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Cyber and Traditional Bullying Victimization as a RiskFactor for Mental Health Problems and Suicidal Ideationin AdolescentsRienke Bannink1, Suzanne Broeren1, Petra M. van de Looij – Jansen2, Frouwkje G. de Waart2, Hein Raat1*1 Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands, 2 Municipal Public Health Service Rotterdam area, Rotterdam,the NetherlandsAbstractPurpose: To examine whether traditional and cyber bullying victimization were associated with adolescent’s mental healthproblems and suicidal ideation at two-year follow-up. Gender differences were explored to determine whether bullyingaffects boys and girls differently.Methods: A two-year longitudinal study was conducted among first-year secondary school students (N = 3181). Traditionaland cyber bullying victimization were assessed at baseline, whereas mental health status and suicidal ideation wereassessed at baseline and follow-up by means of self-report questionnaires. Logistic regression analyses were conducted toassess associations between these variables while controlling for baseline problems. Additionally, we tested whether genderdifferences in mental health and suicidal ideation were present for the two types of bullying.Results: There was a significant interaction between gender and traditional bullying victimization and between gender andcyber bullying victimization on mental health problems. Among boys, traditional and cyber bullying victimization were notrelated to mental health problems after controlling for baseline mental health. Among girls, both traditional and cyberbullying victimization were associated with mental health problems after controlling for baseline mental health. Nosignificant interaction between gender and traditional or cyber bullying victimization on suicidal ideation was found.Traditional bullying victimization was associated with suicidal ideation, whereas cyber bullying victimization was notassociated with suicidal ideation after controlling for baseline suicidal ideation.Conclusions: Traditional bullying victimization is associated with an increased risk of suicidal ideation, whereas traditional,as well as cyber bullying victimization is associated with an increased risk of mental health problems among girls. Thesefindings stress the importance of programs aimed at reducing bullying behavior, especially because early-onset mentalhealth problems may pose a risk for the development of psychiatric disorders in adulthood.Citation: Bannink R, Broeren S, van de Looij – Jansen PM, de Waart FG, Raat H (2014) Cyber and Traditional Bullying Victimization as a Risk Factor for MentalHealth Problems and Suicidal Ideation in Adolescents. PLoS ONE 9(4): e94026. doi:10.1371/journal.pone.0094026Editor: Yinglin Xia, University of Rochester, United States of AmericaReceived October 1, 2013; Accepted March 9, 2014; Published April 9, 2014Copyright: 2014 Bannink et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permitsunrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Funding: The publication of this study was supported by the Netherlands Organization for Scientific Research (NWO). This funder had no role in study design,data collection and analysis, decision to publish, or preparation of the manuscript.Competing Interests: The authors have declared that no competing interests exist.
E-mail: h.raat@erasmusmc.nlIntroductionRecent studies indicate that approximately 20–35% of adolescents report involvement in traditional, offline bullying either as abully, a victim or both [1]. Bullying can be defined as an aggressiveact that is carried out by a group or an individual repeatedly andover time against a victim who cannot easily defend himself orherself [2]. Traditionally, four main types of bullying aredistinguished: physical (e.g., assault), verbal (e.g., threats),relational (e.g., social exclusion) and indirect (e.g., spreadingrumors) [3]. With the increased use of Internet and mobile phones,a new form of bullying has emerged, often labeled ‘cyber bullying’[3–5]. In cyber bullying, aggression occurs via electronic forms ofcontact [6].Increased exposure to the online environment has contributedto a heightened appreciation of the potential negative impact ofcyber bullying [7]. Recent cross-sectional studies have shown anassociation between cyber bullying victimization and mentalhealth problems, and even between cyber bullying victimizationand suicide [4,6,8,9]. Despite evidence from these cross-sectionalstudies, little is known with regard to the longitudinal impact ofcyber bullying. To the best of our knowledge, only SchultzeKrumbholz et al. studied the longitudinal association betweencyber bullying victimization and mental health problems in arelatively small sample (N = 233). They only showed a significantassociation between cyber bullying victimization and mentalhealth problems in girls, not in boys [10].The few available longitudinal studies examining the relationship between traditional bullying and mental health problems orsuicide (ideation) show that being a victim of traditional bullyingincreases the risk of developing mental health problems andcommitting suicide later in life [6,11–16]. However, longitudinalPLOS ONE | www.plosone.org 1 April 2014 | Volume 9 | Issue 4 | e94026studies