Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Mar 22, 2017; 7(1): 60-76
Published online Mar 22, 2017. doi: 10.5498/wjp.v7.i1.60
Consequences of bullying victimization in childhood and adolescence: A systematic review and meta-analysis
Sophie E Moore, Rosana E Norman, Shuichi Suetani, Hannah J Thomas, Peter D Sly, James G Scott
Sophie E Moore, Peter D Sly, Child Health Research Centre, the University of Queensland, South Brisbane, QLD 4101, Australia
Rosana E Norman, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
Rosana E Norman, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
Shuichi Suetani, Queensland Centre for Mental Health Research, the Park Centre for Mental Health, Wacol, QLD 4076, Australia
Shuichi Suetani, Faculty of Medicine, the University of Queensland, Herston, QLD 4029, Australia
Hannah J Thomas, James G Scott, the University of Queensland Centre for Clinical Research, the University of Queensland, Herston, QLD 4029, Australia
James G Scott, Metro North Mental Health, Royal Brisbane and Women’s Hospital, Herston, QLD 4029, Australia
Author contributions: Norman RE and Scott JG designed the study, supervised the systematic review and meta-analysis and supervised the writing of the manuscript; Moore SE and Suetani S conducted the systematic review; Moore SE conducted the meta-analysis and wrote the first draft of the manuscript; Thomas HJ drafted sections of the manuscript related to bullying measurement and supervised the manuscript content; all authors contributed to and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data is available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: James G Scott, Associate Professor, the University of Queensland Centre for Clinical Research, the University of Queensland, Bowen Bridge Rd, Herston, QLD 4029, Australia.
Telephone: +61-73-6368111 Fax: +61-73-6361166
Received: September 13, 2016
Peer-review started: September 14, 2016
First decision: October 21, 2016
Revised: December 4, 2016
Accepted: December 27, 2016
Article in press: December 28, 2016
Published online: March 22, 2017

To identify health and psychosocial problems associated with bullying victimization and conduct a meta-analysis summarizing the causal evidence.


A systematic review was conducted using PubMed, EMBASE, ERIC and PsycINFO electronic databases up to 28 February 2015. The study included published longitudinal and cross-sectional articles that examined health and psychosocial consequences of bullying victimization. All meta-analyses were based on quality-effects models. Evidence for causality was assessed using Bradford Hill criteria and the grading system developed by the World Cancer Research Fund.


Out of 317 articles assessed for eligibility, 165 satisfied the predetermined inclusion criteria for meta-analysis. Statistically significant associations were observed between bullying victimization and a wide range of adverse health and psychosocial problems. The evidence was strongest for causal associations between bullying victimization and mental health problems such as depression, anxiety, poor general health and suicidal ideation and behaviours. Probable causal associations existed between bullying victimization and tobacco and illicit drug use.


Strong evidence exists for a causal relationship between bullying victimization, mental health problems and substance use. Evidence also exists for associations between bullying victimization and other adverse health and psychosocial problems, however, there is insufficient evidence to conclude causality. The strong evidence that bullying victimization is causative of mental illness highlights the need for schools to implement effective interventions to address bullying behaviours.

Keywords: Bullying, Victimization, Systematic review, Meta-analysis, Child, Adolescent

Core tip: There is convincing evidence of a causal association between exposure to bullying victimization in children and adolescents and adverse health outcomes including anxiety, depression, poor mental health, poor general health, non-suicidal self-injury, suicidal ideation and suicide attempts. It is probable that bullying victimization also causes an increased risk of cigarette smoking and illicit drug use. This review highlights that bullying victimization is associated with a wide and diverse range of problems and reinforces the need for effective interventions to be implemented in schools to address the high prevalence of children and adolescents engaging in bullying behaviours.