{"kind":"task","effective_mode":"full","benchmark":{"kind":"benchmark","effective_mode":"full","slug":"longbench-v2","formal_name":"LongBench v2","introduction":"LongBench v2 evaluates deep understanding and reasoning over long contexts through multiple-choice questions. Its official description lists 503 questions spanning tasks such as single-document and multi-document QA and code-repository understanding.","introduction_ja":"","introduction_en":"","category":"Category not supplied","task_count":null,"acquisition_status":"Acquisition status not supplied","official_url":"https://huggingface.co/datasets/zai-org/LongBench-v2","indexing_mode":"noindex","profile":{"resources":[],"task_format":"","scoring":"","metric":"","size":"","answer_access":"","license":"","citation":"","maintainer":"","released":"","why_hard":"","related":[]}},"task_id":"cbd01edb-edd3-5260-8f01-1d791c205529","task_key":"train--66ed2c87821e116aacb1f149","task_revision_id":"3","upstream_id":"66ed2c87821e116aacb1f149","short_description":"From the table 1, with the increase of current annual income, people who is LGBT…","config":"","split":"train","body":"{\"choice_A\":\"From the table 1, we can conclude that all people of LGBT will suffer less from campus bullying with more annual income under 3565, but when the income exceeds this number, the victims of bullying increase.\",\"choice_B\":\"From the table 1, we can conclude that all people of LGBT will suffer less from campus bullying with more annual income.\",\"choice_C\":\"From the table 1, we can conclude that only sexual minority youths will suffer less from campus bullying with more annual income.\",\"choice_D\":\"Based on Table 1 in the provided document, we cannot conclude that people who identify as LGBT+ suffer less from bullying as their annual income increases.\",\"context\":\"Original Paper\\nEffects of Bullying on Anxiety, Depression, and Posttraumatic\\nStress Disorder Among Sexual Minority Youths: Network Analysis\\n1School of Psychology, South China Normal University, Guangzhou, China\\n2Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China\\n3Center for Studies of Psychological Application, South China Normal University, Guangzhou, China\\n4Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China\\n5College of Education for the Future, Beijing Normal University, Beijing, China\\n6Northeast Asian Research Center, Jilin University, Changchun, China\\n7Department of Population, Resources and Environment, Jilin University, Changchun, China\\n8Faculty of Health and Life Sciences, De Montfort University, De Montfort, United Kingdom\\n*these authors contributed equally\\nSchool of Psychology\\nSouth China Normal University\\n55 West Zhongshan Avenue\\nAbstract\\nBackground: Bullying victimization is highly prevalent among sexual minority youths, particularly in educational settings,\\nnegatively affecting their mental health. However, previous studies have scarcely explored the symptomatic relationships among\\nanxiety, depression, and posttraumatic stress disorder (PTSD) among sexual minority youths who experienced bullying on college\\ncampuses.\\nObjective: The objectives of our study were to (1) characterize the anxiety-depression-PTSD network structures of gay or\\nlesbian, bisexuals, and other sexual minority youths previously bullied on college campuses; and (2) compare symptomatic\\nassociations in the anxiety-depression-PTSD networks among bullied sexual minority youths and heterosexual youths’ groups.\\nMethods: This cross-sectional study recruited college participants from Jilin Province, China. Data were analyzed using a subset\\nof the data extracted after screening for sexual orientation and history of bullying victimization. Sexual minority youths were\\nthen divided into 3 subgroups: gay or lesbian (homosexual), bisexual, and other. Mental health symptom severity was assessed\\nusing scales: the 7-item Generalized Anxiety Disorder Scale measuring anxiety, the 9-item Patient Health Questionnaire measuring\\ndepression, and the 10-item Trauma Screening Questionnaire measuring PTSD symptoms. Combining the undirected and Bayesian\\nnetwork analyses, the anxiety-depression-PTSD networks were compared among sexual minority youths subgroups, and the\\ndifference between heterosexual youths and sexual minority youths was investigated. Chi-square tests were used to compare the\\ndifference in categorical variables, while independent-sample t tests were run on continuous variables.\\nResults: In this large-scale sample of 89,342 participants, 12,249 identified as sexual minority youths, of which 1603 (13.1%,\\n95% CI 12.5%-13.7%) reported being bullied on college campuses in the past year. According to the expected influence (EI) and\\nbridge expected influence (bEI) index, in the global network structure of anxiety, depression, and PTSD, sad mood (EI=1.078,\\nbEI=0.635) and irritability (EI=1.077, bEI=0.954) were identified as central and bridge symptoms; emotional cue reactivity\\n(EI=1.015) was a central symptom of PTSD in this global network. In the anxiety-depression-PTSD Bayesian network, anhedonia\\nhad the highest prediction priority for activating other symptoms; and feeling afraid linked symptoms from anxiety to the PTSD\\ncommunity. Compared to their heterosexual counterparts, sexual minority youths exhibited a stronger association between\\nJMIR Public Health Surveill 2023 | vol. 9 | e47233 | p. 1\\nhttps://publichealth.jmir.org/2023/1/e47233\\n(page number not for citation purposes)\\nLi et al\\nJMIR PUBLIC HEALTH AND SURVEILLANCE\\nXSL•FO\\nRenderX\\n\\n\\ndifficulty concentrating and appetite. The “sad mood-appetite” edge was strongest in the gay or lesbian network; the\\n“irritability-exaggerated startle response” edge was strongest in the bisexual network.