|Year : 2019 | Volume
| Issue : 3 | Page : 207-212
Association between bullying, peer victimization and mental health problems among adolescents in Bengaluru, India
P James Ranjith1, Christy Jayakumar1, M Thomas Kishore2, B Binukumar3, Adhin Bhaskar3
1 Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
2 Department ofClinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
3 Department of Biostatistics, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
|Date of Submission||08-Feb-2019|
|Date of Decision||23-Apr-2019|
|Date of Acceptance||09-Jun-2019|
|Date of Web Publication||30-Sep-2019|
Dr. Christy Jayakumar
Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bengaluru - 560 029, Karnataka
Source of Support: None, Conflict of Interest: None
Context: Adolescents face quite a few psychosocial problems in schools, bullying is one such problem. Although bullying has become a routine phenomenon, it is a poorly understood in the Indian setting. Undergoing experiences of bullying often result in serious mental health consequences which can have an impact on individual's well-being. However, much of our understanding on bullying and peer victimization comes from the studies conducted in the West and are not completely relevant to Indian settings. Aim: The aim is to explore the prevalence of bullying, victimization, and its association with mental health among the adolescents. Methods: The study included 419 boys and girls from Class VIII to X grade in English medium, private schools in Bengaluru through stratified sampling. Adolescent peer relation instrument and strengths and difficulties questionnaire were administered in small groups. Results and Conclusion: Majority of the participants (97.1%) reported that they bullied others at some point of time, with verbal bullying (95.5%) being the most common form. Majority of the participants (97.9%) also reported that they were victims of bullying at some point of time and were mainly subjected to verbal victimization (93.3%). Boys indulged more in physical bullying. Emotional problems, conduct problems, and hyperactivity were highly associated with specific forms of bullying and victimization. Prosocial behaviors were negatively correlated with all form of bullying. Both victimization and bullying may indicate the presence of emotional and behavioral problems. These findings imply a need for school-based psychosocial interventions to deal with bullying and victimization.
Keywords: Adolescents, bullying, mental health, peer victimization, psychosocial intervention
|How to cite this article:|
Ranjith P J, Jayakumar C, Kishore M T, Binukumar B, Bhaskar A. Association between bullying, peer victimization and mental health problems among adolescents in Bengaluru, India. Indian J Soc Psychiatry 2019;35:207-12
|How to cite this URL:|
Ranjith P J, Jayakumar C, Kishore M T, Binukumar B, Bhaskar A. Association between bullying, peer victimization and mental health problems among adolescents in Bengaluru, India. Indian J Soc Psychiatry [serial online] 2019 [cited 2019 Oct 13];35:207-12. Available from: http://www.indjsp.org/text.asp?2019/35/3/207/268341
| Introduction|| |
Majority of the Indian population is children and young adults. Nearly 253 million are adolescents (10–19) years. With the population growth, there are growing concerns over children's mental health in India. One among them is bullying in the school-going population, which is often unrecognized, and most school authorities find it difficult to address.
