How does bullying shape the future of an adolescent with epilepsy? The mediating role of loneliness and self-esteem.

AIM: The present study examined the mediating roles of loneliness and self-esteem in the relationship between peer bullying victimization and future expectations in adolescents with epilepsy.

METHOD: This cross-sectional, descriptive study was conducted in the paediatric neurology and outpatient clinics of a training and research hospital in south-eastern Turkey between 01/09/2025 and 30/04/2026. The sample comprised 137 adolescents with epilepsy, aged 11-18 years. Data were collected using the Bullying and Cyberbullying Scale for Adolescents (BCS-A), the Adolescent Future Expectations Scale (FESA), the UCLA Loneliness Scale Short Form (ULS-8), and the State Self-Esteem Scale (SSES-S). Mediation analyses were performed using structural equation modelling and the bootstrap method. Ethics committee approval and informed consent were obtained from all participants.

RESULTS

Peer bullying victimisation was negatively correlated with future expectations (r = -0.666, p < 0.001) and self-esteem (r = -0.475, p < 0.001), and positively correlated with loneliness (r = 0.589, p < 0.001). In the partial mediation model, the direct negative effect of bullying on future expectations remained significant (β = -0.179, p < 0.001). Bootstrapped mediation analysis revealed that both loneliness (indirect effect: β = -0.543, 95% confidence interval [CI]: [-0.613, -0.473]) and self-esteem (indirect effect: β = -0.420, 95% CI: [-0.798, -0.304]) significantly mediated the relationship between bullying victimisation and future expectations. The overall model accounted for 92.5% of the variance in adolescents' future expectations.

CONCLUSION

The results demonstrate that peer bullying victimisation is significantly associated with diminished future expectations among adolescents with epilepsy, and this relationship appears to be partly explained by increased loneliness and lowered self-esteem.These findings suggest thatinterventions that reduce bullying, alleviate loneliness, and boost self-esteemcould be beneficial insafeguarding the future outlook of this vulnerable group. It is therefore recommended that routine screening for bullying experiences and psychosocial strategies that enhance self-esteem and social connectedness be incorporated into clinical care for adolescents with epilepsy.