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Many studies have reported on gender differences in bully and victim rates, but with the majority of reports from a small number of countries. Here we report on such gender differences from five large cross-national data bases. We report on overall male:female (M:F) ratios, and variations in these by age (or grade), by survey time point, and by offline/online bullying. We also compare consistency of M:F ratios across countries, over the five surveys. The preponderance of male perpetrators of bullying is found consistently across surveys, and survey time point. It is also consistent by age, but HBSC data suggest a curvilinear trend in early adolescence. Males also tend to more frequently be victims of bullying, consistent across age and survey time point, but with variations by survey. There is some indication of a decrease in M:F ratio recently in mid-adolescence, possibly related to online bullying. At least relatively, females are more involved as victims of online than offline bullying. Comparing recent findings on M:F ratio across countries for the five surveys, correlations vary from high to near zero.Implications for the explanation of gender differences in different countries, the comparability of data from different surveys, and for gender-specific interventions, are discussed.

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This brief commentary article considers the implications of intensive outcome monitoring which is central to children and young people's Improving Access to Psychological Therapies (CYP IAPT) in England and Wales. Services are being provided with a range of free software solutions to enable data collection, and guidance on interpretation of the measures, but there will still be some burden of data entry and collation for already overstretched services. It may be that the utility of the feedback will go some way to offset the sense of burden but this remains to be seen. Whether commissioners and others will rise to the challenge of supporting this aspect may prove crucial to the success or otherwise of such intensive ROM use. Many aspects of the CYP IAPT approach are new and whilst drawing on experience from earlier pilots of session by session monitoring in CAMHS both in the UK and abroad, and from Adult IAPT, there is likely to be much for us to learn. Time will tell whether the approach helps to improve the care children and young people receive but we are cautiously optimistic.

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Background: Establishing what constitutes clinically significant change is important both for reviewing the function of services and for reflecting on individual clinical practice. A range of methods for assessing change exist, but it remains unclear which are best to use and under which circumstances. Method: This paper reviews four indices of change [difference scores (DS), crossing clinical threshold (CCT), reliable change index (RCI) and added value scores (AVS)] drawing on outcome data for 9764 young people from child and adolescent mental health services across England. Results: Looking at DS, the t-test for time one to time two scores indicated a significant difference between baseline and follow up scores, with a standardised effect size of d = 0.40. AVS analysis resulted in a smaller effect size of 0.12. Analysis of those crossing the clinical threshold showed 21.2% of cases were classified as recovered, while 5.5% were classified as deteriorated. RCI identified 16.5% of cases as showing reliable improvement and 2.3% of cases as showing reliable deterioration. Across RCI and CCT 80.5% of the pairings were exact (i.e., identified in the same category using each method). Conclusions: Findings indicate that the level of agreement across approaches is at least moderate; however, the estimated extent of change varied to some extent based on the index used. Each index may be appropriate for different contexts: CCT and RCI may be best suited to use for individual case review; whereas DS and AVS may be more appropriate for case-mix adjusted national reporting. Key Practitioner Message• There is a potential for different approaches to measuring a change in symptoms over time leading to different conclusions about the effectiveness of services: therefore it is inadvisable to make automatic summative judgements of services based on one approach or metric.• It is important to use the most appropriate method corresponding to the specific question being asked. For example, CCT and RCI at the individual case level to review changes for individual children and families; standardised effect sizes (such as the AVS) to compare populations with a similar case-mix and provide comparisons at the national policy level.• Triangulation with other informationincluding service satisfaction, therapeutic alliance and functioning in everyday lifeis an essential pre-requisite if such data are to be used in meaningful ways.• It is essential that practitioners, service managers, policy makers, commissioners and service users themselves understand the differences in these metrics so that they can appropriately make sense of outcome data presented to them.

The characteristics of bullies who act face to face and those who do so in cyberspace were compared directly in one sample across 25 countries. The nature of cross-country differences due to their technological infrastructure was also explored. Cyberbullies compared to face-to-face bullies were more likely to engage in risky online activities, spend more time online, and were finding it easier to be themselves online. Private access to the internet did not make a difference. Gender differences showed girls more likely to be cyber-than face-toface bullies when a profile on a social networking site was present. Age and internet ability beliefs were also positively but not independently associated with cyberbullying. Cross-country differences were small and patterns remained mostly stable across countries, suggesting that individual and not country-level characteristics are pivotal in explaining cyberbullying.

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