The prevalence of bullying varies considerably across the countries. However, a survey conducted among schoolchildren in 66 countries estimated that 32.1% of the children were bullied at least once in a day. Bullying is categorized into three types such as bullying, victimization, and bully victims., A prevalence study conducted in Bengaluru among college students using retrospective bullying questioner estimated that 3.5% people had bullied others, while 22.2% were both bullies and victims. A study conducted in Rohtak reported bullying is more common among males (24.4%) than females (1.7%), and most of them were bullied by their peers. A study from Davangere in Karnataka estimated that the prevalence of bullying among the school-going girls was lower (53%) as compared to boys (63.9%). Another study from both private and government schools in Chandigarh found that boys were more likely to be both bullies and victims (27.9%), while girls were more likely to be victims (21.6%), and bullies had hyperactivity and conduct problems. Thus, gender differences seem to be fairly consistent with males being more active in bullying as compared to females. Previous studies have found that being different in physical appearances such as skin tone, dressing style, and general behavior; cognitive attributes such as low intelligence and learning difficulties; and behavioral disorders such as attention-deficit hyperactivity disorder and conduct problems put a child at risk for victimization.,,
Victims of bullying face a wide range of mental health problems such as low self-esteem, loneliness, psychosomatic problems, substance use, depression, anxiety, sadness, and self-worth.,,,,, Conversely, children involved in bullying were also found to have poor school adjustment, low academic performance, increased externalizing behavior such as fighting and weapon carrying, and long-term consequences including antisocial personality, intimate partner violence, delinquency, suicidal thoughts and behavior, and low self-esteem.,,,,,,,, In summary, the literature indicates that bullying and peer victimization are common among the adolescents, and surprisingly, victims can also become bullies. Studies differ in their operational definition of bullying, therefore, clear generalizations about the nature and prevalence of bullying is difficult. Most of the studies are from the West and are not completely relevant to Indian settings. In this background, the present aims to find out the prevalence and pattern of bullying, victimization, and its association with mental health among school-going adolescents.
| Methods|| |
The study was carried out from November 2015 to February 2016. The study adopted a cross-sectional research design. The sample size was calculated based on a study from India, which reported bullying in 53% among girls and 63.9% in boys in a sample of 500 participants, allowing a 5% of precision error with a confidence level of 95%. The sample in the current comprised of 419 school-going adolescents. From the list of 29 schools located in approximately 5-km radius from NIMHANS, Bengaluru, three private, English-medium, day-care schools were randomly selected out of which two schools gave permission for the study. Classes VIII–X were identified by sections, and simple random method was used to select equal number of students from each section till the desired sample size was achieved. In one school, permission was not given to include Class X students because of the school policy. Adolescents who were formally diagnosed with significant medical problems, developmental disorders, attention-deficit hyperactive disorder, specific learning disorder, neurological problems, and impaired sensory functions were excluded from the study for the reason that they are more vulnerable for bullying than the healthy controls and which would confound the results.
Adolescent peer relation instrument (APRI), a self-administered, 36-item questionnaire, was used in this study. The scale measures bullying and victimization across three dimensions such as physical, verbal, and social domains. The scale considers information over the past 1 year to generate responses. Six-point Likert scale is used to generate scores on subdomains, namely, 1 – never to 6 – every day. Children who score <36 (or 18 in each scale) are considered to have never been bullied or never bullied over the past 1 year. The scale has good internal consistency, and it has been used in a study in India.,, Strengths and Difficulties Questionnaire (SDQ) was used as a measure of mental health, as it assesses the emotional and behavioral difficulties. There are parent-report and self-report versions available, but we have used the latter in this study. The scale consists of 25 items, and each item is rated on a three-point Likert-type scale, with the scores ranging from 0 – Not true, 1 –Somewhat true to 2 – Certainly true. The scale yields information across five subscales such as emotional symptoms, conduct problems, hyperactivity-inattention, peer relationship problems, and prosocial behavior. Except for the prosocial scale, higher scores on each scale indicate higher mental health needs. This scale has been widely used in Indian studies.
The study was approved by the NIMHANS Ethical Committee. Due permission was sought from the respective authors for using the tools mentioned in the study. Due permission was obtained from school authorities for the data collection. Informed consent was obtained from the parents and assent forms from the participants to take part in the study. The participants were assessed class-wise, with each class consisting of 40–50 students. They were explained about the study and the procedure in detail and were encouraged to clarify the doubts. APRI and SDQ were administered in the same order on all groups, with a 10 minutes break between the two. It took 45 minutes for administration of each measure.
