Anat Brunstein Klomek

The association of suicide and bullying in childhood to young adulthood: a review of cross-sectional and longitudinal research findings

Objective: To review the research addressing the association of suicide and bullying, from childhood to young adulthood, including cross-sectional and longitudinal research findings. Method: Relevant publications were identified via electronic searches of PsycNet and MEDLINE without date specification, in addition to perusing the reference lists of relevant articles. Results: Cross-sectional findings indicate that there is an increased risk of suicidal ideation and (or) suicide attempts associated with bullying behaviour and cyberbullying. The few longitudinal findings available indicate that bullying and peer victimization lead tosuicidality but that this association varies by sex. Discrepancies between the studies available may be due to differences in the studies participants and methods. Conclusions: Bullying and peer victimization constitute more than correlates of suicidality. Future research with long-term follow-up should continue to identify specific causal paths between bullying and suicide.

High School Bullying as a Risk for Later Depression and Suicidality

This is the first study to examine whether high school students experiencing frequent bullying behaviors are at risk for later depression and suicidality. A total of 236 students who reported frequent bullying behavior without depression or suicidality during a suicide screening were interviewed 4u2003years later to reassess depression, suicidal ideation, attempts, substance problems, and functional impairment and were compared to at-risk youth identified during the screen, including 96 youth who also experienced bullying behavior. Youth who only reported frequent bullying behaviors (as bullies, victims, or both) did not develop later depression or suicidality and continued to have fewer psychiatric problems than students identified as at-risk for suicide. Students who experienced bullying behaviors and depression or suicidality were more impaired 4u2003years later than those who had only reported depression or suicidality. Thus, assessment of bullying behaviors in screening protocols is recommended.

Suicidal Adolescents’ Experiences With Bullying Perpetration and Victimization during High School as Risk Factors for Later Depression and Suicidality

This is the first study to examine the extent to which frequent involvement in high-school bullying (as a bullying perpetrator, victim of bullying, or bully-victim) increases the risk for later depression and suicidality beyond other well-established risk factors of suicide. The study included 96 students who reported being a bully, a victim, or a bully-victim, and also reported depression, suicidality, or substance problems during an initial suicide screen. These students were interviewed 2 years later and were compared with 142 youth identified during the initial screen as suicide-at-risk by virtue of their depression, suicidal ideation, attempts, and substance problems, but who did not report any involvement in bullying behavior. Students who reported both bullying others and other suicide-related behaviors at baseline had higher suicide ideation and were more functionally impaired at follow-up than students who reported suicide-related behaviors but were not involved in bullying. Preventive efforts in high school should target those children who are characterized by both psychological disturbance and bullying, especially the frequent bullies.

Bullying by peers in childhood and effects on psychopathology, suicidality, and criminality in adulthood

Bullying is shown to be associated with adverse outcomes in cross-sectional studies, but only a few studies have prospectively examined the effects of childhood bullying on adult outcomes. Our Series paper focuses on prospective longitudinal studies that used large, population-based, community samples analysed through quantitative methods and published between 1960 and 2015. We describe the results of childhood bullying in adulthood in three of the most burdensome areas: psychopathology, suicidality, and criminality. We note that the different groups involved (ie, victims, bullies, and bully-victims) are at risk of difficulties later in life, but their risk profiles differ and the contributions are probably not independent. Controlling for confounders reduces the risk and sometimes eliminates it. Victims are at a high risk of internalising disorders. Bullies seem to be at risk of later externalising disorders and criminality, mainly violent crime and illicit drug misuse. Bully-victims seem to be at risk of internalising disorders, externalising disorders, and criminality, but not all studies examined bully-victims as a separate group. Boys and girls differ in their long-term outcomes. A dose effect exists in which frequent bullying involvement in childhood is most strongly associated with adult adversities. Future studies need to control for additional factors (including genetic, psychosocial, and environmental) to account for the mechanisms behind the reported longitudinal associations.

Association of Bullying Behavior at 8 Years of Age and Use of Specialized Services for Psychiatric Disorders by 29 Years of Age

IMPORTANCEnBullying and being exposed to bullying among children is prevalent, especially among children with psychiatric symptoms, and constitutes a major concern worldwide. Whether childhood bullying or exposure to bullying in the absence of childhood psychiatric symptoms is associated with psychiatric outcomes in adulthood remains unclear.nnnOBJECTIVEnTo study the associations between bullying behavior at 8 years of age and adult psychiatric outcomes by 29 years of age.nnnDESIGN, SETTING, AND PARTICIPANTSnNationwide birth cohort study of 5034 Finnish children with complete information about childhood bullying behavior was followed up from 8 to 29 years of age. Follow-up was completed on December 31, 2009, and data were analyzed from January 15, 2013, to February 15, 2015.nnnMAIN OUTCOMES AND MEASURESnInformation about bullying, exposure to bullying, and psychiatric symptoms were obtained from parents, teachers, and child self-reports when children were 8 years of age. Use of specialized services for psychiatric disorders from 16 to 29 years of age was obtained from a nationwide hospital register, including outpatient and inpatient treatment.nnnRESULTSnAmong the 5034 study participants, 4540 (90.2%) did not engage in bullying behavior; of these, 520 (11.5%) had received a psychiatric diagnosis at follow-up; 33 of 166 (19.9%) who engaged in frequent bullying, 58 of 251 (23.1%) frequently exposed to bullying, and 24 of 77 (31.2%) who both frequently engaged in and were frequently exposed to bullying had received psychiatric diagnoses at follow-up. When analyses were adjusted by sex, family factors, and child psychiatric symptoms at 8 years of age, we found independent associations of treatment of any psychiatric disorder with frequent exposure to bullying (hazard ratio [HR], 1.9; 95% CI, 1.4-2.5) and being a bully and exposed to bullying (HR, 2.1; 95% CI, 1.3-3.4). Exposure to bullying was specifically associated with depression (HR, 1.9; 95% CI, 1.2-2.9). Bullying was associated with psychiatric outcomes only in the presence of psychiatric problems at 8 years of age. Participants who were bullies and exposed to bullying at 8 years of age had a high risk for several psychiatric disorders requiring treatment in adulthood. However, the associations with specific psychiatric disorders did not remain significant after controlling for concurrent psychiatric symptoms.nnnCONCLUSIONS AND RELEVANCEnExposure to bullying, even in the absence of childhood psychiatric symptoms, is associated with severe adulthood psychiatric outcomes that require treatment in specialized services. Early intervention among those involved in bullying can prevent long-term consequences.

