BACKGROUND: Exposure to traumatic events in childhood, including bullying, can negatively affect physical and mental health in adulthood. The aim of the present study was to determine the prevalence of bullying in different sociodemographic groups of the Slovak Republic and to assess the moderating effect of bullying on the associations between childhood trauma, resilience, and the later occurrence of psychopathology. METHODS: For the analyses, a representative sample of the population of the Slovak Republic was used (N = 1018, mean age 46.24 years, 48.7% of men). Multivariate linear regression models were used to investigate the predictive ability of childhood trauma (The Childhood Trauma Questionnaire, CTQ) and resilience (The Brief Resilience Scale, BRS) to explain psychopathology (The Brief Symptom Inventory, BSI-53). Bullying (The Adverse Childhood Experiences - International Questionnaire, ACE-IQ) was used as a moderator. RESULTS: In total, 13.5% of respondents have experienced bullying. The most common form of bullying was making fun of someone because of how their body or face looked (46.7%) and excluding someone from activities or ignoring them (36.5%). Higher scores in all types of psychopathology and the Global Severity Index (GSI) were significantly associated with higher scores of emotional and sexual abuse, and some of them with physical neglect. The protective effect of resilience was moderated by bullying in several types of psychopathology, specifically in somatization, obsessive-compulsive, interpersonal sensitivity, depression, psychoticism, and the GSI. CONCLUSION: Understanding the links between childhood trauma, bullying, and later psychopathology can help professionals target policies, resources, and interventions to support children and families at risk. Every child should feel accepted and safe at home and school.

Olomouc University Social Health Institute Palacky University Olomouc Univerzitni 22 Olomouc 77111 Czech Republic

Psychiatric Psychotherapeutic Outpatient Clinic Heydukova 27 Bratislava 81108 Slovakia

Zobrazit více v PubMed

UN General Assembly, Declaration of the Rights of the Child, 20. November 1959, A/RES/1386(XIV). https://www.refworld.org/docid/3ae6b38e3.html. Accessed 27 November 2022.

Panksepp J, Biven L. The Archeology of mind. Neuroevolutionary Origins of Human Emotions. New York: W.W.Norton & comp; 2012.

Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Stokes J, Handelsman L, Medrano M, Desmond D, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003;27(2):169–90. PubMed

Idsoe T, Dyregrov A, Idsoe EC. Bullying and PTSD symptoms. J Abnorm Child Psychol. 2012;40(6):901–11. PubMed

Idsoe T, Dyregrov A, Idsoe EC, Nielsen MB, Bullying Symptoms in children and adolescents. Comprehensive Guide to post-traumatic stress disorder. Springer Cham. 2015 doi: 10.1007/978-3-319-08613-2_101-1. DOI

Plexousakis SS, Kourkoutas E, Giovazolias T, Chatira K, Nikolopoulos D. School bullying and post-traumatic stress disorder symptoms: the role of parental bonding. Front Public Health. 2019 doi: 10.3389/fpubh.2019.00075. PubMed DOI PMC

Sigurdson JF, Undheim AM, Wallander JL, Lydersen S, Sund AM. The long-term effects of being bullied or a bully in adolescence on externalizing and internalizing mental health problems in adulthood. Child Adolesc Psychiatry Ment Health. 2015;23(9):42. PubMed PMC

Inchley J, Currie D, Budisavljevic S, Torsheim T, Jåstad A, Cosma A, et al., editors. Spotlight on adolescent health and well-being. Findings from the 2017/2018 Health Behaviour in School-aged children (HBSC) survey in Europe and Canada. International report. Volume 1. Key findings. Copenhagen: WHO Regional Office for Europe; 2020.

Craig W, Harel-Fisch Y, Fogel-Grinvald H, Dostaler S, Hetland J. A cross-national profile of bullying and victimization among adolescents in 40 countries. Int J Public Health. 2009;54(S2):216–24. PubMed PMC

Detstvo bez násilia, Výskumná správa. 2022 https://detstvobeznasilia.gov.sk/web_data/content/upload/subsubsub/8/vyskumna_sprava_2022-1.pdf. Accessed on 2 JULY 2023.

