Bullying is not included in Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria (Criteria A, APA, 2013) for posttraumatic stress disorder (PTSD), however, several studies have demonstrated the association between bullying (including those being the bully, victim) and PTSD. The aim of the present study was to investigate the relationship between bullying and PTSD and suicide attempts among adolescents across nine countries. A total of 4051 adolescents with a mean age of 14.9 years found that 36.6% of the adolescents reported exposure to bullying. There were some gender differences across countries. Bullying was significantly associated with PTSD symptoms and suicide attempts among the adolescents. National prevention plans and interventions are needed to prevent bullying.
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.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Alavi, N., Nasreen Roberts, M., Axas, N., & Repetti, L. (2015). Bullying victimization (being bullied) among adolescents referred for urgent psychiatric consultation: prevalence and association with suicidality. Canadian Journal of Psychiatry, 60, 427–431.
Bjorkqvist, K. (1994). Sex differenecs in physical, verbal, and indirect aggression: a review of recent research. Sex Roles, 30, 177–188.
Bödvarsdóttir, Í., & Elklit, A. (2007). Victimization and PTSD-like states in an Icelandic youth probability sample. BMC Psychiatry, 7, 51–57.
Carlisle, N., & Rofes, E. (2007). School bullying: do adult survivors perceive long-term effects? Traumatology, 13, 16–26.
Carney, J. (2008). Perceptions of bullying and associated trauma during adolescence. Professional School Counseling, 11, 179–188.
Chui, W. H., & Chan, H. C. O. (2015). Self-control, school bullying perpetration, and victimization among Macanese adolescents. Journal of Child and Family Studies, 24, 1751–1761.
Copeland, W. E., Wolke, D., Angold, A., & Costello, E. J. (2013). Adult psychiatric outcomes of bullying and being bullied by peers in childhood and adolescence. JAMA Psychiatry, 70, 419–426.
Craig, W., Harel-Fisch, Y., Fogel-Grinvald, H., Dostaler, S., Hetland, J., Simons-Morton, B., et al. (2009). A cross-national profile of bullying and victimization among adolescents in 40 countries. International Journal of Public Health, 54, 216–224.
Crosby, J. W., Oehler, J., & Capaccioli, K. (2010). The relationship between peer victimization and post-traumatic stress symptomatology in a rural sample. Psychology in the Schools, 47, 297–310.
Dempsey, A. G., & Storch, E. A. (2008). Relational victimization: the association between recalled adolescent social experiences and emotional adjustment in early adulthood. Psychology in the Schools, 45, 310–322.
Domanskaité-Gota, V., Elklit, A., & Christiansen, D. M. (2009). Victimization and PTSD in a Lithuanian national youth probability sample. Nordic Psychology, 61(3), 66–81.
Due, P., Holstein, B. E., Lynch, J., Diderichsen, F., Gabhain, S. N., Scheidt, P., & Currie, C. (2005). Bullying and symptoms among school-aged children:international comparative cross sectional study in 28 countries. The European Journal of Public Health, 15, 128–132.
Elklit, A. (2002). Victimization and PTSD in a Danish national youth probability sample. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 174–181.
Erikson, E. H. (1959). Identity and the life cycle: Selected papers. Psychological issues, 1(1). New York: International Universities Press.
Fleming, L. C., & Jacobsen, K. H. (2009). Bullying among middle-school students in low and middle income countries. Health Promotion International, 25, 73–84.
Folkman, S., & Lazarus, R. (1988). The relationship between coping and emotions: implications for theory and research. Social Science & Medicine, 26, 309–317.
Fosse, G. K., & Holen, A. (2004). Cohabitation, education, and occupation of psychiatric outpatients bullied as children. The Journal of Nervous and Mental Disease, 192, 385–388.
Hay, C., & Meldrum, R. (2010). Bullying victimization and adolescent self-harm: testing hypotheses from general strain theory. Journal of Youth and Adolescence, 39, 446–459.
Hazler, R. J. (1996). Bystanders: an overlooked factor in peer on peer abuse. Journal for the Professional Counselor, 11, 11–21.