examining the associations between traditional bullyingvictimization and mental health problems or suicide (ideation)within large samples are still rare and further research isrecommended [6].Therefore, it is of interest to examine the longitudinalassociations between traditional bullying and mental health andsuicide (ideation), as well as the longitudinal associations betweencyber bullying and mental health and suicide (ideation) in a largesample. The impact of traditional bullying victimization on mentalhealth and suicide may be different than the impact ofcyberbullying victimization on mental health. It is possible that forexample blocking online bullying messages, an option notavailable for face-to-face bullying, lessens the impact of cyberbullying on mental health while, in contrast, the possible breadthof audience on for instance websites may heighten the impact [3].Furthermore, the impact of bullying victimization on boys maydiffer from the impact on girls. Few longitudinal studies haveexamined gender differences in victimization and mental health.These longitudinal studies indicate that both genders may havedifferent risk profiles [6,17–21], with girls who are victimized atbaseline developing symptoms of depression or suicidal ideation atfollow-up [10,17,20,21] and boys not [10,18–23].The purpose of the current study was to examine whethertraditional and cyber bullying victimization were associated withmental health problems and suicidal ideation at two-year followup (when controlling for mental health problems or suicidalideation at baseline) in a large sample of adolescents. In line withprevious findings [6,17–23], we hypothesize that being a victim oftraditional bullying is associated with mental health problems andsuicidal ideation at two-year follow-up. In line with cross-sectionalstudies on cyber bullying victimization [4,6,8,9], we hypothesizethat cyber bullying victimization is associated with mental healthproblems and suicidal ideation at two year follow-up. Additionally,we explored whether bullying affects boys and girls in a differentway, as previously suggested [6,17–21].MethodsDesign and participantsA prospective study with two-year follow-up was conducted aspart of the Rotterdam Youth Monitor (RYM), a longitudinalyouth health surveillance system. The RYM monitors the generalhealth, well-being, behavior and related factors of youth aged 0 to19 years living in Rotterdam and the surrounding region in theNetherlands. The RYM is incorporated in the care (regular healthexaminations) of the preventive youth healthcare system; the RYMis used to detect (potential) individual health risks and problems inorder to take the necessary preventive measures (includingreferrals for treatment).The current study used RYM data from students at secondaryschools. At baseline, the students were in their first year ofsecondary education (Mage= 12.50 years, SD= 0.62), and atfollow-up in their third year (Mage= 14.31 years, SD = 0.58). Datawere collected throughout the school year, except for July andAugust (Dutch summer holidays). The students completed abaseline questionnaire between September 2008 and July 2009and a follow-up questionnaire between September 2010 and July
Administration of the questionnaire took place at schoolsand was conducted by specially trained researchers and schoolnurses from the Municipal Public Health Service and/or by ateacher. In 2008–2009, 8,272 adolescents participated (95%participation rate), of whom 3,181 participated again in 2010–2011 (38%). The main reason for non-response (62%) at follow-upwas schools being unwilling to participate again, which led to 49%of adolescents not being invited to participate at follow-up. Otherreasons were: students were absent at the time of administering thefollow-up questionnaire (about 5%), students had transferred to aschool that did not participate at follow-up or students hadrepeated a school year (about 8%).Ethics statementThe data became available in the context of the governmentapproved routine health examinations of the preventive youthhealth care. Separate informed consent was therefore notrequested. Only anonymous data were used and the questionnaires were completed on a voluntary basis. Adolescents receivedverbal information about these questionnaires each time they wereapplied, whereas their parents received written information atevery assessment point. Adolescents and their parents were free torefuse participation. Observational research with data does not fallwithin the ambit of the Dutch Act on research involving humansubjects and does not require the approval of an ethics reviewboard. As the data was provided anonymously tothe researchers,the study is not covered by the WMA Declaration of Helsinki.MeasuresBullying victimization. At baseline, two questions assessedwhether the adolescent had been bullied in the past four week: 1)at school, and/or 2) via the Internet or via their telephone viaShort Message Service (SMS). The response categories were: Never,Once or twice, Once a week, Several times a week, and Daily. For analysispurposes, being a victim of bullying at school (traditional victim),and being a victim on the Internet or via SMS (cyber victim) weredichotomized into the following categories: Never being victimizedand Being victimized at least