Emergency Preparedness Drills for Active and Mass Shootings in Schools.

PURPOSE OF REVIEW: There is widespread use of emergency preparedness drills in public K-12 schools across the US, but considerable variability exists in the types of protocols used and how these practices are conducted. This review examines research into both "lockdown drills" and "active shooter drills" as it relates to their impact on participants across different outcomes and evaluations of their procedural integrity. RECENT FINDINGS: A number of studies on lockdown drills yielded largely consistent findings about their impacts, whereas findings related to the effects of active shooter drills are less uniform. The research also demonstrated that lockdown drills, though not active shooter drills, can help participants build skill mastery to be able to successfully deploy the procedure. Differences in how drills impact participants and whether they cultivate skill mastery are largely attributable to the type of drill being conducted. This review suggests that employing clearly defined drill procedures incorporating best practices, coupled with instructional training, can help schools prepare for emergencies without creating trauma for participants.

Individual and contextual-level predictors of progression in the bystander intervention model.

The situational model of bystander behavior is a validated 5-step process for understanding intervention in bullying and sexual harassment, yet the individual-level and contextual-level factors that facilitate the progression from one step to the next are not well understood. The purpose of the current study was to examine whether individual characteristics (social-emotional skills, affective empathy, cognitive empathy, and personal attitudes toward bullying and sexual harassment) and contextual-level factors (school climate and perceived peer attitudes toward bullying and sexual harassment) explained the association between subsequent steps of the bystander intervention model. A sample of 788 high school students completed several validated measures of these constructs. Structural equation modeling analysis revealed that each step significantly and positively predicted the next step, and the addition of a direct path from accepting responsibility to helping improved model fit. The mediational model indicated that individual-level characteristics had significant direct effects on interpreting bullying and sexual harassment as problems, accepting responsibility, and helping, and indirect effects from noticing the bullying and sexual harassment to all subsequent steps except knowing. In contrast, contextual-level effects contributed to accepting responsibility in an inverse direction.

Sexual Victimization in Adolescence: Pathways of Risk from Sexual Harassment via Risky Alcohol Use and Delinquency Among U.S. Adolescents.

Sexual harassment is a common, yet understudied form of peer victimization experienced by adolescents during a critical period in the development of sexual identity. Adverse sexual experiences early in life (e.g., child sexual abuse) can increase risk of future sexual assault victimization; however, it is unclear as to whether sexual harassment victimization is also a risk factor for sexual assault. We examined the prospective association between peer sexual harassment and experiencing sexual victimization in the following year among a community sample of 13-15-year-old adolescents (N = 800, 57% female) from the northeastern USA. We also examined whether risky alcohol use and delinquency mediated the association between sexual harassment and sexual assault victimization, as well as whether the paths differed by gender. Results indicated that sexual harassment victimization prospectively predicted later sexual victimization for both girls and boys. Using a parallel mediation path model, we determined that for girls, sexual harassment victimization predicted both risky alcohol use and delinquency, but only risky alcohol use was predictive of sexual victimization. For boys, sexual harassment victimization predicted delinquency but not risky alcohol use. Risky alcohol use was not associated with sexual victimization for boys. Findings indicate that sexual harassment victimization increases risk of later sexual victimization in adolescence, but the pathways differ by gender.

Prenatal substance exposure, early-life adversity, and parenting: Associations with adolescent stress response.

We tested a conceptual model examining associations between prenatal substance exposure and adolescent cortisol reactivity profiles in response to an acute social evaluative stressor. We included cortisol reactivity in infancy, and direct and interactive effects of early-life adversity and parenting behaviors (sensitivity, harshness) from infancy to early school age on adolescent cortisol reactivity profiles in model testing. Participants were 216 families (51% female children; 116 cocaine-exposed) recruited at birth, oversampled for prenatal substance exposure, and assessed from infancy to early adolescence (EA). Majority of participants self-identified as Black (72% mothers, 57.2% adolescents), and caregivers were primarily from low-income families (76%), were single (86%), and had high school or below education (70%) at recruitment. Latent profile analyses identified three cortisol reactivity patterns including elevated (20.4%), moderate (63.1%), and blunted (16.5%) reactivity groups. Prenatal tobacco exposure was associated with higher likelihood of membership in the elevated reactivity compared to the moderate reactivity group. Higher caregiver sensitivity in early life was associated with lower likelihood of membership in the elevated reactivity group. Prenatal cocaine exposure was associated with higher maternal harshness. Interaction effects among early-life adversity and parenting indicated that caregiver sensitivity buffered, and harshness exacerbated, the likelihood that high early adversity would be associated with the elevated and blunted reactivity groups. Results highlight the potential importance of prenatal alcohol and tobacco exposure for cortisol reactivity and the role of parenting as exacerbating or buffering the impact of early-life adversity on adolescent stress response.

