Risk Factors and Psychological Outcomes of Bullying Victimization: A Community-based Study

To understand the negative impact of bullying on the psychological well-being of children and adolescents we need to examine the associated context of adverse home life, problem peer relationships and school experience. Standardized retrospective in-depth interviews provide a useful method. A sample of 160 high-risk community-based emerging adults in the UK (age 16–30) were interviewed to rate familial and peer/school relationships, and severity of bullying with or without aggression before age 17. A clinical interview assessed psychiatric disorders in teenage years. Statistical analyses showed a differential model for bullying victims versus aggressive victims and internalizing versus externalizing disorders. Both types of bullying experiences were associated with parental neglect and abuse, parental discord and inadequate supervision; victimization alone related to problem school context and internalizing disorders (anxiety disorders and major depression); in contrast, bullying victimization with aggression was distinctly associated with experiences of violence in family, problem peer group, and externalizing disorders (conduct disorder and substance use disorder). Thus differentiation of context of young people’s experience can inform effective psychosocial, educational and clinical approaches to reduce the risks associated with bullying victimization.     

The impact of peer victimization on later maladjustment: mediating and moderating effects of hostile and self‐blaming attributions

Background: Evidence indicates that being a victim of bullying or peer aggression has negative short‐ and long‐term consequences. In this study, we investigated the mediating and moderating role of two types of attributional mechanisms (hostile and self‐blaming attributions) on children’s maladjustment (externalizing and internalizing problems). Methods: In total, 478 children participated in this longitudinal study from grade 5 to grade 7. Children, parents, and teachers repeatedly completed questionnaires. Peer victimization was assessed through peer reports (T1). Attributions were assessed through self‐reports using hypothetical scenarios (T2). Parents and teachers reported on children’s maladjustment (T1 and T3). Results: Peer victimization predicted increases in externalizing and internalizing problems. Hostile attributions partially mediated the impact of victimization on increases in externalizing problems. Self‐blame was not associated with peer victimization. However, for children with higher levels of self‐blaming attributions, peer victimization was linked more strongly with increases in internalizing problems. Conclusions: Results imply that hostile attributions may operate as a potential mechanism through which negative experiences with peers lead to increases in children’s aggressive and delinquent behavior, whereas self‐blame exacerbates victimization’s effects on internalizing problems.     

Ethnic differences in the link between physical discipline and later adolescent externalizing behaviors

BACKGROUND: Parents' use of physical discipline has generated controversy related to concerns that its use is associated with adjustment problems such as aggression and delinquency in children. However, recent evidence suggests that there are ethnic differences in associations between physical discipline and children's adjustment. This study examined race as a moderator of the link between physical discipline and adolescent externalizing behavior problems, extending previous research beyond childhood into adolescence and considering physical discipline at multiple points in time. METHODS: A representative community sample of 585 children was followed from pre-kindergarten (age 5) through grade 11 (age 16). Mothers reported on their use of physical discipline in the child's first five years of life and again during grades 6 (age 11) and 8 (age 13). Mothers and adolescents reported on a variety of externalizing behaviors in grade 11 including aggression, violence, and trouble at school and with the police. RESULTS: A series of hierarchical linear regressions controlling for parents' marital status, socioeconomic status, and child temperament revealed significant interactions between physical discipline during the child's first five years of life and race in the prediction of 3 of the 7 adolescent externalizing outcomes assessed and significant interactions between physical discipline during grades 6 and 8 and race in the prediction of all 7 adolescent externalizing outcomes. Regression slopes showed that the experience of physical discipline at each time point was related to higher levels of subsequent externalizing behaviors for European American adolescents but lower levels of externalizing behaviors for African American adolescents. CONCLUSIONS: There are race differences in long-term effects of physical discipline on externalizing behaviors problems. Different ecological niches may affect the manner in which parents use physical discipline, the meaning that children attach to the experience of physical discipline, and its effects on the adjustment of children and adolescents.     

