Yossi Harel-Fisch

Socioeconomic Inequality in Exposure to Bullying During Adolescence: A Comparative, Cross-Sectional, Multilevel Study in 35 Countries

OBJECTIVES We examined the socioeconomic distribution of adolescent exposure to bullying internationally and documented the contribution of the macroeconomic environment. METHODS We used an international survey of 162,305 students aged 11, 13, and 15 years from nationally representative samples of 5998 schools in 35 countries in Europe and North America for the 2001-2002 school year. The survey used standardized measures of exposure to bullying and socioeconomic affluence. RESULTS Adolescents from families of low affluence reported higher prevalence of being victims of bullying (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.10, 1.16). International differences in prevalence of exposure to bullying were not associated with the economic level of the country (as measured by gross national income) or the school, but wide disparities in affluence at a school and large economic inequality (as measured by the Gini coefficient) at the national level were associated with an increased prevalence of exposure to bullying. CONCLUSIONS There is socioeconomic inequality in exposure to bullying among adolescents, leaving children of greater socioeconomic disadvantage at higher risk of victimization. Adolescents who attend schools and live in countries where socioeconomic differences are larger are at higher risk of being bullied.

Negative School Perceptions and Involvement in School Bullying: A Universal Relationship across 40 Countries.

Cross-national analyses explore the consistency of the relationship between negative school experiences and involvement in bullying across 40 European and North American countries, using the 2006 (40 countries n = 197,502) and 2002 (12 countries, n = 57,007) WHO-HBSC surveys. Measures include two Cumulative Negative School Perception (CNSP) scales, one based on 6 mandatory items (2006) and another including an additional 11 items (2002). Outcome measures included bullying perpetration, victimization and involvement as both bully and victim. Logistic regression analyses suggested that children with only 2-3 negative school perceptions, experience twice the relative odds of being involved in bullying as compared with children with no negative school perceptions. Odds Ratios (p < 0.001) increase in a graded fashion according to the CNSP, from about 2.2 to over 8.0. Similar consistent effects are found across gender and almost all countries. Further research should focus on the mechanisms and social context of these relationships.

Parents, teachers and peer relations as predictors of risk behaviors and mental well-being among immigrant and Israeli born adolescents.

This study examines the roles of parents (monitoring, involvement and support at school), teachers (support) and peers (excess time spent with friends, peer rejection at school) in predicting risk behaviors (smoking and drinking) and mental well-being among 3499 Israeli-born and 434 immigrant adolescents ages 11, 13 and 15, in the 2006 WHO Health Behavior in School-Aged Children cross-national survey. Structural Equation Modeling (SEM) showed that for native Israeli youth, in line with previous developmental literature, all three relationships - parents, teachers and peers - have a significant impact on both mental well-being and risk behaviors. However, for immigrant adolescents, it was the school environment (parental support at school, teacher support and peer relationships) that proved to be the significant predictor of risk behaviors and mental health outcomes. These findings suggest that the school is an important social support in the health and mental well-being of immigrant schoolchildren.

Exploring substance use normalization among adolescents: A multilevel study in 35 countries

The substance use normalization thesis predicts that adolescent substance users are less likely to report substance use risk factors in high than in low prevalence countries. This study tests whether national population-level alcohol, cigarette and cannabis prevalence rates moderate the strength of the relationship between individual level social and behavioral risk factors and individual level alcohol, cigarette and cannabis use. Data from 2009/2010 Health Behaviour in School-Aged Children Study (N = 68,045, age = 15) from 35 countries was analyzed using logistic Hierarchical Linear Modeling. As expected based on low cannabis prevalence rates in all countries studied, no evidence of normalization was found for recent cannabis use. Also in line with the normalization thesis, results show that for substance use that reaches above 40% in at least some of the countries studied (drunkenness, alcohol and cigarette use), adolescents who reported use are less likely to report social and behavioral risk factors in high prevalence countries than in low prevalence countries. However, support for the normalization thesis was only partial in that results show that in models where evidence for normalization was found, there are risk factors that predict substance use to an equal degree regardless of country level prevalence rates. The current research shows that the normalization thesis is a useful framework for understanding the contextual aspects of adolescent alcohol, tobacco, and cannabis use. The study has implications for drug prevention as it suggests that selective prevention efforts may be particularly useful in low prevalence countries where screening based on risk factors may usefully identify adolescents at most risk for developing drug use problems. This approach may be less useful in high prevalence countries where screening based on risk factors is less likely to satisfactorily identify those at risk for developing drug use problems.

