The association between chronic bullying victimization with weight status and body self-image: a cross-national study in 39 countries

A Longitudinal Study on Body Image Perception and Size among Italian Early Adolescents: Changes over Time and Discrepancies between Genders

BACKGROUND/OBJECTIVES

The discrepancy between the current perceived body image (BI) and beauty ideals leads to dissatisfaction, which is believed to be common among adolescents. This study aimed to investigate the stability in BI perceptions and dissatisfaction during early adolescence. Another aim was to highlight differences in dissatisfaction according to Body Mass Index (BMI) and inconsistencies in weight status perception.

METHODS

Two hundred and nine participants (mean age at first survey: 11.33 ± 0.38 years) were enrolled in this longitudinal study with three years of follow-up. Data on size and BI perceptions were collected through individual interviews. Stature and weight were directly measured.

RESULTS

Findings indicated significant changes over three years in anthropometric traits but not in weight status prevalence or BI perception and dissatisfaction, except for the ideal figure in males and weight control in females. The results also indicated a significant difference in BI perception and dissatisfaction by BMI categories. Self-reported body measurements were found to be unreliable with a weak-to-moderate agreement between self-perceived and actual weight status.

CONCLUSIONS

BI perception appears quite stable across the three years considered. Dissatisfaction is similar in both genders, although a tendency toward different gender aesthetic ideals is already appreciable in early adolescence. We suggest that the lower frequency of normal-weight adolescents compared with peers in previous studies is attributable to the effects of the recent pandemic. Given the growing dissatisfaction with increasing BMI and misinterpretations of weight status, school actions to promote a healthy lifestyle and positive BI should be undertaken.

Exploring the interplay of weight-based teasing and sociodemographic factors in adolescent weight bias internalization

OBJECTIVE

Research has highlighted the potential adverse effects of weight bias internalization (WBI) on adolescents, but there has been little examination of WBI and sources of weight teasing (family, peers, or both) or across racial/ethnic diversity of adolescents. We aimed to examine the relationship between WBI and sources of weight teasing across sociodemographic characteristics and weight status in a diverse community sample of adolescents.

METHODS

Data were collected from a U.S. sample of 1859 adolescents aged 10-17 years (59% female; 43% White, 27% Black or African American, and 25% Latino). An online questionnaire was used to assess participants' experiences of weight teasing from family members, peers, or both, and their weight status, weight-related goals, WBI, and sociodemographic characteristics.

RESULTS

Adolescents experiencing weight teasing from both family and peers reported the highest levels of WBI, while those reporting no teasing exhibited the lowest levels. These patterns were observed across sex, race/ethnicity, weight status, and weight goals, and persisted after controlling for depressive symptoms. Notably, family influences played a salient role, with adolescents reporting higher WBI if teased by family only compared to teasing from peers only. Sex and racial differences were also observed in adolescents' experiences with weight-based teasing.

CONCLUSION

Our study reveals associations between adolescent weight-based teasing, WBI, and sociodemographic factors. Weight-based teasing, whether from family and peers or from family only, was associated with increased WBI. Interventions targeting weight stigma in youth should not be limited to peer-focused efforts, but should also emphasize supportive family communication.

Body Weight Perceptions Among Youth From 6 Countries and Associations With Social Media Use: Findings From the International Food Policy Study

BACKGROUND

Body dissatisfaction is associated with poor psychological and physical health, particularly among young people. However, limited data exist on body size perceptions across countries and factors associated with dissatisfaction.

OBJECTIVE

This study examined dissatisfaction prevalence and associations with sociodemographics and social media use among youth in 6 countries.

DESIGN

Repeat cross-sectional national online surveys were conducted as part of the 2019 and 2020 International Food Policy Study Youth Survey.

PARTICIPANTS

The sample included 21 277 youth aged 10 to 17 years from Australia, Canada, Chile, Mexico, the United Kingdom, and the United States. Youth were recruited to complete the online survey through parents/guardians enrolled in the Nielsen Consumer Insights Global Panel and their partners' panels.

MAIN OUTCOME MEASURES

Figural drawing scales assessed self-perceived and ideal body images, with differences between scales representing body dissatisfaction.

STATISTICAL ANALYSES PERFORMED

Multinomial logistic regression models examined differences in body dissatisfaction by country, and associations with sociodemographics and either social media screen time or platforms used, including 2-way interactions with country.

RESULTS

Overall, approximately 45% of youth reported the same perceived and ideal body sizes, whereas 35% were "larger than ideal" (from 33% in Canada and Australia to 42% in Chile) and 20% were "thinner than ideal" (from 15% in Chile to 22% in Mexico). Greater social media screen time was associated with a higher likelihood of moderate-severe dissatisfaction for being "thinner than ideal" and at least mild dissatisfaction for being "larger than ideal" (P < .003 for all contrasts), with greater dissatisfaction among users of YouTube and Snapchat than nonusers (P ≤ .005 for both contrasts). Modest differences in body dissatisfaction between countries were observed for age, ethnicity, body mass index, and weight-based teasing.

CONCLUSIONS

Body dissatisfaction is prevalent among youth across diverse countries. These findings highlight the need to promote healthy body image in youth, particularly among social media users.

The long-term spatio-temporal trends in burden and attributable risk factors of major depressive disorder at global, regional and national levels during 1990-2019: a systematic analysis for GBD 2019

AIMS

Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990-2019.

METHODS

We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age-period-cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors.

RESULTS

During 1990-2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990-2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60-64 in women, and at the age of 75-84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5-9. Population living during 2000-2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively.

CONCLUSIONS

Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000-2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.