Concordance in Child-Parent Reporting of Social Victimization Experiences in the Adolescent Brain Cognitive Development Study

ObjectiveTo investigate child-parent concordance in reporting social victimization experiences and whether concordance was associated with child behavioral symptoms.MethodsThis was an observational study with data from the Adolescent Brain Cognitive Development study. The analytic sample was 11,235 9- or 10-year-old children from the United States. Exposure variables were demographic and protective factors (child perceptions of parental relationships, school protective factors, neighborhood safety). The outcome was parent-child concordance on 6 domains of child social victimization: conventional crime, peer victimization, witnessing violence, internet victimization, school victimization, and gun violence. Child behavior symptoms were measured using the Child Behavior Checklist.ResultsExposure to social victimization was low (9% of the sample). Concordance ranged from 18% to 50%. The highest levels of concordance were observed for conventional crime (k = 0.48, P < .001) and witnessing violence (k = 0.48, P < .001). Parents’ perceptions of greater neighborhood safety was associated with lower odds of concordant conventional crime (odds ratio [OR] = 0.92, 95% confidence interval [CI] 0.86–0.99) and witnessing violence (OR = 0.92, 95% CI0.84–0.99). Concordance was associated with more internalizing/externalizing behaviors.ConclusionsParents under-report social victimization in relation to children. Concordance in reporting social victimization may be an indicator of the severity of experiences, underscoring the need to consider child reports when screening for adversity.     

Reactive and Proactive Aggression Differentially Predict Later Conduct Problems

This study tested whether proactive and reactive aggression were differently predictive of later externalizing problems such as delinquency and DSM-related disruptive behaviors (i.e. oppositional defiant and conduct disorders). It also tested whether these two subtypes of aggressive behaviors interacted in predicting externalizing problems. A community sample of low SES boys participated in the study. Proactive and reactive aggression were rated by teachers when boys were 12 years old. Delinquency, oppositional disorders, and conduct disorders were assessed during mid-adolescence. Proactive but not reactive aggression predicted delinquency and disruptive behaviors. Moreover, high levels of reactive aggression weakened the link between proactive aggression and delinquency. Reactive aggression, however, did not moderate the link between proactive aggression and disruptive behaviors. We conclude that reactive and proactive aggression are two distinct types of aggressive behaviors with different predictive abilities. We also offer tentative explanations to account for the present findings.     

Exposure to potentially traumatic events in early childhood: differential links to emergent psychopathology

Objective: To examine associations between exposure to potentially traumatic events (PTEs) and clinical patterns of symptoms and disorders in preschool children. Method: Two hundred and thirteen referred and non‐referred children, ages 24 to 48 months (MN = 34.9, SD = 6.7 months) were studied. Lifetime exposure to PTEs (family violence and non‐interpersonal events) and recent stressful life events were assessed with the Preschool Age Psychiatric Assessment (PAPA) and Child Life Events Scale. Child psychiatric symptoms and disorders were assessed with parent‐reports in the PAPA, a comprehensive, developmentally sensitive interview. Sociodemographic risk, parental anxiety and depressive symptoms (Center for Epidemiologic Studies Depression, Beck Anxiety Inventory), and child developmental level (Mullen Scales of Early Learning) also were assessed. Results: Violence exposure was broadly associated with psychiatric status in the areas of depression, separation anxiety, posttraumatic stress, and conduct problems, whereas potentially traumatic non‐interpersonal exposure was associated with phobic anxiety. The majority of the associations between violence exposure and preschoolers’ symptoms were significant even when other key factors, including economic disadvantage and parental mood and anxiety symptoms, were controlled statistically. However, parental depressive/anxious symptoms may have partially or fully mediated the relationships between violence exposure and depressive and conduct symptoms. Conclusions: Evidence of robust associations between violence exposure and early childhood internalizing and externalizing disorders and symptoms highlights the need for longitudinal prospective research concerning neurodevelopmental mechanisms and pathways. Findings underscore the relevance of assessing trauma exposure, particularly interpersonal violence, to identify young children at risk.     

