Bullying and symptoms among school-aged children: international comparative cross sectional study in 28 countries

TLDR

No large‑scale international studies have compared bullying and health among adolescents. The study investigated how bullying relates to physical and psychological symptoms in adolescents across 28 countries. Data were collected from 123,227 nationally representative students aged 11, 13, and 15 in 28 European and North American countries, measuring physical and psychological symptoms. Bullying prevalence varied widely, from 6.3 % in Swedish girls to 41.4 % in Lithuanian boys, and weekly bullying increased odds of physical symptoms (OR 1.83–2.11) and psychological symptoms (OR 1.67–7.47), showing a consistent, strong, graded association across all countries.

Abstract

Background: There have been no large-scale international comparisons on bullying and health among adolescents. This study examined the association between bullying and physical and psychological symptoms among adolescents in 28 countries. Methods: This international cross-sectional survey included 123,227 students 11, 13 and 15 years of age from a nationally representative sample of schools in 28 countries in Europe and North America in 1997–98.The main outcome measures were physical and psychological symptoms. Results: The proportion of students being bullied varied enormously across countries. The lowest prevalence was observed among girls in Sweden (6.3%, 95% CI: 5.2–7.4), the highest among boys in Lithuania (41.4%, 95% CI 39.4–43.5). The risk of high symptom load increased with increasing exposure to bullying in all countries. In pooled analyses, with sex stratified multilevel logistic models adjusted for age, family affluence and country the odds ratios for symptoms among students who were bullied weekly ranged from 1.83 (95% CI 1.70–1.97) to 2.11 (95% CI 1.95–2.29) for physical symptoms (headache, stomach ache, backache, dizziness) and from 1.67 (95% CI 1.55–1.78) to 7.47 (95% CI 6.87–8.13) for psychological symptoms (bad temper, feeling nervous, feeling low, difficulties in getting to sleep, morning tiredness, feeling left out, loneliness, helplessness). Conclusion: There was a consistent, strong and graded association between bullying and each of 12 physical and psychological symptoms among adolescents in all 28 countries.