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1.
J Res Adolesc ; 2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39044317

RESUMO

This study tested to what extent the relation between bullying victimization and future symptoms of depression could be explained by victims being more hostile and less assertive than non-involved individuals. Data came from waves 2-4 of the Dutch TRacking Adolescents' Individual Lives Survey (TRAILS). Participants' bullying experiences were assessed at age 13, interpersonal style at age 16, and depression symptoms at age 19. Mediation analyses were performed primarily on 274 self-reported victims and 1498 non-involved peers. Self-reported victims had an increased risk for depression symptoms. About a third of that risk could be explained by victims' hostile style, which was also higher than those of non-involved peers. Although victims also reported lower levels of assertiveness than non-involved peers, this interpersonal style did not mediate the link between bullying victimization and depression. Our findings suggest that high hostility, but not low assertiveness, partly explains the increased depression risk of self-reported victims. Therefore, interventions could focus on addressing hostility, to help reduce the likelihood that adolescents who have experienced bullying victimization will have more interpersonal conflicts and mental health problems in the future. Supplementary materials also include analyses for bullies and bully-victims, and for peer-reported measures.

2.
J Youth Adolesc ; 53(3): 550-562, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38183532

RESUMO

Positive and negative leadership styles may influence classroom norms and be related to the school and psychological adjustment of children in general, and victims in particular. This study tested the relation between leadership styles and children's adjustment, and the moderating effects of leadership on the association between self-reported victimization and school and psychological adjustment (self-esteem, social anxiety, and depressive symptoms); and it tested for potential gender differences. Classrooms were classified into those with only positive leaders, only negative leaders, both positive and negative leaders, and without leaders. The sample contained 8748 children (Mage = 10.05, SD = 1.22; 51.2% girls) from 392 classrooms, in grades three to six, in 98 Dutch schools. Multilevel analysis revealed that, in general, children in negative leader classrooms experienced lower school well-being than children in other classrooms. In positive leader classrooms, male and female victims had lower school well-being. For psychological well-being, female victims had lower self-esteem and more depressive symptoms in positive leader classrooms. Male and female victims in negative leader classrooms did not suffer from additional maladjustment. These results demonstrate that negative leadership styles are related to lower school well-being of all children, whereas victimization in classrooms with positive leaders is negatively related to male and female victims' school well-being and girls' psychological adjustment (depressive symptoms); this is in line with the 'healthy context paradox'.


Assuntos
Bullying , Vítimas de Crime , Criança , Humanos , Masculino , Feminino , Ajustamento Emocional , Grupo Associado , Instituições Acadêmicas , Estudantes/psicologia , Bullying/psicologia , Vítimas de Crime/psicologia
3.
J Youth Adolesc ; 2024 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-38704468

RESUMO

Previous studies on peer relationships in school transitions neglected individual differences, or did not examine the relation with academic performance in secondary school. This study followed 649 students from their last year of primary school to their first year in secondary school (Mage at T1 = 11.6 (SD = 0.6); 53.6% girls). Results revealed that students became more attached to peers, less lonely, and were stable in victimization across the transition. Particularly students with more negative peer experiences in primary school enjoyed a "fresh start" in terms of peer experiences in secondary school. Students who had more co-transitioning peers experienced greater reductions in loneliness. Changes in peer experiences over the transition did not relate to academic performance in secondary school.

