|Year : 2017 | Volume
| Issue : 3 | Page : 240-249
Experiences of bullying in relation to psychological functioning of young adults: An exploratory study
Kangkana Bhuyan1, M Manjula2
1 Department of Clinical Psychology, LGB Regional Institute of Mental Health, Tezpur, Assam, India
2 Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
|Date of Web Publication||14-Sep-2017|
Department of Clinical Psychology, LGB Regional Institute of Mental Health, Tezpur - 784 001, Assam
Source of Support: None, Conflict of Interest: None
Background: The young adult undergoes a vast number of experiences while socializing with his/her peers, bullying is one such experience. Though there have been increasing instances of bullying, it is a poorly understood phenomenon in the Indian setting. Undergoing experiences of bullying often result in long-term psychological consequences which may have an impact on individual's well-being. Keeping this background in mind, the present study was an attempt to explore the experiences of bullying in young adults in the Indian setting and to assess his/her psychological functioning so as to make an attempt to understand the interplay between the two variables. This may further help in planning interventions and prevention strategies for the same. Methodology: The sample consisted of 311 students, both males and females. They were assessed on Retrospective Bullying Questionnaire and Achenbach's Adult Self-report. Results: Around 22.2% of the sample had been both bullies and victims of bullying, while 13.2% were only victims and 3.5% were only bullies. Males had higher incidence of bullying and victimization experiences compared to females. Assessing for psychological functioning had shown higher reports of depression and antisocial personality problems in young adults. Overall findings suggest that people with bullying experiences tend to have more psychological problems compared to people who had no experiences of bullying. Conclusion: The findings suggest that bullying experiences lead to long-term consequences for the victims. There is a need to identify such instances at school level and plan interventions at various stages.
Keywords: Bullying experiences, Indian setting, psychological functioning, young adults
|How to cite this article:|
Bhuyan K, Manjula M. Experiences of bullying in relation to psychological functioning of young adults: An exploratory study. Indian J Soc Psychiatry 2017;33:240-9
|How to cite this URL:|
Bhuyan K, Manjula M. Experiences of bullying in relation to psychological functioning of young adults: An exploratory study. Indian J Soc Psychiatry [serial online] 2017 [cited 2019 Oct 19];33:240-9. Available from: http://www.indjsp.org/text.asp?2017/33/3/240/214604
| Introduction|| |
An imperative reason to assess bullying phenomenon is because peer relationships during the growing years play a critical role in a young adult's emotional development as well as in the formation of one's self-image and self-concept. The youth of today are exposed to a range of forum for socialization, there is an ever-increasing demand for competencies and excellence and a pressure to make a niche for self in the performance-oriented society. Cumulated with such pressures, bullying experiences may have long-term consequences for a developing adult.
Although many definitions exist, Olweus described bullying as a phenomenon where a student is being exposed repeatedly and over time to negative action on the part of one or more other students. Such behavior needs to be intentional; there should be a real or perceived imbalance of power and should be a repeated action that occurs regularly over time. Bullying can be classified as direct or indirect, direct bullying may involve open attacks on the victim and indirect bullying is characterized by social isolation, exclusion from a group or nonselection from activities.
Several reviews and surveys have underlined the consistency of the phenomenon across cultures, although the individual characteristics and the manifestations of the dynamics may differ within each culture. The Health Behavior in School-age Children, a WHO collaborative, conducted a survey involving participants from 40 countries (not including India) and found a midpoint prevalence rate for boys' bullying to be 23.4% whereas among girls, it was 15.8%. In a survey of 28 European and North American countries, it was found that for 11-, 13-, and 15-year-old, bullying prevalence rates ranged from 5% (girls) and 6% (boys) in Sweden to as high as 38% (girls) and 41% (boys) in Lithuania. In India, a study carried out by Kshirsagar et al. found the prevalence rate of bullying in middle schools to be 31.4%.
A large body of literature links aggressive behavior with childhood anti-social behavior as a risk factor for later maladjustment and a possible indicator for school failure and delinquency. On the other hand, a growing literature has indicated toward the onset of negative psychological consequences of chronic harassment by peers. A common finding across literature has been the experience of internalizing problems, including low self-esteem, loneliness, social anxiety, and depression in children and adolescents, who were the victims of peer harassment.