Relationship between Physical Fitness and Cyberbullying Patterns (Cybervictimization and Cyberperpetration) in Spanish Adolescents

(1) Background: Cyberbullying is a growing problem among adolescents, and deeper knowledge of this phenomenon could facilitate the implementation of adequate prevention and intervention strategies. Therefore, the aim of this study was to analyze the relationships between victimization and aggression patterns in cyberbullying and physical fitness levels in Spanish adolescents. (2) Methods: A total of 741 adolescents aged 12 to 19 years from two high schools in Andalusia, Spain (mean = 14.52 ± 1.96 years; 50.9% girls, 49.1% boys) participated in the study. The participants underwent the EUROFIT battery test and completed the Spanish version of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) scale. T-test, bivariate correlations and a linear regression analysis were used for statistical analysis. (3) Results: The study results indicated positive relationships between cyberbullying patterns, especially cybervictimization, and age, as well as several physical fitness measures, including BMI, sit-ups, sit-and-reach, and handgrip tests. On the other hand, cyberperpetration was positively related only to age and the specific grip strength test. Further statistical analysis revealed that cybervictimization was primarily influenced by age, while cyberperpetration was mainly influenced by age and performance in a functional test (sit-and-reach). (4) Conclusions: Cyberbullying roles, both as victims and aggressors, may not be strongly influenced by isolated physical fitness factors. Thus, in order to reach a more comprehensive understanding and better explanations of individual involvement in cyberbullying behavior, future studies should analyze psychological and social factors along with the variables considered in this study.

Food for thought or food for emotions? An analysis of marketing strategies in television food advertising seen by children in Colombia

OBJECTIVE

To establish the relationship between the marketing strategies and nutritional quality of foods and beverages promoted in television food advertisements (TV ads) seen by Colombian child audiences overall and based on child gender and socio-economic strata (SES).

DESIGN

A quantitative content analysis of marketing appeals was combined with nutritional data of the food products advertised and matched with TV audience ratings data for each food and beverage ads for Colombian children between 4 and 11 years.

SETTING

All beverages and foods TV ads cable or over-the-air channels in Colombia in 2017.

PARTICIPANTS

N/A.

RESULTS

Compared with rational appeals (e.g. freshness, health or nutrition messages), emotional appeals (referencing or depicting human senses or emotions, e.g. using cartoons to suggest fun) were more frequently used in the TV ads most viewed by Colombian children. Female children and children in lower SES tended to be more exposed to emotional appeals in TV ads than their male or higher SES counterparts. Furthermore, TV ads using more emotional appeals tended to be for products high in problematic nutrients.

CONCLUSION

The findings of this study highlight the need to implement statutory measures to reduce the deleterious effect of food marketing on children.

Association between childhood trauma and affective lability among adolescents: A moderated mediation model

BACKGROUND

Affective lability is an important feature of psychopathology. However, there is limited relevant research involving adolescents. To fill this research gap, the present study assessed the relationship between childhood trauma and affective lability among adolescents using a moderated mediation model.

METHODS

A total of 3738 students were recruited from four high schools in Shenzhen, China, between September and December 2019. The participants completed self-reported questionnaires measuring childhood trauma, affective lability, body image dissatisfaction, and the experience of being bullied. Linear regression and moderated mediation analyses were used in this study.

RESULTS

Linear regression analysis showed that emotional abuse and body image dissatisfaction positively predicted affective lability in boys and girls (all p < 0.001). Body image dissatisfaction mediated the relationship between emotional abuse and affective lability. In the moderated mediation model, being bullied moderated the direct path from emotional abuse to affective lability (p = 0.0236, p = 0.0188), and gender did not have a significant moderating effect on any direct or indirect path (all p > 0.05).

LIMITATIONS

A causal relationship could not be ascertained due to the cross-sectional design, and the results cannot be generalized to other populations.

CONCLUSIONS

The findings support that childhood trauma has an impact on affective lability in adolescents. Specifically, body image dissatisfaction and being bullied affect the relationship between emotional abuse and affective lability.

The effect of childhood trauma and resilience on psychopathology in adulthood: Does bullying moderate the associations?

BACKGROUND

Exposure to traumatic events in childhood, including bullying, can negatively affect physical and mental health in adulthood. The aim of the present study was to determine the prevalence of bullying in different sociodemographic groups of the Slovak Republic and to assess the moderating effect of bullying on the associations between childhood trauma, resilience, and the later occurrence of psychopathology.

METHODS

For the analyses, a representative sample of the population of the Slovak Republic was used (N = 1018, mean age 46.24 years, 48.7% of men). Multivariate linear regression models were used to investigate the predictive ability of childhood trauma (The Childhood Trauma Questionnaire, CTQ) and resilience (The Brief Resilience Scale, BRS) to explain psychopathology (The Brief Symptom Inventory, BSI-53). Bullying (The Adverse Childhood Experiences - International Questionnaire, ACE-IQ) was used as a moderator.

RESULTS

In total, 13.5% of respondents have experienced bullying. The most common form of bullying was making fun of someone because of how their body or face looked (46.7%) and excluding someone from activities or ignoring them (36.5%). Higher scores in all types of psychopathology and the Global Severity Index (GSI) were significantly associated with higher scores of emotional and sexual abuse, and some of them with physical neglect. The protective effect of resilience was moderated by bullying in several types of psychopathology, specifically in somatization, obsessive-compulsive, interpersonal sensitivity, depression, psychoticism, and the GSI.

CONCLUSION

Understanding the links between childhood trauma, bullying, and later psychopathology can help professionals target policies, resources, and interventions to support children and families at risk. Every child should feel accepted and safe at home and school.

Beyond Binge Eating: The Impact of Implicit Biases in Healthcare on Youth with Disordered Eating and Obesity

(1) Background: Obesity and eating disorders (ED) can coexist resulting in worse health outcomes. Youth with ED are more likely to have obesity relative to peers with a healthy weight. Pediatric providers deliver first-line care to children and youth of all sizes and body shapes from infancy to adolescents. As healthcare providers (HCPs), we bring biases into our practice. Learning to recognize and address these biases is needed to provide the best care for youth with obesity. (2) Purpose: This paper aims to summarize the literature regarding the prevalence of ED beyond binge eating in youth with obesity and discuss how the intersection of weight, gender, and racial biases impact the assessment, diagnosis, and treatment of ED. We provide recommendations for practice and considerations for research and policy. (3) Conclusions: The assessment and treatment of ED and disordered eating behaviors (DEBs) in youth with obesity is complex and requires a holistic approach. This approach begins with identifying and understanding how one's implicit biases impact care. Providing care from a patient-centers lens, which considers how the intersection of multiple stigmatized identities increases the risk for DEBs in youth with obesity may improve long-term health outcomes.

