Klomek Anat Brunstein, Sourander Andre, Elonheimo Henrik
Interdisciplinary Centre (IDC), Herzliya, Israel.
Research Centre for Child Psychiatry, University of Turku, Turku, Finland; Turku Unviersity Hospital, Turku, Finland.
Lancet Psychiatry. 2015 Oct;2(10):930-41. doi: 10.1016/S2215-0366(15)00223-0. Epub 2015 Sep 29.
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.
在横断面研究中,欺凌行为被证明与不良后果相关,但只有少数研究前瞻性地考察了童年欺凌对成人结局的影响。我们的系列论文聚焦于前瞻性纵向研究,这些研究使用基于人群的大型社区样本,通过定量方法进行分析,且发表于1960年至2015年之间。我们描述了童年欺凌在成年后三个最具负担的领域中的结果:精神病理学、自杀倾向和犯罪行为。我们注意到,所涉及的不同群体(即受害者、欺凌者和受欺凌-欺凌者)在以后的生活中都有面临困难的风险,但他们的风险概况不同,且这些影响可能并非相互独立。控制混杂因素会降低风险,有时甚至能消除风险。受害者患内化性障碍的风险很高。欺凌者似乎有患后期外化性障碍和犯罪行为的风险,主要是暴力犯罪和非法药物滥用。受欺凌-欺凌者似乎有患内化性障碍、外化性障碍和犯罪行为的风险,但并非所有研究都将受欺凌-欺凌者作为一个单独的群体进行考察。男孩和女孩的长期结局有所不同。存在剂量效应,即童年时期频繁卷入欺凌行为与成人期逆境的关联最为强烈。未来的研究需要控制其他因素(包括遗传、心理社会和环境因素),以解释所报告的纵向关联背后的机制。