once or twice.Mental health problems. At baseline and follow-up, mentalhealth was assessed by the Dutch self-report version of theStrengths and Difficulties Questionnaire (SDQ) [24,25]. The SDQconsists of 25 items describing positive and negative attributes ofadolescents that can be divided into five subscales (five items each),i.e. emotional problems, conduct problems, hyperactivity-inattention, peer problems, and prosocial behavior. Each item is scoredon a 3-point scale, with 0 = ‘not true’, 1 = ‘somewhat true’, and 2 =‘certainly true’. A total difficulties score is calculated by summing thescores on the emotional problems, conduct problems, hyperactivity-inattention and peer problems subscales (range 0–40; currentstudy a= 0.74).In line with other authors who divided their sample intosubgroups (normal versus borderline/abnormal) based on questionnaire scores [13,17,19–23], we created two ‘mental health’groups: normal (cut-off point SDQ total score at follow-up #80thpercentile; score #13) and borderline/abnormal mental healthproblems (cut-off point SDQ total score at follow-up .80thpercentile; score $14) [26]. These cut-off points were based on alarge national survey in the Netherlands among 14–15 year-oldadolescents [27].Suicidal ideation. Suicidal ideation during the past 12months was examined with one question at baseline and followup: ‘In the past 12 months, have you ever seriously consideredending your life?’. This item was scored on a 5-point scale: Never,Once in a while, Sometimes, Often and Very often. For analysis purposes,suicidal ideation was dichotomized in: Never had suicidal ideationover the last year; versus Had suicidal ideation at least once in awhile over the last year.Confounders. Age, gender, ethnicity, and level of educationof the adolescent were measured at baseline and were incorporated as potential confounders in this study. Age was dichotomizedinto Below 13 years versus 13 years or older. Education wasBeing Bullied, Mental Health and Suicidal IdeationPLOS ONE | www.plosone.org 2 April 2014 | Volume 9 | Issue 4 | e94026dichotomized into Basic or theoretical pre-vocational educationversus, General secondary/pre-university education [28]. Ethnicity was classified as Dutch or non-Dutch in accordance with thedefinition of Statistics Netherlands [29]; i.e., adolescents with atleast one parent born outside the Netherlands were classified asnon-Dutch.Statistical analysesAll analyses were conducted using the total sample. Descriptivestatistics were used to describe general characteristics of the studypopulation. Differences in age, ethnicity, educational level,bullying victimization, mental health problems, and suicidalideation between boys and girls were evaluated using chi-squaretests. A chi-square test was also conducted to assess the associationbetween traditional and cyber bullying victimization.Furthermore, binary logistic regression analyses were used toassess the association between bullying victimization and mentalhealth status or suicidal ideation at follow-up. Model 1 tested theassociation between traditional or cyber bullying victimization andmental health status or suicidal ideation at follow-up, adjusting forconfounders (i.e., gender, age, ethnicity, and education) and theother type of bullying victimization. Model 2 also adjusted forbaseline mental health status or suicidal ideation. Model 2corresponds with the purpose of the study to examine the twoyear longitudinal association between bullying victimization andmental health status or suicidal ideation, while controlling formental health problems or suicidal ideation at baseline. Inaddition, we tested whether there were gender differences onmental health and suicidal ideation for the two types of bullying byrespectively adding a Gender 6Traditional bullying victimization(Model 3a) or a Gender6Cyber bullying victimization (Model 3b)interaction term to Model 2. If there was a significant Gender 6Bullying victimization interaction, the results were describedseparately for boys and girls. Finally, we explored whether therewere significant interactions between traditional and cyberbullying victimization on mental health and suicidal ideation.Odds ratios (OR) and their corresponding 95% confidenceintervals (95% CI) were calculated.Analyses were conducted using SPSS version 20. Results wereconsidered significant at p,0.05, with the exception of interactionswhich were considered significant at p,0.10, in line withrecommendations of Twisk [30].ResultsNon-response analysisDifferences between the boys/girls included in this study(N = 3181) and the boys/girls who did not participate in thefollow-up assessment (N = 5091) were examined using chi-squaretests (Table 1). Chi-square tests did not yield significant agedifferences between adolescents who participated at follow-up andwho were lost-to-follow-up. However, group differences werefound for education, ethnicity, mental health problems, suicidalideation, and bullying victimization, with the lost–to-follow-upgroup having a lower education level, more often being of Dutchethnicity, having more mental health problems, more suicidalideation, and more often being a traditional and cyber bullyingvictim (only for girls) than the adolescents who participated atfollow-up.DescriptivesMean age of adolescents in the