For each of the learning objectives, provide an analysis of how th
Summer Research Scholars Final Paper
1. 1
BACKGROUND: Although the association between bully victimization and depression has
received significant scientific attention, the extant research has yet to focus on the association of
early childhood bully victimizations and levels of depression in adulthood. The present study
investigates this relationship while controlling for prior levels of mental health as well as the
stressful events that occur in the participants’ lives.
METHODS: This study uses data from the National Longitudinal Survey of Youth 1997
(NLSY97). The NLSY97 is a population-based longitudinal study of individuals who were
between the ages of 12 and 16 as of December 31, 1996. Repeat bully victimizations were
assessed before the age of 12 and then associated with measures of depression beginning in late
adolescence and into adulthood. Subgroup analyses were then conducted to explore the
similarities (or differences) across categories of sex and race.
RESULTS: The results indicate that repeat bully victimizations experienced before the age of 12
were associated with higher levels of depression in late adolescence and adulthood. Subgroup
analyses by gender revealed that these relationships were specific to females only; levels of
depression for male respondents were not related to repeat bully victimizations. Subgroup
analyses by race revealed that whites were primarily affected in late adolescence while non-
whites were impacted in adulthood.
CONCLUSIONS: Being the victim of a bully during childhood serves as a marker for
subsequent mental health problems in late adolescence and adulthood. Prevention and
intervention programs aimed at reducing mental health problems would benefit by targeting
bully victimization occurring early in the life course.
2. 2
Introduction
Children and adolescents face many obstacles that impact them both positively and
negatively in the long term (Case, Fertig, Paxon, 2004). Bullying and bully victimizations is one
obstacle that has been documented to have a significant impact on the lives of youth (Arseneault
et al., 2006; Farrington & Ttoft, 2011; Kaltiala-Heino et al., 1999; Klomek et al., 2007; Klomek
et al., 2008; Klomek et al., 2009; Kumpulainen & Rasanen, 2000; Nansel et al., 2003; Sharp et
al., 2000; Sourander et al., 2000; Sourander et al., 2007; Sourander et al., 2007). Nearly one-
third of children from sixth to tenth grade experience a bullying incident (Nansel et al., 2001).
Generally, bullying has been defined as the persistent harassment (physical, verbal, emotional, or
psychological) of one individual by another and accompanied by a power imbalance (Nansel et
al., 2001). Bullying has recently been labeled as one of the most significant problem behaviors
that children and adolescents have to deal with today (Surgeon General Report, 2001). Bullying
can be physical, verbal or cyber (Rivers & Smith, 2006). Repeat bullying victimization can lead
to many diverse problems, which can follow an individual into adulthood (Copeland et al., 2013;
Niemela et al., 2011 ;Sourander, 2007, Tucker et al., 2013). Bullying between siblings has also
been found to have a strong negative effect on adolescent mental health (Tucker, Finkelhor,
Turner & Sharttuck, 2013).
The association between bullying and poor mental health is a topic that has garnered
significant scientific attention (Kumpulainen et al., 2001; Kaltiala, 2000; Baldry, 2004;
Sourander, 2007; Schreier, 2009; Copeland et al., 2013; Klomek et al. 2010; Niemela, 2011;
Riittakerttu et al. 1999; Arseneault et al. 2006; Turner et al. 2013). Poor mental health has been
found to have deleterious effects in many areas of an individual’s life. Five of the ten leading
causes of disabilities worldwide are contributed to mental health problems (Geneva, 2000). Poor
3. 3
mental health has also been found to have detrimental effects of academic successes in college.
Through interviews with psychology professionals and access to participant’s grade point
averages it was found that college students with poor mental health tend to have a significantly
lower grade point average when compared to students who exhibited good mental health
(Eisenberg, Golberstein & Hunt, 2009).
