Effects of sexual orientation-based bullying on feelings of loneliness and sleeping difficulty among Brazilian middle school students

Jomar, Rafael Tavares; Fonseca, Vitor Augusto de Oliveira; Ramos, Dandara de Oliveira

doi:10.1016/j.jped.2020.03.005

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Original article • J. Pediatr. (Rio J.) 97 (2) • Mar-Apr 2021 • https://doi.org/10.1016/j.jped.2020.03.005 copy

Effects of sexual orientation-based bullying on feelings of loneliness and sleeping difficulty among Brazilian middle school students^☆ ☆ Study linked to the Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, RJ, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To investigate the extent to which sexual orientation-based bullying relates to self-reported feelings of loneliness and sleeping difficulty among Brazilian middle school students.

Method:

This is a cross-sectional study using data from the 2015 PeNSE (Pesquisa Nacional de Saúde do Escolar), a survey designed to monitor the health of children and adolescents enrolled in the ninth grade in public and private Brazilian schools. Multiple linear regressions stratified by sex were used on a sample of 101,646 students, considering as reference students who had not experienced bullying, as well as students who had experienced other causes of bullying; a significance level of p < 0.05 was accepted.

Results:

When the reference group was composed of students who had not experienced bullying, the associations between sexual orientation-based bullying and feelings of loneliness and between sexual orientation-based bullying and sleeping difficulty were positive (p < 0.05) for both male and female students, with magnitudes about twice as large as those found among those who reported having experienced other cause s of bullying. However, when the reference group was composed of students who had experienced other causes of bullying, only the association between sexual orientation-based bullying and feelings of loneliness was positive (p < 0.05) for both male and female students.

Conclusion:

This study highlights that sexual orientation-based bullying is a predictor of feelings of loneliness.

KEYWORDS
Adolescent health; Brazil; Bullying; Homophobia; Mental health; Health surveys

Variables	Bullying
Variables	None (95% CI)	Sexual orientation-based (95% CI)	Other causes (95% CI)
Total	56.2 (55.9-56.5)	0.8 (0.7-0.9)	42.9 (42.6-43.2)

Geographic region
North	56.9 (56.3-57.6)	0.8 (0.7-1.0)	42.1 (41.4-42.7)
Northeast	57.6 (57.1-58.1)	0.7 (0.6-0.8)	41.6 (51.0-42.1)
Central-West	54.6 (53.7-55.4)	0.8 (0.7-1.0)	44.5 (43.7-45.3)
Southeast	53.9 (53.2-54.7)	0.9 (0.8-1.1)	45.0 (44.3-45.7)
South	55.5 (54.6-56.5)	0.7 (0.5-0.9)	43.6 (42.6-44.6)

State capital
Yes	56.9 (56.5-57.3)	0.8 (0.7-0.9)	42.1 (41.7-42.5)
No	55.4 (55.0-55.9)	0.8 (0.7-0.9)	43.6 (43.2-44.1)

Anti-bullying policies present in the school
Yes	55.9 (55.6-56.3)	0.8 (0.7-0.9)	43.1 (42.8-43.4)
No	58.0 (57.0-58.9)	0.7 (0.5-0.8)	41.2 (40.3-42.1)

Sex
Male	55.5 (55.1-56.0)	1.1 (1.0-1.2)	43.2 (42.8-43.6)
Female	56.8 (56.3-57.2)	0.6 (0.5-0.7)	42.6 (42.2-43.0)

Age (in years)
11	57.1 (38.4-75.8)	10.7 (0.9-22.3)	32.1 (14.5-49.7)
12	52.4 (48.1-56.8)	0.3 (0.1-0.9)	47.1 (42.7-51.4)
13	53.4 (52.6-54.1)	0.6 (0.4-0.7)	45.9 (45.2-46.7)
14	55.1 (54.6-55.5)	0.7 (0.6-0.8)	44.1 (43.6-44.5)
15	58.3 (57.7-59.0)	0.9 (0.8-1.1)	40.6 (39.9-41.2)
16	60.6 (59.5-61.7)	1.2 (1.0-1.5)	38.0 (36.9-39.1)
17	61.4 (59.7-63.2)	1.4 (1.0-1.8)	37.0 (35.3-38.7)
18	63.3 (60.1-66.6)	1.2 (0.5-2.0)	35.3 (32.1-38.5)
19	61.4 (57.4-65.4)	1.2 (0.3-2.1)	37.3 (33.3-41.3)

Color/race
White	56.2 (55.7-56.8)	0.8 (0.7-0.9)	42.8 (42.3-43.3)
Black	56.7 (55.8-57.5)	0.8 (0.5-0.9)	42.4 (41.5-43.2)
Yellow	53.2 (51.8-54.7)	0.9 (0.6-1.2)	45.7 (44.2-47.1)
Brown	56.4 (56.0-56.9)	0.8 (0.7-0.9)	42.7 (42.2-43.1)
Indigenous	54.0 (52.4-55.6)	0.8 (0.5-1.1)	45.0 (43.4-46.6)

