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The current study used meta-regression to establish trends in bullying from 1998 to 2017, to identify factors that help explain variation in bullying trends, and to determine differences in the trends by gender and grade. This study focused on trends of face-to-face (FTF) bullying victimization and perpetration, cyberbullying victimization, relational bullying victimization, verbal bullying victimization, and physical bullying victimization, as well as characteristics of the youth involved. It also explored methodological and survey differences to help determine which factors contribute to variation from study to study. A systematic search found 91 studies reporting trends of bullying, from 1998 to 2017, that met predefined inclusion and exclusion criteria. The findings illustrate no significant time trend when looking at FTF bullying victimization, yet an increasing time trend for cyberbullying victimization. Additional trends begin to emerge when stratifying the findings by grade and gender, with FTF bullying victimization among boys declining, while FTF bullying victimization among girls is increasing. Across both FTF bullying victimization and cyberbullying victimization, younger adolescents report significantly more bullying than older adolescents, and this is consistent over time. Verbal and physical bullying victimization as well as FTF bullying perpetration have significantly declined over time. This study also identified key variables that contribute to the variation from trend study to trend study. The implications of these findings inform both policy and practice and provide insight into the overall scope of bullying within the United States.

Background Limited prior research has examined the rates or predictors of re-perpetration of child maltreatment. Yet, perpetrators may have multiple victims, and perpetrators, rather than their victims, are often the primary focus of child welfare services. Objective We examine rates of child maltreatment re-perpetration of repeat and new victims, and test perpetrator demographics and maltreatment index incident case characteristics as predictors of re-perpetration. Participants and setting We use a sample of 285,245 first-time perpetrators of a substantiated maltreatment incident in 2010 from the National Child Abuse and Neglect Data System. Methods We use linear probability models with full information maximum likelihood to test new victim and same victim perpetration by the end of FY 2018. Results Fifteen percent of perpetrators re-maltreated one or more of their original victims (“same victim re-perpetration”); 12% maltreated a new victim. Overall, re-perpetration was more common among younger, female, and White perpetrators. Perpetrators who were the biological or adoptive parent of their initial victim(s) had higher rates of same victim re-perpetration; new victim re-perpetration was more common among perpetrators who initially victimized an adoptive or stepchild. Same victim re-perpetration was less common among perpetrators of physical abuse than other types of maltreatment, and new victim re-perpetration was more common among perpetrators of sexual abuse and neglect than physical abuse. Conclusions Child welfare agencies should track re-perpetration in addition to revictimization as part of agency evaluations and risk assessments.

Bully-victims are often found to be the most high-risk group involved in bullying, yet limited prior research has explored differences among bully-victims. This study aims to fill that gap by exploring within-group differences of youth involved in both bullying perpetration and victimization. In a nationally representative sample of 165 youth ages 5 to 17, four bully-victim types were created using cutoff points based on the amount of perpetration and victimization reported: high bully-victims ( n = 38), aggression predominant bully-victims ( n = 67), victimization predominant bully-victims ( n = 23), and moderate bully-victims ( n = 37). Analyses revealed distinct differences among the groups, particularly relating to traumatic symptoms, types of bullying involvement, and nonvictimization adversity. The findings confirm that there is heterogeneity among bully-victims. The most substantial difference was found between the high group and the moderate group, with the high group significantly more likely to report depression ( p < .05) and anxiety symptoms ( p < .05), and more than two times more likely to experience past-year adversity than the moderate group. The findings from this study indicate that youth involved in high amounts of both perpetration and victimization are considerably more at risk of traumatic symptoms and nonvictimization adversity than youth involved in fewer bullying behaviors. These findings can be used to inform both research and practice, particularly in regard to targeted evidence-based interventions that meet the unique needs of each type.

Sleep disturbance is known to be associated with psychosis, but sleep disorders (eg, insomnia, nightmare disorder, sleep apnea) have rarely been investigated. We aimed to provide the first detailed assessment of sleep disorders and their correlates in patients with early psychosis. Sixty outpatients aged between 18 and 30 with nonaffective psychosis were assessed for sleep disorder presence, severity, and treatment using a structured diagnostic interview, sleep diaries, and actigraphy. Psychotic experiences, mood, and psychological wellbeing were also measured. Forty-eight patients (80%) had at least one sleep disorder, with insomnia and nightmare disorder being the most common. Comorbidity of sleep disorders within this group was high, with an average of 3.3 sleep disorders per patient. Over half of the sleep disorders had been discussed with a clinician but almost three-quarters had received no treatment. Treatment according to clinical guidelines was rare, occurring in only 8% of cases (n = 13). Sleep disorders were significantly associated with increased psychotic experiences, depression, anxiety, fatigue, and lower quality of life. Sleep disorders are very common in patients with psychosis, may have wide-ranging negative effects, and merit routine assessment and treatment in psychiatric practice.