4.
Arch Sex Behav ; 52(3): 971-989, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36454435

RESUMO

Because no measure for sexual orientation-related rejection sensitivity (RS) for adolescents exists, we aimed to develop and validate the Sexual Minority Adolescent Rejection Sensitivity Scale (SMA-RSS). In Study 1, interviews with 22 sexual minority youth were conducted (M age = 18.86, SD = 3.03). Based on these interviews, 29 scenarios were developed as potential items for the SMA-RSS. In Study 2, exploratory factor analyses were conducted on these 29 scenarios in a sample of 397 sexual minority adolescents (M age = 16.63, SD = 1.07). The 14 best performing items were selected and a two-factor structure best fit the data. In Study 3, a confirmatory factor analysis was conducted and the test-retest reliability, criterion validity, convergent validity, and incremental validity of the SMA-RSS were assessed in a sample of 499 sexual minority adolescents (M age = 16.61, SD = 1.34). A bifactor model best fit the data and evidence was provided for a strong enough general factor to justify unidimensionality. For criterion validity, the SMA-RSS evidenced small to moderate correlations with minority stressors and mental health indicators. For convergent validity, we found a moderate correlation with general RS. For incremental validity, the SMA-RSS was associated with mental health indicators over and above minority stressors and general RS. Participants were moderately stable in their scores on the SMA-RSS over a one-month period. Taken together, the SMA-RSS captured unique situations in which sexual minority adolescents anxiously expect rejection and can aid in better understanding health disparities among sexual minority adolescents.


Assuntos
Minorias Sexuais e de Gênero , Humanos , Masculino , Adolescente , Feminino , Reprodutibilidade dos Testes , Saúde Mental , Comportamento Sexual
5.
Child Dev ; 94(6): 1531-1549, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37226680

RESUMO

This study examined whether having vulnerable friends helps or hurts victimized and depressed (i.e., vulnerable) adolescents and whether this depends on classroom supportive norms. Students (n = 1461, 46.7% girls, 93.4% Han nationality) were surveyed four times from seventh and eighth grade (Mage = 13 years) in 2015 and 2016 in Central China. Longitudinal social network analyses indicated that having vulnerable friends can both hurt and help vulnerable adolescents. Depressed adolescents with depressed friends increased in victimization over time. Victimized adolescents with victimized friends increased in victimization but decreased in depressive symptoms. These processes were most likely in classrooms with high supportive norms. Having friends and a supportive classroom may hurt vulnerable adolescents' social position but help victims' emotional development.


Assuntos
Comportamento do Adolescente , Bullying , Depressão , População do Leste Asiático , Amigos , Adolescente , Feminino , Humanos , Masculino , Comportamento do Adolescente/psicologia , Bullying/psicologia , Depressão/psicologia , População do Leste Asiático/psicologia , Amigos/psicologia , Grupo Associado , Apoio Social
6.
Dev Psychopathol ; : 1-12, 2023 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-37069820

RESUMO

Bullying research has shown repeatedly that victims of bullying have an increased risk for later internalizing problems and bullies have an increased risk for later externalizing problems. Bullying involvement is often, either explicitly or implicitly, presented as part of a causal mechanism for maladjustment. However, genetic vulnerability may confound the reported associations. This study examined to what extent genetic vulnerability can account for the reported associations between bullying involvement (age 11-14) and later internalizing and externalizing problems (age 16), using data from the TRacking Adolescents' Individual Lives Survey (n = 1604). Because polygenic scores capture only a fraction of the total genetic effect, they were extrapolated to the size of single-nucleotide polymorphism and twin heritability estimates to examine genetic confounding while controlling for (hypothetical) polygenic scores that fully capture the genetic effect. Genetic vulnerability for internalizing and externalizing problems confounded, respectively, the association between bullying victimization and later internalizing problems, and the association between bullying perpetration and later externalizing problems. As such, this study showcases a method that can be broadly used to assess the magnitude of genetic confounding. Caution is, however, warranted in interpreting particularly the less straightforward extrapolations of polygenic scores to the size of twin heritability estimates.

7.
Dev Psychopathol ; : 1-13, 2023 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-36794389

RESUMO

This study's aim was to examine whether there are negative increasing cycles of peer victimization and rejection sensitivity over time. Drawing from Social Information Processing Theory, we hypothesized that victimization leads to higher levels of rejection sensitivity, which would put adolescents at risk for higher future victimization. Data were collected in a four-wave study with 233 Dutch adolescents starting secondary education (Mage = 12.7 years), and a three-wave study with 711 Australian adolescents in the last years of primary school (Mage = 10.8 years). Random-intercept cross-lagged panel models were used to disentangle between-person from within-person effects. In each sample, a significant between-person association was found: adolescents with higher levels of victimization as compared to their peers also reported higher levels of rejection sensitivity. At the within-person level, all concurrent associations between individual fluctuations of victimization and rejection sensitivity were significant, but there were no significant cross-lagged effects (except in some sensitivity analyses). These findings demonstrate that victimization and rejection sensitivity are interrelated, but there may not be negative victimization-rejection sensitivity cycles during the early-middle adolescent years. Possibly, cycles establish earlier in life or results are due to shared underlying factors. Further research is needed examining different time lags between assessments, age groups, and contexts.