current sample was 12.47 years(SD = 0.62); 51.0% of the sample consisted of boys and 48.4% wasof Dutch ethnicity (Table 2). In total, 21.4% of the adolescents wasa victim of traditional bullying and 5.1% was a victim of cyberbullying. No significant gender differences were found on bullyingvictimization (p= 0.10). Compared with boys, girls had significantly more mental health problems at follow-up (x2= 10.04;p,0.002) and suicidal ideation at baseline (x2= 52.42; p,0.001)and at follow-up (x2= 58.69; p,0.001). Furthermore, cyberbullying victims were more likely to also be traditional bullyingvictims compared to non-cyber bullying victims (boys: x2= 60.38;p,0.001; girls: x2= 29.21; p,0.001).Bullying victimization and mental health problemsThere was a significant interaction between gender andtraditional bullying victimization (p= 0.08) (Model 3a) in the totalsample (Table 3). Among boys, traditional bullying victimizationwas not significantly related to mental health problems in the fullyadjusted model (OR 1.03; 95% CI 0.72–1.47). Among girls,traditional bullying victimization was significantly related tomental health problems in the fully-adjusted model (OR 1.41;95% CI 1.02–1.96).There was a significant interaction between gender and cyberbullying victimization (p= 0.04) (Model 3b). Being a victim ofcyber bullying was not related to mental health problems amongboys (OR 1.18; 95% CI 0.64–2.17), whereas among girls, cyberbullying victimization was significantly related to mental healthproblems after controlling for baseline mental health (OR 2.38;95% CI 1.45–3.91).No significant interaction was found between traditional andcyber bullying victimization on mental health.Bullying victimization and suicidal ideationNo significant interaction was found between gender andtraditional bullying victimization (p= 0.20) (Model 3a) andbetween gender and cyber bullying victimization (p= 0.48) (Model3b) (Table 4). In the total sample, traditional bullying victimizationwas significantly related to suicidal ideation in the fully-adjustedmodel (Model 2: OR 1.56; 95% CI 1.21–2.02). Cyber bullyingvictimization was not associated with suicidal ideation aftercontrolling for baseline suicidal ideation (Model 2: OR 1.22;95% CI 0.80–1.87).A significant interaction was found between traditional andcyber bullying victimization on suicidal ideation (p= 0.01). Followup logistic regression analysis revealed that there was no furtherincreased risk of developing suicidal ideation for adolescents beinga victim of both types of bullying compared to adolescents beingsolely a victim of cyber (OR 1.35; 95% CI 0.86–2.12) ortraditional bullying (OR 1.13; 95% CI 0.91–1.41).DiscussionThis study shows that both traditional and cyber bullyingvictimization were associated with mental health problems in girlsbut not in boys, after controlling for baseline problems. Onlytraditional bullying victimization was associated with suicidalideation after controlling for baseline suicidal ideation.As hypothesized, but only among girls, traditional bullyingvictimization was associated with mental health problems aftercontrolling for baseline mental health. This difference betweenboys and girls in the long-term effects of traditional bullyingvictimization on mental health is supported by various previousstudies [6,17–21]. The current study extends these findings tocyber bullying victimization, as we too found that the associationbetween cyber bullying victimization and mental health problemswas particularly driven by girls.Being Bullied, Mental Health and Suicidal IdeationPLOS ONE | www.plosone.org 3 April 2014 | Volume 9 | Issue 4 | e94026The gender differences in the impact of bullying on mentalhealth found in our study may be partly explained by differences inthe types of bullying (e.g. physical, relational) to which girls andboys are exposed. Regarding to traditional bullying, previousstudies have found that girls more often experience relationalvictimization and that relational victimization has a greater impacton mental health problems than overt victimization, which is moreoften experienced by boys [31–33]. However, as the present studydid not distinguish between different types of traditional or cyberbullying, it remains unclear whether the gender differences foundin our study can be explained by the type of bullying. Therefore,future research should focus on different types of traditionalbullying, as well as cyber bullying (e.g., via photos or video clips,emails), as different types of cyber bullying may also have differentassociations with mental health problems and suicidal ideation,and girls and boys may be exposed to different types of cyberbullying as well.Furthermore, this study confirms the results of earlier studiesindicating an association between traditional bullying victimization and suicidal ideation [6,12,15]. In contrast with ourTable 1. Differences between boys/girls who did and did not participate at follow-up (N = 8271).Boys GirlsParticipatedn = 1623%Lost-to-follow-upn = 2645%p value(x2)Participatedn = 1558%Lost-to-follow-upn = 2445%p value(x2)Age (mean = 12.50, SD = 0.62),13 years 53.9 51.2 0.09 58.6 56.0 0.09EthnicityDutch 50.4 56.9 ,0.001 46.3 55.4 ,0.001Level of educationBasic or theoretical pre-vocationaleducation49.3 63.6 ,0.001 51.0 64.2 ,0.001Victim of