Allison S, Roeger L, Reinfeld-Kirkman N. Does school bullying affect Adult Health? Population Survey of Health-Related Quality of Life and Past Victimization. Aust N Z J Psychiatry. 2009;43(12):1163–70. PubMed

Vaughn MG, Fu Q, Bender K, DeLisi M, Beaver KM, Perro BE, Howard MO. Psychiatric correlates of bullying in the United States: findings from a national sample. Psychiatric Quart. 2010;81:183–95. PubMed

Brown RC, Plener PL, Braehler E, Fegert JM, Huber-Lang M. Associations of adverse childhood experiences and bullying on physical pain in the general population of Germany. J Pain Res, 2018; 3099–108. PubMed PMC

McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky A, Kessler RC. Childhood adversities and first onset of psychiatric disorders in a national sample of adolescents. Arch Gen Psychiatry. 2012;69:1151–60. PubMed PMC

McLaughlin KA, Koenen KC, Hill E, Petukhova M, Sampson NA, Zaslavsky A, Kessler RC. Trauma exposure and posttraumatic stress disorder in a US national sample of adolescents. J Am Acad Child Adolesc Psychiatry. 2013;52:815–30. PubMed PMC

Bellis MA, Hughes K, Ford K, Ramos Rodriguez G, Sethi D, Passmore J. Life course health consequences and associated annual costs of adverse childhood experiences across Europe and North America: a systematic review and meta-analysis. Lancet Public Health. 2019;4(10):517–28. PubMed PMC

Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles WH. The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2006;256(3):174–86. PubMed PMC

O’Neill S, McLafferty M, Ennis E, Lapsley C, Bjourson T, Armour C, Murphy S, Bunting B, Murray E. Socio-demographic, mental health and childhood adversity risk factors for self-harm and suicidal behaviour in College students in Northern Ireland. J Affect Disord. 2018;15(239):58–65. PubMed

Angelakis I, Austin JL, Gooding P. Association of Childhood Maltreatment with suicide behaviors among Young People. JAMA Netw Open. 2020;e2012563. 10.1001/jamanetworkopen.2020. PubMed PMC

Allison S, Roeger L, Reinfeld-Kirkman N. Does school bullying affect adult health? Population survey of health-related quality of life and past victimization. Aust N Z J Psychiatry. 2009;43(12):1163–70. PubMed

Norrington J. Adolescent peer victimization, Self-Concept, and psychological distress in emerging Adulthood. Youth Soc. 2020;53(2):273–95.

Sweeting JA, Garfin DR, Holman EA, Silver RC. Associations between exposure to childhood bullying and abuse and adulthood outcomes in a representative national US sample. Child Abuse Negl. 2020 doi: 10.1016/j.chiabu.2019.104048. PubMed DOI

Wingate VS, Palomares NA. The severity of bullying messages predicts increased levels of targets’ depression and general anxiety as a function of targets’ inferences of a bully ‘s goals. J Soc Pers Relatsh. 2021;38(4):1194–215.

Gattario KH, Lindwall M, Frisen A. Life after childhood bullying: body image development and disordered eating in adulthood. Int J Behav Dev. 2020;44(3):246–55.