The data were analyzed using IBM corp. Released 2013. IBM SPSS Statistics for Windows, (version 22.0. Armonk, NY; IBM Corp). Quantitative variables were summarized using descriptive statistics such as mean and standard deviation, whereas frequency distribution and percentages were used to summarize the qualitative variables. Mann–Whitney U-test was used for finding the significance of difference between boys and girls. Spearman's rho was employed to examine the relationship between the variables under study. Significance for each test was set at P < 0.05.
| Results|| |
The sample consisted of 227 (54.2%) boys and 192 (45.8%) girls. Majority of the participants were Hindus (65.4%), followed by equal representation from both Christian (17.4%) and Muslims (17.2%). Item analysis indicated that verbal bullying predominantly involved calling others by names (24.3%), teasing and saying bad things (19.8%), and making jokes about others (19.8%).
[Table 1] presents the APRI score. The results indicate that 95.5% of the participants (n = 400) were verbally bullied in their lifetime. Physical bullying (n = 330, 78.8%) and social bullying (n = 276, 65.9%) were widely prevalent. Most of the participants reported that they bullied others at some point of time (n = 407, 97.1%). The same group also reported a high prevalence of victimization (n = 410, 97.9%). Most of the participants had experienced verbal victimization (n = 335, 80.0%), physical victimization (n = 330, 78.8%), and 323 (77.1%) social victimization.
[Figure 1] presents the scores on SDQ, which indicate that 60.7% had significant mental health problems, while 26.1% has some borderline level of mental health problems; significant emotional problems (10.5%), conduct issues (20.3%), hyperactivity-inattention (6.2%), and peer problems (16.9%) were noted along with low prosocial behaviors (5.7%).
Mann–Whitney U-test was employed to understand the gender differences in verbal bullying, physical bullying, social bullying, verbal victimization, physical victimization, and social victimization [Table 2]. The results showed that there is statistically significant difference with boys involving more both in verbal bullying (U = 18,215, P < 0.01), physical bullying (U = 14,622; P < 0.01), and in social bullying (U = 15,085; P < 0.01) than girls. With regard to victimization, boys were more physically victimized than girls (U = 15,643; P < 0.01). However, there were no significant gender differences between boys and girls in verbal and social victimization.
|Table 2: Comparison of bullying and victimization between boys and girls|
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Boys and girls were compared with regard to the emotional and behavioral problems [Table 3]. The results indicate that boys had significantly more emotional problems than girls (U = 14,304; P < 0.001), but girls were significantly better than boys in prosocial behaviors (U = 18,930; P < 0.01). There were no significant differences between boys and girls on conduct problems, hyperactivity, and peer problems.
|Table 3: Comparison of psychological problems on strengths and difficulties questionnaire between boys and girls|
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Correlation coefficients are computed to see the relationship between bullying/victimization and mental health needs as measured by APRI and SDQ, respectively. Results indicate that social bullying, verbal victimization, physical victimization, and social victimization were positively correlated with emotional symptoms. The results also indicate that all forms of bullying and victimization were positively correlated with conduct problems and hyperactivity. Prosocial behaviors were negatively correlated with all form of bullying and physical and social victimization [Table 4].