Intimate partner violence during pregnancy and behavioral problems in children and adolescents: a meta-analysis

Objective

To evaluate the association of intimate partner violence during the gestational period and the development of externalizing and internalizing behavioral problems in children and adolescents.

Predictive power of peer behavioral assessment for subsequent maladjustment in community samples of disruptive and nondisruptive children

In a prospective, longitudinal study with community samples of disruptive and nondisruptive children, the predictive relations between peer-assessed dimensions of behavioral reputation in elementary school and teacher-rated behavioral adjustment and test scores of academic achievement were examined over a 4-year period. The Revised Class Play (RCP), a social role matching instrument completed by students about their classmates, was used to assess behavioral dimensions of children's peer reputation at baseline. Regression analyses showed that the RCP dimensions of aggressive-disruptive, sensitive-isolated, and social etiquette were the best predictors of later teacher-rated externalizing problems, internalizing problems, and subsequent adaptive skills respectively. Only IQ predicted later academic achievement. When IQ and disruptive/nondisruptive group status were added to each regression equation they further contributed as significant predictors. When parent and teacher ratings of behavior problems at baseline were entered jointly with RCP dimensions into regression equations, the peer dimensions further explained outcome variance. Additive effects of the RCP dimensions were found only for the externalizing problems outcome. Disruptive children with mild levels of aggressive behavior and high levels of sensitive-isolated behavior had less externalizing problems at outcome. A comparison of the difference between disruptive and nondisruptive groups in the relationship of baseline RCP scores to teacher outcomes showed no difference between groups, suggesting that the groups did not depart appreciably from their initial differences relative to each other over time.     

Preschool developmental pathways to preadolescent internalizing and externalizing problems

The present study investigated longitudinal pathways from specific early preschool behavioral problems (ages 2-3 years) to internalizing and externalizing problems in preadolescence (ages 10-11 years), and the role of social problems at school entry (ages 4-5 years) in such pathways. Path analyses were performed using both parent and teacher reports in a sample of 251 to 346 children from the general population, depending on the availability of parent and teacher data at each time of assessment. Structural equation modeling revealed homotypic internalizing and externalizing pathways, predictions from early preschool externalizing problems to later internalizing problems, and negative predictive paths from early internalizing problems to externalizing problems in preadolescence. Cross-informant predictions spanning 8 years were found between parent-reported aggression and overactivity at ages 2-3 years and teacher-reported externalizing problems at ages 10-11 years. Further, results showed that boys' pathways were more complex and showed greater predictive validity than pathways for girls, and that social problems at school entry played a significant role in pathways to internalizing problems, but only for boys. The results are discussed from a developmental psychopathology perspective.     

Psychiatric comorbidity in children and adolescents with reading disability

This study investigated the association between reading disability (RD) and internalizing and externalizing psychopathology in a large community sample of twins with (N = 209) and without RD (N = 192). The primary goals were to clarify the relation between RD and comorbid psychopathology, to test for gender differences in the behavioral correlates of RD, and to test if common familial influences contributed to the association between RD and other disorders. Results indicated that individuals with RD exhibited significantly higher rates of all internalizing and externalizing disorders than individuals without RD. However, logistic regression analyses indicated that RD was not significantly associated with symptoms of aggression, delinquency, oppositional defiant disorder, or conduct disorder after controlling for the significant relation between RD and ADHD. In contrast, relations between RD and symptoms of anxiety and depression remained significant even after controlling for comorbid ADHD, suggesting that internalizing difficulties may be specifically associated with RD. Analyses of gender differences indicated that the significant relation between RD and internalizing symptoms was largely restricted to girls, whereas the association between RD and externalizing psychopathology was stronger for boys. Finally, preliminary etiological analyses suggested that common familial factors predispose both probands with RD and their non-RD siblings to exhibit externalizing behaviors, whereas elevations of internalizing symptomatology are restricted to individuals with RD.     

