Rates of victimization and bullying perpetration may vary by adolescents’ health status. The purpose of this study was to examine risk for bullying and victimization while considering multiple health conditions and health-related behaviors. Self-reported data were collected from 64,670 youth (50.3% female; 48.8% White; 25.7% Black/African American) enrolled at 107 middle and high schools across the state of Maryland. Two-level logistic regressions examined the association between health conditions and other health-related behaviors (i.e., physical activity, asthma, healthy eating, sleep troubles, obesity, and being overweight) and bullying. Results indicated that obese youth had higher odds of being a victim or bully-victim. Youth with asthma were more likely to be victimized, both in-person and online, and were more likely to be cyberbully-victims. Sleep difficulties were consistently associated with involvement in bullying, having higher odds of being a victim or bully-victim in-person and online as well as higher odds of perpetration of bullying. In contrast, healthy food consumption was associated with significantly lower odds of bullying perpetration, and physical activity was associated with significantly lower odds of being a bully-victim. Taken together, the findings suggest that various conditions and health-related behaviors may be important risk factors for both bullying victimization and perpetration.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Adams, R. E., & Bukowski, W. M. (2008). Peer victimization as a predictor of depression and body mass index in obese and non‐obese adolescents. Journal of Child Psychology and Psychiatry, 49(8), 858–866.
Add Health. (2016). California Healthy Kids Survey: Physical Health & Nutirtion Module. Retrieved from http://chks.wested.org/wp-content/uploads/ms-physhealth-1718_watermark.pdf, http://www.cpc.unc.edu/projects/addhealth/documentation.
Alhaboby, Z. A., Barnes, J., Evans, H., & Short, E. (2017). Cyber-Victimization of People With Chronic Conditions and Disabilities: A Systematic Review of Scope and Impact. Trauma, Violence, & Abuse, 1-18. https://doi.org/10.1177/1524838017717743.
Benton, D. (2007). The impact of diet on anti-social, violent and criminal behaviour. Neuroscience and Biobehavioral Reviews, 31(5), 752–774.
Bradshaw, C. P., Sawyer, A. L., & O’Brennan, L. M. (2007). Bullying and peer victimization at school: Perceptual differences between students and school staff. School Psychology Review, 36(3), 361–382.
Bradshaw, C. P., Sawyer, A. L., & O’Brennan, L. M. (2009). A social disorganization perspective on bullying-related attitudes and behaviors: the influence of school context. American Journal Of Community Psychology, 43(3-4), 204–220. https://doi.org/10.1007/s10464-009-9240-1.
Bradshaw, C. P., Waasdorp, T. E., Debnam, K. J., & Lindstrom Johnson, S. (2014). Measuring school climate: a focus on safety, engagement, and the environment. Journal of School Health, 84(9), 593–604. https://doi.org/10.1111/josh.12186.
CDC. (1999). National Health Interview Survey: research for the 1995–2004 redesign. Vital and Health Statistics 2, 126, 121–129.
CDC. (2000). Measuring childhood asthma prevalence before and after the 1997 redesign of the National Health Interview Survey—United States. MMWR Morbidity and Mortality Weekly Report, 49(40), 908–911.
Cortese, S., Faraone, S. V., Konofal, E., & Lecendreux, M. (2009). Sleep in children with attention-deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. Journal of the American Academy of Child and Adolescent Psychiatry, 48(9), 894–908.
Erermis, S., Cetin, N., Tamar, M., Bukusoglu, N., Akdeniz, F., & Goksen, D. (2004). Is obesity a risk factor for psychopathology among adolescents?. Pediatrics International, 46(3), 296–301.
Erickson, S. J., Robinson, T. N., Haydel, K. F., & Killen, J. D. (2000). Are overweight children unhappy?: Body mass index, depressive symptoms, and overweight concerns in elementary school children. Archives of Pediatrics and Adolescent Medicine, 154(9), 931–935.
Espelage, D. L. & Swearer, S. M. (Eds.) (2004). Bullying in American schools: A socialecological perspective on prevention and intervention. Mahwah, NJ: Erlbaum.
Faith, M. A., Reed, G., Heppner, C. E., Hamill, L. C., Tarkenton, T. R., & Donewar, C. W. (2015). Bullying in medically fragile youth: a review of risks, protective factors, and recommendations for medical providers. Journal of Developmental and Behavioral Pediatrics, 36(4), 285–301.
