Time trends and disparities in anxiety among adolescents, 2012-2018.

PURPOSE: Prior studies have been inconclusive in documenting whether the prevalence of adolescent anxiety is increasing, given sampling and measurement limitations. This study adds new information on recent time trends in anxiety prevalence, specifically investigating trends among previously unexamined sociodemographic subgroups. METHODS: Weighted data of 37,360 youth respondents (51.1% female, 71.8% White, 91.3% heterosexual, 99.2% cisgender) from the 2012-2018 Dane County Youth Assessment, a county-wide survey administered to youth in participating school districts, were analyzed to estimate time trends in anxiety prevalence among the whole sample and by sociodemographic subgroups. RESULTS: The prevalence of youth meeting anxiety-screening criteria increased from 34.1% (95% CI 33.4-34.9) in 2012 to 44% (95% CI 43.2-44.7) in 2018 (OR for trend = 1.07, P for trend < 0.001). The trend remained significant after adjusting for known confounds (AOR for trend = 1.07, P for trend < 0.001). Anxiety increased significantly for several subgroups and widening disparities were documented among females relative to males (P < 0.001), and sexual minority youth relative to heterosexual youth (P = 0.003). In addition, Black youth did not increase at the same swift rate as White youth over the study period (P < 0.001). CONCLUSION: This study reports recent data on anxiety time trends and finds that among a geographically representative sample of adolescents, anxiety prevalence is rising. Findings provide new evidence documenting increased anxiety prevalence among sexual minority youth relative to their peers. Results highlight the need to bolster public health interventions focused on adolescent mental health, with tailored interventions for vulnerable groups.

School Connectedness Still Matters: The Association of School Connectedness and Mental Health During Remote Learning Due to COVID-19.

School connectedness is consistently associated with adolescent mental health and well-being. We investigated whether student perceptions of school connectedness were associated with anxiety and depressive symptoms, even during remote learning due to COVID-19. In June of 2020, after 13 weeks of remote learning, 320 middle and high school students in one Massachusetts school district completed an online survey that included questions about their perceptions of school connectedness, social connectedness, and symptoms of anxiety and depression. Students were approximately evenly distributed across grades, with 37% in middle school (grades 6-8) and 63% in high school (grades 9-12). School connectedness had a significant negative association with symptoms of anxiety and depression. This association persisted in models controlling for demographic factors and social connectedness. Findings indicate that school connectedness is associated with student mental health, even in the context of remote learning due to COVID-19. Schools engaged in remote learning should consider how to foster school connectedness as a means of supporting youth mental health, particularly given expected increases in the mental health needs of adolescents.

A systematic review of primary prevention strategies for sexual violence perpetration.

This systematic review examined 140 outcome evaluations of primary prevention strategies for sexual violence perpetration. The review had two goals: 1) to describe and assess the breadth, quality, and evolution of evaluation research in this area; and 2) to summarize the best available research evidence for sexual violence prevention practitioners by categorizing programs with regard to their evidence of effectiveness on sexual violence behavioral outcomes in a rigorous evaluation. The majority of sexual violence prevention strategies in the evaluation literature are brief, psycho-educational programs focused on increasing knowledge or changing attitudes, none of which have shown evidence of effectiveness on sexually violent behavior using a rigorous evaluation design. Based on evaluation studies included in the current review, only three primary prevention strategies have demonstrated significant effects on sexually violent behavior in a rigorous outcome evaluation: Safe Dates (Foshee et al., 2004); Shifting Boundaries (building-level intervention only, Taylor, Stein, Woods, Mumford, & Forum, 2011); and funding associated with the 1994 U.S. Violence Against Women Act (VAWA; Boba & Lilley, 2009). The dearth of effective prevention strategies available to date may reflect a lack of fit between the design of many of the existing programs and the principles of effective prevention identified by Nation et al. (2003).

Social-emotional functioning among bias-based bullies, victims, and bully-victims.

