Bullying and Cyberbullying Perpetration and Victimization: Prospective Within-Person Associations.

Bidirectional associations between bullying and cyberbullying have consistently identified during adolescence. However, little is known about how this relationship works on the within-person level, after controlling for potential overlap at the between-person level. This study examined the bidirectional longitudinal associations between bullying and cyberbullying perpetration and victimization during 18-month period over four time points. A total of 2835 participants, aged 11 to 16 years in time 1 (50% girls; Mage = 13.13, SD = 1.06) were surveyed. Random intercept cross-lagged analyses revealed the stability of bullying perpetration and victimization. Cyberbullying victimization predicted inversely bullying and cyberbullying perpetration. The results indicate spirals of positive long-term associations between bullying (perpetration and victimization) and cyberbullying perpetration but no long-terms spirals of victimization.

The effectiveness of a day hospital mentalization-based therapy programme for adolescents with borderline personality traits: Findings from Touchstone-Child and Adolescent Mental Health Service.

BACKGROUND: Individuals with borderline personality disorder (BPD) are at a substantial risk of harm to themselves and others, experience high levels of functional impairment and typically are high users of tertiary healthcare to address their mental health concerns. As indicators for BPD typically emerge in adolescence, a day therapy service in Bentley, Western Australia, Touchstone Child and Adolescent Mental Health Service (CAMHS), was developed as an intensive intervention for adolescents with indicators for BPD and its associated symptomology. Touchstone utilizes mentalization-based therapy (MBT) in a therapeutic community setting, where the current study sought to document the anecdotal outcomes using the data provided at Touchstone, to enable a greater understanding of this treatment approach for adolescents with indicators for BPD. METHOD: Forty-six participants attended the Touchstone programme between 2015 and 2020. The programme involved 6 months of MBT (group and individual), occupational therapy, education and creative therapies. Measures of self-injury, mood and emergency department presentations were collected pre- and post-programme. RESULTS: Results indicate that participants show a reduction in non-suicidal acts and thoughts, as well as a reduction in negative moods and feelings from pre-Touchstone to post-Touchstone. There is also a decrease in participant presentation to tertiary emergency departments for mental health concerns. CONCLUSIONS: The current study shows evidence for the efficacy of Touchstone as an MBT therapeutic community intervention to reduce symptoms of emerging BPD and effectively reduce presentations to emergency departments for mental health presentations, alleviating pressure on tertiary hospitals and reducing economic impact of adolescents within this demographic.

Parents' experiences of children with a rare disease attending a mainstream school: Australia.

PURPOSE: To explore the perceptions of parents who had a child or adolescent (6-18 years) diagnosed with a rare disease who attended a mainstream school in Western Australia. DESIGN AND METHODS: A cross-sectional online survey was conducted with 41 parents of children with a rare disease. Here we report the findings of 14 open-ended questions on their experience of illness-related factors and impact on school-related social activities, such as sports, school camps and leadership roles whilst their child with a rare disease attended a mainstream school in Australia. Responses were analysed using an inductive thematic content approach. RESULTS: We identified three themes (resources, experiences and needs), seven categories (illness, support, knowledge, acceptance, isolation, activities of daily living and adjunctive therapy) and 24 codes from the parents' responses describing the experiences of their child at school. Parents want the government and educational systems to provide the necessary funding and resources to reflect an inclusive curricula and supportive environment that can meet the learning needs of children with a rare disease at a mainstream school. CONCLUSIONS: Further research, policy development and interventions are needed to explore how schools can meet the diverse psychosocial physical and emotional needs of children diagnosed with a rare disease who attend a mainstream school in Australia. PRACTICE IMPLICATIONS: A child needs to be viewed from a holistic ecological viewpoint; future research with larger representative samples to explore rare disease experiences and a critical review of existing legislation, interventions and initiatives is required.

Bullying Perpetration, Moral Disengagement and Need for Popularity: Examining Reciprocal Associations in Adolescence.

Precursors and consequences of bullying have been widely explored, but much remains unclear about the association of moral and motivational factors. This study examined longitudinal associations between need for popularity, moral disengagement, and bullying perpetration. A total of 3017 participants, aged 11 to 16 years in wave 1 (49% girls; Mage = 13.15, SD = 1.09), were surveyed across four waves with six-month intervals. At the between-person level, cross-lagged modeling revealed a positive bidirectional association between moral disengagement and need for popularity; bullying perpetration was predicted by both need for popularity and moral disengagement. From the within-person level, random intercept cross-lagged analyses revealed that need for popularity predicted both moral disengagement and bullying perpetration. The results highlight the interplay between motivational and moral mechanisms that underlies bullying behavior.

