EXPERIENCES OF CORPORAL PUNISHMENT AND ANXIETY AMONG ADOLESCENTS IN ALBANIA

Eglantina DERVISHI (1), Albana CANOLLARI-BAZE (2), Skënder RAVOLLI (3)
Keywords: corporal punishment, anxiety, adolescence.

DOI: https://doi.org/10.26758/14.1.13

 (1), (3) Department of Psychology and Pedagogy, Faculty of Social Sciences, University of Tirana, Albania; e-mail: (1)  eglantina.dervishi@unitir.edu.al (corresponding author);

(2) Schiller International University, Paris, France; e-mail: albana.canollari-baze@faculty.schiller.edu   (3) skender.ravolli@yahoo.com

Address correspondence to: Eglantina Dervishi, Department of Psychology and Pedagogy, Faculty of Social Sciences, University of Tirana, Bulevardi “Gjergj Fishta”, Tiranë, Albania; Phone: +355-682804081; E-mail: eglantina.dervishi@unitir.edu.al

Abstract

Objectives. This study aims to examine the influence of corporal punishment (CP) on the occurrence of anxiety during adolescence. Specifically, it investigates the prevalence of resilient survivors who do not exhibit clinical levels of anxiety symptoms after severe maltreatment.

Materials and methods. A total of 191 adolescents (94 females and 97 males) with an average age of 14.37 (standard deviation = 0.68) from the Tirana region were included in the study. Participants completed the “Brief Physical Punishment Scale” and the “Hamilton Anxiety Rating Scale (HAM-A).” Statistical analyses, including descriptive statistics, the T-test, Pearson correlation, and multiple regression using SPSS 25, were conducted to examine the relationship between corporal punishment and anxiety symptoms in adolescents.

Results. The findings indicate that adolescents who experienced persistent CP had higher levels of anxiety. The severity of CP was positively correlated with increased anxiety symptoms in both the somatic and psychological dimensions. Gender differences were observed, with females (M = 12.87, SD = 10.42) demonstrating higher overall anxiety levels compared to males (M = 5.73, SD = 8.97), suggesting that females may be more susceptible to experiencing elevated anxiety resulting from CP.

Conclusions The study reveals that CP has a detrimental impact on a child’s well-being, with a significant association between CP and increased anxiety symptoms during adolescence. The consequences of childhood CP extend into adolescence, indicating that it is a persistent risk factor for anxiety. Furthermore, females appear to be more vulnerable to anxiety resulting from childhood CP, although males also experience some level of anxiety.

Keywords: corporal punishment, anxiety, adolescence.

Introduction

Adolescence is a critical period characterized by significant physical, cognitive, and emotional changes (Zhang, Xu, Dai, & Jia, 2021; Sabramani et al., 2021; Zhang & Jia, 2023). During this developmental phase, adolescents often encounter numerous challenges and stressors that can impact their mental well-being (Tsuno, 2022; Pengpid & Peltzer, 2020; Samara et al., 2017). One such factor that has attracted considerable attention in recent years is the use of corporal punishment (CP) as a disciplinary strategy (Fabris, Longobardi, Morese, & Marengo, 2022; Arhin, Oppong Asante, Kugbey, & Oti-Boadi, 2019; Tarafa, Alemayehu, Bete, & Tarecha, 2022; Malaeb et al., 2020). Corporal punishment refers to the deliberate infliction of physical pain or discomfort as a means of behavior modification (Burger, 2022).

Corporal punishment is a disciplinary practice involving using physical force to inflict pain or discomfort upon an individual, typically as a response to perceived undesirable or disobedient behavior (Estric, Calati, & Lopez-Castroman, 2022). This punitive action is frequently administered through physical means, such as spanking, hitting, or slapping, resulting in bodily pain or discomfort (Durrant, Stewart-Tufescu, & Afifi, 2020). CP is commonly employed in child-rearing, educational settings, and certain legal systems (Lokot, Bhatia, Kenny, & Cislaghi, 2020). However, its use remains a topic of extensive debate and controversy, particularly concerning its potential physical and psychological effects, especially within the Albanian context.

The reference to the two dimensions of CP, namely the physical and psychological dimensions, signifies two distinct facets of this disciplinary approach. The physical dimension pertains to the immediate physical consequences experienced by individuals subjected to CP (Breger, Sorensen, Asal, & Willis, 2019). It encompasses the physical discomfort and pain inflicted upon the individual as a direct result of punitive measures, such as spanking or physical reprimand (Stewart-Tufescu, 2023). The physical dimension predominantly addresses the tangible act of administering physical discipline.

Conversely, the psychological dimension of CP alludes to the potential long-term psychological and emotional effects it may exert on the individuals who undergo such punitive measures (Rohner, Kean, & Cournoyer, 1991). This dimension encompasses a range of emotional responses, including feelings of fear, anxiety, aggression, trauma, and various other complex psychological reactions resulting from the experience of CP (Gershoff, 2002). The psychological dimension encompasses the intricate interplay between this form of discipline and its potential impact on the individual’s psychological well-being, especially since an intergenerational transmission of violent behavior from the family of origin to the family of procreation was identified (Rada, 2014).

The primary goal of this study is to investigate and elucidate the potential influence of CP on the occurrence of anxiety during adolescence. Anxiety disorders are among the most prevalent mental health issues experienced by adolescents (Bitsko et al., 2022), and their long-term implications can be substantial, affecting academic performance, social relationships, and overall quality of life. Therefore, understanding the factors that contribute to the development and maintenance of anxiety during this crucial developmental period is of the utmost importance.

While previous research (Goulter et al., 2020; Murray et al., 2018; Martin et al., 2021; Chen et al., 2021) has explored the association between CP and various negative outcomes, including aggression, antisocial behavior, and depressive symptoms, the relationship between CP and anxiety remains relatively understudied. It is essential to comprehensively examine this link to determine whether the use of CP represents a potential risk factor for anxiety in adolescents.

By conducting a systematic investigation into this topic, this study aims to contribute to the existing body of knowledge and provide valuable insights into the potential implications of CP on adolescent mental health. The findings will have implications for parents, educators, and policymakers, shedding light on the appropriateness and potential consequences of employing corporal punishment as a disciplinary measure. Ultimately, the goal is to promote evidence-based practices and interventions that foster healthy and supportive environments for adolescents, conducive to their overall well-being and psychological development.

