Middle-School Bullying: Review of Risk and Protective Factors, Mental Health, and Prevention
DOI:
https://doi.org/10.37287/ijghr.v8i6.2754Keywords:
adolescent, bullying, cyberbullying, mental health, school prevention, systematic reviewAbstract
Bullying during early adolescence is a persistent school-health problem associated with emotional distress, impaired school adjustment, and difficulties in peer relationships. Evidence concerning determinants, mental-health consequences, and prevention is distributed across heterogeneous study designs. To synthesise evidence on risk and protective factors, mental-health consequences, and school-based prevention among middle-school or lower-secondary students. This systematic review used narrative synthesis. The final supplementary search was completed on 31 August 2026 using PubMed/MEDLINE, ERIC, PubMed Central, indexed publisher sources, verifiable DOI/Crossref records, and backward and forward citation searching. Reporting was structured according to PRISMA 2020 and PRISMA-S; risk of bias was assessed using RoB 2 and design-specific JBI tools. The included primary studies were published from 2021 to 2026. Eighty-three reports were assessed; 28 were excluded and 55 met the eligibility criteria. After three companion reports were linked with their parent studies, 52 unique studies remained. Family adversity and weak school connectedness were repeatedly associated with bullying involvement, while victimisation was related to depression, anxiety, stress, suicidality, self-harm, and sleep problems. School-based interventions were generally promising, although heterogeneity precluded a single pooled effect. The findings indicate a need for multilevel prevention integrating a supportive school climate, social-emotional competence, family involvement, digital literacy, and meaningful bystander or defender participation.
References
Acevedo, B. P., Sperati, A., Williams, C., Griffin, K. W., Tork, A., & Botvin, G. J. (2025). The moderating role of sensory processing sensitivity in social skills enhancement and bullying prevention among adolescents. Behavioral Sciences, 15(10), 1344. https://doi.org/10.3390/bs15101344
Arnon, S., Brunstein Klomek, A., Visoki, E., Moore, T. M., Argabright, S. T., DiDomenico, G. E., Benton, T. D., & Barzilay, R. (2022). Association of cyberbullying experiences and perpetration with suicidality in early adolescence. JAMA Network Open, 5(6), e2218746. https://doi.org/10.1001/jamanetworkopen.2022.18746
Bai, T., Lang, M., Jin, Y., Li, J., & Chen, P. (2025). Examining the interplay of childhood abuse, bullying, and bullying victimization in middle school students: A serial mediation analysis. Frontiers in Psychology, 16, 1586797. https://doi.org/10.3389/fpsyg.2025.1586797
Bai, Y. P., Yuan, H., Yu, Q. Y., Liu, L. M., & Wang, W. C. (2025). Longitudinal study of peer bullying victimization and its psychological effects on adolescents. World Journal of Psychiatry, 15(5), 104145. https://doi.org/10.5498/wjp.v15.i5.104145
Barker, T. H., Habibi, N., Aromataris, E., Stone, J. C., Leonardi-Bee, J., Sears, K., Hasanoff, S., Klugar, M., Tufanaru, C., Moola, S., & Munn, Z. (2024). The revised JBI critical appraisal tool for the assessment of risk of bias for quasi-experimental studies. JBI Evidence Synthesis, 22(3), 378–388. https://doi.org/10.11124/JBIES-23-00268
Barker, T. H., Hasanoff, S., Aromataris, E., Stone, J. C., Leonardi-Bee, J., Sears, K., Habibi, N., Klugar, M., Tufanaru, C., Moola, S., Liu, X.-L., & Munn, Z. (2025). The revised JBI critical appraisal tool for the assessment of risk of bias for cohort studies. JBI Evidence Synthesis, 23(3), 441-453. https://doi.org/10.11124/JBIES-24-00103
Barker, T. H., Hasanoff, S., Aromataris, E., Stone, J. C., Leonardi-Bee, J., Sears, K., Klugar, M., Tufanaru, C., Moola, S., Liu, X.-L., & Munn, Z. (2026). The revised JBI critical appraisal tool for the assessment of risk of bias for analytical cross-sectional studies. JBI Evidence Synthesis, 24(3), 401–408. https://doi.org/10.11124/JBIES-24-00523
