This meta-analysis integrates the results from 198 studies that compared psychological well-being of visually impaired individuals with unimpaired control groups or population norms. On average, visually impaired people showed a strong decline of vision-specific psychological well-being. However, declines in vision-unspecific measures were only small. Furthermore, declines of psychological wellbeing were stronger in studies with convenience samples (rather than probability samples) and in studies that used population norms as standard for comparison (rather than control groups), in individuals with greater vision loss, in patients with age-related macular degeneration as compared to glaucoma, in adults as compared to children, and, in part, in older studies. These factors should inform researchers and practitioners for developing and implementing interventions aimed at protecting psychological well-being. K E Y WO R D S an xiet y, depr ession, met a -a n a l ys i s , psychologic al health, vision-loss

The present study analyzed change in psychological problems of German adolescents with and without visual impairment across a 2-year interval. A total of 182 adolescents with severe visual impairment and 560 sighted adolescents provided longitudinal data. At the start of the study, adolescents with visual impairment had, on average, elevated scores on all difficulties scales of the Strengths and Difficulties Questionnaire (SDQ) (Goodman R, J Child Psychol Psychiat 38:581-586), 1997 and about 39 % of them scored in the abnormal range of one or more scales as compared to 30.5 % of their sighted peers (p < 0.05). However, between-group differences of emotional and total problems declined over time. While adolescents who are blind and those who have low vision had similar levels of psychological problems, SDQ scores showed less improvement in adolescents with an earlier age at onset of vision loss. In conclusion, a minority of adolescents with visual impairment and with early onset of visual impairment in particular, may benefit from psychological interventions aimed at preventing and reducing psychological problems and increasing the ability to cope with stressors associated with vision loss.

Adolescents who attend boarding schools share more time with peers than do students from day schools which, in turn, could provide more opportunities for bullying. Furthermore, some students attend boarding schools because of former social problems. In order to analyse the role of these factors, we examined the bullying behaviour of 706 German adolescents at boarding and day schools in a cross-sectional design. Adolescents at boarding schools showed higher levels of bullying by comparison to adolescents in day schools. Elevated levels of overt bullying in boarding schools could be explained by selection effects. In addition, more time spent with peers was associated with elevated levels of relational victimization. Furthermore, being overtly bullied showed stronger negative associations with life-satisfaction in students from boarding school than in students living at home.

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