Bullying, depression, and suicidality in adolescents

OBJECTIVE: To assess the association between bullying behavior and depression, suicidal ideation, and suicide attempts among adolescents. METHOD: A self-report survey was completed by 9th- through 12th-grade students (n = 2342) in six New York State high schools from 2002 through 2004. Regression analyses were conducted to examine the association between being victimized and bullying others with depression, ideation, and attempts. RESULTS: Approximately 9% of the sample reported being victimized frequently, and 13% reported bullying others frequently. Frequent exposure to victimization or bullying others was related to high risks of depression, ideation, and suicide attempts compared with adolescents not involved in bullying behavior. Infrequent involvement in bullying behavior also was related to increased risk of depression and suicidality, particularly among girls. The findings indicate that both victims and bullies are at high risk and that the most troubled adolescents are those who are both victims and bullies. Psychopathology was associated with bullying behavior both in and away from school. CONCLUSIONS: Victimization and bullying are potential risk factors for adolescent depression and suicidality. In evaluations of students involved in bullying behavior, it is important to assess depression and suicidality.     

Psychotic experiences in the context of depression: The cumulative role of victimization

Previous studies have reported an association between depression and psychotic experiences, but little is known about what drives this co-occurrence. This study tests the hypothesis that exposure to trauma and bullying may strengthen the relation between depression and psychotic experiences. A total of 799 college students completed self-report questionnaires on psychotic experiences, depression, bullying, and sexual trauma. Hierarchical linear regression analyses were conducted to test the direct relationship between depression and psychotic experiences, as well as interactions. Approximately 20% of respondents reported a history of being bullied, and 7% reported exposure to childhood sexual trauma. There was a significant direct relationship between depression and psychotic experiences. The association between depression and psychotic experiences was significantly stronger among respondents who were victims of both bullying and sexual violence compared to those who experienced either exposure alone, or who were not exposed to either form of victimization. These findings suggest that cumulative exposure to trauma and victimization may contribute to the co-occurrence of depression and psychotic experiences. History of victimization should be assessed among individuals with depressive symptoms to improve treatment plans and outcomes.     

Predictors of Bullying among 10 to 11 Year Old School Students in Australia

Cross-sectional data collected at baseline from the Grade 6 cohort of the Friendly Schools, Friendly Families Project (n = 1,257) were analysed to investigate differences in self-reported attitudes and behaviours of students who reported bullying regularly and occasionally compared with those who reported never bullying others. This study found some similarities and some differences between students who reported bullying regularly and those who reported bullying occasionally, supporting the need to consider both groups when developing school-based bullying interventions. Attitudes to bullying, social and emotional health, peer support and being bullied were predictors of both regular and occasional bullying. The findings of this study support the need for universal bullying prevention interventions targeting the whole school community, including specific selective and indicated strategies, to effect a change in bullying behaviours.     

School bullying,cyberbullying, or both: Correlates of teen suicidality in the 2011 CDC youth risk behavior survey

While school bullying has been shown to be associated with depression and suicidality among teens, the relationship between these outcomes and cyberbullying has not been studied in nationally representative samples. Data came from the 2011 CDC Youth Risk Behavior Survey (YRBS), a nationally representative sample of high-school students (N = 15,425). We calculated weighted estimates representative of all students in grades 9–12 attending school in the US. Logistic regression was used to calculate adjusted odds ratios. Overall, girls are more likely to be report being bullied (31.3% vs. 22.9%), in particularly to be cyberbullied (22.0% vs. 10.8%), while boys are only more likely to report exclusive school bullying (12.2% vs. 9.2%). Reports of 2-week sadness and all suicidality items were highest among teens reporting both forms of bullying, followed by those reporting cyberbullying only, followed by those reporting school bullying only. For example, among those reporting not being bullied 4.6% reported having made a suicide attempt, compared to 9.5% of those reporting school bullying only (adjusted odd ratio (AOR) 2.3, 95% C.I. 1.8-2.9), 14.7% of those reporting cyberbullying only (AOR 3.5 (2.6-4.7)), and 21.1% of those reporting victimization of both types of bullying (AOR 5.6 (4.4-7)). Bullying victimization, in school, cyber, or both, is associated with higher risk of sadness and suicidality among teens. Interventions to prevent school bullying as well as cyberbullying are needed. When caring for teens reporting being bullied, either at school or in cyberbullying, it’s important to screen for depression and suicidality.     