Facilitators and barriers to the implementation of motivational interviewing for bullying perpetration in school settings.

Bullying is a perplexing and persistent problem with negative consequences for all involved. Schools are assigned considerable responsibility for the management of bullying because of its prevalence amongst youth. Despite considerable efforts over decades to curtail bullying through the use of anti-bullying policies and other school-based interventions, the rates of young people who frequently bully has not decreased significantly. Motivational Interviewing (MI) is a relational and affirming conversational method that strengthens an individual's motivation and commitment to change, overcoming ambivalence toward the problem. The aim of the current study was to provide preliminary insight into the feasibility of incorporating MI into student service repertoires for addressing bullying. Ten staff participants from six secondary schools, who had roles in bullying intervention within their respective schools, were offered training in MI and invited to use and monitor this method in their practice as an intervention for students who perpetrate bullying. Results indicated a number factors which influenced the uptake of MI in schools. Facilitators enabling the use of MI included practitioner's professional background, administrative support, training and implementation of MI. Barriers to the use of MI included time pressure and administrative expectations, school roles and system limitations, and preconceptions and the stigma of bullying.

Functional connectivity of the vigilant-attention network in children and adolescents with attention-deficit/hyperactivity disorder.

The ability to maintain attention to simple tasks (i.e., vigilant attention, VA) is often impaired in attention-deficit/hyperactivity disorder (ADHD), but the underlying pathophysiological mechanisms at the brain network level are not clear yet. We therefore investigated ADHD-related differences in resting-state functional connectivity within a meta-analytically defined brain network of 14 distinct regions subserving VA (comprising 91 connections in total), as well as the association of connectivity with markers of behavioural dysfunction in 17 children (age range: 9-14 years) with a diagnosis of ADHD and 21 age-matched neurotypical controls. Our analyses revealed selective, rather than global, differences in the intrinsic coupling between nodes of the VA-related brain network in children with ADHD, relative to controls. In particular, ADHD patients showed substantially diminished intrinsic coupling for 7 connections and increased coupling for 4 connections, with many differences involving connectivity with the anterior insula. Moreover, connectivity strength of several aberrant connections was found to be associated with core aspects of ADHD symptomatology, such as poor attention, difficulties with social functioning, and impaired cognitive control, attesting to the behavioural relevance of specific connectivity differences observed in the resting state.

Moral Disengagement of Pure Bullies and Bully/Victims: Shared and Distinct Mechanisms.

The vast majority of adolescents recognize that bullying is morally wrong, yet bullying remains a problem in secondary schools, indicating young people may disengage from their moral values to engage in bullying. But it is unclear whether the same mechanisms enabling moral disengagement are active for bully/victims (who both bully and are bullied) as for pure bullies (who are not targets of bullying). This study tested the hypotheses that mechanisms of moral disengagement, including blaming the victim and minimizing the impact of bullying, may operate differently in bully/victims compared to pure bullies. From a sample of 1895 students from grades 7-9 (50.6% female; 83.4% from English speaking homes), 1870 provided self-reports on bullying involvement and mechanisms of moral disengagement associated with bullying. Two cut-offs were compared for bullying involvement (as perpetrator and as target of bullying) during the previous school term: a conservative cut-off (every few weeks or more often) and a liberal cut-off (once-or-twice). Using the conservative cut-off, both pure bullies and bully/victims enlisted moral disengagement mechanisms to justify bullying more than did uninvolved students and pure victims, with no significant difference in scores on any of the moral disengagement scales between pure bullies and bully/victims. For the liberal cut-off, bully/victims reported lower overall moral disengagement scores than did pure bullies, and specifically less distortion of consequences, diffusion of responsibility, and euphemistic labeling. This study advances bullying research by extending the role of moral disengagement in bullying episodes beyond pure bullies to victims, both pure victims and bully/victims. Examination of specific moral disengagement mechanisms and the extent of involvement in bullying enabled a more nuanced differentiation between the bullying groups. These results will inform future interventions aimed at reducing the use of moral disengagement mechanisms that sustain bullying and victimization. Targeted interventions are needed to challenge specific moral disengagement mechanisms from the perspectives of pure bullies and bully/victims.