Ben Fredj, M., Bennasrallah, C., Amor, I., Abroug, H., Zemni, I., Dhouib, W., Kacem, M., Bouanene, I., Trimech, F., & Belguith Sriha, A. (2023). Associations of psychological factors, parental involvement, and adverse health behaviors with bullying among Tunisian middle school students. BMC Psychology, 11, 154. https://doi.org/10.1186/s40359-023-01190-7
Biernesser, C., Ohmer, M., Nelson, L., Mann, E., Farzan, R., Schwanke, B., & Radovic, A. (2023). Middle school students’ experiences with cyberbullying and perspectives toward prevention and bystander intervention in schools. Journal of School Violence, 22(3), 339–352. https://doi.org/10.1080/15388220.2023.2186417
Borualogo, I. S., Mubarak, A., & Dwarawati, D. (2025). From stress to screens: How internet use, loneliness, and social media habits relate to cyberbullying perpetration. Jurnal Psikologi, 52(2), 161-178. https://doi.org/10.22146/jpsi.98607
Brandau, M., Dilley, T., Schaumleffel, C., & Himawan, L. (2022). Digital citizenship among Appalachian middle schoolers: The Common Sense Digital Citizenship Curriculum. Health Education Journal, 81(2), 157–169. https://doi.org/10.1177/00178969211056429
Cameron, D. L., Stray, I. E., & Skreland, L. L. (2021). Lower secondary school pupils’ written descriptions of their experiences with bullying and the tendency to seek help. International Journal of Adolescence and Youth, 26(1), 487-500. https://doi.org/10.1080/02673843.2021.2001348
Chen, H., Guo, H., Chen, H., Cao, X., Liu, J., Chen, X., Tian, Y., Tang, H., Wang, X., & Zhou, J. (2023). Influence of academic stress and school bullying on self-harm behaviors among Chinese middle school students: The mediation effect of depression and anxiety. Frontiers in Public Health, 10, 1049051. https://doi.org/10.3389/fpubh.2022.1049051
Coelho, V. A., Sousa, M., Marchante, M., & Cruz, S. (2026). Does a social and emotional learning program have the same effect for all students regardless of their bullying roles? School Psychology Review, 55(3), 300–313. https://doi.org/10.1080/2372966X.2025.2464527
Coyle, S., Cipra, A., & Rueger, S. Y. (2021). Bullying types and roles in early adolescence: Latent classes of perpetrators and victims. Journal of School Psychology, 89, 51–71. https://doi.org/10.1016/j.jsp.2021.09.003
Dai, Z., Hu, Y., Wang, C., Mei, C., Wang, Y., Tao, J., Yang, Y., Liu, Y., Cheng, Z., & Su, D. (2026). The effect of campus bullying on negative emotions among middle school students: A moderated mediation model. Frontiers in Public Health, 14, 1811136. https://doi.org/10.3389/fpubh.2026.1811136
Demir, K., & Küçük, S. (2025). Effectiveness of a theory-based peer bullying counseling program on cognition, empathy, friendship, and anger control: A quasi-experimental study among middle school students. The Journal of School Nursing. Advance online publication. https://doi.org/10.1177/10598405251396151
Doumas, D. M., & Midgett, A. (2021). The relationship between witnessing cyberbullying and depressive symptoms and social anxiety among middle school students: Is witnessing school bullying a moderator? Journal of Child and Adolescent Counseling, 7(3). https://doi.org/10.1080/23727810.2021.1934369
Doumas, D. M., & Midgett, A. (2023). Witnessing cyberbullying and suicidal ideation among middle school students. Psychology in the Schools, 60(4), 1149–1163. https://doi.org/10.1002/pits.22823
Evangelio, C., Rodríguez-González, P., Fernández-Río, J., & González-Víllora, S. (2022). Cyberbullying in elementary and middle school students: A systematic review. Computers & Education, 176, 104356. https://doi.org/10.1016/j.compedu.2021.104356
Gaffney, H., Ttofi, M. M., & Farrington, D. P. (2021). Effectiveness of school-based programs to reduce bullying perpetration and victimization: An updated systematic review and meta-analysis. Campbell Systematic Reviews, 17(2), e1143. https://doi.org/10.1002/cl2.1143