Over the past decade scholars have investigated the variety of negative consequences that
are associated with experiencing bully victimizations. Several studies have been conducted that
found significant associations between bullying and depression (Kumplulainen et al.; 2001,
Kaltiala-Heino et al., 2000; Baldry, 2004; Copeland et al. 2013; Riittakerttu et al., 1999; Turner
et al., 2013), suicidality and suicide ideation Copeland et al.,2013; Klomek et al., 2010;
Riirrakerttu et al., 1999; Turner et al., 2013), as well as other serious mental health problems
such as eating disorders (Kalitiala-Heino et al., 2000), anxiety ( Kalitiala-Heino et al., 2000;
Sourander, 2007), anti-social personality disorder (Sourander et al.), and other
psychotic/psychiatric symptoms/disorders (Kumpulainen et al., 2001; Kaltianla-Heino et al.,
2000; Sourander, 2007; Schreier et al., 2009).
Although promising, the extant research examining the association between bullying and
mental health has often been limited by one or more factors. First, many studies have failed to
control for pre-existing mental health issues. This omission is important because documented
mental health deficiencies might have occurred prior to the bully victimization experiences. The
bully victimization experience is therefore not a cause of the poor mental health but instead a
comorbid circumstance. Second, many studies have used relatively small, geographically-
specific samples with limited generalizability. Third, the extant research has measured the
bullying experience or the mental health outcome (or both) over a restricted timeframe. Finally,
4. 4
research has yet to systematically explore whether the bully victimization experience impacts
groups of people (i.e. males vs. females or whites vs. nonwhites) similarly (or differently).
The present study uses data from the National Longitudinal Survey of Youth, 1997
(NLSY97) to build upon the literature documenting the mental health problems associated with
repeat bully victimizations. Specifically, this study investigated the association of experiencing
repeat bully victimizations from birth to age 12 with mental health consequences experienced in
late adolescence and adulthood. Importantly, these associations were investigated while
controlling for mental health problems early in the life course as well as stressful circumstances
in adulthood. Drawing on prior research, these relationships were also examined across
categories of sex and race (Klomek et al., 2009; Spriggs et al., 2007).
Methods
Data Collection and Sample
The data used for the present study were extracted from waves 1 through 14 of the
NLSY97. The NLSY97 is data set consisting of approximately 8,984 youth who were 12-16
years of age as of December 31, 1996. Wave one of the survey occurred in 1997 where the
youth and one of their parents received a one-hour personal interview and participated in a two-
part extensive questionnaire regarding the demographics of the youth’s household and immediate
family. After the initial wave, youths were interviewed on an annual basis. The participants
selected for this study were part of the cross-sectional sample, between the ages of 12 and 14
years old at Wave 1, and completed an interview during each of the waves of analysis used in the
present study.
We had to limit our participants to those who were between the ages of 12 and 14 years at
the first wave for those were the only participants to complete the behavioral/emotional scale in
5. 5
1997. To have the most complete data set we needed to limit our participants to those who
answered the relevant questions during every wave that we analyzed.
Repeat Bully Victimization
In wave 1, when subjects were an average age of 13, they responded to a question
“Before you turned age 12, were you ever the victim of repeated bullying?” Response options
were 0 = ‘no’ and 1 = ‘yes.’ A total of .21 percent of the sample acknowledged they were
victims of repeat bully victimizations before the age of 12.
Dependent Variable: Depression
The main outcome variable is a five-item measure of the youth’s level of depression.
This measure is a shortened version of the Center for Epidemiological Studies Depression (CES-
D) scale. Beginning in wave 4, youths were asked how often in the past month they were
“nervous,” “felt calm,” “felt blue,” “were happy,” and “felt depressed.” Response options were
1 = ‘all of the time,’ 2 = ‘most of the time,’ 3 = ‘some of the time,’ and 4 = ‘none of the time.’
Items were recoded so that higher scores were indicative of more severe forms of depression.
The depression measure was assessed every other year beginning in wave 4 when subjects were
an average age of 17.03 through wave 14 when they were an average age of 26.92. The scale has
good reliability (alphas ranged from .77 to .81).
