The associations between bullying victimization and internalizing distress,suicidality,and substance use in Jamaican adolescents: The moderating role of parental involvement

Abstract

The present study investigated whether bullying victimization and parental involvement were associated with internalizing distress, suicidal thoughts and behavior, and substance use in Jamaican adolescents as well as whether parental involvement moderated the relation between bullying victimization and measures of psychological and behavioral distress. Analyses were based on a sample of 1,595 adolescents who were participating in the 2010 Global School-Based Student Health Survey. Data were collected using a complex survey design. Regression models were estimated using weighted data, which allowed us to draw conclusions about the population of Jamaican adolescents. Consistent with findings from international studies, bullying victimization was uniquely and positively associated with feelings of loneliness, sleep difficulties due to worry, smoking frequency, and suicidality for both male and female adolescents as well as with alcohol use frequency for female adolescents. Our pattern of findings also suggested that parental involvement is a more robust correlate of psychological and behavioral adjustment for female adolescents. Female adolescents who reported higher levels of parental involvement were less lonely and less likely to consider or plan suicide. For boys, parental involvement was only negatively related to loneliness. Finally, we found evidence that parental involvement moderated the relation between bullying victimization and cigarette use and considering suicide, although the latter finding was at the level of a nonsignificant trend. Our findings suggest parental involvement may attenuate the relation between bullying victimization and considering suicide but may strengthen the relation between bullying victimization and smoking. We discuss our findings in the context of Jamaican cultural socialization and with an appreciation for the social challenges faced by adolescents experiencing bullying victimization.

Keywords

Adolescents bullying internalizing distress Jamaica parental involvement substance use

Introduction

Bullying is defined broadly as any intentional aggressive behavior that aims to cause the victim harm and distress and involves an imbalance of power between perpetrator and victim, with the imbalance favoring the perpetrator (UNICEF, 2014a). School bullying is a global phenomenon that pervades all societies and demographic groupings (UNICEF, 2014a, 2014b). It is deemed a critical breach of children’s human rights and a serious threat to public health (UNICEF, 2014a, 2014b). Data from a comprehensive global study on violence against children showed that an average of 33% (range: 7–74%) of students between 13 and 15 years old reported being victims of bullying on a regular basis. In Europe and North America, 31% (range: 14–59%) of adolescents aged 11–15 years admitted to bullying others at school in the past few months (UNICEF, 2014a). In 2013, 20% of high school students in the United States reported that they were bullied at school in the last 12 months (CDC, 2016). Arguably, the impact of bullying on developmental outcomes is difficult to decipher and quantify. However, its adverse consequences on the well-being and quality of life of victims are well documented and shown to be associated with an array of acute and chronic socioemotional problems (Nansel, Craig, Overpeck, Saluja, & Ruan, 2004; Wolke & Lereya, 2015).

The purpose of this study was to investigate whether bullying victimization was associated with the psychosocial functioning of Jamaican adolescence as well as whether those associations were moderated by parental involvement. The Jamaican context was studied because of the paucity of relevant research coupled with high levels of interpersonal violence in that country. However, one form of violence that has garnered extensive attention worldwide, but far less so in Jamaica, is bullying. Hudson-Davis et al. (2015) noted that despite heightened interest in bullying globally, research activity on the topic lacks sufficient intensity in Jamaica. Therefore, what is assumed about bullying and its impact on Jamaican children and youth has been gleaned via extrapolations from studies emanating from developed societies (Smith, 2016a; UNICEF, 2014a, 2015). Undoubtedly, generalizing findings from one culture to another can be helpful in understanding the potential correlates of bullying in Jamaica, but also potentially problematic in that specific cultural nuances may influence the extent to which findings generalize across cultures (Smith, 2016a, 2016b). Thus, it is prudent to investigate whether the psychosocial correlates of bullying victimization in Jamaica are similar to those reported by children from other cultures. Furthermore, there is a dire need for relevant robust data to inform the development of evidence-based programs; improve relevant campaigns, laws, regulations; and for services that foster children’s protection, safety, and well-being (UNICEF, 2014b).

The Jamaican context

Findings from the scant available data on bullying in Jamaican schools have suggested that the rate of bullying in that society mimics and, in many instances, exceeds global levels (UNICEF, 2015). For example, one pivotal national study (UNICEF, 2015) surveyed 1,867 Jamaican students from 70 elementary and secondary public schools on whether they had been bullied. Findings indicated that 65% of the students reported having ever been bullied and 70% of those bullied experienced it over the past school year. Additionally, an inordinately high proportion (93.4%) of students indicated that they had witnessed their peers being bullied at school. In that same study, of the 174 school personnel surveyed, 80% indicated that they knew about children at their schools being bullied and 93% indicated that such incidents had taken place during the school year. Hudson-Davis et al. (2015) surveyed 153 elementary aged students, 9 teachers, and 26 parents from three Jamaican public schools to capture their views on the prevalence of bullying at their institutions; 65% of students indicated that physical bullying was a daily occurrence at school and 67% noted that that verbal bullying occurred on a daily basis. Among teachers, 90% agreed that both physical and psychological bullying occurred at their school on a daily basis. All parents (100%) agreed that bullying was a problem and 92% bemoaned the fact that because of bullying, schools were no longer fun for children. In both studies noted here, students were asked their opinions about the effect of bullying; however, neither study investigated the psychosocial impact of bullying on study participants.