Fekkes, M., Pijpers, F. I. M., Fredriks, A. M., Vogels, T., & Verloove-Vanhorick, S. P. (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(5), 1568–1574.
Fekkes, M., Pijpers, F. I. M., & Verloove-Vanhorick, S. P. (2004). Bullying behavior and associations with psychosomatic complaints and depression in victims. Journal of Pediatrics, 144, 17–22.
Finkelhor, D. (2013). Trends in bullying and peer victimization. Durham, NH: Crimes against Children Research Center. Updated on August 2014.
Fisher, G. G., Matthews, R. A., & Gibbons, A. M. (2016). Developing and investigating the use of single-item measures in organizational research. Journal of Occupational Health Psychology, 21(1), 3–23.
Fitzgerald, A., Fitzgerald, N., & Aherne, C. (2012). Do peers matter? A review of peer and/or friends’ influence on physical activity among American adolescents. Journal of Adolescence, 35(4), 941–958.
Gibson‐Young, L., Martinasek, M. P., Clutter, M., & Forrest, J. (2014). Are students with asthma at increased risk for being a victim of bullying in school or cyberspace? Findings from the 2011 Florida youth risk behavior survey. Journal of School Health, 84(7), 429–434.
Gini, G., & Pozzoli, T. (2009). Association between bullying and psychosomatic problems: a meta-analysis. Pediatrics, 123(3), 1059–1065.
Gini, G., Pozzoli, T., Lenzi, M., & Vieno, A. (2014). Bullying victimization at school and headache: a meta‐analysis of observational studies. Headache: The Journal of Head and Face Pain, 54(6), 976–986.
Gladden, R. M., Vivolo-Kantor, A. M., Hamburger, M. E., & Lumpkin, C. D. (2014). Bullying Surveillance Among Youths: Uniform Definitions for Public Health and Recommended Data Elements, Version 1.0. Atlanta, GA.: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, U.S. Department of Education.
Graham, S., Bellmore, A., & Juvonen, J. (2003). Peer victimization in middle school: when self-and peer views diverge. Journal of Applied School Psychology, 19(2), 117–137.
Gray, W. N., Kahhan, N. A., & Janicke, D. M. (2009). Peer victimization and pediatric obesity: a review of the literature. Psychology in the Schools, 46(8), 720–727.
Gregory, A. M., Cousins, J. C., Forbes, E. E., Trubnick, L., Ryan, N. D., Axelson, D. A., & Dahl, R. E. (2011). Sleep items in the child behavior checklist: a comparison with sleep diaries, actigraphy, and polysomnography. Journal of the American Academy of Child and Adolescent Psychiatry, 50(5), 499–507.
Iossi Silva, M. A., Pereira, B., Mendonça, D., Nunes, B., & Oliveira, W. A. D. (2013). The involvement of girls and boys with bullying: an analysis of gender differences. International Journal of Environmental Research and Public Health, 10(12), 6820–6831.
Jansen, P. W., Verlinden, M., Berkel, A. D.-v., Mieloo, C. L., Raat, H., Hofman, A., & Tiemeier, H. (2014). Teacher and peer reports of overweight and bullying among young primary school children. Pediatrics, 134(3), 473–480.
Kinney, T. A., Smith, B. A., & Donzella, B. (2001). The influence of sex, gender, self-discrepancies, and self-awareness on anger and verbal aggressiveness among US college students. The Journal of Social Psychology, 141(2), 245–275.
Kowalski, R. M., Giumetti, G. W., Schroeder, A. N., & Lattanner, M. R. (2014). Bullying in the digital age: a critical review and meta-analysis of cyberbullying research among youth. Psychological Bulletin, 140(4), 1073–1137.
Kowalski, R. M., & Limber, S. P. (2013). Psychological, physical, and academic correlates of cyberbullying and traditional bullying. Journal of Adolescent Health, 53(1, Suppl), S13–S20. https://doi.org/10.1016/j.jadohealth.2012.09.018.
Låftman, S. B., Modin, B., & Östberg, V. (2013). Cyberbullying and subjective health: a large-scale study of students in Stockholm, Sweden. Children and Youth Services Review, 35(1), 112–119.
