Victimization
Conditions
Keywords
peer victimization, bullying, trauma
Brief summary
IVY (Intervention for Victimized Youth). Just as ivy plants are strong and can flourish in difficult environments, the goal of IVY will be for targets of peer victimization to thrive academically and socially despite challenging circumstances.
Detailed description
The project involves the development of a virtual intervention program for targets of peer victimization. Intervention for Victimized Youth (IVY) will improve upon many limitations of existing interventions described above since it is the first intervention program to specifically address the needs of targets of peer victimization from a trauma perspective. Moreover, it addresses key limitations of CBITS and increases the flexibility of the intervention by using a virtual delivery model. Just as ivy plants are strong and can flourish in difficult environments, the goal of IVY is for victimized youth to thrive academically and socially despite challenging circumstances. IVY uses a cognitive behavioral therapy (CBT) approach to address current distress due to peer victimization and teach strategies for handling any future peer victimization. Common elements of effective CBT-based trauma treatments are psychoeducation, emotion regulation skills, imaginal or in vivo exposure, cognitive processing, and/or problem solving. Several methods are used within sessions to teach the content, including psychoeducation, didactic teaching, modeling, role playing, and guided self-reflection. The proposed 8-week intervention. The focus of the first 4 sessions will be on teaching skills to help students overcome emotional difficulties associated with being victimized. Weekly topics include: 1) Introduction & Psychoeducation, 2) Emotional Regulation Skill Building and Practice, 3) Identifying & Coping with Difficult Thoughts and Emotions, and 4) Connecting Thoughts, Emotions, and Behaviors. The last 4 sessions are specific to peer victimization issues with a focus on avoiding re-victimization since victimized youth often are victimized repeatedly and report that they defend other victims. Weekly topics include: 5) Options for Protecting Yourself, 6) Social Problem-Solving Skills, 7) Adaptive Thinking, and 8) Future Planning & Celebration. Participants will be taught several options for intervening. A decision-making process for evaluating social situations will be taught. Based on the outcome of that decision-making process, participants will be taught options for responding with the goal of avoiding re-victimized.
Interventions
BEHAVIORALcounseling
The intervention (IVY; Intervention for Victimized Youth) is an 8 week group counseling intervention delivered in a virtual environment.
Sponsors
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Florida State University
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
We are using a waitlist control model where half of the participants will be randomly assigned to the treatment condition. When that intervention is completed, the treatment will be offered to the waitlist participants.
Eligibility
Sex/Gender
ALL
Age
11 Years to 14 Years
Healthy volunteers
No
Inclusion criteria
* current middle school student in US (defined as grades 6, 7, or 8) * experience at least one instance of peer victimization in past month * Have elevated or extremely elevated social-emotional distress score, as measured by the BESS (Behavior and Emotional Screening System)
Exclusion criteria
* not current middle school student * not experience victimization in past month * no elevated score on BESS
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Social-emotional Distress | Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit) | The Behavioral and Emotional Screening System is a 30 item measure. For each item, participants decide how often a statement is true for them and respond using a 4-point Likert scale (0=never to 3=always). Personal adjustment is measured by 8 items (possible mean scores ranging from 0 to 3) and internalizing problems is measured by 10 items (possible mean scores ranging from 0 to 3). Mean item scores are computed for personal adjustment and internalizing problems, respectively, at pretest (time 1) and posttest (time 2). For both subscales, higher scores indicate greater difficulties, i.e., worse adjustment and worse internalizing issues. |
| Change in Knowledge of Self-protection Skills | Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit) | The Knowledge of Self-Protection Options (KSPO) scale consists of 9 items assessing the degree to which participants have knowledge of how to protect themselves. Participants are asked If I am being bullied, I know how to... then rate each item on a 3 point scale ranging from 0 (No), 1 (A little bit), or 2 (Yes). Mean scores were calculated for each participant, which could range from 0 to 2, which higher scores representing greater knowledge of how to protect oneself. |
| Change in Self-efficacy for Protecting Self | Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit) | The Self-Efficacy for Protecting Self (SEPS) scale consists of 8 items with the stem of How do you rate your ability to engage in each action? Response options range from 1 (I can not do this well at all) to 4 (I can do this very well). Mean scores were calculated for each participant, which could range from 1 to 4, which higher scores representing greater efficacy in protecting oneself. |
