Elsevier

Addictive Behaviors

Volume 36, Issues 1–2, January–February 2011, Pages 6-13
Addictive Behaviors

Adolescent bullying victimisation and alcohol-related problem behaviour mediated by coping drinking motives over a 12 month period

https://doi.org/10.1016/j.addbeh.2010.08.016Get rights and content

Abstract

Background

Despite the adverse externalising risks associated with bullying victimisation, no study has investigated the underlying mechanisms of adolescent victims' engagement with alcohol. This current study investigated the development of risky coping drinking motives as a mediator in the relationship between adolescent school victimisation and alcohol-related problem behaviour using a longitudinal design over 12 months.

Method

We recruited 324 participants, aged 13 to 15 from schools across London, England. Participants were surveyed during class time at 2 time points: baseline and 12 months. At both time points participants answered questions related to bullying victimisation, alcohol-related problem behaviour, drinking motives and the quantity by frequency of alcohol consumption.

Results

The relationships between victimisation, drinking and drinking motives were investigated using Pearson correlations. Path analysis showed that victimisation leads both directly and indirectly, through coping motives to alcohol-related problems, rather than to the quantity and frequency of alcohol use. Significance of mediation was tested using 5000 bias corrected and accelerated bootstrapped intervals. Baseline victimisation was significantly correlated with baseline alcohol-related problem behaviour and predictive of future problems at 12 months. Drinking to cope at 12 months partially mediated the relationship between baseline victimisation and alcohol-related problems at 12 months.

Conclusions

Results show that victims of bullying are drinking alcohol in a risky style, partly due to the development of self medicating drinking behaviour. Victims of bullying could therefore benefit from coping skills interventions targeting negative affect regulation in order to reduce the risk for future alcohol misuse.

Research Highlights

►Adolescent bullying victimisation is predictive of alcohol-related problems over 12-months. ►A direct and indirect predictive relationship is seen between victimisation and risky drinking. ►This association is mediated by the development of risky coping drinking motives.

Introduction

Bullying within high schools is a severe problem throughout Europe and the US, with studies showing that on average 11% of adolescents report experiencing victimisation (Nansel et al., 2004, Nansel et al., 2001) (see Olweus, 2000 for a definition of school bullying). The psychological associations of victimisation are thought to be wide ranging, including depression, low self esteem and anxiety (Hawker and Boulton, 2000, Ivarsson et al., 2005).

In addition to associated psychological disorders, adolescent victimisation presents an additional risk towards the development of externalising behaviours; such as aggression, delinquency, and substance misuse (Khatri, Kupersmidt & Patterson, 2000). These behaviours may be partly explained by the inhibition of pro-social behaviours, which are a noted consequence of experiencing school victimisation (Tremblay, Pihl, Vitaro & Dobkin, 1994). However, they may also reflect an avoidant coping process, at least with respect to substance misuse.

Exposure to stress is an influencing factor underlying increases in alcohol self administration (e.g. Pelham et al., 1997). Colder, Campbell, Ruel, Richardson and Flay (2002) longitudinally assessed 1918 adolescents at 4 time points between grades 7 and 12. Latent growth mixture modelling was used to identify different trajectories of adolescent alcohol use. The authors showed that emotional distress increased the risk for occasional heavy drinking. This result was purported to support self medication models of alcohol use, in which occasional or episodic heavy drinking is triggered as a coping mechanism for specific stressors. To support this theory, a wide literature reports associations between various forms of victimisation and alcohol misuse. For example, Berenson, Wiemann and McCombs (2001) showed that victims of violent attacks (such as rape), were up to 4 times more likely to experiment with alcohol and marijuana. Additionally, parental maltreatment has been robustly linked to substance misuse, with up to 81% of adult women treated for drug dependency reporting childhood abuse or neglect (Liebschutz et al., 2002). Further, in a small cross sectional study of 49 adolescents who had experienced trauma, traumatic stress symptom levels were positively and uniquely associated with coping drinking motivations (Dixon, Leen-Feldner, Ham, Feldner & Lewis, 2009). Whilst the literature acknowledges that stress and many consequences are associated with bullying victimisation, few studies have investigated alcohol misuse as a specific and adverse result of this form of victimisation.

Furthermore, research that does investigate links between adolescent bullying victimisation and alcohol misuse report conflicting conclusions. Sullivan, Farrell and Kliewer (2006) reported a modest association between bullying victimisation and alcohol use. This result was supported recently in an ethnically diverse sample of 11 to 14 year olds. The authors used logistic regression to analyse the relationship between different types of victimisation and substance use over a 12 month period. Results showed that victims of both mental and physical bullying were more likely to report concurrent substance use at 12 months (no predictive relationship was shown) (Tharp-Taylor, Haviland & D'Amico, 2009). However, two studies published by Nansel and colleagues (Nansel et al., 2004, Nansel et al., 2001) dispute this finding. In a cross national study which gathered data in 25 different countries, a relationship between victimisation and alcohol use was shown, only when those victims were also engaged in bullying other adolescents (Nansel et al., 2004). The differences in the results previously mentioned may be partly due to the focus upon quantity or frequency of use within these studies. It is possible that victimisation may not impact solely upon alcohol consumption; rather victimisation may render a young person susceptible to specific facets of drinking, instead of provoking a general vulnerability to high levels of drinking: a style of drinking which would mirror the ‘emotional distress’ drinking trajectory described by Colder, Campbell, Ruel, Richardson and Flay (2002).