Adolescent Peer Victimization and Deliberate Self-Harm: A Three-Wave Moderated Mediation Model

Background: Identifying deliberate self-harm (DSH) and peer victimization in adolescents is a public health issue. The present study evaluates a three-wave longitudinal model to examine the effect of peer victimization on DSH and the roles of internalizing problems (depression and anxiety) and perceived peer and teacher support climate in this relationship. Methods: The participants were 2381 adolescents (51.2% boys, Mage = 13.38, SD = .59) from Chinese middle schools. Self-report measures were used to collect data every 6 months in three waves. Results: (1) Peer victimization at T1 positively predicted DSH at T3. (2) Depression at T2, rather than anxiety, mediated the relationship between peer victimization at T1 and DSH at T3. (3) Perceived peer support climate at T1 played a moderating role between peer victimization at T1 and depression and anxiety at T2, but perceived teacher support climate did not. Peer victimization had a stronger predictive effect on depression and anxiety for students with high level of perceived peer support climate. Limitations: Study limitations include the short interval (6 months) of the longitudinal design, the reliance on self-report questionnaires, the inclusion of only one aspect of student-student and teacher-student relationships, and the age limitation. Conclusions: The results demonstrated the importance of prevention for improving social and emotional skills to reduce peer victimization and of interventions to promote a peer support climate in the classroom. The findings highlight the need to consider different types of internalizing problems and perceived support in studies of DSH in adolescents.

Association between weight status and bullying experiences among children and adolescents in schools: An updated meta-analysis

BACKGROUND

The association between weight status and bullying experience is well established, but little is known about the association between overweight or obesity and bullying behaviors among children and adolescents.

OBJECTIVE

The aim of this study was to provide updated evidence on the association between weight status and exposure to bullying among school children and adolescents.

METHODS

All literature published not later than December 12, 2019 was obtained from PubMed, Web of Science, Embase, and PsycINFO databases. The odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) were used to measure the effect size. Results were combined using random-effects or fixed-effects meta-analysis, and sensitivity analysis was conducted to explore potential heterogeneity moderator factors.

RESULTS

This meta-analysis included 26 studies on the association between obesity overweight and bullying. Overall, children and adolescents with obesity had greater odds of experiencing bullying than their counterparts with healthy weight. Children and adolescents with obesity (OR = 1.46, 95 % CI:1.31-1.62), and overweight (OR = 1.24, 95 % CI: 1.17-1.32) were more likely to experience bullying than their normal weight peers. With regards to gender, boys with obesity experienced an increased risk of bullying behaviors than girls with obesity (OR = 1.40, 95 % CI: 1.30-1.50). Similarly, boys with overweight experienced an increased risk of bullying behaviors than girls with overweight (OR = 1.19, 95 % CI:1.06-1.34).

CONCLUSIONS

The present results suggest that children and adolescents must be protected from bullying, especially those that are children and adolescents with obesity overweight and effective strategies are needed to reduce bullying behaviors among children and adolescents in schools.

Peer victimization (bullying) on mental health, behavioral problems, cognition, and academic performance in preadolescent children in the ABCD Study

Objective

Peer victimization is a substantial early life stressor linked to psychiatric symptoms and poor academic performance. However, the sex-specific cognitive or behavioral outcomes of bullying have not been well-described in preadolescent children.

Methods

Using the baseline dataset of the Adolescent Brain Cognitive Development (ABCD) Study 2.0.1 data repository (N = 11,875), we evaluated associations between parent-reported bullying victimization, suicidality (suicidal ideation, intent, and/or behavior), and non-suicidal self-injury (NSSI), as well as internalizing and externalizing behavioral problems, cognition, and academic performance.

Results

Of the 11,015 9-10-year-old children included in the analyses (5,263 girls), 15.3% experienced bullying victimization, as reported by the primary caregiver. Of these, boys were more likely to be bullied than girls (odds ratio [OR], 1.2 [95% CI, 1.1-1.3]; p = 0.004). Children who were bullied were more likely to display NSSI or passive suicidality (OR, 2.4 [95% CI, 2.0-2.9]; p < 0.001) and active suicidality (OR, 3.4 [95% CI, 2.7-4.2]; p < 0.001). Bullied children also had lower cognitive scores, greater behavioral problems, and poorer grades (p < 0.001). Across all participants, boys had poorer grades and greater behavioral problems than girls; however, bullied boys had greater behavioral problems than girls in several areas (p < 0.001). Compared to their non-bullied peers, bullied children with greater non-suicidal self-injury or suicidality also had greater behavioral problems and poorer grades (p < 0.001).

Conclusion

These findings highlight the sex-specific effects of bullying, and the negative associations of bullying victimization with cognitive performance, behavioral problems, and academic performance. Future longitudinal studies will identify the natural history and neural correlates of these deficits during adolescence.

Gender Differences in the Effects of BMI on School Bullying and Victimization in China: Comparing Normal Weight, Underweight and Overweight Secondary School Students

Weight-related school bullying and victimization have become important public health issues among adolescents around the world. This study aims to examine gender differences in the effects of Body Mass Index (BMI) on school bullying and victimization among secondary school students. This study conducted a survey among 2849 adolescents—1393 girls (48.9%) and 1456 boys (51.1%). The students were between 12 and 18 years of age and were recruited from ten secondary schools in 2019 in Suqian City in China. The study showed that overweight boys were more likely to bully others and be bullied by peers compared to normal weight boys. In contrast, overweight girls reported less bullying than normal-weight girls. No significant relationship was found between overweight and victimization among female students. The implications for comprehensive sexuality education practices are also discussed.

Management of eating disorders for people with higher weight: clinical practice guideline

INTRODUCTION

The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population.

AIM

The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations.