Hyman, I., Cohen, I., & Mahon, M. (2003). Student Alienation Syndrome: A paradigm for understanding the relation between school trauma and school violence. The California School Psychologist, 8, 73–86.
Idsoe, T., Dyregrov, A., & Idsoe, E. C. (2012). Bullying and PTSD symptoms. Journal of Abnormal Child Psychology, 40, 901–911.
Isolan, L., Salum, G. A., Osowski, A. T., Zottis, G. H., & Manfro, G. G. (2013). Victims and bully-victims but not bullies are groups associated with anxiety symptomatology among Brazilian children and adolescents. European Child & Adolescent Psychiatry, 22, 641–648.
Jessor, R. (1991). Risk behavior in adolescence: a psychosocial framework for understanding and action. Journal of Adolescent Health, 12(8), 597–605.
Kevorkian, M., & D’Antona, R. (2008). 101 facts about bullying: What everyone should know. Lanham: R&L Education.
Lancaster, S. L., Melka, S. E., & Rodriguez, B. F. (2009). An examination of the differential effects of the experience of DSM-IV defined traumatic events and life stressors. Journal of Anxiety Disorders, 23, 711–717.
Lancaster, S. L., Melka, S. E., & Rodriguez, B. F. (2011). Emotional predictors of PTSD symptoms. Psychological Trauma: Theory, Research, Practice, and Policy, 3, 313–317.
Ledley, D. R., Storch, E. A., Coles, M. E., Heimberg, R. G., Moser, J., & Bravata, E. A. (2006). The relationship between childhood teasing and later interpersonal functioning. Journal of Psychopathology and Behavioral Assessment, 28, 33–40.
Luukkonen, A. H., Räsänen, P., Hakko, H., & Riala, K. (2009). Bullying behavior is related to suicide attempts but not to self-mutilation among psychiatric inpatient adolescents. Psychopathology, 4, 131–138.
Mandrup, L., & Elklit, A. (2014). Victimization and PTSD in Ugandan youth. Open Journal of Epidemiology, 4, 141–156.
Meltzer, H., Vostanis, P., Ford, T., Bebbington, P., & Dennis, M. S. (2011). Victims of bullying in childhood and suicide attempts in adulthood. European Psychiatry, 26, 498–503.
Mollica, R. F., Caspi-Yavin, Y., Bollini, P., Truong, T., Tor, S., & Lavelle, J. (1992). The Harvard trauma questionnaire: validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. Journal of Nervous and Mental Disease, 180, 111–116.
Morrell, R. (2006). Corporal punishment in South African schools: a neglected explanation for its existence. South African Journal of Education, 21, 292–299.
Moser, J. S., Hajcak, G., Simons, R. F., & Foa, E. B. (2007). Posttraumatic stress disorder symptoms in trauma-exposed college students: The role of trauma-related cognitions, gender, and negative affect. Journal of Anxiety Disorders, 21, 1039–1049.
Muuss, R. E. (1975). Theories of adolescence (3rd ed.). New York: Random House.
Mynard, H., Joseph, S., & Alexander, J. (2000). Peer victimization and posttraumatic stress in adolescents. Personality and Individual Differences, 29, 815–821.
Nansel, T. R., Overpeck, M. D., Haynie, D. L., Ruan, W. J., & Scheidt, P. C. (2003). Relationships between bullying and violence among US youth. Archives of Pediatrics & Adolescent Medicine, 157, 348–353.
Newman, M. L., Holden, G. W., & Delville, Y. (2011). Coping with the stress of being bullied: consequences of coping strategies among college students. Social Psychological and Personality Science, 2, 205–211.
Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry, 70, 300–310.
Obrdajj, E. C., Sesar, K., Santic, Z., Klaric, M., Sesar, I., & Rumboldt, M. (2013). Trauma symptoms in pupils involved in school bullying — a cross-sectional study conducted in Mostar, Bosnia and Herzegovina. Collegium Antropologicum, 37, 11–16.
Olweus, D. (1993). Bullying in schools. What we know and what we can do. Oxford: Blackwell.
