according to data from a large, cohort study of 1,760 children in Canada.
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“Peer victimization is characterized by substantial individual variability in its timing, duration, and intensity,” but the specific variations in victimization patterns have not been well studied, wrote Sinziana I. Oncioiu, MPH, of the University of Bordeaux (France) and colleagues.
To better describe the trajectories of peer victimization and identify factors associated with them, the researchers used data from the Quebec Longitudinal Study of Child Development of children born in Quebec in 1997-1998 and followed from 5 months to 17 years of age. Participants reported being the target of a bully at least once in ages 6-17 years. The study included 862 boys and 898 girls; 59% provided data on being bullied seven or eight times out of a possible eight assessments in the study published in Pediatrics.
The researchers identified four trajectories of peer victimization for ages 6-17 years: low (33%), moderate emerging (30%), childhood limited (26%), and high chronic (11%). Low victimization was defined as low victimization throughout the follow-up period. Moderate-emerging victimization was defined as steady levels from 6-12 years, followed by adolescent victimization. Childhood-limited peer victimization was defined as a high level of bullying at 6 years of age, followed by a sharp decline from 6 to 17 years. High-chronic victimization was defined as persistently high victimization compared, with the other groups, although levels declined from 6 to 17 years.
Overall, in a multivariate analysis, children in the moderate-emerging, childhood-limited, and high-chronic groups were more likely than those in the low victimization group to demonstrate externalizing behavior problems in early childhood. In addition, children with a paternal history of antisocial behavior were significantly more likely to be in moderate-emerging and high-chronic groups, compared with the low group (odds ratios 1.54 and 1.93, respectively). Children living in a nonintact family in early childhood were significantly more likely to fall into the childhood-limited and high-chronic groups, compared with the low group.
The study findings were limited by several factors including lack of assessment of power imbalances between bullies and victims and a lack of differentiation between children who were both bullies and victims and those who were victims only, the researchers noted. The use of self-reports and some attrition of the study population also limited the results, they said.
However, the study’s large size and long-term follow-up strengthen the results, which support the need for targeted interventions to address individual and family vulnerabilities and prevent persistent victimization during children’s school years, the researchers concluded.
Pediatricians have an important role to play in reducing potential vulnerability to being bullied among their patients, Stephen S. Leff, PhD; Brooke S. Paskewich, PsyD; and Nathan J. Blum, MD, of Children’s Hospital of Philadelphia, wrote in an accompanying editorial.
“Given that nearly two-thirds of school-aged youth in the current study report peer victimization during elementary and/or middle school, this is an important period in which pediatricians can screen for victimization during well-child visits,” they said. It also is important to have resources and referral information available, whether it is in the practice, the community, or online. Anticipatory guidance also is valuable by defining bullying (“aggressive or mean behavior that happens repeatedly in the context of a power imbalance,”) forms of bullying (physical, verbal, using gossip, and social exclusion in real time or online), and the impact of bullying on children and families.
In addition, pediatricians should “recognize externalizing behaviors as risk factors for adverse outcomes and assist families in accessing evidence-based interventions such as family behavioral counseling or parent training,” the editorialists said. “There may also be value in pediatricians being more attuned to indicators of parental psychopathology so that they can make recommendations to address the parents’ mental health needs and better prepare parents to support their child’s social-emotional development.”
The study was supported by the Quebec Government Ministry of Health, Canadian Institute of Health Research, Quebec’s Health Research Fund, and other Canadian organizations and universities. The editorial was supported in part by the National Institutes of Health and the Department of Health and Human Services. The researchers and editorialists had no financial conflicts to disclose.
SOURCEs: Oncioiu SI et al. Pediatrics. 2020. doi: 10.1542/peds.2019-2654.