| Change in Knowledge of Coping Skills | Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit) | Coping skills will be measured using the Brief COPE, which is a 28-item scale that assesses coping strategies. Items are rated on a scale from 1 (I haven't been doing this at all) to 4 (I've been doing this a lot). Avoidance coping is measured by 11 items and approach coping is measured by 12 items. Mean scores were calculated for each participant, which could range from 1 to 4, which higher scores representing greater knowledge of how to protect oneself. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Peer Victimization | Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit) | The victim subscale of the Bullying Participant Behavior Questionnaire will be used to assess traditional/in-person victimization. The scale consists of 10 items Participants respond ranging from 1 (never) to 5 (7 or more times) in the past 30 days. A mean score was calculated for each participant, which could range from 1 to 5 with higher scores representing more victimization. |
| Change in Cyber Victimization | Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit) | The victim subscale of the Cyber Bullying Participant Rating Scales will be used to assess cyber victimization. The scale consists of 11 items. The 6-point Likert scale (1 = not at all to 6 = many times a week) requires participants to rate how often they have been a victim. A mean score was calculated for each participant, which could range from 1 to 6 with higher scores representing more cyber victimization. |
| Change in Traumatic Stress Symptoms | Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit) | Child PTSD Symptom Screener-Self-Report Version for DSM-5 will be used to assess traumatic stress symptoms. The scale consists of 16 self-report items with item responses ranging from 0 (not at all) to 4 (6 or more times a week/almost always). A mean score was calculated for each participant, which could range from 0 to 4 with higher scores representing more traumatic stress. |
| Change in Social Support | Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit) | The Child and Adolescent Social Support Scale will be used to assess perceptions of social support. Only the peer support scale will be used. It consists of 12 items with response options ranging from 1 (never) to 6 (always). A mean score was calculated for each participant, which could range from 1 to 6 with higher scores representing more social support. |
Countries
United States
Participant flow
Recruitment details
We recruited participants from September 2024 to March 2025. We sent out recruitment information to schools to share with families, conducted targeted online recruitment, posted physical flyers, and used word of mouth snowball recruitment strategies.
Pre-assignment details
Parents initially completed an interest survey. Each response was evaluated to assess whether the child met the inclusion criteria and whether the response passed the validity checks to ensure it was not a bot. After passing these checks, a pre-survey was sent with a request for the child to complete assent and confirm they experienced at least one instance of bullying in the past month. After returning the second survey, they were randomly assigned to the treatment or control group.
Participants by arm
| Arm | Count |
|---|---|
| 8 Weeks of Group Counseling Delivered in Virtual Environment The treatment to be piloted is a 8 week virtual group counseling intervention with a focus on teaching participants skills to overcome emotional difficulties (Visit 1-4) and avoiding re-victimization (Visit 5-Visit 8).
counseling: The intervention (IVY; Intervention for Victimized Youth) is an 8 week group counseling intervention delivered in a virtual environment. | 22 |
| Control Group Participants in this arm do not receive the intervention at the same time as the treatment group. | 20 |
| Total | 42 |
Baseline characteristics
| Characteristic | Control Group | Total | 8 Weeks of Group Counseling Delivered in Virtual Environment |
|---|---|---|---|
| Age, Categorical <=18 years | 20 Participants | 42 Participants | 22 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 7 Participants | 7 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 20 Participants | 35 Participants | 15 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 2 Participants | 2 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 8 Participants | 14 Participants | 6 Participants |
| Race (NIH/OMB) More than one race | 2 Participants | 2 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 8 Participants | 24 Participants | 16 Participants |
| Region of Enrollment United States | 20 participants | 42 participants | 22 participants |
| Sex: Female, Male Female | 12 Participants | 17 Participants | 5 Participants |
| Sex: Female, Male Male | 8 Participants | 25 Participants | 17 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 22 | 0 / 20 |
| other Total, other adverse events | 0 / 22 | 0 / 20 |
| serious Total, serious adverse events | 0 / 22 | 0 / 20 |
Outcome results
Primary
Change in Knowledge of Coping Skills
Coping skills will be measured using the Brief COPE, which is a 28-item scale that assesses coping strategies. Items are rated on a scale from 1 (I haven't been doing this at all) to 4 (I've been doing this a lot). Avoidance coping is measured by 11 items and approach coping is measured by 12 items. Mean scores were calculated for each participant, which could range from 1 to 4, which higher scores representing greater knowledge of how to protect oneself.
