Moderators of the Effect of Peer Victimization During Fifth Grade on Subsequent Symptoms of (Anxious) Depression: The Roles of Engagement in Bullying and Baseline Symptomatology

Two hypothesized moderators of the effect of peer victimization during fifth grade on subsequent symptoms of (anxious) depression in sixth grade were examined: engagement in bullying and baseline fifth grade symptoms of (anxious) depression. Analyses were conducted on longitudinal data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Interview data from 1,081 fifth grade participants assessed peer victimization and engagement in bullying classmates during the school year. Self-reported symptoms of depression were measured in fifth and sixth grade with the Child Depression Inventory Short form. Additionally, maternal reports of child anxious depression were measured with the Child Behavior Checklist. Engagement in bullying and concurrent depression symptoms moderated the effect of peer victimization in fifth grade on child-reported symptoms of depression in sixth grade. The adverse effect of peer victimization was stronger for children with high levels of concurrent depression symptoms or engagement in bullying. Concurrent symptomatology also moderated the effects of peer victimization on mother-reported child anxious depression 1 year later.     

The long-term effects of intimate partner violence on adolescent mothers' depressive symptoms

Adolescent mothers are at high risk of experiencing intimate partner violence (IPV) which may increase their likelihood of depressive symptoms in adulthood, yet little is known about the long-term effects of IPV on adolescent mothers' trajectories of depressive symptoms. The study reported here uses prospective data spanning 14 years from a study of 229 adolescent mothers from Washington State, USA to evaluate the effects of adolescent exposure to IPV on the trajectories of depressive symptoms over time, as well as the likelihood of depressive symptoms at age 28 years. After controlling for levels of economic insecurity, the results indicate that adolescent IPV and an early vulnerability to depression were significantly related to the intercept, but not the slope of the adult depressive symptom trajectories. Both cumulative and concurrent IPV predicted the likelihood of depressive symptoms at age 28 years. Follow-up analyses indicate that adolescent IPV is associated with greater levels of adult IPV, and that women who report both adolescent and adult IPV have the highest mean levels of depressive symptoms. These findings suggest that exposure to IPV in adolescence may alter the life course of young women, increasing their risk for continuing exposure to intimate partner violence in adulthood and its concomitant negative mental health effects. Efforts aimed at prevention and early intervention in IPV among adolescent mothers are important components of the clinical care of young mothers.     

初中生抑郁在心理忽视与校园欺凌间的作用

分析初中生心理忽视、抑郁与校园欺凌的关系,为制定防范与干预初中校园欺凌方案提供实证参考.方法 采用心理虐待与忽视量表、中学生传统/网络欺凌行为问卷和抑郁量表,对从辽宁省方便抽取的927 名初中生进行调查.结果 除传统身体与关系欺凌维度外,男生在校园欺凌的其他维度得分均高于女生(P 值均<0.01); 除传统关系欺凌与网络关系欺凌2 个维度外,初一学生在校园欺凌的其他维度得分均低于初二学生(P 值均<0.05).心理忽视和抑郁、校园欺凌及其各维度两两间均呈正相关(P 值均<0.01).心理忽视不仅能直接影响初中生的校园欺凌,还可以通过抑郁间接影响校园欺凌,传统欺凌与网络欺凌间接效应分别占总效应的17.00%,15.40%.中介模型拟合指标χ2 /df = 3.14,NFI = 0.97,CFI = 0.98,TLI = 0.97, IFI = 0.98,GFI = 0.98,RMSEA= 0.05.结论 初中生心理忽视、抑郁与校园欺凌的关系密切,且抑郁在心理忽视预测校园欺凌间起部分中介作用.     

