Mental health problems both precede and follow bullying among adolescents and the effects differ by gender: a cross-lagged panel analysis of school-based longitudinal data in Vietnam

Mental health dynamics of adolescents: A one-year longitudinal study in Harari, eastern Ethiopia

AIMS

This study aims to assess the dynamics of in-school adolescents' mental health problems in Harari regional state, eastern Ethiopia for a year.

MATERIALS AND METHODS

Using multistage sampling technique, we conducted a year-long longitudinal study at three public high schools between March 2020 and 2021. Three hundred fifty-eight in-school adolescents were chosen by systematic random sampling for the baseline assessment, and 328 completed the follow-up assessment. We used self-administered, adolescent version of SDQ-25 Questionnaire to collect the data. Wilcoxon matched-pairs signed-rank test and McNemara's Chi-squared tests were used to examine the median difference and distribution of mental health problems between times one and two. Random-effects logistic regressions on panel data was used to identify factors associated with mental health problems. A p-value < 0.05 was considered as statistically significant.

RESULTS

The magnitude of overall mental health problems at baseline assessment was 20.11% (95% CI: 16-25), with internalizing problems accounting for 27.14% (95% CI: 23-32) and externalizing problems accounting for 7.01% (95% CI: 4.6-10.3). At the follow-up assessment, these proportions rose to 22.56% (95% CI, 18-27) for overall problems and 10.3% (95% CI, 7.7-14.45) for externalizing problems. On other hand, internalizing problems decreased unexpectedly to 22.86% (95% CI, 18.6-27.7) at follow-up assessment. Internalizing problem scores at time two were significantly lower than baseline among older adolescents, girls and those with average wealth index in our study cohort.

CONCLUSIONS

The prevalence of mental health problems were high among the study cohort. The proportion of overall problems and externalizing problems has increased over time, indicating a deterioration in the mental health of the study cohort. However, the decrease in internalizing problems among older adolescents, girls, and those with an average wealth index is a positive sign. The findings highlight that tailored interventions are required to reduce externalizing problems and maintain the decrease in internalizing problems. These interventions should target middle-aged and male adolescents from low-income families.

Prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in eastern Ethiopia: a cross-sectional study

Adolescent's mental health issues are a major social burden and a significant public health issue, but they have not received enough attention in Ethiopia. Therefore, this study aimed to determine the prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in the Harari region, eastern Ethiopia. A cross-sectional study was conducted among 3227 in-school adolescents. Multistage sampling was used to select schools and eligible students to participate in the study. A guided, self-administered strength and difficulty questionnaire measured mental health problems. Data were double-entered, validated, and cleaned using EpiData 3.1 and analyzed using STATA version 17. Ordinal logistic regression analysis was performed to estimate the adjusted odds ratio between mental health problems and their correlates. Statistical significance was set at p-value < 0.05. The magnitudes of mental health problems among in-school adolescents by subscale was 24.17% (95% CI 22.72; 25.67) for internalizing and 11.93% (95% CI 10.85; 13.09) for externalizing problems. A high internalizing problem score was associated with females, rural residents, alcohol users, attending public schools, those bullied at school, and those in the lowest wealth index. Likewise, the likelihood of a high externalizing problem score was high among alcohol users, adolescents whose fathers are uneducated, rural, and bullied at school. The study suggests that mental health problems are prevalent among in-school adolescents in Ethiopia, especially internalizing problems. The study also identifies several risk factors associated with internalizing and externalizing problems, such as wealth index, school types, alcohol use, bullying, and rural residence. These factors may indicate the need for more mental health awareness and support programs for adolescents in Ethiopia. This highlights that schools and communities should prioritize mental health awareness and support programs for adolescents. These programs should be tailored to address the specific needs of the population, such as rural residents, those in the lowest wealth index, and those who have experienced bullying.