\\nConclusions: For the first time, this study identified the most central and bridge symptoms (sad mood and irritability) within\\nthe depression-anxiety-PTSD network of sexual minority youths with past bullying-victim experiences on college campuses.\\nEmotional cue reactivity, anhedonia, and feeling afraid were other vital symptoms in the comorbid network. Symptomatic\\nrelationships existed showing heterogeneity in bullied heterosexual youths and sexual minority youth networks, which also was\\npresent within the sexual minority youth subgroups. Consequently, refined targeted interventions are required to relieve anxiety,\\ndepression, and PTSD symptoms.\\n(JMIR Public Health Surveill 2023;9:e47233) doi: 10.2196/47233\\nKEYWORDS\\nsexual minority youths; bullying victimization; anxiety; depression; posttraumatic stress disorder; network analysis; Bayesian\\nnetwork\\nIntroduction\\nBullying is defined as the intent or behavior that seeks to harm\\nanother person repeatedly, with an imbalance of power [1,2].\\nIt is reported in the literature that the rate of bullying in higher\\neducation (on college or university campuses) varies across\\ncultures, ranging from 1.7% to 25.2% [3-5]. Particularly, sexual\\nminority youths, who identify their sexual orientations as\\nnonheterosexual, such as lesbian, gay, or bisexual, are vulnerable\\nto discrimination and bullying [5,6], and have higher odds of\\nexperiencing bullying on campus than their heterosexual\\ncounterparts [7-10]. A national survey in the United States\\nfurther reported that sexual minority youths experience a high\\nrate of verbal harassment (76.1%), sexual harassment (53.7%),\\nphysical harassment (31.2%), and physical assault (12.5%) [11].\\nIn addition, after being bullied, sexual minority youths may\\nexperience adverse physical health and persistent negative\\neffects on their mental health [12].\\nA considerable amount of literature has reported that sexual\\nminority youths exhibit higher rates of anxiety, depression, and\\nposttraumatic stress disorder (PTSD) than their heterosexual\\ncounterparts [13-16]. As a recent meta-analysis noted [17],\\ncompared to heterosexual counterparts, lesbian or gay, as well\\nas bisexual individuals yielded a higher risk of anxiety and\\ndepression. In addition, sexual minority individuals were found\\nto be vulnerable to adverse experiences, such as being harassed\\nand even bullied in school, increasing the risk for anxiety,\\ndepression, and PTSD than those participants who have not\\nexperienced adverse life events [18].\\nPast research has found differences in mental health problems\\namong subgroups of sexual minorities [17,19]. For example,\\nthe result from a longitudinal study suggests that bullying\\nvictimization is connected to stronger depressive symptoms\\namong bisexual women, and stronger anxiety symptoms among\\nbisexual men [20]. Bisexual individuals are also more likely to\\nreport PTSD than their gay or lesbian counterparts [21].\\nPansexual women appear to be more open about their sexuality\\nbut with a higher consciousness in regard to their sexual\\norientation-based stigma than bisexual women, which is linked\\nto poorer mental health [22]. Further, asexual men are suggested\\nto have higher scores of depression and psychiatric disturbance\\nthan their homosexual and bisexual counterparts [23]. The above\\nstudies show a high heterogeneity of mental health outcomes\\namong sexual minority subgroups. However, whether these\\ndifferences remain consistent among sexual minority youths\\nwho are being bullied on college campuses requires further\\nexploration.\\nMinority stress theory provides a conceptual model that the\\nmental health issues of sexual minorities are partially derived\\nfrom minority stressors, which are defined as the excess stress\\nto which individuals from stigmatized social categories are\\nexposed to due to their minority position [24], such as higher\\nrates of bullying and discrimination. Furthermore, minority\\nstress can cause biological responses that are related to mental\\nhealth symptoms [25]. For example, exposure to general\\nminority stress can affect one’s gene expression, which is\\nconnected to cardiovascular function [26] and exerts an\\ninteractional effect between anxiety, depression, and PTSD\\n[27-29]. Meanwhile, it may increase the dysregulation of the\\nhypothalamus-pituitary-adrenal axis, directly adding to the risk\\nof depression, anxiety, and PTSD [30,31]. Nevertheless, the\\nsymptomatic relationship between anxiety, depression, and\\nPTSD among sexual minority youths who are bullied on college\\ncampuses lacks investigation.