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2015 ; 2
(6
): 524-31
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Adult mental health consequences of peer bullying and maltreatment in childhood:
two cohorts in two countries
#MMPMID26360448
Lereya ST
; Copeland WE
; Costello EJ
; Wolke D
Lancet Psychiatry
2015[Jun]; 2
(6
): 524-31
PMID26360448
show ga
BACKGROUND: The adult mental health consequences of childhood maltreatment are
well documented. Maltreatment by peers (ie, bullying) has also been shown to have
long-term adverse effects. We aimed to determine whether these effects are just
due to being exposed to both maltreatment and bullying or whether bullying has a
unique effect. METHODS: We used data from the Avon Longitudinal Study of Parents
and Children in the UK (ALSPAC) and the Great Smoky Mountains Study in the USA
(GSMS) longitudinal studies. In ALSPAC, maltreatment was assessed as physical,
emotional, or sexual abuse, or severe maladaptive parenting (or both) between
ages 8 weeks and 8·6 years, as reported by the mother in questionnaires, and
being bullied was assessed with child reports at 8, 10, and 13 years using the
previously validated Bullying and Friendship Interview Schedule. In GSMS, both
maltreatment and bullying were repeatedly assessed with annual parent and child
interviews between ages 9 and 16 years. To identify the association between
maltreatment, being bullied, and mental health problems, binary logistic
regression analyses were run. The primary outcome variable was overall mental
health problem (any anxiety, depression, or self-harm or suicidality). FINDINGS:
4026 children from the ALSPAC cohort and 1420 children from the GSMS cohort
provided information about bullying victimisation, maltreatment, and overall
mental health problems. The ALSPAC study started in 1991 and the GSMS cohort
enrolled participants from 1993. Compared with children who were not maltreated
or bullied, children who were only maltreated were at increased risk for
depression in young adulthood in models adjusted for sex and family hardships
according to the GSMS cohort (odds ratio [OR] 4·1, 95% CI 1·5-11·7). According to
the ALSPAC cohort, those who were only being maltreated were not at increased
risk for any mental health problem compared with children who were not maltreated
or bullied. By contrast, those who were both maltreated and bullied were at
increased risk for overall mental health problems, anxiety, and depression
according to both cohorts and self-harm according to the ALSPAC cohort compared
with neutral children. Children who were bullied by peers only were more likely
than children who were maltreated only to have mental health problems in both
cohorts (ALSPAC OR 1·6, 95% CI 1·1-2·2; p=0·005; GSMS 3·8, 1·8-7·9, p<0·0001),
with differences in anxiety (GSMS OR 4·9; 95% CI 2·0-12·0), depression (ALSPAC
1·7, 1·1-2·7), and self-harm (ALSPAC 1·7, 1·1-2·6) between the two cohorts.
INTERPRETATION: Being bullied by peers in childhood had generally worse long-term
adverse effects on young adults' mental health. These effects were not explained
by poly-victimisation. The findings have important implications for public health
planning and service development for dealing with peer bullying. FUNDING:
Wellcome Trust, Medical Research Council, Economic and Social Research Council,
National Institute of Mental Health, the National Institute on Drug Abuse, NARSAD
(Early Career Award), and the William T Grant Foundation.