One study conducted by Nakanishi and colleagues (2022) aimed to examine the long-term effects of CP on adolescent mental health outcomes, including anxiety. The researchers followed a large sample of adolescents from diverse backgrounds over a period of several years. They utilized validated measures to assess the frequency and severity of CP experienced by the participants and also evaluated their levels of anxiety at different stages of adolescence.

The findings of this study revealed a significant association between persistent corporal punishment and heightened levels of anxiety among adolescents. Specifically, adolescents who had experienced frequent and severe forms of CP throughout their upbringing displayed higher levels of anxiety compared to those who had not been subjected to such disciplinary measures. These findings held true even after controlling for other potential confounding factors, such as socioeconomic status and parental mental health.

Another notable study conducted by Fortier et al. (2022) corroborated the aforementioned findings, further strengthening the evidence for the link between CP and anxiety during adolescence. The researchers employed a longitudinal design, following a cohort of adolescents from early adolescence into young adulthood. They assessed the occurrence of CP experienced by the participants at various stages and measured their levels of anxiety using standardized self-report measures.

The results of this study consistently demonstrated that individuals who had experienced persistent CP exhibited significantly higher levels of anxiety symptoms throughout adolescence and into young adulthood. Moreover, the researchers found that the relationship between CP and anxiety was partially mediated by factors such as low self-esteem and impaired emotion regulation skills. These findings suggest that the adverse effects of CP on anxiety may be mediated by internal psychological processes.

The relationship between the severity of CP and anxiety in adolescents has been a topic of interest in research, as understanding the impact of the intensity of punishment on anxiety levels can provide valuable insights into the potential mechanisms underlying this association. This analysis explores the evidence surrounding the idea that the more severe CP, the greater the anxiety experienced by adolescents (Neaverson et al., 2022). Furthermore, it investigates how CP may affect the onset of anxiety in both somatic and psychological dimensions.

These studies (Gershoff & Font, 2016; Martin et al., 2021; Toseeb & Wolke, 2022; Memba & Ostrov, 2023) suggest that the severity of CP plays a crucial role in exacerbating anxiety symptoms in adolescents. The more extreme and intense the punishment, involving physical harm or emotional distress, the higher the likelihood of increased anxiety levels (Xiong, Wang, Wang, Wang, & Ren, 2023; Huang et al., 2022; Zheng et al., 2023; Wang, Yao, Patel, & Li, 2023). The physical pain and fear associated with severe CP may contribute to heightened somatic symptoms of anxiety, such as increased heart rate, muscle tension, and headaches (Estell et al., 2009; Pronk et al., 2020; Fang et al., 2022; Healy, Thomas, Sanders, & Scott, 2022).

Additionally, CP can impact the psychological dimensions of anxiety in adolescents. Research by Fortier et al. (2022) found that adolescents who experienced severe CP reported higher levels of cognitive and emotional symptoms of anxiety, such as excessive worry, difficulty concentrating, and feelings of apprehension or fear. The psychological distress caused by severe punishment may lead to maladaptive cognitive patterns and negative self-perceptions, contributing to the development and maintenance of anxiety disorders.

Furthermore, studies (Heinze, Cook, Wood, Dumadag, & Zimmerman, 2018; Goulter et al., 2020; Lv & Li, 2023; Forsberg & Thorvaldsen, 2022; Valles, 2007) have explored potential mechanisms through which CP influences the onset of anxiety in adolescents. One proposed mechanism is the disruption of secure attachment bonds between caregivers and adolescents (Totura & MacKinnon-Lewis, 2011; Ttofi, Bowes, Farrington, & Lösel, 2014; Andersen, Orm, Fossum, Øie, & Skogli, 2023). CP can create fear, mistrust, and a sense of insecurity, compromising the formation of healthy attachment relationships. This insecurity and lack of emotional support may contribute to the development of anxiety symptoms (Tang et al., 2023; Valente et al., 2023; Gong et al., 2023).

Another mechanism is the impact of CP on the adolescent’s self-esteem and self-efficacy. Severe punishment can lead to feelings of shame, worthlessness, and a negative self-concept, which are known risk factors for anxiety disorders (Koele, Blankenstein, Schreuders, van Duijvenvoorde, & Güroğlu, 2023). Moreover, the use of physical force as a disciplinary strategy may inhibit the development of effective emotion regulation skills, leaving adolescents more vulnerable to anxiety symptoms (Bäker & Schütz-Wilke, 2023; Hunt, Peters, & Rapee, 2012; Goodman & Goodman, 2009).

It is important to acknowledge that the findings presented in this review highlight a correlational relationship between CP and anxiety among adolescents. While the results are compelling, they do not establish causality. It is possible that other confounding factors not accounted for in the studies may contribute to the observed association. Additionally, the subjective nature of self-report measures used to assess anxiety may introduce biases in the findings.

Nevertheless, the cumulative evidence from multiple studies (Mills-Koonce, Towe-Goodman, Swingler & Willoughby, 2022; Rothenberg et al., 2023; Ng, Chua, & Shorey, 2022; Peng et al., 2019) suggests a strong association between persistent CP and elevated levels of anxiety among adolescents. These findings underscore the potentially detrimental effects of relying on physical punishment as a disciplinary strategy, emphasizing the importance of exploring alternative, non-violent approaches to shaping adolescent behavior.

The implications of these findings extend to parents, educators, and policymakers. It is crucial for parents and caregivers to be aware of the potential psychological consequences of CP and consider alternative, more positive, and constructive methods of discipline. School systems and policymakers should also prioritize the dissemination of evidence-based practices that promote positive parenting techniques and emphasize the importance of creating safe and nurturing environments for adolescents.

In conclusion, the existing evidence supports the notion that the severity of CP is positively associated with increased anxiety levels in adolescents. Severe CP affects both the somatic and psychological dimensions of anxiety, potentially contributing to the onset and maintenance of anxiety disorders. The physical and emotional distress caused by severe punishment, along with the disruption of secure attachment bonds and negative self-perceptions, may underlie this relationship. These findings emphasize the importance of promoting non-violent, positive discipline strategies and creating supportive environments that foster the well-being and mental health of adolescents.