Dietary patterns, body mass index and inflammation: Pathways to depression and mental health problems in adolescents.

BACKGROUND: Observational studies suggest that dietary patterns may impact mental health outcomes, although biologically plausible pathways are yet to be tested. We aimed to elucidate the longitudinal relationship between dietary patterns, adiposity, inflammation and mental health including depressive symptoms in a population-based cohort of adolescents. METHODS: Data were provided from 843 adolescents participating in the Western Australian Pregnancy Cohort (Raine) Study at 14 and 17 years (y) of age. Structural equation modelling was applied to test our hypothesised models relating dietary patterns, energy intake and adiposity (body mass index) at 14 y to adiposity and the pro-inflammatory adipokine (leptin) and inflammation (high sensitivity C-reactive protein - hs-CRP) at 17 y, and these inflammatory markers to depressive symptoms (Beck Depression Inventory) and Internalising and Externalising Behavioral Problems (Child Behavior Check List Youth Self- Report) at 17 y. We further tested a reverse hypothesis model, with depression at 14 y as a predictor of dietary patterns at the same time-point. RESULTS: The tested models provided a good fit to the data. A 'Western' dietary pattern (high intake of red meat, takeaway, refined foods, and confectionary) at 14 y was associated with higher energy intake and BMI at 14 y, and with BMI and biomarkers of inflammation at 17 y (all p < .05). A 'Healthy' dietary pattern (high in fruit, vegetables, fish, whole-grains) was inversely associated with BMI and inflammation at 17 y (p < .05). Higher BMI at 14 y was associated with higher BMI (p < .01), leptin (p < .05), hs-CRP (p < .05), depressive symptoms (p < .05) and mental health problems (p < .05), all at 17 y. CONCLUSION: A 'Western' dietary pattern associates with an increased risk of mental health problems including depressive symptoms in adolescents, through biologically plausible pathways of adiposity and inflammation, whereas a 'Healthy' dietary pattern appears protective in these pathways. Longitudinal modelling into adulthood is indicated to confirm the complex associations of dietary patterns, adiposity, inflammation and mental health problems, including depressive symptoms.

Does the Risk Outweigh the Benefits? Adolescent Responses to Completing Health Surveys.

The aim of this study is to describe the self-reported experiences of adolescents in population-based samples when completing health-related surveys on topics with varying potential for evoking distress. Survey data were collected in three school-based studies of bullying behaviors (N = 1,771, 12-14 years), alcohol use (N = 823, 12, 15, and 17 years), and electronic image sharing (N = 274, 13 years). Between 5% and 15% of respondents reported being upset at survey completion, but at most 1.4% were entirely negative in their evaluation. Age was not associated with being upset, but younger adolescents were more likely to see benefit in participation. Although concurrent mental health symptoms increased the risk of being upset, this was mostly mitigated by perceived benefits from participation.

Beyond the reactive-proactive dichotomy: Rage, revenge, reward, and recreational aggression predict early high school bully and bully/victim status.

The role of reactive and proactive aggression in school bullying perpetration remains unclear. In this study, we explore the predictive value of an expanded model of aggression motives based on the Quadripartite Violence Typology (QVT), which distinguishes between motivational valence (appetitive or aversive) and recruitment of deliberative self-control to derive four classes of motives: Rage, Revenge, Reward, and Recreation. With a sample of 1,802 students from grades 7-9, we assessed aggression motives via self-report, along with self-report of bullying perpetration and victimization, which were used to assign students into categories of Pure Bully, Bully/Victim (B/V), Pure Victim, and Uninvolved. Two structural models were computed to examine the relationship between these four categories of bullying involvement and aggression motives, using conservative and liberal bullying cutoffs. As predicted, B/V status was more strongly related to Rage and Revenge motives. However, B/Vs had higher scores than Pure Bullies for almost all aggression motives, including Recreation. We discuss the implications of addressing Revenge and Recreation, as well as Reward and Rage (which map most clearly to proactive and reactive aggression, respectively) aggression motives, for bullying prevention and intervention strategies, especially among adolescents for whom extant bullying prevention strategies may be ineffective or counterproductive.

Disentangling functions of online aggression: The Cyber-Aggression Typology Questionnaire (CATQ).