Inpatient treatment has no impact on the core thoughts and perceptions in adolescents with anorexia nervosa

Examine changes in core perceptions and thoughts during the weight restoration phase of inpatient treatment for adolescents with anorexia nervosa.

Changes in Mental Health, Bullying Behavior, and Service Use Among Eight-Year-Old Children Over 24 Years.

OBJECTIVEnThe aim of this study was to examine changes in the mental health problems, bullying, and service use of 8-year-old children at 4 different time points (1989, 1999, 2005, and 2013) using population-based, time-trend data.nnnMETHODnInformation from 4 cross-sectional samples was compared over a 24-year period. The target population was Finnish-speaking children born in 1981 (nxa0= 1,038), 1991 (nxa0= 1,035), 1997 (nxa0= 1,030), and 2004 (nxa0= 1,114) and living in selected school districts in the Turku University Hospital area in southwestern Finland. The participation rates varied from 84% (2005) to 95% (1989). Information about the childrens psychiatric symptoms, bullying experience, and service use was obtained from parents and teachers using Rutter questionnaires. Child depression was measured using the Childrens Depression Inventory (CDI).nnnRESULTSnParental reports showed that emotional (pxa0<xa0.001) and conduct (pxa0= .001) problems among boys and emotional (pxa0= .002) problems among girls decreased over the 24-year period. In teacher reports, there were noxa0significant changes in hyperactivity, emotional, and conduct problems between 1989 and 2013. Girls self-reported depression scores increased between 1989 and 2005, but leveled off in 2013. There were no significant decreases in bullying behavior between 2005 and 2013 despite the introduction of a nationwide school-based anti-bullying program in 2009. Mental health service use increased constantly during the study period: in 1989, 4.2% of boys and 0.9% of girls were in contact with services, and by 2013 this had risen to 15.1% and 6.1% (pxa0< .001).nnnCONCLUSIONnNo substantial increases in childrens mental health problems were seen between 1989 and 2013. Service use increased constantly, indicating lower thresholds for seeking help. Bullying behavior is strongly related to mental health problems, and that is why school-based bullying interventions, including mental health perspectives, are needed.

KIP3: Robotic Companion as an External Cue to Students with ADHD

We present the design and initial evaluation of Kip3, a social robotic device for students with ADHD that provides immediate feedback for inattention or impulsivity events. We designed a research platform comprised of a tablet-based Continuous Performance Test (CPT) that is used to assess inattention and impulsivity, and a socially expressive robotic device (Kip3) as feedback. We evaluated our platform with 10 students with ADHD in a within subject user study, and report that 9 out of 10 participants felt that Kip3 helped them regain focus, but wondered if it will be effective over time and how it will identify inattention in more complex situations outside the lab.

Childhood bullying and becoming a young father in a national cohort of Finnish boys.

Childhood bullying is known to be associated with various adverse psychosocial outcomes in later life. No studies exist on its association with becoming a young father. The study is based on a national cohort, which included 2,946 Finnish boys at baseline in 1989. Information on bullying was collected from children, their parents and their teachers. Follow-up data on becoming a father under the age of 22 were collected from a nationwide register. The follow-up sample included 2,721 boys. Bullying other children frequently was significantly associated with becoming a young father independently of being victimized, childhood psychiatric symptoms and parental educational level. Being a victim of bullying was not associated with becoming a young father when adjusted for possible confounders. When the co-occurrence of bullying and victimization was studied, it was found that being a bully-victim, but not a pure bully or a pure victim, is significantly associated with becoming a young father. This study adds to other studies, which have shown that the risk profile and relational patterns of bully-victims differ from those of other children, and it emphasizes the importance of including peer relationships when studying young fathers.

The Association Between Gender, Ethnicity, and Suicidality Among Vocational Students in Israel

Gender and ethnicity are significant factors when evaluating suicidal risk, especially among ethnically diverse populations. In the current study we explored the association between gender, ethnicity, and suicide ideation and attempts among Arab and Jewish vocational education and training high school students in Israel. Students (Nxa0=xa03,554) completed a self-report survey evaluating suicide ideation and attempts, depression, anxiety, somatization, and sense of belonging. Hierarchical generalized linear modeling indicated that female Arab adolescents had elevated levels of suicide ideation, higher rates of suicide attempts, and greater psychological distress than Arab males and Jewish students. Furthermore, female Arab adolescents were found to be more susceptible to suicide ideation when depression levels were high. These results are discussed in the context of the double-jeopardy Arab young women face, as members of a minority ethnic group in Israel and their status as women within the patriarchal Arab culture.