Prosocial Behaviours and Resilience in School Coexistence: Implications of Creative Self-Efficacy and Stress in Adolescents

Adolescence brings with it a number of problems such as school violence. To reduce stress and increase the well-being of students, it is necessary to enhance certain skills such as prosocial behaviours, resilience, and creative self-efficacy. This cross-sectional study investigated the impact of prosocial behaviours and creative self-efficacy on school violence, stress, and resilience in adolescent students. A total of 743 students aged 14-19 years participated. The results revealed positive correlations between the dimensions of prosocial behaviours, creative self-efficacy, and resilience, and negative correlations with perceived stress. Differences were also observed in the relationship between prosocial behaviours, school violence, and stress. Mediation models indicated that creative self-efficacy acted as a mediator between prosocial behaviours and resilience. In addition, stress was found to moderate the relationship between prosocial behaviours and resilience. This study provides evidence on how prosocial behaviours, resilience, and creative self-efficacy act as a positive element in adolescence.

Child abuse and individual traits related to developmental trajectories of bullying victimization: An integrated, multitheoretical approach

INTRODUCTION

Adolescents who experience prior victimization such as child abuse within the home and experience low self-esteem/depression are at higher risk of repetitive bullying victimization when compared to those without such experiences. Recent scholarship has explored growth trajectories of bullying during adolescent development; however, relatively little is known about distinct trajectory patterns of bullying victimization across adolescent development. The current study identifies unobserved subgroups thus capturing the heterogeneity in developmental pathways in bullying victimization.

METHOD

The current study uniquely utilized a multitheoretical approach to help explain the phenomenon of bullying victimization among a national sample of 2,190 youth in South Korea from 2010 to 2016. Theories tested include the integrated approach of target congruence, lifestyle and routine activities theories (LRAT), and the state dependence and population heterogeneity perspectives. To conduct this analysis, we performed a three-step latent class growth analysis.

RESULTS

The study revealed three distinct trajectory groups. Korean adolescents who had higher levels of low self-esteem demonstrated greater odds of belonging to both the early-onset and decreasing and increasing and late peak groups. Those who had low-self-esteem and were depressed demonstrated greater odds of belonging to the early-onset and decreasing group. Prior experience of child abuse for the early-onset and decreasing group was fully mediated by the measures of target congruence and lifestyles.

CONCLUSION

The current study contributes to research on developmental victimization by demonstrating the utility of integrating target congruence variables with lifestyle-routine activity concepts in explaining heterogeneity.

Mental health and its determinants among adolescents living in families with separated or divorced parents in an urban area of Vietnam

BACKGROUND

We assessed the prevalence of stress, anxiety, and depression among adolescents living in families with separated or divorced parents in Hue City, Vietnam and identified factors associated with these conditions.

METHODS

This cross-sectional study enrolled 309 adolescents, aged 12 to 17 years, living in families with separated or divorced parents in Hue City, Vietnam. The depression anxiety stress scale-21 (DASS-21) was used to measure stress, anxiety, and depression. Predictors of overall and individual mental health problems were identified using ordered and binary logistic regression, respectively.

RESULTS

The DASS-21 scale revealed a 49.2% prevalence of stress, while anxiety and depression had s prevalence rates of 61.5%. Among participants, 42.4% experienced all 3 mental health issues. Several factors were identified as significant predictors of mental health problems, including poor to average economic status (adjusted odds ratio [aOR], 2.00; 95% confidence interval [CI], 1.21-3.31; p=0.007); being in high school (aOR, 5.02; 95% CI, 2.93-8.60; p<0.001); maternal occupation of teacher, healthcare professional, or official (aOR, 2.39; 95% CI, 1.13-5.03; p=0.022); longer duration of family separation or divorce (aOR, 1.24; 95% CI, 1.05-1.45; p=0.009); living with one's mother (aOR, 1.69; 95% CI, 1.03-2.76; p=0.04); alcohol consumption (aOR, 1.70; 95% CI, 0.99-2.92; p=0.050); and being bullied (aOR, 5.33; 95% CI, 1.10-25.69; p=0.037). Most of these factors were associated with stress, anxiety, and depression. Additionally, smoking was associated with stress.