METHODS

The National Eating Disorders Collaboration Steering Committee auspiced a Development Group for a Clinical Practice Guideline for the treatment of eating disorders for people with higher weight. The Development Group followed the 'Guidelines for Guidelines' process outlined by the National Health and Medical Research Council and aim to meet their Standards to be: 1. relevant and useful for decision making; 2. transparent; 3. overseen by a guideline development group; 4. identifying and managing conflicts of interest; 5. focused on health and related outcomes; 6. evidence informed; 7. making actionable recommendations; 8. up-to-date; and, 9. accessible. The development group included people with clinical and/or academic expertise and/or lived experience. The guideline has undergone extensive peer review and consultation over an 18-month period involving reviews by key stakeholders, including experts and organisations with clinical academic and/or lived experience.

RECOMMENDATIONS

Twenty-one clinical recommendations are made and graded according to the National Health and Medical Research Council evidence levels. Strong recommendations were supported for psychological treatment as a first-line treatment approach adults (with bulimia nervosa or binge-eating disorder), adolescents and children. Clinical considerations such as weight stigma, interprofessional collaborative practice and cultural considerations are also discussed.

CONCLUSIONS

This guideline will fill an important gap in the need to better understand and care for people experiencing eating disorders who also have higher weight. This guideline acknowledges deficits in knowledge and consequently the reliance on consensus and lower levels of evidence for many recommendations, and the need for research particularly evaluating weight-neutral and other more recent approaches in this field.

Risk of eating disorders in a representative sample of Italian adolescents: prevalence and association with self-reported interpersonal factors

PURPOSE

Adolescence represents a critical period for the onset of eating disorders (EDs). The present study aimed to provide the prevalence of individuals at risk for EDs psychopathology in a representative population of adolescents aged 14-19 and to characterize this population regarding interpersonal and psychological factors.

METHODS

The percentage of participants at risk for EDs in a representative high school population was assessed through the SCOFF screening questionnaire (cut-off score: 3) in the total sample (N: 6551) and in gender-based subgroups for different body mass index (BMI) categories. Odds ratios for being at risk of ED (SCOFF ≥ 3) were esteemed in a multivariable analysis including self-reported parental education, quality of family and peer relationships, bullying victimization, age at first sexual intercourse, and psychological distress.

RESULTS

A SCOFF score ≥ 3 was found in 31.0% of participants (boys: 19.4%; girls: 44.6%), with a greater prevalence among higher BMI categories. Bad family relationships, being bullied, having the first sexual intercourse before the age of 14, and experiencing high distress were associated with this risk condition. Among girls, bad peer relationships were associated with a low-risk SCOFF score.

CONCLUSION

A remarkable percentage of adolescents reported significant body image or eating concerns. Screening programs are deeply needed, and particular attention should be devoted to interpersonal factors, such as the quality of family relationships and interactions with peers, which represent potential indicators of this vulnerability.

LEVEL OF EVIDENCE

Level V - Cross-sectional study.

The mediation effect of perceived weight stigma in association between weight status and eating disturbances among university students: is there any gender difference?

BACKGROUND

The study aimed to examine the association between perceived weight stigma (PWS), weight status, and eating disturbances. We hypothesized that PWS would partially mediate the association between weight status and eating disturbances among university students.

METHODS

The study involved 705 undergraduate students (379 females and 326 males) recruited from Hong Kong and Taiwan Universities (399 Hong Kong; 306 Taiwan participants). Our sample was from one Hong Kong university (located in Kowloon) and five Taiwan universities (three located in Southern Taiwan, one located in Central Taiwan, and one located in North Taiwan). Participants' mean age was 20.27 years (SD = 1.79). All participants completed a demographic information sheet, the Three-Factor Eating Questionnaire-18 (TFEQ-R18), and the PWS questionnaire. PROCESS macro models were used to analyze potential mediations.

RESULTS

We found a significantly higher PWS scores in a high weight group for females and males. There was a significant difference between weight status and eating disturbances. Moreover, PWS partially mediated the association between weight status and eating disturbances for both genders.

CONCLUSIONS

PWS is associated with weight status and eating disturbances, making it an important target for health improvement among young adults. Further studies are needed to corroborate such associations in participants from other societies and cultures.

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.

Associations Between Weight-Based Bullying, Developmental Internal Assets, and Perceived Social Support Among Youth

BACKGROUND

Youth with obesity are likely to experience weight-based bullying victimization, and adolescents have the highest obesity rates among children. Factors that protect youth from traditional bullying victimization may protect youth from weight-based bullying victimization: internal assets such as positive identity and social competence, and external assets such as perceived support from parents and friends.

METHODS

To examine this proposition, data from 8th, 9th, and 11th graders were obtained from the 2016 Minnesota Student Survey (N = 126,495). Logistic regressions were conducted to identify the relationship between assets and weight-based bullying and to determine possible moderation by weight status.

RESULTS

Results demonstrate that positive identity, parent support, and friend support were associated with lower odds of experiencing weight-based bullying victimization. Moderation analyses revealed that perceived parent support was most protective against experiencing weight-based bullying victimization among youth with obesity compared to youth with overweight, normal weight, or underweight.

CONCLUSION

School administrators, counselors, and teachers should be aware of the increased risk of weight-based bullying for youth with obesity and underweight. Results underscore the need to foster youth's internal assets like positive identity to promote a strength-based approach for prevention. Parent involvement is warranted in weight-based bullying prevention efforts.

Juvenile obesity in terms of various evaluation methods

INTRODUCTION

Obesity is a civilization disease of the 21st century. The prevalence of obesity and overweight among children and adolescents is constantly increasing. BMI (body mass index) and WHR (waist to hip ratio) are methods of obesity assessment recommended by the WHO. Also, the WtHR (waist to height ratio), which takes into account height, is one of the most popular methods of diagnosing childhood obesity. A more recent diagnostic indicator is the FMI (fat mass index), which considers the percentage of the patient's body fat.

THE AIM OF THE STUDY

was to compare the methods of assessing obesity in children and adolescents using the following indicators: BMI, WHR, WtHR, and FMI and to determine the consistency of the results obtained with them.