The Longitudinal Effects of Second Step Child Protection Unit on Children: Gender as a Moderator.

We investigated the longitudinal effects of the Second Step Child Protection Unit (CPU; Committee for Children) on student outcomes through a randomized controlled trial. Eight schools with a total sample including 2,031 students were assigned randomly to the CPU intervention or the wait-list control condition. We employed a multi-process latent growth model using a structural equation modeling framework which simultaneously analyzed student outcome growth via the effects of the intervention. The moderating effect of gender was also included. Over four data collection waves (pretest, posttest, follow-up [6 months] and follow-up [12-months]), the intervention group students were better able to recognize appropriate requests in CSA scenarios than control group students over time. Teacher-student relations improved for the students in the intervention schools but worsened for the students in the control schools over time. Despite concerns that CSA prevention programs may result in the unintended consequence of making children more fearful, children in both conditions did not show increased fears over time. The longitudinal effect on CSA recognition was more pronounced among girls, who suffer from higher CSA prevalence, compared with boys. Implications for prevention, policy, and directions for future research are discussed.

Family cohesion and the relations among peer victimization and depression: A random intercepts cross-lagged model.

The relation between peer victimization and depressive symptoms is complex, requiring the use of methodologically rigorous designs to examine these relations and potential mediating factors. The current study used a random intercepts cross-lagged panel model (RI-CLPM) to investigate both between-person and within-person associations in peer victimization, depressive symptoms, and family cohesion across five waves in a sample of adolescents (N = 801, ages 13-15 years at recruitment) in the Northeast. We also investigated the moderating effects of sex and victimization status (i.e., bullying victimization vs. peer victimization). Overall, findings revealed a reciprocal relation between peer victimization and depressive symptoms for females, but no relation for males. A reciprocal relation between peer victimization and family cohesion was found for males. No significant differences were found by victimization status. Future research on peer victimization and associated outcomes and the role of family should account for both between-person and within-person variance.

Teacher victimization and teachers' subjective well-being: Does school climate matter?

Guided by the job demands-resources model, we examined the multilevel associations between victimization experience with student violence directed against teachers, school climate, and teachers' subjective well-being (i.e., school connectedness and teaching efficacy) among 1711 teachers (7th-12th grade) from 58 middle and high schools in China. Hierarchical linear modeling analyses revealed that teachers who reported more frequent teacher victimization perceived a lower level of teaching efficacy; however, teachers in schools with a higher level of teacher victimization scores at the school level perceived a higher level of teaching efficacy. Although school climate was positively related to teacher well-being at both teacher and school levels, the negative association between teacher victimization and teachers' subjective well-being at the teacher level was exacerbated in schools with a more positive school climate at the school level. The significant cross-level moderating effect of school-level school climate in the association between teacher-level victimization and subjective well-being was consistent with the "healthy context paradox" but contradicted with the "emotion contagion hypothesis." Our findings support the risk influence of teacher victimization and the promotive role of positive school climate on teachers' subjective well-being. Our results also indicate that teachers in schools with a more positive and collective perception of school climate tend to be more attuned to the negative influences of teacher victimization on their subjective well-being than teachers in schools with a less positive and collective perception of school climate.

Peer sexual harassment, affect, and substance use: Daily level associations among adolescents.

