Bullying, sleep/wake patterns and subjective sleep disorders: Findings from a cross-sectional survey

The meditating role of sleep in the longitudinal associations between peer victimization and internalizing symptoms: A cross-lagged panel analysis

Adolescence is a time of heightened vulnerability for both peer victimization (PV) and internalizing symptoms. While the positive association between them is well established, there is little understanding of the mechanisms underpinning this relationship. To address this gap, the current study aimed to investigate sleep hygiene and school night sleep duration as individual and sequential mediators of the relationship between PV and both depressive and social anxiety symptoms during pre- to mid-adolescence. The study drew upon a community sample of 528 Australian youth aged 10-12 years at baseline (M age = 11.19, SD = .55; 51.1% boys) and data were collected over five annual measurement occasions. Direct and indirect longitudinal and bidirectional associations were examined using cross-lagged panel analysis. There was no evidence of sequential mediation through both sleep hygiene and sleep duration to depression and social anxiety. Instead, the findings show that sleep hygiene mediated the prospective association between PV and both depressive and social anxiety symptoms, and between PV and sleep duration. Overall, sleep hygiene represents a modifiable transdiagnostic factor that can be targeted to break the cycle of PV, inadequate sleep, and internalizing symptoms.

The Indirect Effect of Sleep Quality on Stress-Related Psychosocial Outcomes in Adolescents: An Investigation Across Genders

Sleep is foundational for adolescent psychosocial outcomes though often compromised by normative developmental changes and external factors. This cross-sectional study examined sleep quality as a mechanism linking stress and psychosocial outcomes and explored gender differences. Adolescents (N = 246; Mage=15.8; 46.3% female) completed self-report measures assessing sleep quality and psychosocial outcomes. Structural equation modeling results indicated sleep quality accounted for 78.4% of the total effect of stress on school functioning (b=-0.45, p < 0.001) and 54.2% of the total effect of stress on pain (b = 0.14, p = 0.002). A larger indirect effect of sleep quality on school functioning (b=-0.26, p = 0.016) emerged for boys than girls, and the effect of sleep quality on pain was significant only for girls (b = 0.18, p < 0.001, 69.6% of total effect). Sleep quality explained a large proportion of the effect of stress on school functioning and pain. Sleep quality represents a modifiable transdiagnostic pathway that may buffer the effects of stress in adolescence.

The Relationship between a Competitive School Climate and School Bullying among Secondary Vocational School Students in China: A Moderated Mediation Model

School bullying is widespread in countries around the world and has a continuous negative impact on the physical and mental health of students. However, few studies have explored the influence mechanism of a competitive school climate on school bullying among Chinese secondary vocational school students. This study aims to explore the relationship between a competitive school climate and bullying in secondary vocational schools in the Chinese context, as well as the mediating role of school belonging and the moderating role of gender. Logit regression analysis and a moderated mediation model were used to analyze 1964 secondary vocational students from China based on PISA 2018 data from Beijing, Shanghai, Zhejiang, and Jiangsu, China. (1) The detection rate of school bullying in secondary vocational schools in China is 17.8%, lower than the world average. (2) A competitive school climate is significantly and positively correlated with secondary vocational school students' exposure to school bullying. (3) A moderated mediation model suggests that school belonging is an important mechanism by which a competitive school climate influences the occurrence of school bullying, whereas gender moderates the direct effect of a competitive school climate and the indirect effect of school belonging, which mitigates the negative effects of a competitive school climate to some extent. The research results show that creating a healthy competitive climate in schools, cultivating students' sense of belonging, and facing up to gender differences are helpful to prevent school bullying in secondary vocational schools.

Involvement in bullying and sleep disorders in Chinese early adolescents

Background

School bullying may cause sleep disorders in early adolescents. Here, we determined the relationship between school bullying (considering all the features of bullying involvement) and sleep disorders, which are the common problems in Chinese early adolescents.

Materials and methods

We conducted a questionnaire survey among 5,724 middle school students from Xuancheng, Hefei, and Huaibei cities in Anhui province, China. The self-report questionnaires included the Olweus Bully/Victim Questionnaire and Pittsburgh Sleep Quality Index. We used latent class analysis to identify the potential subgroups of bullying behavior. Logistic regression analysis was used to investigate the association between school bullying and sleep disorders.

Results

Active participants in bullying interactions, including the bullies and victims, reported higher levels of sleep disorders compared with the non-active participants [Bully: physical (aOR = 2.62), verbal (aOR = 1.73), relational (aOR = 1.80), and cyber (aOR = 2.08); Victim: physical (aOR = 2.42), verbal (aOR = 2.59), relational (aOR = 2.61), and cyber (aOR = 2.81)]. A dose-response relationship was observed between the number of school bullying types and sleep disorders. In the context of bullying roles, bully-victims had the highest risk of reporting sleep disorders (aOR = 3.07, 95% CI: 2.55-3.69). We identified four potential categories of school bullying behaviors: low involvement in bullying, verbal and relational victims, medium bully-victims, and high bully-victims, and the highest frequency of sleep disorders was observed in the high bully-victims group (aOR = 4.12, 95% CI: 2.94-5.76).

Conclusion

Our findings indicate a positive correlation between bullying roles and sleep disorders in early adolescents. Therefore, targeted intervention for sleep disorders should include an evaluation of bullying experiences.