8.
Dev Psychopathol ; : 1-15, 2023 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-37990407

RESUMO

The finding that victims' psychological problems tend to be exacerbated in lower-victimization classrooms has been referred to as the "healthy context paradox." The current study has put the healthy context paradox to a strict test by examining whether classroom-level victimization moderates bidirectional within- and between-person associations between victimization and psychological adjustment. Across one school year, 3,470 Finnish 4th to 9th graders (Mage = 13.16, 46.1% boys) reported their victimization, depressive symptoms, anxiety, and self-esteem. Three types of multilevel models (cross-lagged panel, latent change score, and random-intercept cross-lagged panel) were estimated for each indicator of psychological adjustment. Findings indicated that the healthy context paradox emerges because classroom-level victimization moderates the prospective effect of victimization on psychological problems, rather than the effect of psychological problems on victimization. In classrooms with lower victimization, victims not only experience worse psychological maladjustment over time compared to others (between-person changes), but also higher maladjustment than before (absolute within-person changes).

9.
Prev Sci ; 2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37656368

RESUMO

This study examined the relation between both implementation fidelity and quality and the outcomes of two different anti-bullying interventions targeting distinct processes involved in bullying: moral disengagement and social norms. In total, 34 French-speaking Belgian teachers from six elementary schools were trained to deliver either the moral disengagement or the social norms intervention to their Grade 4-6 students (N = 747, 50.4% boys) in a randomized controlled trial. Students reported their moral disengagement, perceived injunctive class norm toward bullying, and bullying behaviors in the fall and spring of the 2018-2019 school year. Teachers' implementation fidelity and quality were assessed through direct observation in each class by two independent raters with a satisfying interrater reliability. A multiplicative moderated mediation model using latent change scores revealed that both greater fidelity and quality amplified students' decrease in moral disengagement, which was accompanied by a decrease in bullying. Importantly, when quality was sufficient, fidelity did not matter. However, higher fidelity could compensate for a lack of quality. Contrary to expectations, there was no significant change in students' perceptions of the class injunctive norm, even under ideal implementation conditions. Alternative mediators should thus be considered. Because implementation by teachers inevitably fluctuates, anti-bullying program components should be evaluated under various implementation conditions to determine their cost-effectiveness ratio and to gain insights into how anti-bullying programs work.

10.
J Youth Adolesc ; 52(8): 1620-1631, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37306833

RESUMO

Previous research has shown that leadership is associated not only with positive but also with negative characteristics and behaviors; knowledge of the similarities and differences between positive and negative leaders remains insufficient. This study aimed to examine (1) the existence of different subtypes of leaders and (2) to what extent these leaders differed on individual and interpersonal characteristics. The sample contained 9213 students in grades 3-6 (Dutch grades 5-8), from 392 classrooms in 98 schools (50.3% girls, Mage = 10.13 ± 1.23 years). Latent profile analysis identified three leader profiles and four non-leader profiles based on peer nominations received for leadership, popularity, and positive (defending) and negative (bullying) behavior: (1) positive leaders, (2) negative leaders, (3) non-popular leaders, (4) popular children, (5) bullies, (6) extreme bullies, and (7) modal children. Multinomial logistic regression showed similarities and differences between positive and negative leaders, as well as between each of these and the other five profiles. Positive leaders were more accepted and less rejected and had more friendships than negative leaders, but the differences in individual characteristics (self-esteem, self-control, and social goals) were less clear. This study demonstrated that 10-15% of the children were perceived as leaders, and that positive leadership became more prevalent in the higher grades. Nevertheless, negative leadership occurred also in the higher grades. Interventions aimed at turning negative leaders into positive leaders may work, because positive and negative leaders do not differ greatly in individual characteristics. Such interventions may improve the relationships of negative leaders with their classmates, which may be good for their likeability (but not at the expense of their popularity) as well as for the social atmosphere in the class as a whole.


