Associations of psychological factors, parental involvement, and adverse health behaviors with bullying among tunisian middle school students

BMC Psychology Fredj et al. BMC Psychology (2023) 11:154 https://doi.org/10.1186/s40359-023-01190-7 Open Access RESEARCH Associations of psychological factors, parental involvement, and adverse health behaviors with bullying among tunisian middle school students Manel Ben Fredj1,2,3, Cyrine Bennasrallah1,2,3*, Ines Amor1,3, Faouzia Trimech4, Hela Abroug1,2, Imen Zemni1,2, Wafa Dhouib1,2, Meriem Kacem1,2,3, Ines Bouanene1,2 and Asma Belguith Sriha1,2,3 Abstract Background Bullying is a serious problem that significantly affect adolescent well-being and health, needing the attention of teachers, school administrators, parents and public health professionals. In this study, we aimed at estimating the prevalence of bullying, from the perspective of victims in middle school students in the region of Monastir Tunisia, as well as analyzing its association with individual and family context variables. Methods This is a cross-sectional study conducted in December 2017 and January 2018 among a sample of students from two middle schools in the region of Monastir (Tunisia), using the Global School-based Student Health Survey (GSHS) self-answered questionnaire. We defined bullying victimization as being bullied in at least one day in the previous 30 days. Binary logistic regression model was used to identify factors associated with being bullied. Results Out of 802 students included in this study, nearly half (43.4%) reported having been bullied in the past month with CI 95%: 38.9–48.2. Gender did not interact with this behavior: (44.5%; CI 95%: 38.1–51.7) in boys versus (43.4% ; CI 95%: 37.2–50.2) in girls. Univariate analysis indicated significant differences regarding some individual factors such as physical fight, cigarette smoking, feeling lonely and being worried, in terms of prevalence of being bully victims. There were no significant differences in parental factors between the two groups (being bullied or not). Multivariate analysis showed the following factors as independently associated with bullying: being involved in physical fight (OR = 2.4; CI95%:1.77–3.25), feeling lonely (OR = 3.38; CI95% :2.04–5.57) and being worried (OR = 2.23; CI 95%:1.44–3.43). Conclusion Bullying victimization was common among school-going adolescents and was linked with physical fight and psychosocial distress. This study highlights the need for school-based violence prevention programs to address this problem among the students. Keywords Bullying, Adolescent, Schools, Tunisia *Correspondence: Cyrine Bennasrallah 1 Department of Epidemiology and Preventive Medicine, University Hospital Fattouma Bourguiba, Monastir, Tunisia 2 Department of Community Medicine and Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia 3 Research Laboratory “Technology and Medical Imaging”, Monastir, Tunisia 4 Directorate of school and university medicine of Monastir, Monastir, Tunisia © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Fredj et al. BMC Psychology (2023) 11:154 Introduction Adolescent violence is a major public health problem. It is the fifth leading cause of death in this age group, responsible for more than 12% of male deaths worldwide. It remains a growing, but a neglected issue globally [1]. According to the UNESCO, approximately 246 million children and adolescents face some form or another of school-based violence and harassment each year [2]. One of the forms of school violence is bullying, a type of peer violence considered as a public health problem. Bullying could include physical contact, verbal harassment, rumor spreading, intentionally social exclusion or lewd gestures. The act of bullying involves both a bully and a victim and it occurs repeatedly when there is a power imbalance between them [3]. Bullying is a global problem, common to many different countries and schools, with 20–56% of the world’s adolescents being involved every year in bullying situations [4–6]. Several studies have documented the adverse effects of bullying on children’s and adolescents’ developmental trajectories with elevated rates of anxiety, depression, and socio-emotional problems; behavioral difficulties, impaired academic performance, absenteeism and increased school dropout rates among victims of bullying [7–9]. Many individual and environmental factors may be related to the occurrence of this phenomenon. According to previous studies, bullying was linked with male gender, physical fighting, mental health disorders and risky behaviors such as substance use [10–14]. Other studies examined that relationship between parent–child communication and the risk of being bullied for a student [15]. This highlights how crucial it is to investigate further parental participation in this matter, especially in developing nations where parental involvement in bullying is still not well-researched. In Tunisia, there have been few studies on bullying prevalence, which makes it difficult to establish trends over time. In this context, we conducted this research to focus on this phenomenon, estimate the nature and prevalence of bullying in Tunisian schools, monitor potential changes over time and pinpoint populations that may be more susceptible to bullying victimization. Thus, this study aimed to estimate the prevalence of bullying, from the perspective of the victims in middle school students in the region of Monastir Tunisia, as well as to analyze its association with individual and family context variables. Methods Study design This is a cross-sectional study conducted in middle schools belonging to the region of Monastir Tunisia in December 2017 and January 2018. Page 2 of 7 Study sample The sample size was calculated using a 95% confidence interval, 5% allowed error, a prevalence rate of bullying of 30.6% as reported previously [16], and a design effect of 2. The calculated sample size was 646. The sample was increased by 25% to account for nonresponse a (...truncated)