Bias-based harassment in U.S. schools is an increasingly significant concern for students' well-being. Although research on bullying broadly defined has indicated that the ways in which youth are involved in bullying (i.e., as bullies, victims, and bully-victims) are differentially associated with functioning, this study adds to extant research by exploring whether similar patterns emerge for bias-based harassment. A nationally representative sample of 639 adolescents, ages 13-17, completed online surveys in 2021 that included measures of bias-based harassment, anxiety, depression, substance use, and school social support. Findings from a multivariate latent variable model indicated that after controlling for demographic variables, compared to individuals not involved in bias-based harassment, students involved as victims, perpetrators, or both victims and perpetrators of bias-based harassment (i.e., bias-based bully-victims) reported more mental health symptoms. Substance use was elevated for bias-based perpetrators and bully-victims, whereas school social support was diminished for bias-based victims and bully-victims. Notably, bias-based bully-victims had the highest levels of anxiety symptoms and substance use, and lowest levels of school social support, among all adolescents. Findings highlight that involvement in bias-based harassment in any capacity is associated with deleterious functioning, with bias-based bully-victims reporting particularly adverse functioning across domains. Bolstering protective factors such as school social support would be a useful component of school practices and prevention programs related to bias-based harassment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Identifying protective factors for gender diverse adolescents' mental health.

Few studies have disentangled differences in victimization exposures and mental health symptoms among gender diverse subgroups, nor considered the role of potential protective factors in ameliorating the impact of victimization on gender diverse youths' mental health. Here we report findings from a secondary data analysis, in which we address this gap by analyzing cross-sectional survey data (N = 11,264 in the final analytic sample) from a population-based survey of youth in participating school districts in a large Midwestern U.S. county. Relative to cisgender youth with gender conforming expression, transgender youth and cisgender youth with nonconforming gender expression are more likely to experience victimization and severe mental health concerns. Additionally, school-connectedness moderates the association between bias-based harassment and depression for cisgender youth with gender nonconforming expression, and family support/monitoring buffers the association of peer victimization with suicide attempts among transgender youth. Findings highlight the need to better understand factors which may confer protection among gender diverse adolescents, so that in turn appropriate supports across key contexts can be implemented.

A systematic meta-review of evaluations of youth violence prevention programs: Common and divergent findings from 25 years of meta-analyses and systematic reviews.

Violence among youth is a pervasive public health problem. In order to make progress in reducing the burden of injury and mortality that result from youth violence, it is imperative to identify evidence-based programs and strategies that have a significant impact on violence. There have been many rigorous evaluations of youth violence prevention programs. However, the literature is large, and it is difficult to draw conclusions about what works across evaluations from different disciplines, contexts, and types of programs. The current study reviews the meta-analyses and systematic reviews published prior to 2009 that synthesize evaluations of youth violence prevention programs. This meta-review reports the findings from 37 meta-analyses and 15 systematic reviews; the included reviews were coded on measures of the social ecology, prevention approach, program type, and study design. A majority of the meta-analyses and systematic reviews were found to demonstrate moderate program effects. Meta-analyses yielded marginally smaller effect sizes compared to systematic reviews, and those that included programs targeting family factors showed marginally larger effects than those that did not. In addition, there are a wide range of individual/family, program, and study moderators of program effect sizes. Implications of these findings and suggestions for future research are discussed.

Associations between school-related factors and mental health among transgender and gender diverse youth.

