IntroductionResilience refers to the ability to adapt to difficult situation or adversity. Resilience is what gives people the psychological strength to cope with stress and hardship. Previous studies have investigated the relationship between resilience and bullying victimization and mental health problems. But whether the moderating effect of resilience against depression varies among victims of different types of bullying victimization remains unknown.MethodsThe study used data from the Taiwan Adolescent to Adult Longitudinal Study (TAALS), which was a school based, nationwide, longitudinal study conducted among adolescents in Taiwan. Between 2015 and 2019, the survey was repeated three times to capture changes in health behaviors. Meanwhile, our study is a cross-sectional study focusing on the 2nd follow-up survey of the TAALS, where we recruited 4,771 Grade 7 (12–13 years) and Grade 10 (15–16 years) students who had experienced bullying at school.ResultsThis study confirms the protective effect of resilience on depression among adolescents who have experienced bullying. The mode resilience score was used as a reference group. Compared to the reference group, victims of verbal bullying from the lowest resilience group were at the greatest risk of depression (OR = 5.91, CI = 4.38–7.99). Compared to the reference group, victims of cyber bullying from the highest resilience group had the lowest risk of depression (OR = 0.72, CI = 0.57–0.90).ConclusionRegardless of the type of bullying victimization, resilience has been shown to offer protection against depression. Specifically, higher resilience levels offer the greatest protection against depression for victims of cyber bullying compared to other three types of bullying victimization. Early interventions to reduce negative effects of bullying victimization may start with increasing an individual's resilience during adolescence.

BackgroundAmong Taiwanese adolescents, how the clustering of unhealthy behaviors, including insufficient physical activity, screen-based sedentary behavior and frequent sugar-sweetened beverage consumption affecting depressive symptom remains unclear. This study aims to examine the cross-sectional association between clustering of unhealthy behaviors and depressive symptom.MethodsWe analyzed 18,509 participants from the baseline survey of the Taiwan Adolescent to Adult Longitudinal Survey in 2015. The outcome was depressive symptoms, and the main exposures were insufficient physical activity, screen-based sedentary behaviors and frequent sugar-sweetened beverage consumption. Generalized linear mixed models were performed to find key factor associated with depressive symptom.ResultsDepressive symptoms were common among participants (31.4%), particularly in female and older adolescents. After adjustments for covariates including sex, school type, other lifestyle factors and social determinants, individuals exhibiting clustering of unhealthy behaviors were more likely (aOR = 1.53, 95% CI: 1.48–1.58) to exhibit depressive symptoms than those who have no or only one unhealthy behavior.ConclusionsClustering of unhealthy behaviors is positively associated with depressive symptom among Taiwanese adolescents. The findings highlight the importance of strengthening public health interventions to improve physical activity and decrease sedentary behaviors.

Smokers of any age can reap substantial health benefits from quitting or reducing their smoking. E-cigarettes have been promoted as a potentially promising product for tobacco harm reduction because e-cigarettes deliver nicotine vapor without many of the hazardous chemical combustion byproducts produced by combustible cigarette smoking. However, there remains an ongoing debate on whether the use of e-cigarettes is effective in combustible cigarette smoking cessation or reduction in both adolescents and adults. Our study uses data from the 2015 (baseline) and from the 2017 (follow-up) waves of the Taiwan Adolescent to Adult Longitudinal Study (TAALS), which is a large nationwide representative cohort study of health behaviors among adolescents in Taiwan. We analyzed the data using logistic regression and multivariate regression with a post-stratification weighting procedure. Among the 474 adolescent combustible cigarette users at baseline, the use of e-cigarettes had no association with smoking cessation (aRR = 0.99, 95% CI = 0.66, 1.50). Furthermore, the use of e-cigarettes was also not associated with change in combustible cigarette consumption among all adolescent combustible cigarette users at follow-up (Coef. = 0.62, 95% CI =  − 36.85, 38.09). In summary, our findings suggest that e-cigarettes may not aid tobacco control among adolescent smokers. Policy makers should be cautious of the potential harms that e-cigarette may bring to young people when they are developing e-cigarette regulations.

Background Few studies have investigated disparities in disordered eating between new immigrant and native adolescents in Taiwan. This study examines the differential pathways to disordered eating in these two populations. Methods This cross-sectional study analyzed data collected from March to June 2019. In total, 729 adolescents aged between 13 and 16 years recruited from 37 classes in 3 middle schools in New Taipei City were included in the final analysis. Standardized assessment tools measured disordered eating (EAT-26) and psychological distress (BSRS-5). Generalized structural equation modeling was used to conduct the path analysis. Results The prevalence of disordered eating was significantly higher in immigrant adolescents than in their native counterparts. Multipath models indicated that weight-teasing driven by overweight and obese status and weight overestimation could lead to disordered eating through psychological distress; however, the pathways differed for the two groups studied. Family weigh-teasing indirectly leads to disordered eating through psychological distress for native adolescents; by contrast, for immigrant adolescents, friend weigh-teasing indirectly leads to disordered eating through psychological distress. Additionally, weight overestimation directly leads to disordered eating and indirectly through psychological distress to disordered eating for immigrant adolescents. Conclusion This study offers a plausible explanation of the differences in the paths to disordered eating between immigrant and native adolescents in Taiwan, which was not reported previously. The study urges the need for school-based prevention programs to improve immigrant students’ mental health.

BackgroundAmong Taiwanese adolescent, how depressive symptoms, screen use affect on substance use remains unclear. This study aimed to examine (1) the cross-sectional association between depressive symptoms, screen use and substance use ; and (2) the modified effects of sex and school type on those mentioned associations.MethodsWe analyzed 18,509 participants from the baseline survey of the Taiwan Adolescent to Adult Longitudinal Survey in 2015. The outcome was substance use including binge drinking, smoking, cigarette smoking and betel chewing. The main predictors were self-reported depressive symptoms and screen use. Multiple logistic regression was employed to estimate predictors, and a subgroup analysis was performed to assess effect modifications.ResultsAmong 18509 participants, 6.4% reported binge drinking, 5.6% reported smoking, 4.4 % reported e-cigarette smoking, 5.0% reported betel chewing. After adjustments for covariates including sex, school type, BMI, skipping breakfast and social determinants, the associations of depressive symptoms, screen use on substance use were significant. Stratified results indicated that depressive symptoms and screen use employed diverse effects on substance use across subgroups based on sex and school types. ConclusionsDepressive symptoms and screen use were notable factors positively associated with substance use among Taiwanese adolescents. The findings highlight the importance of strengthening public health interventions to monitor substance use, decrease depression, and screen use among adolescents.