Abstract
PURPOSE: Identification of the temporal pattern of associations between bullying perpetration and mental health problems among youth is needed for the optimal targeting of intervention and prevention. We examined the bidirectional association between bullying perpetration and internalizing problems among youth in the U.S. METHODS: We used data from the prospective cohort study of the Population Assessment of Tobacco and Health waves 1 (September 12, 2013, to December 14, 2014) and 2 (October 23, 2014, to October 30, 2015), a nationally representative sample of youth. We analyzed the associations of bullying perpetration with internalizing problems using binary and multinomial logistic regressions. The 13,200 youths aged 12-17 years were included in the analytic sample. RESULTS: There was a cross-sectional association between bullying perpetration and moderate/high lifetime internalizing problems (OR(moderate vs. no/low) = 3.13, 95% CI 2.67-3.65; and OR(high vs. no/low) = 8.77, 95% CI 7.53-10.20). In the prospective analyses, bullying perpetration was associated with increased likelihood of moderate/high internalizing problems at follow-up (OR(moderate vs. no/low) = 1.49, 95% CI 1.15-1.94; and OR(high vs. no/low) = 1.71, 95% CI 1.23-2.38), and youth with moderate/high internalizing problems had higher odds of bullying perpetration at follow-up (OR(moderate) = 1.95, 95% CI 1.65-2.31; and OR(high) = 3.21, 95% CI 2.74-3.76). CONCLUSIONS: The association between bullying perpetration and internalizing problems appears to be bidirectional. Bullying behaviors prevention and intervention strategies among youth should consider how to take into account and handle negative feelings and mental health problems.