School and electronic bullying among adolescents: Direct and indirect relationships with sadness, sleep, and suicide ideation

INTRODUCTION

Bullying is an increasing concern for education, health, and policy. Adolescence is a particularly vulnerable period for the development of depressive symptoms and suicidality following exposure to bullying. However, limited research investigating the potential impact of depressive symptoms on the bullying-suicide relationship exists.

METHODS

Using national data (N = 13,677) from the most recent 2019 Youth Risk Behavior Survey, the aim of the present study was to examine the prevalence among adolescents' (school/electronic) bullying victimization, depressive symptoms (sadness; sleep), and suicide ideation as well as their associations including direct and indirect relationships including exploring differences by gender and race/ethnicity.

RESULTS

Descriptive results indicated an increase in the prevalence of adolescents being bullied (both on school property and electronically), experiencing feelings of sadness, and hopelessness as well as a decrease in getting more than 8 h of sleep between 2017 and 2019. In 2019, over one-third of respondents felt sad or hopeless almost every day for 2 weeks or more in a row, which stopped them from doing some usual activities. Structural equation modeling indicated that (school/electronic) bullying was directly associated with feelings of sadness/hopelessness and suicide ideation, with sadness mediating the link between bullying and suicide ideation.

CONCLUSION

Now more than ever, it is critical to promote the collaboration between educators, mental health specialists, policymakers, and researchers to develop and implement evidence-based strategies and approaches to preventing and reducing both bullying victimization and the associated psychological distress and mental health outcomes.

Associating sleep quality, quality of life and child poly-victimization

BACKGROUND

The role of sleep deprivation in the relationship between child poly-victimization and pediatric quality of life (PedsQL) has received little attention.

OBJECTIVE

This study aims to provide a profile of the association between child victimization and poly-victimization and PedsQL among children, examining the role of sleep quality patterns in these relationships.

PARTICIPANTS AND SETTING

We conducted a cross-sectional school survey study of family structure and child victimization among families in Hong Kong in 2016-17 with two-stage stratified sampling. The final sample consisted of 5, 567 students recruited from a representative sample of 107 kindergartens, primary schools, and secondary schools in all districts of Hong Kong.

METHODS

Multi-phase regression analysis and simple slope analysis were conducted to examine the moderating effects of sleep quality between child victimization and PedsQL.

RESULTS

The findings showed that children who experienced four or more types of victimization were more likely to show parasomnia and daytime dysfunction symptoms than those experiencing one to three types of victimization and non-victims. It also revealed significant relationships between child poly-victimization and lower levels of PedsQL, which were moderated by parasomnia and daytime dysfunction.

CONCLUSIONS

This study has implications for clinicians in targeting the pattern of sleep changes combined with holistic screening in outpatient services for early detection of child poly-victims.

Smartphone addiction and victimization predicts sleep problems and depression among children

BACKGROUND

In this study we examined the phenomena of smartphone addiction, online harassment, and school bullying/victimization to predict the prospective influence these could have on the onset and persistence of sleep problems and depression among children.

METHODS

Responses from 2155 fifth-grade children recruited from 30 primary schools in Taipei were assessed, and a follow-up was performed in the 6th grade. Self-administered questionnaires were collected for each year.

FINDINGS

Children who reported smartphone addictions, online harassment, and school bullying/victimization coupled with an increase in those factors were more likely to experience the onset and persistence of sleep problems. In addition, children who reported smartphone addiction, online harassment, school bullying/victimization, and poor sleep quality were more likely to experience the onset and persistence of depression.

IMPLICATIONS

School nurses or pediatric nurses should be able to assess children's Internet use and risks to understand potential influences on sleep quality and mental status and provide recommendations for children, parents and schools.

Sleep and violence perpetration: A review of biological and environmental substrates

Violence is a worldwide societal burden that negatively impacts individual health, wellbeing and economic development. Evidence suggests a bidirectional relationship between sleep changes and violence. This review details, evaluates and discusses the biological and demographic substrates linking sleep and violence perpetration, and summarizes the overlap of brain areas, functional neuronal systems and genetic features involved, not including violent behaviours during sleep. Knowledge on the biological variables that affect the individual's susceptibility to violent behaviour may have implications for criminology, management of detentions and rehabilitation strategies.

Sibling, Peer, and Cyber Bullying Among Children and Adolescents: Co-occurrence and Implications for Their Adjustment

Bullying across the sibling, peer, and cyber context has consistently been associated with a range of long-term health and well-being consequences for children and adolescents. Although research examining different bullying forms simultaneously in the same study are emerging, it remains unclear to what extend sibling, peer, and cyber bullying co-occur and in what ways they are associated. Moreover, previous work has demonstrated that children and adolescents who experience multiple forms of victimization are at a particular risk of adverse outcomes. However, whether different constellations of co-occurring bullying forms have differential impacts has not yet been investigated sufficiently. The aim of the present study was to examine the frequencies of isolated and co-occurring sibling, peer, and cyber bullying as well as to explore their independent and cumulative relationships with child adjustment. This study was based on a sample of 329 children and adolescents aged between 9 and 15. Bullying experiences across the sibling, peer, and cyber context in the previous 6 months were assessed via self-report. Youth further reported on emotional problems, conduct problems, sleep problems, and academic achievement via an online questionnaire. Sibling, peer, and cyber bullying were uniquely associated with child outcomes. A cumulative relationship between bullying victimization across contexts and emotional problems, conduct problems, and sleep problems could be identified, while bullying perpetration across contexts was only linked to more conduct problems in a cumulative manner. The findings have important practical implications arguing for the adoption of a holistic approach toward bullying in prevention and intervention.