CONCLUSION

Adolescents with separated or divorced parents were at increased risk of stress, anxiety, and depression. The findings of this study provide important implications for prevention programs.

Moderating role of mental health literacy on the relationship between bullying victimization during the life course and symptoms of anxiety and depression in Chinese college students

BACKGROUND

Exposure to persistent bullying victimization across multiple periods results in a high risk of worse consequences. Although amples studies support the association between bullying victimization and symptoms of anxiety and depression, whether mental health literacy can serve as a moderator on this relationship remains unknown. Therefore, the aim of this study was to examine the patterns of bullying victimization across the life course, and disentangle the moderating effect of mental health literacy between bullying victimization patterns and symptoms of anxiety and depression in Chinese college students.

METHODS

A total of 4036 college students were enrolled by cluster sampling from November 2020 to January 2021. Bullying victimization, mental health literacy, and symptoms of anxiety and depression were measured by self-report validated questionnaires. A latent class analysis was applied to identify bullying patterns. The PROCESS program was conducted to analyze whether mental health literacy moderates the link between bullying victimization patterns and symptoms of anxiety and depression.

RESULTS

Three latent patterns of bullying victimization were identified as follows: persistent bullying pattern (6.2%), moderate bullying pattern (10.5%), and low bullying pattern (83.3%). Logisitic regression analysis of anxiety and depressive symptoms indicated that compared with low bullying pattern, persistent bullying pattern had the highest risk. Specifically, mental health literacy moderated the association between bullying victimization pattern and anxiety symptoms (B = -0.039, P < 0.05).

CONCLUSIONS

It is important for practitioners to examine bullying victimization across the life course concurrently rather than a single period in isolation. Interventions and research should enhance mental health literacy to improve the mental health in college students with a history of bullying victimization.

Gendered Differences in Experiences of Bullying and Mental Health Among Transgender and Cisgender Youth

Even though previous studies have shown that transgender youth have poorer mental health and more experiences of being bullied than their cisgender counterparts, and that bullying associates with poorer mental health, knowledge on such associations in different gender identity groups is scarce. This study investigated how mental health problems and experiences of being bullied appear across different gender identity groups, and how bullying is associated with mental health among the groups in question. Data from the Finnish School Health Promotion 2021 study (n = 152,880, mean age 16.2 years (standard deviation 1.22)) was used and categorized into four gender identity groups: cisgender girls (n = 76,521), cisgender boys (n = 69,735), transfeminine youth (n = 1317), and transmasculine youth (n = 5307). Transgender youth experienced more bullying and reported poorer mental health than cisgender youth. While transfeminine youth faced the most bullying, transmasculine youth had the most mental health symptoms. In each group, bullying associated with poorer mental health. Compared to cisgender boys without bullying experiences, odds of poorer mental health were dozens-fold among transmasculine youth with weekly bullying experiences. In addition, compared to cisgender boys with bullying experiences, odds of poorer mental health were greater among all other gender identity groups with bullying experiences, and among transmasculine youth in particular (e.g., odds ratio of generalized anxiety = 8.36 (95% confidence interval, 6.59-10.6)). Bullying is associated with poorer mental health in all youth, but transgender youth, and especially transmasculine youth, may be in an even more vulnerable position for its implications. This suggests that there is a need for improving effective measures to decrease bullying in schools and to improve wellbeing of transgender youth.

The longitudinal course of childhood bullying victimization and associations with self-injurious thoughts and behaviors in children and young people: A systematic review of the literature

INTRODUCTION

Bullying victimization has consistently been highlighted as a risk factor for self-injurious thoughts and behaviors (SITBs) in young people. This systematic review of prospective, community-based studies explored associations between bullying victimization (traditional/face-to-face and cyber) across the full spectrum of self-harm and suicidality, in children and young people aged up to (and including) 25 years. Importantly, associations by sex/gender were explored.

METHODS

MEDLINE, Embase, PsycINFO, CINAHL and Scopus were searched for articles meeting the inclusion criteria. Articles were screened by title, abstract and full text. Quality appraisal was performed using the Newcastle-Ottawa Scale for cohort studies. Data were synthesized narratively. The protocol is registered on PROSPERO (CRD42021261916) and followed PRISMA 2020 guidelines.

