Long-term effects of bullying in adolescence: Mental health and social adaptation in adulthood

The main purpose of this thesis was to investigate the long-term effects of bullying. Previous studies have shown that the effects of being bullied or bullying others during childhood and youth affect mental health and psychosocial functioning later in youth life. This applies to those who were being bullied, bully-victims, or who are aggressive toward others. However, most longitudinal studies to date have been performed within the education system. Little is known about the long-term effects of bullying among youth and how this affects mental health in (young) adulthood. In particular, we know little about how bullying may have affected social functioning in young adults. Many studies are often retrospective and examine the effects of public records (e.g., psychiatric diagnoses or criminal records). One can more strongly decide whether there are any long-term effects of bullying reported in young adulthood using a prospective study of a representative youth population. This thesis is based on the survey data from the Youth and Mental Health Study conducted by the Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Midt-Norge) formerly known as the Centre for Child and Adolescent Mental Health Central Norway (RBUP Midt-Norge). The representative sample of youth in central Norway was previously assessed in 1998 (T1, n = 2464, Mean Age (MA) 13.7 years, SD = 0.58) and 1999–2000 (T2, n = 2432, MA 14.9 years, SD = 0.60). In 2012, a 12-year follow-up study was performed (T4, n = 1266, MA = 27.2, SD = 0.59). The data consist of self-reports at all three time points. The adolescents at T1 and T2 were broadly assessed with respect to their psychological distress and psychosocial functioning, family functioning, and physical health. The same instruments were used for the follow-up survey at T4 with a few age-related adjustments. The analyses of Papers I and II were based on four groups assessed at T1 and T2, who were categorized as being bullied, bully-victims, aggressive toward others, or not involved. Paper III examines the being-bullied group with the not-involved group by gender in relation to suicidal ideation, self-harm, and attempted suicide. Adjusted for gender and parental socioeconomic status, the findings in Paper I showed that those who were being bullied, bully-victims, or who are aggressive towards others are more likely to have lower educational attainment as young adults compared with those not involved in bullying in youth. Those who were aggressive towards others in youth have an almost 3 times higher risk of being unemployed and/or receiving some form of social assistance. Those who were bully-victims in youth reported an almost 3 times higher odds ratio (OR) in having poor general health. As young adults, they reported a 2.5 times increased risk of pain than those who were not involved in bullying. Bully-victims had almost 3 times increased risk for tobacco use and reported lower job functioning than those who were not involved in bullying. Those who were bullied and those who were aggressive towards others had more than a doubled higher risk for illegal drug use than those who were not involved in bullying. The results from Paper II showed that those involved in bullying (those who were bullied, bully-victims, or aggressive towards others) had higher mean scores than the not-involved group on the total adult self-report (ASR), i.e., in total, externalizing, and internalizing problems and the critical problem scales. When comparing low-to-moderate-scorers versus high scorers (90th percentile), we found that all groups involved in bullying had higher OR of both ASR externalizing and internalizing mental health problems compared with the not-involved group. When we adjusted for the impact of mental health in youth, we found that those who were bullied still had an increased risk of depressive problems in young adulthood compared with the not-involved group. Youth who were bullied also reported reduced psychosocial functioning and increased risk to seek help for mental health problems last year and earlier in life compared with the notinvolved group. All groups involved in bullying reported between 4–8 times higher risk of hospitalization since young adolescence because of a mental health problem compared with the noninvolved group. Our main finding from Paper III is that regardless of gender, being bullied in adolescence strongly predicts suicidal attepts and self –harm. Moreover, as young adults, bullied male adolescents had the highest risk of suicide attempts and self-harm, while formerly bullied adult women had the highest risk of suicidal ideation. In conclusion, detecting and preventing bullying in early adolescence has potential to improve both psychosocial functions and mental health in young adults. More specifically, this might reduce suicidal ideation, self-harm, and suicide attempts in young adulthood. Clinical practitioners and other health-care personnel should address past bullying experiences to prevent suicidal behavior in both adolescence and young adulthood

Long-term follow-up of a community sample of adolescents with frequent headaches.

