Cross-national consistency in the 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.


METHODS
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.


METHODS
Surveys were conducted at public and private schools throughout the participating countries.


METHODS
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.


METHODS
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.
Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, Bethesda, MD 20892-7510, USA. nanselt@mail.nih.gov
Tonja R
TR
Nansel
Wendy
W
Craig
Mary D
MD
Overpeck
Gitanjali
G
Saluja
W June
WJ
Ruan
D000223:Adaptation, Psychological; D000293:Adolescent; D000374:Aggression / Q000523:psychology*; D000428:Alcohol Drinking / Q000453:epidemiology; D002648:Child; D019548:Crime Victims / Q000706:statistics & numerical data; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004644:Emotions; D005389:Firearms / Q000706:statistics & numerical data; D014943:Global Health; D006304:Health Status; D006801:Humans; D016017:Odds Ratio; D010379:Peer Group; D015995:Prevalence; D012574:Schools / Q000706:statistics & numerical data; D012917:Social Adjustment; D013334:Students / Q000523:psychology; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data*