Romo Matthew L, Kelvin Elizabeth A
Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States of America.
Rev Panam Salud Publica. 2016 Nov;40(5):347-355.
To compare the prevalence of bullying victimization, suicidal ideation, suicidal attempts, and negative health behaviors (current tobacco use, recent heavy alcohol use, truancy, involvement in physical fighting, and unprotected sexual intercourse) in five different Latin American countries and determine the association of bullying victimization with these outcomes, exploring both bullying type and frequency.
Study data were from Global School-based Student Health Surveys from Bolivia, Costa Rica, Honduras, Peru, and Uruguay, which covered nationally representative samples of school-going adolescents. The surveys used a two-stage clustered sample design, sampling schools and then classrooms. Logistic regression models were run to determine the statistical significance of associations with bullying.
Among the 14 560 school-going adolescents included in this study, the prevalence of any bullying victimization in the past 30 days was 37.8%. Bullying victimization was associated with greater odds of suicidal ideation with planning (adjusted odds ratio (AOR): 3.12; P < 0.0001) and at least one suicide attempt (AOR: 3.07; P < 0.0001). An increasing exposure-response effect of increasing days of bullying victimization on suicide outcomes was also observed. Bullying victimization was associated with higher odds of current tobacco use (AOR: 2.14; P < 0.0001); truancy (AOR: 1.76; P < 0.0001); physical fighting (AOR: 2.40; P < 0.0001); and unprotected sexual intercourse (AOR: 1.77; P < 0.0001).
Although the prevalence of bullying victimization varied by country, its association with suicidal ideation and behavior and negative health behaviors remained relatively consistent. Addressing bullying needs to be made a priority in Latin America, and an integrated approach that also includes mental and physical health promotion is needed.
比较五个不同拉丁美洲国家中受欺凌、自杀意念、自杀未遂以及负面健康行为（当前吸烟、近期大量饮酒、逃学、参与肢体冲突和无保护性行为）的发生率，并确定受欺凌与这些结果之间的关联，同时探究欺凌类型和频率。
研究数据来自玻利维亚、哥斯达黎加、洪都拉斯、秘鲁和乌拉圭的全球学校学生健康调查，涵盖具有全国代表性的在校青少年样本。调查采用两阶段整群抽样设计，先抽取学校，再抽取班级。运行逻辑回归模型以确定与欺凌相关联的统计学显著性。
在本研究纳入的14560名在校青少年中，过去30天内任何形式受欺凌的发生率为37.8%。受欺凌与有计划的自杀意念（调整优势比[AOR]：3.12；P<0.0001）以及至少一次自杀未遂（AOR：3.07；P<0.0001）的更高几率相关。还观察到受欺凌天数增加对自杀结果的暴露-反应效应增强。受欺凌与当前吸烟（AOR：2.14；P<0.0001）、逃学（AOR：1.76；P<0.0001）、肢体冲突（AOR：2.40；P<0.0001）和无保护性行为（AOR：（1.77；P<0.0001）的更高几率相关。
尽管受欺凌的发生率因国家而异，但其与自杀意念、行为以及负面健康行为之间的关联相对一致。在拉丁美洲，应对欺凌需要成为优先事项，并且需要一种包括促进身心健康在内的综合方法。
