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European Journal of Psychology of Education 2006, Vol. XXI, nº 2, 183-208 © 2006, I.S.P.A.

Bullying among students and its consequences on health

Barbara Houbre Cyril Tarquinio Isabelle Thuillier University of Metz, France

Emmanuelle Hergott CEFP, France

Violence among students at school is an ever-growing problem. Bullying can be defined as all forms of repeated physical or mental violence performed by an individual on another person who is not capable of defending him/herself (Roland & Idsoe, 2001). The three studies conducted here reveal some of the characteristics and implications of this type of aggression. Whether the attacker(s) or the attacked, all protagonists in a bullying episode suffer the consequences of this behavior. Study 1 showed that students who were both victims and bullies had the lowest self-concepts in all areas studied. Victims exhibited inferior self-concepts to bullies, who in turn obtained lower scores than students not involved in bullying at all. Study 2 showed, as expected, that the group of bully/victims reported more psychosomatic problems than all other groups. In addition, there was a positive link between behavioral problems and the onset of psychosomatic disorders. Study 3, which was mainly exploratory, looked at the traumatic impact of bullying and the emergence of addictive behavior. Children who had vivid memories of being the victim of an aggressive act manifested a high level of post-traumatic stress, although no link was observed between post-traumatic stress and the type of aggression (physical, verbal, or relational). A dependency relationship was found between post-traumatic stress and substance use. The results of these studies suggest that the many complexities of the different protagonists of bullying should be taken into account in view of developing servicing that is geared to each individual.

Within the past few decades, aggressive behavior among students has been an important issue for both researchers and policy makers. The findings of studies on this subject appear to

The authors would like to thank the Moselle Board of Education and the various school
The authors would like to thank the Moselle Board of Education and the various school

The authors would like to thank the Moselle Board of Education and the various school principals, teachers, students, and all other individuals, close and far, who made this study possible.


be the same in Europe and in the United States: serious bullying affects about 5% of all students, less serious bullying, between 15% and 30% (Baldry, 1998; O’Moore, 1989; Pepler, Craig, Ziegler, & Charach, 1993; Slee & Rigby, 1993; Withney & Smith, 1993). In parallel with prevention programs, an abundant body of literature has been developing on this issue. According to Olweus (1989), “a student is being bullied or victimized when he or she is exposed, repeatedly and over time, to negative actions on the part of one or more students.” Bullying has three specific characteristics: frequency, the intention to hurt, and an asymmetric relationship between the bully and the victim. This kind of aggression can be direct or indirect; it can be expressed in words (threats, mocking, teasing, name calling), via physical contact (hitting, shoving, kicking, pinching, holding someone back), or by way of social relations (ostracizing, manipulating friendships) (Berkowitz, 1993; Dodge & Coie, 1987; Olweus, 1984; Smith & Sharp, 1994). In addition to these distinctions, Austin and Joseph (1996) classified students according to their roles in bullying. Four types were defined: victims, bullies, bully/victims (who are both the attackers and the attacked), and “not involved”. Naturally, these aggressive acts have an impact on the students who are involved. We will address this impact in terms of various psychological characteristics. Whether the effects show up as an altered self-concept, health problems (psychosomatic symptoms and addictive behavior), or psychologically traumatic consequences, we will try to determine the extent to which bullying is an explanatory factor in their emergence. Concerning the self-concept, many authors have raised the question of how identity might be related to a child’s status, itself defined by his/her role in the bullying process (bully, victim, bully/victim, or not involved). It seems that children who are victims of bullying invariably see themselves as socially “incompetent”. They are generally unpopular among peers, are more anxiety-ridden and unstable, and display little self-confidence (Craig, 1997; Kahtri, Kupersmidt, & Patterson, 2000; Olweus, 1989; Perry, Kusel, & Perry, 1988; Slee, 1995). More specifically, high scores on certain victimization scales are often associated with low scores in scholastic competence, social acceptance, athletic competence, physical appearance, and global self-worth (Andreou, 2000; Boulton & Smith, 1994). Victims tend to have more negative self-concepts than individuals in the other two groups involved in bullying (Boulton & Underwood, 1992; Largerspets, Björkqvist, Berts, & King, 1982; Olweus, 1978, 1984). The findings regarding the self-concepts of bullies are not so clear-cut and are sometimes even contradictory. According to some authors (Boulton & Underwood, 1992; Johnson & Lewis, 1999), there is no link between aggressive behavior and self-worth in students. On the other hand, Andreou (2000) and O’Moore (1997) showed that bullies have less overall self-worth than children who are not involved in bullying. O’Moore and Kirkham (2001) mentioned two factors that could account for the discrepancy in these results. The first concerns the psychometric properties of the assessment tools used. If we separate one- dimensional scales (self-worth) from multidimensional ones (self-concept), however, differences show up once again. For O’Moore and Hillery (1991), for example, bullies have poorer self-concepts than children who are not involved, whereas for Mynard and Joseph (1997), bullies have better self-concepts in most areas. The second factor concerns the typology used to differentiate the students. In a study by Olweus (1993), “typical” bullies were differentiated from “passive” bullies, but then certain passive bullies may also be victims. Students who were both victims and bullies were found to have lower global self-worth scores than students in all other groups (Austin & Joseph, 1996; Mynard & Joseph, 1997). Thus, discrepancies across studies may be due to the criteria used to classify the children. In matters of bullying, the implications in terms of health have mainly been examined among bullied victims. Several studies have found a link between being victimized and the psychosomatic effects of the aggressive events on students’ health (Forero, McLellan, Rissel, & Bauman, 1999). In 1998, Rigby noted a strong connection between being bullied and headaches. More recently, Rigby (1999) showed that severe victimization was often associated with poor physical health. In particular, victims were found to suffer more from sleep disorders, bed- wetting, headaches, stomachaches, and feeling unhappy (Williams, Chambers, Logan, & Robinson, 1996). The symptoms also varied according to the victimized child’s gender. Boys



tended to have more headaches and backaches, and to be more irritable than girls, who were more nervous and had more sleep disorders. Moreover, the greater the exposure to bullying, the more numerous the symptoms. The number of symptoms appears to be additionally dependent on the distress level, and also on the social support provided by the teacher for girls, and by peers for boys. The less support received, the greater the symptoms. The data also show that girls are more inclined to report a wider variety of symptoms than boys (Natvig, Albrektsen, & Qvarnstrom, 2001). Only one study found that the presence of psychosomatic symptoms was a function of the child’s bullying status (Natvig, Albrektsen, & Qvarnstrom, 2001). Bullies manifested more symptoms than children not involved, but still fewer than victims and bully/victims. The bully/victim group had the highest proportion of symptoms. Note that there are no bullying studies to date that have related psychosomatic symptoms to behavioral disorders. Being victimized also generates a great deal of distress in a child. Anxiety, depression, loneliness, isolation, fear of going to school – all the necessary elements are present for provoking emotional and behavioral disorders in the bullied child (Boulton & Underwood, 1992; Boulton & Smith, 1994; Perry et al., 1988; Rigby & Slee, 1993). As such, victimization can be a precursor to mental-health disorders. However, for some authors, these same disorders are the cause, not the consequence, of being bullied (Hodges & Perry, 1999), so the link can be envisaged in both directions. Bullies are dominating (and they like domination; Olweus, 1994) and anxious (Lagerspetz et al., 1982). While being popular in some cases (Olweus, 1994), they are rejected by their peers in others (Boulton & Smith, 1994). Bully/victims differ from both victims and bullies by their personality; they obtain high scores on neurotic and psychotic scales, are at the bottom of the social acceptance ranking (Mynard & Joseph, 1997), and are rejected by peers (Bower, Smith, & Binney, 1992). Studies have shown that children who play a bully/victim or bully “role” are subject to hyperactivity and manifest many externalization behaviors – extraversion, inability to sit still, need to shout, etc. By contrast, victims exhibit mainly internalization behaviors – withdrawal, introversion, etc. (Kumpulainen et al., 1998; Laukkanen, Shemeikka, Notkola, Koivumaa-Honkanen, & Nissinen, 2002). Beyond these studies on the traits of each group, no research has been conducted on the behavioral problems associated with the four bullying statuses identified by Austin and Joseph (1996). Another possible impact of bullying is addictive behavior. Research on this topic is scarce, although there are a few studies on the problem of substance abuse and its link not only to aggressive acts but also to stressful life events. Relationships of dependency between aggressive behavior and alcohol consumption are found very early. Accordingly, if children exhibit behavioral problems at the age of 8 (aggressiveness, fighting), then they are 1.9 times more likely to drink alcohol and twice as likely to smoke or take drugs (Lynskey & Ferguson, 1995). By the age of 13, aggressive children differ from non-aggressive ones by their greater consumption of alcohol, cigarettes, and illicit drugs (Choquet, Menke, & Manfredi, 1991). These results are comparable to those obtained in other studies on aggressive behavior and its link to substance use (Hore, 1988; Kandel, 1986; Tygard, 1989). Concerning victimization, we know that by the age of 10, alcohol and tobacco consumption is associated with stressful life events and daily problems (Steinhausen & Metzke, 1998). It seems that regular consumers of alcohol, tobacco, and/or drugs, as compared to non-consumers, are more often victims of insults, violence, theft, and rackets (Oubrayrie-Roussel & Safont-Mottay, 2001). From this angle, substance use is considered as a response, adjustment, or coping strategy that is non- adaptive for the child. The results suggest that such substances are consumed by children in an attempt to reduce behavioral problems related to peer perceptions. Alcohol is thought to restore self-perceptions about one’s “social” skills. As such, substance consumption would be highly affected by peer attributions (Adler & Latecka, 1973; McKillip, Johnson, & Petzel, 1973; Smith, Canter, & Robin, 1987). In the case of bullying, however, Kaltiala-Heino, Rimpela, Rantanen, and Rimpela’s (2000) study showed that bullies are greater consumers of substances than victims. In short, the relationships between substance use, aggression, and victimization are not easy to define. Can addictive behavior be considered to generate aggressive acts and/or to serve as a way of maintaining a satisfactory sense of self-worth?


