زورگویی کلامی مدرسه ای و رضایت از زندگی در میان نوجوانان برزیل: پروفایل متجاوز و قربانی

Abstract Background Bullying is a common occurrence in adolescence that may damage the physical and emotional health. Objective The purpose of the present cross-sectional study was to analyze the profile of the adolescent aggressor only, aggressor/victim, victim only, and those not involved in verbal school bullying, and to associate their profiles with life satisfaction and familial characteristics evaluated through socioeconomic status. Subjects and methods A cross-sectional study was carried out with 366 Brazilian adolescents between 13 and 15 years. Verbal school bullying was identified using the Brazilian National School-Based Adolescent Health Survey (PeNSE) questionnaire. The life satisfaction of the adolescents was assessed using the Multidimensional Life Satisfaction Scale for Adolescents (MLSSA). Statistical analyses involved the chi-square test, Fisher's exact test and the Poisson regression with robust variance.

1. Introduction School bullying is a phenomenon that occurs in an educational setting and is common in adolescence [1]. There are four main types of school bullying: physical; verbal; relational; and indirect, which involves the spreading of rumors [2]. In adolescence, there is a clear need to feel accepted by the group, particularly in a school environment, where adolescents spend a large part of their time and maintain personal relationships [1], [3], [4] and [5]. The acceptance of an adolescent by his or her peers is influenced by factors such as physical characteristics and socioeconomic status. When these characteristics do not correspond to the expectations of the group, the individual may be rejected and bullied [5], [6], [7] and [8]. Verbal school bullying episodes can be motivated by physical characteristics [5], [6], [7] and [8], such as obesity or excessive thinness [3] and [9]. Oral characteristics, including the position, color, and shape of teeth, can also affect self-image and quality of life [10] and [11]. Racial prejudice, religious, fashion clothing, height and hair type are some features that can also trigger verbal school bullying [12]. The prevalence of school bullying among adolescents from different countries ranges from 5.4% to 67.5% [11], [13], [14] and [15]. Cultural differences and different diagnostic methods related to school bullying in the population may explain this discrepancy. According to a national survey carried out in Brazil in 2009, 5.4% of adolescents were victims of school bullying [16]. School bullying manifests itself through demeaning behaviors [13], [14] and [15]. Therefore, the use of nicknames that degrade the image of the adolescent, verbal provocation, and sexual harassment characterize episodes of school bullying, possibly leading to stress and affecting the physical and emotional health of the individual [2]. Victims of verbal school bullying may suffer from depression, anxiety, and low self-esteem, or may drop out of school or even commit suicide [1], [2], [3], [5] and [14]. Although school bullying occurs in an educational setting, the family exerts an important influence on this activity. Some individual characteristics of the behavior of adolescents may be influenced by family environment [4]. Thus, when the family environment is not harmonious, it becomes a source of stress for the adolescent, who becomes embroiled in matrimonial conflicts, financial crises, jealousy among siblings, and problems with neighbors [4] and [14]. This adolescent becomes more short-tempered, which can influence their relationships within the school environment [4]. The behavior of an adolescent at school is not always known by their family [12], who usually only find out in cases of extreme violence [4] and [12]. The school and the family are important support systems in the life of an adolescent, and any alteration in these mainstays can affect their life satisfaction [17], [18] and [19], possibly leading to stress and depression [4] and [18]. Dissatisfaction with the family environment affects the attitudes of adolescents in the school environment [20]. Aggressors could use the vantage of being male [5], their size and physical force [7] as well as better socioeconomic status (SES) [5] and [6]. Therefore, knowledge about socioeconomic status as well as life satisfaction of the adolescent in relation to their family, school, and self-image can enable the identification of adolescents who may have the profile of an aggressor, as well as those that may be the victims of school bullying [4], [5] and [21]. In recognition of the factors related to verbal school bullying, as well as victimization, it is important to elaborate prevention policies for school bullying and its negative consequences [7]. Thus, controversies over results, cultural differences, as well as the lack of standard methodological criteria or study designs regarding verbal school bullying in adolescents, demonstrate the need to encourage research on this subject. Therefore, the purpose of the present cross-sectional study was to analyze the profile of the adolescent aggressor only, aggressor/victim, victim only, and those not involved in verbal school bullying, and to associate their profiles with life satisfaction and familial characteristics evaluated through socioeconomic status.

