Article Text
PDF
Abstract
Background Childhood bullying can result in serious injury. Our objective was to compare bullying victimisation and perpetration of school-aged youth from 2018 to 2022 in different households: foster care, kinship care and birth families. A second objective examined correlations between bullying and adverse childhood experiences, child gender, age and race while stratifying by household type.
Methods The 2018–2022 samples of the National Surveys of Children’s Health were used. Bullying victimisation and perpetration were reported by caregivers and ranged from none, yearly, monthly to weekly or daily. Adversities include parental separation, death or incarceration; witnessing or experiencing violence; living with an adult with a substance problem or severe mental illness; or racial discrimination. Pearson χ2 and ordinal logistic regression models were used.
Results Pre-COVID-19, 69% of foster youth were victimised compared with 44% of kinship and 48% of birth-family youth, and 57% of foster youth perpetrated compared with 21% of kinship and 20% of birth-family youth. During COVID-19, the relative risk of both victimisation and perpetration flipped between groups: 25% of fosters were victimised compared with 34% of both kinship and birth youth, and 24% of fosters perpetrated compared with 35% of kinship and 33% of birth youth. In 2022, younger foster youth were at a higher risk of victimisation and perpetration, while males were at risk of perpetration.
Discussion and conclusions Foster youth are at high risk for victimisation and perpetration compared with youth living with kinship or birth families. Results indicate that prevention efforts in school settings may be the most effective.
- Youth
- Health Disparities
- Trauma Systems
- School
- Child abuse
Statistics from Altmetric.com
WHAT IS ALREADY KNOWN ON THIS TOPIC
Youth who have experienced adverse childhood experiences are at risk for bullying victimisation. Yet, we know little about youth in foster care and those living in kinship homes away from birth families.
WHAT THIS STUDY ADDS
Our results showed foster youth at a high relative risk of both victimisation and perpetration compared with youth living in birth homes pre-COVID and post-COVID, but a lower relative risk during COVID-19.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
Our findings suggest a need for targeted bullying prevention programmes for foster youth that address both victimisation and perpetration in school settings.
Bullying victimisation and perpetration of foster and kinship youth
Bullying is associated with both injury1 and non-suicidal self-injury2 in childhood. Prior to the COVID pandemic in 2020, 22% of youth, aged 12–18, reported being the victims of bullying3 and the mean prevalence rate of bullying—victimisation or perpetration—is estimated at 35%.4 Certain risk factors are associated with increased rates of bullying, including male gender compared with female gender,5 younger age compared with older age, white compared with all other races6 and a high number of adverse childhood experiences (ACEs) compared with no ACEs.7
Foster youth are perceived to be at high risk for bullying victimisation due to previous experience with ACEs, including abuse, neglect, caregiver mental illness and various forms of household dysfunction,8 frequent moves9 and being perceived as ‘abnormal’ or ‘damaged’.10 However, this research is limited in that youth in formal foster care make up a small percentage of children who experience ACEs or are living away from their birth families. Every year, an estimated 3 million children in the USA live in households without a birth parent.11 Less than half a million live in formal foster care under the purview of family courts.12 Millions of other children are living with grandparents in what are sometimes termed ‘skipped generation’ homes.13
Despite the detrimental impact of bullying victimisation14 and perpetration15 on health, we have little information about bullying in substitute care. Although research assumes children experiencing trauma may exhibit behaviours that make them susceptible targets for bullies, these children may also resort to bullying as a coping mechanism. Furthermore, it appears the dynamics of bullying underwent significant changes during the COVID-19 pandemic. While traditional in-person interactions conducive to bullying diminished during lockdowns in the USA,16 it is speculated that sibling bullying rates increased due to sheltering at home.17 We do not know how this changed for youth living away from their birth parents. Therefore, this study compares the frequency of bullying victimisation and perpetration of school-aged youth from 2018 to 2022 in different households: foster care, kinship care and birth families. We will also examine the correlation between bullying and ACEs, controlling for child demographics (biological sex, age and race) stratified by households.
Methods
Data from the 2018–2022 samples of the National Surveys of Children’s Health (NSCH) were used for the analysis. NSCH are yearly, cross-sectional surveys of parent or guardian reports of child health and well-being. Pooled yearly samples of children 6–17 years of age were used for 2018/2019 (n=43 213), 2020/2021 (n=60 809) and 2022 (n=34 362). Sampling weights adjusted for non-response and selection bias.18
Patients were not involved in this study and due to the data being publicly available, and the first author’s Institutional Review Board determined this study does not constitute human subjects research.
Measures
Bullying
Bullying victimisation and perpetration were measured separately. For each, caregivers were asked:
In the past year, how often was this child (bullied, picked on or excluded by other children), and did this child (bully, pick on or exclude other children).
Responses for each were coded never, yearly, monthly or at least weekly.
Living arrangement
Living arrangement was measured in several steps. First, if caregivers reported that any adult in the household was a biological parent, they were coded as ‘birth family’. Next, if any adult was identified as a grandparent or other relative, they were coded as ‘kinship’. Finally, if any adult was identified as a foster parent, they were coded as ‘foster’.
Adverse childhood experiences
Caregivers were asked whether the child had ever experienced a parental separation, death or incarceration; witnessed or experienced violence; lived with an adult with a substance problem or severe mental illness; or were racially discriminated against. These eight items were dichotomised (1=yes and 0=no) and then added to create a continuous measure ranging from 0 ACEs to 8.
Covariates
Child age (continuous), biological sex (female or male) and race and ethnicity (Hispanic, non-Hispanic Black, non-Hispanic white, Asian and other) were reported by caregivers.
