European Journal of Pediatrics

, 166:1253

Bullying behaviours and psychosocial health: results from a cross-sectional survey among high school students in Istanbul, Turkey

  • Mujgan Alikasifoglu
  • Ethem Erginoz
  • Oya Ercan
  • Omer Uysal
  • Deniz Albayrak-Kaymak
Original Paper


The aim of this study was to investigate bullying behaviours and their associations with health and health risk behaviours. This study involved completion of the Health Behaviour in School-Aged Children (HBSC) and Youth Self Report (YSR) questionnaires by 3,519 students. Of the students, 59.4% (n = 2,091) were neither bullies/nor victims, 22% (n = 774) victims, 9.4% (n = 331) bully/victims and 9.2% (n = 323) bullies. Generally, students involved in bullying behaviours were more likely to have higher YSR scale scores than students who were not involved in bullying behaviours. Bully/victims had higher scores on the YSR subscales than others. Students involved in bullying behaviours were more likely not to use seat belts, to watch TV ≥ 4 h/day, to be involved in a physical fight, to skip class and to spend time with friends than students who were not involved in bullying behaviours. Bully/victims and bullies were more likely to smoke cigarettes, to drink alcohol, to be drunk, to play computer games and to be sexually active than others. Bully/victims were more likely to have less educated mothers and to have difficulty in talking to both parents than others. Victims were more likely to have a lower socioeconomic status, to have difficulty in talking to opposite gender friends and to have difficulty in making new friends than others. Bullying behaviour is common and associated with other risk behaviours and psychological health problems in Istanbul high school students. Health professionals should be aware of the influence of bullying on health and particularly on bully/victims’ health. There is a strong need for bullying prevention programmes in schools in Turkey.


Bullying Adolescence Psychosocial health Risk behaviours 


  1. 1.
    Alikasifoglu M, Erginoz E, Ercan O, Albayrak-Kaymak D, Uysal O, Ilter O (2006) Sexual abuse among female high school students in Istanbul, Turkey. Child Abuse Negl 30:247–255PubMedCrossRefGoogle Scholar
  2. 2.
    Bond L, Carlin JB, Thomas L, Rubin K, Patton G (2001) Does bullying cause emotional problems? A prospective study of young teenagers. BMJ 323:480–484PubMedCrossRefGoogle Scholar
  3. 3.
    Craig WM, Pepler DJ (2003) Identifying and targeting risk for involvement in bullying and victimization. Can J Psychiatry 48:577–582PubMedGoogle Scholar
  4. 4.
    Currie C, Hurrelmann K, Settertobulte W, Smith R, Todd J (2000) Health and health behaviour among young people. Health behaviour in school-aged children: a WHO cross-national study (HBSC) international report. Health policy for children and adolescents (HEPCA) Series No. 1Google Scholar
  5. 5.
    Currie C, Roberts C, Morgan A, Smith R, Settertobulte W, Samdal O, Rasmussen-Barnekow V (2004) Young people’s health in context: international report from the HBSC 2001/2002 survey. WHO policy series: health policy for children and adolescents Issue 4. WHO Regional Office for Europe, CopenhagenGoogle Scholar
  6. 6.
    Dake JA, Price JH, Telijohann SK (2003) The nature and extent of bullying at school. J Sch Health 73:173–180PubMedCrossRefGoogle Scholar
  7. 7.
    Due P, Holstein BE, Lynch J, Diderichsen F, Gabhain SN, Scheidt P, Currie C, The Health Behaviour in School-Aged Children Bullying Working Group (2005) Bullying and symptoms among school-aged children: international comparative cross sectional study in 28 countries. Eur J Public Health 15:128–132PubMedCrossRefGoogle Scholar
  8. 8.
    Erginoz E, Alikasifoglu M, Ercan O, Uysal O, Ercan G, Albayrak Kaymak D, Ilter O (2004) Perceived health status in a Turkish adolescent sample: risk and protective factors. Eur J Pediatr 163:485–494PubMedCrossRefGoogle Scholar
  9. 9.
    Verhulst FC, Achenbach TM, van der Ende J, Erol N, Lambert MC, Leung PWL, Silva MA, Zilber N, Zubrick SR (2003) Comparisons of problems reported by youths from seven countries. Am J Psychiatry 160:1479–1485PubMedCrossRefGoogle Scholar
  10. 10.
    Eslea M, Menesini E, Morita Y, O’Moore M, Mora-Merchan JA, Pereira B, Smith PK (2004) Friendship and loneliness among bullies and victims: data from seven countries. Aggress Behav 30:71–83CrossRefGoogle Scholar
  11. 11.
    Fekkes M, Pijpers FIM, Verlove-Vanhorick SP (2004) Bullying behavior and associations with psychosomatic complaints and depression in victims. J Pediatr 144:17–22PubMedCrossRefGoogle Scholar
  12. 12.
    Forero R, McLellan L, Rissel C, Bauman A (1999) Bullying behaviour and psychosocial health among school students in New South Wales, Australia: cross sectional survey. BMJ 319:344–348PubMedGoogle Scholar
  13. 13.
    Gofin R, Palti H, Gordon L (2002) Bullying in Jerusalem schools: victims and perpetrators. Public Health 116:173–178PubMedGoogle Scholar
  14. 14.
    Green MB (2005) Reducing violence and aggression in schools. Trauma Violence Abuse 6:236–253CrossRefGoogle Scholar
  15. 15.
    Green MB (2006) Bullying in school: a plea for measure of human rights. J Soc Issues 62:63–79CrossRefGoogle Scholar
  16. 16.
    Hawker DS, Boulton MJ (2000) Twenty years’ research on peer victimization and psychosocial maladjustment: a meta-analytic review of cross-sectional studies. J Child Psychol Psychiatry 41:441–455PubMedCrossRefGoogle Scholar
  17. 17.
    Ivarsson T, Broberg AG, Arvidsson T, Gillberg C (2005) Bullying in adolescence: psychiatric problems in victims and bullies as measured by the Youth Self Report (YSR) and the Depression Self-Rating Scale (DSRS). Nord J Psychiatry 59:365–373PubMedCrossRefGoogle Scholar
  18. 18.
    Juvonen J, Graham S, Schuster MA (2003) Bullying among young adolescents: the strong, the weak, and the troubled. Pediatrics 112:1231–1237PubMedCrossRefGoogle Scholar
  19. 19.
    Kaltiala-Heino R, Rimpela M, Marttunen M, Rimpela A, Rantanen P (1999) Bullying, depression, and suicidal ideation in Finnish adolescents: school survey. BMJ 319:348–351PubMedGoogle Scholar
  20. 20.
    Kaltiala-Heino R, Rimpela M, Rantanen P, Rimpela A (2000) Bullying at school-an indicator of adolescents at risk for mental disorders. J Adolesc 23:661–674PubMedCrossRefGoogle Scholar
  21. 21.
    Kepenekci-Karaman Y, Cinkir S (2006) Bullying among Turkish high school students. Child Abuse Negl 30:193–204CrossRefGoogle Scholar
  22. 22.
    Kim YS, Koh YJ, Leventhal B (2005) School bullying and suicidal risk in Korean middle school students. Pediatrics 115:357–363PubMedCrossRefGoogle Scholar
  23. 23.
    Kristensen SM, Smith PK (2003) The use of coping strategies by Danish children classed as bullies, victims, bully/victims, and not involved, in response to different (hypothetical) types of bullying. Scand J Psychol 44:479–488PubMedCrossRefGoogle Scholar
  24. 24.
    Kumpulainen K, Rasanen E, Henttonen I, Almqvist F, Kresanov K, Linna SL, Moilanen I, Piha J, Puura K, Tamminen T (1998) Bullying and psychiatric symptoms among elementary school-age children. Child Abuse Negl 22:705–717PubMedCrossRefGoogle Scholar
  25. 25.
    Kumpulainen K, Rasanen E, Henttonen I (1999) Children involved in bullying: psychosocial disturbance and the persistence of the involvement. Child Abuse Negl 23:1253–1262PubMedCrossRefGoogle Scholar
  26. 26.
    Kumpulainen K, Rasanen E (2000) Children involved in bullying at elementary school age: their psychiatric symptoms and deviance in adolescence. Child Abuse Negl 24:1567–1577PubMedCrossRefGoogle Scholar
  27. 27.
    Nansel TR, Overpeck M, Pilla RS, Ruan WJ, Simons-Morton B, Scheidt P (2001) Bullying behaviors among US youth. Prevalence and association with psychosocial adjustment. JAMA 285:2094–2100PubMedCrossRefGoogle Scholar
  28. 28.
    Newman ML, Holden GW, Delville Y (2005) Isolation and the stress of being bullied. J Adolesc 28:343–357PubMedCrossRefGoogle Scholar
  29. 29.
    Olweus D (1994) Bullying at school: basic facts and effects of a school based intervention program. J Child Psychol Psychiatry 35:1171–1190PubMedCrossRefGoogle Scholar
  30. 30.
    Rigby K (2000) Effects of peer victimization in schools and perceived social support on adolescent well-being. J Adolesc 23:57–68PubMedCrossRefGoogle Scholar
  31. 31.
    Rigby K (2003) Consequences of bullying in schools. Can J Psychiatry 48:583–590PubMedGoogle Scholar
  32. 32.
    Rivers I, Smith PK (1994) Types of bullying behavior and their correlates. Aggresse Behav 20:359–368CrossRefGoogle Scholar
  33. 33.
    Salmivalli C (1999) Participant role approach to school bullying: implication for interventions. J Adolesc 22:453–549PubMedCrossRefGoogle Scholar
  34. 34.
    Salmon G, James A, Smith DM (1998) Bullying in schools: self reported anxiety, depression, and self esteem in secondary school children. BMJ 317:924–925PubMedGoogle Scholar
  35. 35.
    Seals D, Young J (2003) Bullying and victimization: prevalence and relationship to gender, grade level, ethnicity, self-esteem, and depression. Adolescence 38:735–747PubMedGoogle Scholar
  36. 36.
    Stevens V, De Bourdeaudhuj I, Van Oost P (2000) Bullying in Flemish schools: an evaluation of anti-bullying intervention in primary and secondary schools. Br J Educ Psychol 70:195–210PubMedCrossRefGoogle Scholar
  37. 37.
    Smith PK, Madsen KC, Moody JC (1999) What causes the age decline in reports of being bullied at school? Towards a developmental analysis of risks of being bullied. Educ Res 41:267–285Google Scholar
  38. 38.
    Smith PK, Talamelli L, Cowie H, Naylor P, Chauan P (2004) Profiles of non-victims, escaped victims, continuing victims and new victims of school bullying. Br J Educ Psychol 74:565–581PubMedCrossRefGoogle Scholar
  39. 39.
    Sourander A, Helstela L, Helenius H, Piha J (2000) Persistence of bullying from childhood to adolescence-a longitudinal 8-year follow-up study. Child Abuse Negl 24:873–881PubMedCrossRefGoogle Scholar
  40. 40.
    van der Wal MF (2004) There is bullying and bullying. Eur J Pediatr 164:117–118PubMedGoogle Scholar
  41. 41.
    van der Wal MF, de Wit CAM, Hirasing RA (2005) Psychosocial health among young victims and offenders of direct and indirect bullying. Pediatrics 111:1312–1317Google Scholar
  42. 42.
    Wolke D, Woods S, Bloomfield L, Karstadt L (2001) Bullying involvement in primary school and common health problems. Arch Dis Child 85:197–201PubMedCrossRefGoogle Scholar
  43. 43.
    Wolke D, Woods S, Stanford K, Schulz H (2001) Bullying and victimization of primary school children in England and Germany: prevalence and school factors. Br J Psychol 92:673–696PubMedCrossRefGoogle Scholar
  44. 44.
    Woods S, White E (2005) The association between bullying behaviour, arousal levels and behaviour problems. J Adolesc 28:381–395PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Mujgan Alikasifoglu
    • 1
  • Ethem Erginoz
    • 2
  • Oya Ercan
    • 3
  • Omer Uysal
    • 4
  • Deniz Albayrak-Kaymak
    • 5
  1. 1.Department of Pediatrics, Division of Adolescent Medicineİstanbul University, Cerrahpasa Medical FacultyIstanbulTurkey
  2. 2.Department of Public Healthİstanbul University, Cerrahpasa Medical FacultyIstanbulTurkey
  3. 3.Department of Pediatrics, Divisions of Adolescent Medicine and Pediatric Endocrinologyİstanbul University, Cerrahpasa Medical FacultyAksaray, Fatih, IstanbulTurkey
  4. 4.Department of Biostatisticsİstanbul University, Cerrahpasa Medical FacultyIstanbulTurkey
  5. 5.Department of EducationBogazici UniversityIstanbulTurkey

Personalised recommendations