3. Results A total of 425 families were contacted. Three hundred and sixty adolescents participated in the present study, corresponding to an 86.1% response rate. As an additional 20.0% of adolescents were invited to participate in the study to compensate for refusals, the final sample size was slightly larger than the estimated minimum size needed to satisfy the requirements (n = 354). Losses occurred due to incomplete data and the non-return of questionnaires. A total of 55.5% of the adolescents were female and the mean age was 13.7 years (SD = 0.702 years). Sixty-six (18%) adolescents were aggressors only, whereas 20 (5.5%) were victims only. The remaining participants were in the group of aggressor/victims of school bullying (2.7%) and those not involved in verbal school bullying (73.8%). A low socioeconomic status was more prevalent among victims (65%) and there were a greater percentage of aggressors in the high socioeconomic status group (59%). Boys were more often the aggressors (63.6%) and the victims (60%). Adolescents who were victims of school bullying were mostly 13-year-olds (60%). No statistically significant association was found between the socioeconomic status of the family, gender, age of the adolescent, and the aggressor/victim group of school bullying concomitantly. On the other hand, the group that was not involved in bullying was associated with gender, given that this profile was more prevalent among girls (63.5%, p < .001) (see Table 1). Table 1. Analysis of the association between the different profiles of bullying and the gender, age and socioeconomic status of the adolescents. Variables Aggressor Victim Aggressor and victim Not involved Yes No Yes No Yes No Yes No Gender Male 42 (63.6) 121 (40.3) 12 (60.0) 151 (43.6) 7(70.0) 156 (43.8) 35 (36.5) 168 (62.3) Female 24 (36.4) 179 (59.7) 8 (40.0) 195 (56.4) 3 (30.0) 200 (56.2) 61 (63.5) 102 (37.7) p value⁎ .001a .152 .117a <.001 Age (years) 13 25 (37.8) 115 (38.3) 12 (60.0) 128 (36.9) 5 (50.0) 135 (37.9) 42 (43.7) 98 (36.2) 14 31 (46.9) 137 (45.6) 7 (35.0) 161 (46.5) 4 (40.0) 164 (46.1) 42 (43.7) 126 (46.6) 15 10 (15.3) 48 (16.1) 1 (5.0) 57 (16.6) 1 (10.0) 57 (16.0) 12 (12.6) 46 (17.2) p value⁎ 1.0b .033b .421b .150b SES Low 27 (41.0) 170 (56.6) 13 (65.0) 186 (53.8) 6 (60.0) 193 (54.2) 48 (50.0) 151 (55.9) High 39 (59.0) 130 (43.4) 7 (35.0) 160 (46.2) 4 (40.0) 163 (45.8) 48 (50.0) 119 (44.1) p value⁎ .045a .032a .760a .317a Values in brackets refer to the percentages between columns. The p value = probability value; SES = socioeconomic status. a Fisher's exact test. b Chi-squared test of linear tendency. ⁎ p < .05. Table options Table 2 displays the bivariate analysis of the MLSSA factors according to the groups of school bullying. The high score of the family satisfaction factor was statistically associated with the aggressor group (p = .023) and the low score of non-violence was statistically associated with the victim group (p = .002). The aggressor and victim group and those who were not involved in bullying were not statistically associated with any of the MLSSA factors. Table 2. Analysis of the association between the different profiles of bullying and the factors of the MLSSA scale. Variables Aggressor Victim Aggressor/victim Not involved Yes No Yes No Yes No Yes No Family High score 54 (81.8) 203 (67.7) 12 (60.0) 245 (70.8) 6 (60.0) 251 (70.5) 185 (68.5) 72 (75.0) Low score 12 (18.2) 97 (32.3) 8 (40.0) 101 (29.2) 4 (40.0) 105 (29.5) 85 (31.5) 24 (25.0) p value⁎ .023b .304b .343a .233b Self High score 28 (42.4) 158 (52.7) 12 (60.0) 174 (50.3) 6 (60.0) 