosis, 19.6% reported substance use, 15.2% had self-harming behaviors, and 8.7% had suicide attempts. Victims of bullying in the university reported a significant negative impact on their daily lives (lack of interest in daily activities, academic decline) (83.7%) and mental health concerns (psychiatric disorders, substance use, suicide attempts) (88.4%).

CONCLUSION

Even though bullying is an event less experienced in university than in school, it is nevertheless still present with potential negative impact on the victims. Bullying in a university setting is a public health issue that could benefit from more studies as well as prevention and intervention programs.

Association of behaviors and asthma control in a sample of Lebanese adolescents with asthma

BACKGROUND

The relationship between behavioral problems and asthma is bidirectional; while the presence of a chronic disease such as asthma might predispose the person to stress, anxiety, and other behavioral issues, behavioral problems might in turn cause uncontrolled asthma through nonadherence to asthma management strategies. In Lebanon, behavioral problems and uncontrolled asthma could be of significant concern for adolescents. Consequently, we found it necessary to evaluate association between behavioral problems and uncontrolled asthma in a sample of Lebanese adolescents.

METHODS

Data for this cross-sectional study were collected using the snowball sampling technique in July 2023. The questionnaire was developed with Google Forms and distributed to participants via social media platforms and messaging applications. The Asthma Control Test (ACT) was used to check for uncontrolled asthma, and the Youth Self-Report (YSR) scale was used to assess behavioral problems. It yields nine subscales (anxious-depressed, withdrawn-depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, aggressive behavior, and other problems) and a total score.

RESULTS

When taking each behavior score as an independent variable, older age was associated with lower ACT scores (more controlled asthma); F(15, 186) = 3.66, P = 0.014, and 95% Confidence Interval (CI) [-0.85, -0.10]. Living in a rural area, compared to urban was associated with higher ACT scores, P = 0.018, and 95% Confidence Interval (CI) [0.28, 2.94]. The intake of the COVID-19 vaccine, P = 0.003 and 95% CI [0.73, 3.55]; waterpipe smoking, P = 0.017 and 95% CI [0.38, 3.85]; and having more somatic complaints, P = 0.005 and 95% CI [0.04, 0.25], also were significantly associated with higher ACT scores (more uncontrolled asthma). When taking the total behavior score as an independent variable, higher YSR scores were associated with higher ACT scores (more uncontrolled asthma), F(10, 191) = 4.30, P = 0.038, and 95% CI [0.003, 0.10].

CONCLUSION

Our findings support the inclusion of mental health treatments for better asthma control and point to a link between behavioral issues and uncontrolled asthma. In a developing nation without a clear established strategy for asthma prevention, the findings of this study could help develop potentially beneficial public health treatments.

The relationship between parental neglect and cyberbullying perpetration among Chinese adolescent: The sequential role of cyberbullying victimization and internet gaming disorder

Cyberbullying perpetration and victimization have been common public health issues that have impaired the development of adolescent physical and mental health. Abundant research has proven associations between negative parental factors and cyberbullying perpetration. However, there is a paucity of research exploring the impact of parental neglect on cyberbullying and its internal mechanisms. Based on the parental acceptance-rejection theory (PARTheory) and the general aggression model (GAM), the present study constructs a sequential mediation model in which parental neglect is related to adolescent cyberbullying perpetration through cyberbullying victimization and internet gaming disorder (IGD). Using random cluster sampling, a total of 699 middle school students (M age = 14.18 years, SD = 1.22, and 324 boys) were recruited from five schools in three provinces on mainland China. The participants completed questionnaires regarding parental neglect, cyberbullying perpetration, cyberbullying victimization, and IGD. The results of structural equation modeling indicated that parental neglect was positively associated with cyberbullying perpetration. The mediating effects of cyberbullying victimization and IGD in this relationship are significant both individually and jointly. The current findings have important implications for enlightening families and schools to pay particular attention to adolescents' experiences of parental neglect and provide them with timely feedback and assistance. This will contribute to the prevention and reduction of adolescent involvement in cyberbullying perpetration.