Bullying Involvement in Adolescence: Implications for Sleep, Mental Health, and Academic Outcomes

Adolescents' involvement in bullying is associated with both sleep and mental health problems, but the nature of this association remains unclear; further, its association with academic outcomes has received little attention. Thus, the aims of the current study were to (a) determine whether involvement in bullying as a victim, bully, or bully-victim was associated with greater sleep and mental health problems and (b) explore the potential mediating effect of sleep and mental health problems on the association between bullying and academic outcomes. A large 2012 population-based study in Hordaland County, Norway, surveyed 10,220 adolescents (16-19 years; 54% girls) about bullying involvement using the revised version of the Olweus Bully/Victim Questionnaire, detailed sleep assessment, and mental health questionnaires. Academic outcomes were obtained from official administrative registries. 1.7% of the adolescents (n = 156) reported being victims of bullying, 1.0% (n = 92) reported being a bully, and 0.5% (n = 50) reported being a bully-victim. All categories of bullying involvement had higher rates of mental health problems compared with adolescents not involved in bullying. Victims reported more symptoms of anxiety and depression, whereas bullies reported higher rates of conduct problems. Adolescents in all bullying categories also reported significantly shorter sleep duration and higher prevalence of insomnia as well as lower grade point average (GPA) compared with adolescents not involved; however, school absence was not associated with bullying involvement. Bullying involvement and GPA showed complete mediation for bullies and bully-victims and partial mediation for victims through sleep duration, conduct problems, and symptoms of depression and attention deficit hyperactivity disorder (ADHD). Bullying is strongly associated with mental health and sleep problems, in addition to lower academic performance. Findings support the importance of addressing bullying involvement during this important developmental period.

Bullying Victimization and Friendship as Influences on Sleep Difficulty among Brazilian Adolescents

Bullying victimization is associated with poor health-related outcomes, including sleeping problems. The present study aimed to investigate the impact of bullying victimization on sleep difficulty, and the moderating effect of the number of close friends on this association, also exploring differences across genders. The study was based on a nationally-representative survey on adolescent health conducted in Brazilian schools, involving a total of 109,104 participants, enrolled at the 9th year in 2012. The measures used in the analysis included socio-demographic characteristics, bullying victimization, sleep difficulty, and number of close friends. In the multilevel models, reporting more peer victimization was associated with more sleep difficulties (b = .18, t = 50.17, p < .05), with girls reporting more sleep difficulties in association with peer victimization than boys. Reporting having more friends was inversely linked to sleep difficulties (b = -.08, t = -15.26, p < .05), and the association between peer victimization and sleep difficulties was significantly buffered by the number of friends. Moreover, in a three way interaction, there was a marginally significant difference in the effect of friends on the link between victimization and sleep difficulties between boys and girls (b = .02, t = 1.86, p = .06), with the buffering effect of friendships being negligible among girls as opposed to boys. The results indicate a significant association between bullying victimization and sleep difficulties, which seems to be more pronounced among girls, also suggesting that the number of close friends may buffer this association, mainly for boys.

Bullying, health complaints, and self-rated health among school-aged children and adolescents

Objective

The aim of the current study was to examine whether health complaints and self-reported health were associated with bullying victimization in a large cohort of Icelandic children and adolescents.

Methods

In this study, we used data from a school-based cross-sectional survey, specifically, the Icelandic contribution to the international research network Health Behavior in School-aged Children (HBSC). The study population included all students throughout Iceland in grades 6, 8, and 10 (mean age 13 years, standard deviation 1.61). The participation rate was 84% (N = 11,018). Participating students completed an anonymous standardized questionnaire in their classrooms.

Results

Bullying victimization was associated with feeling depressed (odds ratio 2.61), having difficulty falling asleep, dizziness, and low self-reported health. No differences were found between sex and age groups.

Conclusions

Children and adolescents who are bullied appear to more often experience depression, difficulties falling asleep, dizziness, and poor health; however, health complaints were also relatively high among non-bullied children and adolescents. Bullying prevention measures must be implemented in children’s and adolescents’ social environments. In addition to assessing bullying interventions, further research should focus on methods of enhancing resilience in this population.

Evidence Base Update on Assessing Sleep in Youth

BACKGROUND

Sleep is vital to youth well-being and when it becomes disturbed - whether due to environmental or individual factors - mental and physical health suffer. Sleep problems can also be a symptom of underlying mental health disorders. Assessing different components of sleep, including quality and hygiene, can be useful both for identifying mental health problems and for measuring changes in well-being over time. However, there are dozens of sleep-related measures for youth and it can be difficult to determine which to select for a specific research or clinical purpose. The goal of this review was to identify sleep-related measures for clinical and/or research use in youth mental health settings, and to update the evidence base on this topic.

