Victimization by traditional bullying and cyberbullying and the combination of these among adolescents in 13 European and Asian countries


Roshan Chudal, Department of Child Psychiatry, University of Turku, Turku, Finland.
Elina Tiiri, Department of Child Psychiatry, University of Turku, Turku, Finland.
Anat Brunstein Klomek, Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzlyia, Israel.
Say How Ong, Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore.
Sturla Fossum, The Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.
Hitoshi Kaneko, Psychological Support and Research Center for Human Development, Nagoya University, Nagoya, Japan.
Gerasimos Kolaitis, Department of Child Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece.
Sigita Lesinskiene, Faculty of Medicine, Institute of Clinical Medicine, Clinic of Psychiatry, Vilnius University, Vilnius, Lithuania.
Liping Li, Shantou University Medical College, Shantou, China.
Mai Nguyen Huong, Department of Psychiatry, Vietnam National Children's Hospital, Hanoi, Vietnam.
Samir Kumar Praharaj, Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Lauri Sillanmäki, Department of Child Psychiatry, University of Turku, Turku, Finland.
Helena R. Slobodskaya, Scientific Research Institute of Physiology and Basic Medicine, Novosibirsk State University, Novosibirsk, Russia.
Jorge C. Srabstein, Division of Psychiatry and Behavioral Sciences, Children's National, Washington, DC, USA.
Tjhin Wiguna, Department of Psychiatry, Faculty of Medicine, Universitas Indonesia-Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Zahra Zamani, Tehran University of Medical Sciences, Tehran, Iran.
Andre Sourander, Department of Child Psychiatry, University of Turku, Turku, Finland. andsou@utu.fi.

Document Type

Journal Article

Publication Date



European child & adolescent psychiatry








Adolescent psychiatry; Bullying; Cross-cultural; Cyberbullying; Victimization


There has been a lack of studies on bullying in non-western low-income and middle-income countries. This study reported the prevalence of traditional victimization, cybervictimization, and the combination of these, in 13 European and Asian countries, and explored how psychiatric symptoms were associated with victimization. The data for this cross-sectional, school-based study of 21,688 adolescents aged 13-15 were collected from 2011 to 2017. The main outcomes were traditional and cybervictimization obtained from student self-reports. The Strengths and Difficulties Questionnaire was used to assess psychiatric symptoms. Generalized estimating equation and logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). The mean prevalence of any victimization was 28.9%, of traditional victimization only, this was 17.7%, and for cybervictimization only this was 5.1%. Cybervictimization occurred both independently, and in combination with, traditional victimization. The mean prevalence of combined victimization was 6.1%. The mean proportion of those who were cyberbullied only among those who were either cyberbullied only or bullied both traditionally and in cyber was 45.1%. The rates of prevalence varied widely between countries. In the total sample, those who experienced combined victimization, reported the highest internalizing symptoms (girls, OR 1.25, 95% CI 1.22-1.29; boys, OR 1.29, 95% CI 1.25-1.33). The study findings suggest that anti-bullying interventions should include mental health components and target both traditional and cyberbullying. Due to the overlap between these, targeting bullying should primarily focus on how to reduce bullying behavior rather than just focusing on where bullying takes place.


Psychiatry and Behavioral Sciences