We could locate no study that assessed concurrent bullying victimization and psychosocial outcomes in a Jamaican sample. Therefore, it is unclear whether Jamaican children who are bullied, compared to their non-bullied peers, would exhibit adverse internalizing and externalizing behavior patterns similar to those reported by children in other societies. It is also unclear whether parenting factors would moderate the associations between bullying victimization and health risk behaviors. In international studies, parental support and involvement have been shown to be a protective barrier to the negative effects of bullying victimization (Hemphill, Tollit, & Herrenkohl, 2014).

Impact of bullying

Compared to their non-bullied peers, children and adolescent bully victims have been shown to have poorer health and psychosocial outcomes in the short and long term. For example, there is evidence that children who were bullied are twice as likely as their non-bullied peers to exhibit psychosomatic problems such as headaches, stomachaches, bed-wetting, and appetite issues (Gini & Pozzoli, 2013). Psychological difficulties such as low self-esteem, anxiety, depression, suicidality (CDC, 2016; UNICEF, 2014a), academic problems, and problematic peer relationships (CDC, 2016; Nansel et al., 2004; UNICEF, 2014a) have also been reported. In addition, victims have been shown to exhibit an increased propensity for engaging in adverse health behaviors such as smoking and illicit drug use (UNICEF, 2014a).

Childhood bullying victimization also predicts a wide array of unfavorable outcomes later in life, including elevated rates of psychological and psychiatric illnesses, poor social relationships, employment difficulties, economic hardship, and lower overall life satisfaction long after initial victimization (CDC, 2016; UNICEF, 2014a; Wolke & Lereya, 2015). In one study (Takizawa, Maughan,& Arseneault, 2014), compared to their non-bullied peers, victims of childhood bullying reported higher rates of depression, anxiety disorders, and suicidality 40 years after exposure. Poor general health, low educational attainment, aggressive tendencies, and violent offending in adulthood have also been reported (Ttofi, Farrington, & Lösel, 2012; Wolke & Lereya, 2015).

In light of the adverse consequences of bullying victimization, researchers have sought to identify protective factors that promote resilience or deflect youth off a path toward negative adjustment outcomes. For example, a body of research literature has shown that family child-rearing strategies such as high parental involvement and positive parent–child relationships protect children against bullying victimization (Lereya, Samara, & Wolke, 2013) and buffer the impact of bullying victimization on externalizing and internalizing outcomes (Hemphill et al., 2014; Swearer & Hymel, 2015). Results from Lereya, Samara, and Wolke’s (2013) meta-analysis of 70 cross-sectional and longitudinal studies revealed various aspects of parental involvement, including support, supervision, and monitoring protected children and adolescents from bullying victimization. Furthermore, being bullied is a stressful life event, a dynamic that emanates problematic psychosocial consequences (Lereya et al., 2013; Swearer & Hymel, 2015), and parental involvement is often found to attenuate the negative effects of stress on children (Swearer & Hymel, 2015). Parental involvement could boost children’s self-concept, autonomy, and resiliency, which, in turn, may enhance adaptive coping strategies (Lereya et al., 2013). Indeed, adaptive coping has been shown to reduce stress and lower rates of depressive symptoms (Hemphill et al., 2014; Lereya et al., 2013; Swearer & Hymel, 2015). As such, one goal of the current study was to examine the extent to which parental involvement was associated with psychological and behavioral outcomes for adolescents as well as whether parental involvement moderated the relation between bullying victimization and psychological and behavioral outcomes in a sample of Jamaican youth.

The present study

The focus of this study is on bullying victimization within Jamaican adolescents. The study uses the World Health Organization’s Global School-Based Student Health Survey (GSHS) data to examine the relationships among bullying victimization, mental health, and health compromising behaviors in school children. We utilize students’ reports of their experience as victims of bullying, health risk behaviors, internalizing distress, and their parents’ involvement. Regarding health risk behaviors, the extant literature has suggested that in order to anesthetize the pain and distress they experience, victimized children and adolescents may resort to problematic coping practices such as smoking and illegal substances as a stress management mechanism (Maniglio, 2016; Springer, 2009). Indeed, childhood adversity and stressful experiences are associated with elevated risk of maladaptive coping behaviors, which, in turn, have been implicated as the main conduits through which many physical and mental health problems occur (Fuller-Thomson, Brennenstuhl, & Franck, 2010; Springer, 2009). Fuller-Thomson, Brennenstuhl, and Franck (2010) concluded from their research that the use of health risk coping mechanisms (e.g., tobacco use and alcohol and drug use) was crucial connecting pathways between childhood adversity and general physical health and well-being. In the current study, we consider whether bullying victimization in Jamaican adolescents is related to loneliness and worry (i.e., internalizing symptoms), suicidal thoughts and behavior, and substance use. These outcomes were selected because previous research in other cultures has found robust relations between bullying victimization and these constructs and these data were available in the GHSH Jamaican data set. Consistent with previous research, we predicted that bullying victimization would be positively related to all outcome measures. Specifically, we predicted that parental involvement would moderate the relationship between bullying victimization and psychosocial adjustment, such that the relationship between bullying victimization and psychosocial adjustment would be weaker at higher levels of parental involvement. We also explored the possibility that these relations would vary as a function of sex.

