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Original Investigation
April 11, 2018

Longitudinal Associations Among Bullying by Peers, Disordered Eating Behavior, and Symptoms of Depression During Adolescence

Author Affiliations
  • 1Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada
  • 2School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
JAMA Psychiatry. Published online April 11, 2018. doi:10.1001/jamapsychiatry.2018.0284
Key Points

Question  What are the concurrent and longitudinal associations by which bullying by peers, disordered eating behavior, and symptoms of depression are related in adolescents assessed annually from 13 to 17 years of age?

Findings  In this longitudinal study, a cascade model revealed significant concurrent associations among bullying by peers, disordered eating behavior, and depressive symptoms at every time point during a 5-year period. Disordered eating behavior was repeatedly associated with future symptoms of depression and bullying by peers at 2 time points during 1-year intervals; the risk of depressive symptoms and bullying by peers 1 year after disordered eating behavior was equivalent in girls and boys.

Meaning  Disordered eating behavior may significantly increase the risk of future psychopathologic symptoms and peer difficulties in adolescent girls and boys.

Abstract

Importance  Bullying by peers has been associated with disordered eating behavior and symptoms of depression among adolescents as both an antecedent and an outcome. Identification of the temporal pattern of associations among bullying by peers, disordered eating behavior, and depression in adolescence is needed for the optimal targeting of intervention and prevention.

Objective  To assess the concurrent and longitudinal associations among bullying by peers, disordered eating behavior, and symptoms of depression using a cascade model that controlled for within-time and across-time (ie, stability paths) associations while examining cross-lag effects.

Design, Setting, and Participants  In this 5-year longitudinal cohort study, 612 participants of the McMaster Teen Study were included. This ongoing Canadian study examines the associations among bullying, mental health, and educational outcomes. Data collection began in 2008 when students were in grade 5 (10 years of age) and have since been collected annually. Data analysis was performed between August 20 and October 18, 2017.

Exposures  Bullying by peers was assessed in grades 7 to 11 using a composite measure of 5 items.

Main Outcomes and Measures  Disordered eating behavior was assessed in grades 7 to 11 using the Short Screen for Eating Disorders, and depressive symptoms were assessed in grades 7 to 11 using the Behavior Assessment System for Children–Second Edition.

Results  The 612 students included in the analytic sample had a mean age (SD) of 13.03 (0.38) years in grade 7; 331 (54.1%) were girls and 392 (71.1%) were white. Bullying by peers was concurrently associated with disordered eating behavior and depressive symptoms at every time point during the 5-year period (r range [SE], 0.15-0.48 [0.04-0.08]; P < .01). Disordered eating behavior was associated longitudinally with depressive symptoms at every time point (β range [SE], 0.14-0.19 [0.06-0.08]; P < .02) and bullying by peers at 2 time points (β range [SE], 0.12-0.22 [0.06-0.07]; P < .04) in girls and boys.

Conclusions and Relevance  Bullying by peers was proximally associated with multiple psychopathologic symptoms, whereas symptoms of disordered eating behavior were a key risk factor for future depressive symptoms and bullying by peers. Interventions aimed at reducing problematic eating behavior in adolescents may attenuate the risk of future depressive symptoms and relational problems.

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