\\nIn recent years, several published studies have adopted network\\nanalysis in both clinical psychology or psychiatric fields to\\nexplore the relationship between symptoms of various disorders\\n[32-34]. The undirected network analysis depicts the interactions\\nbetween individual symptoms, with a symptom being termed\\na “node,” and the partial correlation coefficient between 2 nodes\\ndetermining their “edge” [35]. According to the expected\\ninfluence (EI) index and the bridge expected influence (bEI)\\nindex, the central and bridge symptoms of the network structure\\ncould be identified, respectively [36,37]. Furthermore, in this\\nstudy, Bayesian network analysis was applied to clarify the\\ndirected relationship between symptoms further. Based on the\\ncompleted partially directed acyclic graph (CPDAG), Bayesian\\nnetwork analysis can unclose the putative directions of the\\npotential causal relationship between 2 nodes [38], and it could\\nhelp to discover activating paths among symptoms of anxiety,\\ndepression, and PTSD network [33].\\nGiven these premises, this study was implemented using\\nundirected and Bayesian network analyses to achieve 2 main\\nobjectives: first, to characterize the symptomatic relationships\\nin the anxiety-depression-PTSD network among bullied sexual\\nJMIR Public Health Surveill 2023 | vol. 9 | e47233 | p. 2\\nhttps://publichealth.jmir.org/2023/1/e47233\\n(page number not for citation purposes)\\nLi et al\\nJMIR PUBLIC HEALTH AND SURVEILLANCE\\nXSL•FO\\nRenderX\\n\\n\\nminority youths and sexual minority youth subgroups; second,\\nto compare the network structures among bullied sexual minority\\nyouth subgroups. For aim 1, based on previous results\\n[34,39,40], the researchers hypothesized that depressive and\\nanxious symptoms would be the most central and bridge among\\nall symptoms. For aim 2, considering sexual minority youth\\nsubgroups have various prevalence and symptomatic\\nmanifestations of anxiety, depression, and PTSD [14,21], the\\nresearchers hypothesized that different strengths of symptomatic\\nassociations would exist among sexual minority youth subgroups\\nwho had disclosed experiences of being bullied. In addition,\\nthe researchers aimed to enrich the field, as well as help offer\\ntargeted suggestions and interventions for specific symptoms\\nassociated with poor mental health.\\nMethods\\nParticipants and Settings\\nThis study was designed with a cross-sectional approach,\\nrecruiting College students from 63 Universities or Colleges in\\nJilin Province, China, from October to November 2021. Students\\ncompleted an electronic questionnaire with a Quick Response\\ncode, delivered by their teachers with their classmates. The\\ninclusion criteria for recruitment were (1) being 15 years old or\\nolder; (2) studying at universities or colleges in Jilin Province,\\nChina; (3) understanding the Chinese questionnaire and having\\nthe ability to provide informed consent.\\nEthical Considerations\\nEthical approval for this study was granted by the Ethics\\nCommittee of Jilin University (NO20210929 [11 October\\n2021]), following the 1964 Helsinki Declaration and its\\namendments in 2013. Electronic informed consent was provided\\nby all participants, with consent that their answers could be\\napplied to any secondary analyses.\\nMeasurements\\nParticipants’sexual orientation was measured by a single-option\\nquestion with 6 items: “Which of the following better describes\\nyour sexual orientation?” Except for heterosexuality, all other\\nsexual orientations are combined to form the sexual minority\\nyouth group [41,42], which was then further divided into 3\\nsubgroups, including homosexuality (gay or lesbian),\\nbisexuality, and others (asexuality, pansexuality, and uncertain).\\nAnxiety was measured by the 7-item Generalized Anxiety\\nDisorder Questionnaire [43], depression by the 9-item Patient\\nHealth Questionnaire [44], and PTSD by the 10-item Trauma\\nScreening Questionnaire [45]. The experience of being bullied\\nduring higher education was measured by a single question:\\n“Have you ever been bullied on campus in the past year?”\\nDetails of measurements are presented in the Section S1 in\\nMultimedia Appendix 1, Additional information for networks.\\nStatistical Analysis\\nDescriptive Analysis\\nIn total, 117,769 participants were recruited and 89,342 were\\nincluded according to the criteria and completion of the\\nquestionnaire. A descriptive analysis was run on the subdata\\nextracted from screening for sexual orientation and history of\\nbullying victimization. In the data set of those who had been\\nbullied on college campuses in the past, they were divided into\\ngroups of heterosexual and sexual minority youth groups.\\nSociodemographic variables included participants’ age, sex,\\nresidence, ethnicity, family type, current annual income, and\\nwhether they were an only child. The categorical variables in\\nheterosexual or sexual minority youth groups were compared\\nby chi-square tests, while continuous variables were compared\\nby two-tailed independent-sample t tests.