青少年遭受同伴欺凌与抑郁症状关系的纵向交叉滞后分析

  目的  探讨青少年不同类型欺凌行为和抑郁症状之间的关系, 为进一步预防青少年同伴欺凌提供科学依据。  方法  基于2019年9月(T1)和2020年9月(T2)对安徽省淮北市1 687名青少年队列随访数据, 采用交叉滞后回归方法探讨不同类型同伴欺凌与抑郁症状的相互关系。  结果  T2时遭受欺凌行为(躯体欺凌、言语欺凌、关系欺凌、网络欺凌)和抑郁症状得分均低于T1时, 差异均有统计学意义(t值分别为13.60, 8.61, 7.24, 3.76, 8.29, P值均 < 0.01)。两个时期青少年的欺凌行为与抑郁症状之间均呈正相关(P值均 < 0.01);交叉滞后回归分析显示, T1时期的遭受躯体、言语、关系和网络欺凌均能正向预测T2时期的抑郁症状(β值分别为0.06, 0.04, 0.12, 0.05), T1时期的抑郁症状也能正向预测T2时期遭受躯体、言语、关系和网络欺凌(β值分别为0.07, 0.10, 0.13, 0.10)(P值均 < 0.05)。  结论  青少年同伴欺凌与抑郁症状之间相互影响, 存在一定的双向关联。     

The associations between sex,immigrant status,immigrant concentration and intimate partner violence: Evidence from the Canadian General Social Survey

Intimate partner violence (IPV) is an important public health concern, yet little is known about the combined effects of individual- and neighbourhood-level characteristics on IPV among immigrants. The aim of this study is to examine: (1) the association between immigrant status and IPV victimisation and whether sex modifies this association, and (2) the association between the neighbourhood concentration of immigrants and IPV victimisation, and whether immigrant status modifies this association. Our sample of 10,964 males and females comes from the 2009 Canadian General Social Survey. After controlling for covariates, immigrant status was not associated with IPV, and sex significantly modified the association between immigrant status and financial and physical/sexual IPV. Compared to males, second-generation females were less likely to report financial IPV and first-generation females were more likely to report physical/sexual IPV. Immigrant status modified the association between the neighbourhood concentration of immigrants and emotional and physical/sexual IPV. Compared to third-generation males, first-generation males living in neighbourhoods with a higher concentration of immigrants were more likely to report emotional IPV, whereas second-generation males in these neighbourhoods were less likely to report physical/sexual IPV. Interventions to reduce IPV should pay equal attention to individual- and neighbourhood-level influences.     

The predictive effects of the behaviour problem variables on peer victimisation in preschool children

Behaviour problems in young children are fairly common. It has been suggested that approximately 5–14% of preschool children exhibit problem behaviour. There are many reasons for behaviour problems in preschool-aged period children. Researches reveal that link between victimisation and individual differences. However, but still, we do not know the prevalence of the possible precursors of peer victimisation among preschool children. The aim of this study was to investigate the predictive effects the level of behaviour problem variables have on peer victimisation of five to six-year-old children attending preschool education. The sample group of the research included 152 normally developed children selected by simple random sampling method among 5–6 years old children receiving preschool education in the city centre of the province of Çorum in Turkey. The relational survey method was used in this study. The Preschool Behaviour Questionnaire (PBQ) and the Peer Victimisation Scale were used in this study. The PBQ and the Peer Victimisation Scale were completed by the teachers. Results of this study concluded that there was a significant positive relationship between the level of child behaviour problems variables and peer victimisation. In addition, results show that behaviour problems of five to six-year-old preschool children have a significant predictive effect on their peer victimisation.     

Moderating effects of team sports participation on the link between peer victimization and mental health problems

This study examined the moderating role of sports participation in the concurrent and longitudinal links of peer victimization with depressive symptoms and externalizing problems. The sample consisted of 1250 participants assessed between ages 7 and 10 years. Children's levels of peer victimization, depressive symptoms and externalizing problems were assessed by teachers. Mothers reported on children's sports participation. Regression analyses revealed that victimized children who often participated in team sports at age 8 years displayed significantly fewer depressive symptoms concurrently compared to victims who rarely participated in such activities. Participation in team sports also counteracted (via a main effect) the longitudinal effect of victimization on depression symptoms two years later. Moreover, victimized children who often participated in team sports showed significantly fewer externalizing problems at age 10 compared to children who rarely participated in such activities. This moderating effect of team sports was partly mediated by a decrease in victimization at age 10. Specifically, victimized children who were part of a sporting team at age 8 were less victimized two years later, which accounted for part of the decrease in externalizing problems at age 10. Similar benefits were not apparent when victimized children participated in individual sports. These results suggest that sports participation may be beneficial in regard to several aspects of development, specifically for children who suffer from peer victimization. However, potential benefits may vary depending on the type of sports played.     

