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Application Assignment 1

Ryan McClain

Mansfield University

PSY 2206: Research Methods 1

Dr. Karri Verno

September 17, 2021

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Application Assignment 1

Antila, H., Arola, R., Hakko, H., Riala, K., Riipinen, P., & Kantojärvi, L. (2017). Bullying

involvement in relation to personality disorders: a prospective follow-up of 508 inpatient

adolescents. European Child & Adolescent Psychiatry, 26(7), 779–789.

https://doi.org/10.1007/s00787-017-0946-6

Establishing the Research Context

 Who conducted the research? What were/ are their interests?

o 3 Researchers from Research The Unit of Clinical Neuroscience’s Department of

Psychiatry, at the University of Oulu, in Oulu, Finland (Henna Antila, Riikka

Arola, Pirkko Riipinen), 2 researchers from the Department of Psychiatry, at

Oulu University Hospital, in Oulu Finland (Helinä Hakko, Liisa Kantojärvi), and

1 researcher from the Helsinki University Hospital Department of Psychiatry, in

Helsinki, Finland (Kaisa Riala). Antila Henna is a general practioner who cares

for people dealing with a medical emergency. Rikka Arola was interested in

studying psychiatry. Pirkko Rippinen is interested in studying adolescent

psychiatry as it pertains to substance abuse and violent/ antisocial behavior.

Helinä Hakko is a “Biostatistician” at Oulu University Hospital, in Oulu Finland,

with the Department of Psychiatry, Helina study’s adolescent psychiatry and how

different environmental and biological issues pertaining to adolescent psychiatry

may extend into adulthood. Liisa Kantojarvi is a psychiatrist at the University of

Oulu, her area of interest is in personality disorder presentations in young

adulthood. Kasia Riala is a Chief physician Helsinki University Central Hospital

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in Helsinki Finland with the Psychiatry Department, her area of interest is

Adolescent mental health.

 When and where was this research conducted?

o The research was conducted between April of 2001 and March 2006, with a

follow up of data on the participants psychiatric diagnoses in 2013. The study

consisted of 508 adolescents between the ages of 13-17 in Finland.

 Why did they do this research?

o To study the correlation of personality disorder development in adulthood and

bullying in childhood and adolescence. At the time of the study, very little data

exhisted on the correlation. Most data involving PD development at the time held

regard to childhood abuse and neglect. This research cites 4 earlier studies

regarding childhood trauma and PD development (Tomko RL, Trull TJ, Wood

PK, Sher KJ (2014) Characteristics of borderline personality disorder in a

community sample: comorbidity, treatment utilization, and general

functioning JPers Disord 28:734–750. doi:10.1521/pedi_2012_26_093)

(Silverman MH, Frankenburg FR, Reich DB, Fitzmaurice G, Zanarini MC

(2012) The course of anxiety disorders other than PTSD in patients with

borderline personality disorder and Axis II comparison subjects: a 10-year

follow-up study. J Pers Disord 26:804–814. doi:10.1521/pedi.2012.26.5.804)

(Baldry AC, Farrington DP (1999) Brief report: types of bullying among Italian

school children. J Adolesc 22:423–426) (Bandelow B, Krause J, Wedekind D,

Broocks A, Hajak G, Rüther E (2005) Early traumatic life events, parental

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attitudes, family history, and birth risk factors in patients with borderline

personality disorder and healthy controls. Psychiatry Res 134:169–179)

 Was this research pertinent only within the authors’ geographic locale, or did it

have broader revelance?

o The research specifically pertained to Finland. However, it could be used to

explain the sudden rise of Borderline Personality Disorder in young females. The

research did conclude that “being a victim of bullying during childhood and

adolescence increases the risk of subsequent PDs by nearly fourfold among

females.” (Antila, H., Arola, R., Hakko, H., Riala, K., Riipinen, P., & Kantojärvi,

L. (2017). Bullying involvement in relation to personality disorders: a prospective

follow-up of 508 inpatient adolescents. European Child & Adolescent Psychiatry,

26(7), 779–789.) Same study states that “In our study, the vast majority of

females with PD had borderline PD.” (Antila, H., Arola, R., Hakko, H., Riala, K.,

Riipinen, P., & Kantojärvi, L. (2017). Bullying involvement in relation to

personality disorders: a prospective follow-up of 508 inpatient adolescents.

European Child & Adolescent Psychiatry, 26(7), 779–789.)

 On what prior observations was the research based? What was known and not

known at the time?

o As stated earlier, the data available to the researchers at the time mostly involved

childhood trauma. The study does discuss early data involving being a perpetrator

of bullying and developing Antisocial Personality as well as some association

with bullying victimization with Borderline PD, but there were no studies

showing any gender specific correlations as this study displays

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 How important was the research question posed by the researcher?

o Incredibly Important. There is still very little work done on personality disorders

even today due to heavy stigma surrounding PD’s, especially cluster B PD’s.