Baseline Measures of Mental Health
We control for baseline measures of mental health with a four-item measure collected at
wave 1. Specifically, youths and their parents separately completed an assessment documenting
the degree of behavioral and emotional problems they had experienced in the prior 6 months
(Achenbach, 1991). Male and female respondents each answered whether “you lie or cheat” and
“you are unhappy.” Male respondents received two additional items documenting the degree to
6. 6
which “you don’t get along with other kids” and you have trouble concentrating or paying
attention.” Female respondents received two additional items documenting the degree to which
“your schoolwork is poor” and “you have trouble sleeping.” Response options for all items were
0 = ‘not true,’ 1 = sometimes true,’ and 2 = ‘often true.’ Scores ranged from 0 to 8 with higher
scores being indicative of more behavioral and emotional problems. The scale has good
reliability (alpha = .52).
We also controlled for a variety of sources of stress occurring after wave 1 that may be
related to levels of depression later in the life course. Starting at wave 6 when subjects reached
an average age of 19.02, participants were asked to acknowledge whether they experienced in the
last five years a variety of stressful life events. The events included in this stress index were, “a
close relative of yours who died,” “an adult member in your household (other than yourself) who
experienced one or more periods of unemployment lasting at least six months,” “whether your
parents divorced, either from each other or from their former spouse,” “whether they were the
victim of a violent crime, for example, physical or sexual assault, robbery, or arson,” “whether
they have been homeless or lived in a shelter for the homeless for two or more nights in a row,”
“whether they had a member of their household stayed in a hospital for at least one week for
treatment of illness or injury,” and “whether they had an adult member of their household (other
than themselves) who had been sent to jail or prison.” Response options for each item were 0 =
‘no’ and 1 = ‘yes.’ This stress index ranged from 0 to 7 with higher values indicative of more
stressful life experiences. The items in this index were also administered in 2007 with identical
response sets.
Statistical Analysis
7. 7
Difference-of-means tests were used to test the bivariate relationships between repeat
bully victimization and depression. The associations between the predictor variables and
depression were estimated via multivariate ordinary least squares regression analysis. A series
of coefficient comparison tests were subsequently performed to assess differences across
categories of race and sex (see Paternoster, Brame, Mazerolle, & Piquero, 1998). All statistical
analyses were performed using SPSS version 20 (SPSS Inc., Chicago, IL).
Results
Table 1 presents the descriptive statistics of the sample under analysis. Respondents
were on average 13 years of age during wave 1 when the repeat bully victimization measure was
assessed. Approximately one-third (31%) of the sample was non-white and these subjects were
equally distributed across sex (49% females and 51% males). One out of five (21%) respondents
reported they had experienced repeated bully victimizations before the age of 12. Levels of
depression among the sample appear to be relatively stable over the decade under analysis.
Table 2 presents the data assessing adult levels of depression across respondents who
reported they were (and were not) repeat bully victims before the age of 12. Two patterns
emerge from this analysis. First, bully victims reported significantly higher levels of depression
in each of the six measurement points. Second, these differences appear to be relatively stable
over time.
Table 3 presents the results of several ordinary least squares regressions predicting levels
of depression during each of the six waves under analysis. Males consistently reported
significantly lower levels of depression than females. Individuals with higher baseline levels of
behavioral/emotional problems during childhood consistently reported significantly higher levels
of depression in adulthood. Similarly, respondents reporting stressful life events during
8. 8
adulthood typically reported significantly higher levels of depression. Finally, respondents who
experienced repeat bully victimizations before the age of 12 consistently reported significantly
higher levels of depression than non-victims across each of the assessment points. These results
indicate that even after controlling for baseline behavioral/emotional levels as well as stressful
life events, experiencing repeat bully victimizations corresponded with significantly higher
levels of depression.