The consequences of bullying can also be approached in terms of its traumatic impact. The notion of “trauma” appeared along with traumatic neurosis, described by Oppenheim (1889) as a state characterized by nightmares, slow onset of disorders, and irritability. Later, the Americans described post-traumatic stress in terms of diagnosis criteria defined in the first version of DSM III (1980). Six criteria are currently listed in DSM IV: (A) The person has experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others, and the person’s response involved intense fear, helplessness, or horror; (B) the traumatic event is persistently reexperienced (dreams, flashbacks, physiological reactivity); (C) persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (diminished interest in work and family); (D) persistent symptoms of increased arousal (irritability, difficulty concentrating); (E) the duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month; and (F) the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. In the child, in addition to the fact that post-traumatic stress may depend on development, two types of psychotraumatic disorders are generally distinguished (Terr, 1991): those following a single deleterious event, and those following a repeated or long-lasting deleterious event. The present study looks in particular at the second type of psychotraumatic disorder, which involves avoidance behavior, intrusive thoughts, fears related to the traumatic event, neurovegetative activation, mood disorders, somatic complaints, fits of rage, anger, forgetting of childhood memories, and personality problems (Terr, 1991). Because the child’s age and developmental level can affect the manifestations of these symptoms, the disorder varies with development (Schwarz & Perry, 1994). Children under six rarely exhibit symptoms of post-traumatic stress as they are described in DSM IV. Cognitive development also appears to play a preponderant role in the interpretation of events, the ability to cope, and anxiety about the future (Keppel- Benson & Ollendick, 1993). However, in Pynoos et al.’s (1993) study following an earthquake, no link was found between post-traumatic stress severity and the children’s ages. These highly specific descriptions of the state of post-traumatic stress have been challenged by many authors, who feel they do not reflect reality due to the many existing interindividual differences (Bowman, 1999). The theory proposed by Horowitz offers a good alternative. According to this author, post-traumatic stress is a cognitive process involving fluctuation between avoidance reactions and intrusive thoughts (which are likened to the processes of assimilation and accommodation; Horowitz, 1974, 1979; Horowitz, Stinson, & Field, 1991). Avoidance (or denial) is characterized by numbing, suppression of stressful material from the consciousness, and avoidance of memories related to stressful stimuli. It satisfies the need to protect the ego from the crushing power of the traumatic event. Intrusion (or approach), which is characterized by invasive thoughts (constant reliving of the event, flashbacks, dreams, etc.), satisfies the need to adapt to reality. But in the case of bullying, can we really speak of post-traumatic stress, knowing that the events in question are not “deleterious”? Various studies on this topic suggest that the answer is yes. An investigation on victims of bullying at work showed that 76% of the bullied individuals were suffering from a post-traumatic stress disorder (Mikkelsen & Einarsen, 2002). A case study on a young victimized adolescent showed that she developed a post- traumatic stress disorder after being subjected to repeated acts of aggression. Other studies concur with these in pointing out the devastating impact of bullying on the lives of the affected persons (Björkvist, Österman, & Hjelt-Bäck, 1994; Leymann & Gustafsson, 1996). In the same vein, Scott and Stradling (1994) described three individuals who did not exhibit DSM IV’s Criterion A (having experienced an event that provoked intense fear and involved death or was a threat to physical integrity) but exhibited post-traumatic stress without trauma, which this author called “prolonged duress stress disorder” (PDSD). In the three experiments reported below, we are going to address each of these points by looking at the effects of bullying on three levels: (1) its impact on identity, (2) somatic and behavior implications, and (3) traumatic consequences.




It is clear from a brief overview of the literature that the available findings are highly contradictory. In the present study, we examine the self-concept in terms of the child’s status as defined by Austin and Joseph (1996), who differentiated bullies, victims, and bully/victims (persons who are not involved make up the control group). Based on the main findings presented above, we expected the lowest self-worth among bully/victims. Within this subgroup, we also examined the self-concept for various areas of life, while paying particular attention to the social-relations dimension and its manifestations in each group.



The sample was composed of 116 pupils ages 9 to 12 (m=10.67), 47.4% of whom were boys. The pupils were from three elementary schools where they were attending fourth or fifth grade (50.9% in fifth grade). The occupational categories of the parents were representative of the general population of France. Of the 145 requests for consent given to the parents, 120 agreed to have their child participate in the study. Four of the children refused to take part.


The pupils filled out two questionnaires. The first one was used to measure the self- concept, and the second to assess aggressive acts executed and received.

Self-concept. Harter’s (1982) Self-Perception Profile for Children (SPPC) was administered. The questionnaire had already been translated from English into French and validated (Pierrehumbert, Plancherel, & Jankech-Caretta, 1987). It is the scale most commonly used in studies on school bullying. This self-evaluation instrument measures the self-concept in a multidimensional perspective and was designed to offset the tendency to give socially desirable responses, which may be particularly unreliable in the youngest children. The questionnaire requires the self-appraisal of competency in several areas of daily life. The areas covered are school (scholastic or cognitive aptitude), social competence (making friends easily, popularity), athletic competence (physical and sports abilities), appearance (satisfaction with one’s looks), conduct (self-control), and global self-worth (overall self-esteem). The answers are scored on a 4-point Likert scale ranging from 1 to 4, with 4 representing the most favorable rating from the standpoint of the self-concept. Thus, for each dimension, the score varied between 5 and 20.

Bullying. The second questionnaire included two subscales, the “Peer Victimization Scale” and the “Bullying Behaviour Scale”, published by Austin and Joseph (1996) and constructed specifically for use in conjunction with Harter’s (1982) self-concept scale. It measures aggressive acts executed and received. Each subscale is composed of six items scored on a four-point scale. A sample item is: “Some children do not hit and push other children about, but other children do hit and push other children about.” To answer, the child had to pick which group of children he/she resembled the most and then state the degree of resemblance (“really true for me” versus “sort of true for me”). A mean score was calculated for each scale (range 1 to 4). A high mean score indicated a high frequency of aggressive acts executed and/or received. A cutoff point (2.50) was used to classify the children by their status as a victim, a bully, a bully/victim, or not involved (control group).



