Just not to go to school: how school bullying is related to PTSD symptoms

Schoolchildren who were bullied were more likely to have symptoms of post-traumatic stress disorder (PTSD). An analysis of 38 studies revealed a connection among those who bullied their peers, especially if they themselves became a target. There was little data on the frequency of confirmed diagnoses. About how traumatic stress can manifest itself in schoolchildren and what is taken into account when making a diagnosis, see the Izvestia article.

How the symptoms differed depending on the role in bullying

A team led by Serap Keles, a researcher at the University of Stavanger, selected works from more than 25 countries. Most of them are dedicated to secondary school students. The average age of the participants in the different samples ranged from about nine to 17 years old.

By bullying, the authors mean repeated intentional actions when it is difficult for one of the participants to defend himself due to the disparity of forces. This can happen in the classroom or online. In the analysis, the researchers took into account the role that the children reported in each job. The same child could be bullied in one situation and bullied by his peers in another.

The connection was found in all three groups, and it was most pronounced in those who were bullied and in children who combined both roles. In the works, the participants of which were on average younger, the connection was stronger. This is a comparison of groups from different studies. To understand how the risk varies with age in the same child, you will need to monitor the children over several years.

The cumulative correlation coefficient between participation in bullying and the severity of symptoms was about 0.24. The closer this indicator is to unity, the stronger the positive relationship. In individual works, her strength varied markedly. In 36 of the 38 studies, data on bullying and symptoms were collected in one period. This design shows which phenomena occur together. Long-term observations will be needed to establish what happened before.

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Why did the proportion of children with symptoms vary so much?

In ten papers, the researchers calculated what proportion of schoolchildren who were bullied scored above the threshold on the PTSD scales. The results ranged from 12.1% to 65.8%. Different assessment tools and thresholds were used in different samples. Therefore, these figures show how much the results depended on the study conditions. They cannot be used to calculate the proportion of children with PTSD among all schoolchildren who have experienced bullying.

Recurring disturbing memories, avoiding reminders of what happened, and increased alertness are among the signs of PTSD. The clinical assessment takes into account the combination and duration of symptoms, their impact on daily life, and the nature of the event after which they appeared.

How was the connection with the diagnosis checked?

There were two papers in the review in which the authors tried to estimate the frequency of the disorder itself. One of them used a structured clinical interview with schoolchildren in Lebanon. At the same time, the children may have had other traumatic experiences, the contribution of which could not be assessed. Another study was based on a survey of teenagers who went to the emergency department for various reasons. The participants themselves reported the symptoms and events they were associated with.

To find out under what circumstances bullying may be associated with clinical PTSD, scientists suggest in future studies to clarify exactly what happened to the child, take into account other severe events and monitor the change in symptoms over time.

The authors suggest that teachers and school psychologists pay attention to signs of traumatic stress in children involved in bullying and, if necessary, refer them to a specialist for additional assessment. When assessing such symptoms in a child, researchers recommend finding out if he has experienced bullying.