180 (50.6) 140 (51.9) 46 (47.9) Low score 38 (57.6) 142 (47.3) 8 (40.0) 172 (49.7) 4 (40.0) 176 (49.4) 130 (48.1) 50 (52.1) p value⁎ .132b .398b .396a .508b School High score 35 (53.0) 156 (52.0) 11 (55.0) 180 (52.0) 6 (60.0) 185 (52.0) 139 (51.5) 52 (54.2) Low score 31 (47.0) 144 (48.0) 9 (45.0) 166 (48.0) 4 (40.0) 171 (48.0) 131 (48.5) 44 (45.8) p value⁎ .879b .796b .431a .651b Self-comparison High score 41 (62.1) 173 (57.7) 8 (40.0) 206 (59.5) 6 (60.0) 208 (58.4) 159 (58.9) 55 (57.3) Low score 25 (37.9) 127 (42.3) 12 (60.0) 140 (40.5) 4 (40.0) 148 (41.6) 111 (41.1) 41 (42.7) p value⁎ .506b .085b .596a .785b Non-violence High score 42 (63.6) 171 (57.0) 5 (25.0) 208 (60.1) 7 (70.0) 206 (57.9) 159 (58.9) 54 (56.3) Low score 24 (36.4) 129 (43.0) 15 (75.0) 138 (39.9) 3 (30.0) 150 (42.1) 111 (41.1) 42 (43.8) p value⁎ .322b .002a .336a .653b Self-efficacy High score 37 (56.1) 162 (54.0) 10 (50.0) 189 (54.6) 8 (80.0) 191 (53.7) 144 (53.3) 55 (57.3) Low score 29 (43.9) 138 (46.0) 10 (50.0) 157 (45.4) 2 (20.0) 165 (46.3) 126 (46.7) 41 (42.7) p value⁎ .761b .686b .090a .504b Friendship High score 51 (77.3) 225 (75.0) 14 (70.0) 262 (75.7) 9 (90.0) 267 (75.0) 202 (74.8) 74 (77.1) Low score 15 (22.7) 75 (25.0) 6 (30.0) 84 (24.3) 1 (10.0) 89 (25.0) 68 (25.2) 22 (22.9) p value⁎ .698b .563b .249a .658b Values in brackets refer to the percentages between columns. The p value = probability value. a Fisher's exact test. b Chi-squared test of linear tendency. ⁎ p < .05. Table options The Poisson regression with robust variance analysis demonstrated that a higher prevalence of boys was found to be the aggressor in school bullying than girls (PR = 1.97, 95% CI: 1.23–3.14). The aggressors exhibited a 2.13-fold greater prevalence of the high score for the family satisfaction factor than those who were not aggressors (PR: 2.13, 95% CI: 1.18–3.85). Low satisfaction of self was also associated with the aggressor group (PR = 0.63, 95% CI: 0.40–0.99) (see Table 2). The victim group exhibited a low prevalence of non-violence compared to those with the high score of non-violence (PR = 0.24, 95% CI: 0.09–0.64). Adolescents who were aggressors and victims demonstrated a low prevalence of family support (PR = 0.25, 95% CI: 0.07–0.89) and a high level of self-efficacy (PR = 6.29, 95% CI: 1.54–25.6). The group not involved in bullying was only associated with gender. Girls exhibited a 1.32-fold (PR: 1.32; 95% CI: 1.16–1.51) greater prevalence of not suffering from or being involved in bullying than boys (Table 3). Table 3. Poisson regression model explaining the independent variables in groups of adolescents. Variables Aggressor PR 95% CI p value Yes; n (%) No; n (%) Family High score 54 (81.8) 203 (67.7) 2.13 (1.18-3.85) .012 Low score 12 (18.2) 97 (32.3) 1.00 Self High score 28 (42.4) 158 (52.7) 0.63 (0.40-0.99) .043 Low score 38 (57.6) 142 (47.3) 1.00 Gender Male 42 (63.6) 121 (40.3) 1.97 (1.23-3.14) .005 Female 24 (36.4) 179 (59.7) 1.00 Victim Yes; n (%) No; n (%) Non-violence High score 5 (25.0) 208 (60.1) 0.24 (0.09-0.64) .005 Low score 15 (75.0) 138 (39.9) 1.00 Aggressor and victim† Yes; n (%) No; n (%) Family High score 6 (60.0) 251 (70.5) 0.25 (0.07-0.89) .033 Low score 4 (40.0) 105 (29.5) 1.00 Self-efficacy High score 8 (80.0) 191 (53.7) 6.29 (1.54-25.6) Low score 2 (20.0) 165 (46.3) 1.00 .011 Not involved Yes; n (%) No; n (%) Gender Male 102 (37.8) 61 (63.5) 1.00 <.001 Female 168 (62.2) 35 (36.5) 1.32 (1.16-1.51) PR = prevalence ratio. Values in brackets refer to the percentages between columns. The p value = probability value. † Model adjusted for gender.