METHOD

We generated a list of candidate measures based on other reviews and searched in PubMed and PsycINFO using the terms "sleep" AND (measure OR assessment OR questionnaire) AND (psychometric OR reliability OR validity). Search results were limited to studies about children and adolescents (aged 2-17) published in English. Additional criteria for inclusion were that there had to be at least three publications reporting on the measure psychometrics in community or mental health populations. Sleep measures meeting these criteria were evaluated using the criteria set by De Los Reyes and Langer (2018).

RESULTS

Twenty-six measures, across four domains of sleep - insomnia, sleep hygiene, sleepiness, sleep quality - met inclusion criteria. Each measure had at least adequate clinical utility. No measure(s) emerged as superior across psychometric domains.

CONCLUSION

Clinicians and researchers must evaluate sleep measures for each use case, as the intended purpose will dictate which measure is best. Future research is necessary to evaluate measure performance in transdiagnostic mental health populations, including youth with serious mental illness.

Community violence exposure and cortisol awakening responses in adolescents who are overweight/obese

BACKGROUND

Community violence exposure has been identified as a salient environmental stressor associated with dysregulated cortisol awakening response (CAR), which may act to exacerbate hypothalamic-pituitary-adrenal (HPA) axis dysregulation observed in adolescents who are overweight/obese.

PURPOSE

To perform an exploratory cross-sectional analysis examining the association between community violence exposure and CAR in adolescents who are overweight/obese.

METHODS

One-hundred adolescents (ages: 13-19 years; 65% female; average BMI percentile: 93.80 ± 4.13) were included in this analysis. Community violence exposure was measured using the Survey of Children's Exposure to Community Violence. Salivary cortisol collected across three days at awakening and 30 min post-awakening was used to calculate CAR area under the curve (AUC).

RESULTS

Community violence exposure was associated with a lower CAR AUC when controlling for baseline cortisol, sex, BMI, pubertal development, race and perceived stress (β = -0.04 ± 0.02; p = 0.04).

CONCLUSION

Findings from this study identified cross-sectional association between community violence and HPA dysregulation in adolescents who were overweight/obese. If long-term exposure to community violence does indeed accelerate HPA dysregulation in adolescents at increased weight status, policymakers and interventionists should consider implementing programs that limit adolescent violence exposure.

Associations between the Canadian 24 h movement guidelines and different types of bullying involvement among adolescents

BACKGROUND

The Canadian 24-Hour Movement Guidelines for Children and Youth recommend ≥60 min of physical activity per day, ≤2 h of recreational screen time per day, and 9-11 hours of sleep per night for 11-13 years old and 8-10 hours per night for 14-17 years old.

OBJECTIVE

This study examined the association between combinations of these recommendations and school bullying and cyberbullying victimization and perpetration among adolescents.

PARTICIPANTS AND SETTING

A total of 5615 Canadian students (mean age = 15.2 years) who participated in the 2017 Ontario Student Drug Use and Health Survey (OSDUHS) self-reported their physical activity, screen time, sleep duration, and their involvement in bullying.

METHODS

Logistic regression analyses were adjusted for important covariates.

RESULTS

Meeting the screen time recommendation alone was associated with lower odds of being a victim (OR: 0.64; 95 % CI: 0.46-0.88) or a bully (OR: 0.64; 95 % CI: 0.43-0.96) at school and a victim of cyberbullying (OR: 0.67; 95 % CI: 0.49-0.91). Meeting both the screen time and sleep duration recommendations was associated with lower odds of being a bully (OR: 0.51; 95 % CI: 0.30-0.88). Meeting all 3 recommendations showed stronger associations (i.e. lowest risk) with being a victim of school bullying (OR: 0.32; 95 % CI: 0.19-0.54), a bully-victim (OR: 0.25; 95 % CI: 0.08-0.78) or a victim of cyberbullying (OR: 0.37; 95 % CI: 0.17-0.84).

CONCLUSIONS

Our findings provide evidence that meeting the 24 -h movement guidelines is associated with lower odds of bullying involvement. Encouraging adherence to the 24 -h movement guidelines could be a good behavioural target to prevent involvement in both school bullying and cyberbullying.

Sleep Quality as a Mediator of the Relationship Between Cyber Victimization and Depression

PURPOSE

Cyber victimization is a national mental health concern, especially among adolescents who are digital natives. The current study examined sleep quality as a mediator of the association between cyber victimization and depressive symptoms among adolescents.

DESIGN AND METHOD

A prospective study design was utilized with a community sample of adolescents (N = 801; 57% female; mean age = 14.45, SD = .85) from the eastern United States. Participants completed (a) the Pittsburgh Sleep Quality Index; (b) the Cyber Victimization Scale; and (c) the Center for Epidemiologic Studies Depression Scale Revised via online surveys at baseline and 6-month follow-up. The inter-relationship between variables was analyzed by Hayes' mediation approach.

FINDINGS

Cyber victimization was not directly associated with having depressive symptoms 6 months later when controlling for adolescents' poor sleep quality, sex, and age (direct effect [c'] = .012, t(676) = 1.12, p < .05, confidence interval [CI] -.008, .036). The mediation analysis indicated a significant indirect effect of poor sleep quality on the relationship between cyber victimization and depressive symptoms (ab = .005, bootstrapped standard error [SE] = .003, bootstrapped CI .001, .011; a is the effect of cyber victimization on poor sleep quality; b is the effect of poor sleep quality on depressive symptoms). Specifically, adolescents' cyber victimization led to poor sleep quality (a = .039, SE = .041, p < .05), which also led to increased depressive symptoms (b = .116, SE = .019, p < .001), after controlling for depressive symptoms at baseline, sex, and age. The indirect effect of cyber victimization on depressive symptoms was estimated through poor sleep quality (a*b = .039(.116) = .0045).