\\nUndirected Network Estimation\\nThis study used R programming [46] to structure the undirected\\nnetwork, with the R package “qgraph” (R Foundation for\\nStatistical Computing) to visualize the Graphical Gaussian\\nModel [35]. The R package “mgm” assessed the predictability\\nof a node, referring to the variance of a node that could be\\nexplained by all others [47]. The differences between the sexual\\nminority youths and heterosexual network structures and among\\nsexual minority youth subgroups were compared using the R\\npackage “Network Comparison Test” with 1000 permutations\\n[48]. For more detail on the method, see Section S2 in\\nMultimedia Appendix 1, Additional information for networks.\\nBayesian Network Estimation\\nIn this study, DAG was modelled by the R package “bnlearn,”\\nwith the hill-climbing algorithm [49]. To further obtain a clear\\ndirection among symptoms, the Markov equivalence classes of\\nthe DAG were drawn, which can be described uniquely by a\\nCPDAG [50]. In CPDAG, all arrows of undirected edges can\\nbe invertible, while all directed edges cannot be converted into\\nundirected edges. Finally, in the determined CPDAG, the direct\\nactivating paths in the Bayesian network are more conclusive.\\nMore details are shown in Section S2 in Multimedia Appendix\\n1, Additional information for networks.\\nResults\\nDescriptive Statistics\\nTable 1 presents the sociodemographic characteristics of\\nparticipants. Within groups, 5063 (6%) heterosexual participants\\nand 1603 (13.1%) sexual minority youth participants reported\\nbeing bullied on college campuses in the past year. The\\nprevalence of bullying among heterosexual youths was 6%\\n(95% CI 5.9%-6.2%), and 13.1% (95% CI 12.5%-13.7%) among\\nsexual minority youths. Furthermore, among gay participants,\\nthe prevalence of bullying was 19.9% (95% CI 17.1%-23.1%),\\n12.2% (95% CI 9.8%-15.1%) among lesbians, 15.6% (95% CI\\n13.6%-17.9%) among bisexual males, and 12% (95% CI\\n11.2%-12.9%) among bisexual females. The odds of being\\nbullied among sexual minority males was 14.4% (95% CI\\n12.7%-16.2%), and 11.8% (95% CI 10.6%-13%) among sexual\\nminority females.\\nJMIR Public Health Surveill 2023 | vol. 9 | e47233 | p. 3\\nhttps://publichealth.jmir.org/2023/1/e47233\\n(page number not for citation purposes)\\nLi et al\\nJMIR PUBLIC HEALTH AND SURVEILLANCE\\nXSL•FO\\nRenderX\\n\\n\\nTable 1. Sociodemographic characteristics of participants who had been bullied on college campuses.\\nP value\\nDegrees\\nof free-\\ndom (df)\\nΧ²a\\nOthers\\n(n=569), n\\n(%)\\nBisexuals\\n(n=815), n\\n(%)\\nGay\\n(n=142), n\\n(%)\\nLesbian\\n(n=77), n\\n(%)\\nSexual minority\\nyouths\\n(n=1603), n (%)\\nHeterosexuals\\n(n=5063), n\\n(%)\\n<.001b\\n1\\n94.2\\nSex\\n234 (41.1)\\n176 (21.6)\\n142 (100)\\nN/Ac\\n552 (34.4)\\n2444 (48.3)\\nMale\\n335 (58.9)\\n639 (78.4)\\nN/A\\n77 (100)\\n1051 (65.6)\\n2619 (51.7)\\nFemale\\n<.001b\\n1\\n44.6\\nResidence\\n333 (58.5)\\n494 (60.6)\\n71 (50)\\n51 (66.2)\\n949 (59.2)\\n2513 (49.6)\\nCity\\n236 (41.5)\\n321 (39.4)\\n71 (50)\\n26 (33.8)\\n654 (40.8)\\n2550 (50.4)\\nTown and county\\n.31\\n1\\n1.0\\nEthnicity\\n503 (88.4)\\n728 (89.3)\\n119 (83.8)\\n74 (96.1)\\n1424 (88.8)\\n4543 (89.7)\\nHan\\n66 (11.6)\\n87 (10.7)\\n23 (16.2)\\n3 (3.9)\\n179 (11.2)\\n520 (10.3)\\nOthers\\n<.001b\\n2\\n17.2\\nFamily type\\n375 (65.9)\\n502 (61.6)\\n86 (60.6)\\n42 (54.5)\\n1005 (62.7)\\n3311 (65.4)\\nNuclear family\\n93 (16.3)\\n143 (17.5)\\n26 (18.3)\\n12 (15.6)\\n274 (17.1)\\n951 (18.8)\\nAbove 3 genera-\\ntion\\n101 (17.8)\\n170 (20.9)\\n30 (21.1)\\n23 (29.9)\\n324 (20.2)\\n801 (15.8)\\nOthers\\n<.001b\\n3\\n20.0\\nCurrent annual income (US $)\\n208 (36.6)\\n234 (28.7)\\n47 (33.1)\\n27 (35)\\n516 (32.2)\\n1659 (32.8)\\n<930\\n167 (29.3)\\n247 (30.3)\\n33 (23.2)\\n16 (20.8)\\n463 (28.9)\\n1688 (33.3)\\n930-2169\\n67 (11.8)\\n143 (17.5)\\n27 (19)\\n14 (18.2)\\n251 (15.6)\\n763 (15.1)\\n2170-3565\\n127 (22.3)\\n191 (23.4)\\n35 (24.6)\\n20 (26)\\n373 (23.3)\\n953 (18.8)\\n≥3565\\n<.001b\\n1\\n19.4\\nOnly-child status\\n320 (56.2)\\n408 (50.1)\\n72 (50.7)\\n42 (54.5)\\n842 (52.5)\\n2340 (46.2)\\nYes\\n249 (43.8)\\n407 (49.9)\\n70 (49.3)\\n35 (45.5)\\n761 (47.5)\\n2723 (53.8)\\nNo\\n.49\\n6659\\n–0.7d\\n19.63 (1.73)\\n19.51 (1.63)\\n19.74 (1.70)\\n19.55 (1.66)\\n19.57 (1.67)\\n19.54 (1.72)\\nAge (years), mean (SD)\\n<.001b\\n6664\\n–11.2d\\n7.69 (5.80)\\n7.93 (5.15)\\n7.61 (5.30)\\n8.06 (5.90)\\n7.82 (5.44)\\n6.25 (474)\\nGAD-7e, mean (SD)\\n<.001b\\n6664\\n–13.1d\\n10.23 (6.85)\\n10.16 (5.96)\\n9.45 (5.42)\\n10.74 (7.52)\\n10.15 (6.33)\\n8.06 (5.30)\\nPHQ-9f, mean (SD)\\n<.001b\\n6664\\n–9.7d\\n5.55 (3.27)\\n5.91 (2.97)\\n5.58 (3.20)\\n5.94 (3.38)\\n5.75 (3.12)\\n4.88 (3.16)\\nPTSD-10g, mean (SD)\\naХ²: used to compare differences between heterosexual and sexual minority youth groups among specified demographic variables.\\nbThere was a significant difference existing with P<.001.\\ncN/A: Not applicable.\\ndT: used to compare differences between heterosexual and sexual minority youth groups among specified demographic variables.\\neGAD-7: the 7-item Generalized Anxiety Disorders Scale.\\nfPHQ-9: the 9-item Patient Health Questionnaire.\\ngPTSD-10: measured by the 10-item Trauma Screening Questionnaire.