In light of research indicating that males and females respond to bully victimizations in
unique ways, we subsequently examined these relationships by gender. Table 4 presents the
results of several ordinary least squares regressions predicting levels of depression during each
of the six waves across categories of sex. Consistent with the prior analysis, individuals
reporting higher baseline behavioral/emotional problems and higher scores on the stressful life
events index experienced significantly higher levels of depression. With a few exceptions, these
results were consistent across sex. The repeat bully victimization measure, however, uniquely
contributed to levels of depression in a fundamental way. Specifically, experiencing repeat bully
victimizations corresponded with significantly higher levels of depression for females during
three of the six waves under analysis. Being repeatedly victimized by a bully before the age of
12 did not correspond with significantly higher levels of depression for males during any of the
waves under analysis. The results of the coefficient comparison test on the repeat bully
victimization variable did not reveal that these differences were significant across males and
females.
Finally, we explored whether experiencing repeat bully victimizations before the age of
12 impacted whites and non-whites in unique ways. Table 5 presents the results of several
ordinary least squares regressions predicting levels of depression during each of the six waves
9. 9
across whites and non-whites. Again, consistent with the prior analysis, individuals reporting
higher baseline behavioral/emotional problems and higher scores on the stressful life events
index experienced significantly higher levels of depression. These estimates were relatively
consistent across whites and non-whites. Similar to the analysis by gender, the repeat bully
victimization measure uniquely contributed to levels of depression across categories of race.
Specifically, whites indicating they were victimized reported higher levels of depression in the
early waves of the analysis (in late adolescence and early adulthood). Non-whites indicating
they were victimized reported significantly higher levels of depression in the final two waves of
the analysis. Similar to the gender analysis, however, the results of the coefficient comparison
test on the repeat bully victimization variable did not reveal that these differences were
significant across whites and non-whites.
Discussion
Research investigating the association of bully victimizations on subsequent levels of
mental health has generally concluded that compared to non-victims, those who experience bully
victimizations generally report significantly more severe mental health problems (Kumpulainen
et al., 2001; Kaltiala, 2000; Baldry, 2004; Sourander, 2007; Schreier, 2009; Copeland et al.,
2013; Klomek et al. 2010; Niemela, 2011; Riittakerttu et al. 1999; Arseneault et al. 2006; Turner
et al. 2013). Although informative, much of this research has: (1) not controlled for baseline
mental health levels, (2) has only investigated the impact of the victimization experience over a
limited period of the life course, (3) has relied on geographically-specific samples with limited
generalizability, and/or (4) has not explored the impact of the victimization experience across sex
and race.
10. 10
Using the NLSY97, the present study fills a significant void in the literature. This is the
first US population-based, prospective longitudinal study to investigate the effects of self-
reported repeat bully victimizations occurring in childhood on levels of depression measured for
over a decade in late adolescence and early adulthood. The repeat bully victimization/depression
relationship was also assessed across categories of sex and race. This approach is unique
because it permitted an assessment of stability and change in depression that is associated with
prior repeat bully victimization experiences. The results revealed three important findings. First,
controlling for baseline behavioral/emotional problems and various sources of stress in
adulthood, experiencing repeat bully victimizations in childhood was consistently associated
with higher levels of depression. Second, the victimization/depression relationship appears to be
more impactful for females than males. Finally, the victimization/depression relationship
impacted whites earlier in life and non-whites later in life.
Limitations
This study has some limitations. First, the repeat bully victimization measure was a self-
reported, single-item measure collected retrospectively at wave 1. Although the reference period
is a lengthy period of the life course, this measure cannot capture the short-term frequency of the
victimization experience. By using the word “repeated” in the bully victimization item, however,
the measure in the present study guards against these victimizations being isolated occurrences.
Research has also shown that youth can retrospectively recall bullying experiences with relative
constancy (Rivers, 2001). Second, since only bully victimizations were measured, it is unclear
what proportion of those who were repeatedly victimized were also bullies themselves. This is
important because the existing evidence has documented how bully-victims are at an elevated
risk for a variety of negative consequences related to the bullying experience (Nansel et al.,
11. 11
2001). Third, the repeat bully victimization measure did not measure the precise type of bully
victimization. Evidence suggests that bullies use a variety of means (i.e., physical, verbal, cyber)
to victimize their targets and the available evidence is beginning to suggest that victims may
respond differently depending upon the type of victimization they experience (Turner et al.,
2013). Fourth, this study did not document the trajectories or pathways through which repeat
bully victimizations might result in various mental health consequences.
