Department of Family and Community Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Faculty of Health, Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
PLoS One. 2022 Jun 3;17(6):e0269451. doi: 10.1371/journal.pone.0269451. eCollection 2022.
Bullying perpetration might be an alternative way of hierarchy formation among adolescents. It can potentially compensate for the negative health influences of low socioeconomic status (SES), rewarding this unwanted behavior. This study aimed to investigate the role of bullying perpetration in the relationship between SES and health among Armenian adolescents. A nationally representative sample of 3679 adolescents aged 11-15 years (mean = 13.1, standard deviation = 1.6) participated in the Health Behavior in School-aged Children 2013/14 survey in Armenia. Complex samples multiple logistic regression were used to estimate the associations between two SES measures (family socioeconomic position [SEP] and material well-being) and three health outcomes (perceived health status, psychosocial well-being, and psychosomatic symptoms). Bullying perpetration was not associated with less than good health or low psychosocial well-being (P > 0.05) but increased the odds of reporting high psychosomatic symptoms (P < 0.05). Perpetration did not change the SES-health gradient substantially. However, in stratified analyses, socioeconomic inequalities in health were consistently weaker among perpetrators. The largest observed difference was in the relationship between low family SEP and less than good health (OR = 3.60, 95% CI = 2.77-4.67 vs. OR = 1.80, 95% CI = 1.06-3.04), whereas the smallest difference was in the relationship between low family SEP and high psychosomatic symptoms (OR = 1.27, 95% CI = 1.03-1.56 vs. OR = 1.04, 95% CI = 0.61-1.77). Our findings suggest that bullying perpetration, as an alternative hierarchy, may be looked at as a compensatory but vicious strategy in the face of the negative health influences of low SES in Armenian adolescents. For high-SES adolescents, on the other hand, social, emotional, or psychological problems might contribute to bullying perpetration. Consequently, bullying prevention activities in Armenia should focus on both low and high-SES adolescents, considering SES-specific pathways and mechanisms.
欺凌行为可能是青少年中等级形成的一种替代方式。它可能会对低社会经济地位（SES）的健康负面影响起到补偿作用，从而助长这种不受欢迎的行为。本研究旨在探讨欺凌行为在亚美尼亚青少年 SES 与健康之间关系中的作用。在亚美尼亚，一个全国代表性的样本包括 3679 名年龄在 11-15 岁的青少年（平均年龄为 13.1 岁，标准差为 1.6 岁）参加了 2013/14 年《青少年健康行为调查》。采用复杂样本多元逻辑回归来估计两个 SES 指标（家庭社会经济地位[SEP]和物质福利）和三个健康结果（感知健康状况、心理社会福祉和身心症状）之间的关联。欺凌行为与健康状况不佳或心理社会福祉较低之间没有关联（P>0.05），但增加了报告高身心症状的几率（P<0.05）。欺凌行为并没有实质性地改变 SES 与健康之间的梯度关系。然而，在分层分析中，欺凌行为者的健康方面的社会经济不平等程度始终较弱。观察到的最大差异在于低家庭 SEP 与健康状况不佳之间的关系（OR=3.60，95%CI=2.77-4.67 与 OR=1.80，95%CI=1.06-3.04），而最小的差异在于低家庭 SEP 与高身心症状之间的关系（OR=1.27，95%CI=1.03-1.56 与 OR=1.04，95%CI=0.61-1.77）。我们的研究结果表明，在亚美尼亚青少年中，欺凌行为作为一种替代等级制度，可能被视为面对低 SES 对健康的负面影响时的一种补偿性但恶性策略。另一方面，对于高 SES 的青少年来说，社会、情感或心理问题可能会导致欺凌行为的发生。因此，亚美尼亚的欺凌预防活动应针对 SES 较高和较低的青少年，考虑 SES 特定的途径和机制。