Transgender and gender diverse youth (TGD) report high rates of mental health concerns. However, there is reason to expect that among TGD youth there is variation in mental health experiences related to specific aspects of gender identity. Furthermore, although certain school characteristics are related to improved mental health for sexual minority youth, it is unclear whether the same school characteristics are associated with improved mental health for TGD youth and whether gender identity moderates the associations between school characteristics and mental health. Using baseline data from Project AVANT, a longitudinal study of TGD youth ages 14-18 years in the United States (N = 252), we report on several mental health outcomes (i.e., depression, anxiety, nonsuicidal self-injury, and PTSD), with attention to differences by gender identity. Secondly, we examined associations of three protective school-related factors (i.e., school-connectedness, presence of a Gay-Straight or Gender-Sexuality Alliance [GSA], and state mandated protections for sexual and gender minority students) with TGD youth mental health. TGD youth reported elevated levels of anxious and depressive symptoms, with nonbinary youth assigned female at birth reporting higher mean depressive symptoms relative to transgender females. Among the aggregate sample of TGD youth, 69.9% reported clinically significant anxiety, 57.9% reported clinically significant depression, 56.7% reported nonsuicidal self-injury, and 46.4% met screening criteria for posttraumatic stress disorder. Despite a small effect size, greater school-connectedness was significantly associated with fewer mental health concerns and gender identity moderated the association between school-connectedness and number of anxiety symptoms. Gender identity also moderated the association between presence of a GSA and number of anxious symptoms, depressive symptoms, and clinically significant depression, respectively. No significant associations of state-level protections and mental health outcomes were detected. Findings highlight the importance of improving mental health and fostering GSA-engagement and school-connectedness among TGD youth. Implications for school psychologists are discussed.

Perceived consequences of hazing exposure during the first year of college: Associations with childhood victimization.

Objective: This study investigates the association between histories of childhood victimization and perceived consequences of college hazing. Participants: First-year college students at four US universities (N = 120). Method: Participants completed Web-based surveys asking about childhood victimization (eg, child maltreatment), peer victimization, and perceived consequences of hazing during college. Results: Results indicated that college students with childhood victimization histories perceived hazing to be negative. In particular, physical dating violence and a greater total number of childhood victimization exposures were related to a higher number of perceived negative consequences. Conclusion: Past victimization exposures confer risk on college students who experience hazing, in that these students are more likely to perceive negative consequences of hazing. Hazing-related policies and outreach efforts should consider these potential negative consequences, and counselors should be aware of the link between past victimization and how hazing might be experienced.

All Things in Moderation? Threshold Effects in Adolescent Extracurricular Participation Intensity and Behavioral Problems.

BACKGROUND: School-based extracurricular activity participation is one of the primary avenues for prosocial activity engagement during adolescence. In this study, we test the "overscheduling hypothesis" or whether the negative relationship between structured activity intensity (ie, hours) and adolescent bullying and fighting levels off or declines at moderate to high intensity (ie, threshold effects). METHODS: This study uses the Dane County Youth Survey (N = 14,124) to investigate the relationship between school-based extracurricular activity participation intensity and bullying perpetration and physical fighting and whether there are threshold effects of activity participation intensity. RESULTS: The results indicate that there is a negative relationship between extracurricular activity participation intensity and bullying perpetration and physical fighting and that there are threshold effects in these relationships at 3 to 4 hours per week. Results also suggest that low-income adolescents engage in more fighting than other youth and the negative relationship between activity participation intensity and physical fighting was mainly concentrated among low-income adolescents. CONCLUSIONS: School-based extracurricular activity participation-in moderation (ie, up to 3-4 hours per week)-may provide a positive, supportive context that could be a promising prevention strategy for bullying and fighting. Implications for future research on how school-based extracurricular activity participation intensity benefits adolescent functioning are discussed.

Initial evidence for the validity of the California Bullying Victimization Scale (CBVS-R) as a retrospective measure for adults.

Childhood bullying is an important predictor of psychological and health outcomes in adulthood; however, validated retrospective measures of childhood bullying are lacking. This study investigates the psychometric properties of an adult retrospective version of the California Bullying Victimization Scale (CBVS). The CBVS self-report measure was developed for use with children and adolescents to assess the three definitional characteristics of bullying (aggression that is chronic, intentional, and involves an imbalance of power), without using the term "bullying." In the current study, we evaluate patterns of retrospective reports of bullying victimization, and compare results to a common definition-first measure of bullying. Concurrent validity and 4-year stability are addressed. In the fall of 2012, entering first-year students at 4 universities in the United States (N = 1,209; 65.2% female) completed the California Bullying Victimization Scale-Retrospective (CBVS-R) as part of an online survey. In spring of 2016, participants at 2 universities who provided contact information (N = 175) completed a 4-year follow-up survey. Results support the validity of the CBVS-R as a retrospective self-report measure of bullying victimization experienced in childhood. In particular, the percent of respondents classified as being bullied (27.9%) and age- and gender-related patterns of victimization were consistent with known patterns of childhood bullying. In addition, respondents reporting childhood victimization indicated increased psychological distress in adulthood. However, stability of reports across a 4-year follow-up period were lower than expected (κ = .38). Implications for the use of retrospective reports of childhood bullying victimization are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Multiple victimization experiences of urban elementary school students: associations with psychosocial functioning and academic performance.

