Burden and preference-based quality of life associated with bullying in children.

The objectives of this study are to assess the association between childhood bullying and preference-based health-related quality of life (QoL) in Australian school children and their parents and estimate quality-adjusted life years (QALYs) associated with bullying chronicity. Children aged 8-10 years completed the child health utilities (CHU-9D), while parents completed the Australian quality of life (AQoL-8D). Children were grouped into four categories of bullying involvement (no bullying, victim, perpetrator, or both perpetrator and victim) based on the Revised Olweus Bully/Victim Questionnaire. Parental data were compared across two bullying involvement groups (bullying vs. no bullying). QALYs were calculated for children over two years and comparisons made based on the number of assessments where bullying was reported (baseline, 1- and 2-year follow up). Children who were involved in bullying (victims and/or perpetrators) reported statistically significantly lower mean utility scores compared to children who were not involved in bullying. Parents whose child was involved in bullying had significantly lower mean utility scores compared to parents of children not involved with bullying. There appeared to be a dose-response relationship, with higher QALY losses associated with increasing frequency of reported bullying. Bullying among Australian school children was associated with significantly lower preference-based QoL for themselves and their parents. This study also confirmed the significant burden of disease for bullying among children measured by an incremental decrease in QALY with an increasing chronicity of bullying over time.

Preventing suicide in refugees and asylum seekers: a rapid literature review examining the role of suicide prevention training for health and support staff.

BACKGROUND: Refugees and asylum seekers are exposed to a unique set of circumstances and experiences that are associated with an increased suicide risk. Suicide prevention training has been recognised as a central component supporting a comprehensive approach to suicide prevention. Limited literature exists exploring the role of suicide prevention training for health and support staff working with refugee and asylum seeker consumers. METHODS: To determine the impact suicide prevention training for health staff may have in supporting refugee and asylum seeker suicide prevention, researchers undertook a rapid literature review exploring what elements should be considered when developing suicide prevention training for health and support staff working with refugee and asylum seeker consumers. RESULTS: Results of academic and grey literature screening identified 14 studies exploring suicide prevention training for health and support staff working with refugee and asylum seeker consumers. Findings of the literature review suggest suicide prevention training for health and support staff working with refugee and asylum seekers should consider the inclusion of content which increases participant competence and confidence to identify and respond to suicide risk; provide staff with an understanding of cultural differences and its impact on refugees and asylum seekers recognition of mental health and suicide as a health matter; highlight the importance trauma informed practices in care and consider the lived experience of refugees and asylum seekers. CONCLUSIONS: Inclusion of specific content in refugee and asylum seeker suicide prevention training may provide health and support staff increased competence and confidence to identify and respond to suicide risk in refugees and asylum seekers.

Supports and Interventions for Carers of a Person with Depressive or Anxiety Symptomology: A Systematic Review.

An increasing body of research attests to the capacity of evidence-based interventions to improve outcomes for informal carers. A review of suitable supports and interventions for carers of a person with depressive or anxiety symptomology is timely. This systematic review explores intervention suitability evidence for this carer group. Searches for relevant primary studies were conducted in six databases across a 15-year timeframe (October 2004-October 2019). Studies were assessed and compared narratively and thematically. Qualitative themes were synthesised with quantitative studies to explore the extent to which carer preferences were embedded in interventions. The initial literature search produced 13,183 studies. Six studies-three randomised controlled trials (RCTs) and three mixed-method studies-were included following a double-blinded screening process, a review of reference lists and risk of bias assessment. Included studies contributed either intervention efficacy or acceptability evidence. The synthesis of qualitative themes with quantitative studies found that carer-specific needs and targeted psychoeducation were featured in interventions from all six quantitative studies. Current evidence for appropriate supports and interventions for this carer group is limited. The review uncovers a lack of interventions for carers of a person with anxiety symptomology and limited intervention suitability evidence for carers of a person with depressive symptomology. More research is needed to explore the needs and preferences of this carer group, and how best to support them.

Post-traumatic growth in prisoners and its association with the quality of staff-prisoner relationships.

