Background Internationally as well as nationally there is a strong call to anchor health promotion in schools, not only but especially in connection with the growing rate of psychological problems during the coronavirus disease 2019 (COVID-19) pandemic. In recent years the promotion of mental health literacy has received increasing attention as a possible approach. Objective What evidence is there for promoting mental health literacy in adolescents in the school setting and how is it practically implemented in Germany? Method Literature review, search in databases on programs to promote mental health literacy in a school setting (lower secondary level). Results The promotion of mental health literacy appears to be a promising approach, especially when implemented in the school context. Initial programs exist and meta-analyses point to significant effect sizes in the lower and middle range; however, there is a need for further research (e.g. with respect to distal endpoints) and there are difficulties in the practical implementation. Conclusion A theory-based and evidence-based implementation has the potential to sensitize schools to this important topic and motivate them to take further steps in health promotion. Consideration of barriers specific to the German school system appears to be decisive for a successful implementation.

International und national wird der Ruf laut, Gesundheitsförderung in Schulen zu verankern, nicht erst, aber insbesondere im Zusammenhang mit dem Anstieg der Rate psychischer Auffälligkeiten seit dem Beginn der „coronavirus disease 2019“(COVID-19)-Pandemie. Die Förderung mentaler Gesundheitskompetenz (mGeKo) erfährt in den vergangenen Jahren als möglicher Ansatzpunkt zunehmende Aufmerksamkeit. Welche Evidenzen gibt es für die Förderung der mGeKo im Jugendalter im schulischen Setting, und wie gestaltet sich die praktische Umsetzung in Deutschland? Literaturübersicht, Recherche in Datenbanken zu Programmen zur Förderung der mGeKo im schulischen Kontext (Sekundarstufe I). Die Förderung der mGeKo erscheint, gerade bei einer Implementierung im Schulkontext, als ein vielversprechender Ansatz: Erste Programme existieren, Metaanalysen weisen auf signifikante Effektstärken im unteren bis mittleren Bereich hin. Es bestehen jedoch ein weiterer Forschungsbedarf (z. B. hinsichtlich distaler Endpunkte) und Schwierigkeiten bei der Umsetzung in die Praxis. Durch eine theorie- und evidenzbasierte Umsetzung kann Schule als Lern- und Lebensort für das wichtige Thema psychische Gesundheit sensibilisiert und für unterstützende Maßnahmen motiviert werden; eine Berücksichtigung der Hürden im deutschen Schulsystem erscheint für eine erfolgreiche Umsetzung maßgeblich.

Research has shown a direct path between peer victimization and poor mental health outcomes. However, the impact of bullying prevention on mental health is a largely unexplored field. Therefore, our study examined the longitudinal association between bullying development and trajectories of psychiatric symptoms (emotional problems, total difficulties, nonsuicidal self-injury, and suicidality) and health-related quality of life (HRQL) during the implementation of school-based bullying prevention. Data of 4,873 pupils (grades 5–13) were collected in 23 schools implementing the Olweus Bullying Prevention Program (OBPP) . Self-report questionnaires were administered at three annual assessment waves and individual codes enabled the association of repeated assessments to the same pupil. Latent growth curve models (LGCMs) were used to examine the relation among bullying status and mental health outcome with mixed-effects linear regressions estimating the association of changes in bullying with changes in continuous scores and mixed-effects logistic regressions for categorical variables. Latent growth curve models revealed an improvement of mental health and HRQL through the termination of bullying for every outcome variable of interest (all p < .001). Correspondingly, we found an explicit increase in psychopathology as well as decrease in HRQL within one year as a result of developing victimization (all p < .001). Interestingly, the growth of psychopathology associated with the onset of bullying was significantly steeper than its decline associated with the termination of bullying. The postulated cumulative effect of ongoing bullying for a further year could only be shown for HRQL ( p = .025) and total difficulties ( p = .034), but not for specific mental health problems (all p > .117). Latent growth curve models clearly showed that the adverse psychosocial consequences of bullying arise quickly but seem to reduce much slower and partly persist over time. Future long-term studies are necessary to clarify if mental health problems will return to baseline after several years or if residual symptoms will remain.