Parental, peer and school experiences as predictors of alcohol drinking among first and second generation immigrant adolescents in Israel

BACKGROUND Ecological perspectives stress the importance of environmental predictors of adolescent alcohol use, yet little research has examined such predictors among immigrant adolescents. This study examines parental, peer and school predictors of alcohol drinking (casual drinking, binge drinking and drunkenness) among Israeli-born adolescents and first and second generation adolescent immigrants from the Former Soviet Union (FSU) and Ethiopia in Israel. METHODS The study uses data from the 2010 to 2011 Israeli Health Behaviors of School age Children (HBSC) survey and includes a representative sample of 3059 adolescents, aged 11-17. Differences between the groups for drinking were examined using Pearsons chi square. Logistic regression models were used to examine group specific predictors of drinking. RESULTS First generation FSU and both Ethiopian groups reported higher levels of binge drinking and drunkenness than Israeli-born adolescents. All immigrant groups reported lower levels of parental monitoring than native born adolescents; both first generation groups reported difficulties talking to parents; and first generation FSU and second generation Ethiopian adolescents reported greater time with friends. Group specific logistic regression models suggest that while parent, peer and school variables all predicted alcohol use among Israeli adolescents, only time spent with peers consistently predicted immigrant alcohol use. CONCLUSIONS Findings highlight specific vulnerability of first generation FSU and second generation Ethiopian adolescents to high levels of drinking and the salience of time spent with peers as predicting immigrant adolescent drinking patterns. They suggest that drinking patterns must be understood in relation to country of origin and immigration experience of a particular group.

Physical and emotional health problems experienced by youth engaged in physical fighting and weapon carrying

Then aims of the current study were 1) to provide cross-national estimates of the prevalence of physical fighting and weapon carrying among adolescents aged 11–15 years; (2) To examine the possible effects of physical fighting and weapon carrying on the occurrence of physical (medically treated injuries) and emotional health outcomes (multiple health complaints) among adolescents within the theoretical framework of Problem Behaviour Theory. 20,125 adolescents aged 11–15 in five countries (Belgium, Israel, USA, Canada, FYR Macedonia) were surveyed via the 2006 Health Behaviour in School Aged Children survey. Prevalence was calculated for physical fighting and weapon carrying along with physical and emotional measures that potentially result from violence. Regression analyses were used to quantify associations between violence/weapon carrying and the potential health consequences within each country. Large variations in fighting and weapon carrying were observed across countries. Boys reported more frequent episodes of fighting/weapon carrying and medically attended injuries in every country, while girls reported more emotional symptoms. Although there were some notable variations in findings between different participating countries, increased weapon carrying and physical fighting were both independently and consistently associated with more frequent reports of the potential health outcomes. Adolescents engaging in fighting and weapon carrying are also at risk for physical and emotional health outcomes. Involvement in fighting and weapon carrying can be seen as part of a constellation of risk behaviours with obvious health implications. Our findings also highlight the importance of the cultural context when examining the nature of violent behaviour for adolescents.

Multiple risk behaviors and suicidal ideation and behavior among Israeli and Palestinian adolescents

Based conceptually on Problem Behavior Theory, Normalization Theory and theories of adolescent ethnic identity formation this study explores relationships between individual and cumulative multiple risk behaviors and suicidal ideation and behavior among mid-adolescents in three different populations in the Middle East. Data from the 2004 Health Behavior in School-Aged Children in the Middle-East (HBSC-ME) study included 8345 10th-grade pupils in three populations: Jewish Israelis (1770), Arab Israelis (2185), and Palestinians in Gaza and the West Bank (4390). We considered risk behaviors and factors including tobacco use, bullying, medically-attended injuries, excessive time with friends, parental disconnectedness, negative school experience, truancy and poor academic performance. Substantial population differences for suicidal tendency and risk behaviors were observed, with notably high levels of suicidal ideation and behavior among Arab-Israeli youth and higher levels of risk behaviors among the Jewish and Arab-Israeli youth. For all populations suicidal tendency was at least 4 times higher among adolescents reporting 4+ risk behaviors, suggesting that similar psychosocial determinants affect patterns of risk behaviors and suicidal tendency. Results highlight the importance of understanding cultural contexts of risk behaviors and suicidal ideation and behavior.

