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Bullying and attention-deficit-hyperactivity disorder in 10-year-olds in a Swedish community
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Allmän pediatrik)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Allmän pediatrik)
2008 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 50, no 2, 134-138 p.Article in journal (Refereed) Published
Abstract [en]

The association of attention-deficit-hyperactivity disorder (ADHD) with bullying in the peer group in school was studied in an entire population of 577 fourth graders (10-year-olds) in one municipality in Stockholm, Sweden. The schoolchildren were screened for ADHD in a two-step procedure that included Conners'ratings of behavioural problems: teacher and parent interviews in a first step; and a clinical assessment in the second. Information about bullying was collected from the children themselves in a classroom questionnaire. Five-hundred and sixteen children (89.4%; 252 females, 264 males), for whom there was information from all data sources, were included in the study population. Conners'ratings that were collected from parents early in first grade were available for 382 of these children. Hypotheses were tested by multivariate analyses with adjustment for sex and parental education. Pervasive ADHD was diagnosed in 9.5% (95% confidence interval [CI] 5.6-12.8) of the males and 1.6% (CI 0.1-3.1) of the females. ADHD was associated with bullying other students (adjusted odds ratios (OR) 3.8 [CI 2.0-7.2]) as well as being bullied (often, OR 10.8 [CI 4.0-29.0]; sometimes, OR 2.9 [CI 1.5-5.7]). Bullying other students in fourth grade was associated with high scores in parental reports of behavioural problems at entry into first grade, suggesting a causal link to the ADHD syndrome. Being bullied, on the other hand, was not linked to behavioural problems at school entry. This study demonstrates a connection between ADHD and bullying in the peer group at school. Evaluation and treatment strategies for ADHD need to include assessment and effective interventions for bullying. Evaluation of ADHD should be considered in children involved in bullying.

Place, publisher, year, edition, pages
2008. Vol. 50, no 2, 134-138 p.
Keyword [en]
ADHD, bullying, school children
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-101023DOI: 10.1111/j.1469-8749.2007.02019.xISI: 000253095700012PubMedID: 18177412OAI: oai:DiVA.org:uu-101023DiVA: diva2:211565
Available from: 2009-04-16 Created: 2009-04-16 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Health Complaints, Bullying and Predictors of Attention-deficit/Hyperactivity Disorder (ADHD) in 10-year-olds in a Swedish Community
Open this publication in new window or tab >>Health Complaints, Bullying and Predictors of Attention-deficit/Hyperactivity Disorder (ADHD) in 10-year-olds in a Swedish Community
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common behavioural disturbances in school children. The aims of this thesis were to explore the association of ADHD with recurrent health complaints and bullying behaviour in children in grade four, and to evaluate whether it is possible to predict ADHD in grade four by screening before or at school entry.

Cohort study in a population of 577 fourth graders (10-year-olds) in Sigtuna, a municipality in Stockholm County. All children were screened for attention and behaviour problems by parents and teachers in fourth grade. In a second step children with high scores underwent further clinical and cognitive assessments. Information about health complaints and bullying was collected from the children themselves in a classroom questionnaire. Hypotheses were tested in multivariate analyses with adjustment for sex and parental education. Screening with developmental indicators and Conners scale from routine child health services was performed. Sensitivity, specificity and positive predictive value for being diagnosed with ADHD in fourth grade was calculated.

Recurrent abdominal pain, sleeping problems, and tiredness were associated with ADHD (adjusted relative risks: 2.2 [1.4-3.4], 1.7 [1.1-2.7], and 2.7 [1.7-4.1] respectively). ADHD was associated with bullying others students (adjusted odds ratios; 3.8 [95% C.I.: 2.0-7.2]) as well as being bullied (often 10.8 [4.0-29.0] and sometimes 2.9 [1.5-5.7]). The predictive value of developmental deviations for ADHD was no more than 20% and 50% when combining a Conner score of at least 10 from both parents and teachers.

This thesis demonstrates a connection between ADHD in one as well as two settings (home and school), health complaints, and bullying in school children. Treatment strategies for ADHD need to include an effective evaluation and treatment of health complaints and effective interventions for bullying. Evaluation of ADHD should be considered in children with recurrent health complaints and in children involved in bullying. Screening does not identify children who are diagnosed with ADHD in grade four with a high degree of selectivity. It may be more important for schools to have an effective strategy for identifying and dealing with children who develop ADHD when these problems evolve, rather than before school entry.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 124 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 454
Keyword
ADHD, health complaints, psychosomatic, bullying, developmental screening, preschool children, school children, behavioural screening, Conners 10-item scale, Wilson and Jungner criteria
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:uu:diva-100928 (URN)978-91-554-7503-1 (ISBN)
Public defence
2009-05-07, Rosénsalen, Akademiska barnsjukhuset, ing 95, Uppsala, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2009-04-16 Created: 2009-04-14 Last updated: 2009-04-21

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Holmberg, KirstenHjern, Anders

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