Background Several outcome studies have reported on the short- and long-term effects of migraine in selected clinical samples of children and adolescents. However, current knowledge of the course, incidence, and outcome predictors of frequent headaches in early adolescents in community populations is limited, and little is known about the long-term effects. Headache remains untreated in most of these young people. Here we examined the course, incidence, and outcome predictors of frequent headaches (at least once a week) over the long term (14 years) using previously assessed data at the baseline and 1-year follow-up of early adolescents. Methods Out of an original sample of 2440 who participated in the first two assessments, a sample of 1266 participants (51.9% response rate) aged 26–28 years (mean = 27.2 years) completed an electronic questionnaire comprising questions about their headache frequency and duration at the long-term follow-up. These headache characteristics together with gender, age, parental divorce, number of friends, school absence, impairment of leisure-time activities and seeing friends, pain comorbidity, and emotional (in particular, depressive symptoms) and behavioral problems were analyzed. Results In these young people, 8.4% reported frequent headaches (at least once a week) at the extended follow-up, while 19% of the participants having such headaches at baseline again reported such levels with a negligible gender difference. Over the follow-up period, 7.4% had developed frequent headaches, and a higher percentage of females reported such headaches (11.3% in females, 1.5% in males). In a multivariate model, frequent headaches at the baseline, gender (worse prognosis in females), impairment of leisure-time activities and seeing friends, and higher level of depressive symptoms significantly predicted headache frequency at the long-term follow-up. Conclusions Our findings suggest that gender, greater social impairment, and comorbid depressive symptoms are important indicators for both the short- and long-term prognosis of frequent headaches in early adolescents in community populations.publishedVersion© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/

Cohort profile: The Youth and Mental Health Study (YAMHS) – a longitudinal study of the period from adolescence to adulthood

The aim of this article is to provide a detailed description of the Youth and Mental Health Study (YAMHS),a population-based, representative (cluster sampling), prospective cohort study that was conducted to investigate risk and resilience factors for mental health conditions, specifically depressive symptoms and disorders, from adolescence to adulthood. The baseline data were collected in 1998 (T1) in two counties in central Norway from 2464 adolescents (response rate 88.3%, mean age 13.7 years). The first follow-up was conducted in 1999 (T2) (n = 2432, response rate of 87.1%, mean age 14.9 years). A subgroup of individuals was assessed at T2 (n = 345) with clinical interviews, and this subgroup was reassessed in 2005 (T3) (n = 265, 70.1%, 20 years). The last follow-up (of participants assessed at T1 and T2) was conducted in 2012 (T4) (n = 1266, 51.9%, 27.2 years). Demographics, depressive symptoms, general psychopathology, suicidal ideation and attempts and psychological and somatic factors were recorded. Among adolescents of both sexes, psychosocial variables were correlated with and predicted depressive symptom severity. The strongest predictors were sex (female), the levels of depressive symptoms the preceding year, and the total number of stressful events. The association between stressful life events and depressive symptoms was moderated by physical activity, while the relationship between stressful events and coping style was mediated by depressive symptoms. The rate of use of specialised mental health services among the depressed was low. The lifetime prevalence of depressive disorders was 23% at 15 years, and the most common disorder was minor depression. Adolescents who attempted suicide were more often victims of violence and less resilient than were non-suicide attempters. The existing longitudinal data from the cohort will be further analysed. Follow-up data will be obtained from existing national registries by links created with individual identification numbers

Cohort profile: The Youth and Mental Health Study (YAMHS) - a longitudinal study of the period from adolescence to adulthood.