|Table 4: Correlation between bullying, peer victimization, and psychological problems|
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| Discussion|| |
The present study intended to explore the prevalence of bullying, victimization, and its mental health consequences. The Health Behavior in School-Aged Children Survey conducted in 2005 indicates that children reported of their involvement in verbal bullying (53.6%), social bullying (51.4%), and physical bullying (20.8%) over the past 2 months. A study conducted by Malhi, reported that the prevalence of any kind of bullying behavior was 53%, which is less than the current study. The current study indicates that majority of the participants (97.1%) reported that they were bullied others at some point of time over 1-year period, which is little higher when comparing other studies. However, these findings are similar to a study from Port Harcourt, Nigeria, which reported that 82.2% of the participants were victims of bullying, and 64.9% have also bullied others. These findings indicate that bullying is widely prevalent among the school-going adolescents., The high prevalence of bullying in the current study could be because of the nature of tool, which considered any bullying and victimization experience within 1 year period and did not focus more on what are the factors contributing for bullying experience. High prevalence could be also because of frequent exposure to violence, achieving the end goal of conflict situation by means of physical aggression, and poor role model.,,
Bullying and gender differences
Boys were found to indulge more in physical bullying and social bullying and are also more likely to receive physical victimization. The findings are consistent with the findings of previous studies., This may be because boys tend to react aggressively and that they do not seek or receive much help from their friends and administrative staffs to manage the conflicts in a socially appropriate way. We can also understand this phenomenon from a generic cultural pattern of nurturing males to use physical strength and aggression in to have their way, particularly in socially conflict situations. Conversely, girls are generally encouraged to involve in caring and emotionally supportive task and discouraged from physically aggressive behaviors. As this study also found that boys were involved in all forms of bullying, it suggests that physical aggression is not the only mode that the boys use for bullying. However, we may not find any gender differences in terms of social and verbal bullying. Somewhat paradoxically those adolescents who were involved in bullying had also been subjected to peer victimization in the past. Literature recognized this group as “bully victims” to refer to a subgroup of bullies who are both victims and bullies.
Bullying and mental health
In the present study, 60.7% of adolescences were found to have higher score on SDQ, suggesting that majority of bully victims were at risk for clinically significant emotional and behavioral disorders. These findings also corroborated with a study found that students being aggressive toward others and victims show lower self-worth, higher levels of depressive symptoms, and more psychological problems. The adolescents who were aggressive toward others show a wide range of conduct problems, delinquent behavior, depressive features, and enjoy lesser social acceptance. Bullies are to be at higher risk for hyperactivity and conduct problems, which also correlate with low prosocial behaviors. Our study found that emotional symptoms correlate with social bullying, verbal victimization, physical victimization, and social victimization. Similarly, conduct problems andhyperactivity-inattention were highly associated with all forms of bullying and victimization. It is beyond the scope of the present study to comment if the behavioral deficits associated with hyperactivity inattention manifest as bullying, but it is desirable for future studies to address it from this view because many children with ADHD are wrongly associated with conduct behaviors including bullying.
The present study results show that peer problems were related with all form of victims. The results also indicated that prosocial behaviors were negatively correlated with all form of bullying. These study findings are consistent with previous studies, which found a positive associated between bullying and behavioral problems.,,, Overall, these findings are similar to a meta-analysis, which found that psychosomatic problems and internalizing problems are more common among bullied adolescents than nonbullied adolescents. Overall findings indicate that prosocial behaviors, social skills, emotional processing skills, adequate levels of attention, and activity levels may hold the key in understanding the phenomenon of bullying. Nonetheless, both victims and bullies need appropriate psychosocial support in the form of screening for mental health needs, promoting healthy peer interactions, opportunities to strengthen socialemotional skills and development of cognitiveacademic skills. There is a scope for school-based psychosocial interventions. For example, life skill approaches and social-emotional learning programs have been effective in managing bullying by helping the children help themselves to understand and manage emotions, set and achieve positive goals, being empathetic, establish and maintain positive relationship, and make responsible decisions.,
This study has specific limitations. We could not assess reasons for bullying and we have done only screening for mental health issues apart for self-rating on SDQ. We did not include cyberbullying, which is gradually emerging as an area of concern in recent years. Another limitation of the study was that the study was conducted in two schools only. Since the study conducted in urban schools, it may not be suitable for rural adolescents. Socioeconomic status could not be assessed because most of the children were not aware of their family income status. We also did not factor for the impact of academic achievement and other sociodemographic variables. Future studies can address these issues.
| Conclusion|| |
The present study indicates that bullying and victimization are common among school-going adolescents, and it correlates with emotional and behavioral problems. There is a good scope for sensitizing the peer group, teachers, parents, and administrators on tackling the issue of bullying and victimization.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Due P, Holstein BE, Soc MS. Bullying victimization among 13 to 15-year-old school children: Results from two comparative studies in 66 countries and regions. Int J Adolesc Med Health 2008;20:209-21.
