TOPLINE:

An analysis of over 5000 youths across three countries revealed bullying as a significant predictor of posttraumatic stress symptoms (PTSS), with 52.6%-56.2% reporting bullying experiences and 57.4%-78.3% of victims showing clinically elevated PTSS.

METHODOLOGY:

• Researchers analysed three clinical samples of children and adolescents referred for mental health care in Norway (N = 3370; mean age, 14 years; 63.4% females), Netherlands (N = 952; mean age, 15.57 years; 68.7% females), and Germany (N = 707; mean age, 13.25 years; 39.0% females).
• Assessment utilised the Child and Adolescent Trauma Screen (CATS) or CATS-2 questionnaire to measure bullying experiences, potentially traumatic events (PTEs), and the severity of PTSS.
• Investigators evaluated unique R² shares to determine the distinct variance contribution of each PTE to PTSS, while controlling for age and sex.
• Linear regression models compared findings across samples to determine the relative importance of bullying compared to other trauma types.

TAKEAWAY:

• Bullying was highly prevalent, reported by 56.2% of participants from Norway, 53.2% from Netherlands, and 52.6% from Germany, with moderate correlations (correlation coefficient, 0.17-0.37; P < .001 for all).
• Clinically elevated PTSS were reported by 57.4%-73.1% of youths who experienced bullying and 78.3% of those who experienced cyberbullying.
• Bullying remained a significant predictor of PTSS across all samples after controlling for other PTEs, explaining 3.8%-22.9% of variance.
• The researchers found that bullying (especially when threat-based language was experienced) and interpersonal PTEs explained more variance in PTSS than non-interpersonal PTEs such as accidents or natural disasters.

IN PRACTICE:

"Recognizing bullying as a potential source of PTSS underscores the importance of addressing it seriously in both educational and clinical mental health contexts," the authors wrote.

"We recommend expanding diagnostic options beyond the traumatic event definitions and focusing on treating the symptoms observed in children," they added.

SOURCE:

This study was led by Cedric Sachser, University of Bamberg, Bavaria, Germany, and Lieke H. Kooij, Amsterdam University Medical Centre, Amsterdam, Netherlands. It was published online on December 16, 2025, in the European Journal of Psychotraumatology.

LIMITATIONS:

This study lacked differentiation between various types of bullying such as cyberbullying and relational, sexual, prejudicial, and physical bullying, which limited the understanding of how specific forms may relate to PTSS. Perceptions and definitions of bullying may have varied significantly across cultural, linguistic, and educational contexts. The generalisability of the findings to non-clinical populations remains unclear. Separate analyses for children vs adolescents could have provided deeper insights into age-specific experiences of bullying.

DISCLOSURES:

No funding information was provided for this study. No potential conflicts of interest were reported by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.