Prospective study on the reciprocal relationship between intimate partner violence and depression among women in Korea

This study aimed to examine the bi-directional relationship between intimate partner violence (IPV) and depression using prospective data. Data from the Korean Welfare Panel Study (KOWEPS) were used to test whether IPV was associated with an increased overall level of depression and with the rate of change over time in depressive symptoms and whether this model of change in depressive symptoms was associated with subsequent incidences of IPV.This study utilized data from 3153 married women who participated in the KOWEPS from 2006 through 2009. The KOWEPS is a panel study of a nationally representative sample of Korean households. The women's responses to multiple questions adopted from the Conflict Tactics Scale (CTS) were used to create a dichotomous IPV variable at Wave1 and Wave4. The CESD-11 was used to measure the women's level of depression. We utilized a latent growth model (LGM) of depression using IPV at Wave1 as a predictor and IPV at Wave4 as an outcome predicted by the model parameters of the LGM of depression.We found that after controlling for the effects of age, education, social support and income, IPV at Wave1 was positively associated with overall depression levels and negatively associated with the growth rate of depression. Further, IPV at Wave4 was associated with the intercept and the slope of the depression LGM and with IPV at Wave1. The overall model fit the data well.This study indicated that experiencing IPV influences a woman's level of depression in terms of its overall level and rate of change, which, in turn, influences the victim's likelihood of experiencing subsequent IPV.     

Psychiatric conditions associated with bullying

Bullying is a complex phenomenon moderated not only by the personal characteristics and behavioral traits of the individual but also by family rearing practices, as well as by situational factors such as the frequency and type of bullying. The phenomenon is also affected by group processes among the individuals present during the event. Bullying is a distressing experience that is often continuous over years and predicts both concurrent and future psychiatric symptoms and disorders, even in adulthood. At young ages, attention-deficit hyperactivity disorder and depression, as well as anxiety, are prevalent concurrently with bullying among the children involved. Later in young adulthood, male victims are at risk for anxiety, male bullies for personality disorders, and male bully-victims for both personality disorders and anxiety, and the risk is especially increased if the child is disturbed when involved in bullying at school age. Rarely does any single behavior predict future problems as clearly as bullying does, and additional assessment of psychiatric problems is always warranted, if the child is involved in bullying as a bully, victim or bully-victim. Based on our current knowledge, school-based interventions regulating the behavior of the child, increasing pro-social skills and promoting peer relationships are recommended for those without concurrent psychiatric disturbance, but those displaying psychiatric symptoms and disorders should be referred for psychiatric consultation and intervention.     

Social Support and Employment Status Modify the Effect of Intimate Partner Violence on Depression Symptom Severity in Women: Results from the 2006 Behavioral Risk Factor Surveillance System Survey

BackgroundDepression and intimate partner violence (IPV) are significant health issues for U.S. women. Interaction effects between IPV and other psychosocial factors on the severity of depressive symptoms have not been fully explored. This study assessed effect modification, that is, how IPV interacts with sociodemographics, psychosocial factors and health risk behaviors, on the severity of depressive symptoms in women.MethodsWe utilized cross-sectional data from female respondents (n = 16,106) of the 2006 Behavioral Risk Factors Surveillance Survey. Sociodemographics, psychosocial variables, and health risk behaviors determined to be significantly associated with depression were tested for interaction effects with IPV. Weighted ordinal logistic regression and predicted probabilities illustrated the effect of IPV status on depressive symptom severity, stratified by interaction effects.ResultsRecent and lifetime IPV exposure were associated with more severe depressive symptoms compared with no IPV exposure. IPV history interacted with employment status and social support on the severity of depressive symptoms in women. Overall, any IPV exposure was associated with more severe depressive symptoms among women with low social support and unemployment, although the effect of recent (versus lifetime) IPV was most pronounced among women with high social support or employed women.ConclusionsSocial support and employment status interact with IPV on the severity of depressive symptoms in women. Therefore, social support or workplace interventions designed to improve depressive symptoms should examine IPV history.     