Materials and methods

Participants

A total of 191 adolescents from the Tirana region, Albania, were included in the study. The parents and teachers of the participating schools were informed about the research aims in a meeting. The study received ethical approval from the Commission on Ethics in Research and Teaching at the University of Tirana. Anonymity and confidentiality procedures were carefully explained to the participants and their parents or legal guardians in the written consent form. Participants were recruited from two public schools in the region. Out of the total sample size of 191 adolescents, 8.4% were 13 years old, 48.7% were 14 years old, 40.3% were 15 years old, and only 2.6% were 16 years old. The sample’s ages ranged from 13 to 16 years, with a mean age of 14.37 years (SD = 0.68). These values indicate a relatively homogeneous age distribution among the participants. Of the total sample, 49.2% were female, while 50.8% were male. The majority of participants were either 14 or 15 years old, with a smaller proportion at the ages of 13 and 16. The gender distribution was nearly equal between females and males.

Measures

The “Brief Physical Punishment Scale” was used to assess the participants’ experiences of CP. The “Brief Physical Punishment Scale” was used to assess both the physical and psychological dimensions of CP. It consists of 15 questions, with the first eight measuring the extent of physical punishment and the subsequent seven measuring the 5-point psychological punishment. The scale utilizes a Likert-type response format with five options on a rating-scale from 0 (no manifestation) to 4 (severe manifestations).

The reliability coefficients for the measures employed in the study demonstrate strong internal consistency. Specifically, Cronbach’s alpha coefficient for the overall construct of CP was found to be α = 0.87, indicating a high level of reliability in assessing this disciplinary practice. Furthermore, the physical dimension of CP exhibited a Cronbach’s alpha coefficient of α = 0.88, signifying robust internal consistency in capturing the immediate physical consequences of such punishment. Similarly, the psychological dimension displayed a high level of reliability, with a Cronbach’s alpha coefficient of α = 0.91, highlighting the consistency in measuring the long-term psychological and emotional effects stemming from CP. These findings underscore the reliability of the instruments used to assess CP and its associated dimensions in the study.

The “Hamilton Anxiety Rating Scale” (HAM-A), a widely used instrument in anxiety research, was employed to evaluate anxiety symptoms. It consists of 13 items, assessing the somatic (9 items) and psychological (4 items) dimensions of anxiety. Similar to the Brief Physical Punishment Scale, the HAM-A utilizes a Likert-type response format with five options ranging from 0 (no manifestation) to 4 (severe manifestations). The reliability coefficient of the pilot study indicated good internal consistency for both instruments. The study also collected demographic data, including age, gender, location, and school affiliation.

The inventory exhibits a high level of internal consistency, as indicated by a Cronbach’s alpha (α) coefficient of 0.94. It is important to emphasize, however, that this inventory does not possess the specificity required for diagnostic purposes.

These instruments and demographic information provided valuable data for analyzing the relationship between CP and anxiety symptoms during adolescence.

Procedure

All schools in the Tirana region were invited to participate in the study, and two schools agreed to take part. The research aims were presented to parents and teachers in a meeting to ensure transparency and informed consent. The written consent form, approved by the Commission on Ethics in Research and Teaching at the University of Tirana, was provided to the participants and their parents or legal guardians. The participants completed the scales in a group setting within their respective schools, following clear instructions provided by the researchers.

The participants completed the Brief Physical Punishment Scale and the Hamilton Anxiety Rating Scale as part of the study. The scales were administered in a group setting, and participants were given clear instructions on how to respond to each item. The data collection took place in the two public schools.

Statistical Analysis

The collected data were analyzed using SPSS 25. Descriptive statistics were calculated to summarize the demographic characteristics of the sample and the scores on the scales. A T-test was conducted to examine the differences in anxiety levels between females and males. Pearson correlation analysis was used to explore the relationship between CP and anxiety symptoms. A multiple regression analysis was performed to determine the extent to which corporal punishment predicts anxiety symptoms in adolescents.

Results

The descriptive statistics related to the CP experienced by the participants include physical and psychological dimensions. The mean score for the physical dimension was 0.48, indicating a relatively low level of physical dimension experienced by the participants on average. The standard deviation (SD) was 0.62, suggesting a moderate amount of variability in the reported levels of physical dimension. Regarding the psychological dimension, the mean score was 0.94, indicating a slightly higher level of psychological dimension experienced by the participants compared to the physical dimension. The standard deviation was 0.70, indicating a moderate degree of variability in the reported levels of psychological dimension. These findings provide a descriptive overview of the levels of physical and psychological dimensions experienced by the participants. The data suggest that, on average, the participants reported relatively low levels of physical and psychological dimensions. However, there is some variability in the reported levels of CP, indicating that some participants experienced higher levels of CP than others. These results set the stage for further analyses examining the relationship between CP and anxiety symptoms during adolescence.

Pearson correlation coefficients between physical dimension and psychological dimension were found to be .519**. This indicates a moderately positive and statistically significant correlation between the two variables. The p-value associated with the correlation coefficient was .000, indicating that the correlation is significant at the 0.01 level (2-tailed). These findings suggest that there is a significant positive relationship between the physical dimension and the psychological dimension. As the physical dimension increases, the levels of the psychological dimension also tend to increase.

The mean score for psychological anxiety was 0.82, indicating a moderate level of psychological anxiety experienced by the participants on average. The standard deviation (SD) was 0.93, suggesting a considerable amount of variability in the reported levels of psychological anxiety. Regarding somatic anxiety, the sample size and range of scores were the same (N = 191, 0.0 to 2.5). The mean score for somatic anxiety was 0.46, indicating a relatively low level of somatic anxiety experienced by the participants. The standard deviation was 0.55, suggesting a moderate degree of variability in the reported levels of somatic anxiety.

These findings provide an overview of the levels of psychological and somatic anxiety experienced by the participants. The data suggest that, on average, the participants reported a moderate level of psychological anxiety and a relatively low level of somatic anxiety. However, there is variability in the reported levels of anxiety, indicating that some participants experienced higher levels of anxiety than others. Further analyses can explore the relationship between anxiety and other variables of interest, such as the experience of CP, to gain insights into the impact of different factors on anxiety symptoms during adolescence.

The correlation coefficient between psychological anxiety and somatic anxiety was found to be .806. This indicates a strong positive and statistically significant correlation between the two variables. The p-value associated with the correlation coefficient was .000, indicating that the correlation is significant at the 0.01 level (2-tailed). These findings suggest that there is a significant positive relationship between psychological anxiety and somatic anxiety. As psychological anxiety levels increase, so do the levels of somatic anxiety. This implies that individuals who experience higher levels of psychological anxiety are also more likely to experience higher levels of somatic anxiety. Understanding the interconnectedness of psychological and somatic anxiety can help inform interventions and treatment approaches for individuals experiencing anxiety symptoms.