Lien, L., Lien, N., Heyerdahl, S., Thoresen, M., & Bjertness, E. (2006). Consumption of soft drinks and hyperactivity, mental distress, and conduct problems among adolescents in Oslo, Norway. American Journal of Public Health, 96(10), 1815–1820.
Morales, J. F., Yubero, S., & Larrañaga, E. (2016). Gender and bullying: Application of a three-factor model of gender stereotyping. Sex Roles, 74(3-4), 169–180.
Nansel, T. R., Overpeck, M., Pilla, R. S., Ruan, W. J., Simons-Morton, B., & Scheidt, P. (2001). Bullying behaviors among US youth: Prevalence and associations with psychosocial adjustment. JAMA, 285(16), 2094–2100.
National Academies of Sciences, E., and Medicine. (2016). Preventing Bullying Through Science, Policy, and Practice. Washington, DC: National Academies Press.
National Center for Health Statistics. (2000). Inadequate Sleep Optional Module. National Health Interview Survey 2000. Retrieved from https://www.cdc.gov/sleep/surveillance.html
Naudé, H., & Pretorius, E. (2003). Investigating the effects of asthma medication on the cognitive and psychosocial functioning of primary school children with asthma. Early Child Development and Care, 173(6), 699–709.
Navarro, R., Larrañaga, E., & Yubero, S. (2011). Bullying-victimization problems and aggressive tendencies in Spanish secondary schools students: the role of gender stereotypical traits. Social Psychology of Education, 14(4), 457–473.
Olweus, D. (1993). Bullying at school: What we know and what we can do. Oxford, England: Wiley-Blackwell.
Rigby, K. (1998). The relationship between reported health and involvement in bully/victim problems among male and female secondary schoolchildren. Journal of Health Psychology, 3(4), 465–476.
Salmivalli, C. (2009). Bullying and the peer group: a review. Aggression and Violent Behavior, 15(2), 112–120.
Sciberras, E., Bisset, M., Hazell, P., Nicholson, J. M., Anderson, V., Lycett, K., & Efron, D. (2016). Health‐related impairments in young children with ADHD: a community‐based study. Child: Care, Health and Development, 42(5), 709–717.
Sesar, D., & Sesar, K. (2012). Psychosomatic problems as the result of participation in bullying behaviour or risk factor for involvement in bullying behavior. Pedijatrija Danas: Pediatrics Today, 8(2), 114–126.
Shochat, T., Cohen-Zion, M., & Tzischinsky, O. (2014). Functional consequences of inadequate sleep in adolescents: a systematic review. Sleeping Medicine Reviews, 18(1), 75–87.
Solberg, M. E., & Olweus, D. (2003). Prevalence estimation of school bullying with the Olweus Bully/Victim Questionnaire. Aggressive Behavior, 29(3), 239–268.
Sontag, L. M., Clemans, K. H., Graber, J. A., & Lyndon, S. T. (2011). Traditional and cyber aggressors and victims: a comparison of psychosocial characteristics. Journal of Youth and adolescence, 40(4), 392–404.
Sourander, A., Klomek, A. B., Ikonen, M., Lindroos, J., Luntamo, T., Koskelainen, M., & Helenius, H. (2010). Psychosocial risk factors associated with cyberbullying among adolescents: a population-based study. Archives of General Psychiatry, 67(7), 720–728.
Strauss, R. S. (1999). Comparison of measured and self-reported weight and height in a cross-sectional sample of young adolescents. International Journal of Obesity and Related Metabolic disorders, 23(8), 904–908.
Strauss, R. S. (2000). Childhood obesity and self-esteem. Pediatrics, 105(1), e15–e15.
Suglia, S. F., Solnick, S., & Hemenway, D. (2013). Soft drinks consumption is associated with behavior problems in 5-year-olds. The Journal of Pediatrics, 163(5), 1323–1328.
Swearer, S. M., Wang, C., Maag, J. W., Siebecker, A. B., & Frerichs, L. J. (2012). Understanding the bullying dynamic among students in special and general education. Journal of School Psychology, 50(4), 503–520.
Tippett, N., & Wolke, D. (2014). Socioeconomic status and bullying: a meta-analysis. American Journal of Public Health, 104(6), e48–e59.