Assuntos
Bullying , Liderança , Feminino , Humanos , Criança , Masculino , Grupo Associado , Instituições Acadêmicas , Amigos , Relações Interpessoais
11.
Soc Sci Res ; 114: 102916, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37597930

RESUMO

Social ties between members of in- and outgroups are theorized to reduce individual levels of prejudice. However, instances of intergroup contact are not isolated events; cross-group interactions are embedded in broader networks defined by various social processes that guide the formation and maintenance of interpersonal relationships. This project reconsiders the potential benefits of intergroup contact by applying a network perspective to examine whether friendships between youth of different sexualities can shape individuals' homophobic attitudes. The impact of cross-sexuality ties is evaluated through the application of stochastic actor-oriented models (SAOMs) to a two-wave sample of Dutch adolescents. Results indicate that the benefits of cross-sexuality connections become negligible when we account for how patterns of network connectivity and segregation are informed by other individual-level traits, such as age, religious background, ethnicity, and gender. In other words, heterosexual adolescents who are situated in network positions that provide opportunities to form cross-sexuality friendships would be expected to report less homophobic attitudes even in the absence of this intergroup contact. These findings suggest that the cross-sexuality contact observed in the social world often represents instances of "preaching to the choir," limiting the potential for intergroup connections to challenge systems of social inequality.


Assuntos
Amigos , Minorias Sexuais e de Gênero , Adolescente , Humanos , Heterossexualidade , Atitude , Rede Social
12.
Child Dev ; 93(6): 1873-1888, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35876243

RESUMO

This three-armed randomized controlled trial examined how moral disengagement and social norms account for change in bullying behavior and their potential as targets of anti-bullying components within separate interventions among 1200 French-speaking Belgian elementary students (48% boys, 9-12 year-olds, 57 classes, nine schools) during 2018-2019 (no ethnicity data available). Mediation analysis revealed that students' moral disengagement successfully decreased (ß = -.46), which, in turn, reduced both bullying (ß = .33) and outsider behaviors (ß = .20), and increased defending (ß = -.10). Intervening on social norms decreased bullying (ß = -.18), but not through the perceived injunctive class norm as intended. Guidelines to open the "black box" of anti-bullying programs and determine the cost-effectiveness ratio of their components are provided.


Assuntos
Bullying , Normas Sociais , Masculino , Criança , Humanos , Feminino , Grupo Associado , Princípios Morais , Estudantes , Instituições Acadêmicas
13.
J Res Adolesc ; 32(3): 1178-1193, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-34448280

RESUMO

Recent work on bullying perpetration includes the hypothesis that bullying carries an evolutionary advantage for perpetrators in terms of health and reproductive success. We tested this hypothesis in the National Child Development Study (n = 4998 male, n = 4831 female), British Cohort Study 1970 (n = 4261 male, n = 4432 female), and TRacking Adolescents' Individual Lives Survey (n = 486 male, n = 521 female), where bullying was assessed in adolescence (NCDS, BCS70: age 16, TRAILS: age 14) and outcomes in adulthood. Partial support for the evolutionary hypothesis was found as bullies had more children in NCDS and engaged in sexual intercourse earlier in TRAILS. In contrast, bullies reported worse health in NCDS and BCS70.