CONCLUSIONS

The findings suggest that poor sleep quality may be a mechanism through which cyber bullying is related prospectively to depressive symptoms. Interventions for cyber-victimized adolescents should include assessment of sleep quality and incorporate sleep hygiene education.

CLINICAL RELEVANCE

Adolescents should be screened for cyber victimization and sleep quality. Moreover, promotion of sleep hygiene among cyber-victimized adolescents may help to reduce depression.

Effects of Peer Victimization and Perceived Social Support on Daily Negative Affect and Sleep Outcomes

OBJECTIVES

The purpose of this study was to examine the effects of peer victimization-measured at the daily and cumulative levels-on daily negative affect and multiple sleep parameters including subjective sleep quality, sleep duration, and sleep continuity (i.e., night awakening) among children affected by parental HIV from rural China. This study also aimed to test the moderation effects of perceived social support and sex in these associations.

METHODS

A total of 637 children (50.4% boys, 8-15 years of age) affected by parental HIV self-reported measures on cumulative peer victimization (i.e., the experience of victimization during the past 6 months) and perceived social support. They were also asked to report daily peer victimization, daily negative affect, and sleep outcomes over three consecutive days.

RESULTS

Multilevel models showed that cumulative peer victimization was associated with both daily negative affect and night awakenings, whereas these associations became statistically nonsignificant after controlling for trait negative affect. Daily peer victimization was significantly related to daily negative affect. All these associations were consistent for boys and girls. There were no buffering effects of perceived social support on these associations.

CONCLUSIONS

The results suggest that peer victimization may contribute to daily negative emotional experiences among children affected by parental HIV. Interventions targeting psychological wellbeing among children affected by parental HIV may need to incorporate peer victimization component.

Later School Start Time: The Impact of Sleep on Academic Performance and Health in the Adolescent Population

The crucial role of sleep in physical and mental health is well known, especially during the developmental period. In recent years, there has been a growing interest in examining the relationship between sleep patterns and school performance in adolescents. At this stage of life, several environmental and biological factors may affect both circadian and homeostatic regulation of sleep. A large part of this population does not experience adequate sleep, leading to chronic sleep restriction and/or disrupted sleep–wake cycles. Studies investigating the effects of different sleep–wake schedules on academic achievement showed that impaired sleep quality and quantity are associated with decreased learning ability and compromised daytime functioning. This review focuses on the most recent studies that evaluated the effects of modified school start time on sleep patterns and related outcomes. Moreover, based on the available empirical evidence, we intend to propose a direction for future studies targeted to implement prevention or treatment programs by modifying sleep timing.

Bullying involvement, psychological distress, and short sleep duration among adolescents

PURPOSE

Previous research has found links between involvement in bullying and sleep duration in adolescents. However, little is known about the factors that might mediate these relationships. This study examined the associations between cyberbullying victimization and school bullying involvement (bully, victim, bully-victim) with short sleep duration in a large sample of middle and high school students and tested whether psychological distress mediates these relationships.

METHODS

Data on 5061 students (49% females; mean age = 15.1 years) from the 2015 Ontario Student Drug Use and Health Survey were used. Participants self-reported their sleep duration and their levels of bullying involvement over the past year. Psychological distress was assessed using the Kessler 6 (K6) scale. Covariates in multiple linear regression analyses included age, sex, racial background, socioeconomic status, and substance use.

RESULTS

Being a victim of cyberbullying (β = - 1.179; 95% CI - 0.238; - 0.120) or school bullying (β = - 0.119; 95% CI - 0.190; - 0.049) was associated with short sleep duration. Mediation analyses suggested that psychological distress fully mediates the relationships between being cyberbullied, a school bullying victim or bully-victim with short sleep duration. There was a complementary mediation by psychological distress on the relationship between being a bully at school and short sleep duration.

CONCLUSIONS

These results suggest that higher levels of bullying involvement place adolescents at risk of developing higher psychological distress which, in turn, can lead to short sleep duration. Longitudinal research is necessary to confirm the mediating role of psychological distress on the relationship between bullying involvement and short sleep duration among adolescents.

Longitudinal effects of insufficient sleep on psychological problems among adolescent bullies based on Korean Child and Youth Panel Survey

This study was performed to investigate longitudinal effects of insufficient sleep on psychological problems among bullies and neutral students using the Korean Child and Youth Panel Survey (KCYPS) collected from 8th to 10th graders. At the first wave, 6.4% of students reported that they had bullied other students two or more times. Bullies having insufficient sleep duration at the first wave exhibited significantly higher aggression levels than bullies with sufficient sleep over time. Among neutral students, sleep insufficiency showed no longitudinal relationship with aggression. Our findings confirm that insufficient sleep was an associated factor for chronically elevated aggression among bullies.