\\nCompared to their heterosexual counterparts, more sexual\\nminority females, and more sexual minority youths living in\\nurban residences reported being bullied on the campuses. In\\naddition, experiences of being bullied were more likely to occur\\namong participants from nuclear families, with lower annual\\nfamily income, or among those who had siblings. Bullied sexual\\nminority youths also reported higher rates of anxiety, depression,\\nand PTSD symptoms than bullied heterosexual youths.\\nUndirected Network Structure\\nAs seen in Figure 1, according to the centrality index EI, GAD2\\n(Generalized Anxiety Disorders Scale; “control worry,”\\nEI=1.134) had the highest EI, followed by PHQ4 (Patient Health\\nQuestionnaire; “energy,” EI=1.116), GAD3 (“worry a lot,”\\nEI=1.085), PHQ2 (“sad mood,” EI=1.078), GAD6 (“irritability,”\\nEI=1.077), and PTSD4 (“energy,” EI=1.015). These 6 symptoms\\nplayed the most central role in the global network of anxiety,\\ndepression, and PTSD symptoms among all bullied sexual\\nJMIR Public Health Surveill 2023 | vol. 9 | e47233 | p. 4\\nhttps://publichealth.jmir.org/2023/1/e47233\\n(page number not for citation purposes)\\nLi et al\\nJMIR PUBLIC HEALTH AND SURVEILLANCE\\nXSL•FO\\nRenderX\\n\\n\\nminority youths. The central network structures of the 3 sexual\\nminority youth subgroups and their centrality index EI are shown\\nin Table S1 and Figures S1, S2, S3, and S4 in Multimedia\\nAppendix 1, Additional information for networks.\\nAs seen in Figure 2, according to bEI, GAD6 (“irritability,”\\nbEI=0.954), PHQ8 (“motor,” bEI=0.883), GAD7 (“feeling\\nafraid,” bEI=0.758), GAD5 (“restless,” bEI=0.718), GAD1\\n(“nervous,” bEI=0.694), and PHQ2 (“sad mood,” bEI=0.635)\\nhad crucial bridging roles in connecting to the other symptoms\\nof anxiety, depression, or PTSD, which may possibly transform\\nfrom 1 community to another. The bridge network structures\\nof the 3 sexual minority youth subgroups and their bridge bEI\\nindex are shown in Table S1 and Figures S5, S6, S7, and S8 in\\nMultimedia Appendix 1, Additional information for networks.\\nFigure 1. The global network structure of central symptoms among all bullied sexual minority youths (N=1603). GAD: the 7-item Generalized Anxiety\\nDisorders Scale; LGB: homosexuality (gay or lesbian), bisexuality and other sexual minority youths; PHQ: the 9-item Patient Health Questionnaire;\\nPTSD: posttraumatic stress disorder measured by the 10-item Trauma Screening Questionnaire.\\nFigure 2. The global network structure of bridge symptoms among all bullied sexual minority youths (N=1603). GAD: the 7-item Generalized Anxiety\\nDisorders Scale; LGB: homosexuality (gay or lesbian), bisexuality and other sexual minority youths; PHQ: the 9-item Patient Health Questionnaire;\\nPTSD: posttraumatic stress disorder measured by the 10-item Trauma Screening Questionnaire.\\nThe average predictability of nodes was 48.67%, which means\\nthat, on average, the variance of 48.67% per node could be\\nexplained by its neighbors. In addition, all networks show good\\nstability in this study (see in Figures S9, S10, S11, and S12 in\\nMultimedia Appendix 1, Additional information for networks).\\nBayesian Network Structure\\nFigure 3 shows the CPDAG results, indicating that PHQ1\\n(“anhedonia”) had the highest predictive priority for other\\nsymptoms occurring in the anxiety-depression-PTSD network.\\nPHQ2 (“sad mood”), GAD6 (“irritability”), and GAD7 (“feeling\\nafraid”) were identified as 3 crucial bridge symptoms, whose\\ndownstream symptoms had more branches and could activate\\nmore pathways. In addition, there were reversible connections\\nbetween PHQ1 (“anhedonia”), PHQ2 (“sad mood”), and PHQ4\\n(“appetite”). Whereas, the edges between PHQ2 (“sad mood”)\\nand PHQ6 (“guilt”), between GAD6 (“irritability”), PHQ8\\n(“motor”), and PTSD7 (“irritability or anger”), and between\\nJMIR Public Health Surveill 2023 | vol. 9 | e47233 | p. 5\\nhttps://publichealth.jmir.org/2023/1/e47233\\n(page number not for citation purposes)\\nLi et al\\nJMIR PUBLIC HEALTH AND SURVEILLANCE\\nXSL•FO\\nRenderX\\n\\n\\nGAD7 (“feeling afraid”) to PTSD9 (“hypervigilance”) were\\nunidirectional and irreversible. These results indicate the most\\nlikely direction from both depression and anxiety symptoms to\\nPTSD symptoms, rather than vice versa. More results of CPDAG\\ncan be found in Figure S13 in Multimedia Appendix 1,\\nAdditional information for networks.\\nFigure 3. The Bayesian network of anxiety, depression, and posttraumatic stress disorder among bullied sexual minority youths, based on a completed\\npartially directed acyclic graph. GAD: the 7-item Generalized Anxiety Disorders Scale; PHQ; the 9-item Patient Health Questionnaire; PTSD: posttraumatic\\nstress disorder measured by the 10-item Trauma Screening Questionnaire. The edges without directions refer to reversiblity. The solid edges with\\ndirection refer to irreversiblity. The dotted edges with direction refer to irreversibility and arrowing to a node in another symptom community.\\nNetwork Comparison Structures\\nFigure 4 shows the results when comparing the network\\nstructures between the sexual minority youths and heterosexual\\ngroups. The edge of PTSD8 (“difficulty concentrating”)-PHQ5\\n(“appetite”) was significantly stronger in the sexual minority\\nyouth network structure than in the heterosexual.