Green JG, McLaughlin KA, Berglund PA, Gruber MJ, Sampson NA, Zaslavsky AM, Kessler RC. Childhood adversities and adult psychiatric disorders in the National Comorbidity Survey replication I: Associations with first onset of DSM-IV disorders. Arch Gen Psychiatry. 2010;67:113–23. PubMed PMC

Belsky J, Pluess M. Beyond diathesis stress: Differential susceptibility to environmental influences. Psychol Bull. 2009;135(6):885–908. PubMed

Caspi A, Houts RM, Belsky The p factor: one general psychopathology factor in the structure of psychiatric disorders? Clin Psychol Sci. 2014;2:119–37. PubMed PMC

Post RM, Leverich GS, Xing G, Weiss SRB. Developmental vulnerabilities to the onset and course of bipolar disorder. Dev Psychopathol. 2001;13:581–98. PubMed

Doorn KA, Kamsteeg C, Silberschatz G. Cognitive mediators of the relationship between adverse childhood experiences and adult psychopathology: a systematic review. Dev Psychopathol. 2019; 1–13. PubMed

McLaughlin KA, Lambert HK. Child trauma exposure and psychopathology: mechanisms of risk and resilience. Curr Opin Psychol. 2017;14:29–34. PubMed PMC

McLaughlin KA, Colich NL, Rodman AM, Weissman DG. Mechanisms linking childhood trauma exposure and psychopathology: a transdiagnostic model of risk and resilience. BMC Med. 2020;18(1):1–11. PubMed PMC

Ayed N, Toner S, Priebe S. Conceptualizing resilience in adult mental health literature: a systematic review and narrative synthesis. Psychol psychother-t. 2019;92(3):299–341. PubMed

Schetter CD, Dolbier C. Resilience in the context of chronic stress and health in adults. Soc Per Psychol Compass. 2011;5(9):634–52. PubMed PMC

Chmitorz A, Kunzler A, Helmreich I, Tuscher O, Kalisch R, Kubiak T, Wessa M, Lieb K. Intervention studies to foster resilience—A systematic review and proposal for a resilience framework in future intervention studies. Clin Psychol Rev. 2018;59:78–100. PubMed

Brendgen M, Poulin F, Denault AS. Peer victimization in school and mental and physical health problems in young adulthood: examining the role of revictimization at the workplace. Dev Psychol. 2019;655(10):2219–30. PubMed

Sapouna M, Wolke D. Resilience to bullying victimization: the role of individual, family and peer characteristics. Child abuse Negl. 2013;37(11):997–1006. PubMed

Ttofi MM, Bowes L, Farrington DP, Lösel F. Protective factors interrupting the continuity from school bullying to later internalizing and externalizing problems: a systematic review of prospective longitudinal studies. J Sch Violence. 2014;13(1):5–38.

Statistical Office of the Slovak Republic, n.d. 2021. http://statdat.statistics.sk/cognosext/cgi-bin/cognos.cgi?b_action=xts.run&m=portal/cc.xts&gohome=. Accessed 23 November 2022.

Sainsbury R, Ditch J, Hutton S. Computer assisted personal interviewing. Soc Res Update. 1993;3:1–12.

Bernstein DP, Fink L. Childhood Trauma Questionnaire, a retrospective Self-report: Manual; NCS Pearson: San Antonio, TX, USA.1998.

Petrikova M, Kascakova N, Furstova J, Hasto J, Tavel P. Validation and adaptation of the Slovak version of the Childhood Trauma Questionnaire (CTQ) Int J Environ Res Public Health. 2021;18(5):2440. PubMed PMC

World Health Organization, Adverse Childhood Experiences International Questionnaire (ACE-IQ)., 2020. https://www.who.int/publications/m/item/adverse-childhood-experiences-international-questionnaire-(ace-iq). Accessed 2 July 2023.

Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: assessing the ability to bounce back. Int J Behav Med. 2008;15(3):194–200. PubMed

Furstova J, Kascakova N, Polackova Solcova I, Hasto J, Tavel P. How Czecho-Slovakia bounces back: population-based validation of the brief resilience scale in two central european countries. Psychol Rep. 2022;125(5):2807–27. PubMed

Derogatis LR, Melisaratos N. The brief Symptom Inventory: an introductory report. Psychol Med. 1983;13:595–605. PubMed

Derogatis LR. BSI brief Symptom Inventory. Administration, Scoring, and Procedures Manual. 4. Minneapolis, MN: National Computer Systems; 1993.