Socioeconomic status (in quartiles)
First	56.7 (56.0-57.4)	0.9 (0.7-1.0)	42.3 (41.6-43.0)
Second	55.5 (54.9-56.2)	0.9 (0.7-1.0)	43.5 (42.8-44.1)
Third	55.3 (54.5-56.1)	0.8 (0.7-0.9)	43.8 (43.0-44.5)
Fourth	55.6 (54.8-56.3)	0.9 (0.8-1.1)	43.4 (42.7-44.1)

Close friends
None	51.9 (50.3-53.4)	1.3 (0.9-1.6)	46.7 (45.2-48.2)
1	49.0 (47.8-50.3)	1.3 (1.0-1.5)	49.6 (48.3-50.8)
2	50.3 (49.5-51.2)	1.2 (1.0-1.3)	48.4 (47.5-49.2)
3 or more	57.8 (57.5-58.1)	0.7 (0.6-0.8)	41.4 (41.0-41.7)

Parents understood their problems and concerns
Never	53.4 (52.6-54.1)	1.4 (1.3-1.6)	45.0 (44.3-45.8)
Rarely	50.3 (49.6-51.1)	0.9 (0.7-1.0)	48.6 (47.9-49.4)
Sometimes	53.2 (52.6-53.9)	0.8 (0.7-0.9)	45.8 (45.1-46.4)
Most of the time	56.6 (55.8-57.4)	0.6 (0.4-0.7)	42.7 (41.9-43.5)
Always	63.1 (62.5-63.7)	0.5 (0.4-0.6)	36.3 (35.7-36.9)

Feelings of loneliness
Never	68.9 (68.4-69.4)	0.4 (0.3-0.5)	30.6 (30.1-31.1)
Rarely	54.4 (53.8-55.1)	0.6 (0.4-0.7)	44.9 (44.2-45.5)
Sometimes	51.1 (50.5-51.7)	0.9 (0.8-1.1)	47.8 (47.2-48.4)
Most of the time	42.0 (41.1-43.0)	1.4 (1.1-1.6)	56.4 (55.5-57.4)
Always	37.9 (36.7-39.0)	2.6 (2.2-3.0)	59.4 (58.2-60.6)

Sleeping difficulty
Never	67.9 (67.4-68.4)	0.4 (0.3-0.5)	31.6 (31.1-32.1)
Rarely	52.5 (51.9-53.0)	0.7 (0.6-0.8)	46.7 (46.1-47.2)
Sometimes	50.1 (49.5-50.7)	1.0 (0.9-1.1)	48.7 (48.1-49.4)
Most of the time	42.7 (41.6-43.7)	1.8 (1.5-2.1)	55.4 (54.3-56.4)
Always	41.2 (39.5-43.0)	2.3 (1.8-2.8)	56.3 (54.6-58.0)

Variables	Sexual orientation-based bullying (95% CI)
Total	1.9 (1.8-2.0)

Geographic region
North	2.0 (1.8-2.3)
Northeast	1.8 (1.6-2.0)
Central-West	1.8 (1.5-2.2)
Southeast	2.1 (1.8-2.4)
South	1.7 (1.3-2.1)

State capital
Yes	2.0 (1.8-2.2)
No	1.8 (1.6-2.0)

Anti-bullying policies present in the school
Yes	1.9 (1.8-2.0)
No	1.7 (1.3-2.1)

Sex
Male	2.6 (2.3-2.8)
Female	1.3 (1.1-1.4)

Age (in years)
11	0.2 (0.1-0.5)
12	0.8 (0.1-1.9)
13	1.2 (1.0-1.5)
14	1.6 (1.5-1.8)
15	2.3 (2.0-2.6)
16	3.2 (2.5-3.8)
17	3.7 (2.6-4.8)
18	3.5 (1.4-5.5)
19	3.1 (0.8-5.5)

Color/race
White	1.9 (1.7-2.1)
Black	1.9 (1.5-2.2)
Yellow	2.0 (1.4-2.6)
Brown	1.9 (1.7-2.0)
Indigenous	1.8 (1.2-2.5)

Socioeconomic status (in quartiles)
First	2.1 (1.8-2.4)
Second	2.0 (1.7-2.3)
Third	1.8 (1.5-2.2)
Fourth	2.1 (1.8-2.4)

Close friends
None	2.7 (2.0-3.5)
1	2.5 (2.0-3.1)
2	2.4 (2.0-2.8)
3 or more	1.7 (1.5-1.8)

Parents understood their problems and concerns
Never	3.2 (2.8-3.5)
Rarely	1.9 (1.6-2.1)
Sometimes	1.8 (1.5-2.0)
Most of the time	1.4 (1.1-1.6)
Always	1.3 (1.1-1.6)

Feelings of loneliness
Never	1.2 (1.0-1.4)
Rarely	1.3 (1.0-1.5)
Sometimes	2.0 (1.7-2.20
Most of the time	2.4 (2.0-2.8)
Always	4.3 (3.6-4.9)

Sleeping difficulty
Never	1.3 (1.0-1.5)
Rarely	1.5 (1.3-1.7)
Sometimes	2.0 (1.8-2.3)
Most of the time	3.2 (2.7-3.7)
Always	4.0 (3.1-4.9)