Association between Bullying Victimization and Aggression in Lebanese Adolescents: The Indirect Effect of Repetitive Negative Thinking-A Path Analysis Approach and Scales Validation

(1) Background: The purpose of the present study was to validate the Perseverative Thinking Questionnaire (PTQ) and the Buss-Perry Aggression Questionnaire-Short Form (BPAQ-SF) and test whether repetitive negative thinking plays an indirect role in the relationship between bullying victimization and aggression among Lebanese adolescents. (2) Methods: This cross-sectional study was conducted between January and May 2022 and included 379 Lebanese adolescent students (64.9% females, mean age 16.07 years). (3) Results: The three-factor solution of the PTQ and the four-factor solution of the BPAQ-SF showed excellent model fit. PTQ mediated the association between bullying victimization and physical aggression, verbal aggression, hostility, and anger. (4) Conclusions: This study expands on previous research by showing that repetitive negative thinking, an impactful socio-cognitive factor for students' mental health, has a mediating (indirect) effect on the cross-sectional relationship between bullying victimization and aggression. This suggests that interventions aiming to prevent aggressive behaviors among adolescent students may be more effective if focused on repetitive negative thinking.

Does Problematic Use of Social Network Mediate the Association between Bullying Victimization and Loneliness among Lebanese Adolescents?

(1) Background: Bullying victimization has been associated with several behavioral outcomes, particularly loneliness. Similarly, an increase in social network use has been identified in recent years, particularly during the COVID-19 pandemic, and has been shown to be associated with bullying and loneliness. Investigating the mediating factors of loneliness among bullied adolescents is useful for taking preventive measures in the Lebanese population. This study aims to examine the association between bullying victimization and loneliness among Lebanese adolescents while considering the indirect effect of problematic social network use. (2) Methods: We carried out a cross-sectional study, between January and April 2022, that enrolled 379 adolescent Lebanese students (64.9% females, mean age 16.07 ± 1.19 years) who were current residents of Lebanon (15 to 18 years), and were from the five governorates of Lebanon (Beirut, Mount Lebanon, North, South and Bekaa). The snowball method was applied to select our sample; an electronic copy of the questionnaire was created using the Google Forms software and an online strategy was designed to collect the data. (3) Results: Negative social comparison and addictive consequences of problematic use of social network mediated the association between bullying victimization and loneliness. Higher bullying victimization was significantly associated with higher negative social comparison and addictive consequences of problematic use of social network, which in turn were significantly associated with more loneliness. Finally, higher bullying victimization was directly significantly associated with more loneliness. (4) Conclusions: Studying the mediating factors of loneliness in bullied adolescents can improve our understanding of this topic, allowing us to propose new interventions to prevent psychological problems in adolescents. Future studies are needed to further clarify the physiological processes that underlie the associations between social triggers and loneliness during adolescence.

Is cyberbullying perpetration associated with anxiety, depression and suicidal ideation among lebanese adolescents? Results from a cross-sectional study

BACKGROUND

As cyberbullying is a new area of investigation, results worldwide point to the prevalence of cyberbullying perpetration. This study aimed to assess the association between cyberbullying perpetration, anxiety, depression and suicidal ideation among Lebanese adolescents.

METHODS

This cross-sectional study was conducted between May and June 2021 and included a sample of adolescents aged between 13 and 16 years old, recruited from private schools chosen in a convenient way from all Lebanese districts. A total of 520 students accepted to participate in our study. To collect data, a questionnaire was shared by google form including: Cyber Bully/Cyber victim questionnaire; Lebanese Anxiety Scale; and Patient Health Questionnaire for Adolescents.

RESULTS

The results of the linear regressions, taking anxiety and depression as dependent variables, showed that female gender, having kind of hard and very/extremely hard influence of problems on daily work, sexual cyberbullying in cyberspace, embarrassing and inserting malicious content in cyberspace and older age were significantly associated with more anxiety and depression. Having kind of hard influence of problems on daily work compared to not at all, higher anxiety, higher depression and higher household crowding index (lower socioeconomic status) were significantly associated with higher odds of having suicidal ideation in the last month.

