Recent national attention to several cases of suicide among youth victims of cyberbullying 1,2 has raised concerns about its prevalence and psychological impact. Most states now have legislation in place that requires schools to address electronic harassment in their antibullying policies, 3 yet schools lack information about cyberbullying correlates and consequences and how they may differ from those of school bullying. To inform schools' efforts, research is needed that examines the overlap between cyberbullying and school bullying and identifies which youths are targeted with either or both types of bullying. It is also necessary to understand whether the psychological correlates of cyberbullying are similar to those of school bullying and whether students targeted with both forms of bullying are at increased risk of psychological harm.With reports indicating that 93% of teens are active users of the Internet and 75% own a cell phone, up from 45% in 2004,4 there is great potential for cyberbullying among youths. Yet the extent of cyberbullying victimization and its prevalence relative to school bullying is unclear. Studies have found that anywhere from 9% to 40% of students are victims of cyberbullying, 5---7 and most suggest that online victimization is less prevalent than are school bullying and other forms of offline victimization. 8,9 Strikingly few reports provide information on youths' involvements in bullying both online and on school property. Cyberbullying has several unique characteristics that distinguish it from school bullying. Electronic communications allow cyberbullying perpetrators to maintain anonymity and give them the capacity to post messages to a wide audience.10 In addition, perpetrators may feel reduced responsibility and accountability when online compared with face-to-face situations. 11,12 These features suggest that youths who may not be vulnerable to school bullying could, in fact, be targeted online through covert methods. The limited number of studies that address the overlap between school and cyberbullying victimization has wide variation in findings, indicating that anywhere from about one third to more than three quarters of youths bullied online are also bullied at school. In addition to comparing the sociodemographics of cyberbullying victims with those of school bullying victims, it is important to understand whether cyberbullying is linked with Objectives. Using data from a regional census of high school students, we have documented the prevalence of cyberbullying and school bullying victimization and their associations with psychological distress.Methods. In the fall of 2008, 20 406 ninth-through twelfth-grade students in MetroWest Massachusetts completed surveys assessing their bullying victimization and psychological distress, including depressive symptoms, self-injury, and suicidality.Results. A total of 15.8% of students reported cyberbullying and 25.9% reported school bullying in the past 12 months. A majority (59.7%) of cyberbullying victims were also school bully...

BackgroundHarm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience.MethodsBuilding on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings.ResultsWe defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting.ConclusionThis paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of their disclosure of negative health behaviors, given that health behaviors are not binary or linear but operate along a continuum based on a variety of individual and social determinants.

A critical step in developing sexual assault prevention and treatment is identifying groups at high risk for sexual assault. We explored the independent and interaction effects of sexual identity, gender identity, and race/ethnicity on past-year sexual assault among college students. From 2011–2013, 71,421 undergraduate students from 120 U.S. post-secondary education institutions completed cross-sectional surveys. We fit multilevel logistic regression models to examine differences in past-year sexual assault. Compared to cisgender (i.e., non-transgender) men, cisgender women (adjusted odds ratios [AOR]=2.47; 95% confidence interval [CI]: 2.29, 2.68) and transgender people (AOR=3.93; 95% CI: 2.68, 5.76) had higher odds of sexual assault. Among cisgender people, gays/lesbians had higher odds of sexual assault than heterosexuals for men (AOR=3.50; 95% CI: 2.81, 4.35) but not for women (AOR=1.13; 95% CI: 0.87, 1.46). People unsure of their sexual identity had higher odds of sexual assault than heterosexuals, but effects were larger among cisgender men (AOR=2.92; 95% CI: 2.10, 4.08) than cisgender women (AOR=1.68; 95% CI: 1.40, 2.02). Bisexuals had higher odds of sexual assault than heterosexuals with similar magnitude among cisgender men (AOR=3.19; 95% CI: 2.37, 4.27) and women (AOR=2.31; 95% CI: 2.05, 2.60). Among transgender people, Blacks had higher odds of sexual assault than Whites (AOR=8.26; 95% CI: 1.09, 62.82). Predicted probabilities of sexual assault ranged from 2.6% (API cisgender men) to 57.7% (Black transgender people). Epidemiologic research and interventions should consider intersections of gender identity, sexual identity, and race/ethnicity to better tailor sexual assault prevention and treatment for college students.

Objectives. We examined the proportion of studies funded by the National Institutes of Health (NIH) that focused on lesbian, gay, bisexual, and transgender (LGBT) populations, along with investigated health topics. Methods. We used the NIH RePORTER system to search for LGBT-related terms in NIH-funded research from 1989 through 2011. We coded abstracts for LGBT inclusion, subpopulations studied, health foci, and whether studies involved interventions. Results. NIH funded 628 studies concerning LGBT health. Excluding projects about HIV/AIDS and other sexual health matters, only 0.1% (n = 113) of all NIH-funded studies concerned LGBT health. Among the LGBT-related projects, 86.1% studied sexual minority men, 13.5% studied sexual minority women, and 6.8% studied transgender populations. Overall, 79.1% of LGBT-related projects focused on HIV/AIDS and substantially fewer on illicit drug use (30.9%), mental health (23.2%), other sexual health matters (16.4%), and alcohol use (12.9%). Only 202 studies examined LGBT health–related interventions. Over time, the number of LGBT-related projects per year increased. Conclusions. The lack of NIH-funded research about LGBT health contributes to the perpetuation of health inequities. Here we recommend ways for NIH to stimulate LGBT-related research.