Close friends often surpass family members as the primary source of social support and contribute to the individual's self-concept and well-being. Added to that, this is an important transitional period during which the adolescents are at an increased vulnerability for developing depressive and anxiety disorders. Stressful life events, which often increase during adolescence,, have been consistently cited across literature to be a nonspecific risk factors for both depression and anxiety. A few studies have focused on interpersonal stressors as unique or shared risk factors for such internalizing problems. Such experiences during adolescence are more damaging as the young person tends to place more emphasis on interpersonal relationships and become more sensitive to disruptions in both peer and family settings. Thus, problematic peer relations play an important role in maladaptive emotional functioning, including the development of symptoms of depression and social anxiety.
For this study, psychological functioning is defined in terms of internalizing and externalizing behaviors.
Studies in the general population,, and in treatment-based samples demonstrate the existence of these three primary categories of common mental disorders: (1) internalizing disorders (e.g., symptoms of depression, anxiety, somatic disorder, traumatic distress, and suicide), (2) externalizing disorders (e.g., symptoms of attention deficit, hyperactivity, conduct, and other impulse control disorders), and (3) substance use disorders (e.g., symptoms of abuse, dependence, other substance-induced health or psychiatric problems).
Being a victim of bullying can be an important etiological factor in the development of several mental health disorders in both adolescence and adulthood. Farrow and Fox found that experiences of bullying is significantly positively correlated with psychological symptoms related to anxiety and depression, restrained eating, and body dissatisfaction in both male and female children. Previous research has also found associations between bullying and unhealthy eating behaviors and cognitions;, bullying and emotional symptoms; and emotional symptoms and unhealthy eating., Victims of bullying often suffer long-term psychological problems, including loneliness, diminished self-esteem, psychosomatic complaints, and depression., Fear of being bullied can result in victims dropping out of school, setting in motion a downward spiral of adversity. Schäfer et al. found that victims who are bullied during school often continue to be bullied in the workplace. The risk of adversity has been found to be greater for bully victims than either bullies or victims, including carrying weapons, incarceration, and continued hostility and violence toward others.,,, A study of 2680 students found that being bullied in the early secondary school years (age 13) was associated with reports of anxiety and depressive symptoms in the following year. Hemphill et al. found that students who were bullied were more likely to report depressive symptoms 1 year later. Importantly, there is evidence that having been bullied places individuals at higher risk for depression well into their adult years. Recalled childhood teasing has also been related to later difficulties with depression and anxiety.
India has a large proportion of young adults. There are ever increasing reports in media about peer victimization and although there is rise in awareness about the consequences of such victimization, there is scarcity of studies exploring the far reaching effects on young adults. Thus, the present study aims at exploring the bullying experiences as well as studying the interplay between bullying experiences and psychological functioning among young adults. The results of the study would help in understanding the phenomenon better and provide a platform to plan interventions for individuals to counter the effects of bullying.
| Methodology|| |
This study adopted an exploratory research design. The universe of the study was young adults in Bengaluru. Sample comprised 311 participants (180 females and 131 males; mean age = 21.29 years, standard deviation [SD] = 3.03) consisting of young adults who were chosen for the study by employing convenience sampling from the colleges of Bengaluru. The participants were recruited from three colleges in Bengaluru from both undergraduate and postgraduate programs and from a nursing college hostel. Participants were selected if they were in the age range of 18–30 years and had fluency in English.
The sociodemographic data sheet was developed for the present study to obtain information regarding demographic details such as age, gender, education, stream of study, relationship status, religion, living arrangements, type of school and college attended (whether single gendered or co-educational), and their satisfaction with their college as well as their satisfaction with their friends.
The Retrospective Bullying Questionnaire (RBQ) was developed by Schäfer et al. based on the extensive work done by Rivers to assess retrospective bullying experiences. The questionnaire contains 44 questions, mostly multiple choices and few questions requiring description of bullying experiences, if any. It covers 6 types of victimization experiences in school, i.e., 2 physical, 2 verbal, and 2 relational kind, and the frequency, the perceived seriousness, and duration (all on 5-point scales) of these experiences. The questions asked were for primary and the high/middle school. The RBQ also included 5-item trauma subscale of intrusive and recurrent recollections of victimization and a question on suicidal ideation for those who have been bullied at college. The questionnaire has been found to have good test-retest reliability with r = 0.88 for elementary school victimization and r = 0.87 for middle/high school victimization.