The schools that participated in the study were chosen at random. Once permission to conduct the study had been obtained from the school principals and teachers, a request for parental consent containing a brief description of the study was given to each child. The data was gathered in May and June. For each questionnaire, the children had to answer in reference to the past school year. The questionnaires were administered collectively during class by a single experimenter, who reminded the children that the questionnaires were anonymous and that no one in their surroundings (parents, teachers, or friends) would find out what answers they gave. The pupils were also told that this was not a test or homework, and that there were no right or wrong answers. Before filling in the questionnaires, the children were given a definition of bullying:

“We say a pupil is being bullied, or picked on, when another pupil, or group of pupils, say nasty and unpleasant things to him or her. It is also bullying when a pupil is hit, kicked, threatened, locked inside a room, sent nasty notes, when no one ever talks to them or things like that. These things can happen frequently, and it is difficult for the pupil being bullied to defend himself or herself. It is also bullying when a pupil is teased repeatedly in a nasty way. But it is not bullying when two pupils of about the same strength have the odd fight or quarrel (Piers, 1984).” Then the questionnaires were handed out and the children were given as much time as they needed to answer them.


For the sample as a whole, 38.8% of the pupils were involved in bullying in one way or another (Table 1). Victims were the most numerous (15.52%), followed by bullies (12.93%) and then children who were both victims and bullies (10.34%). There was no significant difference across ages (χ 2 =7.05, df=9, p=NS), school grades (χ 2 =3.75, df=3, p=NS), or the occupational categories of the father (χ 2 =17.79, df=15, p=NS) or mother (χ 2 =11.14, df=15, p=NS). However, the child’s gender had an impact on the distribution (χ 2 =9.365, df=3, p<.05). Girls were less involved in bullying than boys, and most of the involved girls were victims. Boys primarily played the “role” of aggressor.

Table 1 Number of students (and percentage of the row), by gender and bullying status





Control group

Girls (n=61)

06 (9.84)

11 (18.03)

05 (8.20)0

39 (63.93)

Boys (n=55)

09 (16.36)

07 (12.73)

07 (12.73)

32 (52.46)

Total (n=116)

15 (12.93)

18 (15.52)

12 (10.34)

71 (61.21)

Concerning the pupils’ self-concepts (Table 2), we can see that the children’s bullying status affected the scores on the following dimensions: social competence (F (3,112) =15.439, p<.001), athletic competence (F (3,112) =4.078, p<.01), physical appearance (F (3,112) =8.665, p<.001), self-control (F (3,112) =8.624, p<.001), and global self-worth (F (3,112) =10.687, p<.001). More specifically, bully/victims obtained the lowest scores on dimensions related to self-control, social competence, physical appearance, and global self-worth. However, their self-perceptions of their athletic abilities were better than those of victims, but still below those of the bully group and the control group. Concerning the victims, they obtained higher scores than the bully/victims but lower ones than the bullies and controls on the social competence, physical appearance, and global self-worth dimensions. At the same time, their self-control score was lower than the control group’s but higher than the scores of the other



two groups. They also obtained the lowest score on self-perceptions of athletic competence. Finally, concerning the bullies as compared to the other two groups involved in bullying, they were the ones who had the best self-concepts, the highest opinions of their physical appearance, and the most global self-worth. They even obtained higher scores than the control group on athletic and social competence. However, their perceived self-control, although above that of bully/victims, was lower than for victims and control subjects.

Table 2 Mean score (and standard deviation) on the self-concept scale, by bullying status





















2.78 (0.67)

3.47 (0.46)

2.96 (0.72)

3.00 (0.61)

2.54 (0.50)

3.13 (0.74)


2.60 (0.60)

2.37 (0.97)

2.30 (0.86)

2.53 (0.83)

2.61 (0.45)

2.52 (0.80)


2.64 (0.69)

2.28 (0.77)

2.51 (0.62)

2.36 (0.85)

2.23 (0.65)

2.46 (0.78)

Control group

2.93 (0.66)

3.15 (0.53)

2.80 (0.61)

3.12 (0.58)

2.98 (0.54)

3.21 (0.51)








Note. The classification was based on a 2.50 cutoff point for the victimization scale and the aggression scale.

A closer look at the strength of the links between the various self-concept dimensions and aggressive acts executed and received indicated a strong negative correlation between bullying and self-control (r=-.52, p<.001), and positive but more moderate correlations between bullying and social competence (r=.22, p<.05), athletic competence (r=.30, p<.01), physical appearance (r=.23, p<.05), and global self-worth (r=.20, p<05). On the victimization side, there were significant negative correlations between being bullied and social competence (r=-.50, p<.001), athletic competence (r=-.26, p<.01), physical appearance (r=-.47, p<.001), and self- worth (r=-.53, p<.05). In addition, there was a strong positive correlation between self-control and being bullied (r=.52, p<.001). However, a linear regression analysis (Table 3) showed that being bullied accounted for the child’s overall self-worth (β=-.55, p<.001) while bullying did not (β=.11, p=NS). The same was true of scholastic competence and appearance. However, both receiving and executing acts of aggression explained social competence and self-control.

Table 3 Linear regressions of the self-concept dimensions, for aggressive acts received and aggressive acts executed

Aggressive acts received α=.82

Aggressive acts executed α=.87


R 2



R 2






































Global self-worth







Discussion of Study 1

The proportions of our pupils in the different bullying-status categories were lower than those published by Austin and Joseph (1996). Only 38.8% of our children were involved in


one way or another in bullying, whereas Austin and Joseph (1996) obtained 46% (bullies 9%, victims 22%, bully/victims 15%). Our figures were lower especially for victims (15%) and bully/victims (10%). Note also that girls were less often involved in bullying than were boys. This gender difference in aggressive behavior has already been observed elsewhere (Olweus, 1984) – aggressive acts were shown to be three or four times more frequent among boys than among girls (Baldry, 1998; Boulton & Underwood, 1992; O’Moore, 1989; Pepler et al., 1993; Slee & Rigby, 1993; Withney & Smith, 1993). However, the boy-girl difference appears to be more than one of mere number, since qualitative differences have also been observed. Violence seems to be expressed differently by the two genders, with girls engaging more readily in indirect, more subtle forms of bullying (backbiting, rumors, manipulation of friendships) rather than in the more overt, physical forms of bullying employed by boys. These distinctions are thought to be rooted in biological differences (Maccoby & Jacklin, 1980) and in gender roles (Eagly & Steffen, 1986). We can also see that pupils who were both victims and bullies had the poorest self- concepts in nearly every area. These findings are consistent with a number of earlier studies (Austin & Joseph, 1996; O’Moore & Kirkham, 2001) but contradict the results obtained by Andreou (2000) and Boulton and Smith (1994). It seems that bully/victims differ from victims and bullies by their relationships to others: they are rejected the most by peers (Bowers et al., 1992) and have the lowest social-acceptance scores (Mynard & Joseph, 1997). It could be, then, that poor relations with peers account for why a child has a particularly bad self-image and substantial identity problems. However, the individual correlations found here indicate that it is especially being bullied that is negatively linked to social competence. Pupils who are victims alone also seem to be affected by identity problems but in lesser proportions. Our victims’ self-perceptions concerning their social competence, physical appearance, global self-worth, and above all, athletic competence were low. These results corroborate past studies and support the idea that victims are not popular (O’Moore & Kirkham, 2001) and tend to see themselves in a negative way (Olweus, 1984). On the aggressor side, bullies seem to suffer less than all others involved in bullying, at least as far as identity is concerned, although their scores were still below those of the control group. This cannot be said for self-ratings of social and athletic competence, however, which exceeded those of the control group. Regarding social competence, several studies have shown that bullies are in fact quite popular, but only among their immediate peer group (Boulton & Underwood, 1992; Cairns, Cairns, Neckerman, Gest, & Gariepy, 1988; Funk, 2001; Olweus, 1993). In particular, we know that social values circulating in a classroom (positive versus negative attitudes toward school) may be such that the prestige of a given child’s conduct is positively correlated with conformity (Hargreaves, 1967). Finally, in the area of athletic competence, our results are consistent with Olweus’s (1984) study, which showed that bullies benefit from greater physical strength. This could explain why bully/victims perceive their physical and sports abilities more favorably than do victims. We now know that bullying is likely to affect a pupil’s identity on both the cognitive (self-concept) and affective (self-worth) levels. But this finding does not suffice. Modified self-perceptions may alter a child’s relationship to the outside world, which in turn could lead to a deeper disorder. This was our rationale for addressing the issue of bullying from a pathological angle. Somatic disorders were assessed by searching for signs of health problems, and mental disorders were examined by looking into potential behavioral problems.