bullyingTraditional alone 22.4 25.8 0.01 20.3 24.4 0.002Cyber alone 4.7 5.3 0.45 5.5 9.0 ,0.001Mental health problems 20.5 24.9 0.001 20.5 25.5 ,0.001Suicidal ideation 13.8 17.5 0.002 23.9 26.8 0.04doi:10.1371/journal.pone.0094026.t001Table 2. General characteristics of the total study population, and by gender (N = 3181).Total Boys Girls p valueN = 3181 n = 1623 n = 1558 (x2)%%%Age (mean = 12.47, SD = 0.62),13 years 56.2 53.9 58.6 0.01EthnicityDutch 48.4 50.4 46.3 0.02Level of educationBasic or theoretical pre-vocational education 50.1 49.3 51.0 0.33Victim of bullying 0.10Traditional alone 18.8 19.6 17.9Cyber alone 2.6 2.0 3.2Traditional and cyber 2.6 2.8 2.4Mental health problemsAt baseline 20.5 20.5 20.5 0.98At follow-up 15.0 13.0 17.0 0.002Suicidal ideationAt baseline 18.8 13.8 23.9 ,0.001At follow-up 11.8 7.5 16.3 ,0.001doi:10.1371/journal.pone.0094026.t002Being Bullied, Mental Health and Suicidal IdeationPLOS ONE | www.plosone.org 4 April 2014 | Volume 9 | Issue 4 | e94026hypothesis, being a cyber bullying victim was not related tosuicidal ideation after controlling for baseline suicidal ideation. Apossible explanation for this discrepancy is the small size of thegroup of adolescents who were either a cyber bullying victim andhad suicidal ideation. This may have resulted in limited power todetect a significant relationship between cyber bullying andsuicidal ideation. Another possible explanation could be thedifference in duration of exposure to the two types of bullying.Adolescents in our sample may have been exposed to cyberbullying for a shorter period of time compared to the time thatthey have been exposed to traditional bullying. This is in line withprevious research showing that traditional bullying victimizationremains relatively stable over time (between the ages of 8 and 16years) [34], whereas cyber bullying victimization may occur at alater age, around the age of 14 years [4], when children spendmore time on their mobile phones and are more likely toparticipate on social network sites (e.g. Facebook, MySpace) whichare likely places for cyber bullying to occur [35]. It is possible thaton the long-term, suicidal ideation only develops as a result ofmore pronounced and further developed mental health problems[36] and/or after persistent long-term exposure to bullying, as mayhave been the case with traditional bullying, but perhaps not yetwith cyber bullying in our sample. Future research is required togain more insight into these associations.The purpose of the current study was to examine if bullyingvictimization was associated with mental health problems andsuicidal ideation at follow-up. Nevertheless, analyzing the crosssectional associations and the change in the percentage ofadolescents with problems between baseline and follow-up amongthe different bullying victimization subgroups could provideadditional information. Exploratory analyses on the baseline data(cross-sectional analyses) showed similar results as the longitudinalanalyses described in the results section of this manuscript. As isoften the case, our cross-sectional analyses yielded somewhatstronger associations between both types of bullying victimizationand mental health and suicidal ideation than our longitudinalanalyses. No significant interactions were found between genderand bullying victimization on mental health or suicidal ideation.This could indicate that the short term impact of bullyingvictimization on adolescents’ mental health is similar for boys andgirls, but that the long term impact of bullying on the mentalhealth is different for boys and girls. Furthermore, additionalanalyses showed that the proportion of adolescents with mentalhealth problems in the bullying victimization group significantlydecreased more over the two year follow-up period compared toadolescents in the non-bullying victimization group (data notshown). However, it must be noted that percentage of mentalhealth problems at two year follow-up was still higher in thebullying victimization group than in the non-bullying group. Thesame results were found for suicidal ideation. The only exceptionwas that no significantly different change in the proportion ofmental health problems in girls in the cyber bullying victimizationgroup over the two-year follow-up period was found compared togirls who were not a cyber bullying victim at baseline.The present study has both strengths and limitations that needto be addressed. A strength of the study is its longitudinal nature.The dataset provided the opportunity to explore relationshipsbetween the particular variables of interest within a large sample.Furthermore, many studies on cyber bullying are conductedonline, and, therefore, may have a bias toward the experiences ofTable 3. Associations of bullying victimization and mental health problems (N = 3181).Model 1 Model 2 Model 3a Model 3bOR (95%CI) p value OR (95%CI) p value p value p valueSociodemographic characteristicsGender, boy 0.73 (0.60–0.89) 0.002 0.71 (0.58–0.88) 0.001 0.80 (0.63–1.02)0.07 0.76 (0.61–0.95)0.01Age, ,13 yearsa 1.13 (0.92–1.39) 0.25 1.10 (0.89–1.38) 0.34 1.11 (0.90–1.38)0.34 1.11 (0.90–1.39)0.33Ethnicity, Dutch 0.95 (0.77–1.17) 0.62 0.89 (0.72–1.10) 0.29 0.89 (0.72–1.11)0.30 0.88 (0.71–1,09)0.24Education, basic or theoretical prevocational education1.58 (1.27–1.96) ,0.001 