The Achenbach System of Empirically Based Assessment – Adult Self-report (ASR) is a 126-item self-report questionnaire for adults (18–59 years) assessing the aspects of adaptive functioning and problems. The ASR includes scales for adaptive functioning as well as empirically based syndromes, substance use, internalizing, externalizing, and total problems. The questionnaire provides scores for the following DSM-oriented scales: Depressive problems, anxiety problems, somatic problems, avoidant personality problems, attention deficit hyperactivity problems (inattention and hyperactivity–impulsivity subscales), and antisocial personality problems. The statements are scored on a 3-point Likert scale. The reliability and validity of the questionnaire is reported to be significantly high with high r'sranging between 0.80 and 0.90. The scoring can be done either manually or with the help of software owned by the Achenbach System of Empirically Based Assessment.
The protocol was reviewed and approved by the Department of Clinical Psychology Review Board. A total of six colleges were approached in Bengaluru, out of which three colleges gave permission for the study. All the three colleges had multiple undergraduate and postgraduate programs and the participants were recruited from different departments. A nursing college hostel for women was also approached for the study and permission was sought from the participants. The colleges were provided with a written letter for permission which introduced the researcher and explained the objectives of the study, i.e., exploring experiences of bullying, if any, and their psychological functioning. The letter was duly signed by the researcher and the guide. After obtaining the necessary permission from the college authorities, the tools were administered in group settings. The participants were explained about the study and the procedures in detail and were encouraged to clarify their doubts. Written informed consent was obtained from them and they were assured of the confidentiality of the information provided. They were also informed that they could withdraw from the study at any time without having to cite a reason for doing so. The groups varied in sizes from 10 to 60 participants. The questionnaires were administered on 370 participants, out of which 59 forms were not filled out completely, thus making the data invalid. Hence, these forms were rejected. The final sample thus consisted of 311 participants (males = 131, females = 180).
| Results|| |
The mean age of the sample is 21.29 years and the SD is ± 3.03. The male sample was of younger age range (20.6 ± 2.75 years) compared to the female sample (21.81 ± 3.13 years). The sociodemographic characteristics of the population are shown in [Table 1].
More than half of the sample comprised females, and majority were single. Almost the entire samples belonged to a middle socioeconomic background and were living either with parents or in hostels. Most had a nuclear family setup and largely belonged to Hindu community, followed closely by Christians and Muslims. A large number of the sample had co-educational background. The participants were also asked about their satisfaction with college and friends on the sociodemographic data sheet. Majority of them reported being happy with their college (88.1%). Almost all had friends in college (99.7%) while only 1 (0.3%) participant reported having no friends at all in college. Of these participants, 95.2% reported being happy with their friends and only 4.8% reported being unhappy with their friends.
These reported experiences in college by the participants were then compared with their early experiences of bullying and current psychological functioning. No significant differences were found for bullying experiences with the participants' current experience in college. On comparing for psychological functioning, however, a significant difference was found for participants who reported being happy with their college on conduct and antisocial problems (FE = 7.100, df = 2, P < 0.05) and those who reported being happy with their friends on affective/depressive behaviors (FE = 6.807, df = 2, P < 0.05) and attention deficit hyperactivity disorder (ADHD) symptoms (FE = 8.070, df = 2, P < 0.05).
Bullying experiences in young adults
A significant difference was noted between male and female participants on the two kinds of bullying experiences, i.e., not having any kind of bullying experiences and being both a bully and a victim. The details are shown in [Table 2].
Psychological functioning of young adults
[Table 3] shows the variation in various syndromes for the sample. On the whole, a significant difference was seen between male and female participants on different syndromes. Scores in the clinical range were seen on many scales across the subscales of the ASR for both male and female participants. The results indicated that affective/depressive and conduct/antisocial personality problems were the predominant problems.