This study was conducted in two phases. In the first, we looked at how a child’s bullying status affects manifestations of psychosomatic symptoms. It was assumed for bully/victims that, because of the characteristics of children with this status (anxiety, instability,



unpopularity), these children would be the most affected by psychosomatic problems. In the second phase, we focused on behavioral problems and their potential link to the onset of psychosomatic symptoms. It was assumed that a positive link exists between these two variables.



The sample was composed of 291 subjects, 148 fourth graders and 143 fifth graders. The pupils ranged in age between 9 and 12 (m=10.14) and were attending five different schools. The occupational categories of the parents were representative of the general population of France. Of the 305 parents who were given requests for consent, 296 agreed to have their child participate in the study. Five of these children did not want to take part.


Four scales were used to test our hypotheses. Only two will be presented here, because the other two are described above (self-concept and aggressive acts executed and received).

Psychosomatic symptom scale. This scale was derived from Boyer and Guelfi’s “Checklists for the Evaluation of Somatic Symptoms” (CHESS, 1978). We used the second version of the scale (CHESS-2: Guelfi & Pull, 1993) composed of 47 items. From these, we eliminated 3 items concerning changes in sexual desire for one’s partner and menstruation problems (9- to 12-year-old children suffer little if at all from these types of problems). This gave us a 44-item scale assessing cognitive difficulties (trouble concentrating, memory problems: 5 items), neurovegetative disorders, part 1 (dizziness, vision problems, tingling sensations: 5 items), sleep disorders (difficulty falling asleep, waking at night: 4 items), digestive disorders (nausea, abdominal pain, stomachaches: 4 items), neurovegetative disorders, part 2 (heart palpitations, trouble breathing: 3 items), somatic pain (pain in the abdomen, lower back, muscles: 3 items), eating disorders (anorexia and bulimia: 3 items), skin conditions (itching, pimples: 2 items), vegetative symptoms and dysuria (dry mouth, perspiration, feeling tense: 13 items), and diarrhea and constipation (2 items). Each item was scored on a scale ranging from 0 (never) to 4 (every day). The answers were to pertain to the past school year.

Inventory of youth behavioral problems (ages 11 to 18). Developed by Aschenbach (“Youth Self-Report”, 1991) and derived from the “Child Behavior Checklist” (CBCL, Aschenbach, 1991), this self-report questionnaire was translated into French by Vermeersch and Fombonne (1997). It enables the child to evaluate his/her psychopathological profile, and provides measures of social competence and behavioral problems. The social-competence scale includes an activity subscale (ranging from 0 to 12), a social subscale (0 to 12), and a school subscale (0 to 4). The behavioral-problem scale consists of 119 forced-choice items to which the child has to answer “not true” (0), “somewhat or sometimes true” (1), or “very true or often true” (2). We asked our children to base their answers on the past six months.


The procedure was the same as in the first study, and the data was also collected in May and June. However, for validity reasons concerning the use of the behavioral-problem scale (which can only be administered to children between the ages of 11 and 18), only the fifth


graders rated themselves on this scale (n=143). The children in this portion of the sample were 11 or 12 years old (m=11.12).


In all, 48.8% of the children were involved in bullying (Table 4). There were no significant differences across ages (χ 2 =10.12, df=9, p=NS), school grades (χ 2 =1.08, df=4, p=NS), or occupational categories of the father (χ 2 =12.58, df=15, p=NS) or mother (χ 2 =7.89, df=15, p=NS).

Table 4 Number of students with each bullying status (using a cutoff point of 2.50)

Number (n)

Percentage (%)










Control Group



Psychosomatic symptoms

The number of symptoms for each bullying status differed significantly (χ 2 =22.462, df=12, p<.05). For the set of all children involved in bullying, 60% had more than 15 symptoms. Among these, 78% were bully/victims, 68% were victims, and 40% were bullies (Table 5).

Table 5 Number of students (and percentage of the column), by number of psychosomatic symptoms exhibited

Number of symptoms




Control group


10 (17.54%)

05 (11.36%)

04 (9.76%)

55 (36.91%)


24 (42.10%)

09 (20.45%)

05 (12.49%)

24 (16.10%)


08 (14.04%)

06 (13.64%)

07 (17.07%)

32 (21.48%)


08 (14.04%)

11 (25%)0.0

11 (26.83%)

23 (15.44%)


07 (12.28%)

13 (29.55%)

14 (34.15%)

15 (10.07%)

Note. χ 2 =22.462; df=12; p<.05.

More specifically, differences across statuses were found on cognitive problems (F (3,287) =2.978, p<.05), neurovegetative disorders part 1 (vision problems, dizziness:

F (3,287) =3.227, p<.05), digestive problems (F (3,287) =3.679, p<.05), neurovegetative disorders part 2 (difficulty breathing, heart palpitations: F (3,287) =4.186, p<.01), somatic disorders (F (3,287) =3.006, p<.05), and skin conditions (F (3,287) =3.360, p<.05) (Table 6). The control group obtained the lowest score on every dimension; pupils who were both victims and bullies obtained the highest score on every dimension (except for cognitive problems, where victims scored higher). Victims had higher means than bullies in all other areas except digestive and neurovegetative disorders part 2, (heart palpitations, difficulty breathing) where their scores were lower. Thus, bullies can be said to fall between victims and bully/victims along the digestive and neurovegetative 1 dimensions. But they fell between



victims and controls along the neurovegetative 2, somatic, and skin dimensions. For all symptoms combined (F (3,287) =4.185, p<.01), bully/victims had the highest number of symptoms (m=9.52, SD=4.62), followed by victims (m=7.49, SD=3.78), bullies (m=7.28, SD=4.14), and finally pupils not involved in bullying at all (m=6.29, SD=3.70).

Table 6 Mean score (and standard deviation) on the psychosomatic symptom subscales, by bullying status





Control group


Cognitive difficulties

0.51 (0.70)

0.64 (0.68)

0.56 (0.45)

0.41 (0.50)


Neurovegetative disorders, part 1

0.57 (0.43)

0.62 (0.46)

0.84 (0.69)

0.50 (0.41)


Sleeping disorders

1.38 (0.99)

1.39 (0.97)

1.56 (0.85)

1.25 (0.95)


Digestive disorders

0.80 (0.62)

0.66 (0.68)

1.13 (0.66)

0.63 (0.58)


Neurovegetative disorders, part 2

0.69 (0.81)

0.55 (0.55)

1.00 (0.83)

0.48 (0.54)


Somatic pain

0.66 (0.51)

0.73 (0.54)

1.06 (0.84)

0.47 (0.61)


Eating disorders

0.96 (0.48)

0.87 (0.53)

1.02 (0.55)

0.76 (0.51)


Skin conditions

0.75 (1.11)

0.87 (0.72)

1.27 (0.86)

0.62 (0.81)


Vegetative symptoms

0.77 (0.57)

0.75 (0.46)

0.86 (0.58)

0.63 (0.41)


Diarrhea and constipation

0.49 (0.67)

0.36 (0.46)

0.27 (0.37)

0.33 (0.47)


A stepwise ascending multiple regression analysis on the psychosomatic symptom data pointed out a link with the self-concept. Eight predictors were input (the six self-concept dimensions and the aggressive-acts-executed and aggressive-acts-received variables). Three models were retained by the multiple regression analysis. For the first, there was a significant regression on aggressive acts received (β=.72, p<.01) that accounted for 22% of the observed variance in the psychosomatic-symptom variable (R 2 =.220, p<.01). The second model explained aggressive acts received (β=.56, p<.01) and social competence (β=-.47, p<.01). Combined, these two variables explained 32% of the observed variance in psychosomatic symptoms (R 2 =.317, p<.01). Finally, the third model had significant regressions for aggressive acts received (β=.39, p<.01), social competence (β=-.39, p<.01), and aggressive acts executed (β=.38, p<.01). This model accounted for 42% of the observed variance (R 2 =.419, p<.01).

Behavioral problems

Recall that the sample used to study behavior disorders was composed of 143 children who were at least 11 years old. The bullying-status distribution of these pupils was similar to that of all subjects pooled (Table 7). Here again, nearly 45% of the pupils were involved in bullying.