Time frame: Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 8 weeks of group counseling delivered in virtual environment | Change in Knowledge of Coping Skills | Avoidance coping at time 1 | 2.00 mean item score on a scale | Standard Deviation 0.46 |
| 8 weeks of group counseling delivered in virtual environment | Change in Knowledge of Coping Skills | Avoidance coping at time 2 | 2.18 mean item score on a scale | Standard Deviation 0.41 |
| 8 weeks of group counseling delivered in virtual environment | Change in Knowledge of Coping Skills | Approach coping at time 1 | 2.44 mean item score on a scale | Standard Deviation 0.56 |
| 8 weeks of group counseling delivered in virtual environment | Change in Knowledge of Coping Skills | Approach coping at time 2 | 2.42 mean item score on a scale | Standard Deviation 0.58 |
| control group | Change in Knowledge of Coping Skills | Approach coping at time 2 | 2.86 mean item score on a scale | Standard Deviation 0.65 |
| control group | Change in Knowledge of Coping Skills | Avoidance coping at time 1 | 2.17 mean item score on a scale | Standard Deviation 0.45 |
| control group | Change in Knowledge of Coping Skills | Approach coping at time 1 | 2.56 mean item score on a scale | Standard Deviation 0.59 |
| control group | Change in Knowledge of Coping Skills | Avoidance coping at time 2 | 2.08 mean item score on a scale | Standard Deviation 0.52 |
Comparison: The outcome measure is avoidance copingp-value: 0.59995% CI: [-0.212, 0.367]ANOVA
Comparison: The outcome measure is approach copingp-value: 0.04495% CI: [0.152, 0.617]ANOVA
Primary
Change in Knowledge of Self-protection Skills
The Knowledge of Self-Protection Options (KSPO) scale consists of 9 items assessing the degree to which participants have knowledge of how to protect themselves. Participants are asked If I am being bullied, I know how to... then rate each item on a 3 point scale ranging from 0 (No), 1 (A little bit), or 2 (Yes). Mean scores were calculated for each participant, which could range from 0 to 2, which higher scores representing greater knowledge of how to protect oneself.
Time frame: Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 8 weeks of group counseling delivered in virtual environment | Change in Knowledge of Self-protection Skills | Knowledge of Self-Protection Options at Time 1 | 1.18 mean item score on a scale | Standard Deviation 0.39 |
| 8 weeks of group counseling delivered in virtual environment | Change in Knowledge of Self-protection Skills | Knowledge of Self-Protection Options at Time 2 | 1.59 mean item score on a scale | Standard Deviation 0.4 |
| control group | Change in Knowledge of Self-protection Skills | Knowledge of Self-Protection Options at Time 1 | 1.16 mean item score on a scale | Standard Deviation 0.41 |
| control group | Change in Knowledge of Self-protection Skills | Knowledge of Self-Protection Options at Time 2 | 1.24 mean item score on a scale | Standard Deviation 0.37 |
p-value: <0.0195% CI: [0.112, 0.539]ANOVA
Primary
Change in Self-efficacy for Protecting Self
The Self-Efficacy for Protecting Self (SEPS) scale consists of 8 items with the stem of How do you rate your ability to engage in each action? Response options range from 1 (I can not do this well at all) to 4 (I can do this very well). Mean scores were calculated for each participant, which could range from 1 to 4, which higher scores representing greater efficacy in protecting oneself.
