Factors associated with bullying victimization among Korean adolescents

[Bullying victimization and associated factors among schoolchildren in a city in the south of Brazil]

The objective was to assess the prevalence of bullying victimization and associated factors among adolescents in the city of Pelotas, Rio Grande do Sul. A cross-sectional school-based study was conducted with 795 ninth grade students from 25 urban municipal schools linked to the School Health Program. Bullying was assessed using questions that addressed the occurrence, frequency, location, type of violence suffered and how much it bothers the victims. Gross and adjusted analyses were performed by Poisson regression. Approximately 71% of the students reported having suffered bullying, and school was the location of greatest occurrence (86.7%). Among the types of aggression suffered, "nicknames" was the most recurrent complaint (88.4%), followed by exclusion or isolation (26.6%). Victimization was more frequent among girls (PR 1.13; 95%CI 1.02-1.27), students with non-white skin color/race (PR 1.16; 95%CI 1.05-1.29), who have already tried tobacco (PR 1.14; 95%CI 1.03-1.27), dissatisfied (PR 1.42; 95%CI 1.27-1.58) or indifferent (PR 1.21; 95%CI 1.02-1.43) about their bodies, and who were overweight (PR 1.15; 95%CI 1.04-1.27). The results show that bullying is a frequent practice in the school environment, pointing to the need for educational practices aimed at reducing and preventing this type of violence.

Patterns of Elementary School Students' Bullying Victimization: Roles of Family and Individual Factors

Physical, verbal, and relational bullying victimization are common forms of bullying victimization. Some victims may suffer only one form of victimization and some may suffer multiple forms of victimization at the same time. Bullying victimization groups are heterogeneous and different forms of victimization may have different combination patterns. Previous studies assessed patterns of bullying victimization among junior and senior high school students. However, limited studies explored patterns among elementary students and explored possible factors in shaping these patterns from the integrated perspective of family and individual. We expanded and deepened research in this area using questionnaires to collect self-report data for 866 parent/child pairs. Latent profile analysis was used to explore patterns of elementary students. Multinomial logistic regression was used to examine relations between patterns and family and individual factors. We found three bullying victimization groups: severe (5.4%), verbal (13.6%), and non-bullying victimization (81%). In family factors, the time parents spent with children was a protective factor for bullying victimization, and negative interactions with children was a risk factor. Individual-level protective factors for bullying victimization were coming from a single child household, positive coping style, and perceived peer support, whereas a negative coping style was a risk factor. These results indicate that different forms of bullying victimization co-occur among elementary school students. Some family and individual factors are associated with bullying victimization patterns. It is important to consider the heterogeneity among the bullying victimization groups of elementary students and influencing factors to develop targeted prevention interventions for different bullying victimization groups.

Effects of Perceived School Rule Enforcement on Traditional and Cyber Victimization: A Panel Study among Early Adolescents

Traditional and cyber victimization can be considered similar in several respects, including the long-lasting damage done to the wellbeing of youth. However, it is important to acknowledge that they represent two clearly distinct phenomena and, as such, the impact of school rules on their development might differ. The present longitudinal study applies a multilevel model for a change approach to data resulting from a four-waves survey that followed a random sample of 101 Swiss middle school classes (N = 1500; M_ageT1 = 11.54, SD = 0.40) for a period of two school years. Findings from the analyses-which were conducted controlling for gender and economic status-showed that those students who perceive that school rules are implemented more consistently experience a slightly less steep increase in victimization online. A similar effect for traditional victimization was not found, probably because the observed change in this phenomenon was less. Considering the overall small effects found by this research, further investigation on the relation between school rule enforcement and peer victimization is recommended.

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.

