Methods: Data were derived from the Health Behavior in School-Aged Children 2009-2010 cohort study (n=12,642). HBSC is a standardized, international World Health Organization study, which comprises repeated cross-sectional surveys in the 43 countries through school-based surveys using random sampling to select a proportion of adolescents, aged 11, 13, and 15 years. Measures for the study included bullying victimization (dependent variable), alcohol or tobacco use, delinquent peer affiliation, and internalizing behavior (independent variables), easy to talk with parents, easy to talk with siblings, and easy to talk with friends (moderators). Sex, age, race/ethnicity, and family well off were controlled for in the models. Analyses included bivariate analyses and hierarchical logistic regression using SAS (version 9.4).
Results: Almost one quarter (24%) of adolescents used alcohol or tobacco, less than half (47%) affiliated with delinquent peers, and the mean of internalizing behavior is 2.3 out of the range of 1 to 5. The findings show that bullying victimization is associated with a higher risk of alcohol and tobacco use (b=.39, p<.001), delinquent peer affiliation (b=.28, p=.018), and internalizing behavior (b=1.31, p<.001). Easy to talk with parents was negatively associated with alcohol and tobacco use (b=.20, p<.001), delinquent peer affiliation (b=.21, p<.001), and internalizing behavior (b=-.19, p<.001). However, easy to talk with siblings and friends were positively associated with alcohol and tobacco use (b=.04, p=.023 and b=.20, p<.001, respectively) and delinquent peer affiliation (b=.11, p<.001 and b=.13, p < .001, respectively). Also, easy to talk with parents moderated the association between victimization and delinquent peer affiliation (b=-.03, p=.003) and internalizing behavior (b=-.05, p=.028), and easy to talk with friends moderated the association between victimization and alcohol and tobacco use (b=.03, p=.002) as well as delinquent peer affiliation (b=-.03, p=.003).
Conclusion: Practitioners working with victims of bullying should assess and screen for adolescents’ communication with parents, siblings, and friends, which might be useful for identifying protective factors that buffer the negative outcomes of bullying. Practitioners should consider interventions that foster effective communications with family and friends, which have been known to impact the success of bullying prevention and intervention efforts. Anti-bullying programs in schools need to seriously consider family and peer contexts.