Comparison of bullying experiences and psychological functioning in young adults
[Table 4] shows the comparison of scores on different subscales of ASR in relation to the bullying experiences. Across the subscales, a significant difference is found (P < 0.05, 0.01) between people who had experiences of bullying and people who had no experience of bullying.
|Table 4: Comparison of bullying experiences and psychological functioning in young adults across the scales of Adult Self-report|
Click here to view
| Discussion|| |
The aim of the study was to explore the experiences of bullying in young adults in the Indian setting, to assess their psychological functioning, and to examine the relationship between them. Figures in the study show that 3.5% of the people are reported to be bullies and around 22.2% reported being both bullies as well as of victims of bullying. This is consistent with the findings of Kshirsagar et al. who reported the prevalence of bullying in Indian population. This shows a worrying trend in the increasing incidence of bullying. These experiences may be of concern to college counselors as bullying during the childhood and adolescent years has been found to be associated with a greater risk for mental health and relational problems during the college years.,
Female participants had largely reported having never experienced any kind of bullying phenomenon compared to male participants. While on the other hand, an overwhelming majority of male participants reported being bullied as well as participated in bullying. These findings follow similar trends as those reported by researchers across countries., A consistent picture is also shown for only victims as well, wherein a larger number of female participants reported being bullied compared to the male participants. Typically, our expectations from males and females differ on how each conduct themselves, and subtle though they might be, they can have influence in shaping later behavior. Usually, girls are encouraged to act nurturing and be more emotionally supportive and are often discouraged from risk-taking. On the other hand, boys are often encouraged to be aggressive or act physically. Young children bring these socialization experiences to their interaction with peers, including interactions that may be defined as teasing or bullying. One reason why boys might be found to be higher on perpetrating bullying than girls is that the definitions of bullying provided include both physical and social aggression, but do not differentiate between them., A wealth of evidence documents that boys are higher on physical and direct aggression than girls., However, gender differences are less clear for social aggression.
With regard to psychological functioning, the WHO claims that at least 20% of young people are likely to experience some form of mental illness such as depression, mood disturbances, substance abuse, suicidal behaviors, eating disorders, and others. Epidemiological studies have found the prevalence of common mental health issues among young adults in India to be around 22.2/1000 population among 15–24-year-old. This indicates that young adulthood is a time of significant behavioral and emotional upheavals and calls out a need to assess the factors for such increase in the reported incidence of emotional problems.
The percentage of sample showing borderline and clinical level of depressive figures [Table 3] is similar to the report on global burden of disease, which estimates the point prevalence of unipolar depressive episodes to be 1.9% for men and 3.2% for women, and the 1-year prevalence has been estimated to be 5.8% for men and 9.5% for women. The findings of the present study follow the predicted trend and show a cause of concern.
A study by Sahoo and Khess show figures of young adults in India with anxiety being 24.5% and generalized anxiety disorder in 19% of the young population. The findings of the present study showed a larger male demographic (15.3%) in the borderline level of anxiety syndrome compared to only 5% of the female participants, while the percentage was similar for both males and females in the clinical level of anxiety syndrome. These findings are consistent with those reported by Deb et al., wherein 20.1% of boys and 17.9% of girls were suffering from high anxiety.
On somatic concerns' subscale, the study findings do not match demographic trend reported in several studies, which reports at least one somatic symptom in their lifetime in 50.1% of the population and women were found to have more somatic symptoms than men. The present study had, however, different findings gender wise with male participants (19.1%) featuring high in the borderline level for somatic concerns while only 8.3% of the female participants were in the same level. There were no significant difference between males and females in the clinical level. The findings can be understood in terms of the items in the questionnaire, where a large number of male participants rated themselves for somatic complaints such as headache, palpitations and other aches, and pains compared to female participants.
When it comes to reporting avoidant personality problems, the findings were much larger than that reported by Gupta and Mattoo, where an overall incidence of avoidant personality problems was reported to be 0.36%. However, the study also showed a preponderance of male population compared to female population which corresponds to the present study's findings where around 15.3% of the male participants were in the clinical level of avoidant personality problems compared to only 10.0% of the female participants.
Findings for ADHD in the present study are slightly higher than the figures reported by the World Mental Health Survey Initiative, where the figures ranged from 0.3% to 6.8% across different countries. A higher prevalence of symptoms is rated in males (1.6 male: female ratio) compared to women. In the present study, higher number of female participants had clinical level of ADHD compared to males. The results could be accounted by the nature of questions in the questionnaire where a large number of female participants rated themselves on symptoms such as day-dreaming, forgetfulness, and difficulty in concentrating.
