Lyndal Thomas

Does bullying cause emotional problems? A prospective study of young teenagers

Abstract Objectives: To establish the relation between recurrent peer victimisation and onset of self reported symptoms of anxiety or depression in the early teen years. Design: Cohort study over two years. Setting: Secondary schools in Victoria, Australia. Participants: 2680 students surveyed twice in year 8 (aged 13 years) and once in year 9. Main outcome measures: Self reported symptoms of anxiety or depression were assessed by using the computerised version of the revised clinical interview schedule. Incident cases were students scoring ≥12 in year 9 but not previously. Prior victimisation was defined as having been bullied at either or both survey times in year 8. Results: Prevalence of victimisation at the second survey point in year 8 was 51% (95% confidence interval 49% to 54%), and prevalence of self reported symptoms of anxiety or depression was 18% (16% to 20%). The incidence of self reported symptoms of anxiety or depression in year 9 (7%) was significantly associated with victimisation reported either once (odds ratio 1.94, 1.1 to 3.3) or twice (2.30, 1.2 to 4.3) in year 8. After adjustment for availability of social relations and for sociodemographic factors, recurrent victimisation remained predictive of self reported symptoms of anxiety or depression for girls (2.60, 1.2 to 5.5) but not for boys (1.36, 0.6 to 3.0). Newly reported victimisation in year 9 was not significantly associated with prior self report of symptoms of anxiety or depression (1.48, 0.4 to 6.0). Conclusion: A history of victimisation and poor social relationships predicts the onset of emotional problems in adolescents. Previous recurrent emotional problems are not significantly related to future victimisation. These findings have implications for how seriously the occurrence of victimisation is treated and for the focus of interventions aimed at addressing mental health issues in adolescents. What is already known on this topic Being bullied is a common experience for many young people Victimisation is related to depression and, to a lesser extent, anxiety, loneliness, and general self esteem Debate remains as to whether victimisation precedes the onset of emotional problems or whether young people with emotional problems “invite” victimisation What this study adds A history of victimisation predicts the onset of anxiety or depression, especially in adolescent girls Previous recurrent emotional problems are not significantly related to future victimisation Reduction in bullying in schools could have a substantial impact on the emotional wellbeing of young people

Promoting Social Inclusion in Schools: A Group-Randomized Trial of Effects on Student Health Risk Behavior and Well-Being

OBJECTIVES We sought to test the efficacy of an intervention that was designed to promote social inclusion and commitment to education, in reducing among students health risk behaviors and improving emotional well-being. METHODS The design was a cluster-randomized trial in 25 secondary schools in Victoria, Australia. The subjects were 8th-grade students (aged 13 to 14 y) in 1997 (n=2545) and subsequent 8th-grade students in 1999 (n=2586) and 2001 (n=2463). The main outcomes were recent substance use, antisocial behavior, initiation of sexual intercourse, and depressive symptoms. RESULTS At 4-year follow-up, the prevalence of marked health risk behaviors was approximately 20% in schools in the comparison group and 15% in schools in the intervention group, an overall reduction of 25%. In ordinal logistic regression models a protective effect of intervention was found for a composite measure of health risk behaviors in unadjusted models (odds ratio [OR]= 0.69; 95% confidence interval [CI]= 0.50, 0.95) and adjusted models (OR= 0.71; CI =0.52, 0.97) for potential confounders. There was no evidence of a reduction in depressive symptoms. CONCLUSION The study provides support for prevention strategies in schools that move beyond health education to promoting positive social environments.

Individual, family, school, and community risk and protective factors for depressive symptoms in adolescents: a comparison of risk profiles for substance use and depressive symptoms.

This study examines the relationship between adolescent depressive symptoms and risk and protective factors identified for substance use. A questionnaire, developed to measure these factors in a young person’s community, family, school, peer group, and individual characteristics for substance use, was used to assess associations with self-reported depressive symptoms. Data were provided by a representative sample of 8984 secondary school students in Victoria, Australia. The prevalence of depressive symptoms was 10.5% (95% CI 9.2,12.0) for males and 21.7% (95% CI 20.3,23.7) for females. Depressive symptoms were associated with factors in all domains, with the strongest associations in the family domain. Strong relationships were found between the number of elevated risk and protective factors and depressive symptoms, maintained after adjusting for substance use. Patterns of associations were similar for users and nonsubstance users. The findings indicate that prevention programs targeting factors for substance use have the potential to impact on depression.