Aggression in online contexts has received much attention over the last decade, yet there is a need for measures identifying the proximal psychological drivers of cyber-aggressive behavior. The purpose of this study was to present data on the newly developed Cyber-Aggression Typology Questionnaire (CATQ) designed to distinguish between four distinct types of cyber-aggression on dimensions of motivational valence and self-control. A sample 314 undergraduate students participated in the study. The results confirmed the predicted four-factor structure providing evidence for distinct and independent impulsive-aversive, controlled-aversive, impulsive-appetitive, and controlled-appetitive cyber-aggression types. Further analyses with the Berlin Cyberbullying Questionnaire, Reactive Proactive Aggression Questionnaire, and the Behavior Inhibition and Activation Systems Scale provide support for convergent and divergent validity. Understanding the motivations facilitating cyber-aggressive behavior could aid researchers in the development of new prevention and intervention strategies that focus on individual differences in maladaptive proximal drivers of aggression. Aggr. Behav. 43:74-84, 2017. © 2016 Wiley Periodicals, Inc.

Reactive aggression and peer victimization from pre-kindergarten to first grade: accounting for hyperactivity and teacher-child conflict.

BACKGROUND: The role of reactive aggression in the development of peer victimization remains unclear due in part to a failure to account for confounding problems of behavioural undercontrol (e.g., hyperactivity). As well, the school social context has rarely been examined to see whether these risks are mediated by relationships with teachers. AIMS: This study tests the prospective relations between reactive aggression, hyperactivity, victimization, and teacher-child (T-C) relationship, to determine whether conflict mediates the relationships between externalizing problems and victimization. SAMPLE: A sample of 1,114 Australian students were followed from pre-kindergarten through first grade. METHODS: Cross-lagged path analyses were conducted, with comparison of gender-moderating models and autocorrelation models. Full-information maximum likelihood was deployed to account for missingness. RESULTS: Best fitting models found that the relationship of early externalizing problems to later victimization was mediated by T-C conflict. No evidence of victimization increasing externalizing problems nor gender differences were observed. T-C conflict in kindergarten predicted subsequent increases in victimization, reactive aggression, and hyperactivity. CONCLUSIONS: Understanding the processes whereby externalizing problems confer risk of victimization involves understanding the whole social context of classrooms, including relationships with teachers. Finer-grained research is needed to better understand how peer dynamics may be influenced by observation of T-C relationships. Pre-service teacher education needs to ensure a focus on the potential social impact of teacher's relationships with students.

Pathways of Socioeconomic Disadvantage and Peer Bullying in Children and Youth: A Scoping Review.

Growing up in socioeconomic disadvantage increases risk of peer bullying at school. Both socioeconomic status and involvement in bullying are predictive of a range of adverse developmental outcomes. However, neither (a) the mechanisms whereby disadvantage increases bullying risk nor (b) the developmental outcomes for which bullying may mediate disadvantage are clear. This review scoped the literature on the relationships between socioeconomic disadvantage, bullying, and health and developmental outcomes for school-aged children and adolescents. Four databases were searched up to June 3, 2023 with 565 studies retrieved, of which 17 met criteria. Most studies were cross-sectional, and studies varied greatly in their definition and measurement of both bullying involvement and disadvantage. No intervention studies were found. Mediators of the disadvantage-bullying association ranged from individual level (e.g., depression) to the national level (e.g., homicide rate); only two studies examined bully-victim status. Of studies where bullying was a mediator, none examined bullying perpetration; the range of outcomes examined was narrowly focused on mental health, failing to capture the full range of developmental outcomes associated with either socioeconomic disadvantage or bullying involvement. This review highlights that future research is needed on identifying and understanding the mediators of the association between disadvantage and bullying victimization, and on the developmental outcomes mediated by bullying perpetration for disadvantaged children. These insights are critical to increase the effectiveness of community- and school-based bullying prevention, particularly in communities with high proportions of socioeconomically disadvantaged families.

Toward a conceptual model of motive and self-control in cyber-aggression: rage, revenge, reward, and recreation.

Despite widespread public attention to cyberbullying, online aggression and victimization have received scant conceptual development. This article focuses on how opportunities for aggression are distinct online from those of offline social contexts. The model developed here is informed by a recent aggression typology, which extends the reactive-proactive distinction by distinguishing aggression based on the affective motive (appetitive vs. reactive) and the recruitment of self-control. This typology informs an analysis of psychological processes linked to individual differences that are relevant to adolescents' aggressive activities. Processes implicated include hostile schema activation, anger and fatigue effects on self-control, anger rumination, empathic failure, excitation transfer, and thrill-seeking. With these processes established, the proposed model focuses on how features of online social platforms may afford opportunities for distinct types of aggression by engaging these processes in adolescent users. Features of online settings that present distinct opportunities for activation of these processes are reviewed for each process, including social cue ambiguity, temporal lag, cue permanence, anonymity, the continual perception of audience, and the availability of online gaming and online pornography. For each of the conceptually grounded cyber-aggression-relevant processes, implications for innovative research directions on adolescent cyber-aggression are presented.

