Mental Health
Bullying victimization and mental health disorders in adolescents with and without autism Kristi Bartholomay* Kristi Bartholomay Brady Holst Sarah Schmiege Lisa Wiggins Nuri Reyes Patrick Powell Elizabeth Wise Carolyn DiGuiseppi
Background Bullying victimization is associated with adverse mental health (MH) outcomes. Risks of bullying and MH disorders are higher in people on the autism spectrum and differ by sex.
Objectives We evaluated the association of bullying victimization with MH disorders in adolescents, and whether sex or autism modified the association.
Methods In a multi-site study, children aged 2-5 identified from health, education and vital records were classified into three groups after standardized evaluation: autism spectrum disorder (ASD), other developmental disorders (DD), and population comparison (POP). Caregivers completed follow-up health and development surveys on these individuals between ages 12 and 16. Log link binomial models estimated prevalence ratios of parent-reported current diagnoses of anxiety (ANX), depression (DEP) and self-injurious behavior (SIB) based on past-year bullying victimization. Interactions of bullying victimization with study group and birth sex, and potential confounders were assessed.
Results Of 287 ASD, 304 DD, and 287 POP adolescents, 62% were male and 67% non-Hispanic white; mean age=14.72 years. Prevalence of any ANX, DEP, or SIB differed significantly by study group: 53%, 34% and 24% in ASD, DD and POP groups, respectively (p<0.001). Adolescents bullied in the past year had higher prevalence of ANX (Prevalence Ratio (PR):1.97, 95%CI:1.59-2.42); DEP (PR:3.15, 95%CI:2.16-4.57); and SIB (PR:1.96, 95%CI:1.14-3.24). Interactions between study group or sex and bullying were not significant for any outcome (p>0.05). Neither sex nor maternal education confounded these relationships. Study group confounded the association with SIB (aPR: 1.40, 95%CI 0.83-2.30).
Conclusions These findings suggest that bullying victimization is associated with ANX and DEP independent of autism or sex and reiterate the importance of regular screening for MH disorders among autistic adolescents and those who are bullied, regardless of underlying development.