VITIMIZAÇÃO POR BULLYING EM ESTUDANTES BRASILEIROS: RESULTADOS DA PESQUISA NACIONAL DE SAÚDE DO ESCOLAR (PENSE)

RESUMO Objetivo: identificar a prevalência de vitimização por bullying em estudantes brasileiros e analisar sua associação com variáveis individuais e de contexto. Método: estudo transversal, de base populacional, com dados provenientes da Pesquisa Nacional de Saúde do Escolar. Participaram 109.104 estudantes do 9º ano do Ensino Fundamental de escolas públicas e privadas. A coleta de dados ocorreu por meio de um questionário autoaplicável. Foi testado o modelo de associação entre o bullying e variáveis sociodemográficas (idade, raça/cor da pele autodeclarada e escolaridade da mãe), de saúde mental (sentimento de solidão, insônia e falta de amigos), de contexto familiar (apanhar em casa), absenteísmo escolar (falta às aulas) e comportamento de risco para a saúde (experimentação de drogas). Foram realizadas análises uni e multivariadas. Resultados: a prevalência de vitimização foi de 7,2%. Os meninos e as meninas de 14 e 15 anos sofreram menos bullying, e as meninas menores de 13 anos sofreram mais (OR: 1,48, IC95%: 1,02-2,15). Foram mais vítimas meninos indígenas (OR: 1,37, IC95%: 1,15-1,65), meninas pretas (OR: 1,24, IC95%: 1,09-1,40) e meninas amarelas (OR: 1,43, IC95%: 1,21-1,70). Sentir-se solitário, não ter amigos, ter insônia, faltar às aulas, sofrer violência física na família e possuir mãe com baixa escolaridade foram variáveis associadas à vitimização para meninos e meninas e usar drogas, somente para as meninas (OR: 1,19, IC95%: 1,03-1,37). Conclusão: os resultados indicam que a vitimização por bullying interfere na escolaridade e na saúde dos estudantes. Dados que podem subsidiar iniciativas de enfrentamento do bullying e de promoção de saúde nas escolas.

Teenage night owls or early birds? Chronotype and the mental health of adolescents

Evidence suggests that the timing of sleep (chronotype) impacts mental health in young people, but previous studies have not accounted for sleep duration or school start time in this association, or examined a broad range of mental outcomes. In this study, we investigated the association between chronotype and mental health in a representative sample of adolescents from the 2014 Canadian Health Behaviour in School-Aged Children survey (29,635 students, 362 schools). We examined positive and negative aspects of mental health, using scores for emotional problems (range 0-33), emotional well-being (0-22), behavioural problems (0-28) and prosocial behaviours (0-25). We estimated chronotype using the time of mid-sleep on weekends and examined the associations using multilevel regressions, adjusted for sleep duration, school start time, individual, family and geographic characteristics. The average time of mid-sleep (chronotype) was 04:11 hr. An hour delay in mid-sleep time was associated with more emotional problems (0.34 [95% confidence interval 0.23, 0.45] point higher score), more behavioural problems (2.0% [95% confidence interval 1.4%, 2.6%] higher score), less emotional well-being (0.19 [95% confidence interval 0.09, 0.20] point lower score), and fewer prosocial behaviours (0.18 [95% confidence interval 0.08, 0.29] point lower score). A later chronotype was associated with poorer mental health, independent of sleep duration and school start time, and across internalizing and externalizing mental health domains. Further research is needed to clarify the mechanisms underlying this association. The timing of sleep, and not just its duration, may be an additional consideration for youth mental health.

Sleep, Circadian Rhythms, and Risk Across Health Domains in Adolescents With an Evening Circadian Preference

Sleep and circadian rhythm changes during adolescence contribute to increased risk across emotional, behavioral, cognitive, social, and physical health domains. This study examines if sleep and dim light melatonin onset (DLMO) are related to greater risk in these 5 health domains. Participants were 163 (93 female, age = 14.7 years) adolescents with an evening circadian preference from a study funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Sleep and circadian measures included weekday total sleep time (TST), bedtime, and shut-eye time assessed via sleep diary, the Children's Morningness-Eveningness Preferences scale, and DLMO. Health domains included self-reported emotional, cognitive, behavioral, social, and physical health. Later DLMO was significantly associated with shorter weekday TST, later weekday bedtime, and later weekday shut-eye time, as well as lower risk in the behavioral domain. At the trend level, later DLMO was related to fewer physical health problems. Earlier DLMO combined with a later bedtime, later shut-eye time, or shorter TST predicted greater risk in the cognitive domain. Later DLMO and shorter TST or a later bedtime predicted worse physical health. DLMO timing was not related to the emotional or social domain. There is evidence that a discrepancy between sleep behaviors and the endogenous circadian rhythm may be related to risk in the cognitive domain for adolescents with an evening circadian preference. Preliminary evidence also indicated that a delayed DLMO and shorter TST or a later bedtime may be related to vulnerability to physical health risk.