Overall, 9.6% of the participants were in the borderline level for antisocial personality problems and an overwhelming 18.3% were in the clinical level of the same scale. Gupta and Mattoo reported around 5.2% prevalence of antisocial personality problems in their study. Moreover, according to Samuels et al., there is a preponderance of anti-social personality problems in males compared to females, which is consistent with the current study's findings, wherein around 27.5% of the male participants came to be in the clinical level of anti-social personality problems compared to only 11.7% of the female participants.
When the findings are compared, affective/depressive problems (16.1%) and conduct/antisocial problems (22.4%) emerged as highly reported in the clinical range of psychological problems. Similar findings were reported in a study by Lavanya and Manjula, wherein problems were highly reported in the above-mentioned domains. In relation to depressive symptoms, interpersonal difficulties, the transition from adolescence to adulthood, the process of identity formation, emerging sexuality, etc., can add on to the development of mood symptoms. The high incidence of conduct/antisocial problems along with depressive disorders is an intriguing finding, especially since they both represent two extreme ends on the continuum from internalizing problems to externalizing problems. The occurrence of mood problems with conduct problems has been documented in several studies. Capaldi proposed an explanation for the finding wherein conduct problems predicted subsequent depressed moods, which may be called a “failure model.” According to this model, externalizing problem behaviors predate and predict internalizing problem behaviors. Specifically, noxious behavior and a lack of skills may result in rejection and a lack of support importantly by others (i.e., parents, teachers, and peers), which in turn may lead to pervasive failure experiences in social interactions with these important others. Failure experiences may eventually lead to an increased vulnerability for depressive moods. Another explanation is that an increase of internalizing problem behaviors is expected to lead to heightened levels of delinquency because depressive moods may lead to a lower attentiveness to social cues or may lead to an absence of a reaction on emotionally significant stimuli. Accordingly, this may minimize the effects of social control on delinquent behavior.
Comparison of bullying experiences and psychological functioning [Table 4] shows that there were significant differences between the groups of participants who had bullying experiences and those who did not have any bullying experiences in terms of their psychological functioning. Across many subscales of ASR, it was found that people with bullying experiences were more in borderline and clinical levels of symptoms compared to those who did not have any prior experiences of bullying. These findings follow the trend documented by a large body of literature. Schäfer et al. documented that experiences of bullying, especially victimization had a significant effect on the adult life, specifically on self-perception, relationship style, and friendship quality. These findings were similar for males and females and across cultures. A higher degree of emotional loneliness was reported by all types of victims compared to nonvictims even when they were no longer identified as a victim. This might explain the findings of high number of people in the clinical range of avoidant personality problems. They might find it difficult to show trust in others and may worry that they will be hurt if they allow themselves to get too close to others.
Retrospective studies of college students who recall experiencing bullying during childhood and/or adolescence have found that being the target of bullying may place one at greater risk for depression,, anxiety disorders, and interpersonal relationships, in comparison to peers who do not recall a history of bullying during childhood or adolescence.
Increases in physical and relational victimization were associated with increases in internalizing symptoms., Internalizing symptoms are frequently comorbid with externalizing ones. Externalizing problems such as aggression and delinquency may increase stresses in relationships with parents and authorities and increase affiliation with aggressive and deviant peer groups, making victimization more likely. This corroborates the previous findings of high scores on affective/depressive subscale and conduct/antisocial personality patterns subscale. The relationship between the two becomes that of a vicious circle which may corrode on the protective factors against victimization, instead leading to more instances of bullying and further manifestations of psychological problems in young adults. These findings are of great implication. Victims, especially if bullying is frequent and severe, frequently abstain themselves from the academics, have lower self-esteem, lack confidence, are low achievers showing affected academic performance, and report several psychosomatic illnesses. In addition, they are more likely to have anxiety, depression, and suicidal ideation. They feel lonely and have fewer friends and may consider themselves as less competent. It can also impact their abilities to form relationships in adult life.
The present study had some strong points such as use of sound tools which had multicultural components. A comprehensive evaluation of the variables was conducted and gender differences were examined. The study extends research in the understanding of the variables and their implications as there is a paucity of such related researches in India. The findings have strongly implicated a need for intervention and increases scope for devising strategies to address the issues at hand.