Method

Study design and sample

Data were obtained from the GSHS. The GSHS was developed by the World Health Organization and the Centers for Disease Control and Prevention in collaboration with the United Nations Children’s Fund, United Nations Educational, Scientific and Cultural Organization, United Nations Programme on HIV/Acquired Immune Deficiency Syndrome, and the Ministry of Health and/or Education in the countries in which it was administered. The GSHS is a school-based surveillance project designed to assess the health behaviors and protective factors related to key areas of morbidity and mortality among youth worldwide. The data are collected through a self-administered country-specific questionnaire and are available for public use. The GSHS was designated as exempt from review by the University Institutional Review Board. Further details of the GSHS can be found at http://www.who.int/chp/gshs/en/.

The current study is a secondary analysis of data collected during the 2010 Jamaica GSHS. The core variables included in this study were demographics, bullying victimization, alcohol use, tobacco use, and mental health. The data do not provide information on indirect bullying and cyberbullying. The sample consisted of 1,623 students, aged 11–16 years, representing grades 7–12, who participated in the 2010 Jamaica GSHS. Male represented 48.8% and female represented 51.2% of the sample.

Measures

Bullying victimization

Bullying victimization was assessed by students’ responses to one question indicating whether over the past 30 days, they were bullied (“During the past 30 days, on how many days were you bullied?”).¹ Response options were 1 = 0 days, 2 = 1 or 2 days, 3 = 3–5 days, 4 = 6–9 days, 5 = 10–19 days, 6 = 20–29 days, and 7 = all 30 days. Previous studies provide support for the validity of a single-item measure of bullying victimization (Shaw, Dooley, Cross, Zubrick, & Waters, 2013; Solberg & Olweus, 2003), including studies using GSHS data that utilized the same single-item measures of bullying employed in the current study (Peltzer & Pengpid, 2017b; Ziaei et al., 2017). Shaw, Dooley, Cross, Zubrick, and Waters (2013) found strong associations between a single-item measure of bullying and the Forms of Bullying Scale measuring bullying victimization (FBS-V), indicating adequate concurrent validity. Additionally, Shaw et al. (2013) found that the FBS-V was correlated in the expected direction with socio-emotional outcomes (e.g., anxiety, depression, conduct problems, and peer support), providing further evidence for the utility of a single-item measure of victimization. Solberg and Olweus (2003) suggest that a single-variable measure for victimization is preferable for accurately estimating prevalence, because prevalence estimates based on composite scores tend to be more abstract and general than single-variable estimates.

Internalizing distress

Internalizing distress was assessed via the following items: “During the past 12 months, how often have you felt lonely?” and “How often have you been so worried about something that you could not sleep at night?” For both items, response options were 1 = never, 2 = rarely, 3 = sometimes, 4 = most of the time, and 5 = always. The validity of this single-item measure of loneliness has been established in prior work using GSHS data (Mazaba, Siziya, & Merrick, 2017; Peltzer & Pengpid, 2017a). For example, Peltzer and Pengpid (2017a) found that this single-item measure of loneliness was positively associated with a greater number of risky lifestyle choices (e.g., fast food and soft drink consumption, two or more sexual partners, physical inactivity, inadequate fruit and vegetable consumption, current tobacco use, and history of being drunk) and experiencing hunger.

Suicidality

Suicidal thoughts and behavior was assessed via the following items: “During the past 12 months, did you ever seriously consider attempting suicide?” and “Did you make a plan about how you would attempt suicide?” Response options were 1 = yes or 2 = no. “During the past 12 months, how many times did you actually attempt suicide?” Response options were 1 = 0 times, 2 = 1 time, 3 = 2 or 3 times, 4 = 4 or 5 times, and 5 = 6 or more times. The validity of these single-item measures of suicidal thoughts and behavior has been established in prior work using GSHS survey data (Badr, 2017; Klomek et al., 2016; Mazaba et al., 2017; Peltzer & Pengpid, 2017a, 2017b; Ruprah, Sierra, & Sutton, 2017; Ziaei et al., 2017). For example, Ziaei et al. (2017) found that suicidal ideation was positively associated with worrying, ability to focus on homework, current cigarette use, thoughts about using alcohol or other drugs, being bullied, and being sexually abused. In another study, Badr (2017) found that the single-item measures of suicidal thoughts and behaviors were endorsed more frequently by youth who were exposed to bullying and physical attacks at school, felt lonely, engaged in physical fights at school, smoked, used drugs, skipped school, and lacked empathetic parents.

