How Mental Health Mediates the Relationship between Bullying and Adolescents' Physical Health

Background/Purpose: Bullying is a physical and/or psychological form of violence that has substantial maladaptive consequences for adolescents’ mental health (Arseneault, 2017). Given the well-established relationship between adolescents’ mental and physical wellbeing (Norman et al., 2012), it is likely to expect that bullying may influence adolescents’ physical health through their mental wellbeing. Yet, surprisingly limited investigation has focused on the association of experiencing bullying and its physical health consequences to adolescents. This study utilizes the Fragile Families and Child Wellbeing Study (FFCWS, 2019) dataset to examine the relationship between bullying and adolescents’ self-rated health, as well as mental health’s mediating role in this relationship.

Methods: The FFCSW is a longitudinal, nationally representative birth cohort study of children born to predominantly unmarried parents. This study draws on data from the 15th year follow-up (released January 2018) which includes adolescents’ self-rated health (n=3435). Variables included: 1. Self-rated health, measured by asking “in general, how is your health?” with 1=Poor to 5=Excellent; 2. Bullying, measured by a summed score of reported frequency of how often an adolescent was “picked on or said mean things to”, “hit by others”, “taken things away”, or “purposefully left out?” 3. Demographic and socio-economic variables (race, sex, parents’ educational attainment, family income) and physical health (measured by number of physical health conditions over the past 12 months); and 4. Mental health (measured by the Teen Mental Health Scale). OLS regression analysis assessed the associations of bullying on adolescents’ self-rated health with the covariates mentioned previously. We also examined the mediating role of mental health on the relationship between bullying and self-rated health. Following Hayes’ (2017) approach, a regression-based path-analytic framework estimated the indirect effect (mediating effect) and its bias-corrected confidence intervals by bootstrapping the indirect effect for 10,000 times.

Results: Most adolescents (n=2536, 75.45%) reported no history of bullying while 825 students reported bullying at least once in their lives. In comparison to adolescents experienced bullying, those who reported no bullying experience reported greater mental health (t(3252)=16.396, p<0.001) and self-rated health (t(3359)=7.796, p<0.001). The main effect model (without mental health) indicated that bullying was significantly associated with lower self-rated health, b=-0.061, p<0.001, after controlling for adolescents’ socio-demographic background and physical health conditions. Once introduced into the model, both mental (b=-0.31, p<0.001) and physical health (b=-0.34, p<0.01) were significant predictors for adolescents’ self-rated health. By bootstrapping the sample 10,000 times, we found a mediating effect of mental health on the relationship between bullying and self-rated health, b=-0.028, 95%CI (-0.036, -0.020), indicating mental health significantly mediates the relationship between bullying and physical health.

Implications: Findings provided empirical support for the adverse physical health consequences of bullying victimization. Our preliminary finding supported mental wellbeing is a mediator of the adverse relationship between bullying in physical health, which further highlights the importance of addressing adolescents’ wellness to address consequences of bullying. Findings also encourage future research on examining such mechanism using a longitudinal design.