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Nansel, T.R., Craig, W., Overpeck, M.D., Saluja, G., & Ruan, W. (2004). Cross-national consistency in the relationship between bullying behaviors and psychosocial adjustment. Archives of Pediatrics and Adolescent Medicine, 158, 730-736.

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According to Olweus, bullying is characterized by aggressive behavior or intentional harm-doing that is carried out repeatedly over time in an interpersonal relationship characterized by an imbalance of power. This aggressive behavior may be verbal, physical, or relational. Whereas verbal aggression is common among 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.

Method: The HBSC Study was used to collect data on health-related behaviors from students at average ages of 11.5, 13.5, and 15.5 years in 25 countries. Measures for this study were obtained from a self-report questionnaire containing 84 core questions and additional country-specific items. Participants were provided with a standard definition of bullying and asked to report how frequently they had been bullied at school during the current school term and how frequently they had bullied others at school during the current term. Psychosocial adjustment was assessed by five composite measures: health problems, emotional adjustment, school adjustment, relationship with classmates, and alcohol use. Weapon carrying was an optional item assessed in 6 countries.

Results: The average prevalence of victims across countries was 11%. With respect to bullying others, the overall average was 10%. Bully-victims averaged 6%. Across all countries, involvement in bullying was associated with poorer psychosocial adjustment for bullies, victims, and bully-victims. Youth involved in bullying consistently reported significantly higher levels of health problems, poorer emotional adjustment, and poorer school adjustment than noninvolved youth. Victims and bully-victims also consistently reported significantly poorer relationships with classmates than noninvolved youth. Bullies and bully-victims consistently reported significantly more frequent alcohol use. In all countries, victims showed poorer emotional adjustment than bullies. In contrast, bullies reported poorer school adjustment. Bully-victims reported levels of emotional adjustment, relationships with classmates, and health problems similar to those of victims, with levels of school adjustment and alcohol use similar to those of bullies. In the United States, bullies and bully victims across countries showed significantly greater odds of weapon carrying than noninvolved youth.

Discussion: Significant differences in the overall prevalence of bullying among countries, as well as the proportion of victims, bullies, and bully-victims, were observed. However, consistent findings were discovered regarding the relationship between bullying and psychosocial adjustment. Bully-victims exhibited the poorest psychosocial adjustment overall. Given the wide range of associated social and emotional correlates, influencing not only individual development but also success in the peer group and academic context, a comprehensive, systemic approach is needed to address bullying.