MATERIAL AND METHODS

The study included 195 children aged 11-18 years, from whom the following data were collected: height, weight, waist circumference, and percentage of body fat. The calculated indices (BMI, WHR, WtHR, FMI), expressed in SDS, were compared using the Bland-Altman test, Passing-Bablok regression, and the slope chart.

RESULTS

The fewest diagnoses of obesity were shown by FMI SDS (15.9%) and the highest by WHR SDS (28.7%). WHR SDS showed the least consistent results with BMI SDS. Significant statistical differences were found between BMI SDS and both FMI SDS and WtHR SDS.

CONCLUSIONS

BMI, as the most acceptable obesity indicator, can be used as a screening method for assessing obesity. However, patients with boundary BMI values should be examined more precisely, using more than one index. FMI is recommended.

Perpetration and Victimization in Offline and Cyber Contexts: A Variable- and Person-Oriented Examination of Associations and Differences Regarding Domain-Specific Self-Esteem and School Adjustment

Self-esteem has been identified as a predictor of bullying perpetration and victimization, which, in turn, may lead to school adjustment problems. However, findings regarding the direction and strength of these associations have been inconclusive. This study aimed to resolve this by differentiating between offline and cyber contexts and various self-esteem domains. An online sample of 459 adolescents retrospectively completed measures of self-esteem domains and offline/cyber perpetration and victimization, and a subsample of 194 adolescents also completed measures of loneliness and school adjustment. A mediation analysis of bullying-related variables on the effect of self-esteem domains on school adjustment indicated that offline victimization was the only significant mediator. Positive indirect effects were found for social and emotional self-esteem, and negative indirect effects were found for school performance-related self-esteem. Furthermore, person-oriented analyses examined differences in bullying-related roles regarding self-esteem domains, loneliness, and school adjustment. Victim groups showed lower self-esteem in many domains, but cyber victims showed higher body-related self-esteem. Bullies showed lower school performance-related but higher social self-esteem. Both bullies and victims showed lower school adjustment and more loneliness. Implications for theory and practice are discussed, as the findings are relevant for teachers and could be used to develop and deploy more effective anti-bullying programs.

Bullying experiences, body esteem, body dissatisfaction, and the moderating role of weight status among adolescents

INTRODUCTION

The present study examined the relationships between bullying victimization experiences, body esteem (BE), and body dissatisfaction (BD) by obesity status.

METHODS

Using a cross-sectional design, adolescents (10-16y) from the U.S. completed surveys. Weight and height were objectively assessed. Bullying was assessed using the Personal Experiences Checklist, with a total score that included three subscales (cyber, verbal-relational, and physical). BE was assessed using total score on the BE Scale, and BD was assessed using the Body Image Assessment for Pre-Adolescents, operationalized as the discrepancy between current and ideal body figure. Linear regression models, controlling for sociodemographics, were used to examine obesity status (with vs. without obesity) and sex as moderators of the relationships between bullying, BE, and BD.

RESULTS

On average, adolescents (n = 328) were 12.6 ± 1.9 y, 45.4% male, 58.2% White, 35.7% Black, and 36.0% had obesity. Obesity status moderated the relationship between bullying experiences and BE, such that these relationships were only significant (B = -0.38, p<.05) among adolescents with obesity compared to adolescents without obesity. In both groups, greater verbal-relational bullying experiences were associated with lower BE, while greater physical bullying experiences were related to higher BE only among adolescents with obesity. In adolescent girls without obesity, greater cyberbullying experiences were associated with lower BD.

CONCLUSIONS

The findings suggest different associations between sub-types of bullying victimization experiences and BE and BD, highlighting the importance of examining these associations separately by obesity status.

Body weight trends in adolescents of Central Italy across 13 years: social, behavioural, and psychological correlates

Aim

The study aimed to determine trends in the prevalence of underweight, overweight, obesity and their putative risk factors in different cohorts from a representative population of adolescents in Central Italy.

Subject and methods

After random sampling, five cohorts of adolescents attending public high schools – aged 14 to 18 years – were evaluated from 2005 to 2018 (n: 25,174). Collected information included self-reported body mass index (BMI), descriptors of family environment, eating behaviour, physical activity, screen use, bullying victimisation, sexual behaviour (age at first intercourse, number of partners) and perceived psychological distress. For these data, between-cohort prevalence differences were used to esteem prevalence variations across time. In the 2018 cohort, the association between these factors and body weight was evaluated through multinomial regressions with sex-specific crude relative risk ratios for different BMI categories.

Results

An increased prevalence of overweight was observed for both boys and girls. The study outlined a transition towards higher parental education and unemployment, reduced soft drinks consumption and higher psychological distress. Sex-specific changes were observed for physical and sexual activity, and a rising percentage of girls reported being bullied and distressing family relationships. Parental education and employment, together with physical activity, confirmed to be protective factors against pathological weight. The latter clustered with reduced soft drinks consumption, bullying victimisation, early sexual activity, worse family relationships and higher distress.

Conclusion

An increased prevalence of both overweight and underweight was observed across time. Economic factors associated with unemployment and changes in behavioural patterns may have contributed to this trend.

Important gender differences in psychosomatic and school-related complaints in relation to adolescent weight status

Underweight or overweight in adolescence is linked to several adverse health outcomes. Less evidence exists about the association between weight status and school-related psychosocial characteristics in high income countries. We sought to investigate the relationship between weight status and psychosomatic and school-related complaints with a focus on gender differences. The study is a cohort of 18,462 adolescents (12-19 years; 51% girls) conducted in Sweden. The associations between weight status and psychosomatic and school-related complaints were estimated by binary logistic regression adjusted for several potential confounders. After correction for multiple testing, being underweight or overweight/obese was adversely associated with several psychosomatic and school-related complaints with significant differences between boys and girls. Specifically, underweight boys had higher odds to have psychosomatic complaints than normal-weight boys, while no such associations were observed among underweight girls. Overweight/obese (vs. normal-weight) boys had higher odds to complain about headache, pain in the back/hips, and feeling low. Overweight/obese (vs. normal-weight) girls were more likely to complain about feeling low, anxious/worried and having difficulty in falling asleep (P ≤ 0.01). In relation to school-related complaints (e.g., being bullied at school and academic failure), greater associations were observed for overweight/obese girls and boys than for underweight adolescents compared with normal-weight peers.