The Pearson correlation coefficients indicate no statistically significant correlation between age and the occurrence of CP (physical dimension, psychological dimension) among the participants. This suggests that age is not a strong predictor of CP in this study.

The results of the independent samples t-tests conducted to examine the mean differences in corporal punishment based on gender for the physical dimension revealed no significant difference between females and males in terms of the physical dimension, with a t-value of 0.787 and a p-value of .434 (p > 0.05). The t-test did not reveal a significant difference in CP between females and males, with a t-value of 0.969 and a p-value of .334 (p > 0.05). This implies that gender is not a significant factor in determining the occurrence of CP in this study. The t-test revealed a significant difference in total anxiety between females and males, with a t-value of 5.069 and a p-value of .000 (p < 0.05). Females exhibited significantly higher levels of total anxiety compared to males. The t-test indicated a significant difference in psychological anxiety between females and males, with a t-value of 4.734 and a p-value of .000 (p < 0.05). Females reported significantly higher levels of psychological anxiety compared to males. For somatic anxiety, there was a significant difference between females and males, with a t-value of 4.853 and a p-value of .000 (p < 0.05). Females exhibited significantly higher levels of somatic anxiety compared to males. In summary, the results indicate that there are significant gender differences in anxiety levels among the participants. Females showed higher levels of total anxiety, psychological anxiety, and somatic anxiety compared to males. These findings suggest that gender plays a role in the manifestation of anxiety symptoms in the studied population.

The objective of this analysis was to assess the extent of the correlation between anxiety levels and physical dimension, psychological dimension, and total CP. The correlation analysis revealed a significant positive correlation between total anxiety and physical dimension, with a Pearson correlation coefficient of .411 (p < .01). This indicates that higher levels of physical dimension are associated with increased levels of anxiety. Similarly, a significant positive correlation was found between total anxiety and the psychological dimension, with a Pearson correlation coefficient of .460 (p < .01). This suggests that higher levels of psychological violence are associated with higher levels of anxiety. Furthermore, there was a significant positive correlation between total anxiety and overall CP, as indicated by a Pearson correlation coefficient of .500 (p < .01). This indicates that higher levels of overall CP, encompassing both physical and psychological dimensions, are associated with increased levels of anxiety. In summary, the results demonstrate that there are significant positive correlations between total anxiety and different forms of CP, including physical corporal punishment and psychological corporal punishment. These findings suggest that experiencing higher levels of CP, whether physical or psychological, is associated with increased anxiety levels.

Table 1

 Pearson correlation between anxiety levels and physical and psychological dimensions (to see Table 1, please click here).

This analysis aimed to examine the extent to which physical and psychological CP contribute to the prediction of total anxiety. The regression model yielded the following results: the constant term (intercept) was found to be 2.678 (p = .015), indicating that when the predictors (physical and psychological dimensions) are zero, the estimated mean value of total anxiety is 2.678. For the predictor variable of physical dimension, the unstandardized coefficient (B) was 3.920 (p = .002), suggesting that a one-unit increase in physical dimension is associated with a 3.920-unit increase in total anxiety. The standardized coefficient (Beta) for the physical dimension was .236, indicating that the physical dimension accounts for 23.6% of the variance in total anxiety. This coefficient represents the relative contribution of the physical dimension to the prediction of total anxiety, taking into account the scale of measurement of both variables. Similarly, for the predictor variable of psychological dimension, the unstandardized coefficient was 4.980 (p < .001), indicating that a one-unit increase in psychological dimension is associated with a 4.980-unit increase in total anxiety. The standardized coefficient (Beta) for the psychological dimension was .338, indicating that the psychological dimension explains 33.8% of the variance in total anxiety. The overall model fit was statistically significant, as indicated by the F-value of 31.76 (p < .001). This suggests that the predictors (physical and psychological dimensions) collectively contribute significantly to the prediction of total anxiety. The coefficient of determination (R2) was calculated to be .253, indicating that approximately 25.3% of the variance in total anxiety can be explained by the predictors included in the model. In summary, the regression analysis revealed that both physical and psychological dimensions significantly contribute to the prediction of total anxiety. The physical dimension accounts for 23.6% of the variance, while the psychological dimension explains 33.8% of the variance in total anxiety.

Table 2

 Regression analyses between physical and psychological dimension with anxiety (to see Table 2, please click here).

These findings highlight the importance of considering both forms of CP when examining their impact on anxiety levels.

Discussion

The findings of this study align with previous research (Pittman & Farrell, 2022; Goodrum et al., 2020) that has established a clear link between violence exposure and anxiety among adolescents. The significant predictive power of both physical and psychological dimensions on anxiety levels further reinforces the notion that the nature of CP, rather than its specific form, plays a critical role in eliciting emotional distress and contributing to anxiety symptoms (Townsend et al., 2020; Dark et al., 2020; Heinze et al., 2018). These results emphasize the detrimental impact of CP exposure on adolescent mental health, highlighting the urgent need for interventions that address both physical and psychological dimensions (Heleniak et al., 2021; Gollub, Green, Richardson, Kaplan, & Shervington, 2019; Heleniak, King, Monahan, & McLaughlin, 2018; Company-Córdoba, Gómez-Baya, López-Gaviño, & Ibáñez-Alfonso, 2020).

Comparing our findings with those of previous studies, we observe a consistent pattern of association between violence exposure and anxiety. For example, Cadely, Mrug, & Windle (2019) found that adolescents who experienced higher levels of CP exhibited increased anxiety symptoms, mirroring our results. Moreover, Hashemi, Fanslow, Gulliver, & McIntosh (2022) reported a positive correlation between violence exposure and anxiety, providing further support for the link established in our study. The convergence of these findings suggests that the relationship between CP exposure and anxiety holds across different populations and settings, reinforcing the generalizability of these associations.

While previous studies have examined the impact of CP exposure on mental health outcomes, our study adds value by considering physical and psychological dimensions as separate predictors. This approach allows for a more comprehensive understanding of the complex interplay between violence and adolescent mental health. By analyzing these dimensions independently, we reveal distinct contributions of the physical and psychological dimensions to anxiety levels, shedding light on the unique mechanisms through which each dimension of CP affects psychological well-being. This nuanced perspective enriches our understanding of the underlying processes and offers valuable insights for targeted interventions.