Modifiable predictors of insufficient sleep durations: A longitudinal analysis of youth in the COMPASS study

The purpose of the current study was to simultaneously examine commonly proposed risk and protective factors for sleep deprivation over time among a large cohort of Ontario and Alberta secondary school students. Using 4-year linked longitudinal data from youth in years 1 through 4 (Y₁[2012/2013], Y₂[2013/2014], Y₃[2014/2015], Y₄[2015/2016]) of the COMPASS study (n=26,205), the likelihood of students meeting contemporary sleep recommendations was tested based on their self-reported substance use, bullying victimization, physical activity, and homework and screen time. Models controlled for the effect of student-reported gender, race/ethnicity, grade, school clustering, and all other predictor variables. Relative to baseline, students became less likely to meet the sleep recommendations if at follow-up they had initiated binge drinking, experienced cyber bullying victimization, or were spending more time doing homework, with other factors held constant. The likelihood of reporting sufficient sleep increased if students had begun engaging in resistance training at least three times a week. No longitudinal effect was observed when students increased their caffeine consumption (energy drinks, coffee/tea), initiated cannabis or tobacco use, experienced other forms of bullying victimization (physical, verbal, or belongings), engaged in more moderate-vigorous physical activity, or increased their screen use of any type. Few of the commonly purported modifiable risk and protective factors for youth sleep deprivation held in multinomial longitudinal analyses. Causal conclusions appear premature, with further research required to confirm the targets likely to be most effective in assisting more youth in meeting the sleep recommendations.

Is sexual minority status associated with poor sleep quality among adolescents? Analysis of a national cross-sectional survey in Chinese adolescents

OBJECTIVES

Recent studies have suggested that sexual minorities are more likely to have poor sleep quality. This study aims to explore sleep quality among sexual minority adolescents and examines the association between sexual minority status and sleep quality.

DESIGN

Cross-sectional survey.

SETTING

A total of 506 high schools in seven Chinese provinces.

PARTICIPANTS

A total of 150 822 students in grades 7-12 completed the questionnaires, and 123 459 students who reported being aware of their sexual orientation were included in analyses.

MAIN OUTCOME MEASURES

The Pittsburgh Sleep Quality Index, sexual attraction and school bullying victimisation.

RESULTS

Of the 123 459 students who were analysed, 5.00% self-reported as sexual minorities. Only 26.67% of sexual minority students slept 8 or more hours/day, which is less than their heterosexual peers (35.70%; χ²=130.04, P<0.001). Of the total sample, 22.41% of the students reported poor sleep quality, and this prevalence was significantly higher in sexual minority students than in heterosexual students (32.56% vs 21.87%; χ²=281.70, P<0.001). After controlling for social demographics, lifestyle and depressive symptoms, sexual minority students had higher odds of poor sleep quality (adjusted OR=1.41, 95% CI 1.31 to 1.51) than their heterosexual peers. The indirect effect of school bullying victimisation (standardised β estimate=0.007, 95% CI 0.006 to 0.009) was significant, indicating that school bullying victimisation partially mediated the association between sexual minority status and sleep quality.

CONCLUSIONS

Our study suggested that poor sleep quality was common in sexual minority adolescents, and more attention should be paid to sleep problems in this population. Conducting interventions to reduce school bullying behaviours is an important step to improving sleep quality in sexual minority adolescents. Further, studies are warranted that focus on the risk factors and mechanisms of and interventions for sleep problems in sexual minority adolescents.

Diet quality and bullying among a cross-national sample of youth

Bullying perpetration and victimization have been linked to a number of high-risk health behaviors, including involvement in sedentary activities and sleep deprivation. Even so, the link between diet quality and bullying is generally overlooked. The present study examines the associations between diet quality, bully perpetration, and bully victimization in a cross-national sample of adolescents. Data come from the Health Behaviors of School Children (HBSC) survey, 2005/2006 (N=142,828-143,425). Youths from 41 countries/regions in North America and Europe reported features of their social context, various health behaviors, and their involvement in bullying. Approximately 11% of youth in the sample bully other youths at least 2-3 times a month, whereas 13% of youth are bullied by other youths at least 2-3 times a month. Logistic regression analyses revealed that youths with low quality diets incurred a 123% increase in the odds of attaining bully status, relative to youths with high quality diets. No such association was detected between diet quality and victim status. Results also suggest that the association between low diet quality and bully perpetration is significantly more pronounced in very developed nations (relative to developed nations). Dietary behaviors may be an important point of intervention in the effort to minimize the prevalence of bullying among youths, particularly in very developed nations. Scholars should seek to build upon the current study by exploring the mechanisms (e.g., low self-control) that might explain the association between diet quality and bullying.

Digital Media and Sleep in Childhood and Adolescence

Given the pervasive use of screen-based media and the high prevalence of insufficient sleep among American youth and teenagers, this brief report summarizes the literature on electronic media and sleep and provides research recommendations. Recent systematic reviews of the literature reveal that the vast majority of studies find an adverse association between screen-based media consumption and sleep health, primarily via delayed bedtimes and reduced total sleep duration. The underlying mechanisms of these associations likely include the following: (1) time displacement (ie, time spent on screens replaces time spent sleeping and other activities); (2) psychological stimulation based on media content; and (3) the effects of light emitted from devices on circadian timing, sleep physiology, and alertness. Much of our current understanding of these processes, however, is limited by cross-sectional, observational, and self-reported data. Further experimental and observational research is needed to elucidate how the digital revolution is altering sleep and circadian rhythms across development (infancy to adulthood) as pathways to poor health, learning, and safety outcomes (eg, obesity, depression, risk-taking).

Self-reported sleep pattern, quality, and problems among schooling adolescents in southwestern Nigeria

OBJECTIVE

Understanding sleep patterns and related factors is vital to development in adolescence, but there is a dearth of this information among adolescents in developing countries such as Nigeria. Therefore, this study describes the sleep patterns, problems, and predictors of poor sleep quality among schooling adolescents.

