Elsevier

Aggression and Violent Behavior

Volume 25, Part B, November–December 2015, Pages 259-265
Aggression and Violent Behavior

Peer victimization in survivors of premature birth and low birth weight: Review and recommendations

https://doi.org/10.1016/j.avb.2015.09.010Get rights and content

Highlights

  • Very preterm children manifest a number of risk factors for bullying.

  • Most studies have found that these children are at increased risk of being bullied.

  • Research to date is limited by small samples and limited measures.

  • More research is needed on the predictors and outcomes of bullying in this sample.

Abstract

Despite the fact that children born very preterm or earlier, or at a very low birth weight (VLBW; < 1500 g) or smaller manifest elevated rates of a number of risk factors that put them at increased risk for peer victimization (e.g., poor motor abilities, lower IQ, and higher anxiety and depression), relatively little is known about the prevalence, predictors, and long-term outcomes of exposure to bullying in this population. Here we review the seven known studies published to date that have investigated peer victimization in those born very preterm or earlier or VLBW or smaller. The majority of these studies have found that these children are at an increased risk of being bullied by peers. Possible risk factors include poorer cognitive functioning, psychiatric disorders, motor difficulties, and functional limitations. However, this field is limited by the use of sub-optimal measures of peer victimization, small sample sizes, and a lack of longitudinal studies. Future research needs to examine the prevalence of bullying and the long-term risks associated with being bullied in those born VLBW and smaller. Regardless of the methodological limitations, parents and teachers should be aware that individuals born VLBW and smaller may be at a higher risk for being bullied.

Introduction

Bullying is a universal problem, with up to a third of children worldwide being victimized by peers (Molcho et al., 2009). Bullying, also known as peer victimization, is a form of aggression that is intentional, occurs on multiple occasions, and includes an abuse of power (Olweus, 1999). Bullying can take several different forms, including physical (e.g., hitting, kicking), verbal (e.g., calling a peer derogatory names), relational (e.g., disrupting social relations by ignoring someone who is trying to start a conversation or join a game, repeating embarrassing gossip to others), and/or cyber bullying that occurs electronically (Berger, 2007). Youths who have experienced peer victimization have been found to have higher levels of social, emotional, and behavioral problems (Arseneault, L., et al., 2010, Gini, G. and Pozzoli, T., 2013, Olweus, D., 2013, Reijntjes, A., et al., 2011, Reijntjes, A., et al., 2010, Wolke, D. and Lereya, S. T., 2015).

The experience of being bullied also has been found to be related to adverse outcomes for many years after the experience has occurred. People who have been bullied in childhood are more likely to live in poverty, be dismissed from a job, never complete college, have fewer friends, and even have poorer relationships with their parents as adults compared to people who were not bullied in childhood (Wolke, Copeland, Angold, & Costello, 2013). They are also more likely to have mood and anxiety disorders, especially generalized anxiety, panic disorder, and agoraphobia (Copeland, Wolke, Angold, & Costello, 2013). Recently, a meta-analysis of 29 longitudinal studies showed that youth who experienced peer victimization were more likely to be depressed up to 36 years later, OR = 1.99; 95% CI [1.71–2.32] (Ttofi, Farrington, Lösel, & Loeber, 2011).

A meta-analysis by Cook, Williams, Guerra, Kim, and Sadek (2010) categorized risk factors for experiencing peer victimization as individual factors (including externalizing behavior, internalizing behavior, social competence, self-regulation cognitions, other-related cognitions, academic performance) and contextual factors (including family/home environment, school climate, community factors, peer status, peer influence). Children who have been found to be at risk for experiencing peer victimization are those with a lower IQ (Norwich, B. and Kelly, N., 2004, Twyman, K. A., et al., 2010, Wynne, S. L. and Joo, H., 2011), poorer physical strength or more physical impairments (Hodges, E. V, et al., 1997, Sentenac, M., et al., 2012, Van Cleave, J. and Davis, M. M., 2006), poorer motor abilities (Campbell, W. N., et al., 2012, Jansen, D. E., et al., 2011), and a higher body mass index (Janssen, I., et al., 2004, Lumeng, J. C., et al., 2010). Social and psychological difficulties are not only a consequence of peer victimization, but also can be risk factors as those who have experienced peer victimization have been found to have higher levels of pre-existing internalizing (Cook, C. R., et al., 2010, Hawker, D. S. and Boulton, M. J., 2000, Reijntjes, A., et al., 2010, Vaillancourt, T., et al., 2013) and externalizing (Cook, C. R., et al., 2010, Reijntjes, A., et al., 2010, Jansen, D. E., et al., 2011) behavior. Bullied individuals also have poorer peer relations (Hodges, E. V, et al., 1997, Knack, J., et al., 2012, Nansel, T. R., et al., 2004, Nansel, T. R., et al., 2001), self-concept, and self-esteem (Cook, C. R., et al., 2010, Egan, S. K. and Perry, D. G., 1998, Hawker, D. S. and Boulton, M. J., 2000), and score lower on peer-valued competencies and assets such as being attractive, funny, and athletic (Knack et al., 2012).