Types and experiences of bullying in adolescents with an autism spectrum disorder

Being victimized by one's peers is a major problem in adolescence, and research has suggested that individuals with autism spectrum disorders (ASD) may experience higher rates of bullying than their typically-developing (TD) peers. However, it is currently unclear whether adolescents with ASD are victimized more by their peers simply because they are ‘different’. This study was designed to examine percentage rates across different types of bullying behaviour in adolescents with an ASD (n = 24), in comparison to a group of special-needs adolescents without an ASD (n = 22), and a group of typically developing peers (n = 24), to determine whether simply being ‘different’ leads to higher rates of victimization. We also examined the agreement between parental and self-reports of bullying behaviour experienced by these groups. Overall, more adolescents with ASD reported victimization than adolescents in the other two groups. In addition, those with ASD reported more social bullying in comparison to the other two groups and more physical bullying than the TD group. No difference was found between parental and self-reports for the bullying experienced by the adolescents with ASD or special needs; however, TD adolescents reported higher levels of victimization than their parents reported for them. Contributing factors for the victimization experienced by adolescents with an ASD are discussed.     

Bullying and people with severe intellectual disability

Although bullying has been shown to reduce quality of life in many spheres, anti‐bullying strategies have yet to be incorporated into services for adults with severe intellectual disability (ID). The present study employed a survey of staff and parent concerns about 54 previously surveyed students who had left a school for pupils with severe ID. A content analysis of follow‐up interviews was performed in 10 cases. Staff identified 19% of the survey sample as bullying others and 11% as being picked on. Neither gender nor communication ability had an impact. There was no significant change in bully or victim status over time, although some people did change. Parents or staff raised bully/victim problems in more than half of the interviews. There is sufficient evidence of bullying behaviour to warrant the adoption of anti‐bullying strategies.     

The relation between bullying, victimization, and adolescents' level of hopelessness

In this study, 419 Turkish middle school students (203 girls, 216 boys) were surveyed on their exposure to and engagement in bullying, and their level of hopelessness. Our findings suggest that girls were victims of indirect (e.g. gossiping) bullying more than boys. Boys reported being victims of physical (e.g. damaging property) and verbal (e.g. teasing) bullying more than girls. While the level of hopelessness among victims of physical and verbal bullying was higher than non-victims, no difference was found between the victims of indirect bullying and non-victims. Students who never talked to their teachers and parents about bullying reported higher levels of hopelessness than others. The implications of the study for intervention and prevention programs are discussed.     

Victimization by traditional bullying and cyberbullying and the combination of these among adolescents in 13 European and Asian countries

There has been a lack of studies on bullying in non-western low-income and middle-income countries. This study reported the prevalence of traditional victimization, cybervictimization, and the combination of these, in 13 European and Asian countries, and explored how psychiatric symptoms were associated with victimization. The data for this cross-sectional, school-based study of 21,688 adolescents aged 13–15 were collected from 2011 to 2017. The main outcomes were traditional and cybervictimization obtained from student self-reports. The Strengths and Difficulties Questionnaire was used to assess psychiatric symptoms. Generalized estimating equation and logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). The mean prevalence of any victimization was 28.9%, of traditional victimization only, this was 17.7%, and for cybervictimization only this was 5.1%. Cybervictimization occurred both independently, and in combination with, traditional victimization. The mean prevalence of combined victimization was 6.1%. The mean proportion of those who were cyberbullied only among those who were either cyberbullied only or bullied both traditionally and in cyber was 45.1%. The rates of prevalence varied widely between countries. In the total sample, those who experienced combined victimization, reported the highest internalizing symptoms (girls, OR 1.25, 95% CI 1.22–1.29; boys, OR 1.29, 95% CI 1.25–1.33). The study findings suggest that anti-bullying interventions should include mental health components and target both traditional and cyberbullying. Due to the overlap between these, targeting bullying should primarily focus on how to reduce bullying behavior rather than just focusing on where bullying takes place.

     

Bullying in school and cyberspace: Associations with depressive symptoms in Swiss and Australian adolescents

Background  

Cyber-bullying (i.e., bullying via electronic means) has emerged as a new form of bullying that presents unique challenges to those victimised. Recent studies have demonstrated that there is a significant conceptual and practical overlap between both types of bullying such that most young people who are cyber-bullied also tend to be bullied by more traditional methods. Despite the overlap between traditional and cyber forms of bullying, it remains unclear if being a victim of cyber-bullying has the same negative consequences as being a victim of traditional bullying.     

Traditional Victims and Cybervictims: Prevalence,Overlap, and Association with Mental Health Among Adolescents in Singapore

Traditional bullying typically occurs in schools and has been associated with a myriad of mental health problems. Recent evidence has indicated that cyberbullying may just be traditional bullying that is extended to the online world, but this possibility has received only limited study in Asian countries. This study explored the co-occurrence of traditional and cybervictimization and its association with mental health among 3319 adolescents aged 12 to 17 years in Singapore. Victims of bullying were categorized into mutually exclusive groups: traditional-only victims, cyber-only victims, or combined traditional and cybervictims. Results indicated that there were substantial overlaps between victimization in traditional bullying and cyberbullying and that traditional victimization was more prevalent than cybervictimization. Being a victim of either form of bullying (i.e., traditional-only or cyber-only victims) was associated with higher reports of internalizing and externalizing problems, and combined traditional and cybervictims reported the most internalizing problems. However, there were no significant differences in problem scores between traditional-only victims and cyber-only victims. The findings highlight the need to consider the extensive overlap between traditional and cybervictimization when investigating their differential association with adolescents’ mental health. Prevention and intervention efforts by school staff and mental health practitioners need to target both traditional bullying and cyberbullying in an integrated manner, and extra attention should be provided to adolescents who are victims of both forms of bullying.     