Table 7 Distribution of students, by bullying status (2.50 cutoff point)

Number (n)

Percentage (%)










Not involved




activities (m=5.98, SD=2.36), social (m=5.47, SD=1.86), and social competence (m=16.07, SD=3.47) subscales. Note the differences, however, for the subscales assessing school (m=4.73, SD=0.87) and behavioral problems (m=52.36, SD=22.03). In our study, we found significant status-related differences on the social (F (3,139) =2.035, p<.05), school (F (3,139) =2.124, p<.05), and behavior (F (3,139) =2.437, p<.05) subscales. It is particularly interesting to note that the lowest score on the social dimension was obtained by the bully/victims (m=4.27, SD=1.66), and the highest score, by the bullies (m=6.31, SD=1.76), even higher than the control group (m=6.03, SD=1.86). These same bullies were the ones who obtained the lowest mean score on the school dimension (m=3.58, SD=0.75), followed by bully/victims (m=4.07, SD=0.78) and then victims (m=5.51, SD=0.93), whose overall mean was close to the control group’s (m=5.77, SD=8.83). The bully/victims (m=64.38, SD=27.0) gave themselves the highest mean rating on behavioral problems, as compared to victims (m=57.29, SD=18.8) followed by bullies (m=51.12, SD=19.7).

Table 8 Mean score (and standard deviation) on the behavioral problems scale by bullying status in Study 2, and in two samples tested by Fombonne using the French Child Behavior Checklist



Study 2






Control group


Clinical sample

Normal sample

Activities α=.67 Social α=.50 School α=.79 Social comp. α=.81 Behav. problems α=.92

05.59 (2.47)

05.25 (2.78)

06.17 (2.25)

06.41 (1.91)


05.5 (2.4)0

6.1 (2.3)0

06.31 (1.76)

05.32 (2.11)

04.27 (1.66)

06.03 (1.86)


04.2 (2.1)0

5.4 (1.7)0

03.58 (0.75)

05.51 (0.93)

04.07 (0.78)

05.77 (8.83)


03.6 (1.3)0

5.0 (0.9)0

15.48 (3.50)

15.03 (3.67)

15.56 (3.36)

18.21 (3.30)


13.5 (4.0)0

16.6 (3.5)0

51.12 (19.7)

57.29 (18.8)

64.38 (27.0)

36.04 (20.7)


51.1 (22.2)

30.0 (18.3)

We might also mention the importance of behavioral problems in the manifestation of psychosomatic symptoms (β=.60, p<.001, R 2 =.342). The more behavioral problems the children had, the greater the number and frequency of psychosomatic problems. We also found a negative link with the social dimension: the lower the social score, the greater the psychosomatic symptoms (β=-.17, p<.05, R 2 =.053). However, no associations were noted with school (β=-.03, p=NS, R 2 =.001), activities (β=.08, p=NS, R 2 =.003), or overall social competence (β=.13, p=NS, R 2 =.012).

Discussion of Study 2

Here again, we obtained a bullying-status distribution that differed from Austin and Joseph’s (1996) – our proportion of bullies was twice as high. However, the proportions of victims and bully/victims were similar. The results of this experiment showed that children involved in bullying (victims, bullies, or bully/victims) exhibited a large number of psychosomatic symptoms. More specifically, bully/victims had the highest mean scores and were the most affected by neurovegetative disorders, digestive problems, somatic pain, and skin conditions. This finding is comparable to that obtained by Natvig et al. (2001), who noted that nearly 71% of these subjects had the highest number of psychosomatic symptoms. Victims had health problems too, especially cognitive difficulties, neurovegetative disorders, somatic pain, and skin conditions. Again, these results are consistent with the findings of other studies (Natvig et al., 2001; Rigby, 1998, 1999; Williams et al., 1996). Bullies had a higher psychosomatic symptom level than controls, particularly symptoms of digestive and neurovegetative disorders, which corroborates earlier findings (Natvig et al., 2001; Kaltiala-Heino, Rimpelä, Rantanen, & Rimpelä, 2000). The



manifestation of psychosomatic symptoms was partially explained by aggressive acts received, low self-perceived social competence, and aggressive acts executed. Thus, being a victim, but also a perpetrator, of bullying can be dangerous for a pupil’s health. We are not suggesting that there is a direct causal relation between aggressive behavior and health, but that the various protagonists of bullying must be taken into consideration in their entirety and with all of the complexities involved. This study also looked for a possible link between behavioral problems and the child’s status with respect to bullying. Bully/victims were deficient in social and scholastic competence, and had significantly more behavioral problems than other children involved or not involved in aggressive acts. This finding also applies to victims and to bullies. More specifically, bullies had low scholastic competence, as observed by Fombonne in a clinical sample. Many studies have found a positive link between failure in school and aggressive behavior (Baranger, 1999; Dornbush, Mounts, Lamborn, & Steinberg, 1991). However, the direction of the link is difficult to determine. For these authors, the two are interdependent – they mutually reinforce each other and thereby increase the feeling of being left out (Aubert, 2001; Perrenoud, 1989). We can also see that bullies had particularly high social competence scores. This result is in line with our preceding study. We now know that bullying is likely to have repercussions on identity (altered self- concept), health (psychosomatic symptoms), and behavior. This set of manifestations, which are only some of the problems examined in the bullying research, are indicative of the probable “ill-being” suffered by victims of bullying. The next question we raised concerned whether these indicators merely represent the tip of the iceberg or whether bullying has a deeper impact. What is the real impact of bullying? Is it simply a factor of stress or anxiety, as various studies have already shown, or, as we suspect, does it have psychotraumatic consequences that jeopardize the very mental soundness of the individual? We will try to answer this question in Study 3.


Few studies have taken an interest in the traumatic effects of aggressive acts among students at school. This is one of the issues tackled in this study. We assumed that a child’s post-traumatic stress level varies with the extent to which he/she is bullied. We were also interested in the manifestations of addictive behavior. To this end, were looked for links between substance use, victimization, and acts of aggression. Our hypothesis was that these three variables are positively correlated. In addition, we predicted that there would be a positive link between substance use and post-traumatic stress level. Two student populations were compared: ones attending normal schools, and ones enrolled in a special-education program 1 . Children enrolled in a special-education program exhibit a number of social and psychological characteristics that make them incapable of adjusting to a normal school environment. They are placed in a special school due to a slight or moderate “intellectual deficiency” or to “maladjustment”. In most cases, they are from families with many children who live in crowded conditions, in homes with a very low socioeconomic standing. Psychologically speaking, these students are mentally unstable, suffer from feelings of failure and inferiority, and are not very resistant to frustrations. In addition, they are highly emotional and adult-dependent. Academically, their scholastic history is marked by repeated failures and disappointments (San José, 1992). Students who are doing poorly in school are known to have below-average levels of self- worth (Chapman, 1988). A study by San José (1992) pointed out three profiles: “uprooted” children, who are the offspring of immigrants but have no apparent personality problems; “welfare” children, who are from underprivileged, culturally deprived homes; and “pathological cases” or children who require therapy because of behavior and personality problems. For all


of these characteristics which make them “unusual”, we wanted to compare special-education children to children attending regular schools, by looking at their self-concept, their involvement in bullying, and its impact on them. We predicted that aggressive behavior and victimization would be more prevalent in a special-education setting than in a regular middle school. We also expected to find more signs of post-traumatic stress in students attending a special school.



The subjects in the sample (n=162) were attending either a regular middle school (n=70) or a special-education school (n=92). Unlike the preceding studies, this study dealt with adolescents. The reason for this difference is that children in France are not tracked and oriented by level until they enter middle school, so this was the only way we could compare “regular” and “special-ed” groups. In addition, as Oubrayrie-Roussel and Safont-Montay (2001) showed in a study on substance use, less than 3% of 11- to 13-year-olds are regular substance consumers. Studying middle school children thus provided us with an older sample (age range 12 to 17 years). In each school, equal-size groups were selected from every grade between the sixth and ninth grades. There was some degree of imbalance across schools in the students’ genders and in the parents’ occupational categories (Table 9). The special-ed group had a majority of boys (68%), whereas the regular-school group had a more balanced gender distribution (41% boys). In addition, parents who were laborers or unemployed made up 73% of the special-ed population, versus 61% for the regular-school group. This group difference was significant for the father’s occupation (χ 2 =5.575, df=1, p<.05): 93.5% of the fathers of special-ed students were farmers, employees, laborers, retired, or unemployed, whereas this figure was 81.4% for the adolescents from regular schools.