INTRODUCTION: Peer sexual harassment is associated with adolescent substance use at the global level; however, it is unknown whether substance use occurs proximal in time to the sexual harassment experience. This study used daily reports to examine the proximal relations between sexual harassment victimization and affect and substance use. Based on theories of self-medication, we hypothesized that negative affect and substance use (cigarettes, electronic cigarettes, alcohol, and marijuana) would be higher than typical on days when sexual harassment occurred relative to nonvictimization days. METHOD: A community sample of 13-16-year-old adolescents (N = 204, 55.4% female) from a metropolitan area in the northeastern United States completed 56 days of online reports assessing experiences with peer sexual harassment, substance use (cigarettes, electronic cigarettes, alcohol, and marijuana), and positive and negative affect. RESULTS: Multilevel modeling revealed that experiencing sexual harassment on a given day was associated with higher than typical negative affect on that day, relative to nonvictimization days. The likelihood of cigarette and alcohol use (but not electronic cigarettes, marijuana, or positive affect) was greater on days when sexual harassment occurred. CONCLUSION: Sexual harassment victimization is proximally associated with negative affect and alcohol and cigarette use, suggesting that adolescents may be using substances to cope with sexual harassment victimization. The co-occurrence of sexual harassment with negative affect and substance use points to the need for prevention efforts that conjointly address sexual harassment victimization, coping, and substance use.

Adolescent Social Media Use: Pitfalls and Promises in Relation to Cybervictimization, Friend Support, and Depressive Symptoms.

The saturation of social media use in adolescents' lives has raised questions about both the risks and positive outcomes that may be associated with use. This study filled this gap by examining longitudinal associations among active social media use and depressive symptoms for male and female adolescents and the mediating role of friend support and cybervictimization. These relations were investigated in a sample of 800 13-15-year-old (M = 14.45) adolescents (57% female, 81% White) across four waves of data over two years. The results indicated that higher levels of active social media use led to reduced depressive symptoms for female adolescents, while active social media use predicted more cybervictimization for male adolescents. In contrast, cybervictimization predicted higher levels of active social media use for female adolescents. Friend support predicted more active social media use for male and female adolescents. Overall, findings reveal a complex picture of social media use for both male and female adolescents and further research is needed which examines types of social media use and their associations with both online and offline experiences.

Developmental Pathways from Prenatal Substance Exposure to Reactive Aggression.

Few studies have examined etiological pathways from prenatal substance exposure to adolescent reactive aggression. We tested a conceptual model that included hypothesized pathways from prenatal substance exposure to adolescent aggression via autonomic reactivity and violence exposure from infancy to early school age and maternal harshness across early childhood. The sample included 216 families (106 boys) who primarily self-identified as Black or Mixed Race. Results supported the hypothesized path from violence exposure across early childhood and early school age to school age autonomic reactivity and early adolescent reactive aggression. There was also a significant interaction effect of sympathetic and parasympathetic reactivity on adolescent reactive aggression, with sympathetic arousal and parasympathetic suppression at early school age associated with higher reactive relational and physical aggression in adolescence. Results emphasize the importance of early experiences and autonomic nervous system changes in contributing to the cascade of risk for reactive aggression in early adolescence.

Developmental cascades to children's conduct problems: The role of prenatal substance use, socioeconomic adversity, maternal depression and sensitivity, and children's conscience.

This study investigated the longitudinal associations among prenatal substance use, socioeconomic adversity, parenting (maternal warmth, sensitivity, and harshness), children's self-regulation (internalization of rules and conscience), and conduct problems from infancy to middle childhood (Grade 2). Three competing conceptual models including cascade (indirect or mediated), additive (cumulative), and transactional (bidirectional) effects were tested and compared. The sample consisted of 216 low-income families (primary caretaker and children; 51% girls; 74% African American). Using a repeated-measures, multimethod, multi-informant design, a series of full panel models were specified. Findings primarily supported a developmental cascade model, and there was some support for additive effects. More specifically, maternal prenatal substance use and socioeconomic adversity in infancy were prospectively associated with lower levels of maternal sensitivity. Subsequently, lower maternal sensitivity was associated with decreases in children's conscience in early childhood, and in turn, lower conscience predicted increases in teacher-reported conduct problems in middle childhood. There was also a second pathway from sustained maternal depression (in infancy and toddlerhood) to early childhood conduct problems. These findings demonstrated how processes of risk and resilience collectively contributed to children's early onset conduct problems.

Sleep Quality as a Mediator of the Relationship Between Cyber Victimization and Depression.