	Male				Female
	Unadjusted β (SE)	Model 1^c c Model 1: adjusted by age, color/race, and socioeconomic status. β (SE)	Model 2^d d Model 2: adjusted by age, color/race, socioeconomic status, close friends, and understanding of parents. β (SE)	Model 3^e e Model 3: adjusted by age, color/race, socioeconomic status, close friends, understanding of parents, geographic region, state capital, and anti-bullying policies. β (SE)	Unadjusted β (SE)	Model 1^c c Model 1: adjusted by age, color/race, and socioeconomic status. β (SE)	Model 2^d d Model 2: adjusted by age, color/race, socioeconomic status, close friends, and understanding of parents. β (SE)	Model 3^e e Model 3: adjusted by age, color/race, socioeconomic status, close friends, understanding of parents, geographic region, state capital, and anti-bullying policies. β (SE)
Bullying ^a a Reference group in bullying variable: students who have not experienced bullying.
Sexual orientation-based	0.17 (0.31)	0.48 (0.28)	0.84 (0.13)^f f p ˂ 0.05.	0.85 (0.13)^f f p ˂ 0.05.	0.84 (0.27)^f f p ˂ 0.05.	0.90 (0.25)^f f p ˂ 0.05.	0.78 (0.13)^f f p ˂ 0.05.	0.78 (0.13)^f f p ˂ 0.05.
Other causes	-0.31 (0.06)^f f p ˂ 0.05.	0.01 (0.64)	0.37 (0.03)^f f p ˂ 0.05.	0.37 (0.03)^f f p ˂ 0.05.	0.27 (0.04)^f f p ˂ 0.05.	0.37 (0.39)^f f p ˂ 0.05.	0.42 (0.21)^f f p ˂ 0.05.	0.41 (0.21)^f f p ˂ 0.05.

Bullying ^b b Reference group in bullying variable: students who have experienced other causes of bullying.
Sexual orientation-based	0.49 (0.15)^f f p ˂ 0.05.	0.50 (0.16)^f f p ˂ 0.05.	0.44 (0.12)^f f p ˂ 0.05.	0.45 (0.12)^f f p ˂ 0.05.	0.56 (0.16)^f f p ˂ 0.05.	0.54 (0.16)^f f p ˂ 0.05.	0.35 (0.14)^f f p ˂ 0.05.	0.35 (0.14)^f f p ˂ 0.05.

	Male				Female
	Unadjusted β (SE)	Model 1^c c Model 1: adjusted by age, color/race, and socioeconomic status. β (SE)	Model 2^d d Model 2: adjusted by age, color/race, socioeconomic status, close friends, and understanding of parents. β (SE)	Model 3^e e Model 3: adjusted by age, color/race, socioeconomic status, close friends, understanding of parents, geographic region, state capital, and anti-bullying policies. β (SE)	Unadjusted β (SE)	Model 1^c c Model 1: adjusted by age, color/race, and socioeconomic status. β (SE)	Model 2^d d Model 2: adjusted by age, color/race, socioeconomic status, close friends, and understanding of parents. β (SE)	Model 3^e e Model 3: adjusted by age, color/race, socioeconomic status, close friends, understanding of parents, geographic region, state capital, and anti-bullying policies. β (SE)
Bullying ^a a Reference group in bullying variable: students who have not experienced bullying.
Sexual orientation-based	-0.15 (0.33)	0.13 (0.31)	0.60 (0.17)^f f p ˂ 0.05.	0.61 (0.17)^f f p ˂ 0.05.	0.50 (0.29)	0.56 (0.29)	0.60 (0.19)^f f p ˂ 0.05.	0.60 (0.19)^f f p ˂ 0.05.
Other causes	-0.45 (0.07)^f f p ˂ 0.05.	-0.10 (0.07)	0.32 (0.03)^f f p ˂ 0.05.	0.32 (0.03)^f f p ˂ 0.05.	0.12 (0.04)^f f p ˂ 0.05.	0.20 (0.04)^f f p ˂ 0.05.	0.31 (0.03)^f f p ˂ 0.05.	0.30 (0.03)^f f p ˂ 0.05.

Bullying ^b b Reference group in bullying variable: students who have experienced other causes of bullying.
Sexual orientation-based	0.29 (0.18)	0.26 (0.20)	0.27 (0.17)	0.27 (0.17)	0.38 (0.18)^f f p ˂ 0.05.	0.37 (0.19)	0.29 (0.17)	0.30 (0.17)

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[1] ⁎ Corresponding author. rafaeljomar@yahoo.com.br

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Effects of sexual orientation-based bullying on feelings of loneliness and sleeping difficulty among Brazilian middle school students☆ ☆ Study linked to the Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, RJ, Brazil.

Abstract

Objective:

Method:

Results:

Conclusion:

Effects of sexual orientation-based bullying on feelings of loneliness and sleeping difficulty among Brazilian middle school students^☆ ☆ Study linked to the Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, RJ, Brazil.