Bullying and psychiatric symptoms among elementary school-age children.

OBJECTIVE: The aim of this study was to assess bullying and psychological disturbance among 5,813 elementary school-aged children. METHOD: The data consisted of information given by the parents, teachers, and children themselves (Rutter A2 Scale, Rutter B2 Scale and Children's Depression Inventory). Children involved in bullying (as bullies, bully-victims, and victims) were compared to other children. RESULTS: More boys than girls were found to be involved in bullying. Bully-victims scored highest in externalizing behaviour and hyperactivity, and they themselves reported feelings of ineffectiveness and interpersonal problems. Victims scored highest in internalizing behavior and also psychosomatic symptoms, and they themselves reported anhedonia. Some gender differences in psychiatric symptomatology were also found. Children involved in bullying, especially children who both bullied and were bullied themselves, were psychologically disturbed. More children involved in bullying than others were referred for psychiatric consultation. The probability of being referred was highest among bully-victims (6.5 fold for males and 9.9 for females when compared to children not involved in bullying). CONCLUSIONS: The findings indicate that bullying is a common phenomenon among children who are psychologically disturbed. Bullying also elevates the probability of being referred for psychiatric consultation.

Validity of child psychiatric screening methods.

The Parent Questionnaire (scale A2), the Teacher Questionnaire (scale B2) by Rutter, and the Children's Depression Inventory (CDI) were validated using ROC-analysis. The material was collected from an epidemiological study of a normal population of 5664 8-9 year-old children. The screening results were compared with the corresponding parent, teacher, and child (DISC) interviews. In addition to this traditional way of validating the combined interview, results from all three interviews were also used. We found that the Teacher Questionnaire scale B2 was the most valid, and had the best overall power to discriminate psychiatric disturbances. The Teacher Questionnaire (scale B2) may be recommended when screening child psychiatric disturbances. The Parent Questionnaire (scale A2) was also found to be a valid instrument. Our results do not support the use of CDI as a sole screening instrument of psychiatric disturbances in children.

Should depression in young school-children be diagnosed with different criteria?

In a two-stage epidemiological study 5686 randomly selected 8 to 9-year-old children were screened using the CDI (Children's Depression Inventory), of whom 418 were questioned with the DISC-C1 (Diagnostic Interview Schedule for Children). According to DSM-III criteria the prevalence of MDD (Major Depressive Disorders) was 0.48% and of DD (Dysthymic Disorder) 0.06%. The prevalence rates did not change when DSM-III-R and DSM-IV criteria were employed. Fifteen children reported suicidal thoughts but according to DSM-III criteria only 1 of these children was depressed. Duration and frequency of depressive symptoms are essential for making a diagnosis of depressive disorder by the DSM-III, but children's reliability in reporting them is questionable. Omitting the duration and frequency of symptoms from the DSM-III criteria raised the prevalence of MDD to 4.0% and of DD to 2.2%. Eight of the children with suicidal thoughts were depressed. By the adapted DSM-III-R and DSM-IV criteria the prevalence rate of MDD was 4.0% and of DD 9.7%.

Self-concept of Finnish children on the second grade of normal elementary school.

The study deals with the self-concept of healthy and disturbed pupils on the second grade of normal elementary school. The self-concept is defined as the cognitive and emotional concept of an individual about himself. The material consisted of 143 urban children (67 boys, 76 girls) and 241 rural children (116 boys, 125 girls). The instruments used were "I think I am" a childrens' self-estimation questionnaire of self-concept (by P. Ouvinen-Birgerstam) and Parent's Questionnaire A2 and Teacher's Questionnaire B2 (both by M. Rutter). The study was carried out as a point-prevalence study in April 1986. The boys had a highly significantly worse self-concept than the girls. There were no differences in self-concept between urban and rural children. The boys and girls who were estimated as psychically disturbed according to the ratings made by parents had a nearly significantly worse self-concept than the children who were estimated as healthy. There were no differences in the self-concept of boys and girls rated as disturbed or healthy by the teachers. The boys and girls rated as disturbed by parents had a worse self-concept than the boys and girls rated as disturbed by teachers. There were no differences in the self-concepts of disturbed boys and girls rated as hyperactive or non-hyperactive by parents and/or teachers.