Bullying Behavior and its Association with Mental Health Symptoms among Senior Secondary School Students in Calabar, Nigeria

Background: The nature of our psychosocial environment and one's response to stressful daily events are key determinants of current and future mental health status. The school environment is one of such settings which expose young people to potentially undue stress, especially through bully-prone interpersonal interaction with peers and older individuals. Although bullying is thought to be prevalent in secondary schools, only a few studies have investigated the association between bullying and the mental health status of secondary school students in developing countries. The present study seeks to obtain data that may be helpful in addressing this research gap. Methodology: This was a cross-sectional analytic study. A stratified sampling technique was used to select six secondary schools within Calabar metropolis. Proportional allocation using a simple random sampling method was employed to recruit the required number of senior secondary students from the selected schools. Multidimensional Peer Victimization Scale and Child and Youth Mental Health General Screening Questionnaires were used to assess for presence/degree of bullying and mental health problems, respectively. Mann–Whitney U-test and Spearman's correlation analysis were used as inferential statistics, and P-value was considered significant if it was < 0.05. Results: Three hundred and four (304) respondents were surveyed, but complete data were obtained from 292. Their ages ranged from 13 to 20 years, with a mean age of 16.5 ± 2.1 years. The male-to-female ratio was 1:0.7. Within the past 12 months, 54.8% of the respondents had bullied someone, while 62.3% had witnessed someone being bullied. Attack on the property was the most common form of bullying (61%), followed by social manipulation (52.7%), verbal (52.1%), and physical (47.9%) forms of victimization. Moderate-to-severe forms of social manipulation, physical victimization, verbal victimization, and attack on property forms of bullying were found in 26.0%, 26.7%, 28.8%, and 32.2% of respondents, respectively. The most frequently elevated component of mental health score in the respondents was conduct symptoms (50.7%), followed by mood symptoms (34.2%) and symptoms of generalized anxiety (19.2%). Respondents with abnormally elevated scores for hyperactivity/distractibility, conduct, generalized anxiety, and mood symptoms had significantly higher mean scores for each of the components of bullying assessed (P < 0.001). Elevated scores on oppositional defiant symptoms did not significantly influence the mean scores of each component of bullying, except for verbal victimization (P = 0.04). A significant positive correlation was observed between each component of bullying and each domain of mental health assessed (P < 0.001). A positive correlation was also observed between the total bullying score and each domain of mental health as well as the total mental health scores (P < 0.001). Of all the domains of mental health assessed, symptoms of hyperactivity/distractibility showed the strongest positive correlation with a total bully score (r = 0.69, P < 0.001). Conclusion: The results from this study suggest that bullying is prevalent in our secondary schools, with a potential adverse effects on the mental health of affected individuals in the near or remote future. These findings may be useful for improvement in existing policies for school health programs in developing countries.