People with Cluster B are often seen as “abusive” and people who should be

avoided and any research done show’s that individuals with personality disorders

did not ask to have a PD.

Evaluating the Text

Introduction

 Read the statement of purpose at the end of the introduction. What was the

objective of the study? Provide a direct quote and then paraphrase it to show your

understanding of it

o “We examined the association of bullying behavior in adolescence to personality

disorder (PD) diagnosed in early adulthood.” (Antila, H., Arola, R., Hakko, H.,

Riala, K., Riipinen, P., & Kantojärvi, L. (2017). Bullying involvement in relation

to personality disorders: a prospective follow-up of 508 inpatient adolescents.

European Child & Adolescent Psychiatry, 26(7), 779–789.

https://doi.org/10.1007/s00787-017-0946-6)

o The authors evaluated adolescent psych patients with a history of severe bullying

into adulthood to determine the effect of bullying on the development of

personality disorders into Adulthood.

 Consider the title. Does it precisely state the subject of the paper?

o Yes. The paper lists the independent variable (bullying), the dependent Variable

(personality disorders), and their relationship with each-other.

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 Check the sequence of statements in the introduction. Does all the information lead

coherently to the purpose of the study? Does it follow the “funnel” design (broad in

the beginning, then further narrows down)?

o Yes, the study is very coherent. The study does great in finding a sample size.

The study also does a good job in excluding members of the sample for having

“outside factors” (ex. Excluding those with a schizophrenia diagnosis or those

under the age of 16). Eventually the study was left with just 57 participants out of

the original 637 adolescents. They discuss Covariates and Socio-demographic

variables including “gender (male/female), age at index hospitalization, family

type (two biological parents, one biological parent, child welfare placement,

other). Family and school-related factors included: repeating a year at school

(yes/no), special services at school (yes/no), close relationships with friends

(yes/no) and mother or father unemployed (yes/no).” (Antila, H., Arola, R.,

Hakko, H., Riala, K., Riipinen, P., & Kantojärvi, L. (2017). Bullying

involvement in relation to personality disorders: a prospective follow-up of 508

inpatient adolescents. European Child & Adolescent Psychiatry, 26(7), 779–789.

https://doi.org/10.1007/s00787-017-0946-6) Finally, the study suggests that at the

time of conduction, there wasn’t much gender specific data on the development

of PD’s as presented in this study, filling a void in gender specific PD

development in regards to childhood bullying.

 At the end of the introduction, you usually can find the author’s hypotheses. List at

least one but no more than three of them. You can directly quote them, but make

sure you have a proper in-text citation for it.

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o “The aim of the present study is to examine whether bullying involvement in

adolescence (either as a perpetrator or victim of bullying) is associated with PDs

diagnosed in early adulthood (under the age of 30).” (Antila, H., Arola, R.,

Hakko, H., Riala, K., Riipinen, P., & Kantojärvi, L et al. p.780)

Method

 Review all methods in relation to the objective(s) of the study. Are the

methods valid for studying the problem?

o Yes, the methods are valid. They gathered a sample size of 508

adolescents and followed the adolescents from April 2001 – March 2006.

The method is clear

 Check the methods for essential information. Could the study be duplicated

from the methods and information given?

o Yes, the study could be duplicated and repeated if the same data is secured

by another party

 Check the methods for flaws. Is the sample selection adequate? Is the

experimental design appropriate?

o They started with 508 participants and ended with 57 participants, and I

think this sample size is rather low. That said, it’s hard to find people

diagnosed with a PD or an adolescent in the process of developing one.

They also accounted for external factors that may make the study invalid.
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Results

 Examine the tables and figures. Does the title accurately describe the content? Are

they clear and easy to understand? Choose one and explain what it is telling you. If

there are no tables or figures, just put N/A.

o Tables are laid out in the study, and they do describe the content. Although the

tables could be made more clear to the average reader, they do accurately explain

the results of the study. Table 3 of the study found on page 786 (Antila, H.,

Arola, R., Hakko, H., Riala, K., Riipinen, P., & Kantojärvi, L et al. p.780) shows

that the chance of developing a PD nearly triples in girls who are bullied vs girls

who are not.