BACKGROUND: Being sentenced to imprisonment can be traumatic. This may lead to further negative effects, including reoffending or disorders of mental health. Emerging research, however, has suggested that traumatic events can, at times, also lead to post-traumatic growth, leading us to question whether prisoners could experience this. AIMS: Our aims were to explore the prevalence of post-traumatic growth in prisoners and any association between this and prisoners' perceptions of the quality of their relationships with staff. Our primary hypothesis was that there would be a positive association between perceptions of the quality of relationships with staff members and post-traumatic growth. We also hypothesised an interaction between staff-prisoner relationships and the extent to which sentencing was experienced as traumatic. METHOD: The Post-traumatic Growth Inventory and the Barrett-Lennard Relationship Inventory were distributed to all 762 prisoners in a high-security prison for adult men in England. First, one-tailed correlations between variables were run, then a hierarchical regression analysis was conducted to test for an interaction between staff-prisoner relationship ratings, trauma of sentencing and post-traumatic growth. RESULTS: Just over one fifth of the men (n = 160) returned questionnaires; 76 (48%) had scores indicative of moderate-to-high post-traumatic growth. There was a significant positive association between perceptions of the relationships with staff members and the post-traumatic growth reported. There was no significant interaction between the staff-prisoner relationships and the experience of trauma of imprisonment. CONCLUSIONS: Our study extends understanding of prisoners through finding that higher levels of self-rated post-traumatic growth were associated with experiencing empathy, positive regard, acceptance and genuineness from prison staff. This highlights the need for high-quality relationships to be adopted in all aspects of prison setting and culture and offers further direction for research into such relationships and their role in promoting positive psychological outcomes.

Defending victims of cyberbullying: The role of self-efficacy and moral disengagement.

Cyberbullying is a significant problem worldwide that affects adolescents' social relations, academic achievement, and mental health. As this form of bullying is typically viewed by a large audience it is important to understand the role of observers as they may hold a key for reducing bullying. The aim of this study was to investigate the role of the socio-cognitive factors of defending self-efficacy (i.e., belief in one's capability to defend) and moral disengagement (i.e., justifications for aggressive behavior) associated with general cyber defending behavior and cyber defending response types: constructive and aggressive. Participants were 540 male and female students of diverse racial identity between the ages of 11 and 15 years who completed a questionnaire comprising multiple measures. Regression analyses revealed that at low levels of defending self-efficacy, moral disengagement was unrelated to general cyber defending behavior. However, at high levels of defending self-efficacy, moral disengagement was positively associated with general cyber defending. Further regression analyses revealed that the results for constructive cyber defending were the inverse of those obtained for aggressive defending. Defending self-efficacy was positively associated with constructive defending and negatively associated with aggressive defending. Moral disengagement was negatively associated with constructive defending and positively associated with aggressive defending. These results address the perplexing issue of why moral disengagement has been related to defending in some studies and not in others. As with most measures of defending, the general cyber defending measure confounds constructive and aggressive defending.

Combining whole-school and targeted programs for the reduction of bullying victimization: A randomized, effectiveness trial.

Despite the extensive evaluation of school-based interventions for bullying, victimization remains a significant problem in schools. Bullying victimization is significantly predicted by contextual (school-related) factors. As a consequence whole-school programs have been commonly used to prevent and reduce bullying victimization. Evidence also points to individual risk factors (such as emotional distress) in predicting victimization, yet programs to prevent bullying victimization by changing these individual risks are far less developed. Few studies have approximated "real-world" implementation conditions in their trials. The current effectiveness trial evaluated the combination of a whole-school program designed to prevent bullying perpetration and victimization together with a targeted intervention for at-risk students, teaching them individual and dyadic strategies to reduce their anxiety and manage victimization, allowing schools some latitude to implement programs as they typically would. Students from Grades 3 and 4 (N = 8,732) across 135 schools were randomly assigned to one of four conditions: combined intervention; whole-school intervention only; individual intervention only; and care as usual. Victimization decreased significantly and similarly across all four conditions at 12 and 24 months following baseline. Similar reductions and failure to discriminate conditions were found on other key constructs: anxiety; bullying perpetration; and depression. Possible reasons for the failure to demonstrate victimization prevention differences and lessons learned from this large, effectiveness trial are considered.

Learning about Aboriginal health and wellbeing at the postgraduate level: novel application of the Growth and Empowerment Measure.