Wealth Inequalities in Different Types of Violence Among Brazilian Adolescents: National Survey of School Health 2015

Studies have assessed inequalities in violence by economic status, but few studies have been done with adolescents from middle-income countries. Our objective was to analyze inequalities in verbal bullying, family physical violence, sexual violence, and fights with weapons among Brazilian adolescents in school according to wealth and stratified by sex and skin color. We used data from the Brazilian National Survey of School Health (Pesquisa Nacional de Saúde do Escolar [PeNSE]), carried out in 2015, with a representative sample of Brazilian adolescents attending ninth grade in public and private schools. We created a wealth index based on questions about access to goods and services through principal component analysis; this index was later divided into quintiles. We calculated the slope index of inequality (SII), the concentration index (CIX), and simple measures of inequality, such as ratio and difference. To identify statistically significant differences in sex and skin color inequality, we used the t test. We found high prevalence values of verbal bullying and family physical violence, 23.9% and 14.5%, respectively. In general, when comparing the types of violence according to SII and CIX, we observed a higher prevalence of violence among adolescents in the lower income quintiles, for both sexes and skin colors. We observed higher wealth inequality in sexual violence among girls (CIX = -14.89) when compared with boys (CIX = -4.63) (p = .001). We also observed higher wealth inequality in sexual violence among Whites (CIX = -15.55) when compared with Brown (CIX = -6.23) (p = .009). Wealth inequality aggravates the occurrence of violence among poorer Brazilian adolescents. Also, the identification of vulnerable groups may contribute to target public policies for fighting violence.

Suicide attempt and violence victimization in Korean adolescents with migrant parents: A nationwide study

BACKGROUND

Suicide and violence exposure are important health related issues in adolescents. This study aimed to investigate suicide attempt and violence victimization in Korean adolescents with migrant parents.

METHODS

Data from the 2016 to 2018 Korea Youth Risk Behavior Web-based Survey (KYRBS) were used. The migration status of the participating students' parents was defined based on parental birthplace, classified into the 'both native Korean parents,' 'mother born abroad,' 'father born abroad,' and 'both parents born abroad' groups. Suicide attempt and violence victimization included events that occurred in the past 12 months. The general characteristics of the population were investigated using chi-square test. The association between dependent and independent variables was examined using multiple logistic regression analysis, expressed as Odds Ratio (OR) and their 95 percent confidence interval (95% CI).

RESULTS

Of the 170,575 study participants, 4,012 (2.4%) attempted suicide and 3,038 (1.8%) experienced violence victimization. Highest proportions of suicide attempt and violence victimization were found in adolescents with both migrated parents born abroad. Compared to adolescents with both native Korean parents, individuals with both migrated parents were more likely to attempt suicide (OR 2.28, 95% CI 1.37-3.81) and experience violence victimization (OR 5.63, 95% CI 3.73-8.48).

LIMITATIONS

This study was cross-sectional in design. Information was unavailable on which immigrant generation the study participants belonged to.

CONCLUSION

Adolescents with both migrated parents were more likely to attempt suicide and experience violence victimization. The findings have important implications in the management of suicide and violence victimization in adolescents.

A multi-country analysis of the prevalence and factors associated with bullying victimisation among in-school adolescents in sub-Saharan Africa: evidence from the global school-based health survey

BACKGROUND

Over the past few years, there has been growing public and research interest in adolescents' experiences with various forms of bullying victimisation because of their psychological, emotional, and/ or physical consequences. The present study examined the prevalence of bullying victimisation and its associated factors among in-school adolescents in sub-Saharan Africa.

METHODS

Using data from the Global School-based Health Survey (GSHS) from 2010 to 2017 of eleven sub-Saharan African countries, a sample of 25,454 in-school adolescents was used for analysis. Statistical analyses included frequencies, percentages, Pearson chi-square and multivariable logistic regression. Results were presented as adjusted odds ratios (aOR) at 95% confidence intervals (CIs).

RESULTS

The overall prevalence of bullying victimisation among the respondents was 38.8%. The prevalence was lowest in Mauritius (22.2%) and highest in Sierra Leone (54.6%). Adolescents who felt lonely [aOR = 1.66, 95% CI = 1.53, 1.80], had history of anxiety [aOR = 1.53, 95% CI = 1.41, 1.66], suicidal ideation [aOR = 1.28, 95% CI = 1.17, 1.39], suicidal attempt [aOR = 1.86, 95% CI = 1.72, 2.02], current users of marijuana [aOR = 1.59, 95% CI = 1.38, 1.84], and truants at [aOR = 1.43, 95% CI = 1.34, 1.52] were more likely to be victims of bullying. Conversely, adolescents who had peer support were less likely to be victims of bullying [aOR = 0.78, 95% CI = 0.73, 0.82]. Adolescents aged 15 years or older had lower odds of experiencing bullying victimization compared to their counterparts aged 14 years or younger [aOR = 0.74, 95% CI = 0.69, 0.78].

