Abstract 4142966: Bullying Behavior in Children with Congenital Heart Disease: Key Findings From The National Survey of Children’s Health

Background: Bullying can negatively impact children’s mental health and well-being. Research shows a higher prevalence of being bullied in those with chronic disease. Data on bullying behavior (being bullied as well as bullying others) in children with congenital heart disease (CHD) is limited. Research Question: Do children with CHD bully and get bullied more than those without? Methods: National Survey of Children’s Health (NSCH) 2022 data were utilized. Children aged 6-17 years were included. Three groups were created: bully, bullied by others, and not involved. Descriptive, univariate, and multivariable multinomial analyses were utilized. Results: A total of 32,984 children were included with 15,857(48%) female; 21,222(64%) Non-Hispanic White; and 803(2%) with CHD. Bullies were found to be 1,136(3%) and 3,566(11%) as being bullied. Children with CHD were more likely to bully(OR=1.53(95%CI:1.2-2.2), p<0.001) and be bullied(OR=1.66(95%CI:1.2-1.8), p<0.001) than those without. Autism, depression, anxiety, and developmental concerns were significantly associated with bullying and being bullied.(Table 1) In multivariable multinomial analysis, CHD was no longer significantly associated with bullying(aOR:0.92(95%CI:0.65-1.29),p=0.644) or being bullied(aOR:0.98(95%CI:0.80-1.24),p=0.983). Other factors including autism, depression, anxiety, and developmental concerns remained significantly associated with both bullying and being bullied.(Table 2) Conclusion: In a large national sample, CHD was not independently associated with bullying or being bullied. However, the presence of comorbidities common in CHD (e.g. developmental concerns) was significantly associated with bullying and being bullied. This suggests that CHD itself is not directly a significant factor, but its common comorbidities are. Additional work is needed to understand bullying and design interventions focused on comorbidities to effectively address and mitigate bullying in children with CHD.