PURPOSE: Cyber victimization is a national mental health concern, especially among adolescents who are digital natives. The current study examined sleep quality as a mediator of the association between cyber victimization and depressive symptoms among adolescents. DESIGN AND METHOD: A prospective study design was utilized with a community sample of adolescents (N = 801; 57% female; mean age = 14.45, SD = .85) from the eastern United States. Participants completed (a) the Pittsburgh Sleep Quality Index; (b) the Cyber Victimization Scale; and (c) the Center for Epidemiologic Studies Depression Scale Revised via online surveys at baseline and 6-month follow-up. The inter-relationship between variables was analyzed by Hayes' mediation approach. FINDINGS: Cyber victimization was not directly associated with having depressive symptoms 6 months later when controlling for adolescents' poor sleep quality, sex, and age (direct effect [c'] = .012, t(676) = 1.12, p < .05, confidence interval [CI] -.008, .036). The mediation analysis indicated a significant indirect effect of poor sleep quality on the relationship between cyber victimization and depressive symptoms (ab = .005, bootstrapped standard error [SE] = .003, bootstrapped CI .001, .011; a is the effect of cyber victimization on poor sleep quality; b is the effect of poor sleep quality on depressive symptoms). Specifically, adolescents' cyber victimization led to poor sleep quality (a = .039, SE = .041, p < .05), which also led to increased depressive symptoms (b = .116, SE = .019, p < .001), after controlling for depressive symptoms at baseline, sex, and age. The indirect effect of cyber victimization on depressive symptoms was estimated through poor sleep quality (a*b = .039(.116) = .0045). CONCLUSIONS: The findings suggest that poor sleep quality may be a mechanism through which cyber bullying is related prospectively to depressive symptoms. Interventions for cyber-victimized adolescents should include assessment of sleep quality and incorporate sleep hygiene education. CLINICAL RELEVANCE: Adolescents should be screened for cyber victimization and sleep quality. Moreover, promotion of sleep hygiene among cyber-victimized adolescents may help to reduce depression.

Student Knowledge Gain Following the Second Step Child Protection Unit: the Influence of Treatment Integrity.

Treatment integrity is an important yet understudied component of school-based prevention programming, particularly for sensitive topics such as child sexual abuse prevention (CSA). This study examined student- and teacher-level characteristics, including components of treatment integrity, that contributed to greater knowledge gain among students participating in the Second Step Child Protection Unit (CPU). The study was conducted with 1132 students and 57 teachers from four elementary schools enrolled in a randomized controlled trial of the CPU. Students were administered assessments at pre-test, post-test, 6-month follow-up, and 12-month follow-up. Teachers were observed and rated on Content Integrity (CI; adherence to content), Process Integrity (PI; teacher enthusiasm, encouragement, behavior management), and Dose Received (DR; student behavior and interest) when delivering the lessons. Hierarchical linear growth modeling indicated that students who received the CPU made gains in the knowledge of CSA concepts and skills over a 12-month follow-up period. Girls had significantly greater CSA knowledge than boys immediately after the intervention, with gender remaining significant even when accounting for level-3 variables. Older children had better knowledge scores at post-test, but growth over time results revealed that younger students made greater gains. For students in 2nd through 4th grade, CI was more important for post-test outcomes, while for all students, CI and grade taught were important to post-test scores. Teachers of lower grades had students with a faster growth rate on correct responses to vignettes. Implications for CSA prevention programming and future research are discussed.

Teacher victimization by students in China: A multilevel analysis.

The goal of this study is to examine individual-level and school-level predictors of teacher victimization (TV) by students in China based upon the multilevel social-ecological framework. A sample of 1711 teachers (7-12th grade) from 58 schools from eight provinces in mainland China completed measures of teacher victimization (i.e., physical TV, verbal TV, social TV, cyber TV, sexual harassment, and personal property offenses) by students, school-wide bullying and disciplinary practices, and demographics. In the present sample, 25.1% of teachers reported that they experienced at least one of the six forms of victimization from students in the past school year. Prevalence of teacher victimization ranged from 4.0% (physical victimization) to 16.8% (social victimization). Male teachers were more likely to experience all forms of TV and homeroom teachers were more likely than non-homeroom teachers to experience social TV. Schools with fewer students, but higher number of teachers, also had higher levels of TV. Student bullying and punitive disciplinary practices at the teacher level were associated with higher levels of most forms of TV. Implications of these findings are discussed.

Teacher Outcomes from the Second Step Child Protection Unit: Moderating Roles of Prior Preparedness, and Treatment Acceptability.