CONCLUSION

Our findings suggest that age, loneliness, anxiety, suicidal ideation, suicidal attempt, and current use of marijuana are associated with increased risk of bullying victimisation. School-wide preventative interventions (e.g., positive behavioural strategies- Rational Emotive Behavioral Education, [REBE], peer educator network systems, face-face counseling sessions, substance use cessation therapy) are essential in promoting a positive school climate and reduce students' bullying victimisation behaviours.

Differences in electronic cigarette use among adolescents in Korea: A nationwide analysis

INTRODUCTION

The use of electronic cigarettes (e-cigarettes) has increased among adolescents. This study aimed to investigate the relationship between e-cigarette use and different sociodemographic factors among Korean adolescents.

METHODS

The study used the 2017 to 2019 Korea Youth Risk Behavior Web-based Survey (KYRBS) data. The study measured sociodemographic status based on living arrangement, economic status, and parental birthplace. We used a Chi-square test to investigate the general characteristics of the study population. We applied multiple logistic regression analysis to analyze the association between e-cigarette use and sociodemographic status. Model 1 included electronic cigarettes only as the outcome variable and model 2 included electronic cigarettes plus combustible cigarettes. The study expressed results as odds ratios (OR) and their 95% confidence interval (95% CI).

RESULTS

A total of 2.4% of adolescents used e-cigarettes only and 6.5% e-cigarettes and/or conventional cigarettes. In e-cigarettes users (model 1), compared to individuals living with their parents, those living with their relatives (OR 3.23, 95% CI 2.45-4.24) and in protective facilities (OR 4.36, 95% CI 2.98-6.39) were more likely to smoke. The "middle" showed lower odds than the "low" economic status group (OR 0.78, 95% CI 0.69-0.87). Adolescents with both parents born abroad (OR 2.92, 95% CI 1.78-4.82) also had a higher likelihood of smoking than those with both native Korean parents. The study found similar trends in model 2, which accounted for both electronic and combustible cigarettes.

CONCLUSION

E-cigarette use among adolescents was associated with living arrangement, economic status, and parental birthplace. E-cigarettes use among adolescents should be monitored, particularly in the vulnerable groups of adolescents that this study identified.

Bullying as a Risk Factor of Depression on Undergraduate Health Students

Depression is a serious health problem that needs to be treated early so that it does not get worse in the future. Bullying can cause a mental health problem on students. This study aims to analyze the relationship between bullying and depression among undergraduate health students. This was an observational study with a cross-sectional design. Respondents filled out questionnaires online using the Google Form application. A total of 246 undergraduate health students participated in this study. Multivariate logistic regression was used to analyse the data. There was a relationship between bullying and the incidence of depression in undergraduate health students (AOR: 2.158 (95% CI: 1.050-4.435)) after being controlled by physical attacked, close friends, loneliness, and smartphone addiction. This study proves that bullying is a risk factor for depression. Prevention of bullying is important to prevent depression. Handling and prevention are done by involving peer support from students through peer-counselor or peer-educator programs. Students with severe depression need to be treated further through an appropriate referral system.

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.

Bullying and Victimization in Native and Immigrant Very-Low-Income Adolescents in Italy: Disentangling the Roles of Peer Acceptance and Friendship

Background

Very-low-income students are a population at a high risk of perpetrating and suffering bullying at school, and at the same time the peer group at school is often one of the few sources of support for these minors.

Objective

This two-wave study is aimed to disambiguate the two different roles of peer acceptance and friendship on bullying and victimization in very-low-income adolescents, exploring the possible differential role of immigrant background.

Method

An online survey was administered to 249 early to late adolescents living below the poverty threshold (Mage = 12.76; SDage = 2.34; 41.8% girls; 19.3% immigrants). A multivariate regression model with multi-group analyses was applied.