Table 9 Characteristics of the samples


Special education

Regular schooling

Whole sample

(n=92) n(%)

(n=70) n(%)

(n=162) n(%)



63 (68.5)0

29 (41.4)0

092 (56.84)


29 (31.5)0

41 (58.6)0

070 (43.2)0

Age [range]















84 (91.3)0

70 (100)0.

154 (95.10)


08 (8.7)00

00 (0)0.00

008 (4.9)00

Parents’ occupational category

Shop owner

08 (4.35)0

18 (12.86)

026 (8.02)0


39 (21.19)

58 (41.43)

097 (29.94)


51 (27.72)

28 (20)0.0

079 (24.38)


03 (1.63)0

01 (0.71)0

004 (1.24)0


83 (45.11)

35 (25)0.0

118 (36.42)

Note. *Unemployed or housewife.


The procedure was the same as in the first two studies. This time, though, data collection took place in March and April.




Four scales were used to test our hypotheses: a self-concept assessment scale, a scale of aggressive acts executed and received, an addictive behavior scale, and a post-traumatic stress scale. Here again, the first two scales will not be presented since they are described above in Study 1.

Addictive behaviors. The addictive behavior scale was derived from Currie and Hurreman’s (2000) “Health Behavior in School Aged Children Survey”. A few questions were added from the ISPA (Swiss Institute for the Prevention of Alcoholism), which is an essentially epidemiological questionnaire pertaining to alcohol, tobacco, and illegal drugs. The questions pertained to both how much and how often a given substance was consumed, such as “If you smoke, how many cigarettes do you smoke per week?” The tobacco subscale consisted of six items, with a total score ranging from 0 to 16. Alcohol drinking was measured on an eight- item subscale (total score: 0-29), and drug use, on a fifteen-item subscale (total score: 0-40). The overall score combining the three subscales thus ranged between 0 and 85. In our study, the internal consistency ratings of the tobacco, alcohol, and drug subscales were .53, .81, and .82, respectively.

Post-traumatic stress. The students each had to state whether, during that year, they had been the victim of one or more aggressive acts that they remembered vividly. If they said yes, they had to state what type of aggression it was (physical, verbal, or relational) and when the event(s) had taken place. Next, the students had to fill out the “Impact Event Scale” (Horowitz, 1979), which assesses the frequency of avoidance and intrusion phenomena linked to the experience of a particular event. This instrument is used to diagnose a state of post- traumatic stress, but also and especially, to measure the post-traumatic stress level following a specific event. Avoidance behaviors are measured on eight items, giving a total score between 0 and 40. Intrusion is assessed on seven items, for a total score of 0 to 35. In our study, the internal consistency ratings of the avoidance and intrusion subscales were .87 and .91, respectively.


We can see that the special-ed students were more involved in bullying than students in regular schools (χ 2 =13.655, df=3, p<.01). Fifty percent of the former had committed aggressive acts and/or been victimized, whereas only 22.9% of the latter had been involved in bullying (Table 10).

Table 10

Number of students (and percentage), by bullying status and schooling (regular schooling versus special education), with a cutoff point of 2.50

Special education (n=92) n (%)

Regular schooling (n=70) n (%)

Whole sample (n=162) n (%)


18 (19.6)

05 (7.1)0

23 (14.2)


21 (22.8)

10 (14.3)

031 (19.1)


07 (7.6)0

01 (1.4)0

008 (4.9)0

Not involved

46 (50)0.

54 (77.1)

100 (61.7)

Note. The difference between special education and regular schooling was significant: χ 2 (3)=13.655, p<.01.


This finding was further supported by the fact that special-ed students obtained a higher mean score on the scale of aggressive acts executed (m=2.19, SD=0.59) than did regular- school students (m=1.92, SD=0.57; t (160) =-2.964, p<.01). However, this difference was no longer found on the scale of aggressive acts received (t (160) =-1.914, p=NS). Also, students whose father was a craftsman, shop owner, manager, head of a firm, or in one of the liberal professions obtained lower average scores on the aggressive-acts-executed scale (m=1.67, SD=0.45) than did the adolescents whose father was a laborer, a farmer, an employee, retired, or unemployed (m=2.12, SD=0.59) (t (160) =2.048, p<.01). However, this finding was not obtained for the mother’s occupational category (t (160) =-0.074, p=NS). These occupation-related differences did not show up in the aggressive-acts-received scores, whether for the father (t (160) =0.902, p=NS) or the mother (t (160) =1.025, p=NS).


Setting aside other considerations, it is interesting to note that the special-ed students obtained a lower score than the regular-school students on several dimensions of the self- concept. This was true of scholastic competence (special m=2.60, SD=0.60; regular m=2.79, SD=0.55; t (160) =2.084, p<.05), social competence (special m=2.98, SD=0.73; regular m=3.20, SD=0.56; t (160) =2.108, p<.05), athletic competence (special m=2.59, SD=0.70; regular m=2.82, SD=0.69; t (160) =2.061, p<.05), and self-control (special m=2.67, SD=0.53; regular m=2.91, SD=0.55; t (160) =2.794, p<.01). However, these differences were not obtained for appearance (t (160) =0.853, p=NS) or global self-worth (t (160) =1.948, p=NS).

Table 11 Mean score (and standard deviation) of students who had/had not experienced an event they remembered vividly, by self-concept dimension


Bullied (n=73)

Not Bullied (n=72)


Scholastic competence

2.60 (0.6)0

2.78 (0.57)


Social competence

2.94 (0.72)

3.20 (0.62)


Athletic competence

2.60 (0.74)

2.77 (0.66)


Physical appearance

2.61 (0.74)

2.79 (0.66)



2.67 (0.53)

2.88 (0.57)


Global self-worth

2.84 (0.67)

3.11 (0.56)


Out of the 145 students tested, 73 said they had undergone at least one aggressive act that they remembered vividly. Note that 17 students were removed from the sample for having experienced impactful events that were unrelated to our theme (death, relational problems with an adult). We can see that students who reported having undergone a particularly impactful act of aggression had poorer self-concepts on several dimensions, namely: social competence (t (143) =-2.261, p<.05), conduct (t (143) =-2.277, p<.05), and global self-worth (t (143) =-2.670, p<.01) (Table 11). These differences did not occur for scholastic competence (t (143) =-1.787, p=NS), athletic abilities (t (143) =-1.538, p=NS), or physical appearance (t (143) =-1.572, p=NS).

Post-traumatic stress

“This year, were you the victim of one or more aggressive acts by your classmate(s) that you left a marked impression on you?” To this question, 42 special-ed students and 31 regular- school students answered “yes”. A majority of these students (65.8%) obtained a high post- traumatic stress level, 17.8% had an intermediate level, and 8.2% a low level. This portion of the sample included 39 boys (53.4%) and 34 girls (46.6%), but there was no significant



difference between the mean post-traumatic stress scores obtained by the two genders (t (71) =0.299, p=NS). However, the student’s age did have an effect (F (5,67) =2.998, p<.05). The 12- to 15-year-olds obtained mean scores that dropped as their age rose (age 12 n=10, m=34.80, SD=19.81; age 13 n=11, m=29.64, SD=12.36; age 14 n=20, m=27.75, SD=15.20; age 15 n=19, m=18.42, SD=14.70). The older students (ages 16 and 17) obtained mean scores of 34.96 (age 16 n=12, SD=21.31) and 64 (age 17 n=1). As predicted, the post-traumatic stress level depended on the student’s bullying status (F (3,69) =4.862, p<.01). Students who were both victims and bullies had the highest level (m=27.62, SD=23.64), followed by victims (m=20.71, SD=23.64), with the post-traumatic stress level tending to be linked to being victimized (r=.20, p<.10). Moreover, intrusion behaviors were positively correlated with being bullied (r=.27, p<.05). Linear regressions on post-traumatic stress level and being victimized also yielded a number of tendencies. Intrusive thoughts (β=.25, p<.10, R 2 =.053) and post-traumatic stress level (β=.20, p<.10, R 2 =.029) tended to be positively affected by the extent of victimization. However, this effect no longer occurred for avoidance behaviors (β=.16, p=NS, R 2 =.013). Regarding the type of aggression, the bullying was verbal in 16.4% of the cases (n=12), relational in 23.3% (n=17), and physical in 60.3% (n=44). However, the type of aggression had no effect on post-traumatic stress (F (2,70) =0.049, p=NS), nor did the time lapse between being bullied and filling out the questionnaires (F (3,69) =0.855, p=NS). In addition, there was no significant difference between the regular-school and special-ed students as far as post-traumatic stress was concerned (t (71) =-0.441, p=NS). Note also that post-traumatic stress was negatively correlated with global self-worth (r=-.31, p<.01). More specifically, self-worth was linked to intrusive thoughts (r=-.41, p<.01) but not to avoidance behaviors (r=-.20, p=NS).