Gan, X., Qin, K.-N., Xiang, G.-X., & Jin, X. (2023). The relationship between parental neglect and cyberbullying perpetration among Chinese adolescent: The sequential role of cyberbullying victimization and internet gaming disorder. Frontiers in Public Health, 11, 1128123. https://doi.org/10.3389/fpubh.2023.1128123
Gan, X., Wang, P., Huang, C., Li, H., & Jin, X. (2022). Alienation from school and cyberbullying among Chinese middle school students: A moderated mediation model involving self-esteem and emotional intelligence. Frontiers in Public Health, 10, 903206. https://doi.org/10.3389/fpubh.2022.903206
Gao, R., Zhao, H., Luo, H., Kuang, H., E, B., & Guo, X. (2024). Analysis of influencing factors and construction of nomogram of school bullying suffered by middle school students in Beijing in 2022. Psychology Research and Behavior Management, 17, 4291–4299. https://doi.org/10.2147/PRBM.S495658
Garthe, R. C., Kim, S., Welsh, M., Wegmann, K., & Klingenberg, J. (2023). Cyber-victimization and mental health concerns among middle school students before and during the COVID-19 pandemic. Journal of Youth and Adolescence, 52(4), 840–851. https://doi.org/10.1007/s10964-023-01737-2
Ghardallou, M., Mtiraoui, A., Ennamouchi, D., Amara, A., Gara, A., Dardouri, M., Zedini, C., & Mtiraoui, A. (2024). Bullying victimization among adolescents: Prevalence, associated factors and correlation with mental health outcomes. PLOS ONE, 19(3), e0299161. https://doi.org/10.1371/journal.pone.0299161
Iordache, M., Claudiu, C., Bucs, A., Banca, A., & Motoi, G. (2025). Bullying and its effects on middle school students in Romania: A quantitative approach. Education Sciences, 15(5), 617. https://doi.org/10.3390/educsci15050617
Jiang, H., Jin, Y., & Yang, Q. (2025). Traditional bullying victimization and cyberbullying perpetration: The role of anger rumination and self-control. Psychology Research and Behavior Management, 18, 877-886. https://doi.org/10.2147/PRBM.S507510
Juli, R., Sarfika, R., Basmanelly, Saifudin, I. M. M. Y., & Abdullah, K. L. (2025). Predictors of bullying victimization among early adolescents in junior high schools: A cross-sectional study. Belitung Nursing Journal, 11(5), 547-559. https://doi.org/10.33546/bnj.3950
Kang, K. I., Kang, K., & Kim, C. (2021). Risk factors influencing cyberbullying perpetration among middle school students in Korea: Analysis using the zero-inflated negative binomial regression model. International Journal of Environmental Research and Public Health, 18(5), 2224. https://doi.org/10.3390/ijerph18052224
Küçük, F., & Eryılmaz Aydın, S. E. (2026). The relationship between family relationships and peer bullying among middle school students. Archives of Psychiatric Nursing, 64, 152211. https://doi.org/10.1016/j.apnu.2026.152211
Levantini, V., Camodeca, M., & Iannello, N. M. (2023). The contribution of bullying involvement and alexithymia to somatic complaints in preadolescents. Children, 10(5), 905. https://doi.org/10.3390/children10050905
Li, H., Liu, C., Shen, X., Nan, Y., & Feng, L. (2024). Analysis of the current situation and factors influencing bullying in junior high schools in backward areas of Western China: A case study of Qingyang City in Gansu. BMC Public Health, 24, 1295. https://doi.org/10.1186/s12889-024-18775-5
Liu, W., & Guo, Z. (2024). Influence of campus exclusion on bullying behavior of junior high school students: Role of callous-unemotional traits and family caring. BMC Psychology, 12, 640. https://doi.org/10.1186/s40359-024-02124-7
Luo, X., Li, Y., Liu, H., Sun, Z., Wei, Q., Zhang, X., Liu, Y., & Zhang, T. (2026). The chain mediating effect of psychological capital and depressive symptoms between school bullying and sleep disorders among middle school students. Scientific Reports. Advance online publication. https://doi.org/10.1038/s41598-026-45804-7