However, it is important to acknowledge the limitations of this study. First, the cross-sectional design restricts our ability to establish causal relationships between CP exposure and anxiety. Longitudinal studies would provide more robust evidence of the temporal sequence and potential causal mechanisms involved. Additionally, the reliance on self-report measures introduces the possibility of response bias or social desirability effects. Future research should consider utilizing multiple data sources, such as objective measures or reports from caregivers and teachers, to enhance the reliability and validity of the findings.

To build upon these findings, future research should investigate potential moderating or mediating factors that influence the relationship between CP exposure and anxiety. For instance, exploring the role of social support networks, coping strategies, and resilience may help identify protective factors that buffer the negative impact of CP exposure on mental health outcomes. Such insights would guide the development of more targeted and tailored interventions that address the specific needs of adolescents exposed to CP.

By considering both physical and psychological dimensions as separate predictors, we offer a nuanced understanding of the impact of CP on adolescent mental health. Our findings underscore the urgency of implementing comprehensive interventions that address both forms of CP to promote the well-being of young individuals. By targeting these factors and exploring potential moderating and mediating factors, we can strive towards developing more effective prevention and intervention strategies that mitigate the adverse effects of CP exposure on anxiety levels and enhance adolescent mental health outcomes.

Implications of Findings

The findings highlight the urgent need for comprehensive prevention and intervention strategies that address both the physical and psychological dimensions experienced by adolescents. Such strategies should aim to reduce the occurrence of violence and provide support to individuals who have been exposed to CP, with a particular focus on mitigating the impact on anxiety symptoms.

The results emphasize the importance of raising awareness about the detrimental effects of CP exposure on adolescent mental health, especially in terms of anxiety. Education programs targeting parents, caregivers, teachers, and the wider community can help foster a supportive and violence-free environment for adolescents.

The significant gender differences observed in anxiety levels and CP exposure call for tailored interventions. These should consider the unique challenges faced by females and males and address the specific needs and vulnerabilities associated with each gender.

Professionals working with adolescents should adopt a multi-dimensional approach to assessing CP exposure and anxiety. This involves considering both physical and psychological dimensions and recognizing the potential impact of each dimension on anxiety symptoms. Comprehensive assessments can guide targeted interventions and facilitate early identification and support for individuals at risk.

To establish causal relationships and better understand the temporal dynamics between CP exposure and anxiety, longitudinal studies are needed. These would provide valuable insights into the long-term effects of CP and help identify critical periods for intervention and support.

The findings call for policy-level changes to address the systemic issues related to CP exposure and its impact on adolescent mental health. Policymakers should prioritize the implementation of evidence-based interventions, allocate resources for mental health support in educational settings, and advocate for legislation that protects adolescents from CP.

Overall, the implications of the findings emphasize the importance of recognizing and addressing the impact of CP exposure on adolescent mental health, particularly anxiety symptoms. By implementing comprehensive prevention, intervention, and support strategies, stakeholders can contribute to the well-being and resilience of adolescents, promoting healthy development and positive mental health outcomes.

Conclusions

In conclusion, this study provides valuable insights into the relationship between CP exposure and anxiety among adolescents. The findings underscore the detrimental impact of physical and psychological dimensions on adolescent mental health, highlighting the need for comprehensive interventions to address these forms of CP.

The positive correlation between CP exposure and anxiety aligns with previous research, emphasizing the robustness of this association. By considering physical and psychological dimensions as separate predictors, this study contributes to a more nuanced understanding of the complex interplay between CP and adolescent mental health.

In conclusion, this study highlights the significant association between CP exposure and anxiety among adolescents and underscores the importance of prioritizing mental health support for this vulnerable population. The findings contribute to our understanding of the complex relationship between CP and mental health outcomes and provide a foundation for future research and the development of effective interventions to promote adolescents’ well-being.

Abbreviation

CP: Corporal punishment

Acknowledgments

A summary of this paper was presented at the online international conference: Individual, Family, Society – Contemporary Challenges, fifth edition, October 4-5, 2023, Bucharest, Romania, and published in the journal Studii şi Cercetări de Antropologie, No. 8/2023.

