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Health-related quality of life associated with bullying and aggression: a cross-sectional study in English secondary schools

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Abstract

Background

Associations between adolescent health-related quality of life (HRQoL), bullying, and aggression are not well understood. We used baseline data from a large-cluster randomized school trial to study the relationship between HRQoL, bullying experience, and other demographic factors.

Methods

Cross-sectional self-reported questionnaires collected pre-randomization from the on-going INCLUSIVE trial. The questionnaires were completed in the classroom. The Gatehouse Bullying Scale measured bullying victimization and the Edinburgh Study of Youth Transitions and Crime school misbehavior subscale (ESYTC) measured aggressive behaviors. HRQoL was assessed using the Child Health Utility 9 Dimensions (CHU-9D) and general quality of life using the Pediatric Quality of Life Inventory (PedsQL). Participants were a cohort of year 7 students (age 11–12 years) from 40 state secondary schools in England. Descriptive statistics for the CHU-9D and PedsQL were calculated using standard methods with tests for differences in median scores by sex assessed using quantile regression. Correlation between HRQoL measures was conducted using Spearman’s rank correlation coefficients. Predictors of HRQoL were identified using univariate and multiple regressions.

Results

A total of 6667 students filled out the questionnaire. The CHU-9D was correlated with the PedsQL (0.63, p < 0.001). The multivariable regression results suggest that if students were bullied frequently and upset it resulted in a decrement in CHU-9D scores of (−0.108) and fall in PedsQL score of (−16.2). The impact of the antisocial/aggressive behavior on the ESYTC scale resulted in a utility decrement of −0.004 and fall of −.5 on the PedsQL.

Conclusions

Adolescents’ involvement in bullying and aggression is a strong correlate of HRQoL. These data have important implications for the potential cost-effectiveness of reducing bullying and aggression in schools.

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Abbreviations

95% CI:

95% Confidence interval

CHU-9D:

Child Health Utility 9 Dimensions

ESYTC:

Edinburgh Study of Youth Transitions and Crime school antisocial/aggressive behavior subscale

GBS:

Gatehouse Bullying Scale

HRQoL:

Health-related quality of life

INCLUSIVE:

Initiating change locally in bullying and aggression through the school environment

IOE:

Institute of Education

IQR:

Interquartile range

LSHTM:

London School of Hygiene and Tropical Medicine

NICE:

National Institute for Health and Clinical Excellence

PedsQL:

Pediatric Quality of Life Inventory

QALY:

Quality-adjusted life year

SD:

Standard deviation

SE:

Standard error

UCL:

University College London

UK:

United Kingdom

WHO:

World Health Organization

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Acknowledgments

The trial was funded by the National Institute for Health Research (NIHR). Thanks to all the students that completed the questionnaire and staff and parents that supported this. Dr. Nichola Shackleton assisted cleaning the dataset and scoring composite measures.

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Authors and Affiliations

  1. London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK

    Catherine Fantaguzzi, Elizabeth Allen, Alec Miners, Charles Opondo, Zia Sadique, Richard Grieve, Chris Bonell & Rosa Legood

  2. University College London Hospitals NHS Foundation Trust, London, UK

    Deborah Christie

  3. School of Social Sciences, Cardiff University, Glamorgan Building, King Edward VII Avenue, Cardiff, CF10 3WT, UK

    Adam Fletcher

  4. UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK

    Russell M. Viner

Authors
  1. Catherine Fantaguzzi
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  2. Elizabeth Allen
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  3. Alec Miners
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  4. Deborah Christie
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  5. Charles Opondo
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  6. Zia Sadique
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  7. Adam Fletcher
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  8. Richard Grieve
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  9. Chris Bonell
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  10. Russell M. Viner
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  11. Rosa Legood
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Contributions

RL, RG, DC, AF, EA, CB, and RV designed the trial and data collection. CF, EA, ZS, CO, AM, advised on the design of the statistical analysis. CF and ZS undertook all analyses under the supervision of RL. All authors were responsible for drafting the manuscript. CF undertook the initial analysis of this project as part of her MSc project dissertation.

Corresponding author

Correspondence to Rosa Legood.

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All authors declare that they have no conflicts of interest.

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Fantaguzzi, C., Allen, E., Miners, A. et al. Health-related quality of life associated with bullying and aggression: a cross-sectional study in English secondary schools. Eur J Health Econ 19, 641–651 (2018). https://doi.org/10.1007/s10198-017-0908-4

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  • DOI: https://doi.org/10.1007/s10198-017-0908-4

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