It had some obvious limitations. The study relied on retrospective recalling of bullying experiences that may be affected by inaccurate recall of events. The study's cross-sectional design limits the extent to which inferences regarding causality can be made and hence a longitudinal study design would be more suited in understanding the long-term impact of peer victimization. Effects of confounding variables such as family history of mental illness or conflicts could not be soundly ruled out in the study.
A longitudinal study design would help draw out the implication in a more illustrative manner. Inclusion of more representative demographics in terms of gender, socioeconomic strata, and different regional backgrounds would provide a richer data. In addition, there is a rising concern of cyber bullying, which may be addressed in future research.
| Conclusion|| |
The findings of current study have shown an increasing number of young adults being bullies while in school, as well as being victims of bullying. This reported incidence was higher for males than for females. This shows a definite albeit worrisome trend in the Indian settings, which by and large goes unacknowledged by parents, peers, teachers, and policy makers. While assessing for psychological functioning, findings have shown higher reports of depression and antisocial personality problems in young adults. The current study has also found a significant difference between the participants who had experiences of bullying and participants who had no such experiences in terms of psychological functioning, wherein the former reported higher incidence of psychological problems such as anxiety, conduct, and antisocial behaviors. These findings provide a strong case for the need of psychological intervention at the early school level to reduce the long-term impact of such experiences of bullying and victimization. The findings also call out for the need of a more focused intervention to reduce the occurrences of such experiences.
The authors are thankful to all the participants of the study and the college authorities who gave permission to collect data and to Dr. Mariamma Philip (Department of Statistics, NIHMANS) for statistical analysis of the data.
Financial support and sponsorship
Conflict of interest
There are no conflicts of interest.
| References|| |
Kuttler A, La Greca A, Prinstein M. Friendship qualities and social-emotional functioning of adolescents with close, cross-sex friendships. J Res Adolesc 1999;9:339-66.
Pepler D, Rubin K. The Development and Treatment of Childhood Aggression. Hillsdale, N.J: L. Erlbaum Associates; 1991.
Rootman I, editor. Evaluation in health promotion: principles and perspectives. Copenhagen: WHO Regional Office Europe; 2001.
Due P, Holstein BE, Lynch J, Diderichsen F, Gabhain SN, Scheidt P, et al.
Bullying and symptoms among school-aged children: International comparative cross sectional study in 28 countries. Eur J Public Health 2005;15:128-32.
Kshirsagar VY, Agarwal R, Bavdekar SB. Bullying in schools: Prevalence and short-term impact. Indian Pediatr 2007;44:25-8.
Coie J, Dodge K. Aggression and antisocial behavior. In: Eisenberg N, editor. Handbook of Child Psychology. 5th
ed., Vol. 3. New York: Wiley; 1998. p. 779-862.
Juvonen J, Graham S. Peer Harassment in School. New York: Guilford Press; 2001.
Bishop J, Inderbitzen H. Peer acceptance and friendship: An investigation of their relation to self-esteem. J Early Adolesc 1995;15:476-89.
Ge X, Lorenz FO, Conger RD, Elder GH, Simons RL. Trajectories of stressful life events and depressive symptoms during adolescence. Dev Psychol 1994;30:467.
Larson R, Ham M. Stress and “storm and stress” in early adolescence: The relationship of negative events with dysphoric affect. Dev Psychol 1993;29:130-40.
Hankin B, Abramson L, Miller N, Haeffel G. Cognitive vulnerability-stress theories of depression: Examining affective specificity in the prediction of depression versus anxiety in three prospective studies. Cognit Ther Res 2004;28:309-45.
Bradford K, Vaughn L, Barber B. When there is conflict: Interparental conflict, parent-child conflict, and youth problem behaviors. J Fam Issues 2007;29:780-805.
Achenbach TM, Edelbrock CS. The classification of child psychopathology: A review and analysis of empirical efforts. Psychol Bull 1978;85:1275-301.
Krueger RF. The structure of common mental disorders. Arch Gen Psychiatry 1999;56:921-6.
Krueger RF, Caspi A, Moffitt TE, Silva PA. The structure and stability of common mental disorders (DSM-III-R): A longitudinal-epidemiological study. J Abnorm Psychol 1998;107:216-27.