Table 12 Correlation Matrix (n=162)



Social Athletic Appearan. Conduct Self-worth Bully


Tobacco Alcohol Drugs Addictions




-.190** 1.00 -.258** -.346** 1.00 -.282** -.410** -.348**





Conduct -.311** -.039** -.094** Self-worth -.418** -.404** -.282**






Bully -.283** -.005** -.015** Victim -.295** -.598** -.226**











-.259** -.112** -.075** -.157** -.092** -.168** -.187** -.091** -.099** -.244** .119** -.077**
























Tot. addictions







.818** .812**


Note. *p<.05, **p<.01.

Substance use

In general, there were strong positive intercorrelations between the consumption of alcohol, tobacco, and drugs (Table 12). Aggressive behavior was positively correlated with addictive behavior in general (r=.31, p<.01), and with smoking (r=.38, p<.01), drugs (r=.23, p<.01), and alcohol (r=.16, p<.05) in particular. Regressions on the various types of substances pointed in the same direction (tobacco β=.00, p=NS, R 2 =.006; alcohol β=-.18, p<.05, R 2 =.032; drugs β=-.08, p=NS, R 2 =.006). Contrary to our hypothesis, a negative correlation was found between being victimized and alcohol consumption (r=-.18, p<.05). Linear regressions supported this finding (tobacco β=.38, p<.01, R 2 =.147; alcohol β=.16, p<.05, R 2 =.025; drugs β=.23, p<.01, R 2 =.052). Note also that each of the addictive-behavior variables correlated negatively with the school dimension. Similar associations were observed with the conduct dimension. Among the 73 students who had been victims of one or more impactful bullying events, the special-ed students and the ones attending regular schools did not differ significantly on


substance use. This was true for tobacco (t (71) =-1.686, p=NS), alcohol (t (71) =0.356, p=NS), and drugs (t (71) =1.387, p=NS). Moreover, no link was found between post-traumatic stress level and substance use, although there was a positive correlation between intrusions and tobacco consumption (r=.28, p<.05).

Discussion of Study 3

This study revealed, first of all, that special-education students had more identity problems than students enrolled in regular schools. In various areas (scholastic competence, social competence, athletic abilities, and self-control), their self-concept was poorer. According to professionals who work in this field, these students are highly stigmatized and have a hard time accepting that they must go to a special school (Coslin, Agou, & Majoux, 1985). In addition, the special-ed students were found to be more involved in bullying than the students attending regular schools. But we also noted that the parents of these adolescents were from a lower social class than those of regular-school students. Poor living conditions are known to constitute a powerful explanatory factor in the appearance of violent behavior (Reid, 1984; Tibbenheim, 1977). Living in a cramped home (Kultus, Wissenschaft, & Kunst, 1994, cited by Funk, 2001), having an unemployed parent (May, 1975), or simply being from the lower class (Reid, 1984) all add up to increasing the likelihood of aggressive behavior. Many studies have already established the link between poverty and violence (Byrne et al., 1999; McLloyd, 1990). Another result obtained here was the lack of a significant difference between the two schooling groups on the impact of bullying (post-traumatic stress). This finding is particularly interesting since it means that even though the special-ed students were more involved in bullying, they apparently did not suffer greater consequences than the students attending regular schools. We can hypothesize that social norms about aggressive behaviors account for this difference. In special schools, more acts of aggression may be committed, but they may also be accepted better. Such differences are known to exist at the intercultural level (Fraczek, 1985; Lagerspetz & Westman, 1980; Tomlinson, 1970) – depending on the culture or social group in which they are expressed, various forms of aggression are tolerated to a greater or lesser extent. Note in addition that the victims of aggression exhibited a higher level of post-traumatic stress (“prolonged duress stress disorder”) than the rest of the sample. More specifically, victimization tended to be associated with greater post-traumatic stress. Furthermore, as expected, bullying was associated with intrusive thoughts, as reported in the case study by Weaver (2000). However, we found no gender-linked differences, unlike earlier studies where girls were shown to be more severely affected than boys (Shannon, Lonigan, Finch, & Taylor, 1994). Age appears to have an impact too, with younger students being affected more than older ones. However, our 16- and 17-year-olds were also highly affected by bullying. We can assume that their age, a testimony to the fact that they were lagging behind in school, was an indication of deficient cognitive development. Moreover, post-traumatic stress was highly linked to low self-worth, which supports the findings of many past studies (Jind, 2001). It is interesting to note that while intrusion was negatively linked to self-worth, avoidance was not. Thus, in line with the observations made here, avoidance of anxiety-generating stimuli in the face of bullying may play a protective role (Naylor, Cowie, & Rey del, 2001). Concerning substance use (alcohol, tobacco, or drugs), it seems that the consumption of any one of these substances generally leads to the use of the other two. Here again, no schooling-related differences were found. However, smoking and taking drugs were linked to committing aggressive acts. This finding is in line with Kaltiala-Heino’s (2000) study, which showed that substance use was particularly prevalent among bullies and bully/victims. Unexpectedly, we did not find a positive link between addictive behavior and being victimized. Note, however, that the higher the level of intrusive thoughts, the greater the consumption of tobacco. Thus, the more the adolescents had thoughts or nightmares related to being bullied, the greater their tendency to smoke. Two possible hypotheses can be set forth to account for this addiction. The first concerns the fact that the psycho-stimulating effect of nicotine is



comparable to that of amphetamines, so high doses have a relaxing and euphoric effect. These mixed effects (the impression of increased productivity followed by the appearance of a sense of well-being) can only contribute to making the smoker more dependent. The other hypothesis concerns the psychosocial dimension of cigarette smoking. Indeed, smoking may restore a child’s social image and thereby sporadically reinforce a failing level of self-esteem. As usual, the most probable explanation is certainly a combination of the two.

General discussion

These three studies showed that the implications of bullying are numerous and varied. Based on Study 1, it seems that bully/victims have the lowest opinions of themselves, followed by victims and then bullies. However, although we showed that being a victim of aggression could play a critical role in a child’s sense of self-worth, the question that arose was the direction of the link between the self-concept and the different possible statuses of the child in the bullying phenomenon. According to some authors (Aubert, 2001; Olweus, 1978), there is a certain predisposition to being a victim, a bully, or even a bully/victim. At the same time, repeated harassment by peers can considerably reinforce feelings of distress, lack of self- confidence, and low self-esteem in victims. We also know that children attach more importance to traits that characterize them as bullies (e.g., traits of temperament like impulsive, extroverted, conceited, leader, and physical traits like strong) than to other traits. Study 2 showed that students involved in bullying may have health problems too, especially psychosomatic symptoms. Bully/victims seem, once again, to be the most highly affected (mainly by neurovegetative disorders, digestive problems, somatic pain, and skin conditions). Victims, on the other hand, seem to suffer in particular from cognitive difficulties; bullies have digestive and neurovegetative disorders. A link was also found between the child’s bullying status and behavioral problems. As shown in earlier work, behavioral problems appeared in all three status groups (in the following decreasing order: bully/victims, victims, and bullies). This helps account for the variations observed in the manifestation of psychosomatic symptoms. Study 3 on middle school students showed that bully/victims and victims exhibited high post-traumatic stress levels, and that there tends to be a positive correlation between being victimized and post-traumatic stress. In addition, it seems that the children who suffer the most from intrusions related to being bullied are the ones to smoke the most. Thus, we can assume that when the well-being of adolescents is threatened in upsetting situations (like being bullied), risky behaviors such as substance use are attempts at maintaining a satisfactory level of self-esteem. As Peele (1985) suggested, addiction may help a child strengthen his/her sense of self-worth. The prevalence of bullying differed in the three studies conducted here. In Study 1, nearly 39% of the children were involved in bullying, in Study 2, the proportion was nearly 49%, and in Study 3, it was about 38%. The figures for Study 2 are comparable to those obtained in research on elementary school pupils. However, this cannot be said for Study 1, where our figures were lower than those obtained elsewhere. This discrepancy seems to be due to environmental factors, since different populations were studied. Indeed, as Carra and Sicot (1997) showed, bullying can vary considerably from one school to the next. Environmental factors in this case refer to physical characteristics of the school likely to favor the emergence of aggressive behavior (Ahmad et al., 1991, cited by Karatzias, Power, & Swanson, 2002). The most commonly mentioned factor is size. As early as 1983, the Léon Report in France indicated that the risk of violence is greater in large schools. Class size also seems to have an impact. Funk and Passenbergen (1999, cited by Funk, 2001) showed that the smaller the student-to-teacher ratio, the fewer the acts of aggression. However, other studies suggest that children who belong to small classes are more often subjected to bullying, as observed in England (Wolke, Woods, Standford, & Shulz, 2001). In fact, a direct causal relation cannot be