Results

Our results indicated that peer friendship was a protective factor against bullying as well as victimization, whilst peer acceptance was not protective. Only for natives (but not for immigrants), a high level of peer acceptance was a risk factor for bullying, and low school achievement was a risk factor for victimization. The persistence of victimization over time was significantly stronger for immigrants than for natives.

Conclusions

The study provides new insights for the unique protective role of classmates’ friendship in natives and immigrants, while acceptance appeared to be less relevant. Research and applied implications are discussed.

Bullying Victimization among In-School Adolescents in Ghana: Analysis of Prevalence and Correlates from the Global School-Based Health Survey

(1) Background: Although bullying victimization is a phenomenon that is increasingly being recognized as a public health and mental health concern in many countries, research attention on this aspect of youth violence in low- and middle-income countries, especially sub-Saharan Africa, is minimal. The current study examined the national prevalence of bullying victimization and its correlates among in-school adolescents in Ghana. (2) Methods: A sample of 1342 in-school adolescents in Ghana (55.2% males; 44.8% females) aged 12–18 was drawn from the 2012 Global School-based Health Survey (GSHS) for the analysis. Self-reported bullying victimization “during the last 30 days, on how many days were you bullied?” was used as the central criterion variable. Three-level analyses using descriptive, Pearson chi-square, and binary logistic regression were performed. Results of the regression analysis were presented as adjusted odds ratios (aOR) at 95% confidence intervals (CIs), with a statistical significance pegged at p < 0.05. (3) Results: Bullying victimization was prevalent among 41.3% of the in-school adolescents. Pattern of results indicates that adolescents in SHS 3 [aOR = 0.34, 95% CI = 0.25, 0.47] and SHS 4 [aOR = 0.30, 95% CI = 0.21, 0.44] were less likely to be victims of bullying. Adolescents who had sustained injury [aOR = 2.11, 95% CI = 1.63, 2.73] were more likely to be bullied compared to those who had not sustained any injury. The odds of bullying victimization were higher among adolescents who had engaged in physical fight [aOR = 1.90, 95% CI = 1.42, 2.25] and those who had been physically attacked [aOR = 1.73, 95% CI = 1.32, 2.27]. Similarly, adolescents who felt lonely were more likely to report being bullied [aOR = 1.50, 95% CI = 1.08, 2.08] as against those who did not feel lonely. Additionally, adolescents with a history of suicide attempts were more likely to be bullied [aOR = 1.63, 95% CI = 1.11, 2.38] and those who used marijuana had higher odds of bullying victimization [aOR = 3.36, 95% CI = 1.10, 10.24]. (4) Conclusions: Current findings require the need for policy makers and school authorities in Ghana to design and implement policies and anti-bullying interventions (e.g., Social Emotional Learning (SEL), Emotive Behavioral Education (REBE), Marijuana Cessation Therapy (MCT)) focused on addressing behavioral issues, mental health and substance abuse among in-school adolescents.

Vitimização por bullying e fatores associados em estudantes brasileiros com idade de 13 a 17 anos: estudo populacional

RESUMO: Objetivo: Analisar fatores escolares, sociodemográficos, nutricionais e de percepção corporal e comportamental associados à vitimização por bullying entre estudantes brasileiros com idade de 13 a 17 anos. Métodos: Trata-se de um estudo transversal com base nos dados da amostra 2 da Pesquisa Nacional de Saúde do Escolar 2015. A amostra do presente estudo é composta de 10.699 adolescentes de escolas de cada grande região do país. Resultados: A prevalência de vitimização por bullying foi de 6,2%, com maiores chances de vitimização em adolescentes que praticam bullying (razão de chances - OR = 1,91, intervalo de confiança de 95% - IC95% 1,48 - 2,45), com idade de 13 anos (OR = 1,76, IC95% 1,04 - 2,97), que se consideram gordos (OR = 1,45, IC95% 1,06 - 1,98) e não são bem tratados na escola pelos colegas (OR = 2,78, IC95% 2,17 - 3,45). Conclusão: Esforços preventivos que incluam programas de incentivo ao maior suporte social entre os estudantes e a implementação de práticas que reforcem o respeito às diferenças e peculiaridades dos alunos podem contribuir para a redução da vitimização por bullying.