Jantzer AM, Hoover JH, Narloch R. The relationship between School-Aged bullying and trust, shyness and quality of friendships in Young Adulthood: a preliminary Research note. Sch Psychol Int. 2006;27(2):146–56.

Kretschmer T, Veenstra R, Branje S, Reijneveld SA, Meeus WHJ, Dekovic M, Oldehinkel AJ. How competent are adolescent bullying perpetrators and victims in mastering normative developmental tasks in early adulthood? J Abnorm Child Psychol. 2018;46(1):41–56. PubMed PMC

Machin S. “Social Disadvantage and Education Experiences”, OECD Social, Employment and Migration Working Papers, No. 32, Publishing OECD. Paris. 2006. 10.1787/715165322333.

Wolke D, Woods S, Stanford K, Schulz H. Bullying and victimization of primary school children in England and Germany: prevalence and school factors. Brit J Dev Psychol. 2001;92:673–96. PubMed

Jansen PW, Verlinden M, Berkel AD. Prevalence of bullying and victimization among children in early elementary school: do family and school neighbourhood socioeconomic status matter? BMC Public Health. 2012;12:494. PubMed PMC

Zendarski N, Breaux R, Eadeh HM, Smith ZR, Molitor SJ, Mulraney M, Sciberras E. Peer victimization and poor academic outcomes in adolescents with ADHD: what individual factors predict risk? J Atten Disord. 2020;25(10):1455–6. PubMed

HBSC- Slovakia 2013/2014. National report on health and health-related behaviour of 11-, 13- and 15- year- old schoolchildren. Office of the World Health Organization in Slovakia. 2015.

Lian QSuQLiR, Elgar FJ, Liu Z, Zheng D. The association between chronic bullying victimization with weight status and body self-image: a cross-national study in 39 countries. PeerJ. 2018;6:e4330. PubMed PMC

Cho S, Lee JM. Explaining physical, verbal, and social bullying among bullies, victims of bullying, and bully-victims: assessing the integrated approach between social control and lifestyles-routine activities theories. Child Youth Serv Rev. 2018;91:372–82.

Koyanagi AOH, Carvalho AF, Smith L, Haro JM, Vancampfort D, DeVylder JE. Bullying victimization and suicide attempt among adolescents aged 12–15 years from 48 countries. J Am Acad Child Adolesc Psychiatry. 2019;58(9):907–18. PubMed

Meltzer H, Vostanis P, Ford T, Bebbington P, Dennis M. Victims of bullying in childhood and suicide attempts in adulthood. Eur Psychiatry. 2011;26(8):498–503. PubMed

Rehan W, Antfolk J, Johansson A, Santtila P. Do single experiences of childhood abuse increase psychopathology symptoms in Adulthood? J Interpers Violence. 2019;34(5):1021–38. PubMed

Iwaniec D, Larkin E, Higgins S. Research review: risk and resilience in cases of emotional abuse. Child Fam Soc Work. 2006;11(1):73–82.

Finzi-Dottan R, Karu T. From emotional abuse in childhood to psychopathology in adulthood: a path mediated by immature defence mechanisms and self-esteem. J Nerv Ment Dis. 2006;194(8):616–21. PubMed

Berzenski SR, Madden AR, Yates TM. Childhood emotional abuse characteristics moderate associations with adult psychopathology and caregiving. Child Abuse Negl. 2019;87:77–87. PubMed

De Bellis MD. The psychobiology of neglect. Child Maltreat. 2005;10(2):150–72. PubMed

Teicher MH, Samson JA. Annual research review: enduring neurobiological effects of childhood abuse and neglect. J Child Psychol Psychiatry. 2016;57(3):241–66. PubMed PMC

Noll JG. Child sexual abuse as a unique risk factor for the development of psychopathology: the compounded convergence of mechanisms. Annu Rev Clin Psychol. 2021;17:439–64. PubMed PMC

van der Kolk BA. The body keeps the score: brain, mind and body in the healing of trauma. New York: Viking; 2014.