How does the school built environment impact students' bullying behaviour? A scoping review.

RATIONALE: School bullying is a public health concern affecting the physical and mental health of children and young people. While school-based interventions to prevent bullying have been developed internationally, the effectiveness of many interventions has been mixed and modest. Despite a growing recognition that the school built environment may impact bullying behaviour, few anti-bullying interventions have addressed the built environment. OBJECTIVE: This systematic scoping review explored existing literature for evidence that the school built environment influences bullying behaviour in school students. METHODS: The review was guided by Arksey and O'Malley's methodological framework for scoping reviews. A search of six databases (Medline, PsycINFO, ERIC, EMBASE, CINAHL Plus and The Cochrane Library) identified studies addressing primary, middle and secondary school students, bullying, school bullying locations, and school built environments. Peer-reviewed journal articles published in English prior to July 19, 2021, were included. RESULTS: In total, 7568 documents were screened by title and abstract. Following a full-text review, 61 studies (63 articles) were selected; 43 studies identified school bullying locations, and 19 studies linked features of the school built environment to bullying behaviour. Classrooms, playgrounds, and corridors were identified as common bullying locations. Features of the school built environment linked to bullying behaviour included security cameras, architectural design, aesthetics, seating, and vandalism. CONCLUSIONS: This review identified key school settings for anti-bullying interventions and identified gaps in existing built environment and bullying literature. Further analyses of published studies will inform anti-bullying policy and practice.

Supporting the Social-Emotional Well-Being of Elementary School Students Who Are Deaf and Hard of Hearing: A Pilot Study.

PURPOSE: Children who are Deaf and Hard of Hearing (DHH), their parents, Teachers of the Deaf, and other community stakeholders were involved in co-designing a web-based resource to support students' social-emotional well-being. The resource was designed to provide families and teachers with strategies to enhance the social and emotional well-being of Grade 4-6 students who are DHH. This study reports outcomes of a pilot study of the web-based resource intervention. METHOD: A pre-post pilot study was conducted to quantitatively examine reported anxiety, well-being, social relationships, school experience, student-teacher relationship, and parent and teacher self-efficacy. A total of 37 students, their parents (n = 37), and their classroom teachers (n = 40) participated in the intervention program and were provided access to the resource. RESULTS: In total, 19 students, 22 parents, and 17 teachers completed both pre- and postsurvey measures. Paired t tests revealed that there was a statistically significant increase in parents' self-efficacy scores from pre- to posttest. Multivariate analysis of covariance revealed a significant association between parent use of the website and student-reported improved peer support and reduced school loneliness. No other statistically significant differences were found. CONCLUSIONS: The use of a web-based resource codeveloped with students who are DHH, their parents, and teachers could potentially be beneficial for the well-being of students who are DHH as well as parents' self-efficacy. Further research is needed to confirm the benefits.

Acute Tryptophan Depletion Moja-De: A Method to Study Central Nervous Serotonin Function in Children and Adolescents.

Serotonin (5-HT) is widely implicated as a key neurotransmitter relevant to a range of psychiatric disorders and psychological processes. The role of central nervous 5-HT function underlying these processes can be examined through serotonergic challenge methodologies. Acute tryptophan depletion (ATD) is a key challenge method whereby a diminished dietary intake of tryptophan-the amino acid precursor to brain 5-HT synthesis-results in temporary diminished central nervous 5-HT synthesis. While this particular methodology has been used in adult populations, it was only recently that modifications were made to enable the use of ATD in child and adolescent populations. Additionally, the Moja-De modification of the ATD challenge methodology has demonstrated benefits over other ATD techniques used previously. The aim of this protocol paper is to describe the ATD Moja-De methodology in detail, its benefits, as well as studies that have been conducted to validate the procedure in child and adolescent samples. The ATD Moja-De protocol provides a potential methodology for investigating the role of central nervous 5-HT via manipulation of brain tryptophan availability in human psychopathology from a developmental viewpoint.