RESULTS

A total of 35 papers were included, across 17 countries. Results were presented by bullying type: traditional/face-to-face (n = 25), cyber (n = 7) and/or an aggregate of both types (n = 7). Outcomes included suicidal ideation (n = 17), self-harm (n = 10), suicide attempt (n = 4), NSSI (n = 4), other (n = 7). Studies measured outcomes in under 18s (n = 24), 18-25-year-olds (n = 8) and both under 18s and 18-25-year-olds (n = 3). Studies exploring the role of sex/gender (20%) found some interesting nuances.

CONCLUSIONS

Some weak to strong associations between bullying and SITBs were found yet conclusions are tentative due to study heterogeneity (e.g., methods used, conceptualizations and operationalisations of exposures/outcomes). Future research should address methodological issues raised in this review, and further explore gender differences in bullying, including by bullying sub-types (e.g., overt or relational) and victim status (e.g., victim or bully-victim).

The Associations between Sibling Victimization, Sibling Bullying, Parental Acceptance-Rejection, and School Bullying

Bullying has been identified as the most common form of aggression experienced by school-age youth. However, it is still unclear about the family's influence on school bullying. Therefore, the current study aimed to explore the associations between sibling bullying and school bullying, sibling victimization and school victimization, and parental acceptance-rejection and school bullying victimization. The study was cross-sectional and conducted on a sample of students aged between 11 and 20 years recruited from middle schools in Algeria. The study used a survey adopted from the scale of Sibling Bullying, Student Survey of Bullying Behavior-Revised 2, and the Survey of parental acceptance-rejection in collecting the data. The model's results assessing the association between sibling bullying and school bullying demonstrated that the effect of sibling physical and sibling verbal victims on school victimization was statistically significant. Despite the non-significant effect of sibling emotional victims on school victimization, the effect of sibling physical and sibling verbal bullying on school bullying was statistically significant. However, the effect of sibling emotional bullying on school bullying was not statistically significant. The direct effect of parental acceptance on school victimization was not statistically significant, whereas the effect of parental rejection on school victimization was statistically significant. The direct effect of parental acceptance on school bullying was not statistically significant, while the effect of parental rejection on school bullying was statistically significant. Based on the results, this study provides insights into the understanding of how the family and siblings contribute to school bullying. In particular, sibling victimization, sibling bullying, and parental acceptance-rejection are predictive factors of school bullying among adolescents. Future research should take into account factors based on family to explore the risks of school bullying.

Variation in the prevalence of different forms of bullying victimisation among adolescents and their associations with family, peer and school connectedness: a population-based study in 40 lower and middle income to high-income countries (LMIC-HICs)

This study aimed to estimate the prevalence of different forms of bullying victimization experiences and their association with family functioning, peer relationships and school connectedness among adolescents across 40 lower and middle income to high-income countries (LMIC-HICs). Data were drawn from the Health Behaviour in School-Aged Children (HBSC) school-based survey of adolescents aged 11-15 years, between 2013 and 2014. We estimated the weighted prevalence by categorising experiences into traditional bullying victimization only, cyberbullying victimization only, and combined traditional and cyberbullying victimization, at country and country income classification. We used multinominal logistic regression models to estimate the adjusted association with the form of bullying victimization by demographic characteristics, family functioning, peer relationships and school connectedness. Overall, 8.0% reported traditional bullying victimization only (8.8% males, 7.4% females), 2.3% of adolescents reported cyberbullying victimization only (2.1% males, 2.2% females), and 1.7% reported combined traditional and cyber bullying victimization (1.7% males, 1.8% females). All three forms of bullying victimization during adolescence were significantly associated with poor family functioning, poor peer relations and poor school connectedness. A consistent finding is that traditional bullying victimization is considerably more common among adolescents across both LMICs and HICs than cyberbullying victimization. This study also demonstrated that a significant proportion of adolescent's experience victimization in both forms. Positive family functioning, strong peer relationships and greater school connectedness are associated with a lower risk of both forms of bullying victimization.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40653-022-00451-8.