\\nAmong the 3 subgroups of sexual minority youths, there was\\nno significant difference in edges between the gay or lesbian\\nnetwork and the other sexual minority youth networks. However,\\nthe edge of PHQ2 (“sad mood”)-PHQ5 (“appetite”) was\\nstrongest in the gay or lesbian network and the edge of PTSD7\\n(“irritability”)-PTSD10 (“exaggerated startle response”) was\\nstrongest in the bisexual sexual minority youth networks (Figure\\nS14 in Multimedia Appendix 1, Additional information for\\nnetworks).\\nJMIR Public Health Surveill 2023 | vol. 9 | e47233 | p. 6\\nhttps://publichealth.jmir.org/2023/1/e47233\\n(page number not for citation purposes)\\nLi et al\\nJMIR PUBLIC HEALTH AND SURVEILLANCE\\nXSL•FO\\nRenderX\\n\\n\\nFigure 4. The comparison of network structure between sexual minority and heterosexual youths. GAD: the 7-item Generalized Anxiety Disorders\\nScale; PHQ: the 9-item Patient Health Questionnaire; PTSD: posttraumatic stress disorder measured by the 10-item Trauma Screening Questionnaire.\\nDiscussion\\nPrincipal Findings\\nThis is the first study based on a large-scale sample to\\ninvestigate the symptomatic relationship of anxiety, depression,\\nand PTSD among sexual minority youths bullied on college\\ncampuses in the past. The results partly supported hypothesis\\n1: sad mood and irritability were identified as the most\\nfrequently crucial activating symptoms of poor mental health,\\nwhere emotional cue reactivity was the most central symptom\\nof the PTSD community. In the Bayesian network, anhedonia\\nhad the highest predictive priority to activate the occurrence of\\nall other symptoms; feeling afraid played a bridging role in the\\nanxiety-depression-PTSD network. The results supported\\nhypothesis 2: compared to heterosexuals, sexual minority youths\\nexhibited a stronger association between difficulty concentrating\\nand appetite. The “sad mood-appetite” edge was strongest in\\nthe gay or lesbian network, and the “irritability-exaggerated\\nstartle response” edge was strongest in the bisexual network.\\nSexual minority youths has been frequently reported to\\nexperience discrimination, prejudice, and stigma-bias because\\nof their sexual orientation [6,51], associated with bullying\\nvictimization of sexual minority youths [52,53]. Our study\\nfurther reported a high prevalence of being bullied on college\\ncampuses among sexual minority youths, which was 13.3%\\n(95% CI 12.5%-13.7%, n=1603). Consistent with previous\\nfindings, exposure to bullying on college campuses was found\\nto be related to the onset of mental health problems among\\nsexual minority youths [53]. As a meta-analysis supported,\\nindividuals who experience bullying victimization had increased\\nodds of depression, anxiety, and PTSD [54].\\nSad mood and irritability were the most crucial symptoms (both\\ncentral and bridge) in all anxiety-depression-PTSD network\\nmodels. Previous network analyses have consistently identified\\nsad mood as the central and bridge symptom in the structure of\\nthe anxiety-depression network [36,55]. This result may be\\nexplained by the external stressors that sexual minority youths\\nface, making them feel sad [51,56]. According to a US national\\nsurvey on youths’risk behavior, high rates of in-school bullying\\nvictimization for homosexuals (28.22%, n=91) and bisexuals\\n(34.03%, n=318) occurred because of external discrimination\\n[7]. When under stressful conditions, if those bullied students\\nexperience insufficient support from teachers, they could feel\\nabandoned and hopeless [57]. In terms of irritability, 2 prior\\nstudies also noted that irritability had a high betweenness index\\n(another bridge centrality index) [34], and was identified as one\\nof the central symptoms in the depression-anxiety-PTSD\\nnetwork [58]. Research has indicated that, once bullied, an\\ninability to find a coping strategy or resist bullying behaviors\\ncan make individuals feel frustrated, which may trap them in\\nrumination anger [9]. Moreover, traumatic memories of bullying\\nvictimization could generate severe distress and irritability as\\nwell [59]. Our results showed irritability also had a high\\npredictive priority of the occurrence of PTSD symptoms.\\nFindings indicate that for those who do withstand cumulative\\nbullying victimization, their subjective aggression can be\\ntriggered, potentially increasing their irritable mood and PTSD\\nsymptoms simultaneously [60]. Notably, emotional cue\\nreactivity (in this study referring to feeling upset by reminders\\nof the events) was the most central symptom in the PTSD\\nnetwork. This may be explained by the influences of\\nautobiographical memories (a mixed memory of complicated\\nlife events) [61]. Experiences of being bullied incur negative\\nemotional cues, such as insults and physical aggression [62],\\nand these negative memories would, in turn, cause further\\ndistress.