OBJECTIVE: This study explored the victimization experiences of urban elementary school students to determine whether subsets of youth emerged with similar victimization profiles (e.g., no victimization, multiple types of victimization). It also evaluated whether multiple victimization was associated with greater psychological distress and lower academic performance. METHODS: Participants were 689 fifth grade students from an urban, ethnically diverse school district in the Northeast. Youth completed self-report measures in school about bullying victimization, victimization in the home and community, and psychosocial functioning. RESULTS: Cluster analysis suggested the existence of three distinct youth profiles: those with minimal victimization, those victimized primarily by their peers, and those with multiple types of victimizations. As hypothesized, youth with multiple victimizations experienced more psychological distress and earned lower grades than their peers. CONCLUSIONS: Findings highlight the heterogeneity of youth victimization experiences and their relations to functioning, and have implications for treatment planning among practitioners working with youth.

Similarities in siblings' experiences of neglectful parenting behaviors.

OBJECTIVE: Researchers and policymakers typically assume that within families, individual children are at an equivalent risk of neglectful behaviors. There is evidence that siblings experience differential parental treatment, and some research suggests that parents may maltreat their children to differing degrees. However, because neglect is typically a family-level construct, there may be a high correlation between siblings for this type of parental behavior. Therefore, our objectives were to investigate the extent to which siblings reported similar parental neglectful behaviors, whether sibling correlations for family-level types of neglectful behaviors were greater than those for child-specific forms of neglectful behaviors, whether high-risk groups differed from lower-risk groups in similarity for sibling reports for neglectful behaviors, and factors predicting differences in sibling reports of parental neglectful behaviors. METHOD: We assessed parental neglectful behaviors using child reports for 59 sibling pairs, representing both clinical and community samples. All children completed the Multidimensional Neglectful Behaviors Scale, which measures both child-specific and family-level neglectful parenting behaviors. RESULTS: Sibling intraclass correlations for neglectful behaviors were high and significant, and there were no differences in sibling correlations between clinical and community samples. Furthermore, there were no differences in correlations for family-level and child-specific items. Opposite sex siblings reported greater differences in parental neglectful behaviors, with boys reporting more neglectful behaviors than girls. CONCLUSIONS: Siblings report similar neglectful parenting behaviors, regardless of whether the family is high-risk or not, and whether neglectful behaviors are measured as a family-level or child-specific phenomenon.

School- and Classroom-Based Supports for Children Following the 2013 Boston Marathon Attack and Manhunt.

School staff provide key mental health services following mass crisis events and teachers, in particular, can provide important supports within their classrooms. This study examines Boston-area teachers' perception of classroom-wide psychiatric distress and the types of supports that schools and teachers provided following the 2013 Boston Marathon bombing and subsequent manhunt. Boston-area K-12 teachers (N = 147) in communities with varying levels of exposure to the bombing and manhunt completed an anonymous web-based survey 2-5 months after the attack. Teachers reported on students' exposure to the bombings and manhunt, classroom-wide psychiatric distress, and the types of supports they and their schools provided students. Teacher reports of student exposure to the bombings and manhunt were significantly associated with their perceptions of greater classroom-wide psychiatric distress. Almost half indicated that their school had no formal policy for responding to the crisis, half reported no training to address events, and even the most common classroom-based support strategy-reassuring students of their safety-was provided by only 76 % of teachers. Teacher perceptions of student exposure to the manhunt, but not the bombing, were significantly associated with greater provision of these supports. In the aftermath of the Boston Marathon bombings and manhunt, teachers and schools provided supports; however, the extent and types of supports varied considerably. Working with teachers to most effectively and consistently serve in this complex role has the potential to improve school-based crisis response plans, as well as student outcomes.