Testing a maternal attachment model of behavior problems in early childhood

BACKGROUND: The purpose of the present study was to test a maternal attachment model of behavior problems in early childhood using phase I data from the NICHD Study of Early Child Care, a prospective study of 1,364 children from birth through sixth grade. METHODS: Mothers' and caregivers' ratings of children's internalizing and externalizing problems at age three were regressed separately on a set of fifteen predictors that included security and disorganization scores from 15, 24, and 36 months using hierarchical and logistical modeling. RESULTS: There were three main findings. First, Q-set mother-child attachment security, based on home observations at 24 months, provided the best evidence that attachment was associated with behavior problems, especially above-average levels of problems. Second, insecurity in the 36-month modified Strange Situation predicted mothers' and caregivers' ratings of internalizing problems for boys and girls as well as their ratings of externalizing problems for boys. Third, maternal depressive symptoms predicted mothers' ratings of internalizing and externalizing problems. CONCLUSIONS: There are meaningful associations between attachment insecurity and behavior problems as assessed not only by mothers but also by caregivers.     

Children who witness violence,and parent report of children's behavior

OBJECTIVES: To examine how much distress children report in response to violence that they have witnessed and how this is associated with parental reports of children's behavior. METHODS: As part of a study of in utero exposure to cocaine, children completed the Levonn interview for assessing children's symptoms of distress in response to witnessing violence. The children's caregivers completed the Exposure to Violence Interview (EVI), a caretaker-report measure of the child's exposure to violent events during the last 12 months. The EVI was analyzed as a 3-level variable: no exposure, low exposure, and high exposure. The caregivers also completed the Children's Behavior Checklist (CBCL). RESULTS: Of 94 six-year-old children, 58% had no exposure to violence, 36% had low exposure to violence, and 6% had high exposure to violence, according to caretaker reports. The children's median+/-SD Levonn score was 64 (SD +/- 19.3). The mean SD +/- CBCL total T-score was 53 (SD +/- 10.2). In multiple regression analyses with gender, low and high exposure on EVI, Levonn, and prenatal cocaine exposure status as predictors, the Levonn score explained 4.8% of total variance in children's CBCL internalizing scores, 9.1% of the total variance in CBCL externalizing score, and 12.2% of the total variance in CBCL total score (P =.04, P =.004, and P<.001, respectively). CONCLUSIONS: After accounting for the caretaker's report of the level of the child's exposure to violence, the child's own report significantly increased the amount of variance in predicting child behavior problems with the CBCL. These findings indicate that clinicians and researchers should elicit children's own accounts of exposure to violence in addition to the caretakers' when attempting to understand children's behavior.     

Witnessing violence among inner-city children of substance-abusing and non-substance-abusing women

OBJECTIVES: To determine if children of substance-abusing mothers witness more violence than children of non-substance-abusing (control) mothers, and to determine if children who witness violence have more behavioral problems and higher stress scores than children who do not witness violence. DESIGN: Cross-sectional research design comparing exposure to violence among children of substance-abusing mothers and control mothers of low socioeconomic status. SETTING: An inner-city pediatric clinic. PARTICIPANTS: Forty substance-abusing mothers and their children, and 40 non-substance-abusing mothers and their children, examined when the children were 6 years old. MAIN OUTCOME MEASURES: Maternal report of children's exposure to violence was assessed using the Exposure to Violence Interview and the Conflict Tactics Scale. Maternal report of children's behavior was assessed using the Child Behavior Checklist and the Children's Response to Stress Inventory. RESULTS: Children of substance-abusing mothers did not witness more violence than the control children (P>.05). However, 6-year-old inner-city children in the present study witnessed a high rate of violence: 43% had seen someone beaten up, 13% had seen someone threatened with a knife, and 7% had seen someone stabbed or shot. Children witnessing violence had significantly higher aggressive, delinquent, anxious/depressed, withdrawn, attention, and social problems (P<.05) on the Child Behavior Checklist, and higher stress scores (P =.05) on the Children's Response to Stress Inventory. CONCLUSIONS: More than half of the 6-year-old inner-city children in the present study witnessed some form of violence. Witnessing violence was associated with more behavioral problems and higher stress scores as assessed through maternal report. Subsequent research should examine the long-term effects of this exposure to violence among young children.     