Substance use

Substance use was assessed with the following questions: Tobacco use—“During the past 30 days, on how many days did you smoke cigarettes?” Response options were 1 = 0 days, 2 = 1 or 2 days, 3 = 3–5 days, 4 = 6–9 days, 5 = 10–19 days, 6 = 20–29 days, and 7 = all 30 days. Alcohol use—“During the past 30 days, on how many days did you have at least one drink containing alcohol?” Response options were 1 = 0 days, 2 = 1 or 2 days, 3 = 3–5 days, 4 = 6–9 days, 5 = 10–19 days, 6 = 20–29 days, and 7 = all 30 days. Several existing studies using GSHS data support the validity of the single-item measures of tobacco and alcohol use (Banzer et al., 2017; Mazaba et al., 2017; Mouhanna et al., 2017; Murshid, 2017; Peltzer & Pengpid, 2017a, 2017b; Ruprah et al., 2017; Ziaei et al., 2017). For example, Banzer et al. (2017) found significant positive associations between adolescents’ tobacco use and anxiety, hyperactivity, conduct problems, self-injurious behaviors, previous suicide attempts, alcohol and drug use, and family problems.

Parental involvement

Parental involvement was assessed via 3 items: “During the past 30 days, how often did your parents or guardians check to see if your homework was done?” How often did your parents or guardians understand your problems?” and “How often did your parents or guardians really know what you were doing with your free time?” Items were rated on a 5-point scale with the following response options: 1 = never, 2 = rarely, 3 = sometimes, 4 = most of the time, and 5 = always. The 3 items measuring parental involvement were averaged to form a parental involvement composite variable and the internal consistency of the parental involvement construct was .64. A prior research study using GSHS data (Ruprah et al., 2017) has demonstrated reliability and validity of the 3-item measure of parental involvement used in the current investigation. Ruprah, Sierra, and Sutton (2017) found that higher scores on parental involvement were associated with lower levels of risk behavior.

Data analytic plan

Participants were 1,623 adolescents participating in the 2010 GSHS, but analyses were based on a subsample of 1,595 adolescents for whom data were available on sex (28 participants did not indicate their sex). Data were collected using a complex survey design. Mean, standard deviations (SDs), correlations, and regression models were estimated in Mplus, version 7.2. To address the complex survey design, we first generated a replicate weight file, which summarizes information from complex survey data and takes into account weight information, sample stratification, and clustering. In the generation of the replicate weight file, we used the TYPE = COMPLEX option with a Jackknife resampling method in Mplus. As part of this analysis, a multiplier file was generated allowing for the computation of standard errors (SEs) in subsequent regression models. Final regression models were estimated using weighted data, a Jackknife resampling procedure, and multiplier values for the computation of SEs. Results from these analyses allow us to draw conclusions about the population of Jamaican adolescents. Across variables, approximately 3.3% of data were missing, with the percent of missing values ranging from 0.5% to 8.7%. Full-information maximum likelihood estimation was used to address missing data, which, in the multivariate case, uses all available information in the data set to estimate model parameters.

Three separate multiple group regression models were estimated to examine whether bullying victimization, parental involvement, and the interaction between bullying victimization and parental involvement were significantly associated with measures of internalizing distress, suicidal thoughts and behavior, and substance use. The first-order predictors were centered prior to computing interactions terms and centered first-order predictors and the interaction term was entered simultaneously into each regression model. Covariances among variables were estimated in each model (i.e., models were fully saturated). The first model regressed variables assessing internalizing distress (i.e., loneliness and sleep difficulties due to worry) on to bullying victimization, parental involvement, and the interaction between bullying victimization and parental involvement. The second model regressed variables assessing suicidal thoughts and behaviors on to bullying victimization, parental involvement, and the interaction between bullying victimization and parental involvement. Because considering suicide and planning suicide were dichotomous variables, both variables were specified as categorical in the regression model, and a logistic regression was performed on these outcomes. In text, we transformed log odds ratios (ORs) to ORs to ease interpretation. Our final model regressed cigarette use and alcohol use on to bullying victimization, parental involvement, and the interaction between bullying victimization and parental involvement.

For each set of dependent variables (i.e., each regression model), we compared a multiple group model where values were freely estimated for adolescent boys and girls to a model where estimates were constrained to be equal across sex. The constrained model fit the data significantly worse than the freely estimated model and thus our final set of analyses was based on a multiple group model where effects were freely estimated for adolescent boys and girls. When a regression effect was significant for boys, girls, or both boys and girls, we examined the extent to which the size of the relation was significantly different by sex. To do this, we compared a freely estimated multiple group model to a model where a significant effect was constrained to be equal across sex via the χ² difference test using log-likelihood values (i.e., Δ-2 (log likelihood)). This model comparison procedure was repeated for each significant effect in our set of analyses. It is important to note that χ² and log-likelihood values were not available in models estimating categorical outcomes using replicate weight files. For categorical outcomes, we examined whether the fit value for the Root Mean Square Error of Approximation (RMSEA) for the constrained multiple group model (i.e., significant effect is constrained to be equal across sex) was outside of the acceptable range (RMSEA > .08) for model fit (Brown, 2015; Little, 2013). We reasoned that a shift from perfect model fit (i.e., saturated model) in the freely estimated saturated model to unacceptable model fit in a constrained model was a conservative test of a significant sex difference. Simple slopes analysis was conducted when an interaction term was significant, and interactions were probed at the following values of the moderator: 1 SD below the mean, at the mean, and 1 SD above the mean. Standardized regression coefficients (or ORs) and SEs for significant effects are reported in text and the full model results are presented in Table 1.