INTRODUCTION: Public health education strives to transform and empower students to engage in policy and practice improvement. However, little is known of the nature of such change among students, especially when studying Aboriginal health and wellbeing, which may involve disrupting long held assumptions and prejudices. This article reports findings regarding the feasibility, specificity and sensitivity of the Growth and Empowerment Measure (GEM) in the evaluation of two innovative Australian 13-week postgraduate public health electives focused on Aboriginal health and wellbeing. The GEM's 14-item Emotional Empowerment Scale (EES14) and its subscales Inner Peace and Self-Capacity, and 12 Scenarios (S12) and its subscales Healing and Growth and Connection and Purpose were used to examine transformative experiences. A new short form of the S12, the Core6, was also trialled as a briefer measure of functional empowerment. METHODS: Pre-course GEM responses and demographic information were collected from consenting students during the mandatory, face-to-face workshops of the Aboriginal public health Perspectives course and the Aboriginal empowerment and wellbeing Lifespan course. The two-day Perspectives course workshop introduced a group scenario-building activity towards ending health inequality. Lifespan students experienced a 3-day immersion based on Stage 1 of the Aboriginal Family Well Being empowerment program. Insights from both workshops were further integrated through structured online discussions and written assessments. At the end of semester, a post-course GEM was mailed to students for completion and return. Students could also provide feedback through evaluation surveys and semi-structured focus groups. Effect sizes were assessed using paired t-tests, Wilcoxon signed-rank tests and multiple ANOVA. Cronbach's alpha confirmed internal consistency. RESULTS: Baseline GEM data was provided for 147 out of a total of 194 workshop experiences from participating students. Twenty students attended workshops for both Perspectives and Lifespan. Fifty-five matched pairs (representing 52 individual participants) were obtained from 170 students who completed one or both courses. Statistically significant positive change of small to medium effect size was detected in all GEM scales, subscales and some individual items. Lifespan yielded larger effects than Perspectives, most markedly on two subscales: Inner Peace, and Connection and Purpose. Participating students reported significant growth in the Scenario item 'knowing and being who I am' following Perspectives and Lifespan. Those completing Perspectives also reported a significant increase in 'gaining voice and being heard', consistent with its action-oriented scenario-building assessment. In contrast, the psychosocial development approach embedded in Lifespan stimulated strong development in spirituality, responding constructively to judgement, appreciating empowerment in their communities and skills to make changes in their lives. Feedback indicated that students valued these personal and professional growth experiences. CONCLUSION: The GEM was sensitive and specific in measuring components of empowering change among participants. Challenges included low post-course response rates that limited extrapolation to overall course impact, and attention needed to starting point when comparing the increment of change. The GEM is a promising tool for studying postgraduate courses designed to stimulate transformative learning, wellbeing and cultural competence through empowerment, and relevant in the education of health professionals in the fields of Aboriginal and rural health.

Depression, Anxiety, and Peer Victimization: Bidirectional Relationships and Associated Outcomes Transitioning from Childhood to Adolescence.

Experiences of depression, anxiety, and peer victimization have each been found to predict one another, and to predict negative outcomes in the domains of school connectedness, social functioning, quality of life, and physical health. However, the common co-occurrence of depression, anxiety, and peer victimization experiences has made it difficult to disentangle their unique roles in these associations. The present study thus sought to characterize the precise nature of the bidirectional relationships between depressive symptoms, anxiety, and victimization over time, and to examine their unique sequelae during the transition from childhood to early adolescence. Longitudinal multi-informant (child-reported, parent-reported, and teacher-reported) data from a nationally representative sample were analyzed using path analysis when the study child was aged 10-11 (n= 4169; Mage = 10.3; 48.8% female) and aged 12-13 (n= 3956; Mage = 12.4; 48.2% female). Depressive symptoms, anxiety, and peer victimization had small but significant unique bidirectional relationships. All three constructs also uniquely and prospectively predicted poorer life functioning across all domains examined. These results demonstrate that current interventions should broaden their scope to simultaneously target depression, anxiety, and peer victimization, as each of these experiences independently act as additive risk factors for subsequent negative outcomes.

Correction to: Cyber Victimization and Internalizing Difficulties: The Mediating Roles of Coping Self-Efficacy and Emotion Dysregulation.

The authors would like to note an error in the appendix, as items 13-16 are worded incorrectly in this paper. We apologise sincerely, this was a mistake made when formatting changes occurred. The stem of the question from the previous item was carried forward and not changed in the current item.

Cyber Victimization and Internalizing Difficulties: The Mediating Roles of Coping Self-Efficacy and Emotion Dysregulation.

Cyber victimization has consistently been associated with internalizing difficulties in adolescents. However, the underlying psychological mechanisms linking this relationship have not been adequately examined. The present study aimed to investigate the mediational roles of coping self-efficacy and emotion dysregulation in the relationships between cyber victimization with depression and social anxiety. Participants were 459 students (199 girls) from independent middle-class schools in grades 8 (M age = 13 years 9 months) and 10 (M age = 15 years 7 months). They completed a self-report questionnaire about cyberbullying participation, internalizing symptoms, coping self-efficacy, and emotion dysregulation. Structural equation modeling revealed that most domains of coping self-efficacy and emotion dysregulation partially mediated the relationship between cyber victimization and depression, and fully mediated the relationship between cyber victimization and social anxiety. The results highlight the importance of targeting these mediating factors in intervention programs to reduce the negative impact of cyber victimization on adolescents.