Assessment of child problem behaviors by multiple informants: a longitudinal study from preschool to school entry

BACKGROUND: Children's early problem behavior that manifests in multiple contexts is often more serious and stable. The concurrent and predictive validity of ratings of externalizing and internalizing by four informants was examined at preschool and early school age in an at-risk sample. METHODS: Two hundred forty children were assessed by mothers and fathers (Child Behavior Checklist (CBCL)), and teachers and laboratory examiners (Teacher Report Form (TRF)) at ages 3 and 5 years. RESULTS: All informants' ratings of externalizing converged on a common factor at ages 3 and 5 that showed strong stability over time (beta = .80). All informants' age 3 externalizing ratings significantly predicted the problem factor at age 5; mothers', fathers', and teachers' ratings were independently predictive. Ratings of internalizing (except by examiners at age 3) also converged at both ages; the problem factor showed medium stability (beta = .39) over time. Only fathers' ratings of age 3 internalizing predicted the age 5 problem factor. CONCLUSIONS: Findings support the value of multi-informant assessment, uphold calls to include fathers in childhood research, and suggest that examiners provide valid, though non-unique assessment data. Examiner contributions may prove useful in many research contexts.     

Disability and victimization in a national sample of children and youth

Although past research has found higher rates of violence, crime, and abuse among children with disabilities, most studies combine diverse forms of disability into one measure and assess exposure to only one particular type of victimization. Based on a representative national sample of 4,046 children aged 2-17 from the 2008 National Survey of Children's Exposure to Violence, the present study examines the associations between several different types of disability and past-year exposure to multiple forms of child victimization. Results suggest that attention-deficit disorder/attention-deficit with hyperactivity disorder elevates the risk for peer victimization and property crime, internalizing psychological disorders increase risk for both child maltreatment and sexual victimization, and developmental/learning disorders heighten risk only for property crime. In contrast, physical disability did not increase the risk for any type of victimization once confounding factors and co-occurring disabilities were controlled. It appears that disabilities associated with interpersonal and behavioral difficulties are most strongly associated with victimization risks.     

Exposure to violence and its relationship to psychopathology in adolescents

OBJECTIVES: This study aimed to establish prevalence of adolescents' exposure to violence and related symptoms in the South African context and to explore relationships between exposure and symptoms. SETTING: Four high schools in Cape Town, South Africa. METHODS: Self report questionnaires were administered to 104 students. Types of violence explored included: witnessing or being a victim of violence perpetrated by someone known to the child or in the home and witnessing or being a victim of violence perpetrated by a stranger. The Harvard Trauma Scale, Beck Depression Inventory, and Zung Self-Rating Anxiety Scale were used to assess potentially related symptoms. RESULTS: The majority of children had been exposed to at least one type of violence, and exposure to the one type of violence was related to the other type. Symptoms of post-traumatic stress disorder and depression appear to be related to most types of exposure to violence, but anxiety symptoms only to exposure to violence perpetrated by someone known to the child or in the home. CONCLUSIONS: Rates of exposure to violence, and related symptoms, were unacceptably high. Symptoms were associated with exposure to violence.     

Somatic complaints in children and community violence exposure

Somatic complaints of children in primary care settings often go unexplained despite attempts to determine a cause. Recent research has linked violence exposure to stress symptomatology and associated somatic problems. Unknown, however, is whether specific physical symptom complaints can be attributed, at least in part, to violence exposure. Urban African-American 6- and 7-year-old children (N = 268), residing with their biological mothers, recruited before birth, and without prenatal exposure to hard illicit drugs participated. Children and mothers were evaluated in our hospital-based research laboratory, with teacher data collected by mail. Community violence exposure (Things I Have Seen and Heard), stress symptomatology (Levonn), and somatic complaints (teacher-and self-report items) were assessed. Additional data collected included prenatal alcohol exposure, socioeconomic status, domestic violence, maternal age, stress, somatic complaints and psychopathology, and child depression, abuse, and gender. Community violence witnessing and victimization were associated with stress symptoms (r = .26 and .25, respectively, p < .001); violence victimization was related to decreased appetite (r = .16, p < .01), difficulty sleeping (r = .21, p < .001), and stomachache complaints (r = .13, p < .05); witnessed violence was associated with difficulty sleeping (r = .13, p < .05) and headaches (r = .12, p < .05). All associations remained significant after control for confounding. Community violence exposure accounted for 10% of the variance in child stress symptoms, and children who had experienced community violence victimization had a 28% increased risk of appetite problems, a 94% increased risk of sleeping problems, a 57% increased risk of headaches, and a 174% increased risk of stomachaches. Results provide yet another possibility for clinicians to explore when treating these physical symptoms in children.     