Table 1.

Regressions.

	Boys					Girls
				95% CI					95% CI
Variable	β	B	SE	Lower	Upper	β	B	SE	Lower	Upper
	Loneliness
Age	.002	.002	.056	−.109	.112	.076	.077	.051	−.053	.177
Bullied	.277	.217**	.058	.103	.331	.193	.163**	.046	.046	.253
PI	−.094	−.102*	.040	−.179	−.024	−.108	−.114**	.041	−.219	−.034
Bullied × PI	−.011	−.009	.023	−.053	.035	.097	.080	.064	−.085	.205
	Sleep difficulty due to worry
Age	−.064	−.067	.053	−.204	.037	.027	.029	.050	−.099	.128
Bullied	.274	.214**	.037	.119	.286	.251	.227**	.037	.132	.299
PI	.029	.031	.068	−.144	.164	−.063	−.071	.039	−.172	.005
Bullied × PI	.053	.045	.027	−.024	.097	.018	.016	.034	−.073	.083
	Considering suicide
Age	−.105	−.092	.097	−.282	.099	−.109	−.094	.092	−.273	.085
Bullied	.370	.241**	.017	.207	.274	.070	.050	.026	−.001	.101
PI	−.068	−.061	.059	−.177	.055	−.242	−.215**	.060	−.334	−.097
Bullied × PI	.081	.056	.059	−.059	.172	−.090	−.062	.033	−.126	.002
	Planning suicide
Age	−.013	−.011	.095	−.197	.174	−.084	−.073	.048	−.116	.021
Bullied	.295	.192**	.069	.056	.328	.205	.146**	.051	.046	.247
PI	−.102	−.092	.074	−.237	.054	−.209	−.186**	.046	−.275	−.097
Bullied × PI	.026	.018	.059	−.098	.134	−.048	−.033	.032	−.096	.029
	Suicide attempts
Age	.073	.070	.052	−.032	.172	−.111	−.092	.067	−.223	.040
Bullied	.434	.307**	.033	.243	.372	.371	.253**	.049	.156	.350
PI	.027	.026	.048	−.069	.121	−.044	−.038	.022	−.082	.006
Bullied × PI	.000	.000	.043	−.085	.085	.023	.015	.024	−.031	.062
	Alcohol use frequency
Age	.115	.174*	.068	.040	.308	.030	.039	.071	−.100	.177
Bullied	.122	.137	.120	−.099	.373	.194	.205**	.042	.122	.288
PI	.011	.017	.062	−.105	.139	−.024	−.031	.059	−.147	.084
Bullied × PI	−.005	−.006	.031	−.067	.056	.078	.080	.049	−.016	.176
	Cigarette use frequency
Age	−.008	−.011	.059	−.127	.105	−.066	−.059	.065	−.185	.068
Bullied	.339	.358*	.170	.026	.691	.258	.188*	.087	.019	.358
PI	−.014	−.020	.066	−.150	.110	.070	.064	.035	−.004	.132
Bullied × PI	−.012	−.013	.098	−.205	.178	.089	.063*	.030	.005	.121

Note. Unstandardized regression coefficients for the outcome of alcohol use frequency and cigarette use frequency are interpreted as log OR. PI = parental involvement; OR = odd ratio; CI = confidence interval; SE = standard error.

*p < .05; **p < .01.

Results

Preliminary analyses

Means and SDs for primary study variables are reported separately by sex in Table 2. Bivariate correlations among primary study variables for boys and girls are reported in Table 3. Boys’ and girls’ bullying victimization was positively associated with most outcomes, but associations were stronger with outcomes measuring internalizing distress and suicide. Parental involvement was negatively associated with considering and planning suicide for girls.

Table 2.

M and SD of primary study variables by sex.

	Boys		Girls
Variables	M (SD)		M (SD)
Age	4.782 (1.138)		4.641 (1.161)
Bullied	1.968 (1.537)		1.799 (1.402)
Parental involvement	2.942 (1.112)		3.014 (1.123)
Loneliness	2.334 (1.204)		2.753 (1.181)
Sleep difficulty due to worry	2.195 (1.201)		2.534 (1.267)
Suicide attempts	1.540 (1.089)		1.433 (.956)
Alcohol use frequency	2.694 (1.724)		2.216 (1.484)
Cigarette use frequency	1.857 (1.616)		1.350 (1.022)
	Yes	No	Yes	No
Considering suicide	165	551	202	580
Planning suicide	152	564	208	584

Note. Age is rated on a 1–6 scale, with a mean score of 4.782 for boys and 4.641 for girls reflecting a mean age of 14.782 and 14.641, respectively. SD = standard deviation; M = mean.

Table 3.

Correlations among primary study variables by sex.