References

  1. Andersen, P. N., Orm, S., Fossum, I. N., Øie, M. G., & Skogli, E. W. (2023). Adolescence internalizing problems as a mediator between autism diagnosis in childhood and quality of life in emerging adults with and without autism: a 10-year longitudinal study. BMC Psychiatry, 23(1), 1-11, 149. https://doi.org/10.1186/s12888-023-04635-w.
  2. Arhin, D. K., Oppong Asante, K., Kugbey, N., & Oti-Boadi, M. (2019). The relationship between psychological distress and bullying victimization among school-going adolescents in Ghana: a cross-sectional study. BMC research notes, 12(1), 264. https://doi.org/10.1186/s13104-019-4300-6.
  3. Bäker, N., & Schütz-Wilke, J. (2023). Behavioral Changes during the First Year of the COVID-19 Pandemic: A Longitudinal Comparison of Bullying, Cyberbullying, Externalizing Behavior Problems and Prosocial Behavior in Adolescents. COVID, 3(2), 289-300. https://doi.org/10.3390/covid3020022.
  4. Bitsko, R. H., Claussen, A. H., Lichstein, J., Black, L. I., Jones, S. E., Danielson, M. L., Hoenig, J. M., Davis Jack, S. P., Brody, D. J., Gyawali, S., Maenner, M. J., Warner, M., Holland, K. M., Perou, R., Crosby, A. E., Blumberg, S. J., Avenevoli, S., Kaminski, J. W., Ghandour, R. M., & Contributor (2022). Mental Health Surveillance Among Children – United States, 2013-2019. MMWR supplements, 71(2), 1–42. https://doi.org/10.15585/mmwr.su7102a1.
  5. Breger, M. L., Sorensen, L., Asal, V., & Willis, C. N. (2019). Corporal punishment, social norms and norm cascades: Examining cross-national laws and trends in homes across the globe. Wm. & Mary J. Race Gender & Soc. Just., 26, 483.
  6. Burger C. (2022). Humor Styles, Bullying Victimization and Psychological School Adjustment: Mediation, Moderation and Person-Oriented Analyses. International journal of environmental research and public health, 19(18), 11415. https://doi.org/10.3390/ijerph191811415.
  7. Cadely, H. S., Mrug, S., & Windle, M. (2019). Comparisons of Types of Exposure to Violence Within and Across Contexts in Predicting the Perpetration of Dating Aggression. Journal of youth and adolescence, 48(12), 2377–2390. https://doi.org/10.1007/s10964-019-01102-2.
  8. Chen, X., Qi, H., Liu, R., Feng, Y., Li, W., Xiang, M., Cheung, T., Jackson, T., Wang, G., & Xiang, Y.-T. (2021). Depression, anxiety and associated factors among Chinese adolescents during the COVID-19 outbreak: A comparison of two cross-sectional studies. Translational Psychiatry, 11 (1), 148. https://doi.org/10.1038/s41398-021-01271-4.
  9. Company-Córdoba, R., Gómez-Baya, D., López-Gaviño, F., & Ibáñez-Alfonso, J. A. (2020). Mental Health, Quality of Life and Violence Exposure in Low-Socioeconomic Status Children and Adolescents of Guatemala. International journal of environmental research and public health, 17(20), 7620. https://doi.org/10.3390/ijerph17207620.
  10. Dark, H. E., Harnett, N. G., Goodman, A. M., Wheelock, M. D., Mrug, S., Schuster, M. A., Elliott, M. N., Emery, S. T., & Knight, D. C. (2020). Violence exposure, affective style, and stress-induced changes in resting state functional connectivity. Cognitive, affective & behavioral neuroscience, 20(6), 1261–1277. https://doi.org/10.3758/s13415-020-00833-1.
  11. Durrant, J. E., Stewart-Tufescu, A., & Afifi, T. O. (2020). Recognizing the child’s right to protection from physical violence: An update on progress and a call to action. Child abuse & neglect, 110(Pt 1), 104297. https://doi.org/10.1016/j.chiabu.2019.104297.
  12. Estell, D. B., Farmer, T. W., Irvin, M. J., Crowther, A., Akos, P., & Boudah, D. J. (2009). Students with exceptionalities and the peer group context of bullying and victimization in late elementary school. Journal of Child and Family Studies, 18, 136-150. DOI 10.1007/s10826-008-9214-1.
  13. Estric, C., Calati, R., & Lopez-Castroman, J. (2022). Adverse Childhood Experiences and Neurocognition in Borderline Personality Disorder: A Call-to-Action Perspective Review. Harvard review of psychiatry, 30(4), 248–260.  https://doi.org/10.1097/HRP.0000000000000344.
  14. Fabris, M. A., Longobardi, C., Morese, R., & Marengo, D. (2022). Exploring Multivariate Profiles of Psychological Distress and Empathy in Early Adolescent Victims, Bullies, and Bystanders Involved in Cyberbullying Episodes. International journal of environmental research and public health, 19(16), 9871. https://doi.org/10.3390/ijerph19169871.
  15. Fang, D., Lu, J., Che, Y., Ran, H., Peng, J., Chen, L., … & Xiao, Y. (2022). School bullying victimization-associated anxiety in Chinese children and adolescents: the mediation of resilience. Child and adolescent psychiatry and mental health, 16(1), 1-7. https://doi.org/10.1186/s13034-022-00490-x.
  16. Forsberg, J. T., & Thorvaldsen, S. (2022). The severe impact of the COVID-19 pandemic on bullying victimization, mental health indicators and quality of life. Scientific reports, 12(1), 22634.
  17. Gershoff, E. T. (2002). Corporal punishment by parents and associated child behaviors and experiences: A meta-analytic and theoretical review. Psychological Bulletin, 128(4), 539–579. https://doi.org/10.1037/0033-2909.128.4.539.
  18. Gershoff, E. T., & Font, S. A. (2016). Corporal punishment in U.S. public schools: Prevalence, disparities in use, and status in state and federal policy. Social Policy Report, 30(1). PMID: 29333055; PMCID: PMC5766273.
  19. Gollub, E. L., Green, J., Richardson, L., Kaplan, I., & Shervington, D. (2019). Indirect violence exposure and mental health symptoms among an urban public-school population: Prevalence and correlates. PloS one, 14(11), e0224499. https://doi.org/10.1371/journal.pone.0224499.
  20. Gong, X., Huebner, E. S., & Tian, L. (2023). Longitudinal relations between child maltreatment in families and psychological maltreatment by teachers: The mediating roles of internalizing and externalizing problems among Chinese children. Journal of interpersonal violence, 38(3-4), 2716-2741.https://doi.org/10.1177/08862605221104524.
  21. Goodman, A., & Goodman, R. (2009). Strengths and difficulties questionnaire as a dimensional measure of child mental health. Journal of the American Academy of Child & Adolescent Psychiatry, 48(4), 400-403.https://doi.org/10.1097/CHI.0b013e3181985068.
  22. Goodrum, N. M., Smith, D. W., Hanson, R. F., Moreland, A. D., Saunders, B. E., & Kilpatrick, D. G. (2020). Longitudinal Relations among Adolescent Risk Behavior, Family Cohesion, Violence Exposure, and Mental Health in a National Sample. Journal of abnormal child psychology, 48(11), 1455–1469. https://doi.org/10.1007/s10802-020-00691-y.
