title: Multiple types of harassment: associations with emotional well-being and unhealthy behaviors in adolescents.
abstract: OBJECTIVE
  To explore relationships between harassment (i.e., race-, weight-, socioeconomic-status (SES)-based, and sexual) and health-related outcomes, including self-esteem, depressive symptoms, body satisfaction, substance use, and self-harm behavior, among diverse adolescents.
  
  
  METHODS
  Cross-sectional analysis using data from a population-based study of adolescents participating in Eating and Activity in Teens 2010 (EAT 2010) (n = 2,793; mean age = 14.4 years). Sample was socioeconomically and racially/ethnically diverse (81% racial/ethnic minority; 54% low or low-middle income).
  
  
  RESULTS
  Having experienced any type of harassment was significantly associated with poor self-esteem, depressive symptoms, low body satisfaction, substance use, and self-harm behaviors. After mutually adjusting for other types of harassment, weight-based harassment was consistently associated with lower self-esteem and lower body satisfaction in both genders (standardized βs ranged in magnitude from .39 to .48); sexual harassment was significantly associated with self-harm and substance use in both genders (ORs: 1.64 to 2.92); and both weight-based and sexual harassment were significantly associated with depressive symptoms among girls (standardized βs = .34 and .37). Increases in the number of different harassment types reported by adolescents were associated with elevated risk for alcohol, cigarette, and marijuana use, and self-harm (ORs: 1.22 to 1.42) as well as emotional well-being (standardized βs: .13 to .26).
  
  
  CONCLUSIONS
  Having had any harassment experience was significantly associated with a variety of negative health and well-being outcomes among adolescents, and risk for these outcomes increases with the number of harassment types an adolescent experiences. Early detection and intervention to decrease harassment experiences may be particularly important in mitigating psychological and behavioral harm among adolescents.
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota. Electronic address: mbucchia@umn.edu.
authors.forename: Michaela M
authors.initials: MM
authors.lastname: Bucchianeri
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Division of General Pediatrics and Adolescent Health, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Marla E
authors.initials: ME
authors.lastname: Eisenberg
authors.affiliation: Departments of Biostatistics and Psychiatry, Columbia University, New York, New York.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.affiliation: Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario.
authors.forename: Niva
authors.initials: N
authors.lastname: Piran
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Dianne
authors.initials: D
authors.lastname: Neumark-Sztainer
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001828:Body Image; D001835:Body Weight; D058445:Bullying / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004644:Emotions / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D008910:Minnesota / Q000453:epidemiology; D010549:Personal Satisfaction; D063505:Racism / Q000523:psychology / Q000706:statistics & numerical data; D012309:Risk-Taking; D012649:Self Concept; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology; D017678:Sex Distribution; D017406:Sexual Harassment / Q000523:psychology* / Q000706:statistics & numerical data; D012919:Social Behavior; D012923:Social Class; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology
keywords: Adolescents; Body satisfaction; Bullying; Depression; Harassment; Race/ethnicity; Self-harm; Socioeconomic status; Substance use; Weight