Bullying and suicidal ideation and behaviors: a meta-analysis.

BACKGROUND AND OBJECTIVES: Over the last decade there has been increased attention to the association between bullying involvement (as a victim, perpetrator, or bully-victim) and suicidal ideation/behaviors. We conducted a meta-analysis to estimate the association between bullying involvement and suicidal ideation and behaviors. METHODS: We searched multiple online databases and reviewed reference sections of articles derived from searches to identify cross-sectional studies published through July 2013. Using search terms associated with bullying, suicide, and youth, 47 studies (38.3% from the United States, 61.7% in non-US samples) met inclusion criteria. Seven observers independently coded studies and met in pairs to reach consensus. RESULTS: Six different meta-analyses were conducted by using 3 predictors (bullying victimization, bullying perpetration, and bully/victim status) and 2 outcomes (suicidal ideation and suicidal behaviors). A total of 280 effect sizes were extracted and multilevel, random effects meta-analyses were performed. Results indicated that each of the predictors were associated with risk for suicidal ideation and behavior (range, 2.12 [95% confidence interval (CI), 1.67-2.69] to 4.02 [95% CI, 2.39-6.76]). Significant heterogeneity remained across each analysis. The bullying perpetration and suicidal behavior effect sizes were moderated by the study's country of origin; the bully/victim status and suicidal ideation results were moderated by bullying assessment method. CONCLUSIONS: Findings demonstrated that involvement in bullying in any capacity is associated with suicidal ideation and behavior. Future research should address mental health implications of bullying involvement to prevent suicidal ideation/behavior.

Development and preliminary psychometric properties of the multidimensional neglectful behavior scale-child report.

This article describes the development and psychometric properties of the Multidimensional Neglectful Behavior Scale-Child Report (MNBS-CR). The measure is broadly conceptualized to tap child neglect across four core domains: cognitive, emotional, physical and supervisory neglect, and it assesses exposure to violence, alcohol-related neglect, abandonment, and children's appraisals of parenting. Features include pictorial items, audio computer-assisted testing, and programming by age and gender of the child and caregiver. A clinical sample of 144 children, age 6 to 15 years, and a comparison sample of 87 children were tested. Results showed that the MNBS-CR has high reliability, with higher reliability found for older children (alpha = .94) than for younger children (alpha = .66). Among older children, the MNBS-CR Supervisory scale was significantly associated with the Child Behavior Check List (CBCL), and total MNBS-CR scores were significantly associated with clinician reports of behavioral disorders. Younger and older neglected children scored significantly higher on the MNBS-CR than community children.

Associations between past bullying experiences and psychosocial and academic functioning among college students.

OBJECTIVES: This study examined whether childhood bullying victimization was associated with psychosocial and academic functioning at college. PARTICIPANTS: The sample consisted of 413 first-year students from a large northeastern university. METHODS: Students completed an online survey in February 2012 that included items assessing past bullying involvement, current psychosocial and academic functioning, and victimization experiences since arriving at college. RESULTS: Regression analyses indicated that reports of past bullying and other peer victimization were associated with lower mental health functioning and perceptions of physical and mental health, but were not associated with perceptions of social life at college, overall college experience, or academic performance. CONCLUSIONS: Childhood bullying victimization is associated with poorer mental and physical health among first-year college students. Colleges should consider assessing histories of bullying victimization, along with other past victimization exposures, in their service provision to students.

Suicidal ideation and school bullying experiences after controlling for depression and delinquency.