  23. Goulter, N., McMahon, R. J., Pasalich, D. S., & Dodge, K. A. (2020). Indirect Effects of Early Parenting on Adult Antisocial Outcomes via Adolescent Conduct Disorder Symptoms and Callous-Unemotional Traits. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 49(6), 930–942. https://doi.org/10.1080/15374416.2019.1613999.
  24. Hashemi, L., Fanslow, J., Gulliver, P., & McIntosh, T. (2022). Intergenerational Impact of Violence Exposure: Emotional-Behavioural and School Difficulties in Children Aged 5-17. Frontiers in psychiatry, 12, 771834. https://doi.org/10.3389/fpsyt.2021.771834.
  25. Healy, K. L., Thomas, H. J., Sanders, M. R., & Scott, J. G. (2022). Empirical and theoretical foundations of family interventions to reduce the incidence and mental health impacts of school bullying victimization. International review of psychiatry, 34(2), 140-153. https://doi.org/10.1080/09540261.2022.2045260.
  26. Heinze, J. E., Cook, S. H., Wood, E. P., Dumadag, A. C., & Zimmerman, M. A. (2018). Friendship Attachment Style Moderates the Effect of Adolescent Exposure to Violence on Emerging Adult Depression and Anxiety Trajectories. Journal of youth and adolescence, 47(1), 177–193. https://doi.org/10.1007/s10964-017-0729-x.
  27. Heleniak, C., Bolden, C. R., McCabe, C. J., Lambert, H. K., Rosen, M. L., King, K. M., Monahan, K. C., & McLaughlin, K. A. (2021). Distress Tolerance as a Mechanism Linking Violence Exposure to Problematic Alcohol use in Adolescence. Research on child and adolescent psychopathology, 49(9), 1211–1225. https://doi.org/10.1007/s10802-021-00805-0.
  28. Heleniak, C., King, K. M., Monahan, K. C., & McLaughlin, K. A. (2018). Disruptions in Emotion Regulation as a Mechanism Linking Community Violence Exposure to Adolescent Internalizing Problems. Journal of research on adolescence : the official journal of the Society for Research on Adolescence, 28(1), 229–244. https://doi.org/10.1111/jora.12328.
  29. Huang, Y., Bullock, A., Liu, J., Wang, Z., Xu, G., & Sang, B. (2022). Co-rumination with friends exacerbates association between peer victimization and adjustment in adolescence. Journal of Applied Developmental Psychology, 80, 101410.https://doi.org/10.1016/j.appdev.2022.101410.
  30. Hunt, C., Peters, L., & Rapee, R. M. (2012). Development of a measure of the experience of being bullied in youth. Psychological assessment, 24(1), 156-165. https://doi.org/10.1037/a0025178.
  31. Koele, I. J., Blankenstein, N. E., Schreuders, E., van Duijvenvoorde, A. C., & Güroğlu, B. (2023). Adolescents’ Friendship Quality, Internalizing Problems, and Academic Achievement during the COVID-19 Pandemic: A Longitudinal Study.https://doi.org/10.21203/rs.3.rs-2653418/v1.
  32. Lokot, M., Bhatia, A., Kenny, L., & Cislaghi, B. (2020). Corporal punishment, discipline and social norms: A systematic review in low- and middle-income countries. Aggression and Violent Behavior, 55, Article 101507. https://doi.org/10.1016/j.avb.2020.101507.
  33. Lv, H., & Li, H. (2023). Association between exposure to domestic violence during childhood and depressive symptoms in middle and older age: A longitudinal analysis in China. Behavioral Sciences, 13 (4), 311. https://doi.org/10.3390/bs13040311.
  34. Malaeb, D., Awad, E., Haddad, C., Salameh, P., Sacre, H., Akel, M., Soufia, M., Hallit, R., Obeid, S., & Hallit, S. (2020). Bullying victimization among Lebanese adolescents: The role of child abuse, Internet addiction, social phobia and depression and validation of the Illinois Bully Scale. BMC pediatrics, 20(1), 520. https://doi.org/10.1186/s12887-020-02413-1.
  35. Martin, A., Muñoz, J. M., Braza, P., Ruiz-Ortiz, R., Del Puerto-Golzarri, N., Pascual-Sagastizábal, E., Azurmendi, A., & Carreras, R. (2021). Parental Corporal Punishment and Peer Victimization in Middle Childhood: A Sex-Moderated Mediation Model of Aggression. Frontiers in Psychology, 11, 573329. https://doi.org/10.3389/fpsyg.2020.573329.
  36. Memba, G. V., & Ostrov, J. M. (2023). The role of peer victimization in predicting aggression and internalizing problems in early childhood: The moderating effect of emotion regulation and gender. Early Education and Development, 34(1), 53-70. https://doi.org/10.1080/10409289.2021.1997497.
  37. Mills-Koonce, W. R., Towe-Goodman, N., Swingler, M. M., & Willoughby, M. T. (2022). Profiles of family-based social experiences in the first 3 years predict early cognitive, behavioral, and socioemotional competencies. Developmental Psychology, 58(2), 297–310. https://doi.org/10.1037/dev0001287.
  38. Murray, J., Shenderovich, Y., Gardner, F., Mikton, C., Derzon, J. H., Liu, J., & Eisner, M. (2018). Risk factors for antisocial behavior in low- and middle-income countries: A systematic review of longitudinal studies. Crime and Justice, 47’, 255–364. https://doi.org/10.1086/696590
  39. Nakanishi, M., Yamasaki, S., Niimura, J., Endo, K., Nakajima, N., Stanyon, D., Baba, K., Oikawa, N., Hosozawa, M., Ando, S., Hiraiwa-Hasegawa, M., Kasai, K., & Nishida, A. (2022). Association between maternal perceived capacity in life and physical punishment of teenage children: a longitudinal analysis of a population-based cohort in Tokyo, Japan. BMJ open, 12(3), e058862. https://doi.org/10.1136/bmjopen-2021-058862.
  40. Neaverson, A., Murray, A. L., Ribeaud, D., & Eisner, M. (2022). Disrupting the link between corporal punishment exposure and adolescent aggression: The role of teacher-child relationships. Journal of Youth and Adolescence, 51(12), 2265–2280. https://doi.org/10.1007/s10964-022-01666-6.
  41. Ng, E. D., Chua, J. Y. X., & Shorey, S. (2022). The effectiveness of educational interventions on traditional bullying and cyberbullying among adolescents: A systematic review and meta-analysis. Trauma, Violence, & Abuse, 23(1), 132-151.https://doi.org/10.1177/1524838020933.
  42. Peng, Z., Klomek, A. B., Li, L., Su, X., Sillanmäki, L., Chudal, R., & Sourander, A. (2019). Associations between Chinese adolescents subjected to traditional and cyberbullying and suicidal ideation, self-harm, and suicide attempts. BMC Psychiatry, 19(1), 1-8. https://doi.org/10.1186/s12888-019-2319-9.
  43. Pengpid, S., & Peltzer, K. (2020). Prevalence and associated factors of psychological distress among a national sample of in-school adolescents in Morocco. BMC psychiatry, 20(1), 475. https://doi.org/10.1186/s12888-020-02888-3.