\\nIn the Bayesian network, anhedonia had the highest predictive\\npriority of activating other symptoms. It parallels a previous\\nnetwork analysis that identified anhedonia as a central symptom\\nin the anxiety-depression network [36]. Previous findings\\nreported that bullying behaviors could lead to poorer mental\\nJMIR Public Health Surveill 2023 | vol. 9 | e47233 | p. 7\\nhttps://publichealth.jmir.org/2023/1/e47233\\n(page number not for citation purposes)\\nLi et al\\nJMIR PUBLIC HEALTH AND SURVEILLANCE\\nXSL•FO\\nRenderX\\n\\n\\nhealth for bullying victims [63]. After being bullied, sexual\\nminority youths may form a negative schema about an\\ninstitution, which influences their interaction with others,\\ndecreasing their interest in participating in activities with their\\npeers [64]. Another possible explanation could be a lack of\\nsupport from teachers and families after exposure to being\\nbullied, which further hinders sexual minority youths’ mental\\nhealth [65] and also makes it harder for them to perceive\\npleasure [66]. Additionally, being bullied may negatively\\ninfluence the release of dopamine, a chemical produced by\\nneuronal receptors that relate to feeling good, in the case of\\nbullying, this causes a lack of pleasure [67]. Feeling afraid also\\nplayed a significant bridging role in the Bayesian network,\\npointing to the occurrence of hypervigilance in the PTSD\\ncommunity. On the one hand, past bullying victimization could\\nlead sexual minority youths to be afraid of reoccurring bullying\\n[68]; on the other hand, without efficient support from others,\\nexposing perpetrators of bullying could trigger their fear of\\nretaliation [69]. In addition, feeling afraid is linked to the\\nsymptoms of PTSD in this study. As early findings stated, those\\nbullied could incur idiopathic nightmares and sleep problems,\\nleading to hypervigilance [70]. From the neuropsychological\\nperspective, fear-related threats increase the steady-state visual\\nevoked amplitudes, thus heightening individuals’vigilance [71].\\nBased on this fear of repeated bullying, sexual minority youths’\\nvisual attention to possible danger may present with\\nover-heightened reactions.\\nCompared to the heterosexual network structure, difficulty\\nconcentrating was found to be more closely associated with\\nappetite in the sexual minority youth network structure. As\\nprevious findings stated, sexual minority youths were more\\nvulnerable to weight-based bullying by peers than heterosexual\\nyouths [72,73]. Moreover, a motivation to avoid or prevent\\nbullying may be a key driver for those who seek treatment for\\nobesity [74]. Thus, the ideal body image and weight bias may\\nresult in more sexual minority youths choosing to diet in order\\nto lose weight or engage in harmful weight-control strategies,\\nsuch as purging, to maintain a satisfactory appearance [75]. It\\nshould be noted that over-preoccupation with body shape might\\nimpair concentration in other areas, supported by a previous\\nstudy in which those who experienced bullying reported that\\nthey perceived their attention was distracted due to the fear\\nassociated with the experience, which led to difficulty\\nconcentrating when learning and during academic achievement,\\nfurther hindering their state of mental well-being [76].\\nDifferently, compared to bullied bisexual youths, sad mood had\\na stronger correlation with appetite among bullied gay or lesbian\\nyouths. Researchers consistently report more disordered eating\\nbehaviors in gay or lesbian youths than in bisexuals [77]. In\\naddition, gay or lesbian youths were reported to have more body\\ndissatisfaction, driven by an ideal body shape [78,79]. Negative\\nmood also relates to subjective appetite, causing poor appetite\\nor overeating [80]. Since discrimination and bullying incur a\\nsad mood for gay or lesbian youths, they may choose binge\\neating to elevate their mood momentarily [81]. Furthermore,\\ncompared to other sexual minority youths, bisexual youths\\nexhibited a stronger correlation between irritability and\\nexaggerated startle response. This may be due to bisexual youths\\nexperiencing dual discrimination from homosexual and\\nheterosexual communities [82]. Since bullying shapes a\\nthreatening context for bisexual youths, they may become\\nirritable and exhibit a high startle reactivity [83]. Meanwhile,\\nhigher irritability can alter attention bias, with decreased\\nfunctional connectivity between the left inferior frontal gyrus\\nand a periaqueductal grey area, which may increase the response\\nto frustrating stimuli [84].\\nLimitations\\nSeveral limitations should be noted in this study. First, as a\\ncross-sectional study, it is hard to explore the dynamic process\\nof psychopathological networks [85], thus, further longitudinal\\nresearch is required to obtain causal conclusions. Second, the\\nreplicability and generalizability of network structures are still\\nlimited across various samples [86]. In the future, neuroimaging\\nstudies are required to explore the organic effects on the brain.\\nThird, measurements were limited in several aspects: (1) the\\nminority stressors, such as lacking peers or family support, were\\nnot directly measured, and the results could be biased because\\nof other potential influences. (2) There may be a part of the\\nyouths who have hesitancy toward or concealment of being\\nidentified as sexual minority youths for fear of being exposed\\nin the context. (3) In addition, the interaction of gender identity\\nand sexual orientation should be considered in future\\ninvestigations. For example, a transgender man attracted to a\\ncisgender man could also consider himself gay. Further studies\\nshould be conducted covering diverse gender identities in detail.