PURPOSE: This cross-sectional study examines differences in the frequency of suicidal ideation and suicidal behaviors across a group of verbal bullies, bully-victims, victims, physically aggressive bullies, and students not involved in bullying. METHODS: A large sample of middle school students (n = 661; fifth through eighth grades; ages 10-13 years of age) completed a pencil-and-paper survey that included the University of Illinois Bully, Fight, and Victim scales. Students also self-reported how often they had thought of killing themselves or deliberating hurting themselves in past 6 months, and provided information about delinquent behaviors and symptoms of depression and anxiety. RESULTS: We used cluster analysis to create bully-victim subtypes: uninvolved (n = 357), victims (n = 110), verbal bullies (n = 114), bully-victims (n = 29), and physically aggressive bullies (n = 42). Approximately 32%-38% of verbal bullies and victims, 60% of bully-victims, and 43% of physically aggressive bullies reported suicidal ideation, compared with 12% of uninvolved youth. Similarly, 24%-28% of verbal bullies and victims, 44% of bully-victims, and 35% of physically aggressive bullies reported deliberately trying to hurt or kill themselves, compared with 8% of uninvolved youth. Females in the bully-victim subtype reported particularly elevated suicidal ideation and behavior. After controlling for delinquency and depression, differences in suicidal thoughts and behaviors emerged only between uninvolved youth and the victim and bully-victim groups, but these differences were minimal. CONCLUSIONS: Findings highlight that at a bivariate level, involvement in bullying in any capacity is linked to increased risk for suicidal ideation and behavior, and echoes previous literature documenting particularly strong mental health implications for bully-victims. Furthermore, this study points to the importance of considering delinquency and depression in conjunction with suicidal ideation and behaviors.

Sexual risk taking and bullying among adolescents.

BACKGROUND: Psychological and educational correlates of bullying have been explored extensively. However, little information is available about the link between bullying and sexual risk-taking behaviors among adolescents, though for some youth it may be that sexual risk taking emerges in response to bullying involvement. Associations for both heterosexual youth and those who identify as gay, lesbian, bisexual, transgender, or questioning (GLBTQ) should be considered, as should the influence of victimization exposures in other domains. Accordingly, associations among bullying, other victimization forms, and sexual risk-taking behaviors were examined among adolescents with particular consideration to sexual orientation. METHODS: A sample of 8687 high school students completed the Dane County Youth Survey, a countywide survey administered high school students from 24 schools. Participants were asked questions about their bullying involvement and sexual risk-taking behaviors (ie, engaging in casual sex and having sex while under the influence of alcohol or drugs). RESULTS: Results indicated that bullies and bully-victims were more likely to engage in casual sex and sex under the influence. In multivariate analyses, these findings held even after controlling for demographic characteristics and victimization exposures in other domains, but primarily for heterosexual youth. CONCLUSIONS: Bullies and bully-victims engaged in more sexual risk-taking behaviors, although patterns of association varied by sexual orientation. Bullying prevention programs and programs aimed at reducing unhealthy sexual practices should consider a broader stress and coping perspective and address the possible link between the stress of bullying involvement and maladaptive coping responses.

Identifying Links Between Sexual Violence and Youth Violence Perpetration: New Opportunities for Sexual Violence Prevention.

OBJECTIVE: One promising opportunity for advancing sexual violence (SV) research and identifying new avenues for prevention involves examining other forms of violence that may share risk factors with SV. Youth violence (YV) is ideal for consideration given evidence of overlap in SV and YV risk factors, a large set of established YV risk factors across the social ecology, and the number of evidence-based YV prevention strategies available. The current paper identifies shared and unique risk factors for SV and YV and highlights evidence-based YV prevention strategies that impact these shared risk factors. CONCLUSIONS: Researchers and program developers should consider adapting and evaluating evidence-based YV prevention strategies to prevent SV. Modifying these programs to address SV's unique risk factors may maximize their potential effectiveness. In addition, expanding SV research at the outer levels of the social ecology is critical to developing community-level prevention strategies. The YV literature suggests several potential risk factors at these levels in need of research for SV, including school connectedness, social disorganization, and availability of alcohol and drugs. Using the YV literature as a starting point for expanding SV research leverages prior investments in YV research, may help identify new SV prevention strategies at a limited cost, and moves the field more quickly toward implementation of cost-effective, multidomain violence prevention strategies in communities.