Victims of adolescent bullying may therefore be motivated to use alcohol episodically in order to self medicate or cope with their victimisation: a style of drinking for which quantity and frequency measures may not be sensitive enough. Motivations for drinking can be reliably measured using a scale that distinguishes between those who initiate alcohol use in order to create a positive consequence, or to pre-empt a negative one. Four identified drinking motives have shown to be empirically independent from one another: conformity (external, negative reinforcement: e.g. to fit in with a group I like); social (external, positive reinforcement: e.g. because it helps me to enjoy a party); coping (internal, negative reinforcement: e.g. to forget my worries); and enhancement (internal, positive reinforcement: e.g. because it's exciting) (Cooper, 1994). Adolescents drinking alcohol due to coping motives are at greater risk for alcohol-related problems (Kuntsche, Knibbe, Engels & Gmel, 2007).

Cooper, Frone, Russell and Mudar (1995) modelled the path from negative emotion to alcohol use. The authors showed that in contrast to enhancement motives, negative emotions predicted drinking to cope, which subsequently led directly to alcohol-related problems. Accordingly, victims of bullying who drink alcohol to cope with emotional distress may be at greater risk for proximal drinking problems, an effect which would not be revealed in the aforementioned studies due to their focus upon consumption of use. Whilst the literature is sparse and divided regarding alcohol quantity and frequency, to our knowledge, no study has yet examined the relationship between victimisation and alcohol-related problems. Furthermore, no study has examined the motivational mechanisms underlying this relationship in a longitudinal design.

This study sought to build on the existing literature, which separately highlights associations between other forms of victimisation (e.g. parental maltreatment and violent attacks) and alcohol use, as well as the relationship between emotional distress and coping drinking motives to alcohol-related problems. We hypothesised that school based victimisation would be associated with alcohol-related problems and predict the development of future problems. Furthermore, we hypothesised that this relationship would be mediated by the development of a self medicating drinking style, or coping motives for drinking. We investigated the relationship between school victimisation and alcohol-related problem behaviour longitudinally over a 12 month period at 2 time points.

Section snippets

Participants

Adolescents (mean age = 13.92, SD = 0.74) were recruited from 18 high schools across Greater London, UK to take part in this study, which forms part of a study entitled Preventure (see Conrod et al., 2010, Conrod et al., 2008). Data were collected over a 24 month period. This study will focus upon data collected over 12 months using 2 time points: baseline and 12 month follow up.

The Preventure project initially surveyed students during school time and invited them to take part in personality targeted

Data analysis

In order to derive scores for participants who were not followed up, a full information maximum likelihood estimation method (SPSS v.15) was used with continuous variables, taking into account baseline scorings. Logistic regression analyses showed that only male gender significantly predicted participant drop out at 12 months (χ2(1) = 11.07, p = 0.01). Scores for all measures at both time points were transformed to correct for positive skew. Victimisation and Q × F scores were log transformed, whilst

Correlations

Table 1 shows Pearson correlations between victimisation, alcohol-related problems (RAPI scores), ‘Quantity × Frequency’ (Q × F) of drinking and coping and non-coping drinking motives at baseline and 12 months. These correlations demonstrate that baseline victimisation was significantly related to RAPI scores at both baseline and 12 months. However, there was no concurrent relationship between victimisation and RAPI scores at 12 months. Baseline victimisation was related to Q × F of drinking at baseline

Discussion

This current study is the first of its kind to examine the impact of bullying victimisation on adolescent alcohol-related problems by looking specifically at motivational mechanisms underlying consequences of alcohol usage. Research focused upon mechanisms is essential within the field of addiction to help inform intervention and prevention strategies for this vulnerable group of adolescents. Analyses examined the relationship between victimisation and both consumption levels of alcohol, as

Conclusions

The results from this study provide evidence to suggest that adolescent bullying victimisation creates a proximal risk for alcohol-related problems, both directly and indirectly through the development of internal and negative drinking motives. However, in order for interventions and preventions to prove successful, it is necessary to better understanding of the underlying causes leading to alcohol problems in victims of peer bullying. More research is needed which differentiates between those

Role of Funding Sources

This study was supported by Action on Addiction, registered charity number 1007308 and is registered on clinicaltrials.gov (NCT00344474) as well as by a fellowship from the Alcohol Education and Research Council, UK. Dr. Conrod's salary was also supported by a grant from NIHR Bio-medical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London from 2008 to 2009. Dr. Mackie is supported by an MRC/ESRC

Contributors

Lauren Topper and Dr. Conrod designed the current study. Lauren Topper conducted the statistical analyses and wrote the manuscript. Dr. Castellanos-Ryan and Dr. Mackie helped with the statistical analyses. Dr. Conrod is the Principal Investigator for the Preventure study and helped with statistical analyses as well as editing the manuscript. All authors contributed to and have approved the final manuscript.

Conflict of Interest

None.

Acknowledgements

We thank all the contributing schools and students. We also wish to thank Sarah Evans, Paul Moody, Kim Hayward, Laura Sully, Nadia Al-Khudhairy and Rebecca Wyton for their invaluable contributions.

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