Menabò, L., Roga, F., Fernández Gea, S., Ginocchio, D., & Guarini, A. (2026). How Italian middle school adolescents conceptualize and navigate cyberbullying: A qualitative analysis of definitions, behaviors, roles, and coping strategies. Behavioral Sciences, 16(3), 435. https://doi.org/10.3390/bs16030435
Midgett, A., Doumas, D. M., Peck, M., & Winburn, A. (2021). The relationship between witnessing bullying, defending targets, and internalizing symptoms: An analysis of gender differences among sixth-grade students. Professional School Counseling, 25(1). https://doi.org/10.1177/2156759X211058159
Midgett, A., Peck, M., & Doumas, D. M. (2025). Bullying in private schools: Can training middle school students to intervene reduce bullying perpetration and victimization? Professional School Counseling, 29(1). https://doi.org/10.1177/2156759X251316870
Movahedi, N., Hosseinian, S., Rezaeian, H., & Nooripour, R. (2024). Mediating role of alexithymia in relationship between cyberbullying and psychotic experiences in adolescents. BMC Psychology, 12, 465. https://doi.org/10.1186/s40359-024-01960-x
Muhopilah, P., Tentama, F., & Yuzarion. (2021). The model influence of authoritarian parenting, extraversion personality, and conformity to bullying among students. International Journal of Evaluation and Research in Education, 10(2), 483–493. https://doi.org/10.11591/ijere.v10i2.20914
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., ... Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Peng, Z., Li, L., Su, X., & Lu, Y. (2022). A pilot intervention study on bullying prevention among junior high school students in Shantou, China. BMC Public Health, 22, 262. https://doi.org/10.1186/s12889-022-12669-0
Porritt, K., Evans, C., Bennett, C., Loveday, H., Bjerrum, M., Salmond, S., Munn, Z., Pollock, D., Pang, D., Vineetha, K., Seah, B., & Lockwood, C. (2024). Systematic reviews of qualitative evidence. In E. Aromataris, C. Lockwood, K. Porritt, B. Pilla, & Z. Jordan (Eds.), JBI Manual for Evidence Synthesis. JBI. https://doi.org/10.46658/JBIMES-24-02
Qiao, X., Gao, W., Yu, J., Li, T., & Lei, L. (2026). Combined effects of traditional and cyberbullying victimization on adolescent non-suicidal self-injury: The buffering role of family and peer support. Psychiatry Research, 365, 117398. https://doi.org/10.1016/j.psychres.2026.117398
Ren, P., Liu, B., Xiong, X., Chen, J., & Luo, F. (2023). The longitudinal relationship between bullying victimization and depressive symptoms for middle school students: A cross-lagged panel network analysis. Journal of Affective Disorders, 341, 42–51. https://doi.org/10.1016/j.jad.2023.08.048
Rethlefsen, M. L., Kirtley, S., Waffenschmidt, S., Ayala, A. P., Moher, D., Page, M. J., Koffel, J. B., & PRISMA-S Group. (2021). PRISMA-S: An extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews. Systematic Reviews, 10, 39. https://doi.org/10.1186/s13643-020-01542-z
Richardson, S. C., & Gunn, L. H. (2024). Factors associated with suicide risk behavior outcomes among Black middle school adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 63(12), 1215-1224. https://doi.org/10.1016/j.jaac.2024.03.019
Shah, S., Choi, M., Miller, M., Halgunseth, L. C., van Schaik, S. D. M., & Brenick, A. (2021). Family cohesion and school belongingness: Protective factors for immigrant youth against bias-based bullying. New Directions for Child and Adolescent Development, 2021(177), 199–217. https://doi.org/10.1002/cad.20410
Sterne, J. A. C., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., Cates, C. J., Cheng, H.-Y., Corbett, M. S., Eldridge, S. M., Emberson, J. R., Hernán, M. A., Hopewell, S., Hróbjartsson, A., Junqueira, D. R., Jüni, P., Kirkham, J. J., Lasserson, T., Li, T., ... Higgins, J. P. T. (2019). RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ, 366, l4898. https://doi.org/10.1136/bmj.l4898
Sullivan, T. N., Farrell, A. D., Sutherland, K. S., Behrhorst, K. L., Garthe, R. C., & Greene, A. (2021). Evaluation of the Olweus Bullying Prevention Program in US urban middle schools using a multiple baseline experimental design. Prevention Science, 22(8), 1134–1146. https://doi.org/10.1007/s11121-021-01244-5