Dennis ML, Dawud-Noursi S, Muck RD, McDermeit M. The need for developing and evaluating adolescent treatment models. Adolescent Substance Abuse Treatment in the United States: Exemplary Models from a National Evaluation Study. Binghamton, NY: Haworth Press; 2003. p. 3-34.
Farrow CV, Fox CL. Gender differences in the relationships between bullying at school and unhealthy eating and shape-related attitudes and behaviours. Br J Educ Psychol 2011;81(Pt 3):409-20.
Libbey HP, Story MT, Neumark-Sztainer DR, Boutelle KN. Teasing, disordered eating behaviors, and psychological morbidities among overweight adolescents. Obesity (Silver Spring) 2008;16 Suppl 2:S24-9.
Lunde C, Frisén A, Hwang CP. Is peer victimization related to body esteem in 10-year-old girls and boys? Body Image 2006;3:25-33.
Hawker DS, Boulton MJ. Twenty years' research on peer victimization and psychosocial maladjustment: A meta-analytic review of cross-sectional studies. J Child Psychol Psychiatry 2000;41:441-55.
Crow S, Eisenberg ME, Story M, Neumark-Sztainer D. Psychosocial and behavioral correlates of dieting among overweight and non-overweight adolescents. J Adolesc Health 2006;38:569-74.
Johnson F, Wardle J. Dietary restraint, body dissatisfaction, and psychological distress: A prospective analysis. J Abnorm Psychol 2005;114:119-25.
Kaltiala-Heino R, Rimpelä M, Marttunen M, Rimpelä A, Rantanen P. Bullying, depression, and suicidal ideation in Finnish adolescents: School survey. BMJ 1999;319:348-51.
Sharp S. The role of peers in tackling bullying in schools. Educ Psychol Pract 1996;11:17-22.
Schäfer M, Korn S, Smith PK, Hunter SC, Mora-Merchán JA, Singer MM, et al
. Lonely in the crowd: Recollections of bullying. Br J Dev Psychol 2004;22:379-94.
Malecki CK, Demaray MK. What type of support do they need? Investigating student adjustment as related to emotional, informational, appraisal, and instrumental support. Sch Psychol Q 2003;18:231.
Ireland JL, Archer J. Association between measures of aggression and bullying among juvenile and young offenders. Aggress Behav 2004;30:29-42.
Juvonen J, Graham S, Schuster MA. Bullying among young adolescents: The strong, the weak, and the troubled. Pediatrics 2003;112(6 Pt 1):1231-7.
Nansel TR, Overpeck M, Pilla RS, Ruan WJ, Simons-Morton B, Scheidt P. Bullying behaviors among US youth: Prevalence and association with psychosocial adjustment. JAMA 2001;285:2094-100.
Bond L, Carlin JB, Thomas L, Rubin K, Patton G. Does bullying cause emotional problems? A prospective study of young teenagers. BMJ 2001;323:480-4.
Hemphill SA, Kotevski A, Herrenkohl TI, Bond L, Kim MJ, Toumbourou JW, et al.
Longitudinal consequences of adolescent bullying perpetration and victimisation: A study of students in Victoria, Australia. Crim Behav Ment Health 2011;21:107-16.
Ttofi MM, Farrington DP, Lösel F, Loeber R. Do the victims of school bullies tend to become depressed later in life? A systematic review and meta-analysis of longitudinal studies. J Aggress Confl Peace Res 2011;3:63-73.
Roth DA, Coles ME, Heimberg RG. The relationship between memories for childhood teasing and anxiety and depression in adulthood. J Anxiety Disord 2002;16:149-64.
Rivers I. Retrospective reports of school bullying: Stability of recall and its implications for research. Br J Dev Psychol 2001;19:129-41.
Achenbach TM, Rescorla LA. Manual for the ASEBA Adult Forms and Profiles. An integrated System of Multi-informant Assessment. Burlington, Vt: ASEBA; 2003.
Dempsey A, Storch E. Relational victimization: The association between recalled adolescent social experiences and emotional adjustment in early adulthood. Psychol Sch 2008;45:310-22.