Bywaters P, Skinner G. The Relationship Between Poverty and Child Abuse and Neglect: New Evidence. 2022.

Ridley M, Rao G, Schilbach F, Patel V. Poverty, depression, and anxiety: causal evidence and mechanisms. Science. 2020 doi: 10.1126/science.aay0214. PubMed DOI

Marbin D, Gutwinski S, Schreiter S, Heinz A. Perspectives in poverty and mental health. Front Public Health. 2022;10:975482. PubMed PMC

Zlotnick C, Mattia JI, Zimmerman M. The relationship between posttraumatic stress disorder, childhood trauma and alexithymia in an outpatient sample. J Trauma Stress. 2001;14(1):177–88.

Iffland B, Sansen LM, Catani C, Neuner F. Emotional but not physical maltreatment is independently related to psychopathology in subjects with various degrees of social anxiety: a web-based internet survey. BMC Psychiatry 2012; 12 (1). PubMed PMC

Wright MO, Crawford E, Del Castillo D. Childhood emotional maltreatment and later psychological distress among college students: the mediating role of maladaptive schemas. Child Abuse Negl. 2009;33(1):59–68. PubMed

O’Dougherty Wright M, Masten AS. Resilience processes in development. In: Goldstein S, Brooks R, editors. Handbook of resilience in children. New York: Kluwer Academic / Plenum Publishers; 2005. pp. 17–38.

Domhardt M, Münzer A, Fegert JM, Goldbeck L. Resilience in survivors of child sexual abuse: a systematic review of the literature. Trauma Violence Abuse. 2015;16(4):476–93. PubMed

Ding H, Han J, Zhang M, Wang K, Gong J, Yang S. Moderating and mediating effects of resilience between childhood trauma and depressive symptoms in chinese children. J Affect Disord. 2017;15:130–5. PubMed

Fritz J, De Graaff AM, Caisley H, Van Harmelen AL, Wilkinson PO. A systematic review of amenable resilience factors that moderate and/or mediate the relationship between childhood adversity and mental health in young people. Front psychiatry. 2018;9:230. PubMed PMC

Meng X, Fleury MJ, Xiang YT, Li M, D’arcy C. Resilience and protective factors among people with a history of child maltreatment: a systematic review. Soc Psychiatry Psychiatr Epidemiol. 2018;53(5):453–75. PubMed

Hodges M, Godbout N, Briere J, Lanktree Ch, Gilbert A, Kletzka NT. Cumulative trauma and symptom complexity in children: a path analysis. Child Abuse Negl. 2013 doi: 10.1016/j.chiabu.2013.04.001. PubMed DOI

Afifi TO, Taillieu T, Salmon S, Davila IG, Stewart-Tufescu A, Fortier J, MacMillan HL. Adverse childhood experiences (ACEs), peer victimization, and substance use among adolescents. Child Abuse Neglect. 2020 doi: 10.1016/j.chiabu.2020.104504. PubMed DOI

Glassner SD, Cho S. Bullying victimization, negative emotions, and substance use: utilizing general strain theory to examine the undesirable outcomes of childhood bullying victimization in adolescence and young adulthood. J Youth Stud. 2018;21(9):1232–49.

Bond NI, McLafferty M, Lapsley C, Ennis E, Murray E, Heenan D, O’Neill SM. Familial and bullying victimisation: the impact of early adversity within the home and peer settings on late adolescence and adult psychopathology. J Child Adolesc Trauma. 2022; 1–11. PubMed PMC

Forster M, Gower AL, McMorris BJ, Borowsky IW. Adverse childhood Experiences and School-Based victimization and perpetration. J interpers Violence. 2020;35(3–4):662–81. PubMed

Hsieh YP, Shen ACT, Hwa HL, Wei HS, Feng JY, Huang SCY. Associations between Child Maltreatment, Dysfunctional Family Environment, post-traumatic stress disorder and children’s bullying perpetration in a National Representative Sample in Taiwan. J Fam Violence. 2020;36(1):27–36.