Olweus, D., & Limber, S. P. (2010). Bullying in school: evaluation and dissemination of the Olweus Bullying Prevention Program. American Journal of Orthopsychiatry, 80, 124–134.
Petersen, T., Elklit, A., & Olesen, J. G. (2010). Victimization and PTSD in The Faroese youth total-population sample. Scandinavian Journal of Psychology, 51, 56–62.
Pfeiffer, J. P., & Pinquart, M. (2014). Bullying in German boarding schools: a pilot study. School Psychology International, 35, 580–591.
Piaget, J. (1972). Intellectual evolution from adolescence to adulthood. Human Development, 15, 1–12.
Randall, J. R., Doku, D., Wilson, M. L., & Peltzer, K. (2014). Suicidal behaviour and related risk factors among school-aged youth in the Republic of Benin. PloS One, 9, e88233.
Salleh, N. M., & Zainal, K. (2014). Bullying among secondary school students in Malaysia: A case study. International Education Studies, 7(13), 184–191.
Salmivalli, C. (2010). Bullying and the peer group: a review. Aggression and Violent Behavior, 15, 112–120.
Salmivalli, C., Kärnä, A., & Poskiparta, E. (2010). From peer putdowns to peer support: a theoretical model and how it translated into a national anti-bullying program. In S. Jimerson, S. Swearer, & D. Espelage (Eds.), Handbook of bullying in schools: an international perspective (pp. 441–454). New York: Routledge.
Sigurdson, J. F., Undheim, A. M., Wallander, J. L., Lydersen, S., & Sund, A. M. (2015). The long-term effects of being bullied or a bully in adolescence on externalizing and internalizing mental health problems in adulthood. Child and Adolescent Psychiatry and Mental Health, 9, 1–13.
Smith, P. K., Cowie, H., Olafsson, R. F., & Liefooghe, A. P. (2002). Definitions of bullying: a comparison of terms used, and age and gender differences, in a fourteen–country international comparison. Child Development, 73, 1119–1133.
Sourander, A., Helstelä, L., Helenius, H., & Piha, J. (2000). Persistence of bullying from childhood to adolescence—a longitudinal 8-year follow-up study. Child Abuse & Neglect, 24, 873–881.
Swearer, S. M., & Hymel, S. (2015). Understanding the psychology of bullying: moving toward a social-ecological diathesis–stress model. American Psychologist, 70, 344–353.
Trach, J., Hymel, S., Waterhouse, T., & Neale, K. (2010). Bystander responses to school bullying: a cross-sectional investigation of grade and sex differences. Canadian Journal of School Psychology, 25, 114–130.
Ttofi, M. M., Farrington, D. P., Losel, F., & Loeber, R. (2011). Do the victims of school bullies tend to become depressed later in life? A systematic review and meta-analysis of longitudinal studies. Journal of Aggression, Conflict and Peace Research, 3, 63–73.
Uba, I., Yaacob, S. N., & Juhari, R. (2010). Bullying and its’ relationship with Depression among Teenagers. The Journal of Psychology, 1, 15–22.
Van Geel, M., Vedder, P., & Tanilon, J. (2014). Relationship between peer victimization, cyberbullying, and suicide in children and adolescents: a meta-analysis. JAMA Pediatrics, 168, 435–442.
Sincere thanks to all participants who gave us their full cooperation during the data collection. Authors wish to thank Siobhan Murphy for assistance with editing.
This study was funded by the National Centre for Psychotraumatology University of Southern Denmark: Grant No UNIMAS L18403 F05 00 PTSD.
Conflict of Interest
All authors declare that they have no conflicts of interest to report.
Ethical Standards and Informed Consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation [institutional and national] and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
This article has not been published elsewhere and has not also been submitted simultaneously for publication elsewhere.
About this article
Cite this article
Chen, Y.Y., Elklit, A. Exposure to Bullying Among Adolescents Across Nine Countries. Journ Child Adol Trauma 11, 121–127 (2018). https://doi.org/10.1007/s40653-017-0172-x
- Suicide attempt