Introduction: The aim of this study was to examine whether (a) cyberbullying has unique associations with mental health problems, risk-taking, and self-harm behavior in victims and perpetrators when compared to school bullying and (b) if cyberbullying is associated with an additional burden for students already involved in school bullying. Methods: Data were collected from 6,561 students across 23 schools in Germany (grades 5–13). The sample was divided into the following four groups: cyber-only involvement (victims = 1.9%, perpetrators = 0.6%), school-only involvement (victims = 17.2%, perpetrators = 11.9%), dual involvement (victims = 5.7%, perpetrators = 2.9%), and noninvolvement (victims = 75.3%, perpetrators = 84.6%). Multilevel mixed-effects regression analysis was conducted to examine group differences in mental health (Strengths and Difficulties Questionnaire, KIDSCREEN-10), risk-taking, and self-harm behavior (e.g., substance use, suicide attempts). Results: Cyber-only bullying had unique associations with mental health problems and risk-taking behavior in victims (lower levels of peer relationship problems: p < 0.001, greater substance use: p < 0.05) and perpetrators (higher levels of peer relationship problems: p < 0.05) when compared to school-only bullying. Dual victims and perpetrators reported significantly more mental health problems (victims: χ2(5) = 221.58, p < 0.001; perpetrators: χ2(5) = 116.40, p < 0.001) and were more likely to report risk-taking and self-harm behavior (victims: χ2(7) = 115.15, p < 0.001; perpetrators: χ2(7) = 38.79, p < 0.001) than students involved in school-only bullying. Conclusion: Cyber-only bullying appears to be related to specific mental health issues beyond those associated with school-only bullying. Cyberbullying and school bullying go along with additive mental health problems, risk-taking, and self-harm behavior in both victims and perpetrators. Thus, bullying prevention and intervention programs should also target cyberbullying.

BACKGROUND Research has shown a direct path between peer victimization and poor mental health outcomes. However, the impact of bullying prevention on mental health is a largely unexplored field. Therefore, our study examined the longitudinal association between bullying development and trajectories of psychiatric symptoms (emotional problems, total difficulties, nonsuicidal self-injury, and suicidality) and health-related quality of life (HRQL) during the implementation of school-based bullying prevention. METHODS Data of 4,873 pupils (grades 5-13) were collected in 23 schools implementing the Olweus Bullying Prevention Program (OBPP). Self-report questionnaires were administered at three annual assessment waves and individual codes enabled the association of repeated assessments to the same pupil. Latent growth curve models (LGCMs) were used to examine the relation among bullying status and mental health outcome with mixed-effects linear regressions estimating the association of changes in bullying with changes in continuous scores and mixed-effects logistic regressions for categorical variables. RESULTS Latent growth curve models revealed an improvement of mental health and HRQL through the termination of bullying for every outcome variable of interest (all p < .001). Correspondingly, we found an explicit increase in psychopathology as well as decrease in HRQL within one year as a result of developing victimization (all p < .001). Interestingly, the growth of psychopathology associated with the onset of bullying was significantly steeper than its decline associated with the termination of bullying. The postulated cumulative effect of ongoing bullying for a further year could only be shown for HRQL (p = .025) and total difficulties (p = .034), but not for specific mental health problems (all p > .117). CONCLUSIONS Latent growth curve models clearly showed that the adverse psychosocial consequences of bullying arise quickly but seem to reduce much slower and partly persist over time. Future long-term studies are necessary to clarify if mental health problems will return to baseline after several years or if residual symptoms will remain.

Bullying is a common and significant risk factor for mental and physical health problems. The aim of the outlined study was to evaluate the German version of the Olweus Bullying Prevention Program (OBPP) and to investigate potential moderators of its effectiveness. 23 schools started with the implementation and all students were invited to complete the Olweus Bullying Questionnaire annually. For our analyses, the data from grades 5 to 9 were used (t0: n = 5759; t1: n = 5416; t2: n = 4894). 16 out of the 23 schools completed the 18-months implementation period. The effectiveness of the program statistically depended on its complete implementation (χ2(2) = 7.62, p = 0.022). In the group of non-completers, the prevalence of victimization did not change during the observation period of 2 years (χ2(2) = 4.64, p = 0.099). In the group of the completer schools, a significant decrease in bullying between t0 and t1 was found for victims (t0: 9.14%; t1: 6.87%; OR = 0.74; 95% CI 0.62–0.88; p = 0.001) and perpetrators (t0: 6.16%; t1: 4.42%; OR = 0.70; 95% CI 0.55–0.89; p = 0.004). After 24 months (t2), this decrease could be retained (victims: t2: 6.83%; OR = 0.73; 95%CI = 0.61–0.88; p = 0.001; perpetrators: t2: 4.63%; OR = 0.72; 95% CI 0.57–0.92; p = 0.009). Furthermore, we found the following moderators of program effectiveness in the completer schools: (1) gender (with a stronger decrease among victimized girls; p = 0.004) and (2) school grade (with a stronger decrease of victimization among grades 5–7; p = 0.028). The German version of the OBPP significantly reduced the bullying prevalence in the completer schools. Effective prevention needs time and resources: fulfilling the 18-months implementation period was the basis for positive results.