Teachers play a critical role in child sexual abuse (CSA) prevention and intervention efforts. We examined the impact of the Second Step Child Protection Unit (CPU) on improving teacher awareness, attitudes, and teacher-student relations for 161 teachers. Teacher baseline scores and treatment acceptability were examined as moderators. Structural equation modeling (SEM) revealed a significant effect of the CPU on teachers' awareness, attitudes, and teacher-student relations, particularly for teachers with lower prior knowledge, attitudes, and student relationships. Teachers' acceptability of the CPU also moderated outcomes, where a higher level of acceptability of CSA interventions was associated with an increase in outcomes.

Bullying participant roles and gender as predictors of bystander intervention.

Although the importance of peer bystanders in bullying has been recognized, there are few studies that examine the phenomenon in relation to Latané and Darley's (1970) classic Bystander Intervention Model, which states that there are five stages of bystander intervention: (i) notice the event; (ii) interpret the event as an emergency that requires assistance; (iii) accept responsibility for intervening; (iv) know how to intervene or provide help; and (v) implement intervention decisions. This study examined preliminary evidence of reliability and validity of the Bystander Intervention Model in Bullying (Nickerson, Aloe, Livingston, & Feeley, 2014), and the extent to which bullying role behavior (bullying, assisting, victimization, defending, and outsider behavior) and gender predicted each step of the model with a sample of 299 middle school students. Results of a Confirmatory Factor Analysis supported a five-factor structure of the measure corresponding to the steps of the model. There was evidence of convergent validity and Cronbach alpha for each subscale exceeded .75. In addition, students who reported defending their peers were more likely to also engage in all five steps of the bystander intervention model, while victims were more likely to notice events, and outsiders were less likely to intervene. Gender differences and gender interactions were also found. Aggr. Behav. 43:281-290, 2017. © 2016 Wiley Periodicals, Inc.

Role of Pediatric Emergency Physicians in Identifying Bullying.

BACKGROUND: Bullying is an important public health issue with broad implications. Although this issue has been studied extensively, there is limited emergency medicine literature addressing bullying. The emergency department (ED) physician has a unique opportunity to identify children and adolescents that are victims of bullying, and make a difference in their lives. OBJECTIVE: Our aim is to discuss the role of the emergency physician (EP) in identifying patients who have been victims of bullying and how to provide effective management as well as referral for further resources. DISCUSSION: This document provides a framework for recognizing, stabilizing, and managing children who have experienced bullying. With the advent of social media, bullying behavior is not limited to in-person situations, and often occurs via electronic communication, further complicating recognition because it may not impart any physical harm to the child. Recognition of bullying requires a high level of suspicion, as patients may not offer this history. After the stabilization of any acute or overt indications of physical injury, along with obtaining a history of the mechanism of injury, the EP has the opportunity to identify the existence of bullying as the cause of the injury, and can address the issue in the ED while collaborating with "physician-extenders," such as social workers, toward identifying local resources for further support. CONCLUSIONS: The ED is an important arena for the assessment and management of children who have experienced bullying. It is imperative that EPs on the front lines of patient care address this public health epidemic. They have the opportunity to exert a positive impact on the lives of the children and families who are the victims of bullying.

Service providers' perceptions of and responses to bullying of individuals with disabilities.

A sample of 124 service providers (e.g. mental health professionals, educators, administrators) completed a survey about bullying of individuals with disabilities and the use and perceived effectiveness of resources and strategies to address bullying. Providing support and performing an action in response to bullying were reported to be used more often and were perceived as more effective than education and minimizing/ignoring. Service providers who reported that the individuals they worked with experienced cyberbullying more frequently were more likely to take action and use education. Those who attributed victimization to social differences were more likely to provide support.

Measurement of the bystander intervention model for bullying and sexual harassment.

Although peer bystanders can exacerbate or prevent bullying and sexual harassment, research has been hindered by the absence of a validated assessment tool to measure the process and sequential steps of the bystander intervention model. A measure was developed based on the five steps of Latané and Darley's (1970) bystander intervention model applied to bullying and sexual harassment. Confirmatory factor analysis with a sample of 562 secondary school students confirmed the five-factor structure of the measure. Structural equation modeling revealed that all the steps were influenced by the previous step in the model, as the theory proposed. In addition, the bystander intervention measure was positively correlated with empathy, attitudes toward bullying and sexual harassment, and awareness of bullying and sexual harassment facts. This measure can be used for future research and to inform intervention efforts related to the process of bystander intervention for bullying and sexual harassment.