Weich S, Patterson J, Shaw R, Stewart-Brown S. Family relationships in childhood and common psychiatric disorders in later life: systematic review of prospective studies. Br J Psychiatry. 2009;194(5):392–8. PubMed

Marshall C, Henderson J. The influence of family context on adolescent depression: a literature review. Can J Fam Youth. 2014;6(1):163–87.

Ringdal R, Bjornsen HN, Espnes GA, Eilertsen MEB, Moksnes UK. Bullying, social support and adolescents’ mental health: results from a follow-up study. Scand J Public Health. 2020;49:309–16. PubMed PMC

Shapiro F. The role of eye movement desensitization and reprocessing (EMDR) therapy in medicine: addressing the psychological and physical symptoms stemming from adverse life experiences. Perm J. 2014;18(1):71–7. PubMed PMC

Elbert T, Schauer M, Neuner F. Narrative exposure therapy (NET): reorganizing Memories of traumatic stress, fear, and violence. Evidence Based Treatments for Trauma-Related Psychological Disorders; 2015. pp. 229–53.

Lydecker JA. Conceptual application of trauma-focused cognitive behavioral therapy to treat victims of bullying. JPHP. 2022;3(2):231–45. PubMed PMC

Watson H, Rapee R, Todorov N. Imagery rescripting of revenge, avoidance, and forgiveness for past bullying experiences in young adults. Cogn Behav Ther. 2016;45(1):73–89. PubMed

Gartland D, Riggs E, Muyeen S, Giallo R, Afifi TO, MacMillan H, Brown SJ. What factors are associated with resilient outcomes in children exposed to social adversity? A systematic review. BMJ Open. 2019;9(4):e024870. PubMed PMC

Afifi TO, MacMillan HL, Taillieu T, Turner S, Cheung K, Sareen J, Boyle MH. Individual- and relationship-level factors related to Better Mental Health Outcomes following child abuse: results from a nationally Representative Canadian Sample. Can J Psychiatry. 2016;61(12):776–88. PubMed PMC

Levitt JT, Cloitre M. A clinician’s guide to STAIR/MPE: treatment for PTSD related to childhood abuse. Cogn Behav Pract. 2005;12(1):40–52.

Hašto J, Tavel P. Mentalization as a challenge for clinical medicine and especially for psychiatry and psychotherapy. Psychiatry. 2015;19:97–103.

Alberti RE, Emmons ML. Your perfect right: assertiveness and equality in your life and relationships. Oakland, CA: New Harbinger Publications Inc; 2017.

Solmi M, Radua J, Olivola M, Croce E, Soardo L, Salazar de Pablo G, Fusar-Poli P. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Mol psychiatry. 2022;27(1):281–95. PubMed PMC

Thornberg R, Pozzoli T, Gini G. Defending or Remaining Passive as a Bystander of School Bullying in Sweden: The Role of Moral Disengagement and Antibullying Class Norms. J Interpers Violence 2021. doi.org.10.1177/08862605211037427. PubMed PMC

Krumpal I. Determinants of social desirability bias in sensitive surveys: a literature review. Qual Quant. 2011;47(4):2025–47.

Della Femina D, Yeager CA, Lewis DO. Child abuse: adolescent records vs. adult recall. Child Abuse Negl. 1990;14:227–31. PubMed

Schwarz N, Sudman S. Autobiographical memory and the validity of retrospective reports. New York: Springer Verlag; 1994.

Hardt J, Rutter M. Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry. 2004;45(2):260–73. PubMed

Associations of multiple adverse childhood experiences, attachment insecurity and loneliness with physical and mental health difficulties in a representative Slovak sample