Tokunaga, R. S. (2010). Following you home from school: a critical review and synthesis of research on cyberbullying victimization. Computers in Human Behavior, 26(3), 277–287.
Tremaine, R. B., Dorrian, J., & Blunden, S. (2010). Subjective and objective sleep in children and adolescents: measurement, age, and gender differences. Sleeping and Biological Rhythms, 8(4), 229–238.
Van Cleave, J., Gortmaker, S. L., & Perrin, J. M. (2010). Dynamics of obesity and chronic health conditions among children and youth. JAMA, 303(7), 623–630.
van Geel, M., Vedder, P., & Tanilon, J. (2014). Are overweight and obese youths more often bullied by their peers? A meta-analysis on the relation between weight status and bullying. International Journal of Obesity, 38(10), 1263–1267.
Vernberg, E. M., Nelson, T. D., Fonagy, P., & Twemlow, S. W. (2011). Victimization, aggression, and visits to the school nurse for somatic complaints, illnesses, and physical injuries. Pediatrics, 127(5), 842–848.
Waasdorp, T. E., & Bradshaw, C. P. (2015). The overlap between cyberbullying and traditional bullying. Journal of Adolescent Health, 56, 483–488.
WaasdorpT. E., MehariK. R., & BradshawC. P. (2018). Obese and overweight youth: risk for experiencing bullying victimization and internalizing symptoms. American Journal of Orthopsychiatry, 88, 483–491.
Waasdorp, T. E., Pas, E. T., Zablotsky, B., & Bradshaw, C. P. (2017).Ten-Year Trends in Bullying and Related Attitudes Among 4th- to 12th graders. Pediatrics, 139(6), 1-8. https://doi.org/10.1542/peds.2016-2615.
Wadden, T. A., & Stunkard, A. J. (1987). Psychopathology and Obesity. Annals of the New York Academy of Sciences, 499(1), 55–65.
Weiss, M. D., & Salpekar, J. (2010). Sleep problems in the child with attention-deficit hyperactivity disorder. CNS drugs, 24(10), 811–828.
Wheaton, A. G., Chapman, D. P., & Croft, J. B. (2016). School start times, sleep, behavioral, health, and academic outcomes: a review of the literature. Journal of School Health, 86(5), 363–381.
Whitney, I., Smith, P. K., & Thompson, D. (1994). Bullying and children with special educational needs. In P. K. Smith & S. Sharp (Eds.), School bullying: Insights and perspectives (pp. 213–240). London: Routledge.
Wildhaber, J., Carroll, W. D., & Brand, P. L. (2012). Global impact of asthma on children and adolescents’ daily lives: the room to breathe survey. Pediatric Pulmonology, 47(4), 346–357.
Zhang, J., Musu-Gillette, L., & Oudekerk, B. (2016). Indicators of School Crime and Safety: 2015 (NCES 2016-079/NCJ 249758). Washington, D.C: Office of Justice Programs, U.S. Department of Justice, National Center for Education Statistics, U.S. Department of Education, and Bureau of Justice Statistics. http://nces.ed.gov.
T.W. conceptualized and ran the analyses and led the writing of the manuscript; K.M. co-wrote manuscript and provided edits; A.M. assisted with CDC weight categorization, writing, and editing the manuscript; C.B. conceived and supervised the study, assisted in writing and editing the manuscript, and was the PI on the grants supporting this work.
This work was funded in part by grants from the U.S. Department of Education and William T. Grant Foundation, and the National Institute of Justice awarded to the last author Catherine P. Bradshaw.
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of The Institutional Review Board at the Johns Hopkins Bloomberg School of Public Health and the University of Virginia; we complied with the APA ethical standards, and with the 1964 Helsinki declaration and its later amendments.
A waiver of active parental consent process was used in the administration of the survey that the data is drawn from and all student participation was voluntary.
About this article
Cite this article
Waasdorp, T.E., Mehari, K.R., Milam, A.J. et al. Health-related Risks for Involvement in Bullying among Middle and High School Youth. J Child Fam Stud 28, 2606–2617 (2019). https://doi.org/10.1007/s10826-018-1260-8
- Health risks
- Cyber bullying
- Cyber victimization