Time frame: Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit)
Population: For this measure, two participants selected the same response option for every item on the scale (e.g., selected 1 for every question, even validity items). We questioned the validity of their responses so we removed those two participants from the analysis for this outcome variable.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 8 weeks of group counseling delivered in virtual environment | Change in Self-efficacy for Protecting Self | Self-Efficacy for Protecting Self at Time 1 | 4.52 mean item score on a scale | Standard Deviation 1.27 |
| 8 weeks of group counseling delivered in virtual environment | Change in Self-efficacy for Protecting Self | Self-Efficacy for Protecting Self at Time 2 | 4.19 mean item score on a scale | Standard Deviation 1.26 |
| control group | Change in Self-efficacy for Protecting Self | Self-Efficacy for Protecting Self at Time 1 | 4.14 mean item score on a scale | Standard Deviation 1.23 |
| control group | Change in Self-efficacy for Protecting Self | Self-Efficacy for Protecting Self at Time 2 | 5.19 mean item score on a scale | Standard Deviation 1.62 |
p-value: 0.1195% CI: [-0.187, 1.549]ANOVA
Primary
Change in Social-emotional Distress
The Behavioral and Emotional Screening System is a 30 item measure. For each item, participants decide how often a statement is true for them and respond using a 4-point Likert scale (0=never to 3=always). Personal adjustment is measured by 8 items (possible mean scores ranging from 0 to 3) and internalizing problems is measured by 10 items (possible mean scores ranging from 0 to 3). Mean item scores are computed for personal adjustment and internalizing problems, respectively, at pretest (time 1) and posttest (time 2). For both subscales, higher scores indicate greater difficulties, i.e., worse adjustment and worse internalizing issues.
Time frame: Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 8 weeks of group counseling delivered in virtual environment | Change in Social-emotional Distress | Personal adjustment at time 2 | 0.97 mean item score on a scale | Standard Deviation 0.61 |
| 8 weeks of group counseling delivered in virtual environment | Change in Social-emotional Distress | Internalizing Problems at time 2 | 1.28 mean item score on a scale | Standard Deviation 0.55 |
| 8 weeks of group counseling delivered in virtual environment | Change in Social-emotional Distress | Internalizing Problems at time 1 | 1.16 mean item score on a scale | Standard Deviation 0.67 |
| 8 weeks of group counseling delivered in virtual environment | Change in Social-emotional Distress | Personal adjustment at time 1 | 1.09 mean item score on a scale | Standard Deviation 0.53 |
| control group | Change in Social-emotional Distress | Internalizing Problems at time 1 | 1.31 mean item score on a scale | Standard Deviation 0.56 |
| control group | Change in Social-emotional Distress | Personal adjustment at time 2 | 1.00 mean item score on a scale | Standard Deviation 0.61 |
| control group | Change in Social-emotional Distress | Personal adjustment at time 1 | 1.07 mean item score on a scale | Standard Deviation 0.55 |
| control group | Change in Social-emotional Distress | Internalizing Problems at time 2 | 1.24 mean item score on a scale | Standard Deviation 0.61 |
Comparison: The outcome measure is personal adjustmentp-value: 0.64695% CI: [-0.296, 0.184]ANOVA
Comparison: The outcome measure is internalizing problemsp-value: 0.19695% CI: [-0.096, 0.473]ANOVA
Secondary
Change in Cyber Victimization
The victim subscale of the Cyber Bullying Participant Rating Scales will be used to assess cyber victimization. The scale consists of 11 items. The 6-point Likert scale (1 = not at all to 6 = many times a week) requires participants to rate how often they have been a victim. A mean score was calculated for each participant, which could range from 1 to 6 with higher scores representing more cyber victimization.