Do weight perception and bullying victimization account for links between weight status and mental health among adolescents?

Background

The purpose of this study was to explore whether the way youth perceive their weight and their experiences of bullying victimization account for the increased risk of depression and anxiety symptoms, and poor psychosocial well-being, associated with overweight/obesity in a large sample of Canadian secondary school students. We also explored if associations differed by gender.

Methods

We used cross-sectional survey data from year 7 (2018–19) of the COMPASS study. The sample included 57,059 students in grades 9–12 (Secondary III-V in Quebec) at 134 Canadian secondary schools (Alberta, British Columbia, Ontario, Quebec). First, multiple regression models tested associations between body mass index (BMI) classification and mental health outcomes (anxiety [GAD-7] and depression [CESD-10] symptoms, and psychosocial well-being [Diener’s Flourishing Scale]). Second, weight perception and bullying victimization were added to the models. Models were stratified by gender and controlled for sociodemographic covariates and school clustering.

Results

When weight perception and bullying victimization were added to the models, obesity BMI status no longer predicted internalizing symptoms and flourishing scores relative to normal-weight BMIs. Students with ‘overweight’ or ‘underweight’ perceptions, and experiences of bullying victimization in the past month, reported higher anxiety and depressive symptomatology, and lower flourishing levels, in comparison to students with ‘about right’ weight perceptions and without experiences of bullying victimization, respectively, controlling for BMI status. Results were largely consistent across boys and girls.

Conclusions

Results suggest perceptions of weight and experiences of bullying independently contribute to differences in mental health outcomes by weight status among youth. Continued efforts targeting weight-based bullying and weight bias, and the promotion of body size acceptance and positive body image, may help reduce the risk of mental illness and poor mental health among adolescents.

Impact of self-determination theory in a physiotherapeutic training : A pilot-study on motivation for movement of obese adolescents

Background

This study determined to what extent the underpinning of physiotherapeutic interventions with the evidence-based motivational psychological concept of the self-determination theory (SDT) by Ryan and Deci can increase motivation and enjoyment of movement in obese adolescents.

Methods

In this study 12 obese adolescents aged 14–18 years were offered a targeted group-specific sports program including a home exercise program of 8 weeks. The group leaders were trained in the SDT and supported to integrate motivational aspects. A SDT-based questionnaire by Kohake and Lehnert was used to evaluate motivational interventions.

Results

In total, seven (58%) patients finished the study. In the before-after comparison there were little changes in motivation. Results showed that contrary to expectations the motivation of the obese adolescents to move and to participate in the study was generally high. In the study, more internalized forms of motivation dominated, the highest quality form of motivation.

Conclusion

Digital technologies could be a successful way to further increase motivation and compliance of our target group. This MotiMove study is a basis for future research programs and empower physiotherapists and movement experts to develop and implement training programs for obese adolescents and children.

Supplementary Information

The online version of this article (10.1007/s00508-021-01849-4) contains supplementary material, which is available to authorized users.

Weight Stigma in Youth: Prevalence, Consequences, and Considerations for Clinical Practice

PURPOSE OF REVIEW

This review summarizes recent evidence on weight stigma experienced by youth with overweight or obesity. We examine the prevalence and sources of weight-based victimization targeting youth, consequences of these stigmatizing experiences for their psychological and physical health, and considerations for addressing weight stigma in clinical practice and pediatric care.

RECENT FINDINGS

Weight stigma is highly prevalent among youth with high body weight, who are targets of weight-based victimization from peers, parents, and teachers. These experiences place youth at risk for psychological distress (primarily depressive symptoms, low self-esteem, and suicidal ideation), worse social and academic outcomes, and adverse physical health consequences including maladaptive eating behaviors, lower physical activity, substance use, and weight gain. Healthcare professionals and clinicians have important roles to play in efforts to help reduce weight stigma and support youth with obesity. Fundamental to these efforts is the use of supportive, compassionate, and non-stigmatizing communication with youth and their families.

Real women have (just the right) curves: investigating anti-thin bias in college women

BACKGROUND

Weight stigma is associated with negative mental and physical health outcomes across the body mass index (BMI) continuum. However, few studies have examined discrimination experienced by people with low body weights.

OBJECTIVES

This study explored the presence of anti-thin bias, defined as the belief that individuals at lower body weights have undesirable personality characteristics, in young adult women. Additionally, we examined perceived etiology of weight for women with underweight.

METHOD

Participants (N =295 women, age 18.84 ± 2.32) were randomly assigned to read one of the six vignettes about women who differed by race (White and Black) and BMI status (slightly underweight, average weight, and slightly overweight).

RESULTS

Negative personality characteristics were more likely to be ascribed to vignette characters with under- or overweight BMIs, compared to characters with average weight BMIs. Participants were more likely to attribute underweight characters' body weight to an eating disorder (ED) compared with average or overweight characters.

CONCLUSION

Results suggest that women with under- or overweight BMIs experience greater stigmatization for their body weight than women with average BMIs, underscoring the need for research to investigate weight discrimination across the weight spectrum.

LEVEL OF EVIDENCE

Level I, experimental study.

Black and White women's attributions of women with underweight

Despite the idealization of thin bodies, many people with low body weights report experiencing weight stigma. This stigma might relate to stereotypes about eating disorders (EDs). Specifically, people with lower body weights might be perceived as having EDs, conditions associated with significant stigma. Also, there is considerable pressure for Black women to obtain a curvy ideal, which could lead to anti-thin bias (i.e., the belief that individuals at lower body weights have undesirable characteristics) in this group. The current study evaluated these possibilities via an examination of anti-thin bias in Black and White women. Further, we explored perceived attributions of weight for Black and White women with underweight. Black (n = 96) and White (n = 128) participants read racially concordant vignettes in which characters varied by body mass index (BMI) status (slightly underweight, average weight, and slightly overweight). White women were more likely to ascribe negative personality characteristics to White vignette characters with underweight than to characters with average weight. In contrast, Black women's perceptions of Black vignette characters did not differ according to weight status. Both Black and White participants were more likely to attribute underweight characters' body weight to an ED compared with average weight characters. Results suggest that weight bias literature should incorporate the assessment and impact of weight stigma for individuals across the BMI spectrum.