Social-psychological correlates of peer victimization in children with endocrine disorders

OBJECTIVE: To examine the relation between victimization by peers and child and parent reports of social-psychological adjustment. STUDY DESIGN: The Social Experience Questionnaire, Children's Depression Inventory, Social Anxiety Scale for Children-Revised, and Asher Loneliness Scale were administered to 93 children diagnosed with various endocrine disorders. The child's parent/guardian completed the Child Behavior Checklist. RESULTS: For the entire sample, peer victimization was positively related to child-reported depression, social anxiety, loneliness, and parent-reported externalizing symptoms. Those children with endocrine disorders without observable features had a stronger relation between peer victimization and depression and internalizing and externalizing behavior problems than did those who had endocrine disorders with observable physical features. CONCLUSIONS: Recognition of the magnitude of the problem and means of evaluating for peer victimization is important for clinicians who see children with chronic diseases.     

Screening for childhood mental health problems: outcomes and early identification

Background: Many childhood psychiatric problems are transient. Consequently, screening procedures to accurately identify children with problems unlikely to remit and thus, in need of intervention, are of major public health concern. This study aimed to develop a universal school‐based screening procedure based on the answers to three questions: (1) What are the broad patterns of mental health problems from kindergarten to grade 5? (2) What are the grade 5 outcomes of these patterns? (3) How early in school can children likely to develop the most impairing patterns be identified accurately? Methods: Mothers and teachers reported on a community sample (N = 328) of children’s internalizing and externalizing symptoms in kindergarten and grades 1, 3, and 5. In grade 5, teachers reported on children’s school‐based functional impairments, physical health problems, and service use; mothers reported on children’s specialty mental health care. Results: Four patterns distinguished children who (1) never evidenced symptoms; (2) evidenced only isolated symptoms; or evidenced recurrent symptoms, either (3) without or (4) with comorbid internalizing and externalizing. By grade 5, children with recurrent comorbid symptoms had the greatest impairments, physical health problems, and service use. These children can be identified quite accurately by grade 1. Conclusions: Universal screening at school entry can effectively identify children likely to develop recurrent comorbid symptoms, and would provide a basis for developing optimal targeted intervention programs.     

Examination of a conceptual model of child neglect

This study attempted to provide empirical support for conceptual definitions of child neglect. We identified 12 types of needs, conceptualizing neglect as occurring when children's basic needs are not adequately met. We examined measures administered to 377 children and caregivers at ages 4 and 6 years participating in longitudinal studies on child mal-treatment to identify potential indicators of these needs. Indicators were found for latent constructs, operationalizing three of the basic needs (emotional support and/or affection, protection from family conflict and/or violence, and from community violence). These latent constructs were used in a measurement model; this supported the conceptual definitions of neglect. A structural equation model then assessed whether the latent constructs were associated with child adjustment at age 8 years. Low level of perceived support from mother was associated with internalizing and externalizing behavior problems. Exposure to family conflict was also linked to these problems, and to social difficulties. Finally, children's sense of experiencing little early affection was associated with subsequent externalizing behavior and social problems. The approach of conceptualizing neglect in terms of unmet child needs, developing a measurement model to define latent neglect constructs, and relating these constructs to subsequent adjustment can build our understanding of neglect.