Time frame: Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 8 weeks of group counseling delivered in virtual environment | Change in Cyber Victimization | Cyber victimization at time 1 | 1.47 mean item score on a scale | Standard Deviation 0.68 |
| 8 weeks of group counseling delivered in virtual environment | Change in Cyber Victimization | Cyber victimization at time 2 | 2.18 mean item score on a scale | Standard Deviation 1.06 |
| control group | Change in Cyber Victimization | Cyber victimization at time 1 | 1.39 mean item score on a scale | Standard Deviation 0.66 |
| control group | Change in Cyber Victimization | Cyber victimization at time 2 | 1.67 mean item score on a scale | Standard Deviation 0.82 |
p-value: 0.049895% CI: [-1.178, -0.0005]ANOVA
Secondary
Change in Peer Victimization
The victim subscale of the Bullying Participant Behavior Questionnaire will be used to assess traditional/in-person victimization. The scale consists of 10 items Participants respond ranging from 1 (never) to 5 (7 or more times) in the past 30 days. A mean score was calculated for each participant, which could range from 1 to 5 with higher scores representing more victimization.
Time frame: Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 8 weeks of group counseling delivered in virtual environment | Change in Peer Victimization | Peer victimization at time 1 | 2.60 mean item score on a scale | Standard Deviation 1.22 |
| 8 weeks of group counseling delivered in virtual environment | Change in Peer Victimization | Peer victimization at time 2 | 2.55 mean item score on a scale | Standard Deviation 1.11 |
| control group | Change in Peer Victimization | Peer victimization at time 1 | 2.69 mean item score on a scale | Standard Deviation 1.1 |
| control group | Change in Peer Victimization | Peer victimization at time 2 | 1.63 mean item score on a scale | Standard Deviation 0.83 |
p-value: <0.0195% CI: [0.284, 1.764]ANOVA
Secondary
Change in Social Support
The Child and Adolescent Social Support Scale will be used to assess perceptions of social support. Only the peer support scale will be used. It consists of 12 items with response options ranging from 1 (never) to 6 (always). A mean score was calculated for each participant, which could range from 1 to 6 with higher scores representing more social support.
Time frame: Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit)
Population: Due to an error in the online survey, some participants did not complete the full social support scale, therefore there was missing data on this outcome variable. Participants who did not respond to at least 50% of the items were excluded from analysis.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 8 weeks of group counseling delivered in virtual environment | Change in Social Support | Peer support at time 2 | 4.02 mean item score on a scale | Standard Deviation 0.89 |
| 8 weeks of group counseling delivered in virtual environment | Change in Social Support | Peer support at time 1 | 3.96 mean item score on a scale | Standard Deviation 1.1 |
| control group | Change in Social Support | Peer support at time 2 | 4.15 mean item score on a scale | Standard Deviation 1.2 |
| control group | Change in Social Support | Peer support at time 1 | 4.05 mean item score on a scale | Standard Deviation 1.15 |
p-value: 0.92795% CI: [-0.612, 0.551]ANOVA
Secondary
Change in Traumatic Stress Symptoms
Child PTSD Symptom Screener-Self-Report Version for DSM-5 will be used to assess traumatic stress symptoms. The scale consists of 16 self-report items with item responses ranging from 0 (not at all) to 4 (6 or more times a week/almost always). A mean score was calculated for each participant, which could range from 0 to 4 with higher scores representing more traumatic stress.
Time frame: Visit 1 (baseline); Visit 8 (8 weeks after baseline at the termination visit)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| 8 weeks of group counseling delivered in virtual environment | Change in Traumatic Stress Symptoms | Traumatic stress at time 1 | 2.11 mean item score on a scale | Standard Deviation 0.68 |
| 8 weeks of group counseling delivered in virtual environment | Change in Traumatic Stress Symptoms | Traumatic stress at time 2 | 2.15 mean item score on a scale | Standard Deviation 0.73 |
| control group | Change in Traumatic Stress Symptoms | Traumatic stress at time 1 | 2.31 mean item score on a scale | Standard Deviation 0.74 |
| control group | Change in Traumatic Stress Symptoms | Traumatic stress at time 2 | 2.22 mean item score on a scale | Standard Deviation 0.56 |
p-value: 0.18295% CI: [-0.127, 0.65]ANOVA