[Association of victimization from bullying with body mass index in schoolchildren]

Many schoolchildren report bullying by their classmates because of their physical appearance. Teenagers' body weight is one of the main reasons for this victimization. The current study aims to investigate the association between victimization from bullying and body mass index (BMI) in Brazilian schoolchildren. This was a cross-sectional study using data from the Brazilian National School Health Survey (PeNSE) in 2015 for students from 11 to 15 years of age. The analysis used the Probit model. The probability of victimization from bullying was 46% in Brazilian schoolchildren in this age bracket. There was a significant non-linear association between BMI and bullying. Both underweight and overweight/obese schoolchildren were more likely to suffer bullying, compared to their peers with adequate weight for age. The association was found in both sexes, and the U-shaped curve was more accentuated in girls. Risk factors included feeling misunderstood by parents, dissatisfaction with one's own body, and enrollment in public schools. Living with the mother, mother's schooling, and a proxy for family income were neither risk factors nor protective factors for bullying. The results show that overweight/obese and underweight students should be considered a risk group for bullying.

Trends and sex disparities in school bullying victimization among U.S. youth, 2011-2019

Background

The prevalence of being bullied traditionally among U.S. high school students is expected to reduce to 17.9%, according to Healthy People 2020 Initiatives. We examined trends in traditional victimization and cybervictimization with the latest large-scale time-series data in the United States.

Methods

We analyzed the data from the 2011–2019 national Youth Risk Behavior Survey (YRBS) to access the trends in traditional victimization and cybervictimization among U.S. high school students. We identified the temporal trends using multivariate logistic regression analyses, accounting for survey design features of YRBS. Participants included 72,605 high school students.

Results

The overall prevalence of victimization was 19.74% for traditional bullying and 15.38% for cyberbullying, suggesting that cyberbullying is not a low frequent phenomenon. The prevalence of victimization ranged from 20.19 to 19.04% for traditional victimization and 16.23 to 14.77% for cybervictimization, and the declined trends for the two kinds of bullying victimization were both statistically non-significant. The degree of overlap between the two kinds of bullying victimization was about 60%. Besides, female students reported more traditional victimization and cybervictimization than male peers within each survey cycle.

Conclusions

No declined trends in traditional victimization and cybervictimization were observed during 2011–2019. Female students are more likely to experience school bullying. To achieve the Healthy People 2020 goal on bullying, more work is needed to explore the underlying reasons behind these unchanging trends.

Weight Status and School Bullying Experiences in Urban China: The Difference Between Boys and Girls

This article examined the associations between weight status (body mass index [BMI] and perceived weight measures) and school bullying experiences (being bullied and bullying others) of children and adolescents in urban China. A national representative sample (n = 3,675) of all types of pre-college schools from seven Chinese cities was employed for the analysis. Students from all grades in high school, vocational school, middle school, and primary grades 4 to 6 were surveyed. Height, weight, perceived weight status, and experiences of being bullied and bullying others were obtained. The results demonstrated that the objective weight status (BMI) was neither associated with being bullied overall by others nor associated with bullying others, but the subjective/perceived weight status was significantly related to being bullied. Regarding the specific forms of being bullied, underweight (measured by BMI) students were less likely to be cyberbullied, whereas obese (measured by BMI) students were more likely to be cyberbullied. Students who perceived themselves as slightly fat and too fat were more likely to be verbally bullied. Overweight and obese students were more likely to bully others physically and relationally, and the students who perceived themselves as too thin were positively associated with physically bullying others. Moreover, BMI had a role in the involvement in school bullying for boys, whereas perceived weight status had a role in school bullying involvement in girls. These results indicate that school bullying prevention and intervention should consider weight status, as well as gender differences.

Well-Being, Obesity and Motricity Observatory in Childhood and Youth (WOMO): A Study Protocol

Background: Childhood obesity is one of the greatest public health problems facing advanced societies, and Spain is one of the countries with the highest incidence. There are many studies that monitor at the national level, but given the lack of specificity, lack of updating and scarcity of epidemiological data on overweight, obesity, physical condition and well-being of children and adolescents in Extremadura, it seems necessary to create a Well-being, Obesity and Motricity Observatory in Childhood and Youth (WOMO) in Extremadura in order to follow up on the evolution of this problem and to propose strategies to combat it. Therefore, this project aims (1) to obtain information on the physical condition, body composition and well-being of children and youth in Extremadura every year and (2) to evaluate the relationship between obesity, overweight, physical condition, well-being, self-perceived physical fitness, physical activity adherence, physical literacy, health-related quality of life (HRQoL), happiness and satisfaction with life, connection with nature, barriers to sports practice, self-concept and bullying in children and youth. Methods: An annual monitoring cross-sectional and follow-up study will be performed. Primary outcome measures will be (1) personal data and anthropometric measurements, (2) family and school information, (3) physical condition, (4) obesity and overweight level, and (5) well-being. Secondary outcome measures will be (1) self-perceived physical fitness, (2) physical activity adherence, (3) physical literacy, (4) HRQoL, (5) happiness and satisfaction with life, (6) connection with nature, (7) barriers to sports practice, (8) self-concept and (9) bullying. Discussion: This project will provide valuable information to adopt appropriate strategies to reduce the level of overweight and obesity in children and youth. Furthermore, orientations will be given to transfer the results obtained to the business sector or to the public sector to evaluate or change the policies adopted.

Association of bullying victimization with overweight and obesity among adolescents from 41 low- and middle-income countries

BACKGROUND

Data on the association between overweight/obesity and bullying victimization among adolescents are scarce from low- and middle-income countries.

OBJECTIVES

We assessed the associations between overweight/obesity and bullying victimization in 41 low- and middle-income countries.