Bullying victimisation,self harm and associated factors in Irish adolescent boys

School bullying victimisation is associated with poor mental health and self harm. However, little is known about the lifestyle factors and negative life events associated with victimisation, or the factors associated with self harm among boys who experience bullying. The objectives of the study were to examine the prevalence of bullying in Irish adolescent boys, the association between bullying and a broad range of risk factors among boys, and factors associated with self harm among bullied boys and their non-bullied peers. Analyses were based on the data of the Irish centre of the Child and Adolescent Self Harm in Europe (CASE) study (boys n = 1870). Information was obtained on demographic factors, school bullying, deliberate self harm and psychological and lifestyle factors including negative life events. In total 363 boys (19.4%) reported having been a victim of school bullying at some point in their lives. The odds ratio of lifetime self harm was four times higher for boys who had been bullied than those without this experience. The factors that remained in the multivariate logistic regression model for lifetime history of bullying victimisation among boys were serious physical abuse and self esteem. Factors associated with self harm among bullied boys included psychological factors, problems with schoolwork, worries about sexual orientation and physical abuse, while family support was protective against self harm. Our findings highlight the mental health problems associated with victimisation, underlining the importance of anti-bullying policies in schools. Factors associated with self harm among boys who have been bullied should be taken into account in the identification of boys at risk of self harm.     

遏制儿童青少年同伴欺凌加强常规行为监测和干预

儿童青少年同伴欺凌已经成为重要的公共卫生问题, 中国政府对国内中小学校园欺凌现象高度重视, 但其系统监测和干预方案尚待制定。研究分析了同伴欺凌对儿童青少年当前乃至终身健康的影响, 阐述了全球范围内国家层面儿童青少年同伴欺凌行为的监测现状, 同时呼吁从生态系统理论的视角加强针对遭受同伴欺凌者干预, 全面降低儿童青少年同伴欺凌发生的风险。     

Reprint of: bullying victimisation, self harm and associated factors in Irish adolescent boys

School bullying victimisation is associated with poor mental health and self harm. However, little is known about the lifestyle factors and negative life events associated with victimisation, or the factors associated with self harm among boys who experience bullying. The objectives of the study were to examine the prevalence of bullying in Irish adolescent boys, the association between bullying and a broad range of risk factors among boys, and factors associated with self harm among bullied boys and their non-bullied peers. Analyses were based on the data of the Irish centre of the Child and Adolescent Self Harm in Europe (CASE) study (boys n = 1870). Information was obtained on demographic factors, school bullying, deliberate self harm and psychological and lifestyle factors including negative life events. In total 363 boys (19.4%) reported having been a victim of school bullying at some point in their lives. The odds ratio of lifetime self harm was four times higher for boys who had been bullied than those without this experience. The factors that remained in the multivariate logistic regression model for lifetime history of bullying victimisation among boys were serious physical abuse and self esteem. Factors associated with self harm among bullied boys included psychological factors, problems with schoolwork, worries about sexual orientation and physical abuse, while family support was protective against self harm. Our findings highlight the mental health problems associated with victimisation, underlining the importance of anti-bullying policies in schools. Factors associated with self harm among boys who have been bullied should be taken into account in the identification of boys at risk of self harm.     

The relationship between intimate partner violence and probable depression among adolescent girls and young women in Lilongwe,Malawi

ABSTRACT

This analysis estimates prevalence of intimate partner violence (IPV) and its association with probable depression among adolescent girls and young women (AGYW) in Lilongwe, Malawi, and whether partner’s controlling behaviour modifies this relationship. Baseline data was utilised from the Girl Power-Malawi study of 1000 15–24-year-old AGYW in Lilongwe. Emotional, physical, and sexual IPV experiences with a current or recent partner were measured using the modified Conflict Tactics Scale. Probable depression was measured by scoring ≥10 on the Centre for Epidemiologic Studies-Short Depression Scale (CES-D-10). Generalised linear models with log-link and binomial distribution estimated prevalence ratios (PR) and 95% confidence intervals (CI) for the association between IPV types and probable depression. Partner’s controlling behaviour was examined as an effect modifier. Participants’ mean age was 19.2 years, with 70% never-married. IPV prevalence varied for emotional (59%), physical (36%), sexual (46%), and all forms (20%). Prevalence of probable depression was 47%. AGYW who experienced each IPV type had a higher prevalence of probable depression: physical (PR:1.54, CI:1.28–1.86), sexual (1.46, CI:1.21–1.75), emotional (1.37, CI:1.14–1.64), all forms (1.72, CI:1.41–2.09). IPV and probable depression were prevalent and strongly associated, especially among AGYW reporting controlling behaviour. Interventions addressing IPV and controlling behaviour may positively impact depression among AGYW.     

