• Tai-Ling Liu, Peng-Wei Wang, Ray C Hsiao, Hsing-Chang Ni, Sophie Hsin-Yi Liang, Chiao-Fan Lin, Hsiang-Lin Chan, Yi-Hsuan Hsieh, Liang-Jen Wang, Min-Jing Lee, Wen-Jiun Chou, and Cheng-Fang Yen.
• Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan. Electronic address: dai32155@gmail.com.
• J Formos Med Assoc. 2022 Nov 1; 121 (11): 2161-2171.

Background/PurposeThis study examined the prevalence and related factors of multiple (two or three) types of harassment victimization, including school bullying, cyberbullying, and teacher harassment, and their cumulative effects on depression, anxiety, self-esteem, and suicidality in adolescents with autism spectrum disorder (ASD) but without intellectual disability.MethodsA total of 219 adolescents with ASD but without intellectual disability and their parents participated in this study. Their experiences of school bullying, cyberbullying, and teacher harassment were evaluated. The related factors of multiple types of harassment victimization, including demographic characteristics, socio-communicative skills, comorbid attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) symptoms, were examined. Moreover, the effects of multiple types of harassment victimization on depression, anxiety, self-esteem, and suicidality were examined.ResultsIn total, 20.54% of participants were victims of multiple types of harassment. Hyperactivity or impulsivity and ODD symptoms were positively associated with multiple types of harassment victimization. Adolescents with ASD who experienced multiple types of harassment victimization had higher severities of depression and anxiety and were more likely to have suicidality than nonvictims and those who experienced only one type of harassment victimization.ConclusionExperiencing more than one type of harassment victimization was significantly associated with the development of mental health problems in adolescents with ASD. ODD and hyperactivity/impulsivity symptoms predicted the risk of experiencing multiple types of harassment.Copyright © 2022 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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