PURPOSE:Self-injurious behavior is a frequent phenomenon in adolescence. The present study prospectively examined life events as risk factors for the first onset of direct self-injurious behavior (D-SIB) in the Saving and Empowering Young Lives in Europe school-based multicenter sample. METHODS:Longitudinal assessments with an interval of 1 year were performed within a sample of 1,933 adolescents (51.47% females; mean age 14.84 ± .9 years) from 10 European countries and Israel. RESULTS:The number of life events during the past 6 months predicted the first onset of D-SIB in the following year. Gender neither predicted the onset of D-SIB nor moderated the association with life events. Moreover, analyses of individual events identified a range of mainly interpersonal events within both family and peer group as proximal risk factors for first episode D-SIB. CONCLUSIONS:The results support the critical role of interpersonal life events in the development of D-SIB for both genders and refine the conceptualization of proximal risk factors in terms of accumulated stressors and interpersonal events.

Cluster-randomized, controlled evaluation of stress management training for high school students Abstract. OBJECTIVE One fifth of German adolescents show elevated levels of mental health problems. The development of mental health problems is often closely related to experiences of stress. Hence, fostering competences in coping with stress offers an approach for counteracting the development of psychological problems. The aim of the present study is to test a stress management training of 3 x 90 minutes in a German high school, 11th grade. METHOD A cluster-randomized, controlled design was used. The primary outcome was stress. Secondary outcome criteria were knowledge about stress, coping behaviour, emotional and behavioural problems as well as health-related quality of life. Students from twenty-one courses from four schools participated in the study. RESULTS The sample comprised 286 students (58.25 % girls; mean age 16.58 ± 0.65). Changes in stress levels from pre- to post-evaluation did not differ significantly between intervention and control group. With regard to secondary criteria, apart from a significant increase in knowledge no further effects were observed. An exploratory moderation analysis hints at a positive association between baseline levels of stress and effectiveness of the training. CONCLUSIONS The results question whether the universal application of a brief cognitive behavioural intervention is appropriate to prevent stress in this population. Future research should, inter alia, investigate the potential of indicated prevention regarding stress.

Zusammenfassung. Fragestellung: Ein Fünftel aller Kinder und Jugendlichen in Deutschland ist von psychischen Auffälligkeiten betroffen, welche mit Beeinträchtigungen von Lebenszufriedenheit und Funktionsniveau einhergehen. Die Entstehung psychischer Probleme steht oft in unmittelbarem Zusammenhang mit hohem Stresserleben. Um der Entwicklung psychischer Symptomkonstellationen entgegenzuwirken, scheint es daher vielversprechend, Kompetenzen zur Stressbewältigung (Coping) zu vermitteln. Ziel der vorliegenden Studie ist die Evaluation eines 3 x 90-minütigen Stressbewältigungs-Trainings für die gymnasiale Oberstufe, Klasse 11. Methodik: In einer clusterrandomisierten kontrollierten Untersuchung wurde geprüft, ob das Präventionsprogramm zu einer Reduktion des Stresserlebens führt. Nebenzielkriterien waren Wissen über Stress und Coping, Copingstrategien, emotionale und Verhaltensauffälligkeiten sowie die gesundheitsbezogene Lebensqualität. 21 Kurse von vier Schulen wurden in die Studie eingeschlossen. Ergebnisse: Die Stichprobe umfasste 286 Jugendliche (58.25 % Mädchen; mittleres Alter 16.58 ± 0.65 Jahre). Die Veränderung des Stresserlebens zwischen Prä- und Post-Erhebung unterschied sich nicht signifikant zwischen der Interventions- und der Kontrollgruppe. Im Bereich der Nebenzielkriterien zeigte sich ein signifikanter Wissenszuwachs, jedoch keine weiteren Effekte. Eine explorative Moderatoranalyse lässt einen positiven Zusammenhang zwischen Höhe der Stressbelastung und Trainingswirksamkeit erkennen. Schlussfolgerungen: Die Erkenntnisse stellen infrage, ob die universelle Prävention von Stress für die Zielgruppe geeignet ist. Künftige Studien sollten u. a. auch das Potenzial indizierter Programme in Bezug auf Stress untersuchen.

This research tests a mediator-model of stress, coping and emotional/behavioral problems. The sample comprises 350 adolescents in the penultimate year of high school. Higher levels of overall stress as well as those related to school and future, the most problematic domains, were associated with more emotional/behavioral problems. The association was partially mediated through withdrawal. The proportion of the indirect effect was higher in the school-specific compared to the future-related or overall model. Future research on successful transitions from school should focus on stress, particularly with school and future, and pay attention to specifics of withdrawal in each context.