 Review the results as presented in the text while referring to the data in the tables

and diagrams. Does the text complement, and not simple repeat, data? Are there

discrepancies between the results in the text and those in the tables? If there are no

tables, simply discuss whether or not the results are presented clearly.

o The data does not repeat and the text is very clear as to what’s in the data

provided in the tables. There is no confusion in this study

 Refer back to the hypothesis or hypotheses you listed above. Were they supported?

o Partially yes, but not completely. The study did find that girls, especially those

with an anxiety disorder, were at most risk for developing a PD vs boys. The

study also found that bullying didn’t seem to increase PD risk in boys. So yes and

no.

o One question I would ask was sexism out of the equation? As a male who has

received a PD diagnosis (BPD/ AvPD), it took forever to get there. I kept getting
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Bipolar Unspecified thrown at my direction. Fortunately, the questioned seemed

free of bias

Discussion

 Check the interpretation against the results. Does the discussion merely repeat the

results? Does the interpretation arise logically from the data or is it too far-fetched?

Have the faults/flaws/shortcomings of the research been addressed?

o The beginning of the discussion seems to repeat the results, however the

discussion then delves into how the study connects with other past studies. They

discuss their findings again, and then proceed to discuss a Finish follow-up study

that discusses increased risk of anxiety for boys who receive frequent bullying

which has little to do with the study.

 Is the interpretation supported by other research cited in the study? In other words,

do they connect their results to those that they mentioned in their literature review?

o Yes, this study cites 51 other studies most of which are related to this study in

question.

 Are there other research possibilities/directions suggested? If so, name one.

o Yes, can prevention of bullying decrease PD diagnoses later in life?

Success of Research

 Did the research reported in your article result in the formulation of new questions

or hypotheses (by the authors, by other researchers)?

o Yes. We now have an understanding that bullying seems to increase the risk of

PD’s in girls, especially Borderline Personality Disorder. However, the presence

of an already existing anxiety disorder in women seemed to escalate the

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formation of BPD into adulthood. Thus, the author’s hypothesized that anxiety,

bullying, and BPD are correlated and need further studying.

 Did the research make a significant contribution to human knowledge?

o Yes, this research absolutely contributes to human knowledge. This provides new

data (besides the general childhood trauma) into the formation of personality

disorders into adulthood. Instead of stigmatizing all PD’s as resulting from child

abuse via a guardian, we now understand that bullying maybe a risk factor and

not all blame is necessarily on the guardian of the child.

 Did the research produce any practical Implications?

o Yes, it destigmatizes PD’s as not always resulting from guardian abuse.

 What are the social, political, technological, medical implications of this research?

o The social impact is that we now have more information in a field that to this day

remains greatly understudied and stigmatized. This is important because more

work needs to be done in treatment of problematic personality, especially cluster

B in which case many psychiatrists discriminate against patients presenting with

BPD, NPD, ASPD, and HPD traits. Politically, this brings awareness to the

forefront of mental health issue and a possible reason to place “end bullying” as a

campaign issue. Medically, this raises the importance of preventing personality

disorders, especially since 10% of those with BPD will complete suicide.

 How do you evaluate the significance of the research?

o This study’s strengths lie in its ability to question things that are left untouched.

Few people are willing to work in the field of PD’s, only the aftermath of those in

a relationship with a person w/ a PD.

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o The study involved a sample size of 508 participants, to which they excluded

participants based on outlying factors eventually narrowing the sample size down

to 57, providing a clear methodology.

o The discussion section is rather shaky. They repeat the data at least twice while

citing a couple of studies that have nothing to do with their own study.

Fortunately, as their saving grace, the studies they cite do connect with their

concluding hypotheses. They did a good showing that bullying in childhood

definitely has a correlation in personality disorder formation in women, especially

BPD.
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References

Antila, H., Arola, R., Hakko, H., Riala, K., Riipinen, P., & Kantojärvi, L. (2017). Bullying

involvement in relation to personality disorders: a prospective follow-up of 508 inpatient

adolescents. European Child & Adolescent Psychiatry, 26(7), 779–789.

Tomko RL, Trull TJ, Wood PK, Sher KJ (2014) Characteristics of borderline personality

disorder in a community sample: comorbidity, treatment utilization, and general

functioning JPers Disord 28:734–750. doi:10.1521/pedi_2012_26_093

Silverman MH, Frankenburg FR, Reich DB, Fitzmaurice G, Zanarini MC (2012) The

course of anxiety disorders other than PTSD in patients with borderline personality

disorder and Axis II comparison subjects: a 10-year follow-up study. J Pers Disord 26:804–814.

doi:10.1521/pedi.2012.26.5.804

Baldry AC, Farrington DP (1999) Brief report: types of bullying among Italian school children.

J Adolesc 22:423–426

Bandelow B, Krause J, Wedekind D, Broocks A, Hajak G, Rüther E (2005) Early

traumatic life events, parental attitudes, family history, and birth risk factors in patients

with borderline personality disorder and healthy controls. Psychiatry Res 134:169–179