Associations between the group processes of bullying and adolescent substance use.

The adverse impact of bullying and victimization on substance use among youth has received increasing attention. Bullying is a specific type of aggressive behavior that not only involves bullies and victims but also followers, who actively support or reinforce the bully; defenders, who intervene to defend or assist the victim; or outsiders who passively observe or ignore the bullying. Limited research to date has linked these five bullying role behaviors to substance use. The aim of this study was to investigate the relationship between each of the bullying role behaviors and adolescent alcohol and tobacco use. Participants were 1255 (748 female) students (Mage=15.3, age range: 13-17years) in Grades 9 (n=714) and 11 (n=541). Bullying role behaviors, alcohol and tobacco onset and intensity, and alcohol-related harms were assessed. Results revealed an association between pro-bullying behavior (bullying and following) and all substance use variables, and between defender behavior and smoking and alcohol-related harm. No relationship between victimization, or outsider behavior, and substance use was found after controlling for the other bullying roles. The findings highlight the complex relationship between bullying roles, alcohol and tobacco use and alcohol-related harm in adolescents.

Improving health service access and wellbeing of young Aboriginal parents in an urban setting: mixed methods evaluation of an arts-based program.

OBJECTIVES: To evaluate an urban art-based community health program (Ngala Nanga Mai; We Dream) that seeks to improve health, education, empowerment and connectedness of Aboriginal parents by describing paediatric health service attendance, maternal educational engagement, participant growth and empowerment, and worker and participant experiences. METHODS: Mixed methods were used. Qualitative data was collected through interviews and focus groups. Demographics, health service use and child health status were extracted from clinical records. Psycho-social empowerment and wellbeing was measured using the Growth and Empowerment Measure (GEM). A Critical Effectiveness Factor framework that measures factors necessary for success, effectiveness and sustainability was used to assess program quality. RESULTS: Between 2009 and 2012, 92 Aboriginal parents participated. A total of 93.5% of regular participants engaged their children at least once with paediatric health services and 27.1% undertook further education. Empowerment scores significantly improved, despite little change in psychological distress. The program operationalised all 10 Critical Effectiveness Factors for youth wellbeing. CONCLUSIONS: Ngala Nanga Mai creates an environment of social connectedness, strengthened parenting, maternal and child wellbeing and empowerment. It supports increased utilisation of health, education and support services, and early detection of treatable child health issues. IMPLICATIONS: Improving the health of Aboriginal children requires new strategies and learning from innovative programs. Solid baseline data, long-term follow-up data and meaningful health outcome data are critical to improving services and health outcomes at the program level. Ultimately, long-term commitment to adequate resourcing is needed in order to deliver broader improvement of child health outcomes.

The development of the Social Bullying Involvement Scales.

This study reports findings of a newly developed measure of social bullying based on Underwood's [2003] framework of social aggression. The Social Bullying Involvement Scales (SBIS) consist of four scales measuring the extent to which children experience social victimization, engage in social bullying, witness social bullying, and intervene in social bullying. The sample consisted of 636 participants (311 females and 325 males, age range 11-16 years; 71% White). Confirmatory factor analysis supported a revised version of Underwood's framework for each of the four participant role scales. Internal consistencies for each scale ranged from .93 to .97. Results revealed that social victimization was related to an increase in anxiety, depressive, and externalizing behaviors. Social bullying was associated with an increase in general externalizing behaviors only. Social witnessing was moderately correlated with depression scores. Intervening in social bullying was not linked with psychological maladjustment or externalizing behaviors. The SBIS provides a comprehensive measure of social victimization, social bullying, social witnessing, and social intervening.

Beyond sorry--the first steps in laying claim to a future that embraces all Australians.

The Prime Minister has issued a formal, unqualified apology to Australia's Indigenous peoples for past mistreatment, particularly for the sufferings of those who were affected by the forced removal of children from their families. The Apology needs to be seen as the first step in a reparations process that adheres to human rights principles, involves Australians at all levels, is sustainable and upholds self-determination. The Apology is the first of five steps recommended in Bringing them home: the report of the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families. Further steps are: guarantees against repetition, measures of restitution, measures of rehabilitation, and monetary compensation, but the Prime Minister has steadfastly refused to discuss reparations or compensation. Monetary compensation has been recognised internationally as an essential component in the redress for similar experiences of the forced removal of children. As long as the final steps in reparation remain unresolved, they will obstruct our pathway to a future that embraces all Australians.