Cook CR, Williams KR, Guerra NG, Kim TE, Sadek S. Predictors of bullying and victimization in childhood and adolescence: A meta-analytic investigation. Sch Psychol Q 2010;25:65.
Menesini E, Modena M, Tani F. Bullying and victimization in adolescence: Concurrent and stable roles and psychological health symptoms. J Genet Psychol 2009;170:115-33.
Gropper N, Froschl M. The role of gender in young children's teasing and bullying behavior. Equity Excell Educ 2000;33:48-56.
Pepler D, Jiang D, Craig W, Connolly J. Developmental trajectories of bullying and associated factors. Child Dev 2008;79:325-38.
Damon W, Lerner R. Handbook of Child Psychology. Hoboken, N.J: John Wiley and Sons; 2006.
Card NA, Stucky BD, Sawalani GM, Little TD. Direct and indirect aggression during childhood and adolescence: A meta-analytic review of gender differences, intercorrelations, and relations to maladjustment. Child Dev 2008;79:1185-229.
Sunitha S, Gururaj G. Health behaviours and problems among young people in India: Cause for concern and call for action. Indian J Med Res 2014;140:185-208.
] [Full text]
Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: Systematic analysis of population health data. Lancet 2006;367:1747-57.
Sahoo S, Khess CR. Prevalence of depression, anxiety, and stress among young male adults in India: A dimensional and categorical diagnoses-based study. J Nerv Ment Dis 2010;198:901-4.
Deb S, Chatterjee P, Walsh K. Anxiety among high school students in India: Comparisons across gender, school type, social strata and perceptions of quality time with parents. Aust J Educ Dev Psychol 2010;10:18-31.
Lieb R, Pfister H, Mastaler M, Wittchen HU. Somatoform syndromes and disorders in a representative population sample of adolescents and young adults: Prevalence, comorbidity and impairments. Acta Psychiatr Scand 2000;101:194-208.
Gupta S, Mattoo SK. Personality disorders: Prevalence and demography at a psychiatric outpatient in North India. Int J Soc Psychiatry 2012;58:146-52.
Kessler RC, Angermeyer M, Anthony JC, De Graaf R, Demyttenaere K, Gasquet I, et al.
Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry 2007;6:168-76.
Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, et al.
The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. Am J Psychiatry 2006;163:716-23.
Samuels J, Eaton WW, Bienvenu OJ 3rd
, Brown CH, Costa PT Jr., Nestadt G. Prevalence and correlates of personality disorders in a community sample. Br J Psychiatry 2002;180:536-42.
Lavanya TP, Manjula M. Emotion Regulation, Attachment Styles and Psychological Problems among College Students. An unpublished M. Phil Dissertation submitted to NIMHANS, Bengaluru; 2013.
Westen D, Betan E, Defife JA. Identity disturbance in adolescence: Associations with borderline personality disorder. Dev Psychopathol 2011;23:305-13.
Capaldi D. Co-occurrence of conduct problems and depressive symptoms in early adolescent boys: II. A 2-year follow-up at grade 8. Dev Psychopathol 1992;4:125.
Rottenberg J, Kasch KL, Gross JJ, Gotlib IH. Sadness and amusement reactivity differentially predict concurrent and prospective functioning in major depressive disorder. Emotion 2002;2:135-46.
Storch EA, Roth DA, Coles ME, Heimberg RG, Bravata EA, Moser J. The measurement and impact of childhood teasing in a sample of young adults. J Anxiety Disord 2004;18:681-94.
McCabe RE, Antony MM, Summerfeldt LJ, Liss A, Swinson RP. Preliminary examination of the relationship between anxiety disorders in adults and self-reported history of teasing or bullying experiences. Cogn Behav Ther 2003;32:187-93.
Phelps CE. Children's responses to overt and relational aggression. J Clin Child Psychol 2001;30:240-52.
Prinstein MJ, Boergers J, Vernberg EM. Overt and relational aggression in adolescents: Social-psychological adjustment of aggressors and victims. J Clin Child Psychol 2001;30:479-91.
Fergusson DM, Wanner B, Vitaro F, Horwood LJ, Swain-Campbell N. Deviant peer affiliations and depression: Confounding or causation? J Abnorm Child Psychol 2003;31:605-18.
[Table 1], [Table 2], [Table 3], [Table 4]