	1	2	3	4	5	6	7	8	9	10	11
1. Age	—	−.018	.033	.077	.021	−.125	−.099*	−.118	.038	−.061	.076*
2. Bullied	.034	—	.020	.205**	.257**	.061	.199*	.374**	.199**	.262*	.211**
3. Parental involvement	−.042	−.051	—	−.129**	−.058	−.226**	−.198**	−.045	−.032	.055	−.072
4. Loneliness	.010	.281**	−.102*	—	.324**	.251**	.224**	.123	.109	.072	.023
5. Sleep difficulty due to worry	−.061	.274**	.013	.281**	—	.274**	.285**	.167**	.175**	.157*	.070
6. Considering suicide	−.092	.366**	−.096	.318**	.238**	—	.806**	.435**	.104**	.148	.131**
7. Planning suicide	.000	.298**	−.121	.240**	.273**	.665**	—	.501**	.203**	.261**	.214**
8. Suicide attempts	.086	.435**	.001	.201**	.200**	.456**	.346**	—	.178**	.341*	.187*
9. Alcohol use frequency	.116**	.125	.004	.074	.058	.071	.034	.098	—	.262**	.245**
10. Cigarette use frequency	.009	.335**	−.026	.204**	.202**	.333**	.174**	.361**	.216**	—	.177**
11. Age of first drug use	.130	.166*	−.187**	.118	−.008	.142**	.128	.199**	.142**	.273**	—

Note. Correlations for boys are presented below the diagonal; correlations for girls are presented above the diagonal.

*p < .05; **p < .01.

Internalizing distress

Boy’s bullying victimization was significantly related to loneliness (β = .277, SE = .071, p < .001) and sleep difficulties due to worry (β = .274, SE = .056, p < .001), such that adolescent boys scoring higher on bullying victimization were more likely to experience loneliness and sleep difficulties due to worry. Boy’s perception of parental involvement was negatively associated with loneliness (β = −.094, SE = .038, p < .05), such that boys scoring higher on parental involvement were less likely to report feeling lonely.

Similar to boys, bullying victimization in girls was positively associated with loneliness (β = .193, SE = .060, p < .001) and sleep difficulties due to worry (β = .251, SE = .043, p < .001). Girls who reported higher levels of bullying victimization were lonelier and reported greater sleep difficulty due to worry. Parental involvement was significantly associated with girl’s level of loneliness (β = −.108, SE = .038, p < .01), such that girls scoring higher on parental involvement reported lower levels of loneliness. A similar effect was found for sleep difficulties due to worry, but the association with parental involvement was at the level of a nonsignificant trend (β = −.063, SE = .034, p = .06). Parental involvement did not moderate the relation between bullying victimization and loneliness or sleep difficulties due to worry for girls. We found no evidence that the size of significant effects varied by sex; significant effects were of comparable size for boys and girls.

Suicidality

Boy’s bullying victimization was positively associated with considering suicide (OR = 1.272, p < .01), planning suicide (OR = 1.212, p < .001), and attempting suicide (β = .434, SE = .048, p < .001). For every one-unit increase in bullying victimization, boys experienced a 27% increase in the extent to which they considered suicide and a 21% increase in the extent to which they planned suicide. In addition, for every one-unit increase in boys’ bullying victimization, their number of suicide attempts increased by approximately .43 SDs. There was also a significant sex difference in the size of the relation between bullying victimization and considering suicide. The model fit moved from perfect in the freely estimated saturated model to not acceptable (RMSE = .102) in the model constraining bullying victimization to be equal across sex, indicating the relation between bullying victimization and considering suicide was significantly stronger for boys. Parental involvement did not moderate the association between peer victimization and suicidal outcomes.

Girl’s bullying victimization was significantly positively associated with having a suicide plan (OR = 1.157, p < .01) and suicide attempts (β = .371, SE = .077, p < .001). For every one-unit increase in bullying victimization, girls experienced approximately a 16% increase in the extent to which they planned suicide. In addition, for every one SD increase in girl’s bullying victimization, there was a .371 SD increase in suicide attempts. Parental involvement was negatively associated with considering suicide (OR = .806, p < .001) and planning suicide (OR = .830, p < .001), but not attempting suicide (β = −.044, p = .109); female adolescents who scored higher on parental involvement were less likely to have suicidal thoughts. The bullying victimization by parental involvement interaction was associated with considering suicide but only at the level of a nonsignificant trend (β = .090, SE = .049, p = .056). Bullying victimization was significantly and positively associated with considering suicide for girls scoring at 1 SD below the mean (OR = 1.128, SE = .046, p < .05), but was not associated with considering suicide when girls scores for parental involvement were at the mean (OR = 1.051, SE = .026, p < .057) or 1 SD above the mean (OR = .987, SE = .037, p = .735) on parental involvement. Other than the significant sex difference for the relation between bullying victimization and considering suicide, there was no other evidence that the size of significant relations varied as a function of sex.

Substance use

Boys’ bullying victimization was positively associated with smoking frequency (β = .339, SE = .131, p < .05), such that boys scoring higher on bullying victimization smoked more often than boys scoring lower on bullying victimization. The interaction between bullying victimization and parental involvement was not significantly associated with smoking frequency or drinking frequency for boys.

