Role of involvement in bullying as predictor for hospital-treated assault exposures among former adolescent psychiatric inpatients

OBJECTIVE Bullying is a common problem among children and adolescents. Previous studies have investigated the associations between involvement in bullying and various psychosocial and mental health outcomes thoroughly. However, only few studies have focused on the association between bullying and exposure to assaults. This study investigated whether the likelihood for severe assault exposure varies among three subgroups of bullying behavior: bullies/bully-victims, victims of bullying, and those not involved in bullying. METHOD The study population consisted of 508 adolescents (208 boys, 300 girls) aged between 13 and 17 years (mean age 15.5 years), admitted for psychiatric inpatient treatment between the years 2001-2006. Adolescents were interviewed at index hospitalization using semi-structured interview, K-SADS-PL, to assess DSM-IV based adolescent psychiatric disorders, and to obtain information on bullying behavior. Treatment episodes for assault incidents were obtained from the Finnish National Care Register for Health Care covering the entire-life of the study participants up to end of year 2016. RESULTS 14.4% (n = 73) of the study participants had experienced severe physical or sexual assault leading to hospital treatment during their lifetime. Results of Cox regression analysis showed that girl bullies/bully-victims had nearly threefold increased likelihood for later assault exposure. CONCLUSIONS Since bullying behavior in childhood and adolescence is a significant predictor for later exposure to severe assault in girls, it should be paid attention to and intervened as early as possible. Moreover, psychosocial risk factors should be taken into account considering those in hospital treatment for severe assault exposure.