A multilevel study of area socio-economic status and food purchasing behaviour.

OBJECTIVE The present study examined the association between area socio-economic status (SES) and food purchasing behaviour. DESIGN Data were collected by mail survey (64.2 % response rate). Area SES was indicated by the proportion of households in each area earning less than

Area variation in recreational cycling in Melbourne: a compositional or contextual effect?

AUS 400 per week, and individual-level socio-economic position was measured using education, occupation and household income. Food purchasing was measured on the basis of compliance with dietary guideline recommendations (for grocery foods) and variety of fruit and vegetable purchase. Multilevel regression analysis examined the association between area SES and food purchase after adjustment for individual-level demographic (age, sex, household composition) and socio-economic factors. SETTING Melbourne city, Australia, 2003. SUBJECTS Residents of 2564 households located in fifty small areas. RESULTS Residents of low-SES areas were significantly less likely than their counterparts in advantaged areas to purchase grocery foods that were high in fibre and low in fat, salt and sugar; and they purchased a smaller variety of fruits. There was no evidence of an association between area SES and vegetable variety. CONCLUSIONS In Melbourne, area SES was associated with some food purchasing behaviours independent of individual-level factors, suggesting that areas in this city may be differentiated on the basis of food availability, accessibility and affordability, making the purchase of some types of foods more difficult in disadvantaged areas.

The psychosocial profile of adolescent risk of homelessness

Objective: To examine whether compositional and/or contextual area characteristics are associated with area socioeconomic inequalities and between-area differences in recreational cycling. Setting: The city of Melbourne, Australia. Participants: 2349 men and women residing in 50 areas (58.7% response rate). Main outcome measure: Cycling for recreational purposes (at least once a month vs never). Design: In a cross-sectional survey participants reported their frequency of recreational cycling. Objective area characteristics were collected for their residential area by environmental audits or calculated with Geographic Information Systems software. Multilevel logistic regression models were performed to examine associations between recreational cycling, area socioeconomic level, compositional characteristics (age, sex, education, occupation) and area characteristics (design, safety, destinations or aesthetics). Results: After adjustment for compositional characteristics, residents of deprived areas were less likely to cycle for recreation (OR 0.66; 95% CI 0.43 to 1.00), and significant between-area differences in recreational cycling were found (median odds ratio 1.48 (95% credibility interval 1.24 to 1.78). Aesthetic characteristics tended to be worse in deprived areas and were the only group of area characteristics that explained some of the area deprivation differences. Safety characteristics explained the largest proportion of between-area variation in recreational cycling. Conclusion: Creating supportive environments with respect to safety and aesthetic area characteristics may decrease between-area differences and area deprivation inequalities in recreational cycling, respectively.

Long-Term Impact of the Gatehouse Project on Cannabis Use of 16-Year-Olds in Australia.

ObjectiveTo contrast the psychosocial profile of adolescents with risk factors for homelessness, identified using Chamberlain and MacKenzie’s self-report scale, compared to the profiles of homeless adolescents.MethodsMultinomial logistic regression analyses were conducted contrasting profiles for (a) 137 homeless adolescents, (b) 766 secondary students reporting risk factors for homelessness, and (c) 4,844 students not reporting risks for homelessness.ResultsFourteen percent of a representative population of at-school adolescents, from Victoria, Australia, showed elevated risk of homelessness. These adolescents showed depressive symptoms at least equivalent to homeless adolescents (RR 6.0, 95% CI: 4.9, 7.3, and RR 3.5, 95% CI: 2.1, 5.8, respectively). In multivariate analyses, homeless and at risk adolescents reported equivalent levels of family conflict, early problem behaviour and low opportunities and rewards for family involvement. Compared to adolescents not at risk, at risk adolescents were more likely to be female and to show poorer social skills/assertiveness and depressive symptoms. Compared to at risk adolescents, homeless adolescents showed additional family, school, peer and individual risks, but lower depressive symptomatology.ConclusionsThe findings highlight the potential we have to quickly and simply detect adolescents showing significant risk of homelessness. This sizable minority of adolescents report risks often equivalent to homeless adolescents. It is hoped that stakeholders working with young people will utilise this screening potential to identify and intervene effectively with this significant subpopulation of youth, and their families, while they are still at home and school.