For girls, bullying victimization was significantly and positively associated with smoking frequency (β = .258, SE = .096, p < .01) and drinking frequency (β = .194, SE = .049, p < .001). Girls who reported higher levels of bullying victimization smoked cigarettes and drank alcohol more frequently than girls scoring lower on bullying victimization. We also found evidence that the relation between bullying victimization and smoking frequency was significantly weaker for girls than for boys (Δχ²(1) = 12.552). However, the relationship between girls’ bullying victimization and smoking frequency was moderated by parental involvement (β = .089, SE = .039, p < .05). Bullying victimization was positively associated with smoking frequency for girls scoring at the mean (β = .188, SE = .087, p < .05) and 1 SD above the mean (β = .251, SE = .104, p < .05) on parental involvement, but was not associated with smoking frequency when girl’s score on parental involvement was 1 SD below the mean (β = .125, SE = .077, p = .102). There was no evidence that the size of the relation between the bullying victimization × parental involvement interaction and smoking frequency or between bullying victimization and drinking frequency varied by sex.

Discussion

This study investigated the associations between bullying victimization and psychological and behavioral outcomes as well as the moderating role of parental involvement in a sample of Jamaican adolescents. This is the first study that we are aware of that has empirically investigated the connections among bullying victimization, parental involvement, and child outcomes specifically in a Jamaican sample. Consistent with other international studies on bullying victimization, our findings indicated that bullying victimization is associated with significant adverse psychological and behavioral outcomes for male and female Jamaican adolescents (e.g., Takizawa et al., 2014; UNICEF, 2014a). Bullying victimization was uniquely and positively associated with feelings of loneliness, sleep difficulties due to worry, smoking frequency, and suicidality for both male and female adolescents as well as alcohol use for female adolescents. In addition, although bullying victimization was significantly related to smoking frequency for both male and female adolescents, the relation between bullying victimization and smoking frequency was significantly stronger for male adolescents. This finding could suggest that when male adolescents are exposed to a chronic stressor, they are more likely than girls to turn to cigarettes as a method for coping with that stressor. A similar pattern emerged when examining the relation between bullying victimization and considering suicide. The relation between bullying victimization and considering suicide was significant for boys and the size of the relation was significantly stronger for boys than for girls. It is important to note that a significant sex difference did not arise when examining the relation between bullying victimization and planning or attempting suicide, but the relation was stronger for boys in both cases. Our findings suggest that Jamaican male adolescents who experience bullying victimization may be slightly more prone to have thoughts of suicide and suicidal behavior than female adolescents.

We also found some evidence that the effect of parental involvement, as well as the interaction between bullying victimization and parental involvement, varied as a function of sex. Parental involvement was a more robust correlate of psychological and behavioral adjustment for female adolescents. Girls who reported higher levels of parental involvement experienced lower levels of loneliness and were less likely to consider or plan suicide. For boys, parental involvement was only negatively related to loneliness. Moreover, there was evidence that the strength of the relationship between girls’ bullying victimization and smoking frequency was influenced by parental involvement. Adolescent girls who reported higher levels of bullying victimization were more likely to smoke cigarettes at moderate and high levels of parental involvement, but the relation between bullying victimization and smoking frequency was not significant when parental involvement was low. A different pattern of findings emerged when looking at the extent to which parental involvement moderated the relation between bullying victimization and considering suicide. Although the interaction was only marginally significant (p = .056), parental involvement appeared to serve a protective function for female Jamaican adolescents. Bullying victimization was only positively associated with considering suicide when parental involvement was low, but not when scores on parental involvement were above the mean. Taken together, our pattern of findings suggests that parental involvement could be more helpful when Jamaican adolescent girl’s level of distress is internal (i.e., loneliness, worry, and suicidal thoughts) but less helpful or potentially counterproductive when distress manifests externally (i.e., smoking). In fact, parental involvement was not significantly related to any behavioral outcome for boys or girls when considered as a first-order predictor, and parental involvement appears to exacerbate smoking for girls who experience bullying victimization. It is important to note that although the pattern of significant relations between parental involvement and behavioral and psychological outcomes was different for male and female adolescents, the difference in the size of the relations between parental involvement and these outcomes was not statistically significant.

The finding that higher levels of parental involvement strengthens the relation between bullying victimization and smoking frequency is not intuitive, particularly in light of research evidence pointing to the benefits of parental involvement (e.g., monitoring) for reducing substance use (Barnes, Eifman, Farell, & Dintcheff, 2000; Van Ryzin, Fosco, & Dishion, 2012; Wang et al., 2013). Although this finding is in need of replication, it may be helpful to consider the social motives of bullied children as a means for interpreting this finding. There is a large body of research linking bullying victimization to peer rejection and peer acceptance (Card, Isaacs, & Hodges, 2007; Hawker & Boulton, 2000); children who are victims of bullying are less likely to have positive peer relations. There is also literature linking bullying victimization and peer rejection to substance use, including cigarettes use (Almquist & Ostberg, 2013; Dishion, Capaldi, & Yoerger, 1999; Tharp-Taylor, Haviland, & D’Amico, 2009; Van Ryzin, Fosco, & Dishion, 2012). Cigarette use is often thought of as a maladaptive and ineffective coping response to stress. When faced with managing negative emotions that arise from repeated peer harassment and victimization, bullied adolescents may turn to cigarettes as a means for coping with a negative social stressor. However, cigarette use may also provide adolescents with increased opportunities for peer affiliation and connection, even if those peer affiliations are deviant. If a bullied adolescent’s cigarette use is in part a strategy to fit in with members of the peer group or increase peer acceptance, then individuals who interfere with this social affiliative goal may further stress the adolescent. We speculate that parental involvement may strengthen the relation between bullying victimization and smoking frequency by interfering with an adolescent’s social motive for smoking, peer acceptance. Thus, although parental involvement may attenuate the relation between bullying victimization and the manifestation of severe internal distress (e.g., considering suicide), it may strengthen the relationship between bullying victimization and behaviors that serve to connect adolescents with members of the peer group. We do not suggest that parental involvement is a negative parenting practice when Jamaican parents learn their children are bullied or using cigarettes; instead parental involvement may have the unintended effect of further stressing a youth who is struggling to fit in and coping ineffectively with a negative social stressor.