CONCLUSION

Cyberbullying perpetration and its associated factors reported in this study are significant enough to call for early detection and prevention strategies for Lebanese adolescents. At the school level, effective programs implemented in the school years are needed, aiming to develop social/emotional control, and conflict resolution skills as they might decrease engagement in cyberbullying perpetration among adolescents. Preventive interventions are needed to reduce the engagement of Lebanese adolescents in cyberbullying perpetration.

Development and validation of a shortened version of the Child Abuse Self Report Scale (CASRS-12) in the Arabic language

BACKGROUND

All available scales to screen for child abuse may be challenging to administer due to their length. Indeed, a higher number of items is associated with more administration time and less motivation to engage in responding. We aimed through this study to examine the psychometric properties of a brief Arabic version of the Child Abuse Self Report Scale (CASRS-12) in terms of factorial structure, internal consistency, divergent validity, and correlations with measures of bullying victimization, eating attitudes and perceived social support.

METHODS

We performed a cross-sectional, web-based study among Community Lebanese adolescents; where two samples have been used (Sample 1: N = 852, aged 15.34 ± 1.18 years, 54.8% females; Sample 2: N = 404, aged 16.60 ± 1.51 years, 57.2% females). The construct validity was tested using both exploratory and confirmatory factor analyses.

RESULTS

Results revealed that both EFA and CFA yielded a four-factor structure for the CASRS-12 that mirrors the original four factors captured by the original CASRS. The scale also showed a good internal consistency as evidenced through McDonald's ω values ranging from 0.87 to 0.93 for the four subscales; and configural, metric, and scalar invariance across gender. Finally, we found that all CASRS-12 dimensions were significantly and positively correlated with more inappropriate eating attitudes and lower social support; and that psychological, physical, and sexual abuse correlated with higher bullying victimization CONCLUSION: In light of these findings, we potentially encourage clinicians and researchers to use this scale as a valid and reliable measure of child abuse among Arabic-speaking populations.

Parental divorce and smoking dependence in Lebanese adolescents: the mediating effect of mental health problems

BACKGROUND

Lebanon has the highest prevalence estimates among Middle Eastern countries and Arab women regarding cigarette smoking, with 43% of men and 28% of women involved in such trends. Marital disruption is a tremendous source of irritability and discomfort that may hinder a child's healthy development, creating perturbing distress and increasing disobedience that may exacerbate smoking addiction. Additionally, Lebanese adolescents are inflicted by high emotional and economic instability levels, rendering increased susceptibility to distress and propensity to engage in addictive behavior. This study aims to investigate the association between parental divorce and smoking dependence among Lebanese adolescents, along with exploring the potential mediating effect of mental health disorders of such correlation.

METHODS

A total of 1810 adolescents (14 and 17 years) enrolled in this cross-sectional survey-based study (January-May 2019). Linear regressions were conducted to check for variables associated with cigarette and waterpipe dependence. PROCESS v3.4 model 4 was used to check for the mediating effect of mental health disorders between parental divorce and smoking dependence.

RESULTS

Higher suicidal ideation and having divorced parents vs living together were significantly associated with more cigarette and waterpipe dependence. Higher anxiety was significantly associated with more waterpipe dependence. Insomnia and suicidal ideation played a mediating role between parental divorce and cigarette/waterpipe dependence.

CONCLUSION

Our results consolidate the results found in the literature about the association between parental divorce and smoking addiction and the mediating effect of mental health issues. We do not know still in the divorce itself or factors related to it are incriminated in the higher amount of smoking in those adolescents. Those results should be used to inspire parents about the deleterious effect of divorce on their children to lower their risk of smoking addiction. Further longitudinal studies are needed to better understand the complexity of such associations and to see whether the divorce experience by itself or the factors that accompany it are involved in the increased smoking addiction among adolescents.