Concurrent developmental course of sleep problems and emotional/behavioral problems in childhood and adolescence as reflected by the dysregulation profile.

OBJECTIVES: Longitudinal data on the course and relationship of concurrent psychopathology in youth are scarce but are of need for better practical patient care and prevention. This study explores the course of (and relationships over time) between sleep problems and concurrent dimensional difficulties relating to anxiety/depression, attention deficiency, and aggressive behaviors in childhood and adolescence. The latter three may jointly form a broad syndrome, the dysregulation profile. METHODS: Young people from the Raine Study, a large community cohort sample (N = 1625) were followed from age 5 to 17 years. Developmental courses of sleep problems and its concurrent regulatory difficulties were estimated separately and jointly. RESULTS: The majority of adolescents reported low levels of problems and which appeared to be stable over time, while a small group (rates between 7.8% and 10.1%) reported enduring problematic developmental courses. Sleep problems and regulatory difficulties shared a strong association in their development over time (individual's probabilities of having the same courses, i.e. low-low and high-high, were between 89.8% and 92.3%). Furthermore, having persistent sleep problems over time was associated with an increased risk of having regulatory difficulties by approximately 10 times, and vice versa. CONCLUSION: Findings from this study provide empirical evidence for a strong mutual association in the development of sleep problems and difficulties of dysregulation with emotion, cognition, and aggression. It may be suggested that a positive screening of one such psychopathological dimension should lead to a careful assessment, not only to reduce the problem in question but also to prevent the youth from further problems.

No detectable effects of acute tryptophan depletion on short-term immune system cytokine levels in healthy adults.

Objectives: Recent research suggested an influence of diminished central nervous serotonin (5-HT) synthesis on the leptin axis via immunological mechanisms in healthy adult females. However, studies assessing immunological parameters in combination with dietary challenge techniques that impact brain 5-HT synthesis in humans are lacking. Methods: In the present trial, a pilot analysis was conducted on data obtained in healthy adult humans receiving either different dietary acute tryptophan depletion (ATD) challenge or tryptophan (TRP)-balanced control conditions (BAL) to study the effects of reduced central nervous 5-HT synthesis on serum tumor necrosis factor α (TNF-α), interleukin-1ß (IL-1ß) and IL-6 concentrations. The data of N = 35 healthy adults were analysed who were randomly subjected to one of the following two dietary conditions in a double-blind between-subject approach: (1) The Moja-De ATD challenge (ATD), or (2) TRP-balanced control condition for ATD Moja-De (BAL). Serum concentrations for the assessment of relevant parameters (TNF-α, IL-1ß and IL-6) and relevant TRP-related characteristics after the respective challenge procedures were assessed at baseline (T0) and in hourly intervals after administration over a period of 6 h (T1-T6). Results: The ATD condition did not result in significant changes to cytokine concentrations for the entire study sample, or in male and female subgroups. Depletion of CNS 5-HT via dietary TRP depletion appears to have no statistically significant short-term impact on cytokine concentrations in healthy adults. Conclusions: Future research on immunological stressors in combination with challenge techniques will be of value in order to further disentangle the complex interplay between brain 5-HT synthesis and immunological pathways.

Bullying and mental health amongst Australian children and young people with cystic fibrosis.

Currently, there is little research investigating how schools can support the mental health and social development of young people with cystic fibrosis (CF), given their heightened risk of mental illness. Few studies have examined the relationship between bullying and mental health in populations of children with CF. This study describes the peer bullying experiences of young people with CF, and examines associations between school bullying and the psychological well-being of these young people. A sequential mixed-methods approach was used to collect data from 26 young people with CF (10-16 years of age). These data were compared with large samples of healthy children. Following an online survey, 11 young people, through online focus groups, expanded on the survey findings, describing their experiences within the school environment. Young people with CF reported lower involvement in bullying victimization and perpetration relative to the comparison population. For older adolescents with CF, victimization was associated with less connectedness to school and less peer support, and more school loneliness, anxiety, and depression. Young people with CF reported they generally liked the school environment, and were happy with their friendships, whereas some older adolescents reported that bullying evoked anxiety and mood problems. Reported bullying was primarily verbal and targeted characteristics of their CF, including their coughing, noninvolvement in certain activities because of shortness of breath, use of medication, and being underweight (for boys only). The findings provide some recommendations for interventions to promote mental health and school engagement among young people with CF. (PsycINFO Database Record