  44. Pittman, S. K., & Farrell, A. D. (2022). Patterns of community violence exposure among urban adolescents and their associations with adjustment. American Journal of Community Psychology, 70(3-4), 265–277. https://doi.org/10.1002/ajcp.12598.
  45. Pronk, J., Olthof, T., Aleva, E. A., van der Meulen, M., Vermande, M. M., & Goossens, F. A. (2020). Longitudinal associations between adolescents’ bullying-related indirect defending, outsider behavior, and peer-group status. Journal of research on adolescence, 30, 87-99. https://doi.org/10.1111/jora.12450.
  46. Rada, C. (2014). Violence against women by male partners and against children within the family: prevalence, associated factors, and intergenerational transmission in Romania:a cross-sectional study. BMC Public Health, 14(129). https://doi.org/10.1186/1471-2458-14-129
  47. Rohner, R. P., Kean, K. J., & Cournoyer, D. E. (1991). Effects of corporal punishment, perceived caretaker warmth, and cultural beliefs on the psychological adjustment of children in St. Kitts, West Indies. Journal of Marriage and the Family, 53(3), 681–693. https://doi.org/10.2307/352743
  48. Rothenberg, W. A., Bizzego, A., Esposito, G., Lansford, J. E., Al-Hassan, S. M., Bacchini, D., Bornstein, M. H., Chang, L., Deater-Deckard, K., Di Giunta, L., Dodge, K. A., Gurdal, S., Liu, Q., Long, Q., Oburu, P., Pastorelli, C., Skinner, A. T., Sorbring, E., Tapanya, S., Steinberg, L., Tirado, L. M. U., Yotanyamaneewong, S., & Alampay, L. P. (2023). Predicting adolescent mental health outcomes across cultures: A machine learning approach. Journal of Youth and Adolescence, 52 (8), 1595–1619. https://doi.org/10.1007/s10964-023-01767-w
  49. Sabramani, V., Idris, I. B., Ismail, H., Nadarajaw, T., Zakaria, E., & Kamaluddin, M. R. (2021). Bullying and Its Associated Individual, Peer, Family and School Factors: Evidence from Malaysian National Secondary School Students. International journal of environmental research and public health, 18(13), 7208. https://doi.org/10.3390/ijerph18137208.
  50. Samara, M., Burbidge, V., El Asam, A., Foody, M., Smith, P. K., & Morsi, H. (2017). Bullying and Cyberbullying: Their Legal Status and Use in Psychological Assessment. International journal of environmental research and public health, 14(12), 1449. https://doi.org/10.3390/ijerph14121449.
  51. Stewart-Tufescu, A. (2023). Corporal Punishment: The Global Picture. Canadian Journal of Children’s Rights Revue Canadienne Des Droits Des Enfants, 10(1). https://doi.org/10.22215/cjcr.v10i1.4373.
  52. Tang, W., Chen, M., Wang, N., Deng, R., Tang, H., Xu, W., & Xu, J. (2023). Bullying victimization and internalizing and externalizing problems in school-aged children: the mediating role of sleep disturbance and the moderating role of parental attachment. Child Abuse & Neglect, 138, https://doi.org/10.1016/j.chiabu.2023.106064.
  53. Tarafa, H., Alemayehu, Y., Bete, T., & Tarecha, D. (2022). Bullying victimization and its associated factors among adolescents in Illu Abba Bor Zone, Southwest Ethiopia: a cross-sectional study. BMC psychology, 10(1), 260. https://doi.org/10.1186/s40359-022-00967-6.
  54. Toseeb, U., & Wolke, D. (2022). Sibling Bullying: A Prospective Longitudinal Study of Associations with Positive and Negative Mental Health during Adolescence. Journal of youth and adolescence, 51(5), 940–955. https://doi.org/10.1007/s10964-021-01495-z.
  55. Totura, C. M. W., & MacKinnon-Lewis, C. (2011). Bullying in middle school: What does it look like, why does it happen, and who does it hurt? In M. Paludi (Ed.), The psychology of teen violence and victimization (vol. 1, pp. 105–125). Santa Barbara, CA: ABC-CLIO.
  56. Townsend, D., Taylor, L. K., Merrilees, C. E., Furey, A., Goeke-Morey, M. C., Shirlow, P., & Mark Cummings, E. (2020). Youth in Northern Ireland: Linking Violence Exposure, Emotional Insecurity, and the Political Macrosystem. Monographs of the Society for Research in Child Development, 85(4), 7–123. https://doi.org/10.1111/mono.12423.
  57. Tsuno K. (2022). Do personal resilience, coping styles, and social support prevent future psychological distress when experiencing workplace bullying? Evidence from a 1-year prospective study. BMC psychology, 10(1), 310. https://doi.org/10.1186/s40359-022-00991-6.
  58. Ttofi, M. M., Bowes, L., Farrington, D. P., & Lösel, F. (2014). Protective factors interrupting the continuity from school bullying to later internalizing and externalizing problems: A systematic review of prospective longitudinal studies. Journal of School Violence, 13(1), 5-38, DOI: 10.1080/15388220.2013.857345.
  59. Valente, J.Y., Ferreira-Junior, V., Paiva de Oliveira Galvão, P., de la Torre, A., & Sanchez, Z. M. (2024). Psychiatric symptoms as predictors of latent classes of bullying victimization and perpetration among early adolescents. Current Psychology, 43(1), 204-213. https://doi.org/10.1007/s12144-022-04146-z.
  60. Valles Jr, R. Q. (2007). How successful high school students cope with bullying: A qualitative study (Doctoral dissertation, University of Southern California).
  61. Wang, C., Yao, J., Patel, A., & Li, B. (2023). Can school climate or peer preference moderate the adjustment difficulties associated with peer victimization among Chinese middle school students?. School Psychology International, 44(1), 5-22. https://doi.org/10.1177/01430343221108345
  62. Xiong, Y., Wang, Y., Wang, Q., Wang, H., & Ren, P. (2023). Can lower levels of classroom victimization be harmful? Healthy context paradox among Chinese adolescents. Journal of interpersonal violence, 38(3-4), 2464-2484. https://doi.org/10.1177/08862605221102482.
  63. Zhang, Y., & Jia, X. (2023). When fate hands you lemons: A moderated moderation model of bullying victimization and psychological distress among Chinese adolescents during floods and the COVID-19 pandemic. Frontiers in psychology, 14, 1010408. https://doi.org/10.3389/fpsyg.2023.1010408.
  64. Zhang, Y., Xu, C., Dai, H., & Jia, X. (2021). Psychological Distress and Adolescents’ Cyberbullying under Floods and the COVID-19 Pandemic: Parent-Child Relationships and Negotiable Fate as Moderators. International journal of environmental research and public health, 18(23), 12279. https://doi.org/10.3390/ijerph182312279.
  65. Zheng, X., Chen, J., Yu, Q., Xiong, Q., Zhang, L., Li, C., & Shi, S. (2023). Associations between peer victimization and problematic internet use among adolescents: Humor makes a difference. Journal of Interpersonal Violence, 38(13-14), 7911-7940. https://doi.org/10.1177/08862605221150463.
PDF
HTML