Georgiou SN, Stavrinides P. Bullies, victims and bully-victims: Psychosocial profiles and attribution styles. Sch Psychol Int 2008;29:574-89.
Pouwels JL, Scholte RH, van Noorden TH, Cillessen AH. Interpretations of bullying by bullies, victims, and bully-victims in interactions at different levels of abstraction. Aggress Behav 2016;42:54-65.
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. [Full text]
Rajput M, Goutam A, Rajawat G. Bullying and being bullied: Prevalence and psychosocial outcomes among school going adolescents of Rohtak. Int J Community Med Public Health 2018;5:991-5.
Ramya SG, Kulkarni ML. Bullying among school children: Prevalence and association with common symptoms in childhood. Indian J Pediatr 2011;78:307-10.
Malhi P, Bharti B, Sidhu M. Aggression in schools: Psychosocial outcomes of bullying among Indian adolescents. Indian J Pediatr 2014;81:1171-6.
Gini G. Associations between bullying behaviour, psychosomatic complaints, emotional and behavioural problems. J Paediatr Child Health 2008;44:492-7.
Mishna F. Learning disabilities and bullying: Double jeopardy. J Learn Disabil 2003;36:336-47.
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.
Guo L, Hong L, Gao X, Zhou J, Lu C, Zhang WH. Associations between depression risk, bullying and current smoking among Chinese adolescents: Modulated by gender. Psychiatry Res 2016;237:282-9.
Sigurdson JF, Wallander J, Sund AM. Is involvement in school bullying associated with general health and psychosocial adjustment outcomes in adulthood? Child Abuse Negl 2014;38:1607-17.
Hong L, Guo L, Wu H, Li P, Xu Y, Gao X, et al.
Bullying, depression, and suicidal ideation among adolescents in the Fujian province of China: A cross-sectional study. Medicine (Baltimore) 2016;95:e2530.
Isolan L, Salum GA, Osowski AT, Zottis GH, Manfro GG. Victims and bully-victims but not bullies are groups associated with anxiety symptomatology among Brazilian children and adolescents. Eur Child Adolesc Psychiatry 2013;22:641-8.
Arsenio WF, Fleiss K. Typical and behaviourally disruptive children's understanding of the emotional consequences of socio-moral events. Br J Dev Psychol 1996;14:173-86.
Bogart LM, Elliott MN, Klein DJ, Tortolero SR, Mrug S, Peskin MF, et al.
Peer victimization in fifth grade and health in tenth grade. Pediatrics 2014;133:440-7.
Tsitsika AK, Barlou E, Andrie E, Dimitropoulou C, Tzavela EC, Janikian M, et al.
Bullying behaviors in children and adolescents: “an ongoing story”. Front Public Health 2014;2:7.
Haynie DL, Nansel T, Eitel P, Crump AD, Saylor K, Yu K, et al
. Bullies, victims, and bully/victims. J Early Adolesc 2001;21:29-49.
Smokowski PR, Kopasz KH. Bullying in school: An overview of types, effects, family characteristics, and intervention strategies. Child Sch 2005;27:101-10.
Halabi F, Ghandour L, Dib R, Zeinoun P, Maalouf FT. Correlates of bullying and its relationship with psychiatric disorders in Lebanese adolescents. Psychiatry Res 2018;261:94-101.
Katsaras GN, Vouloumanou EK, Kourlaba G, Kyritsi E, Evagelou E, Bakoula C. Bullying and suicidality in children and adolescents without predisposing factors: A systematic review and meta-analysis. Adolesc Res Rev 2018;3:193-217.
Pepler D, Jiang D, Craig W, Connolly J. Developmental trajectories of bullying and associated factors. Child Dev 2008;79:325-38.