Global and physical self-esteem and body dissatisfaction as mediators of the relationship between weight status and being a victim of bullying

Research has found evidence of a link between being overweight or obese and bullying/peer victimisation, and also between obesity and adjustment problems such as low self-esteem and body dissatisfaction. Studies have also found that adjustment problems can put children at an increased risk of being bullied over time. However, to date the factors that place overweight or obese children at risk of being bullied have been poorly elucidated. Self-report data were collected from a sample of 11–14 year olds (N = 376) about their weight status, about their experiences of three different types of bullying (Verbal, Physical and Social), their global self-worth, self-esteem for physical appearance, and body dissatisfaction. Overweight or obese children reported experiencing significantly more verbal and physical (but not social) bullying than their non-overweight peers. Global self-worth, self-esteem for physical appearance and body dissatisfaction each fully mediated the paths between weight status and being a victim of bullying.     

Attempted suicide and associated risk factors among youth in urban Japan

BACKGROUND: Suicide is a major social and health issue in Japan. We assessed prevalence of attempted suicide and explored individual, interpersonal, behavioral, and psychological risk factors associated with attempted suicide in a general community sample of youth in a metropolitan Japanese city. METHOD: Survey of 2,095 participants age between 15 and 24 who were recruited using street-intercept techniques. RESULTS: Overall, 6% of males and 11% of females reported a prior suicide attempt. For males, attempted suicide was independently associated with experience of school bullying, being homosexual or bisexual, history of drug use, experience of unwanted sex, history of a diagnosed sexually transmitted infection, and low self-esteem. For females, attempted suicide was independently associated with being younger (ages 15-19 compared to 20-24), experience of school bullying, history of drug use, and history of smoking. CONCLUSION: Prevention intervention programs for youth in Japan are necessary to achieve national aims to reduce attempted suicides and suicide mortality.     

Victims and bully-victims but not bullies are groups associated with anxiety symptomatology among Brazilian children and adolescents

School bullying is frequent and is associated with a broad spectrum of psychiatric problems. The aims of this study were to examine the prevalence of bullying behaviors in a large sample of Brazilian children and adolescents and to investigate the association between bullying behaviors and DSM-IV anxiety symptomatology. This cross-sectional study involved completion of a questionnaire about bullying behaviors and their frequency and the Screen for Child Anxiety-Related Emotional Disorders (SCARED) that is a self-report screening tool for childhood anxiety disorders by 2,355 students. A total of 22.9 % of the sample reported frequent involvement in bullying, as a bully (7.6 %), as a victim (5.7 %), or as a bully-victim (9.6 %). In general, our findings showed that students involved in bullying behaviors, as victims or bully-victims, were more likely to have higher scores in SCARED total and its subscales than bullies and than uninvolved students. The prevalence of bullying behaviors among Brazilian youth is about average when compared with previous samples described in the literature. Victims and bully-victims, but no bullies, are groups associated with higher anxiety symptomatology.     

Self-reported needs among older persons with intellectual disabilities in an Irish community-based service

Current research indicates that older persons with intellectual disabilities (ID) are a growing population with very specific needs. There are few existing studies that identify and characterise these needs. This study aimed to assess the health and social care needs of a group of older persons with ID in a community-based service in Ireland. The Camberwell Assessment of Need for Adults with Intellectual Disabilities-Short form (CANDID-S) was used to identify the health and social needs of 75 older persons with ID in a community-based service who were over the age of 50. The mean age of the sample was 57.6 years (SD = 5.4, range 50–72) and 37.3% had mild ID, 46.7% had moderate ID and 16% had severe or profound ID. The most common ‘unmet needs’ reported were basic education and money budgeting (the ability to independently manage one's own finances). The top-rated ‘met needs’ were food and daytime activities. Participants with severe or profound ID reported significantly more ‘unmet needs’ than those with mild or moderate ID. The current study identified education and financial skills as unmet needs for older persons with ID, implying that continuing lifelong learning programmes might be a valuable and appropriate addition to service provision and retirement options. Further research should be carried out to inform a comprehensive evidence base of the health and social care needs of this group.     