Analysis
The differences in victimisation and perpetration frequency (never, yearly, monthly or weekly) by living arrangements were examined using a 4×3 Pearson χ2 test for each pooled year. Separate ordinal logistic regression models predicting victimisation and perpetration frequency by ACEs, age, gender and race, stratified by living arrangement, were used for the 2022 sampled youth.
Results
In 2018/2019, 69% of foster youth were bullied at least once in the previous year compared with 44% of kinship youth and 48% of birth family youth. Twice as many foster youth were victimised at least monthly compared with youth living with birth families (31% vs 15%), χ2 (6, n=43 213)=3.07, p=0.01. During the school closing and partial reopening that occurred during the COVID-19 pandemic (2020/2021), the relative risk of victimisation flipped between groups: 25% of foster youth were bullied compared with 34% of kinship youth and 34% of birth family youth, χ2 (6, n=60 809)=6.51, p=0.01. In 2022, 43% of foster youth were bullied compared with 38% of kinship youth and 38% of birth family youth. More than twice as many foster youth were bullied at least monthly (26%) compared with birth family youth (11%), χ2 (6, n=34 362)=2.86, p=0.01.
In 2018/2019, almost three times as many foster youth (57%) bullied another child at least once in the previous year than kinship (21%) and birth family (20%) youth, χ2 (6, n=43 213)=10.3, p=0.001. Six times more foster youth bullied another child at least monthly (24%) compared with birth family youth (4%). Like victimisation, the relative risk flipped during COVID: 24% of foster youth bullied another child compared with 35% of kinship and 33% of birth family youth, χ2 (6, n=60 809)=8.67, p=0.001. In 2022, more than twice as many foster youth (39%) bullied another child compared with kinship (16%) and birth family (14%) youth. Four times more foster youth bullied another child at least monthly (12%) compared with birth family youth (3%), χ2 (6, n=34 362)=6.32, p=0.001.
Ordinal logistic regression models (table 1) showed that youth in 2022 with higher ACE scores in kin and birth families were at greater odds of victimisation (kin, OR=1.32; birth, OR=1.45) and perpetration (kin, OR=1.43; birth, OR=1.44), but this association was not present in foster youth. Older child age was associated with decreased odds of victimisation and perpetration for foster youth (OR=0.61 and OR=0.64, respectively), and female foster youth had decreased odds of perpetration compared with male foster youth (OR=0.17). Hispanic youth in kin or birth families were at decreased odds of victimisation (OR=0.26 and OR=0.59, respectively) and perpetration (OR=0.34 and OR=0.44, respectively) compared with non-Hispanic white youth.
Ordinal logistic regressions modelling bullying victimisation and perpetration by ACEs and controls, stratified by living arrangement in the USA in 2022 (n=34 362)
Discussion and conclusions
Foster youth are at high risk for victimisation and perpetration compared with youth living with kinship or birth families, both pre-COVID and post-COVID. However, during COVID lockdowns in 2020 and 2021, foster youth were at a lower risk of both victimisation and perpetration. In 2022, one in four foster youth were bullied at least monthly, and they were also four times more likely to bully others than youth living with birth families. Younger foster youth were at a higher risk of both victimisation and perpetration, while male foster youth were at the highest risk of perpetration. Previous ACEs were not predictive of either victimisation or perpetration of foster youth. Although foster youth are more likely to have high rates of ACEs, this finding may indicate that frequent moves9 and stigmatisation10 may play a greater role than trauma history.
One limitation of this study was caregiver reports because although caregivers may be aware of their child’s bullying, they may have underreported. However, our results show that 39% of youth were reported as victimised or perpetrating (result not in table), which is slightly higher than the mean prevalence rate (35%) of a meta-analysis on bullying involvement.4 Another limitation was that the form of bullying was not reported and that both victimisation and perpetration relied on one-item indicators. More robust measures would incorporate cyberbullying and separate other forms: physical, verbal, emotional, sexual and racial. Despite these and other limitations, this first national study of foster youth bullying showed high rates of both victimisation and perpetration (figure 1).
Bullying victimisation by living arrangement and year in the USA (n=138 384). Note: Pearson χ2 test results for each cohort year: 2018/2019, χ2 (6, n=43 213)=3.07, p=0.01; 2020/2021, χ2 (6, n=60 809)=6.51, p=0.01; 2022, χ2 (6, n=34 362)=2.86, p=0.01.
The drop in foster care bullying during COVID may indicate that foster youth are at a higher risk in school settings compared with at home with other foster youth, foster family siblings and biological siblings. More research is needed to identify which setting is most appropriate for targeted prevention efforts. Given the disparities before, during and after COVID, it may be more effective to create cross-disciplinary prevention options that incorporate child welfare agencies and schools to reduce bullying in both school and home environments to effectively mitigate perpetration and victimisation. Tailored interventions specific to foster youth are necessary to address the unique vulnerabilities that may contribute to these behaviours. Regardless of where and by whom, the promotion of bullying prevention programmes that encourage building social and emotional competencies is essential to lower the risk of this potential form of injury.19
Ethics statements
Patient consent for publication
Ethics approval
Not applicable.
Footnotes
Contributors JJH and JSH both conceptualised and designed the study, drafted the initial manuscript and critically reviewed and revised the manuscript. VK aided in writing the introduction and discussion.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer JJH accepts full responsibility for the finished work and/or the conduct of the study, had access to the data and conduct of the study, had access to the data and controlled the decision to publish.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.