established between these factors and the emergence of aggressive behavior. Certain studies suggest that in large schools where supervision is not as great, it is more difficult to find out who is at fault (Léon, 1983). In this case, both anonymity and size may be risk factors in the emergence of aggressive behavior at school. The results of Study 3 are inconsistent, once again, with those of earlier work, since bullying was more prevalent in our study. A gradual drop in bullying with age was observed by Olweus (1984) and other investigators, who showed that bullying declined and finally disappeared altogether at the age of 16 (Elsea & Smith, 1994, cited by Eslea & Rees, 2001; Whitney & Smith, 1993). This overall effect did not occur in our third study. However, the distribution we obtained was different for the two types of schools studied. In regular schools, only about 23% of the students were involved in bullying, whereas in special-education schools, this figure jumped to 50%. Thus, for regular-school students there was indeed a decline in bullying with age, as already observed elsewhere. However, the reason given by the authors for the decrease is that bullying in fact changes in nature over the years. Several studies (Owens, 1996; Rivers & Smith, 1994) have shown that younger children more often resort to direct forms of aggression, whereas older ones prefer more relational, indirect forms. The bullying scale we used only assessed direct forms of aggression (physical and verbal). So the phenomenon we observed was essentially a decrease in direct aggression in regular middle school students and “stabilization” of direct aggression among students attending a special school. Why? One hypothesis is related to the characteristics of the population. As stressed above, these socioeconomically, cognitively, and/or behaviourally disadvantaged students were also lagging behind in the development of social competence and abilities, so that recourse to indirect forms of aggression could not emerge until later. Indeed, we found a link between the type of bullying and social cognition skills. Clearly, indirect and relational aggressions cannot be executed unless the child has some awareness of, and ability to, manipulate the mental states and beliefs of others (Björkqvitz, Lagerspetz, & Kaukiainen, 1992; Crick & Grotpeter, 1995). Moreover, Kaukiainen et al. (1999) found a positive correlation in 8-, 12-, and 14-year-old age groups between indirect aggressive acts and social intelligence, but not when the aggressions were physical or verbal. To conclude, it would seem worthwhile in future research to address the issue of the specific characteristics of each bullying status examined here, particularly for the bully/victim role, and in doing so, to take a more in-depth approach to child behavior. This is especially important for these children, who cannot seek the necessary support from parents or siblings, with whom they feel little closeness or connectedness (Bowers et al., 1992). In addition, we can assume that the various symptoms exhibited by these children are interdependent, as already shown in some studies (Kaltiala-Heino et al., 2000; Laukkanen et al., 2002), and that this leads to a cumulative effect (aggressive behavior, substance use, psychosomatic symptoms) called “cumulative continuity” (Brook & Newcomb, 1995). This interaction style prompts the individual to choose and create an environment that will reinforce that style. Through the mechanism of cumulative continuity, the “deviant” child is likely to adopt another “deviant” behavior such as substance use. Furthermore, in some cases, the relationships between psychosomatic symptoms, substance use, and aggression are interactive. This type of “interactional continuity” refers to the effects of reciprocal interactions between an individual and his/her environment, such as the link between aggressive acts and substance use (Vuchinick, Bank, & Paterson, 1992). Reciprocal interactions like these are thought to prevent the situation from changing (Ensminger, & Slusarcick, 1992). Henceforth, anyone striving to reduce bullying in the schools should take the wide range of factors underlying its occurrence into account, so that an effective investigation can be conducted and conclusive results can be obtained.


1 The special-education children were in a “SEGPA” school – Section for General Occupational and Adapted Teaching.




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Les agressions entre élèves en milieu scolaire constituent un problème grandissant. Le bullying peut être défini comme toutes formes de violences physiques ou mentales répétées, effectuées par un individu sur une personne qui n’est pas capable de se défendre elle-même (Roland & Idsoe, 2001). Trois études révèlent partiellement les tenants et les aboutissants de cette violence. Qu’ils soient victimes ou agresseurs, les différents protagonistes en subissent les conséquences. L’étude 1 montre que les élèves simultanément victimes et agresseurs ont l’expression du concept de soi la plus faible, et ce, dans différents domaines. On constate également que les victimes manifestent des concepts de soi inférieurs aux agresseurs, qui eux-mêmes, obtiennent des scores inférieurs à ceux du groupe contrôle. L’étude 2, conformément à nos attentes, montre que les victimes/agresseurs rapportent les atteintes psychosomatiques les plus élevées. En outre nous pouvons observer un lien positif entre la manifestation de troubles du comportement et l’apparition de troubles psychosomatiques. L’étude 3, principalement exploratoire, s’intéresse à l’impact traumatique du bullying et à l’émergence de conduites additives. Ainsi, les enfants affirmant avoir vécu une (ou des) agression(s) les ayant particulièrement marquée(s) manifestent un niveau élevé de stress post- traumatique. Cependant, nous ne trouvons pas de lien entre ce dernier et le type d’agression subie (physique, verbal ou relationnel). En outre, un rapport de dépendance apparaît entre le stress post traumatique et la consommation de toxiques. Les résultats de ces études suggèrent de tenir compte des différents protagonistes du bullying dans toute leur complexité afin de définir avec précisions les directions à emprunter dans le cadre d’une prise en charge.


Key words: Addictive behavior, Behavioral problems, Health, Post-traumatic stress, School bullying, Self-concept.

Received: April 2004

Revision received: December 2005

Barbara Houbre. Laboratory of Psychology, University of Metz UFR SHA, Ile du Saulcy, 57000 Metz, France; E-mail:; Web site:

Current theme of research:

School bullying. Self-schemata. Adaptation and coping. Exclusion.

Most relevant publications in the field of psychology of education:

Houbre, B., Fischer, G.-N., & Tarquinio, C. (2003). Les violences scolaires. In G. Fischer (Ed.), Psychologie des violences sociales (pp. 77-105). Paris: Dunod.

Cyril Tarquinio. Department of Psychology, University of Metz, UFR SHA, Ile du Saulcy, 57000 Metz, France; E-mail:; Web site:

Current theme of research:

Self-schemata and health. Therapeutic compliance and HIV. Value systems and coping.

Most relevant publications in the field of psychology of education:

Tarquinio, C., & Fischer, G.N. (2001). Therapeutic compliance methodologies in HIV-Infection treatment: A comparative study. Swiss Journal of Psychology, 60(3), 136-160.

Tarquinio, C., & Somat, A. (2001). Scholastic achievement, academic self-schemata, and normative clearsightedness. European Journal of Psychology of Education, XVI(1), 117-129.

Tarquinio, C., Fischer, G.N., Gauchet, A., & Perarnaud, J. (2001). The self-schema and addictive behaviors: Studies of alcoholic patients. Swiss Journal of Psychology, 60(2), 73-81.

Tarquinio, C., Fischer, G.N., Gauchet, A., Dodeler, V., Grégoire, A., & Romary, B. (2003). Compliance et concept de soi chez des patients atteints par le VIH: Une approche dynamique du soi. Revue Internationale de Psychologie Sociale, 16(1), 21-54.

Isabelle Thuillier. University of Metz, 68 rue Sainte Elisabeth, 57100 Thionville, France; E-mail:

Current theme of research:

School bullying and self-schemata.

Most relevant publications in the field of psychology of education:

Emmanuelle Hergott. Centre Educatif et de Formation Professionnelle Charles Thilmont (CEFP), 45 route de Metzvisse, 57310 Guénange, France; E-mail: