Journal of Abnormal Child Psychology

, Volume 42, Issue 8, pp 1313–1324 | Cite as

Bullying Victimisation, Internalising Symptoms, and Conduct Problems in South African Children and Adolescents: A Longitudinal Investigation

  • Mark E. BoyesEmail author
  • Lucy Bowes
  • Lucie D. Cluver
  • Catherine L. Ward
  • Nicholas A. Badcock


Bullying victimisation has been prospectively linked with mental health problems among children and adolescents in longitudinal studies in the developed world. However, research from the developing world, where adolescents face multiple risks to social and emotional development, has been limited by cross-sectional designs. This is the first longitudinal study of the psychological impacts of bullying victimisation in South Africa. The primary aim was to examine prospective relationships between bullying victimisation and internalising and externalising symptoms in South African youth. Secondary aims were to examine gender and age-related differences in experiences of bullying victimisation. Children and adolescents (10–17 years, 57 % female, n = 3,515) from high HIV-prevalent (>30 %) communities in South Africa were interviewed and followed-up 1 year later (97 % retention). Census enumeration areas were randomly selected from urban and rural sites in two provinces and door-to-door sampling included all households with a resident child/adolescent. Exposure to multiple experiences of bullying victimisation at baseline predicted internalising symptoms and conduct problems 1 year later. Additionally, baseline mental health scores predicted later bullying victimisation, demonstrating bi-directionality of relationships between bullying victimisation and mental health outcomes in this sample. Expected gender differences in physical, verbal, and relational bullying victimisation were evident and predicted declines in bullying victimisation over time were observed. In the developed world, school-based anti-bullying programmes have been shown to be effective in reducing bullying and victimisation. Anti-bullying programmes should be implemented and rigorously evaluated in South Africa, as this may promote improved mental health among South African children and adolescents.


Bullying Victimisation Anxiety Depression Adolescent Gender South Africa 



This study was funded by the UK Economic and Social Research Council, the South African National Research Foundation, the Health Economics and HIV/AIDS Research Division (HEARD) at the University of KwaZulu-Natal, the South African National Department of Social Development, the Claude Leon Foundation, the John Fell Fund, and the Nuffield Foundation. The authors wish to thank the South African fieldwork teams and all the participants and their families.

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. Amaya-Jackson, L., McCarthy, G., Cherney, M. S., & Newman, E. (1995). Child PTSD Checklist ©. Durham: Duke University Medical Center.Google Scholar
  2. Anderson, J. C., Williams, S. M., McGee, R., & Silva, P. A. (1987). DSM-III disorders in preadolescent children: Prevalence in a large sample from the general population. Archives of General Psychiatry, 44, 69–76.PubMedCrossRefGoogle Scholar
  3. Arseneault, L., Milne, B. J., Taylor, A., Adams, F., Delgado, K., Caspi, A., et al. (2008). Being bullied as an environmentally mediated contributing factor to children’s internalizing problems: A study of twins discordant for victimization. Archives of Pediatrics and Adolescent Medicine, 162, 145–150.PubMedCrossRefGoogle Scholar
  4. Arseneault, L., Bowes, L., & Shakoor, S. (2010). Bullying victimization in youths and mental health problems: ‘Much ado about nothing’? Psychological Medicine, 40, 717–729.PubMedCrossRefGoogle Scholar
  5. Barnes, H., & Wright, G. (2012). Defining child poverty in South Africa using the socially percieved necessities approach. In A. Minujin (Ed.), Global child poverty and well-being: measurement, concepts, policy and action. Bristol: The Policy Press.Google Scholar
  6. Bjorkqvist, K., Lagerspetz, K. M. J., & Kaukiainen, A. (1992). Do girls manipulate and boys fight? Developmental trends in regard to direct and indirect aggression. Aggressive Behavior, 18, 117–127.CrossRefGoogle Scholar
  7. Blunch, N. J. (2008). Introduction to structural equation modelling using SPSS and AMOS. London: Sage.Google Scholar
  8. Bond, L., Carlin, J., Thomas, L., Rubin, K., & Patton, G. (2001). Does bullying cause emotional problems? A prospective study of young teenagers. British Medical Journal, 323, 480–484.PubMedCrossRefPubMedCentralGoogle Scholar
  9. Boyes, M. E., & Cluver, L. (2013a). Performance of the Revised Children’s Manifest Anxiety Scale in a sample of children and adolescents from poor urban communities in Cape Town. European Journal of Psychological Assessment, 29, 113–120.CrossRefGoogle Scholar
  10. Boyes, M. E., & Cluver, L. (2013b). Relationships among HIV/AIDS-orphanhood, stigma, and symptoms of anxiety and depression in South African youth: A longitudinal investigation using a path analysis framework. Clinical Psychological Science, 1, 323–330.CrossRefGoogle Scholar
  11. Boyes, M. E., Cluver, L., & Gardner, F. (2012). Psychometric properties of the Child PTSD Checklist in a community sample of South African children and adolescents. PLOS ONE, 7, e46905. DOI:  10.1371/journal.pone.0046905.
  12. Bronfrenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge: Harvard University Press.Google Scholar
  13. Brown, D., Riley, L., Butchart, A., & Kann, L. (2008). Bullying among youth from eight African countries and associations with adverse health behaviours. Pediatric Health, 2, 289–299.CrossRefGoogle Scholar
  14. Brunstein Klomak, A., Marrocco, F., Kleinman, M., Schonfeld, I., & Gould, M. (2007). Bullying, depression, and suicidality in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 40–49.CrossRefGoogle Scholar
  15. Burton, P. (2008). National primary school violence survey 2007. Cape Town: Centre for Justice and Crime Prevention.Google Scholar
  16. Cluver, L., Gardner, F., & Operario, D. (2007). Psychological distress amongst AIDS-orphaned children in urban South Africa. Journal of Child Psychology and Psychiatry, 48, 755–763.PubMedCrossRefGoogle Scholar
  17. Cluver, L., Gardner, F., & Operario, D. (2009). Poverty and psychological health among AIDS-orphaned children in Cape Town, South Africa. AIDS Care, 21, 732–741.PubMedCrossRefGoogle Scholar
  18. Cluver, L., Bowes, L., & Gardner, F. (2010). Risk and protective factors for bullying victimization among AIDS-affected and vulnerable children in South Africa. Child Abuse and Neglect, 34, 793–803.PubMedCrossRefGoogle Scholar
  19. Cluver, L., Orkin, M., Boyes, M., Gardner, F., & Nikelo, J. (2012a). AIDS-orphanhood and cargiver AIDS-sickness status: Effects on psychological symptoms in South African youth. Journal of Pediatric Psychology, 37, 857–867.PubMedCrossRefGoogle Scholar
  20. Cluver, L., Orkin, M., Gardner, F., & Boyes, M. E. (2012b). Persisting mental health problems among AIDS-orphaned children in South Africa. Journal of Child Psychology and Psychiatry, 53, 363–370.PubMedCrossRefGoogle Scholar
  21. Coelho, R., Martins, A., & Barros, H. (2002). Clinical profiles relating gender and depressive symptoms among adolescents ascertained by the Beck Depression Inventory II. European Psychiatry, 17, 222–226.PubMedCrossRefGoogle Scholar
  22. Cortina, M. A., Fazel, M., Hlungwani, T. M., Kahn, K., Tollman, S., Cortina-Borja, M., & Stein, A. (2013). Childhood psychological problems in school settings in rural Southern Africa. PLOS ONE, 8, e65041, DOI:  10.1371/journal.pone.0065041.
  23. Eccles, J., Midgley, C., Wigfield, A., Buchannan, C., Reuman, D., Flanagan, C., et al. (1993). Development during adolescence: The impact of stage-environment fit on young adolescents’ experiences in schools and in families. American Psychologist, 48, 90–101.PubMedCrossRefGoogle Scholar
  24. Fekkes, M., Pijpers, F., Fredriks, A., Vogels, T., & Verloove-Vanhorick, S. (2006). Do bullied children get ill, or do ill children get bullied? A prospective cohort study on the relationship between bullying and health-related symptoms. Pediatrics, 117, 1568–1574.PubMedCrossRefGoogle Scholar
  25. Field, A. (2005). Discovering statistics using SPSS (2nd ed.). London: Sage.Google Scholar
  26. Flisher, A. J., Ward, C., Liang, H., Onya, H., Mlisa, N., Terblanche, S., et al. (2006). Injury-related behaviour among South African high-school students at six sites. South African Medical Journal, 96, 825–830.PubMedGoogle Scholar
  27. Forero, R., McLellan, L., Rissel, C., & Bauman, A. (1999). Bullying behaviour and associations with psychosocial health among school students in New South Wales, Australia: Cross-sectional survey. British Medical Journal, 319, 344–348.PubMedCrossRefPubMedCentralGoogle Scholar
  28. Ghoul, A., Niwa, E., & Boxer, P. (2013). The role of contingent self-worth in the relation between victimisation and internalising problems in adolescents. Journal of Adolescence, 36, 457–464.PubMedCrossRefGoogle Scholar
  29. Giaconia, R. M., Reinherz, H. Z., Silverman, A., Pakis, B., Frost, A., & Cohen, E. (1993). Ages of onset of psychiatric disorders in a community population of older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 707–716.Google Scholar
  30. Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586.PubMedCrossRefGoogle Scholar
  31. Goodman, R., Meltzer, H., & Bailey, V. (1998). The Strengths and Difficulties Questionnaire: A pilot study on the validity of the self-report version. European Child and Adolescent Psychiatry, 7, 125–130.PubMedCrossRefGoogle Scholar
  32. Hawker, D., & Boulton, M. (2000). Twenty year’s research on peer victimization and psychosocial maladjustment: A meta-analytic review of cross-sectional studies. Journal of Child Psychology and Psychiatry, 41, 441–455.PubMedCrossRefGoogle Scholar
  33. Kaltiala-Heino, R., Rimpela, M., Rantanen, P., & Rimpela, A. (2000). Bullying at school - An indicator of adolescents at risk for mental disorders. Journal of Adolescence, 23, 661–674.PubMedCrossRefGoogle Scholar
  34. Kaltiala-Heino, R., Frojd, S., & Marttunen, M. (2010). Involvement in bullying and depression in a 2-year follow-up in middle adolescence. European Child and Adolescent Psychiatry, 19, 45–55.PubMedCrossRefGoogle Scholar
  35. Kessler, R. C., Mcgonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-Month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the national comorbidity survey. Archives of General Psychiatry, 51, 8–9.PubMedCrossRefGoogle Scholar
  36. Khatri, P., Kupersmidt, J. B., & Patterson, C. (2000). Aggression and peer victimization as predictors of self-reported behavioral and emotional adjustment. Aggressive Behavior, 26, 345–358.CrossRefGoogle Scholar
  37. Kim, Y., Koh, Y., & Leventhal, B. (2005). School bullying and suicidal risk in Korean middle school students. Pediatrics, 115, 357–363.PubMedCrossRefGoogle Scholar
  38. Kovacs, M. (1992). Children’s Depression Inventory. Niagra Falls: Multi-health Systems.Google Scholar
  39. Larson, R., & Richards, M. (1991). Daily companionship in late childhood and early adolescence: Changing developmental contexts. Child Development, 62, 284–300.PubMedCrossRefGoogle Scholar
  40. Lewinsohn, P. M., Gotlib, I. H., Lewinsohn, M., Seeley, J. R., & Allen, N. B. (1998). Gender differences in anxiety disorders and anxiety symptoms in adolescents. Journal of Abnormal Psychology, 107, 109–117.PubMedCrossRefGoogle Scholar
  41. Liang, H., Flisher, A. J., & Lombard, C. (2007). Bullying, violence, and risk behavior in South African school students. Child Abuse and Neglect, 31, 161–171.PubMedCrossRefGoogle Scholar
  42. McLean, C. P., & Anderson, E. R. (2009). Brave men and timid women? A review of gender differences in fear and anxiety. Clinical Psychology Review, 29, 496–505.PubMedCrossRefGoogle Scholar
  43. Michael, K. D., & Merrell, K. W. (1998). Reliability of children’s self-reported internalizing symptoms over short to medium length time intervals. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 194–201.PubMedCrossRefGoogle Scholar
  44. Mulis, I. V. S., Martin, M. O., Kennedy, A. M., & Foy, P. (2007). PIRLS 2006: IEAs progress in international reading literacy study in primary schools in 40 countries. MA: Chestnut Hill.Google Scholar
  45. Mynard, H., & Joseph, S. (2000). Development of the Multidimensional Peer Victimization Scale. Aggressive Behavior, 26, 169–178.CrossRefGoogle Scholar
  46. Nansel, T. R., Overpeck, M. O., Pilla, R. S., Ruan, W. J., Simons-Morton, B., & Scheidt, P. (2001). Bullying behaviors among US youth: Prevalence and association with psychosocial adjustment. Journal of the American Medical Association, 16, 2094–2100.CrossRefGoogle Scholar
  47. Nansel, T. R., Craig, W., Overpeck, M. O., Saluja, G., Ruan, W. J., & Health Behavior in School-aged Children Analyses Working Group. (2004). Cross-national consistency in the relationship between bullying behaviors and psychosocial adjustment. Archives of Pediatrics and Adolescent Medicine, 158, 730–736.PubMedCrossRefPubMedCentralGoogle Scholar
  48. Olweus, D. (1993). Bullying at school: What we know and what we can do. Oxford: Blackwell.Google Scholar
  49. Pillay, U., Roberts, B., & Rule, S. (2006). South African social attitudes: changing times, diverse voices. Cape Town: HSRC Press.Google Scholar
  50. Reddy, S. P., Panday, S., Swart, D., Jinabhai, C. C., Amosun, S. L., James, S., et al. (2003). Umthenthe Uhlaba Usamila – The South African Youth Risk Behaviour Survey 2002. Cape Town: South African Medical Research Council.Google Scholar
  51. Reijntjes, A., Kamphuis, J., Prinzie, P., & Telch, M. (2010). Peer victimization and internalizing problems in children: A meta-analysis of longitudinal studies. Child Abuse and Neglect, 34, 244–252.PubMedCrossRefGoogle Scholar
  52. Reynolds, C., & Richmond, B. (1978). What I think and feel: A revised measure of children’s anxiety. Journal of Abnormal Child Psychology, 6, 271–280.PubMedCrossRefGoogle Scholar
  53. Richter, L., & Dawes, A. (2008). Child abuse in South Africa: Rights and wrongs. Child Abuse Review, 17, 79–93.CrossRefGoogle Scholar
  54. Rigby, K. (2002). New perspectives on bullying. London: Jessica Kingsley.Google Scholar
  55. Rivers, I., & Smith, P. K. (1994). Types of bullying behaviour and their correlates. Aggressive Behavior, 20, 359–368.CrossRefGoogle Scholar
  56. Rothon, C., Head, J., Klineberg, E., & Stansfeld, S. (2011). Can social support protect bullied adolescents from adverse outcomes? A prospective study on the effects of bullying on the educational achievement and mental health of adolescents at secondary schools in East London. Journal of Adolescence, 34, 579–588.PubMedCrossRefPubMedCentralGoogle Scholar
  57. Ruchkin, V., Schwab-Stone, M., & Vermeiren, R. (2004). Social and Health Assessment (SAHA) psychometric development summary. New Haven: Yale University.Google Scholar
  58. Salmivalli, C., & Peets, K. (2009). Bullies, victims, and bully-victim relationships in middle childhood and early adolescence. In K. Rubin, M. Bukowski, & B. Laurens (Eds.), Handbook of peer interactions, relationships, and groups (pp. 322–340). New York: Guildford Press.Google Scholar
  59. Schwartz, D., McFayden-Ketchum, S. A., Dodge, K. A., Pettit, G. S., & Bates, J. E. (1998). Peer group victimization as a predictor of children’s behavior problems at home and in school. Development and Psychopathology, 10, 87–99.PubMedCrossRefGoogle Scholar
