• Mei-Ni Hsiao, Yueh-Ming Tai, Yu-Yu Wu, Wen-Che Tsai, Yen-Nan Chiu, and Susan Shur-Fen Gau.
• Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
• J Formos Med Assoc. 2022 Sep 1; 121 (9): 1739-1747.

Background/PurposeYouths with autism spectrum disorder (ASD) are at a high risk of involvement in school bully. The study investigated whether comorbid psychopathologies mediated the link between ASD and bullying involvement.MethodsWe assessed 353 youths (mean age, 11.8 ± 3.1 years), including 121 youths with ASD and 232 typically developing (TD) controls, using semi-structured diagnostic interviews on ASD and other psychiatric conditions. Follow-up assessments took place 2-5 years (37.6 ± 15 months) later. Meanwhile, their parents reported on the Social Adjustment Inventory for Children and Adolescents about bullying involvement statuses. We identified significant mediators by simple mediation models, followed by multiple mediation models to scrutinize the mediation effects of selected mediators.ResultsThe results showed a sevenfold increased risk of bullying involvement among youths with ASD compared with TD controls at follow-up. In general, psychopathologies mediated the link between ASD and bullying involvement, even independent of age and sex. Specifically, we found mediating effects of social problems on victimization-only and aggressive behaviors on victimization-perpetration.ConclusionOur findings strongly suggest the link between ASD and later bullying involvement is mediated by pre-existing comorbid psychiatric conditions, besides the direct effect of ASD on bullying victimization. Hence, early identification and intervention of these psychopathologies are highly suggested.Copyright © 2022 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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