Ünal Çelik, E., Koçak Uyaroğlu, A., & Selçuk Tosun, A. (2026). Middle school students' perceptions of peer bullying: A qualitative study. Journal of Pediatric Nursing, 87, 31–42. https://doi.org/10.1016/j.pedn.2025.12.033
Van Ryzin, M. J., & Roseth, C. J. (2022). The longitudinal relationship between peer relations and empathy and their joint contribution to reducing bullying in middle school: Findings from a randomized trial of cooperative learning. Journal of Prevention and Health Promotion, 3(2), 147–165. https://doi.org/10.1177/26320770221094032
Vivolo-Kantor, A. M., Niolon, P. H., Estefan, L. F., Le, V. D., Tracy, A. J., Latzman, N. E., Little, T. D., Lang, K. M., DeGue, S., & Tharp, A. T. (2021). Middle school effects of the Dating Matters comprehensive teen dating violence prevention model on physical violence, bullying, and cyberbullying: A cluster-randomized controlled trial. Prevention Science, 22(2), 151-161. https://doi.org/10.1007/s11121-019-01071-9
Walters, G. D., Runell, L., & Kremser, J. (2025). Peer-aggression victimization and perpetration in middle school youth: Estimating prevalence and frequency, joint trajectory patterns, and predictive utility. Aggressive Behavior, 51(4), e70039. https://doi.org/10.1002/ab.70039
Wang, L., & Song, Y. (2021). The influence of school loose-tight culture on bullying of middle school students: The mediating role of collective moral disengagement and collective efficacy. Best Evidence in Chinese Education, 9(2), 1263–1272. https://doi.org/10.15354/bece.21.ar060
Wang, L., Chen, Q., Peng, Z., Ye, C., & Zhou, X. (2023). Six-week grit training course reduces school bullying: A quasi-experimental study. Frontiers in Child and Adolescent Psychiatry, 1, 1045808. https://doi.org/10.3389/frcha.2022.1045808
Williams, C., Griffin, K. W., Botvin, C. M., Sousa, S., & Botvin, G. J. (2023). Effectiveness of digital health tools to prevent bullying among middle school students. Adolescents, 3(1), 110–130. https://doi.org/10.3390/adolescents3010009
Wright, M. F. (2024a). The moderating effect of parental mediation in the longitudinal associations among cyberbullying, depression, and self-harm among Chinese and American adolescents. Frontiers in Psychology, 15, 1459249. https://doi.org/10.3389/fpsyg.2024.1459249
Wright, M. F. (2024b). The role of parental mediation and age in the associations between cyberbullying victimization and bystanding and children’s and adolescents’ depression. Children, 11(7), 777. https://doi.org/10.3390/children11070777
Wright, M. F. (2025). The moderating effect of peer attachment on associations between children’s and adolescents’ cyberbullying victimization, bystanding, and depressive symptoms. International Journal of Environmental Research and Public Health, 22(1), 8. https://doi.org/10.3390/ijerph22010008
Wright, M. F., & Wachs, S. (2023). Cyberbullying involvement and depression among elementary school, middle school, high school, and university students: The role of social support and gender. International Journal of Environmental Research and Public Health, 20(4), 2835. https://doi.org/10.3390/ijerph20042835
Wright, M. F., & Wachs, S. (2025). The role of parental mediation in the associations among cyberbullying bystanding, depression, subjective health complaints, and self-harm. Youth & Society, 57(2). https://doi.org/10.1177/0044118X241272062
Xiao, Z., Shao, Y., Chen, S., & Wang, W. (2025). How family cohesion affects adolescents' cyberbullying: The chain mediating role of social support and self-esteem. Medicine, 104(39), e44579. https://doi.org/10.1097/MD.0000000000044579
Zhou, X., Chen, Y., & Xiao, H. (2026). The role of physical exercise in promoting bystander intervention in school bullying: Evidence from cross-sectional and longitudinal studies. Frontiers in Psychology, 17, 1718104. https://doi.org/10.3389/fpsyg.2026.1718104.
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