School bullying associated suicidal risk in children and adolescents from Yunnan, China: The mediation of social support

OBJECTIVE

We aimed to investigate the mediation of social support in the association between school bullying and suicidal risk among a large group of Chinese children and adolescents.

METHOD

In this two-wave cross-sectional study, we analyzed 6,063 children and adolescents from southwest China. A two-stage simple random clustering sampling method with probability proportionate to sample size design had been used to select study subjects. Univariate and multivariate Logistic regression models were adopted to determine the inter-associations between school bullying, suicidal risk indicators, and social support. Path models were further fitted to estimate the mediation of social support.

RESULTS

Compared with students who were not involved in school bullying, only victimization was associated with increased suicidal risk, the adjusted ORs for suicidal ideation, suicidal plan, and suicidal attempt were 2.06 (95% CI: 1.61-2.65), 2.07 (95% CI: 1.62-2.64), and 2.41 (95% CI: 1.90-3.05), respectively. Path model indicated that parental social support significantly mediated the association between bullying victimization and suicidal risk. For different types of victimization, only relational bullying victimization was associated with increased suicidal risk, social support from classmates and close friends presented as significant mediators.

LIMITATIONS

Causal inference cannot be made because of cross-sectional study design. Information was collected by using self-reporting method, the possibility of information bias exists. Generalization of study results could be limited.

CONCLUSIONS

Intervention measures on improving parental and peer social support may be effective in reducing school bullying victimization associated suicidal risk for Chinese children and adolescents.

Bullying and coping with bullying among obese\overweight and normal weight children

This study aimed to determine the obese\overweight and normal weight children's status of encountering and coping with bullying and the correlational factors. This case-control study was conducted with 1.680 students in the second level (5th, 6th, 7th, 8th grades) from September 24, 2018 to May 31, 2019 in the Mediterranean Region in Turkey. The data were collected using a personal information form, the Traditional Peer Victimization Scale and the Coping with Bullying Scale. Data were analyzed using the Shapiro-Wilk test, Mann-Whitney U test, Binary Logistic Regression, Backward Wald Elimination, and Simple Linear and Backward Stepwise Multiple Linear Regression analyses. This study indicated that the risk of becoming victims, bullies or bully-victims increases among boys and 8th grade students. It also found that the risk of being victims and bully-victims increases among children whose father is illiterate. There was no significant difference between obese\overweight and normal weight children in terms of being victims, bullies and bully-victims. Grade level, academic performance, father's education level and awareness of reporting bullying were effective in coping with bullying among the children, while weight was not. Further studies are needed to determine different factors that affect children's coping strategies against bullying.

Bullying at school and mental health problems among adolescents: a repeated cross-sectional study

OBJECTIVE

To examine recent trends in bullying and mental health problems among adolescents and the association between them.

METHOD

A questionnaire measuring mental health problems, bullying at school, socio-economic status, and the school environment was distributed to all secondary school students aged 15 (school-year 9) and 18 (school-year 11) in Stockholm during 2014, 2018, and 2020 (n = 32,722). Associations between bullying and mental health problems were assessed using logistic regression analyses adjusting for relevant demographic, socio-economic, and school-related factors.

RESULTS

The prevalence of bullying remained stable and was highest among girls in year 9; range = 4.9% to 16.9%. Mental health problems increased; range = + 1.2% (year 9 boys) to + 4.6% (year 11 girls) and were consistently higher among girls (17.2% in year 11, 2020). In adjusted models, having been bullied was detrimentally associated with mental health (OR = 2.57 [2.24-2.96]). Reports of mental health problems were four times higher among boys who had been bullied compared to those not bullied. The corresponding figure for girls was 2.4 times higher.

CONCLUSIONS

Exposure to bullying at school was associated with higher odds of mental health problems. Boys appear to be more vulnerable to the deleterious effects of bullying than girls.