1.23 (0.98–1.54) 0.08 1.23 (0.98–1.54)0.08 1.23 (0.98–1.54)0.08Bullying victimizationTraditional victim 1.64 (1.31–2.05) ,0.001 1.20 (0.95–1.53) 0.13 1.45 (1.06–2.00)0.02 1.22 (0.96–1.54)0.11Cyber victim 2.35 (1.64–3.36) ,0.001 1.79 (1.23–2.61) 0.003 1.81 (1.24–2.65)0.002 2.53 (1.55–4.12),0.001Mental health problems atbaseline4.59 (3.68–5.73) ,0.001 4.59 (3.68–5.73),0.001Gender 6 Traditional bullyingvictimization0.66 (0.42–1.54)0.08Gender 6 Cyber bullyingvictimization0.44 (0.20–0.95)0.04Note: OR = odds ratio; CI = confidence interval. aSimilar results were obtained when age was included as a continuous variable in the analysis.Model 1 is adjusted for sociodemographic characteristics and bulling victimization. Mental health problems is the dependent variable.Model 2 is the same as Model 1, but also adjusted for mental health problems at baseline.Model 3a is the same as Model 2, but also includes a Gender 6 Traditional bullying victimization interaction term.Model 3b is the same as Model 2, but also includes a Gender 6 Cyber bullying victimization interaction term.doi:10.1371/journal.pone.0094026.t003Being Bullied, Mental Health and Suicidal IdeationPLOS ONE | www.plosone.org 5 April 2014 | Volume 9 | Issue 4 | e94026adolescents who use the Internet more frequently. However, thisstudy also has some limitations. First, not all adolescents in thestudy were available for analyses due to non-participation atfollow-up. A non-response analysis showed that the adolescentswho did not participate at follow-up had a lower educational level,were older, more often of Dutch ethnicity, more often a traditionalor cyber bullying victim, and more often had mental healthproblems and suicidal ideation at baseline. Although we includedthese variables as confounders and adjusted for baseline problemsin our analyses, it is possible that this selective drop out led tounderestimation of the size of the association between bullyingvictimization and mental health problems or suicidal ideation,since a vulnerable group (i.e. a group with a high risk of mentalhealth problems and suicidal ideation) dropped out. However,additional analyses showed that the relationship between bothtypes of bullying victimization and mental health or suicidalideation at baseline did not significantly differ between adolescentswho dropped out and adolescents who did not drop out at followup. Nevertheless, the current findings should be generalized withcaution, and we propose replication in large and variedpopulations. Second, traditional and cyber bullying victimizationwere assessed using single, self-reported items. Moreover, there iscurrently no consensus among researchers how to measure cyberbullying, and the changing nature of communication technologymakes it difficult to establish a fixed definition. Third, mentalhealth and suicidal ideation were also assessed using self-reporteditems, which may have resulted in less reliable outcomes.Nevertheless, research suggests that adolescents are betterreporters of their own mental health status than parents andteachers [37].In conclusion, our findings suggest that traditional bullyingvictimization is associated with an increased risk of suicidalideation, and traditional and cyber bullying victimization areassociated with an increased risk of mental health problems amonggirls. Future research should examine the mechanisms responsiblefor this differential response of girls and boys to the stress causedby bullying victimization. Furthermore, based on our results andresults of other studies, studies on the current topic may want toconsider differentiating between boys and girls. Our findings stressthe importance of programs aimed at reducing bullying behaviorin schools and online. These programs are particularly importantbecause early-onset mental health problems may pose a risk for thedevelopment of psychiatric disorders in adulthood [38–40].Moreover, although several intervention programs are availablethat reduce bullying behavior and victimization in schools [41,42]such programs should not solely focus on school bullying.Prevention of cyber bullying should also be included in schoolanti-bullying policies [3,4] since this is currently often lacking [43].While some traditional methods for reducing bullying may beuseful for cyber bullying too (e.g., peer support), more specificinterventions will also be needed to reduce cyber bullying, such ashow to contact mobile phone companies and internet serviceproviders [3].AcknowledgmentsThe authors thank the Municipal Public Health Service Rotterdam areafor providing research data.Table 4. Associations of bullying victimization and suicidal ideation (N = 3181).Model 1 Model 2 Model 3a Model 3bOR (95%CI) p value OR (95%CI) p value p value p valueSociodemographic characteristicsGender, boy 0.40 (0.32–0.51) ,0.001 0.48 (0.37–0.60) ,0.001 0.53 (0.40–0.70),0.001 0.49 (0.38–0.63),0.001Age, ,13 yearsa 0.89 (0.71–1.12) 0.31 0.90 (0.71–1.15) 0.39 0.90 (0.71–1.15)0.39 0.90 (0.71–1.14)0.39Ethnicity, Dutch 1.06 (0.84–1.34) 0.63 1.10 (0.87–1.41) 0.42 1.11 (0.87–1.41)0.41 1.10 (0.86–1.40)0.44Education, basic or theoretical prevocational education1.32 (1.04–1.68) 0.02 1.17 (0.91–1.50) 0.22 1.17 (0.91–1.50)0.22 1.17 (0.91–1.50)0.22Bullying victimizationTraditional victim 1.95 (1.53–2.48) ,0.001 1.56 (1.21–2.02) ,0.001 1.77 (1.29–2.44),0.001 1.57 (1.21–2.03)0.001Cyber victim 1.74 (1.17–2.61) 0.007 1.22 (0.80–1.87) 0.36 1.23 (0.80–1.89)0.34 1.36 (0.81 02.28)0.24Suicidal ideation at baseline 4.82 (3.79–6.12) ,0.001 4.84 (3.81–6.15),0.001 4.81 (3.79–6.10),0.001Gender 6 Traditional bullyingvictimization0.71 (0.43–1.20)0.20Gender 6 Cyber bullyingvictimization0.72 (0.29–1.79)0.48Note: OR = odds ratio; CI = confidence interval. aSimilar results were obtained when age was included as a continuous variable in the analysis.Model 1 is adjusted for sociodemographic characteristics and bulling victimization. Suicidal ideation is the dependent variable.Model 2 is the same as Model 1, but also adjusted for suicidal ideation at baseline.Model 3a is the same as Model 2, but also includes a Gender 6 Traditional bullying victimization interaction term.Model 3b is the same as Model 2, but also includes a Gender 6 Cyber bullying victimization interaction term.doi:10.1371/journal.pone.0094026.t004Being Bullied, Mental Health and Suicidal IdeationPLOS ONE | www.plosone.org 6 April 2014 | Volume 9 | Issue 4 | e94026Author ContributionsConceived and designed the experiments: RB SB PL FW HR. Performedthe experiments: RB SB. Analyzed the data: RB SB HR. Contributedreagents/materials/analysis tools: RB SB PL FW HR. Wrote the paper:RB SB.References
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BODY WEIGHT & BULLYING AMONG US ADOLESCENTSBODY WEIGHT AND BULLYINGVICTIMIZATION AMONG US ADOLESCENTS•AUTHORS:CLAUDIA WANG, PHDYIN LI, MPHKAIGANG LI, PHDDONG-CHUL SEO, PHD, FAAHBABOUT THE JOURNAL•SCHOOL BULLYING HAS BECOME AN INCREASINGLY SIGNIFICANT SOCIAL ANDPUBLIC HEALTH ISSUE IN THE UNITED STATES DURING THE LAST FEWDECADES.•BULLYING OCCURS BETWEEN BULLIES AND VICTIMS THROUGH A VARIETY OFACTIONS, INCLUDING PHYSICAL CONTACT, VERBAL ABUSE, SOCIALEXCLUSION, AND MISUSING ELECTRONIC DEVICES.•THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE ASSOCIATION BETWEENBODY WEIGHT STATUS AT ALL LEVELS (INCLUDING UNDERWEIGHT, SLIGHTLYUNDER- WEIGHT, NORMAL WEIGHT, OVERWEIGHT, AND OBESITY) ANDBULLYING VICTIMIZATION AMONG US ADOLESCENTS USING A NATIONALLYREPRESENTATIVE SAMPLE.HYPOTHESIS OF RESEARCH“TO DETERMINE IF THERE IS A LINEAR OR QUADRATIC (U-SHAPED)ASSOCIATION BETWEEN BODY WEIGHT STATUS AND BULLYINGVICTIMIZATION AND IF THE ASSOCIATION VARIES BY SEX.”PARTICIPANTS • STUDENTS COMPLETED A SELF-ADMINISTERED QUESTIONNAIRE DURING A REGULAR CLASSPERIOD.• RESPONSES WERE RECORDED DIRECTLY ON COMPUTER-SCANNABLE QUESTIONNAIREBOOKLETS.• WEIGHTING WAS APPLIED TO EACH RECORD TO ADJUST FOR NONRESPONSES ANDOVERSAMPLING OF BLACK AND HISPANIC STUDENTS.• FOR THE 2013 YRBS, 13,633 QUESTIONNAIRES WERE COMPLETED IN 148 PUBLIC ANDPRIVATE SCHOOLS.• AMONG THE COMPLETED QUESTIONNAIRES, 50 FAILED QUALITY CONTROL AND WEREEXCLUDED FROM ANALYSIS, RESULTING IN 13,583 USABLE QUESTIONNAIRES.• THE SCHOOL RESPONSE RATE WAS 77%, AND THE STUDENT RESPONSE RATE WAS 88%.METHODS USED TO OBTAIN FINDINGS• DATA USED IN THIS STUDY WERE DRAWN FROM THE 2013 NATIONAL YOUTHBEHAVIOR SURVEY (YRBS).• THE YRBS IS A BIENNIAL SURVEY SPONSORED BY THE US CENTERS FOR DISEASECONTROL AND PREVENTION (CDC).• THE CDC HAS MONITORED RISK BEHAVIORS AMONG US HIGH SCHOOL STUDENTSSINCE 1991.• A 3-STAGE CLUSTER SAMPLING DESIGN WAS USED TO PRODUCE A NATIONALLYREPRESENTATIVE SAMPLE OF PUBLIC AND PRIVATE HIGH SCHOOL STUDENTS FROM9TH THROUGH 12TH GRADES IN THE US.EXAMPLE QUESTIONS ON SURVEYBULLYING. TWO QUESTIONS WERE ASKED ABOUTSTUDENTS’ BULLYING STATUS:
“DURING THE PAST 12 MONTHS, HAVE YOU EVERBEEN BULLIED ON SCHOOL PROPERTY?”
“DURING THE PAST 12 MONTHS, HAVE YOU EVERBEEN ELECTRONICALLY BULLIED?” (INCLUDEBEING BULLIED THROUGH EMAIL, CHAT ROOMS,INSTANT MESSAGING, WEB SITES, OR TEXTING.)”**STUDENTS WHO REPORTED YES TO EITHER OR BOTHOF THE 2 QUESTIONS WERE CONSIDERED TO BEBULLIED.BODY WEIGHT STATUS. SELF-REPORTED HEIGHT ANDWEIGHT TO CALCULATE BODY MASS INDEX. BMIPERCENTILE WAS DERIVED ACCORDING TO CDCBMI-FOR-AGE-AND-SEX GROWTH CHARTS FOR YOUTHAGED 2–20 YEARS. A BODY WEIGHT STATUS VARIABLEWAS CREATED TO CATEGORIZE PARTICIPANTS INTO 5GROUPS:
UNDERWEIGHT
SLIGHTLY UNDERWEIGHT
NORMAL WEIGHT
OVERWEIGHT
OBESEDATA ANALYSIS OF THE 13,583 PARTICIPANTS IN THE 2013 YRBS:•1004 (7.3%) WITH MISSING DATA ON WEIGHT STATUS•150 (1.1%) ON BULLYING VICTIMIZATION•508 (3.7%) ON BEHAVIORAL CONFOUNDERS•407 (3.0%) ON DEMOGRAPHIC CHARACTERISTICSWERE EXCLUDED FROM ANALYSIS . AS A RESULT, A TOTAL OF 11,825 STUDENTSWITH COMPLETE DATA WERE INCLUDED IN THIS STUDY.FINDINGS/CONCLUSION ON WEIGHTOF THE 11,825 PARTICIPANTS•49.4% WERE BOYS, (57.4% WERE WHITE, 13.4% BLACK, 10.0% HISPANIC, AND19.2% OTHERS)•59.4% WERE 16 YEARS OR YOUNGER.•APPROXIMATELY 7.7% OF STUDENTS WERE UNDERWEIGHT OR SLIGHTLYUNDERWEIGHT•30.1% WERE OVERWEIGHT OR OBESEThe body weight distribution for both female and male students demonstrated a bell-shaped curve.FINDINGS/CONCLUSION ON BULLYINGAPPROPRIATELY 25.3% OF THE STUDENTS REPORTED HAVING BEEN BULLIED ATLEAST ONCE IN THE PAST 12 MONTHS•32.1% FOR GIRLS•18.4% FOR BOYS25.3% of the students reported havingbeen bullied at least once in the past 12months (32.1% for girls and 18.4% forboys)LIMITATIONS
CAUTION IS WARRANTED IN INFERRING A CAUSAL RELATIONSHIP BETWEEN BODYWEIGHT STATUS AND BULLYING VICTIMIZATION BE- CAUSE DATA WERE OBTAINEDFROM A CROSS-SECTIONAL STUDY.