School assets and bullying in Chinese youth: A multiple mediation model of intentional self-regulation and internet gaming disorder

Bullying is a severe social problem affecting young people all over the world. Previous studies suggested that engagement in bullying had massive effects on teenagers' physical and psychological development. It is critical and necessary to investigate the antecedents and underlying mechanisms of this phenomenon among young generations. The present study, based on the positive youth development perspective and the developmental assets theory, attempts to explore the positive factors in the school subsystem that could effectively prevent adolescents from bullying, as well as the multiple mediation effects of intentional self-regulation (ISR) and internet gaming disorder (IGD). In this study, we adopted a two-wave design and recruited a sample of 768 Chinese adolescents using a randomized cluster sampling method in the post-pandemic era. The results revealed that T1 school assets significantly and negatively predicted T2 adolescent bullying. Furthermore, T2 ISR and T2 IGD mediated the association between T1 school assets and T2 bullying separately and sequentially. Overall, school resources play a protective role in adolescent development and could effectively prevent them from negative outcomes. These current findings contribute to the literature by providing a further understanding of the direct and indirect protective effects of school assets on adolescent bullying. Moreover, practitioners could also benefit from these findings in preventing and intervening in bullying in the school subsystem.

Parental divorce and nicotine addiction in Lebanese adolescents: the mediating role of child abuse and bullying victimization

BACKGROUND

Lebanon ranks first amongst Middle-Eastern countries in terms of cigarette and waterpipe smoking. Understanding the mediating factors for nicotine addiction in adolescents who have experienced parental divorce is vital to take effective measures that will help in lowering its prevalence in our community. The objective of this study was to investigate the association between the increasingly concerning parental divorce and nicotine addiction in Lebanese adolescents while taking into consideration the plausible mediating effect of abuse and bullying victimization.

METHODS

This was a cross-sectional survey-based study that was conducted between January and May 2019. A total of 1810 adolescents aged between 14 and 17 years was enrolled from 16 Lebanese schools. Linear regressions taking the cigarette and waterpipe dependence scores as dependent variables were conducted respectively, using the SPSS software. PROCESS v3.4 model 4 was used for mediation analysis.

RESULTS

A total of 11.9% of the enrolled participants had divorced parents. Higher cigarette and waterpipe dependence were found in adolescents whose parents were divorced compared to those living together. More child psychological abuse, having divorced parents vs living together, and more child physical abuse were significantly associated with higher cigarette dependence. More child psychological and physical, and having divorced parents vs living together were significantly associated with more waterpipe dependence. In addition, all forms of abuse (except neglect) and bullying victimization had a partially mediating effect in the associations between parental divorce and nicotine dependence (cigarette and waterpipe) in adolescents.

CONCLUSION

This study results may serve as a first step towards enrolling separated parents and their children in special prevention programs to help them create a protective and supportive environment.

Premenstrual dysphoric disorder and childhood maltreatment, adulthood stressful life events and depression among Lebanese university students: a structural equation modeling approach

BACKGROUND

Premenstrual Syndrome (PMS) is a cyclic sequence of physical and behavioral symptoms that arise in the second half of the menstrual cycle. The extreme type of PMS is Premenstrual Dysphoric Disorder (PMDD). The current study aims at examining 1) the effects of childhood maltreatment and current life's stressful events on PMDD, and 2) the mediating role of depression in these associations among Lebanese university female students.

METHODS

This cross-sectional study was conducted between February and March 2021 during the COVID-19 pandemic. Lebanese students were recruited using a snowball technique from all national universities in Lebanon via an auto-administrated online survey. Structural equation modeling was performed to examine the structural relationship between childhood maltreatment and life's stressful events, depression and PMDD.

RESULTS

Higher life's stressful events (Beta = 0.18; p < 0.001), physical (Beta = 0.19; p < 0.001), sexual (Beta = 0.18; p < 0.001) and psychological (Beta = 0.33; p < 0.001) abuse were significantly associated with higher depression. Moreover, higher sexual (Beta = 0.11; p = 0.021) and psychological (Beta = 0.11; p = 0.040) abuse and higher depression (Beta = 0.37; p < 0.001) were significantly associated with higher PMDD. The indirect relationships between psychological abuse/sexual abuse, depression and PMDD showed that depression mediated the association between both psychological (Beta = 0.22; p = 0.001) and sexual (Beta = 0.38; p = 0.004) abuse and PMDD.