Bullying experience in urban adolescents: Prevalence and correlations with health-related quality of life and psychological issues

This study examined the 3-month rate of bullying experience, associated factors, and measure the relationships between bullying experience with health-related quality of life and different mental disorders among secondary school students. We performed a cross-sectional study in four secondary schools in Hanoi, Vietnam. Bullying experience was evaluated by using questions about eighteen specific-bullying behaviors. EuroQol-5 dimensions-5 levels (EQ-5D-5L) and Depression, Anxiety, and Stress Scale- 21 items (DASS-21) were used to measure health-related quality of life (HRQOL) and mental health of participants, respectively. Among 712 secondary school students, the 3-month prevalence of physical, social aggression, verbal, and sexual bullying experience were 8.4%; 31.2%; 11.9%, and 2.7%, respectively. Being bullied were negatively associated with levels of classmates and family support, as well as levels of school security. Being overweight or obese was related to a higher likelihood of suffering social aggression compared to normal BMI. Being bullied was significantly associated with the decrement of HRQOL, and the increased risk of depression, anxiety, and stress among adolescents. Findings of this study suggested that holistic approaches involving family, peers, and schools, along with enhancing school security, are potential approaches to reduce the impact of bullying on adolescents' life and well-being.

The Zero Violence Brave Club: A Successful Intervention to Prevent and Address Bullying in Schools

Bullying among peers in schools is a growing problem affecting children and adolescents from an early age worldwide. The consequences of bullying victimization in the emotional development of children and youth and their academic achievement are adverse for them and the rest of the school community, with its negative impact extending into the mid and long run. The Zero Violence Brave Club is implemented in schools in the framework of the Dialogic Model of Violence Prevention, a successful educational action according to the INCLUD-ED project [Strategies for inclusion and social cohesion in Europe from Education] (6th Framework Program of Research of the European Commission). The Zero Violence Brave Club has decreased peer bullying in schools by establishing and cultivating a culture of zero tolerance to violence in educational centers located in diverse socioeconomic and cultural contexts. This evidence-based intervention is grounded in the principle that only the person who denounces violence suffered by a peer and takes a stand always on the victim's side-and those who support her or him-against the aggressor can be considered brave. This article reports a qualitative study of the Zero Violence Brave Club as a successful intervention in seven schools in Spain. The schools are diverse in terms of public or private ownership, religious or lay background, and population served (different proportions of cultural minorities and students with special needs), challenging the misconception that the impact of educational interventions depends on the context. Interviews were conducted with teachers in the schools implementing the Zero Violence Brave Club in their class, using the communicative methodology of research. The results shed light on specific mechanisms through which the Zero Violence Brave Club prevents and responds to bullying in schools, such as emptying of social attractiveness any aggressive behaviors or attitudes. Benefits on mental health and psychological wellbeing are also reported.

Assessing the Mental Health of Brazilian Students Involved in Risky Behaviors

Adolescence, which is the transition from childhood to adulthood, is marked by emotional sensitivity and inconsistency and may be affected by mental health problems. In order to fill the gap related to the risky behaviors in students in Brazil, our cross-sectional study aimed to analyze the relationship between risky behaviors and indicators of mental health of Brazilian students. We used the data from the National School Health Survey to analyze the relationship between risk behaviors and three symptoms of mental health issues: feeling of being alone, number of close friends, and trouble sleeping due to worries. The sample consisted of 102,072 students in Brazil (48.3% boys and 51.7% girls), aged between 11 to 19 years. The risk behaviors evaluated were substance use, sedentary lifestyle, sexual behavior, and suffering violence and bullying. We have performed a multivariate analysis based on the Poisson regression model, and the measure of effect used was the prevalence ratio (PR) with confidence intervals (CI) of 95%. Our results showed that students with symptoms of mental health issues were involved in risky behaviors, including drug use and unsafe sex. Thus, mental illness outcomes may be associated with risky behaviors, or mental health may be impaired by them. Given these findings, in-school programs focused on improving mental health outcomes should be developed.