The aim of this article is to provide a detailed description of the Youth and Mental Health Study (YAMHS),a population-based, representative (cluster sampling), prospective cohort study that was conducted to investigate risk and resilience factors for mental health conditions, specifically depressive symptoms and disorders, from adolescence to adulthood. The baseline data were collected in 1998 (T1) in two counties in central Norway from 2464 adolescents (response rate 88.3%, mean age 13.7 years). The first follow-up was conducted in 1999 (T2) (n = 2432, response rate of 87.1%, mean age 14.9 years). A subgroup of individuals was assessed at T2 (n = 345) with clinical interviews, and this subgroup was reassessed in 2005 (T3) (n = 265, 70.1%, 20 years). The last follow-up (of participants assessed at T1 and T2) was conducted in 2012 (T4) (n = 1266, 51.9%, 27.2 years). Demographics, depressive symptoms, general psychopathology, suicidal ideation and attempts and psychological and somatic factors were recorded. Among adolescents of both sexes, psychosocial variables were correlated with and predicted depressive symptom severity. The strongest predictors were sex (female), the levels of depressive symptoms the preceding year, and the total number of stressful events. The association between stressful life events and depressive symptoms was moderated by physical activity, while the relationship between stressful events and coping style was mediated by depressive symptoms. The rate of use of specialised mental health services among the depressed was low. The lifetime prevalence of depressive disorders was 23% at 15 years, and the most common disorder was minor depression. Adolescents who attempted suicide were more often victims of violence and less resilient than were non-suicide attempters. The existing longitudinal data from the cohort will be further analysed. Follow-up data will be obtained from existing national registries by links created with individual identification numbers

The long-term effects of being bullied or a bully in adolescence on externalizing and internalizing mental health problems in adulthood.

BackgroundThe aim is to examine associations between bullying involvement in adolescence and mental health problems in adulthood.MethodsInformation on bullying-involvement (being bullied, bully-victim, aggressive toward others) and non-involved was collected from 2464 adolescents in Mid-Norway at mean age 13.7 and again at mean age 14.9. Information about mental health problems and psychosocial functioning was collected about 12 years later at mean age 27.2 (n = 1266).ResultsAll groups involved in bullying in young adolescence had adverse mental health outcomes in adulthood compared to non-involved. Those being bullied were affected especially regarding increased total sum of depressive symptoms and high levels of total, internalizing and critical symptoms, increased risk of having received help for mental health problems, and reduced functioning because of a psychiatric problem in adulthood. While those being aggressive toward others showed high levels of total and internalizing symptoms. Both those being bullied and bully-victims showed an increased risk of high levels of critical symptoms. Lastly, all groups involved in bullying on adolescence had increased risk of psychiatric hospitalization because of mental health problems.ConclusionInvolvement in bullying in adolescence is associated with later mental health problems, possibly hindering development into independent adulthood

The long-term effects of being bullied or a bully in adolescence on externalizing and internalizing mental health problems in adulthood.

BackgroundThe aim is to examine associations between bullying involvement in adolescence and mental health problems in adulthood.MethodsInformation on bullying-involvement (being bullied, bully-victim, aggressive toward others) and non-involved was collected from 2464 adolescents in Mid-Norway at mean age 13.7 and again at mean age 14.9. Information about mental health problems and psychosocial functioning was collected about 12 years later at mean age 27.2 (n = 1266).ResultsAll groups involved in bullying in young adolescence had adverse mental health outcomes in adulthood compared to non-involved. Those being bullied were affected especially regarding increased total sum of depressive symptoms and high levels of total, internalizing and critical symptoms, increased risk of having received help for mental health problems, and reduced functioning because of a psychiatric problem in adulthood. While those being aggressive toward others showed high levels of total and internalizing symptoms. Both those being bullied and bully-victims showed an increased risk of high levels of critical symptoms. Lastly, all groups involved in bullying on adolescence had increased risk of psychiatric hospitalization because of mental health problems.ConclusionInvolvement in bullying in adolescence is associated with later mental health problems, possibly hindering development into independent adulthood