Tural Hesapcioglu S, Yesilova Meraler H, Ercan F. Bullying in schools and its relation with depressive symptoms, self-esteem, and suicidal ideation in adolescents. Anadolu Psikiyatri Derg 2018;19:210-6.
Hamburger ME, Basile KC, Vivolo AM. Measuring Bullying, Victimization, perpetration and Bystander Experiences: A Compendium of Assessment Tools. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2011. p. 38.
Parada RH, Marsh HW, Craven R. There and back again from bully to victim and victim to bully: A reciprocal effects model of bullying behaviours in schools. In Australian Association for Research in Education 2005 Conference Papers; 2005.
Hamilton LR, Marsh HW, Morin AJ, Craven RG, Parada RH, Nagengast B. Construct validity of the multidimensional structure of bullying and victimization: An application of exploratory structural equation modeling. J Educ Psychol 2011;103:701-32.
Goodman R, Meltzer H, Bailey V. The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry 1998;7:125-30.
Wang J, Iannotti RJ, Nansel TR. School bullying among adolescents in the United States: Physical, verbal, relational, and cyber. J Adolesc Health 2009;45:368-75.
Alex-Hart BA, Okagua J, Opara PI. Prevalence of bullying in secondary schools in Port Harcourt. Int J Adolesc Med Health 2015;27:391-6.
Esposito C, Bacchini D, Affuso G. Adolescent non-suicidal self-injury and its relationships with school bullying and peer rejection. Psychiatry Res 2019;274:1-6.
Brunstein Klomek A, Barzilay S, Apter A, Carli V, Hoven CW, Sarchiapone M, et al.
Bi-directional longitudinal associations between different types of bullying victimization, suicide ideation/attempts, and depression among a large sample of European adolescents. J Child Psychol Psychiatry 2019;60:209-15.
Schwartz D, Dodge KA, Pettit GS, Bates JE. The early socialization of aggressive victims of bullying. Child Dev 1997;68:665-75.
Unnever JD. Bullies, aggressive victims, and victims: Are they distinct groups? Aggress Behav 2005;31:153-71.
Boulton MJ, Underwood K. Bully/victim problems among middle school children. Br J Educ Psychol 1992;62(Pt 1):73-87.
Narayanan A, Betts LR. Bullying behaviors and victimization experiences among adolescent students: The role of resilience. J Genet Psychol 2014;175:134-46.
Kochenderfer BJ, Ladd GW. Victimized children's responses to peers' aggression: Behaviors associated with reduced versus continued victimization. Dev Psychopathol 1997;9:59-73.
Undheim AM, Sund AM. Prevalence of bullying and aggressive behavior and their relationship to mental health problems among 12- to 15-year-old Norwegian adolescents. Eur Child Adolesc Psychiatry 2010;19:803-11.
Keder R, Sege R, Raffalli PC, Augustyn M. Bullying and ADHD: Which came first and does it matter? J Dev Behav Pediatr 2013;34:623-5.
Bouman T, van der Meulen M, Goossens FA, Olthof T, Vermande MM, Aleva EA. Peer and self-reports of victimization and bullying: Their differential association with internalizing problems and social adjustment. J Sch Psychol 2012;50:759-74.
Wolke D, Woods S, Bloomfield L, Karstadt L. The association between direct and relational bullying and behaviour problems among primary school children. J Child Psychol Psychiatry 2000;41:989-1002.
Yen CF, Yang P, Wang PW, Lin HC, Liu TL, Wu YY, et al.
Association between school bullying levels/types and mental health problems among Taiwanese adolescents. Compr Psychiatry 2014;55:405-13.
Gini G, Pozzoli T. Bullied children and psychosomatic problems: A meta-analysis. Pediatrics 2013;132:720-9.
American Educational Research Association. Prevention of Bullying in Schools, Colleges, and Universities: Research Report and Recommendations. Washington, DC: American Educational Research Association; 2005. p. 25-6.
[Table 1], [Table 2], [Table 3], [Table 4]