Adverse childhood experiences and bullying victimization among Tunisian youth: The mediating role of body esteem.

BACKGROUND

Bullying is a widespread phenomenon among adolescents. Several authors have reported the link between ACEs and school bullying. However, little is known about the mechanism by which ACEs are linked to bullying among youth.

OBJECTIVE

To assess the relationship between ACEs and bullying victimization, with body esteem as a mediating factor.

PARTICIPANTS AND

SETTING

This cross-sectional study was conducted among adolescents aged 11 to 19, attending middle and high schools during the period from September 2023 to January 2024.

METHODS

Participants completed the questionnaire Adolescent Peer Relations Instrument questionnaire, the Body Esteem Scale for Adolescents and Adults questionnaire, and the Adverse Childhood Experiences-International Questionnaire.

RESULTS

We included 1005 adolescents, with an average age of 14.62 years and a sex ratio of 0.73. Among the participants, 92.1% had experienced bullying, 88.1% reported good body esteem, and 92.2% had been exposed to at least one adverse childhood experience (ACE) in their lifetime. Our analyses showed a significant link between total ACEs with body esteem (p 〈10-3) and bullying victimization (p < 10-3). We also observed a significant positive association between body esteem and being exposed to bullying at least once per month (p < 10-3). A statistically significant major mediation effect through body esteem was observed for bullying victimization and intrafamilial ACEs: physical neglect (% mediated = 60%). household dysfunction (% mediated = 51.1%) and emotional neglect (% mediated = 47.5%).

CONCLUSIONS

Our study highlights the importance of early interventions aimed at fostering a positive body image and resilience in adolescents with a history of ACEs.