Assuntos
Bullying , Vítimas de Crime , Adolescente , Adulto , Criança , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Inquéritos e Questionários
14.
J Adolesc ; 94(1): 45-56, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-35353409

RESUMO

INTRODUCTION: This study examined the effect of popularity levels on friendship selection and friends' influence on popularity levels in early and mid-adolescence. METHODS: Participants were 4205 Spanish adolescents (Mage = 13.1 years at Wave 1; 48% girls) belonging to 160 classrooms in two waves. Adolescents were asked about their friendships and the popularity of their classmates. RESULTS: Longitudinal social network analyses showed that adolescents preferred similarly popular peers as friends. High popular classmates were more attractive as friends, particularly in early adolescence. Popular adolescents were more selective in their friendship nominations and adolescents with popular friends became more popular over time. These two effects were only significant in mid-adolescents, although comparative analyses showed a similar tendency at both age groups. CONCLUSIONS: This study highlights the importance of popularity levels in adolescents' friendship selection and suggests that popularity, at the individual and group level, plays a relevant role in social development. Implications adapted to the different selection and influence processes in early and mid-adolescence are discussed.


Assuntos
Comportamento do Adolescente , Amigos , Adolescente , Feminino , Humanos , Masculino , Grupo Associado , Estudantes
15.
J Youth Adolesc ; 51(3): 540-555, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34609673

RESUMO

Acceptance and rejection by parents and peers play an important role in pre-adolescents' educational outcomes. Prior research focused on either parents or peers, did not encompass effects into adulthood, or considered either acceptance or rejection. This study investigated the relation between parental and peer acceptance and rejection, and their interplay, in pre-adolescence and educational attainment in early adulthood. A sample of 2229 pre-adolescents (Mage T1 = 11.11, SD = 0.56; 50.7% girls) was followed to early adulthood (Mage T5 = 22.29, SD = 0.65). Ordinal logistic regression showed that pre-adolescents' perceived parental acceptance was positively related to educational attainment in early adulthood, whereas peer rejection was negatively related, even when WISC score and socioeconomic status were considered. No interaction effects were found, revealing no "dual-hit effect" of being rejected by parents and peers, no "dual-miss effect" of being accepted by parents and peers, and no effects of acceptance in one context (i.e., parents or peers) buffering the negative effect of rejection in the other context. The findings underscore unique and long-term links of parental acceptance and peer rejection with early adults' educational attainment, underlining the importance of not only peers but also parents in adolescence. These insights can be used in promoting long-term educational outcomes through relationships with parents and peers.


Assuntos
Sucesso Acadêmico , Comportamento do Adolescente , Adolescente , Adulto , Pré-Escolar , Escolaridade , Feminino , Humanos , Lactente , Masculino , Pais , Grupo Associado
16.
J Res Adolesc ; 31(4): 889-907, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34820944

RESUMO

Compelling evidence demonstrates that peer influence is a pervasive force during adolescence, one that shapes adaptive and maladaptive attitudes and behaviors. This literature review focuses on factors that make adolescence a period of special vulnerability to peer influence. Herein, we advance the Influence-Compatibility Model, which integrates converging views about early adolescence as a period of increased conformity with evidence that peer influence functions to increase affiliate similarity. Together, these developmental forces smooth the establishment of friendships and integration into the peer group, promote interpersonal and intragroup compatibility, and eliminate differences that might result in social exclusion.


Assuntos
Comportamento do Adolescente , Influência dos Pares , Adolescente , Pesquisa Empírica , Amigos , Humanos , Relações Interpessoais
17.
J Youth Adolesc ; 50(10): 1995-2006, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33464443

RESUMO

Bullying is known to be associated with social status, but it remains unclear how bullying involvement over time relates to social position (status and affection), especially in the first years at a new school. The aim of this study was to investigate whether (the development of) bullying and victimization was related to the attainment of status (perceived popularity) and affection (friendships, acceptance, rejection) in the first years of secondary education (six waves). Using longitudinal data spanning the first- and second year of secondary education of 824 adolescents (51.5% girls; Mage T1 = 12.54, SD = 0.45) in the SNARE-study, joint bullying and victimization trajectories were estimated using parallel Latent Class Growth Analysis (LCGA). The four trajectories (decreasing bully, stable high bully, decreasing victim, uninvolved) were related to adolescents' social position using multigroup analysis that examined differences in slope and intercepts (T1 and T6) of social positions, and indicated that the relative social position of the different joint trajectories was determined at the start of secondary education and did not change over time, with one exception: adolescents continuing bullying were besides being popular also increasingly rejected over time. Although bullying is functional behavior that serves to optimize adolescents' social position, anti-bullying interventions may account for the increasing lack of affection that may hinder bullies' long-term social development.