CONCLUSION

This work presents a unique analysis using the structural equation model that enlightens the effect of childhood maltreatment, particularly sexual and psychological abuse on PMMD symptoms, with depression playing the role of a mediating factor. It would be interesting to test, in future studies, whether there are other mediating factors besides depression that could be indirect indicators of PMDD.

Association between parental divorce and mental health outcomes among Lebanese adolescents: results of a national study

Background

In Lebanon, divorce rates have jumped from nearly 7000 in recent years to 8580 in 2017, an increase of 22.5%, with North Lebanon recording the highest number, followed by Beirut, likely resulting in increased behavioral problems in the offspring of divorced parents. Furthermore, one out of two Lebanese adolescents whose biological parents were divorced, separated, or deceased has a psychiatric disorder. More information regarding the impact of divorce on the mental health of Lebanese adolescents is still missing. The objective of this study was to explore the association between divorce and mental health outcomes, particularly depression, anxiety, and suicidal ideation among Lebanese adolescents.

Methods

A cross-sectional study conducted between January and May 2019 enrolled 1810 adolescents aged 14 to 17 years, using a simple randomization method to choose schools. A proportionate number of schools was selected from each of the five Lebanese Mohafazat (Beirut, Mount Lebanon, North, South, and Beqaa), based on the list of the Ministry of Education and Higher Education. A total of 18 private schools were approached; two declined, and 16 accepted to participate.

Results

The mean age of participants was 15.42 ± 1.14 years, with 53.3% females. After adjustment for the covariates (age, sex, and house crowding index), the results showed that adolescents whose parents are separated compared to living together had more social fear (Standardized Beta (SB = 0.270) and avoidance (SB = 0.188), higher depression (SB = 0.045), and higher suicidal ideation (SB = 0.370).

Conclusion

Our findings reveal that teens with divorced parents had higher social fear and avoidance, depression, and suicidal ideation, highlighting the need for adequate prevention programs to support both children and parents during this emotionally difficult period.

Lebanese Waterpipe Dependence Scale (LWDS-11) validation in a sample of Lebanese adolescents

BACKGROUND

Salameh et al. developed the Lebanese Waterpipe Dependence Scale (LWDS-11) that assesses nicotine dependence among adult waterpipe smokers. In view of the high waterpipe use among Lebanese youth and other neighboring countries, it was deemed necessary to check the psychometric properties of the LWDS-11, originally adapted to the Lebanese population, to measure nicotine dependence among adolescents.

METHODS

Two cross-sectional investigations were conducted; Study 1 (January and May 2019) enrolled a total of 449 students who were exclusive waterpipe smokers; this sample was used to conduct the exploratory factor analysis. Study 2 enrolled another sample composed of 243 waterpipe smoking adolescents. This sample was independent from the first one and was used to conduct the confirmatory analysis.

RESULTS

The results also showed that 312 (69.5%) [95% CI 0.652-0.738] had high waterpipe dependence (scores of ≥10). Results of the factor analysis in sample 1 showed that all LWDS-11 items were extracted following the factor analysis. Items converged over a solution of one factor; total variance explained = 70.45%, αCronbach = 0.96). The results of the confirmatory factor analysis were as follows: the Maximum Likelihood Chi-Square = 129.58 and Degrees of Freedom = 45, which gave a χ2/df = 2.88. For non-centrality fit indices, the Steiger-Lind Root Mean Square Error of Approximation (RMSEA) was 0.08 [0.071-0.106]. Moreover, the Comparative Fit Index (CFI) value was 0.77.

CONCLUSION

The preliminary results suggest that the LWDS-11 has good psychometric properties to measure waterpipe dependence among adolescents. We hope this tool would serve the benefit of research and epidemiology.