Victimization Experiences and Mental Health Outcomes Among Grades 7 to 12 Students in Manitoba, Canada

Victimization experiences, including traditional forms of bullying, discriminatory harassment, and cyber victimization, are associated with numerous detrimental consequences in adolescence and over the life course. The objective of the current study was to understand the relationships between nine experiences of victimization and mental health outcomes among students in grades 7 to 12 in Manitoba, Canada. Data were drawn from the 2012-2013 Manitoba Youth Health Survey (N = 64,174; response rate = 67%). Mental health outcomes included mental health functioning and emotional well-being, and feelings of sadness and hopelessness. The prevalence of moderate/languishing mental health functioning and emotional well-being ranged from 35.2% (boys in grades 7 to 9) to 51.0% (girls in grades 10 to 12). The prevalence of feeling sad and hopeless ranged from 31.4% (boys in grades 7 to 9) to 57.7% (girls in grades 10 to 12). All nine victimization types were associated with increased odds of having moderate/languishing mental health functioning and emotional well-being and feeling sad and hopeless for both boys and girls in grades 7 to 9 and 10 to 12, although some gender and grade differences were noted. A dose-response trend was found with increased odds of moderate/languishing mental health functioning and emotional well-being corresponding with increased frequency of being victimized. A similar trend was noted for girls only for feeling sad and hopeless. Effective prevention and intervention strategies targeting boys and girls and across grades 7 to 12 are needed to improve mental health functioning and emotional well-being, and reduce feelings of sadness and hopelessness among adolescents with victimization experiences.

A study on the school violence experience of children with attention-deficit hyperactivity disorder in the context of bullying

INTRODUCTION

School violence causes harmful effects to victims. Harmful effects are likely to persist into adulthood. There are many studies about the relationship between attention-deficit hyperactivity disorder (ADHD) and school violence. But, there are few comparative studies dividing groups by the context of bullying and by the school grade. Therefore, this study will identify the differences between general students and patients with ADHD under treatment, creating two groups (one with experience of the perpetration of violence and one with victimization).

METHODS

This study was conducted by questionnaires that dealt with experiences of being a bully and being bulled at school in the past year as six items each. A 5-point Likert scale was used. The ADHD group was 49, and the general students group was 245. The data were compared using the chi-squared test. Statistical analysis was performed using SPSS version 24, with statistical significance at P < 0.05.

RESULTS

The ADHD group was significantly high who reported severely beating other people than the general group. Likewise, ADHD group who reported threatening other people was significantly higher than in the general group. However, for the remaining items, there was no significant difference between the ADHD group and the general student group.

DISCUSSION

Previous studies suggested that ADHD symptoms are major causes of both bullying and being the victim of bullying. However, in this study, ADHD patients have more being the victim of bullying experiences than general students. Further, a well-designed study will be needed to accurately evaluate the relationship between school violence and ADHD.

Bullying Victimization Among School-Going Adolescents in Malaysia: Prevalence and Associated Factors

This study aimed to assess the prevalence and factors associated with bullying victimization from a nationwide school-based survey among 27 458 students aged 13 to 17 years. The overall prevalence of having been bullied in the past 30 days was 16.2%; this decreased with age. Multivariate logistic regression analysis revealed that factors most strongly associated with bullying victimization were exposure to physical attacks (adjusted odds ratio [aOR] = 2.46, 95% confidence interval [CI] = 2.17-2.79), illicit drug use (aOR = 2.44, 95% CI = 1.78-3.34), involvement in physical fights (aOR = 1.97, 95% CI = 1.74-2.23), being younger than 14 years (aOR =1.95, 95% CI = 1.59-2.38), and having ever attempted suicide (aOR = 1.83, 95% CI = 1.51-2.21). Other significantly associated factors include loneliness, truancy, making suicidal plans, and symptoms of depression, anxiety, and stress. Exposure to bullying victimization can result in negative lifelong sequelae and important associated factors should be considered in planning effective school-based anti-bullying interventions.