Assuntos
Bullying , Vítimas de Crime , Adolescente , Feminino , Amigos , Humanos , Lactente , Masculino , Prazer , Instituições Acadêmicas
18.
Child Dev ; 91(4): 1336-1352, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31429084

RESUMO

This study investigates the dynamic interplay between bullying relationships and friendships in a sample of 481 students in 19 elementary school classrooms (age 8-12 years; 50% boys). Based on a relational framework, it is to be expected that friendships would be formed when two children bullied the same person and that children would start to bully the victims of their friends. Similarly, it is to be expected that friendships would be formed when two children were victimized by the same bully and that children would become victimized by the bullies of their friends. Longitudinal bivariate social network analysis supported the first two hypotheses but not the latter two. This study provides evidence for group processes in bullying networks in childhood.


Assuntos
Bullying , Processos Grupais , Análise de Rede Social , Criança , Vítimas de Crime , Feminino , Amigos , Humanos , Estudos Longitudinais , Masculino , Grupo Associado , Instituições Acadêmicas , Estudantes , Inquéritos e Questionários
19.
Dev Psychopathol ; 32(1): 11-20, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30642413

RESUMO

Relationships with parents and peers are crucial for children's socialization, but how parent-child and peer relationships mutually affect each other is not well understood. Guided by spillover theory, we zoomed in on the bidirectional interplay between parental rejection and warmth on the one hand and peer victimization on the other, and examined whether children's maladjustment symptoms mediated hypothesized cross-domain spillover effects. Data stem from five waves of the longitudinal KiVa study among 9,770 children (50% boys; mean age = 9.16, standard deviation = 1.29). Results from random intercept cross-lagged panel models showed that higher parental rejection and lower parental warmth predicted increases in peer victimization and vice versa across waves, thus supporting the bidirectional model. Moreover, spillover from parent-child rejection and warmth to peer victimization was partially driven by children's depressive symptoms and bullying perpetration. Vice versa, spillover from peer victimization to parent-child rejection and warmth was partially driven by children's social anxiety, depressive symptoms, conduct problems, and bullying perpetration. Thus, children might get caught in persistent problems in two important social domains, and these two domains influence each other through children's maladjustment. Family and school interventions should be integrated to prevent a downwards spiral.


Assuntos
Bullying/psicologia , Vítimas de Crime/psicologia , Relações Pais-Filho , Grupo Associado , Ansiedade/psicologia , Criança , Depressão/psicologia , Feminino , Humanos , Relações Interpessoais , Estudos Longitudinais , Masculino
20.
J Res Adolesc ; 30 Suppl 2: 516-531, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30927389

RESUMO

This study investigated whether lesbian, gay, and bisexual (LGB) adolescents were at higher risk for persistent victimization of bullying compared to heterosexual adolescents, and how victimization trajectories were associated with internalizing symptom development across LGB and heterosexual adolescents. Data came from a five-wave study (Mage T1 = 11.1 to Mage T5 = 22.3; n = 151 LGB; n = 1,275 heterosexual) and informants were adolescents and their parents. Adolescents were classified in three victimization trajectories: persistent (5.6%), decreasing (28.1%) or low (66.3%) victimization. LGB adolescents reported more persistent victimization, relative to no (OR = 6.79, 95% CI [3.52, 13.13]) or decreasing victimization (OR = 3.09, 95% CI [1.53, 6.24]), compared to heterosexual peers. Further, persistent victimization was more strongly associated with anxiety among LGB than among heterosexual adolescents.


Assuntos
Bullying/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adolescente , Bullying/psicologia , Vítimas de Crime/psicologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Medição de Risco
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