Cross-national consistency in relationship between bullying behaviors and psychosocial adjustment

Objective To determine whether the relationship between bullying and psychosocial adjustment is consistent across countries by standard measures and methods. Design Cross-sectional self-report surveys were obtained from nationally representative samples of students in 25 countries. Involvement in bullying, as bully, victim, or both bully and victim, was assessed. Setting Surveys were conducted at public and private schools throughout the participating countries. Participants Participants included all consenting students in sampled classrooms, for a total of 113 200 students at average ages of 11.5, 13.5, and 15.5 years. Main Outcome Measures Psychosocial adjustment dimensions assessed included health problems, emotional adjustment, school adjustment, relationships with classmates, alcohol use, and weapon carrying. Results Involvement in bullying varied dramatically across countries, ranging from 9% to 54% of youth. However, across all countries, involvement in bullying was associated with poorer psychosocial adjustment (P<.05). In all or nearly all countries, bullies, victims, and bully-victims reported greater health problems and poorer emotional and social adjustment. Victims and bully-victims consistently reported poorer relationships with classmates, whereas bullies and bully-victims reported greater alcohol use and weapon carrying. Conclusions The association of bullying with poorer psychosocial adjustment is remarkably similar across countries. Bullying is a critical issue for the health of youth internationally. The problem of bullying among youth has become an international concern.1 Recent studies on school-aged children in Australia,2 England,3 Finland,4 Germany,3 Scotland,5 and the United States6 suggest that bullying is associated with adverse outcomes for both the victim and the bully, including poorer social, emotional, and physical health. Findings from research in Australia, Finland, and Norway indicate that these psychosocial challenges may persist into later adolescence7,8 and adulthood.9,10 According to Olweus,11 bullying is characterized by (1) aggressive behavior or intentional harm-doing that is (2) carried out repeatedly over time in (3) an interpersonal relationship characterized by an imbalance of power. This aggressive behavior may be verbal, physical, or relational. Whereas verbal aggression is common among both girls and boys, physical aggression and taking of personal belongings tend to occur more frequently among boys, and rejection or isolation is more common among girls.12,13 Research published during the past 15 years has shown that bullying is prevalent across countries.3- 23 However, studies vary as to the definition of bullying used, the methods used to measure bullying, and the cutoff point used for reporting of prevalence. Consequently, comparing prevalence and outcomes of bullying cross-nationally has been difficult.3 The Health Behaviour in School-aged Children (HBSC) Study provides a unique opportunity to compare data on bullying across countries. This international collaborative effort was coordinated by a multicountry committee with measures, sampling, and administration procedures designed to be consistent across participating countries, thus allowing for international comparisons. In addition, the sampling design provides nationally representative estimates, as opposed to reflecting smaller regions or communities of unknown generalizability. In the present study, we used data collected from the 1997-1998 HBSC Study in 25 countries. The purpose of this study is to compare the relationship between bullying and psychosocial adjustment across countries by standard measures and methods. We examined the relationship of being bullied and bullying others with physical health, emotional adjustment, school adjustment, peer relationships, alcohol use, and weapon carrying.