In closing, this study highlights the important role that pediatricians and other
medical personnel (i.e., general and nurse practitioners) can play during routine medical
checkups. That is, with appropriate questioning, medical staff could be critical first points of
contact to repeat bully victims whose victimizations go unaccounted for by school staff or
parents and guardians. Intervention programs aimed at assisting youths with managing the
adversity they often experience following repeat bully victimizations could be implemented in a
timely manner. The results of these interventions might be helpful in reducing important mental
health problems like depression that may develop later in the life course.
12. 12
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15. 15
Table One. Descriptive Statistics
Variable Mean
Standard
Deviation Range
Age (Wave 1) 13.00 .81 12-14
Race (1= non-white) .31 .46 0-1
Sex (0= female) .49 .50 0-1
Repeat Bully Victimization (1= yes) .21 .41 0-1
Wave 1 Behavioral/Emotional Scale: Youth Report (α=.52) 2.16 1.60 0-8
Wave 6 Stress Index (2002); Mean Age 1.07 .97 0-7
Wave 11 Stress Index (2007) .94 .87 0-7
Wave 4 Depression Scale (2000) (α=.77); Mean Age = 17.02 9.72 2.50 5-20
Wave 6 Depression Scale (2002) (α=.78); Mean Age = 19.02 9.88 2.46 5-20
Wave 8 Depression Scale (2004) (α=.78); Mean Age = 21.01 9.53 2.37 5-20
Wave 10 Depression Scale (2006) (α=.79); Mean Age = 22.93 9.46 2.38 5-20
Wave 12 Depression Scale (2008) (α=.79); Mean Age = 24.90 9.60 2.34 5-20
Wave 14 Depression Scale (2010) (α=.81); Mean Age = 26.92 9.33 2.39 5-20
16. 16
Table 2. Depression Scale: Victim vs Non-Victim
Variable
Depression
Mean Age = 17.02
Depression
Mean Age = 19.02
Depression
Mean Age = 21.01
Depression
Mean Age = 22.93
Depression
Mean Age = 24.90
Depression
Mean Age = 26.92
Bully Victim 10.12‡
(2.71)
10.26‡
(2.51)
9.79†
(2.54)
9.81‡
(2.52)
9.95‡
(2.53)
9.67‡
(2.45)
Non-Victim 9.62
(2.42)
9.78
(2.43)
9.47
(2.32)
9.36
(2.32)
9.51
(2.28)
9.24
(2.36)
*P<.05; †P<.01; ‡P<.001
17. 17
Table 3. Ordinary Least Squares Regression Estimates Predicting Depression
Variables
Depression
Age = 17.02
Depression
Age = 19.02
Depression
Age=21.01
Depression
Age = 22.93
Depression
Age = 24.90
Depression
Age = 26.92
b SE b SE B SE b SE b SE b SE
Age -.94 .06 .03 .06 -.04 .06 -.08 .06 -.02 .06 -.04 .06
Race 1.39 .10 -.02 .10 -.06 .10 -.07 .10 .02 .10 -.01 .10
Sex -1.40 .09‡ -.85 .09‡ -.78 .91‡ -.70 .09‡ -.60 .09‡ -.61 .01‡
Bully Victim .31 .12† .26 .12* .11 .16 .28 .12* .25 .12* .30 .12*
Behavior/ Emotional Scale .31 .03‡ .30 .03‡ .28 .03‡ .24 .03‡ .26 .03‡ .26 .03‡
Stress 2002 --- --- .21 .05‡ .14 .05† .06 .05 .16 .05† .07 .05
Stress 2007 --- --- --- --- --- --- --- --- .14 .05* .09 .06
Constant 10.72 .74‡ 9.02 .74‡ 9.67 .73‡ 10.21 .74‡ 9.25 .73‡ 9.31 .75‡
R2
.10 --- .08 --- .07 --- .05 --- .06 --- .06 ---
*P<.05; †P<.01; ‡P<.001