Normalisation theory: Does it accurately describe temporal changes in adolescent drunkenness and smoking?

INTRODUCTION AND AIMS The multiple risk model postulates that accumulating risk factors increase adolescent drunkenness and smoking. The normalisation theory adds to this by arguing that the relation between accumulative risk and drunkenness and smoking is dependent on the distribution of these behaviours in the larger population. More concretely, normalisation theory predicts that: (i) when population level use increases, low risk adolescents will be more likely to use alcohol and cigarettes; and (ii) adolescents facing multiple risk factors will be equally likely to use alcohol and cigarettes, regardless of trends in population level use. The current study empirically tests these assumptions on five waves of nationally representative samples of Israeli Jewish youth. DESIGN AND METHODS Five cross-sectional waves of data from the Israeli Health Behaviour in School-aged Children survey for Jewish 10th graders were used. Logistic regression models measured the impact of changes in population level use across waves on drunkenness and smoking, and their association with differing levels of risk factors. RESULTS Between zero and two risk factors, the risk of drunkenness and smoking increases for each additional risk factor. When reaching two risk factors, added risk does not significantly increase the likelihood of smoking and drunkenness. Changes in population level drunkenness and smoking did not systematically relate to changes in the individual level relationship between risk factors and smoking and drunkenness. DISCUSSION AND CONCLUSIONS The pattern of results in this study provides strong evidence for the multiple risk factor model and inconsistent evidence for the normalisation theory. [Sznitman SR, Zlotnick C, Harel-Fisch Y. Normalisation theory: Does it accurately describe temporal changes in adolescent drunkenness and smoking? Drug Alcohol Rev 2016;35:424-432].

The role of identity and psychosomatic symptoms as mediating the relationship between discrimination and risk behaviors among first and second generation immigrant adolescents

The study examines psychosomatic symptoms, and host and heritage identities as mediators of the relationship between discrimination and aggressive behavior and substance use. Israeli data from the 2013-14 Health Behaviors of School-aged Children study included a representative sample of 1503 first- and second-generation immigrant adolescents aged 11-17 years (45.2% male) from the Former Soviet Union and Ethiopia in Israel. Structural equation modeling, controlling for age, gender, family affluence and immigrant generation, showed different pathways for the two groups. For FSU-heritage adolescents, the relationship between discrimination and aggressive behavior and substance use was partially mediated by psychosomatic symptoms. Lower host and heritage identities also predicted psychosomatic symptoms. For Ethiopian-heritage adolescents, the relationship between discrimination and outcomes was fully mediated by psychosomatic symptoms and a weaker host identity. Results support an externalizing model, whereby discrimination leads to a weaker host identity and increased psychosomatic symptoms, associated with substance use and aggressive behavior.

Social Capital as a Moderator of the Relationship Between Perceived Discrimination and Alcohol and Cannabis Use Among Immigrant and Non-immigrant Adolescents in Israel

Literature highlights the relationship between perceived discrimination and frequency and severity of alcohol and cannabis use. One mechanism for explaining this is the nature of perceived discrimination as a potentially traumatic interpersonal stressor, which can lead to the depletion of social and personal resources. Within a Recovery Capital (RC) framework, the current study explores whether the existence of social capital in the form of parental monitoring, friend and teacher support can buffer the relationship between perceived discrimination and alcohol and cannabis use among immigrant and non-immigrant adolescents, by replenishing the depleted resources. The study included a representative sample of 8,598 students in Israel, aged 11–18, from the Health Behaviors of School Aged Children (HBSC) 2013–2014 data: 1503 immigrant adolescents from the Former Soviet Union [FSU] (N = 955) and Ethiopia (N = 548) and 7086 non-immigrants. Results confirmed that perceived discrimination was positively related to substance use; all three forms of social capital were negatively related to alcohol and cannabis use and moderated the relationship between perceived discrimination and substance use, with the exception of friend support in the case of alcohol use. When all three social capital measures were included together, the adult social capital measures were significant predictors of substance use. Results suggest that levels of social capital, especially as provided by parents and teachers, can help young people, both immigrant and majority group adolescents, to cope with perceived discrimination.