Predictors of insomnia onset in adolescents in Japan

ObjectiveThe objective of this study was to clarify the incidence rate and predictive factors of insomnia in Japanese junior and senior high school students.MethodsWe conducted a baseline survey on first year junior and senior high school students (seventh and 10th graders) throughout the nation. A follow-up survey was then conducted two years later. For both surveys, we used self-administered questionnaires inquiring about sleep, mental health status, lifestyle, participation in club activities, and study hours.ResultsA total of 3473 students (776 junior high and 2697 senior high) were suitable for analysis. During the two years leading to the follow-up study, the incidence rate of newly developed insomnia was 7.8% among junior high and 9.2% among senior high school students. Multiple logistic regression analyses revealed that factors associated with new insomnia onset were ‘sleep paralysis experience’ and ‘poor mental health status’ in junior high school students, and ‘being woken by a nightmare’, ‘poor mental health status’, ‘≥2 h of extracurricular learning per day’ and ‘mobile phone use for ≥2 h per day’ in senior high school students.ConclusionsIn junior and senior high school students, parasomnias such as nightmares and sleep paralysis, and mental health status can be predictors of insomnia onset. For senior high school students, longer use of mobile phones can be a predictor of insomnia onset. The present findings suggest that sleep health must be promoted among junior and senior high school students in the future.     

Diffuse Lewy body disease

Diffuse Lewy body disease (DLBD) has been studied from various viewpoints and, although clinical diagnostic criteria for DLBD have been proposed, diagnosis remains difficult. DLBD has been reported to be the second most common form of dementia in the aged, following Alzheimer‐type dementia. It has, however, been clinically under‐diagnosed. Therefore, the search for diagnostic markers for DLBD must continue. Very recently, ‘dementia with Lewy bodies’ (DLB) was proposed as a generic term for various forms of dementia with Lewy bodies, including DLBD and similar disorders. Cortical Lewy bodies are the most important pathologic marker for diagnosis of DLBD. At present, however, the mechanism responsible for cortical Lewy body formation has yet to be disclosed.     

Attention to body mass index by child psychiatry providers when prescribing second-generation antipsychotic medication to children: a survey study using a clinical vignette

Aim: We sought to determine whether weight and body mass index measurement were taken into consideration when prescribing second‐generation antipsychotic (SGA) medication to a child. Methods: Two hundred clinicians were surveyed using a hypothetical clinical case vignette at a child psychopharmacology, postgraduate medical education course. The vignette described an overweight 10‐year‐old boy who was about to be prescribed an SGA medication to control psychotic symptoms. The reference to the patient's being ‘overweight’ was purposefully included to determine if providers would assess the patient's risk of morbidity from the metabolic side effects of the SGAs at the time of prescribing. Results: Only 7.0% of prescribers listed either ‘body mass index’ or a combination of ‘height’ and ‘weight’ as part of their next treatment steps for an overweight child before prescribing an SGA. Conclusions: These results suggest the need for education as to the importance of body mass index monitoring when prescribing second‐generation antipsychotic medications to children.     

Symptoms of ADHD and depression in a large adolescent population: Co-occurring symptoms and associations to experiences of sexual abuse

Background: Symptoms of either attention-deficit hyperactivity disorder (ADHD) or depression constitute the most common reasons for contact with child and adolescent psychiatry. The development of psychiatric symptoms can be explained by a combination of environmental stress events and genetic vulnerability. One common form of environmental stress with high impact on health is sexual abuse. Aims: To investigate the prevalence and co-occurrence of symptoms of ADHD and depression in relation to experiences of sexual abuse in a large adolescent general population. Method: All 15- and 18-year-old students (n = 4910) in the Swedish county of Vestmanland answered a school-based screening instrument including the six-question ADHD self-rating scale (ASRS), the Depression Self-Rating Scale (DSRS) and questions relating to experiences of sexual abuse. Results: The prevalence of co-occurring symptoms of ADHD and depression was 2.4% (boys 1.0%, girls 3.9%). The prevalence of experience of any sexual abuse was 20.9% (boys 13.3%, girls 28.7%). Of those with co-occurring symptoms, 48% of the boys and 47% of the girls reported a history of sexual abuse. Conclusions: School-based screening for co-occurring symptoms of ADHD and depression might be a method that identifies students at psychiatric and psychosocial risk.     

Stopped,Delayed or Discouraged: What Are the Barriers for Adolescents Fully Engaging in the Mental Health System?

The aim of this study is to identify factors that stopped, discouraged or delayed mental health help-seeking in adolescents. An Online survey of 113 adolescents aged 14–18 years old, living in Perth, Western Australia, was conducted. For participants who had not yet accessed a mental health service, the top barrier was ‘Having no-one who could help me get professional care’ (62%). For participants who had previously accessed a mental health service, the top barrier was ‘Previous experiences with a mental health service were not helpful’ (63%). Major reported barriers in this population included financial costs, negative past experiences and having no one to help access professional care.