METHODS

Cross-sectional data from the Global School-based Student Health Survey were analysed. Data on past 30-day bullying victimization (including type) and body mass index based on measured weight and height were collected. The 2007 WHO Child Growth reference was used to define overweight and obesity. Multivariable logistic regression (multinomial and binary) and meta-analyses based on country-wise estimates were conducted. Data on 114 240 adolescents aged 12 to 15 years were analysed (mean age [SD], 13.8 [1.0] y; 48.8% girls).

RESULTS

Among girls, compared with normal weight, overweight (OR = 1.08; 95% CI, 1.02-1.16; between-country heterogeneity I²  = 0.0%) and obesity (OR = 1.20; 95% CI, 1.07-1.34; I²  = 0.0%) were associated with significantly higher odds for any bullying victimization, but no significant association was observed among boys. However, overweight and obesity were both associated with significantly increased odds for bullying by being made fun of because of physical appearance among both sexes-obesity (vs normal weight): girls OR = 3.42 (95% CI, 2.49-4.71); boys OR = 2.38 (95% CI, 1.67-3.37).

CONCLUSIONS

Effective strategies to reduce bullying of children with overweight/obesity are needed in low- and middle-income countries.

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.

Chinese Sexual Minority Male Adolescents' Suicidality and Body Mass Index

Excess weight status may increase the risk of suicidality among sexual minority females, but few studies have examined this suicidality disparity in sexual minority males. This study examined the association between sexual minority status and suicide attempts in Chinese male adolescents and tested whether body mass index (BMI) had a moderating effect on that association. Data were collected from 7th to 12th graders from seven randomly selected provinces of China in the 2015 School-Based Chinese Adolescents Health Survey. In total, 72,409 male students completed the questionnaires regarding sexual attraction, self-reported weight and height, and suicide attempts. After adjustment for covariates, sexual minority status was associated with suicide attempts among male students (AOR = 1.74, 95% CI = 1.57–1.93). Stratification analyses showed that BMI category moderated this association; compared with the results before stratification analyses, sexual minority males who were obese had increased risk of suicide attempts (AOR = 2.15, 95% CI = 1.09–4.24), sexual minority males who were overweight had reduced odds of suicide attempts (AOR = 1.40, 95% CI = 1.01–1.92), and no significant association change was found in sexual minority males who were underweight (AOR = 1.82, 95% CI = 1.43–2.33). Our study indicated that BMI moderated the risk of suicide attempts in sexual minority males. Suicide prevention targeting sexual minority males should be focused on weight status disparity and the creation of a positive climate to reduce minority stressors due to body image.

Association Between Early Menarche and School Bullying

PURPOSE

Early pubertal onset may relate to more involvement in bullying in adolescent girls, both as a target and as a perpetrator. However, the few studies of the association between early menarche and school bullying have shown mixed findings. The present study examined whether early menarche is associated with bullying victimization and perpetration.

METHODS

We obtained survey data on adolescent girls from the 2001-2002, 2005-2006, and 2009-2010 cycles of the Health Behaviour in School-aged Children study in 35 European and North American countries. We identified school bullying in the past 2 months using the Revised Olweus Bully/Victim Questionnaire. We defined early menarche as a reported onset of menarche before 11 years and tested the associations between early menarche and bullying victimization and perpetration using three-level logistic regression models.

RESULTS

The sample included 227,443 adolescent girls with a mean age of 13.64 (standard deviation [SD] 1.63) years, of which 10,172 (4.47%) were early matured; 62,528 (28.33%) and 56,582 (25.67%) were occasional victims and perpetrators, respectively; and 21,985 (9.96%) and 14,115 (6.40%) were frequent victims and perpetrators, respectively. Early menarche related to occasional victimization (adjusted odds ratio [OR] [95% confidence interval [CI] = 1.21 [1.12-1.31]) and perpetration (aOR [95% CI] = 1.19 [1.11-1.27]) and to frequent victimization (aOR [95% CI] = 1.35 [1.22-1.50]) and perpetration (aOR [95% CI] = 1.46 [1.31-1.63]).

CONCLUSIONS

Early menarche in European and North American adolescent girls positively relates to bullying victimization and perpetration. Early-maturing girls should not be neglected in antibullying programs.

The impact of the Wenchuan earthquake on early puberty: a natural experiment

Background

The factors influencing pubertal timing have gained much attention due to a secular trend toward earlier pubertal onset in many countries. However, no studies have investigated the association between the Great earthquake and early puberty. We aimed to assess whether the Wenchuan earthquake is associated with early puberty, in both boys and girls.

Methods

We used data from two circles of a survey on reproductive health in China to explore the impact of the Wenchuan earthquake on early puberty , and a total of 9,785 adolescents (4,830 boys, 49.36%) aged 12-20 years from 29 schools in eight provinces were recruited. Wenchuan earthquake exposure was defined as those Sichuan students who had not experienced oigarche/menarche before May 12, 2008. Early puberty was identified as a reported onset of oigarche/menarche at 11 years or earlier. We tested the association between the Wenchuan earthquake and early puberty in boys and girls. Then, subgroup analysis stratified by the age at earthquake exposure also was performed.

Results

In total, 8,883 adolescents (4,543 boys, 51.14%) with a mean (SD) age of 15.13 (1.81) were included in the final sample. In general, children exposed to the earthquake had three times greater risk of early puberty (boys, RR [95% CI] = 3.18 [2.21-4.57]; girls: RR [95%CI] =3.16 [2.65-3.78]). Subgroup analysis showed that the adjusted RR was 1.90 [1.19-3.03] for boys and 2.22 [1.75-2.80] for girls. Earthquake exposure predicted almost a fourfold (RR [95%CI] = 3.91 [1.31-11.72]) increased risk of early puberty in preschool girls, whereas the increase was about twofold (RR [95%CI] = 2.09 [1.65-2.64]) in schoolgirls. Among boys, only older age at earthquake exposure was linked to early puberty (RR [95%CI] = 1.93 [1.18-3.16]).

Conclusions

Wenchuan earthquake exposure increased the risk of early puberty in boys and girls, and preschoolers were more at risk than schoolchildren. The implications are relevant to support policies for those survivors, especially children, to better rebuild after disasters.