Temperament and peer relations: investigating the effect the temperament of 5–6-year-olds has on their peer relations

The purpose of this study is to investigate the predictor effect temperamental characteristics of Turkish children aged between 5 and 6 have on peer relationship variables (social impact, prosocial behaviour, aggression, asocial behaviour, exclusion, fear–anxiety, and victimisation). About 140 children, aged between 5 and 6, and their mothers, from Denizli in Turkey, participated in this study. The Short Temperament Scale for Children was used to measure the temperamental characteristics of children. The Child Behaviour Scale, the Victimisation Scale, and the sociometric technique based on peer nomination were used to assess peer relationship variables. Results of this study concluded that there was a significant positive relationship between the level of approach, persistence, and rhythmicity and social impact and prosocial behaviour; there was a significantly adverse relationship between the level of aggression, asocial behaviour, exclusion, fear–anxiety, and victimisation. The children's level of inflexibility/reactivity had a significant inverse relationship with social impact and prosocial behaviour and a significant positive relationship with aggression, asocial behaviour, exclusion, fear–anxiety, and victimisation levels. All temperamental characteristics taken into consideration for this study had a significant predictor effect on peer relationship variables of children aged between 5 and 6.     

School bullying, homicide and income inequality: a cross-national pooled time series analysis

Objectives

To examine the relation between income inequality and school bullying (perpetration, victimisation and bully/victims) and explore whether the relation is attributable to international differences in violent crime.

Methods

Between 1994 and 2006, the Health Behaviour in School-aged Children study surveyed 117 nationally representative samples of adolescents about their involvement in school bullying over the previous 2 months. Country prevalence rates of bullying were matched to data on income inequality and homicides.

Results

With time and country differences held constant, income inequality positively related to the prevalence of bullying others at least twice (b = 0.25), victimisation by bullying at least twice (b = 0.29) and both bullied and victimisation at least twice (b = 0.40). The relation between income inequality and victimisation was partially mediated by country differences in homicides.

Conclusions

Understanding the social determinants of school bullying facilitates anti-bullying policy by identifying groups at risk and exposing its cultural and economic influences. This study found that cross-national differences in income inequality related to the prevalence of school bullying in most age and gender groups due, in part, to a social milieu of interpersonal violence.     

同伴欺凌经历对青春期发育影响的队列研究

探讨童年期同伴欺凌经历对青春期发育的影响,为开展预防青少年欺凌行为的健康教育提供参考.方法 于2014年9月采取整群抽样方法,选取安徽省马鞍山市3所小学三到四年级693名学生为调查对象,采用自编同伴欺凌问卷评价同伴欺凌经历,青春期发育量表(Pubertal Developmental Scale,PDS)评价儿童青春期发育情况.2015年9月再次对所有研究对象开展随访(654人),评估同伴欺凌与青春期发育的关联.根据儿童在基线与随访调查中2次报告的被同伴欺凌经历,将儿童分为无受欺凌组、持续组、新发组和消退组.结果 61.0% (399/654)的儿童在基线与随访中均无同伴欺凌经历,11.5%(75/654)儿童有持续受欺凌经历,14.8% (97/654)有随访期新发受欺凌经历,12.7% (83/654)随访期不再受欺凌.4组同伴欺凌经历青少年PDS得分与体质量指数(BMI)随访前后变化差值比较,持续欺凌组PDS得分明显高于无欺凌组、消退组和新发组;BMI变化值在同伴欺凌不同分组中差异无统计学意义(P>0.05).多元线性回归分析显示,相比于无欺凌组,持续受欺凌组男生PDS得分增高(β=0.249,95%CI=0.136~ 0.362);女生新发组和持续组PDS得分显著增高(β值分别为0.191,0.245,95%CI分别为0.076~0.305,0.123~ 0.367).结论 持续被同伴欺凌经历可能致男女童青春期发育加速.     