METHODS

In a cross-sectional study design, 450 adolescents were selected and interviewed about their sleep experience and problems over the preceding one-month period using a validated form with components adapted from the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Data were analyzed using descriptive statistics, χ², and logistic regression model with p set at 0.05.

RESULTS

The mean age of respondents was 13.4 ± 1.2 years. Only half (50.2%) had a global PSQI score of <6, suggesting little or no difficulty with sleep. Significantly, a higher proportion of respondents spent a short time in bed before sleep, ≤15 min among those who had good sleep quality (81.4%) compared with those who had poor sleep quality (65.2%) (p < 0.001). The odds of having poor sleep quality was significantly higher in the subgroup who had ≤8.5 h sleep than those who had 8.5 h sleep or more (adjusted odds ratio = 4.62; 95% confidence interval = 2.61, 8.17, p < 0.001).

CONCLUSION

Remarkably poor sleep quality exists among schooling adolescents in Ibadan, Nigeria, and sleep problems are prevalent, especially among those with short sleep duration.

Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth

The objective of this systematic review was to examine the relationships between objectively and subjectively measured sleep duration and various health indicators in children and youth aged 5-17 years. Online databases were searched in January 2015 with no date or study design limits. Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth aged 5-17 years), intervention/exposure/comparator (various sleep durations), and outcome (adiposity, emotional regulation, cognition/academic achievement, quality of life/well-being, harms/injuries, and cardiometabolic biomarkers) criteria. Because of high levels of heterogeneity across studies, narrative syntheses were employed. A total of 141 articles (110 unique samples), including 592 215 unique participants from 40 different countries, met inclusion criteria. Overall, longer sleep duration was associated with lower adiposity indicators, better emotional regulation, better academic achievement, and better quality of life/well-being. The evidence was mixed and/or limited for the association between sleep duration and cognition, harms/injuries, and cardiometabolic biomarkers. The quality of evidence ranged from very low to high across study designs and health indicators. In conclusion, we confirmed previous investigations showing that shorter sleep duration is associated with adverse physical and mental health outcomes. However, the available evidence relies heavily on cross-sectional studies using self-reported sleep. To better inform contemporary sleep recommendations, there is a need for sleep restriction/extension interventions that examine the changes in different outcome measures against various amounts of objectively measured sleep to have a better sense of dose-response relationships.

School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature

BACKGROUND

Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students' academic performance, reduce engagement in risk behaviors, and improve health.

METHODS

This article reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students.

RESULTS

Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes.

CONCLUSIONS

Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies.

Bullying as a risk for poor sleep quality among high school students in China

Objective

To determine whether involvement in bullying as a bully, victim, or bully-victim was associated with a higher risk of poor sleep quality among high school students in China.

Methods

A cross-sectional study was conducted. A total of 23,877 high school students were surveyed in six cities in Guangdong Province. All students were asked to complete the adolescent health status questionnaire, which included the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and bullying involvement. Descriptive statistics were used to evaluate sleep quality and the prevalence of school bullying. Multi-level logistic regression analyses were conducted to examine the association between being victimized and bullying others with sleep quality.

Results

Among the 23,877 students, 6,127 (25.66%) reported having poor sleep quality, and 10.89% reported being involved in bullying behaviors. Of the respondents, 1,410 (5.91%) were pure victims of bullying, 401 (1.68%) were bullies and 784 (3.28%) were bully-victims. Frequently being involved in bullying behaviors (being bullied or bullying others) was related to increased risks of poor sleep quality compared with adolescents who were not involved in bullying behaviors. After adjusting for age, sex, and other confounding factors, the students who were being bullied (OR=2.05, 95%CI=1.81-2.32), bullied others (OR=2.30, 95%CI=1.85-2.86) or both (OR=2.58, 95%CI=2.20-3.03) were at a higher risk for poor sleep quality.

Conclusions

Poor sleep quality among high school students is highly prevalent, and school bullying is prevalent among adolescents in China. The present results suggested that being involved in school bullying might be a risk factor for poor sleep quality among adolescents.

Advancing a biopsychosocial and contextual model of sleep in adolescence: a review and introduction to the special issue

Sleep problems in adolescence have been identified as an international public health issue. Over the past few decades, notable advances have been made in our understanding of the patterns and consequences of sleep in adolescence. Despite these important gains, there is much about the role of sleep in adolescence that remains to be understood. This Special Issue brings together studies that examine sleep as it specifically pertains to adolescent development and adjustment. In this introductory article, we argue for the importance of grounding the study of sleep and adolescence in developmental science and a developmental psychopathology framework. First, a review of the literature is used to outline a biopsychosocial and contextual model of sleep in adolescence. Second, attention-deficit/hyperactivity disorder (ADHD) is used as an exemplar of the proposed model given the pervasiveness of sleep problems among youth with ADHD and the likelihood that sleep problems and ADHD symptoms are interconnected in complex ways. Finally, a brief introduction to the empirical articles included in the Special Issue is provided, with particular attention given to how these articles fit within the proposed biopsychosocial and contextual model. Along with the framework proposed in this article, the studies included in this Special Issue advance the current literature and point to critical directions for future research.