BODY WEIGHT STATUS AND THE PREVALENCE OF BULLYING VICTIMIZATION IN THISSTUDY WAS BASED ON SELF-REPORT, WHICH MIGHT HAVE LED TO SOME BIASEDSUBJECTIVE RESPONSES.
DUE TO THE NATURE OF SECONDARY DATA ANALYSIS OF THIS STUDY, THEANALYSIS MAY NOT HAVE CONTROLLED FOR ALL THE MAJOR COVARIATES OFBULLYING VICTIMIZATION.Reflection:WHY BODY WEIGHT & BULLYING?•UNFORTUNATELY, THIS IS VERY COMMON IN TODAYS SOCIETY AND I THINK ITSSO IMPORTANT FOR PEOPLE TO FEEL CONFIDENT IN THEIR OWN SKIN.•BOTH YOUNG FEMALES AND MALES FEEL LIKE THEY HAVE TO LOOK LIKETHOSE IN THE SPOTLIGHT DUE TO SOCIAL MEDIA AND THE WEIGHT OFCELEBRITIES.•I HAVE ALWAYS SUFFERED WITH MY OWN INSECURITIES DUE TO MY WEIGHT,SO THIS IS SOMETHING I CAN RELATE TO.REFERENCESWANG, C., LI, Y., LI, K., & SEO, D. (2018). BODY WEIGHT AND BULLYINGVICTIMIZATION AMONG US ADOLESCENTS.AMERICAN JOURNAL OF HEALTH BEHAVIOR,42(1), 3-12.DOI:10.5993/AJHB.42.1.1
Reflection Paper:
You will choose an article a topic of developmental psychology of your choosing from a peer reviewed professional journal. Topics must be related to psychology concerns and modern issues. If you cannot think of a topic, skim through the textbook and see if something catches your eye or email me.
Materials should contain required content, correct spelling, citations, punctuation, grammar, and reflect a professional manner.
To include in the paper:
highlight the main points of the article->
1.The hypothesis of study and theories discussed
2.participants (ethnicity, number, gender, ages, etc.)
3.describe the theory used by investigators
4. methods used to obtain findings
5. findings/conclusions
6. limitations.
7.The broader relevance of the research
8. Any other pertinent information you deem necessary to summarize the article.
9. Reflection section: How the article (your research) made you feel/ think about/ what your experience with the topic, and why are these your thoughts, why you chose the topic, how does it relate to concepts addressed in class already, what more did you want to know that was not included in the article?
10. Reference (article, textbook, and any other sources used to help you in your presentation, use APA style for citations)
CAUTION: presenting the work of another person as one’s own work including papers, words, ideas, information, computer code, data, evidence-organizing principles, or style of presentation of someone else taken from the Internet, books, periodicals, or other sources constitutes plagiarism, which can and will result in serious academic penalties.
PRESENTATION: Each student will create a presentation based on their research paper. In the presentation, students will be discussing the most important information, definitions other students need to know, provide, outside media/articles, etc. to enhance their presentation and help in understanding the concepts discussed in their paper. Attach to the presentation 1 slide titled Reference and use APA format for your sources. Add link to article! So I may read article as well as your classmates whose interest you peaked.
1 slide must have five (5) quiz questions based on the presentation and your outside resources.1 slide will have: the title of the research article and your name. .
TIPS: , proofread for grammatical and/or syntax errors; do not clutter the slide, include no more than five (5) bullets or talking points.
DO NOT WRITE SENTENCES !!! Your job is to inform (transfer learning) the class on your research; paraphrased where appropriate with material and theory covered in class. Make sure to include a slide citing the sources you used to gather your information.
DUE DATE NOVEMBER 2, 2020 by 11:59 pm!
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