Intimate Partner Violence/Abuse and Depressive Symptoms among Female Health Care Workers: Longitudinal Findings

Intimate partner violence and abuse (IPV/A) have been shown to have a major impact on mental health functioning. This study assessed the longitudinal association between recent IPV/A and depressive symptoms to identify potential targets for preventive interventions for women. Random effects models were used to examine four waves of data collected at 6-month intervals from a cohort of 1,438 female health care workers. IPV/A (e.g., sexual and physical violence, psychological abuse) in the past 5 years was associated with higher Center for Epidemiologic Studies Depression Scale (CES-D) 10 scores across four waves after adjustment for age, time, marital status, and childhood trauma. Women who reported IPV/A in the past 5 years had higher CES-D 10 scores (β, 1.31; 95% confidence interval, 0.79–1.82; p < .0001) than nonabused women. This association was generally constant with time, suggestive of a cross-sectional association across all four waves of data. Additionally, recent IPV/A was associated with change in depressive symptoms over time among the full cohort and those with CES-D 10 scores below 10 (the threshold for likely depression) at baseline. Recent IPV/A was independently associated with depressive symptoms both cross-sectionally and longitudinally. The longitudinal association was stronger among those not depressed at baseline. Implications for health care settings and workplace policies addressing IPV/A are discussed.     

Intimate partner violence and women's physical, mental, and social functioning

OBJECTIVE: To describe the relationship between women's health and the timing, type, and duration of intimate partner violence (IPV) exposure. METHODS: A telephone interview was completed by 3429 women aged 18 to 64 randomly selected from a large health plan, to assess IPV exposure and heath status (response rate 56.4%). Questions from the Behavioral Risk Factor Surveillance System and the Women's Experience with Battering scale were used to construct IPV exposures: (1) recent (past 5 years) and remote (before past 5 years only) IPV exposure of any type (physical, sexual, or non-physical); (2) recent (past 5 years) IPV exposure to physical and/or sexual or non-physical only; and (3) IPV duration (0 to 2 years, 3 to 10 years, and >10 years). Health outcomes were measured using the Short Form-36 survey (SF-36), the Center for Epidemiologic Studies Depression scale, and the National Institute of Mental Health Presence of Symptoms survey. RESULTS: In adjusted models, compared to women with no IPV in their adult lifetime, more-pronounced adverse health effects were observed for women with recent (vs remote) IPV; for physical and/or sexual (vs non-physical) IPV; and for longer IPV exposure. Compared to women who never experienced IPV, women with any recent IPV (physical, sexual, or non-physical) had higher rates of severe (prevalence ratio [PR]=2.6; 95% confidence interval [CI]=1.9-3.6) and minor depressive symptoms (PR=2.3; 95% CI=1.9-2.8); higher number of physical symptoms (mean, 1.0; 95% CI=0.7-1.2); and lower SF-36 mental and social functioning scores (range, 4.3-5.5 points lower across subscales). Women with recent physical and/or sexual IPV were 2.8 times as likely to report fair/poor health, and had SF-36 scores that ranged from 5.3 to 7.8 points lower, increased risk of depressive symptoms (PR=2.6) and severe depressive symptoms (PR=4.0), and more than one additional symptom. Longer duration of IPV was associated with incrementally worse health. CONCLUSIONS: Women's health was adversely affected by the proximity, type, and duration of IPV exposure.     

Bullying and symptoms among school-aged children: international comparative cross sectional study in 28 countries

BACKGROUND: There have been no large-scale international comparisons on bullying and health among adolescents. This study examined the association between bullying and physical and psychological symptoms among adolescents in 28 countries. METHODS: This international cross-sectional survey included 123,227 students 11, 13 and 15 years of age from a nationally representative sample of schools in 28 countries in Europe and North America in 1997-98.The main outcome measures were physical and psychological symptoms. RESULTS: The proportion of students being bullied varied enormously across countries. The lowest prevalence was observed among girls in Sweden (6.3%, 95% CI: 5.2-7.4), the highest among boys in Lithuania (41.4%, 95% CI 39.4-43.5). The risk of high symptom load increased with increasing exposure to bullying in all countries. In pooled analyses, with sex stratified multilevel logistic models adjusted for age, family affluence and country the odds ratios for symptoms among students who were bullied weekly ranged from 1.83 (95% CI 1.70-1.97) to 2.11 (95% CI 1.95-2.29) for physical symptoms (headache, stomach ache, backache, dizziness) and from 1.67 (95% CI 1.55-1.78) to 7.47 (95% CI 6.87-8.13) for psychological symptoms (bad temper, feeling nervous, feeling low, difficulties in getting to sleep, morning tiredness, feeling left out, loneliness, helplessness). CONCLUSION: There was a consistent, strong and graded association between bullying and each of 12 physical and psychological symptoms among adolescents in all 28 countries.