\\n(4) Because the experience of being bullied on college campuses\\nin the past was measured by a self-report as well, in which the\\nstandard to determine the conceptualization of bullying varies\\nacross individuals, it was inevitable to include samples with\\ndifferent severities of bullying victimization. Future research\\nshould provide more detailed standards to define bullying and\\nexplore the underlying mechanism between various types or\\nlevels of bullying behaviors and the impact this has on the\\nmental health of sexual minority populations. Bullying\\noff-campus perpetrated by peers should be measured, and its\\nimpacts must be explored. (5) The bias of recall errors or social\\ndesirability effects is unavoidable for data from subjective\\nreporting scales. Finally, other psychiatric disorders, such as\\nobsessive-compulsive disorder or eating disorders, were not\\nmeasured directly, which may affect the results.\\nConclusions\\nThis cross-sectional study based on a large-scale sample,\\ncombined the undirected network analysis and Bayesian network\\nanalysis, for the first time, identifying the most central and\\nbridge symptoms (sad mood and irritability), as well as the\\ncentral role of emotional cue reactivity within the\\ndepression-anxiety-PTSD network of sexual minority youths\\nwho were bullied on college campuses in the past. CPDAG\\nresults also indicated the vital roles of anhedonia and feeling\\nafraid in the global Bayesian network in this study. In addition,\\nthe comparisons of networks supported three findings: (1)\\ncompared \\nto \\nheterosexuals, \\nthe \\nedge \\nof \\n“difficulty\\nconcentrating” was stronger than in the global sexual minority\\nyouth network, (2) the edge of “sad mood-appetite” was\\nstrongest in the gay or lesbian network, and (3) the edge of\\nJMIR Public Health Surveill 2023 | vol. 9 | e47233 | p. 8\\nhttps://publichealth.jmir.org/2023/1/e47233\\n(page number not for citation purposes)\\nLi et al\\nJMIR PUBLIC HEALTH AND SURVEILLANCE\\nXSL•FO\\nRenderX\\n\\n\\n“irritability-exaggerated startle response” was strongest in the\\nbisexual network. These findings should be considered when\\noffering targeted support for improving the physical health and\\nmental well-being of sexual minority youths. Consequently,\\nrefined targeted interventions could be formulated [6] to relieve\\nthe symptoms of anxiety, depression, and PTSD comorbidity\\namong sexual minority youths.\\nAcknowledgments\\nThe conception and design of this study was done by YW and SX. SX and XS did the data collection. Data quality control was\\ndone by SX. Data analysis and all figures were done by YJ, CC, XLuo, YL, and XLing. This study’s write-up was performed by\\nJL, YJ, and SX. Critical comments were made by YW and AW. This study was supervised by YW and SX. We thank all the\\nparticipants and staff involved in this study. This study was supported by the National Natural Science Foundation of China\\n(82201708).\\nData Availability\\nThe data set for this specific paper is available from the corresponding author upon reasonable request.\\nConflicts of Interest\\nNone declared.\\nMultimedia Appendix 1\\nAdditional information for networks.\\n[DOCX File , 7006 KB-Multimedia Appendix 1]\\nReferences\\n1.\\nSmith PK. Bullying: definition, types, causes, consequences and intervention. Soc Personal Psychol Compass\\n2016;10(9):519-532 [doi: 10.1111/spc3.12266]\\n2.\\nYounan B. A systematic review of bullying definitions: how definition and format affect study outcome. J Aggress Confl\\nPeace Res 2019;11(2):109-115 [doi: 10.1108/jacpr-02-2018-0347]\\n3.\\nLund EM, Ross SW. Bullying perpetration, victimization, and demographic differences in college students: a review of the\\nliterature. 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J Abnorm Psychol 2017;126(7):969-988 [FREE Full text] [doi: 10.1037/abn0000276] [Medline: 29106281]\\nAbbreviations\\nbEI: bridge expected influence\\nCPDAG: completed partially directed acyclic graph\\nEI: expected influence\\nGAD: Generalized Anxiety Disorder Scale\\nPHQ: Patient Health Questionnaire\\nPTSD: posttraumatic stress disorder\\nEdited by A Mavragani, T Sanchez; submitted 13.03.23; peer-reviewed by E Fedele, M Scutari; comments to author 17.05.23; revised\\nversion received 06.06.23; accepted 05.09.23; published 01.11.23\\nPlease cite as:\\nLi J, Jin Y, Xu S, Wilson A, Chen C, Luo X, Liu Y, Ling X, Sun X, Wang Y\\nEffects of Bullying on Anxiety, Depression, and Posttraumatic Stress Disorder Among Sexual Minority Youths: Network Analysis\\nJMIR Public Health Surveill 2023;9:e47233\\nURL: https://publichealth.jmir.org/2023/1/e47233\\ndoi: 10.2196/47233\\nPMID: 37910159\",\"difficulty\":\"easy\",\"domain\":\"Long Structured Data Understanding\",\"length\":\"short\",\"question\":\"From the table 1, with the increase of current annual income, people who is LGBT can suffer less from bullying?\",\"sub_domain\":\"Table QA\"}","display_format":"text","language":"","answer_status":"published","assets":[],"source_url":"https://huggingface.co/datasets/zai-org/LongBench-v2","history":"initial import","indexing_mode":"noindex","subproblems":[],"grids":[]}