Background Sleep dysfunction is extremely common in patients with schizophrenia. Recent research indicates that sleep dysfunction may contribute to psychotic experiences such as delusions and hallucinations. Objectives The review aims to evaluate the evidence for a relationship between sleep dysfunction and individual psychotic experiences, make links between the theoretical understanding of each, and highlight areas for future research. Method A systematic search was conducted to identify studies investigating sleep and psychotic experiences across clinical and non-clinical populations. Results 66 papers were identified. This literature robustly supports the co-occurrence of sleep dysfunction and psychotic experiences, particularly insomnia with paranoia. Sleep dysfunction predicting subsequent psychotic experiences receives support from epidemiological surveys, research on the transition to psychosis, and relapse studies. There is also evidence that reducing sleep elicits psychotic experiences in non-clinical individuals, and that improving sleep in individuals with psychosis may lessen psychotic experiences. Anxiety and depression consistently arise as (partial) mediators of the sleep and psychosis relationship. Conclusion Studies are needed that: determine the types of sleep dysfunction linked to individual psychotic experiences; establish a causal connection between sleep and psychotic experiences; and assess treatments for sleep dysfunction in patients with non-affective psychotic disorders such as schizophrenia., Highlights • The review assesses the link between sleep dysfunction and psychotic experiences, particularly delusions and hallucinations. • A systematic review is undertaken of 66 papers that assessed sleep and individual psychotic experiences. • Sleep dysfunction and psychosis clearly co-occur and sleep dysfunction may predict later psychotic experiences. • The effect of improving sleep on psychotic experiences remains to be tested in an adequately powered trial. • The mechanisms linking sleep dysfunction to psychotic experiences require testing.

Highlights • Insomnia, negative affect, and psychotic experiences are all related across time. • Negative affect mediates the insomnia and psychotic experience relationship. • Insomnia predicts later hallucinations to a greater extent than vice versa. • Insomnia and paranoia have a bidirectional relationship across time., Insomnia has been shown to contribute to the development of psychotic experiences, predominantly via increasing negative affect. However, the role of insomnia in the persistence of psychotic experiences is yet to be investigated in a clinical population. Furthermore, other plausible influences, such as psychotic experiences contributing to insomnia, remain to be evaluated. This study tests the role of insomnia as a predictor of persistence of psychotic experiences versus other potential causal routes. Twenty-nine patients aged 18–30 with non-affective psychosis completed three assessments over three months of their insomnia, negative affect, and psychotic experiences. Mixed effect models allowed comparisons between hypothesis-based models (comprising insomnia as predictor, negative affect as mediator, and psychotic experiences as outcome) and oppositional models, where relationships were reversed. The results supported the hypothesised mediation model above models where negative affect was primary. Insomnia was also found to be a stronger predictor of later hallucinations than vice versa, although a bidirectional relationship was indicated between insomnia and paranoia. In conclusion, insomnia predicts persistence of psychotic experiences over time to the same or greater extent than psychotic experiences contribute to insomnia. This supports insomnia as a potential intervention target in psychosis.

Background When patients are admitted onto psychiatric wards, sleep problems are highly prevalent. We carried out the first trial testing a psychological sleep treatment at acute admission (Oxford Ward sLeep Solution, OWLS). Methods This assessor-blind parallel-group pilot trial randomised patients to receive sleep treatment at acute crisis [STAC, plus standard care (SC)], or SC alone (1 : 1). STAC included cognitive–behavioural therapy (CBT) for insomnia, sleep monitoring and light/dark exposure for circadian entrainment, delivered over 2 weeks. Assessments took place at 0, 2, 4 and 12 weeks. Feasibility outcomes assessed recruitment, retention of participants and uptake of the therapy. Primary efficacy outcomes were the Insomnia Severity Index and Warwick–Edinburgh Mental Wellbeing Scale at week 2. Analyses were intention-to-treat, estimating treatment effect with 95% confidence intervals. Results Between October 2015 and July 2016, 40 participants were recruited (from 43 assessed eligible). All participants offered STAC completed treatment (mean sessions received = 8.6, s.d. = 1.5). All participants completed the primary end point. Compared with SC, STAC led to large effect size (ES) reductions in insomnia at week 2 (adjusted mean difference −4.6, 95% CI −7.7 to −1.4, ES −0.9), a small improvement in psychological wellbeing (adjusted mean difference 3.7, 95% CI −2.8 to 10.1, ES 0.3) and patients were discharged 8.5 days earlier. One patient in the STAC group had an adverse event, unrelated to participation. Conclusions In this challenging environment for research, the trial was feasible. Therapy uptake was high. STAC may be a highly effective treatment for sleep disturbance on wards with potential wider benefits on wellbeing and admission length.

Mental health problems are inseparable from the environment. With virtual reality (VR), computer-generated interactive environments, individuals can repeatedly experience their problematic situations and be taught, via evidence-based psychological treatments, how to overcome difficulties. VR is moving out of specialist laboratories. Our central aim was to describe the potential of VR in mental health, including a consideration of the first 20 years of applications. A systematic review of empirical studies was conducted. In all, 285 studies were identified, with 86 concerning assessment, 45 theory development, and 154 treatment. The main disorders researched were anxiety (n = 192), schizophrenia (n = 44), substance-related disorders (n = 22) and eating disorders (n = 18). There are pioneering early studies, but the methodological quality of studies was generally low. The gaps in meaningful applications to mental health are extensive. The most established finding is that VR exposure-based treatments can reduce anxiety disorders, but there are numerous research and treatment avenues of promise. VR was found to be a much-misused term, often applied to non-interactive and non-immersive technologies. We conclude that VR has the potential to transform the assessment, understanding and treatment of mental health problems. The treatment possibilities will only be realized if – with the user experience at the heart of design – the best immersive VR technology is combined with targeted translational interventions. The capability of VR to simulate reality could greatly increase access to psychological therapies, while treatment outcomes could be enhanced by the technology's ability to create new realities. VR may merit the level of attention given to neuroimaging.