Parental Recognition of Bullying and Associated Factors Among Children After the Fukushima Nuclear Disaster: A 3-Year Follow-Up Study From the Fukushima Health Management Survey

This study examined parental recognition of bullying victimization and associated factors among evacuated children after the 2011 Fukushima Daiichi Nuclear Power Plant accident, using a 3-year follow-up data (wave 1: January 2012; wave 2: January 2013; wave 3: February 2014). The sample included the caregivers of 2,616 children in the first-sixth grades of elementary school, who lived in one of the 13 municipalities that were the target areas of the Mental Health and Lifestyle Survey, conducted as part of the Fukushima Mental Health Management Survey. Across 3 years, around 80% of caregivers responded "not true," 15% responded "somewhat true," and 5% responded "certainly true" in response to a question about bullying victimization of their children. Being male was significantly associated with the parental recognition of bullying victimization at wave 1 and wave 3. At wave 1, experiencing the nuclear plant explosion was significantly associated with parental recognition of bullying victimization. Moreover, age at wave 3 was negatively associated with parental recognition of bullying victimization. Our findings will be helpful for establishing community- and school-based mental health care for children, parents, and teachers.

Peer Victimization, Supportive Parenting, and Depression Among Adolescents in South Korea: A Longitudinal Study

PURPOSE

The aims of this study were to examine relationships among peer victimization, supportive parenting, and depression in South Korean adolescents and the moderating effect of supportive parenting on the peer victimization-depression relationship.

METHODS

Data were drawn from the Korean Children and Youth Panel Survey performed from 2010 to 2016. The first-year middle-school panel collected from the first year of middle school to the first year of university was used, and the final sample size was 1750. Generalized estimating equation models were employed to examine relationships among peer victimization, supportive parenting, and depression.

RESULTS

About 6% of participants reported the experience of peer victimization at least once during the previous year. Females were more likely to report higher level of depression compared to males. Participants who were from lower family income, reported the past experience of peer victimization, and reported less supportive parenting were more likely to report higher level of depression compare to the counterpart. The moderating effect of supportive parenting on the association between peer victimization and depression was not statistically significant.

CONCLUSIONS

Participants who had experienced of peer victimization and less supportive parenting showed higher levels of depression. The supportive parenting did not have significant moderating effect on the relationship between peer victimization and depression.

PRACTICE IMPLICATIONS

Future research on adolescent depression should include development of interventions targeting both adolescent students' behaviors and their parents' styles of parenting aimed at the reducing the rate of peer victimization and the level of depression among adolescents in South Korea.

Risk factors for disordered weight control behaviors among Korean adolescents: Multilevel analysis of the Korea Youth Risk Behavior Survey

OBJECTIVE

To investigate the prevalence and risk factors for disordered weight control behaviors (DWCB) in South Korean adolescents at multiple levels, including individual, family, school, and geographic area.

METHOD

We drew participants from the 11th Korea Youth Risk Behavior Web-based Survey, conducted in 2015, with 65,529 adolescents (31,687 girls, 33,842 boys) aged 12-18 years. DWCB was defined as engaging in any of the following behaviors for weight control over the past month: fasting, one-food diet (eating only one food over an extended period of time for weight control), vomiting, and taking laxatives/diuretics/unprescribed diet pills. Sex-stratified four-level multilevel logistic models examined potential predictors of DWCB, including age, body-mass index, puberty, perceived household economic status, parental education, living structure, school type and sex-composition, percentage of students participating in school nutrition programs, and urbanicity.

RESULTS

Overall, 6.2% of Korean adolescents (8.9% of girls, 3.7% of boys) exhibited any DWCB. We found significant between-school variation among girls and boys and between-classroom variation among girls. Older age, overweight/obesity, pubertal maturity, high household economic status (vs. mid-range economic status), and vocational schooling (vs. general) were positively associated with DWCB among girls and boys. Low household economic status (vs. mid-range economic status), higher parental education, and coeducational schooling (vs. single-sex) were positively associated with DWCB among girls only.

DISCUSSION

The findings suggest that DWCB are prevalent among Korean adolescents across age, sex, and socioeconomic status. Social contextual factors including school and familial environmental factors, as well as individual characteristics, should be considered when developing effective prevention strategies.