It is important to note, however, that the same pattern of findings was not found for male adolescents. Cultural expectations in Jamaica and differential treatment of girls and boys may explain these sex differences. According to one source (N. Jones, personal communication, April 20, 2017), boys’ smoking is seen as an exhibition of strength and manliness, when girls behave in a similar manner, they are typically maligned and viewed as having low moral standards. Therefore, parents may respond more negatively to female adolescents who smoke in response to bullying, and this may be particularly true for parents who are more highly involved in the lives of their female children. Alternatively, the benefits of parental involvement for Jamaican female adolescents who are considering suicide in response to bullying could be explained by the fact that it is culturally acceptable for Jamaican girls to seek help when distressed and for parents to respond quickly with comfort and support in response to girls’ distress; this is not true for boys (James & Davis, 2014; Pitter, 2016; UNICEF, 2007). Thus, parental involvement may have positive implications for managing distress in girls but could be less important for boys due to cultural norms around the need for parents to promote autonomy (Coomarsingh, 2012).

Our study adds to the paucity of research on bullying victimization in Jamaican adolescents and extends the broader literature on bullying. This study has several strengths. The sample was large and representative of the population of Jamaican adolescents in grades 7–12. Analyses were based on an approach that allows us to draw conclusions about the population of Jamaican adolescents instead of limiting our conclusions to the identified sample. We also assessed a number of important outcomes related to several domains of functioning. However, several limitations to the current study are worth noting. Because the data are cross-sectional, we could not determine whether bullying victimization was acute or chronic or whether there was a temporal association between bullying victimization and parental involvement and our measured outcomes. Therefore, the extent to which we can drawl causal inferences or establish direction of effect is limited. Moreover, our data did not include other pertinent contextual factors that might affect adolescent functioning. For example, the high rates of community violence that have been documented to place the Jamaican populace, particularly those residing in inner-city communities, in a constant state of anxiety and distress (Smith, 2016a, 2016b) could be associated with our measured outcomes. We did not include other measures of violence exposure in our analyses to test for the unique influence of bullying victimization. Indeed, some international research has shown that children who grow up in violent environments may be at particular risk for bully involvement and its adverse outcomes (Lereya et al., 2013). Relatedly, we did not have information on the socioeconomic background of our sample, but given the complex sampling procedure, it is reasonable to assume that the sample is representative of the larger Jamaican population. Another methodological drawback stems from the fact that many of our measured constructs were assessed through a single item. However, it has been argued that single-item measures can be useful when the construct being measured is unambiguous. Single-item measures ease the interpretation of the measured construct and reduce participant burden (Bowling, 2005; Solberg & Olweus, 2003). Moreover, other studies using GSHS data provide evidence of validity for the single-item measures used in the current investigation. In addition, in bullying research, the “use of single variable/item with specific response alternatives is the ‘method of choice’ for prevalence estimation” (Solberg & Olweus, 2003, p. 242). Finally, our results are based on self-report data. It is unclear whether similar associations would have emerged if information were available from other report sources.

In conclusion, this study replicates international findings that bullying victimization is associated with a host of negative psychological and behavioral adjustment difficulties for adolescents. In addition, the current investigation provides evidence that parental involvement can help Jamaican female adolescents who are struggling with loneliness or suicidal thoughts, but that parental involvement may have a smaller impact on Jamaican boys’ psychological and behavioral functioning. Furthermore, we found that parental involvement can influence the relation between bullying experiences and cigarette use and suicidal thoughts for female adolescents. Although our findings are in need of replication, it appears that parental involvement may be helpful for girls who are considering suicide as a consequence of bullying but have unintended negative consequences for girls who are being bullied and smoke. It is possible that parents may need to be mindful of bullied youths’ motives for smoking when deciding how to intervene or support their child. One major implication from this study is the need to examine further, how gender socialization practices in Jamaica impact risk for being bullied and associated psychosocial functioning. We speculate that involved parents may respond negatively to female adolescents who violate a cultural norm by smoking and that this response may interfere with the adolescent’s goal of fostering peer acceptance. However, to date, it is unclear how involved Jamaican parents respond when they find out their male or female child is being bullied and smoking or the extent to which Jamaican male and female adolescents’ decision to smoke as a consequence of being bullied is driven in part by a desire for peer acceptance. Future research needs to address this question as it could have implications for prevention and intervention efforts.

Footnotes

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Delores E. Smith

Note

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