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皮下之患:校园欺凌受害的精神科结局是否会随时间推移而持续?一项前瞻性干预研究。

Under the skin: does psychiatric outcome of bullying victimization in school persist over time? A prospective intervention study.

机构信息

Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.

Faculty of Behavioral and Cultural Studies, Institute of Psychology, University of Heidelberg, Heidelberg, Germany.

出版信息

J Child Psychol Psychiatry. 2022 Jun;63(6):646-654. doi: 10.1111/jcpp.13502. Epub 2021 Aug 16.

Abstract

BACKGROUND

Research has shown a direct path between peer victimization and poor mental health outcomes. However, the impact of bullying prevention on mental health is a largely unexplored field. Therefore, our study examined the longitudinal association between bullying development and trajectories of psychiatric symptoms (emotional problems, total difficulties, nonsuicidal self-injury, and suicidality) and health-related quality of life (HRQL) during the implementation of school-based bullying prevention.

METHODS

Data of 4,873 pupils (grades 5-13) were collected in 23 schools implementing the Olweus Bullying Prevention Program (OBPP). Self-report questionnaires were administered at three annual assessment waves and individual codes enabled the association of repeated assessments to the same pupil. Latent growth curve models (LGCMs) were used to examine the relation among bullying status and mental health outcome with mixed-effects linear regressions estimating the association of changes in bullying with changes in continuous scores and mixed-effects logistic regressions for categorical variables.

RESULTS

Latent growth curve models revealed an improvement of mental health and HRQL through the termination of bullying for every outcome variable of interest (all p < .001). Correspondingly, we found an explicit increase in psychopathology as well as decrease in HRQL within one year as a result of developing victimization (all p < .001). Interestingly, the growth of psychopathology associated with the onset of bullying was significantly steeper than its decline associated with the termination of bullying. The postulated cumulative effect of ongoing bullying for a further year could only be shown for HRQL (p = .025) and total difficulties (p = .034), but not for specific mental health problems (all p > .117).

CONCLUSIONS

Latent growth curve models clearly showed that the adverse psychosocial consequences of bullying arise quickly but seem to reduce much slower and partly persist over time. Future long-term studies are necessary to clarify if mental health problems will return to baseline after several years or if residual symptoms will remain.

摘要

背景

研究表明,同伴受害与心理健康不良结果之间存在直接关系。然而,欺凌预防对心理健康的影响在很大程度上仍是一个未被探索的领域。因此,我们的研究考察了欺凌行为发展与精神症状(情绪问题、总困难、非自杀性自伤和自杀意念)和健康相关生活质量(HRQL)轨迹之间的纵向关联,同时在实施基于学校的欺凌预防过程中。

方法

共收集了 23 所实施反欺凌计划(OBPP)的学校中 4873 名(5-13 年级)学生的数据。使用自报告问卷进行了三次年度评估,个体代码将重复评估与同一学生关联起来。使用潜在增长曲线模型(LGCM)来检验欺凌状态与心理健康结果之间的关系,使用混合效应线性回归来估计欺凌变化与连续评分变化的关系,使用混合效应逻辑回归来估计分类变量的关系。

结果

潜在增长曲线模型显示,通过终止欺凌行为,每个感兴趣的心理健康和 HRQL 结果变量都得到了改善(所有 p<0.001)。相应地,我们发现,由于遭受欺凌,在一年内心理病理学明显增加,HRQL 明显下降(所有 p<0.001)。有趣的是,与欺凌发生相关的心理病理学增长速度明显快于与欺凌结束相关的下降速度。进一步的一年持续欺凌的累积效应仅在 HRQL(p=0.025)和总困难(p=0.034)方面显示出来,而在特定心理健康问题方面则不显示(所有 p>0.117)。

结论

潜在增长曲线模型清楚地表明,欺凌的不良社会心理后果很快就会出现,但似乎减少得更慢,而且在一段时间内部分持续存在。未来的长期研究有必要阐明,在几年后心理健康问题是否会恢复到基线,还是会残留症状。

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