  60. Seedat, S., Nyamai, C., Njenja, F., Vythilingum, B., & Stein, D. (2004). Trauma exposure and posttraumatic stress symptoms in urban African schools. British Journal of Psychiatry, 184, 169–175.PubMedCrossRefGoogle Scholar
  61. Shetgiri, R., Lin, H., & Flores, G. (2012). Identifying children at risk for being bullies in the United States. Academic Pediatrics, 12, 509–522.PubMedCrossRefPubMedCentralGoogle Scholar
  62. Shields, N., Nadasen, K., & Pierce, L. (2009). A comparison of the effects of witnessing community violence and direct victimization among children in Cape Town, South Africa. Journal of Interpersonal Violence, 24, 1192–1208.PubMedCrossRefGoogle Scholar
  63. Siziya, S., Muula, A., & Rudatsikira, E. (2007). Prevalence and correlates of truancy among adolescents from Swaziland: Findings from the Global School-Based Health Survey. Child and Adolescent Psychiatry and Mental Health, 1, 15.PubMedCrossRefPubMedCentralGoogle Scholar
  64. Suliman, S., Mkabile, S. G., Fincham, D. S., Ahmed, R., Stein, D., & Seedat, S. (2009). Cumulative effect of multiple trauma on symptoms of posttraumatic stress disorder, anxiety, and depression in adolescents. Comprehensive Psychiatry, 50, 121–127.PubMedCrossRefGoogle Scholar
  65. Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2, 53–55.CrossRefGoogle Scholar
  66. Townsend, L., Flisher, A. J., Chikobvu, P., Lombard, C., & King, G. (2008). The relationship between bullying behaviours and high school dropout in Cape Town, South Africa. South African Journal of Psychology, 38, 21–32.CrossRefGoogle Scholar
  67. Ttofi, M. M., & Farrington, D. P. (2011). Effectiveness of school-based programs to reduce bullying: a systematic and meta-analytic review. Journal of Experimental Criminology, 7, 27–56.CrossRefGoogle Scholar
  68. van der Wal, M., de Wit, C., & Hirasing, R. (2003). Psychosocial health among young victims and offenders of direct and indirect bullying. Pediatrics, 111, 1312–1317.PubMedCrossRefGoogle Scholar
  69. Visconti, K., & Troop-Gordon, W. (2010). Prospective relations between children’s responses to peer victimization and their socioemotional adjustment. Journal of Applied Developmental Psychology, 31, 261–272.CrossRefGoogle Scholar
  70. Vreeman, R. C., & Carroll, A. E. (2007). A systematic review of school-based interventions to prevent bullying. Archives of Pediatrics and Adolescent Medicine, 161, 78–88.PubMedCrossRefGoogle Scholar
  71. Williford, A., Boulton, A., Noland, B., Little, T. D., Karna, A., & Salmivalli, C. (2012). Effects of the KiVa anti-bullying program on adolescent’s depression, anxiety, and perception of peers. Journal of Abnormal Child Psychology, 40, 289–300.PubMedCrossRefGoogle Scholar
  72. Yen, C.-F., Huang, M.-F., Kim, Y., Wang, P.-W., Tang, T.-C., Yeh, Y.-C., et al. (2013). Association between types of involvement in school bullying and different dimensions of anxiety symptoms and the moderating effects of age and gender in Taiwanese adolescents. Child Abuse and Neglect, 37, 263–272.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Mark E. Boyes
    • 1
    • 2
    Email author
  • Lucy Bowes
    • 2
  • Lucie D. Cluver
    • 2
    • 3
  • Catherine L. Ward
    • 4
    • 5
  • Nicholas A. Badcock
    • 6
  1. 1.Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech PathologyCurtin UniversityPerthWestern Australia
  2. 2.Centre for Evidence-Based Intervention, Department of Social Policy and InterventionUniversity of OxfordOxfordUnited Kingdom
  3. 3.Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
  4. 4.Department of PsychologyUniversity of Cape TownCape TownSouth Africa
  5. 5.Safety and Violence InitiativeUniversity of Cape TownCape TownSouth Africa
  6. 6.ARC Centre of Excellence in Cognition and its Disorders, Department of Cognitive ScienceMacquarie UniversitySydneyAustralia

Personalised recommendations