Children born at very low birth weight (VLBW, < 1500 g) or extremely low birth weight (ELBW; < 1000 g) have been found to have many of the characteristics that put children at higher risk for being bullied by peers. These include poorer motor abilities (Evensen, K. A. I., et al., 2004, Hack, M., et al., 2005, Saigal, S., et al., 1991), lower IQ (Hack, M., et al., 2005, Rickards, A. L., et al., 2001, Saigal, S., et al., 1991), and higher levels of anxiety and depression (Botting, N., et al., 1997, Hack, M., et al., 2009). As a result, VLBW and ELBW children may be at an increased risk for experiencing peer victimization.

Survivors who are born VLBW or ELBW may also be at an elevated risk for peer victimization because they have lower rates of resilience factors. Research from general population samples suggest that these include better academic performance (Hemphill, S. A., et al., 2014, Vassallo, S., et al., 2014) and superior peer relations and social skills (Hodges, E. V, et al., 1999, McVie, S., 2014, Vassallo, S., et al., 2014). Unfortunately, ELBW children are not only at greater risk for poorer academic performance (Anderson, P. J. and Doyle, L. W., 2008, Rickards, A. L., et al., 2001), but they also tend to have poorer social skills and peer relations (Anderson, P. J. and Doyle, L. W., 2008, Rickards, A. L., et al., 2001) than normal birth weight (NBW; > 2500 g) children.

Researchers have only recently begun to investigate peer victimization in VLBW and ELBW samples. If VLBW and ELBW youths are indeed at an increased risk for experiencing peer victimization, parents, teachers, and clinicians need to be aware so that they can pay special attention to these youth and intervene as needed.

In this review, the literature is summarized that examines levels of peer victimization in VLBW, ELBW, and extremely low gestational age (ELGA; < 29 weeks) survivors, and the characteristics of these children who are more likely to be victimized. The purpose of this review was to (1) highlight existing findings in this area, and (2) help direct future research by providing specific recommendations.

Section snippets

Prevalence of peer victimization

Only seven studies are known to have examined levels of peer victimization in youth born at ELGA or at VLBW or smaller (See Table 1). The sample sizes in these studies ranged from 30 to 174 ELGA, VLBW, or ELBW participants, and from 30 to 133 control participants. Three of these studies examined children born VLBW (Grindvik, A. S., et al., 2009, Nadeau, L. and Tessier, R., 2009, Nadeau, L., et al., 2004), three examined children born ELBW (Day, et al., 2015, Georgsdottir, I., et al., 2013, Yau,

Predictors of victimization among preterm youth

As most research conducted to date suggests VLBW and ELBW survivors are at an increased risk for peer victimization, parents, teachers, and clinicians need to know what characteristics may put VLBW and ELBW children at greater risk so they know who to focus on the most when they are attempting to prevent or intervene when peer victimization occurs. Researchers have investigated a large number of possible risk factors, including those that are biological (e.g., birth weight, gestational age,

Limitations and future directions

Data from existing studies suggest that children born at VLBW or smaller seem to be at increased risk for peer victimization and that certain characteristics may put some VLBW and ELBW children at even greater risk for peer victimization. Nevertheless, these studies do have a number of limitations.

Conclusions

All but one of the seven studies that have examined peer victimization in VLBW and ELBW children suggest that they are at an increased risk. However, although researchers have found that VLBW and ELBW children were more at risk for experiencing peer victimization (Day, et al., 2015, Georgsdottir, I., et al., 2013, Grindvik, A. S., et al., 2009, Nadeau, L. and Tessier, R., 2009, Nadeau, L., et al., 2004, Yau, G., et al., 2013), there have been conflicting findings (Johnson et al., 2003). More

Acknowledgments

This research was supported by a Lawson Post-Doctoral Fellowship awarded to Kimberly L. Day.

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