10.22235/cp.v17i2.2952
Perpetração de bullying e depressão em crianças e adolescentes: uma revisão de escopo
Perpetration of bullying and depression in children and adolescents: a scoping review
Perpetración del bullying y depresión en niños y adolescentes: una revisión de alcance
Gleyde Raiane de Araújo1, ORCID 0000-0002-0680-1250
Wesley Rodrigues da Costa2, ORCID 0000-0001-9124-2248
Sandra Elisa de Assis Freire3, ORCID 0000-0003-1083-6963
Fauston Negreiros4, ORCID 0000-0003-2046-8463
Emerson Diógenes de Medeiros5, ORCID 0000-0002-1407-3433
1 Universidade Federal do Delta do Parnaíba, Brasil, gleydearaujo@hotmail.com
2 Universidade Federal do Delta do Parnaíba, Brasil
3 Universidade Federal do Delta do Parnaíba, Brasil
4 Universidade de Brasília, Brasil
5 Universidade Federal do Delta do Parnaíba, Brasil
Resumo:
O presente estudo consiste em uma revisão de escopo em consonância com o protocolo de Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Assim, a pesquisa objetivou conhecer a relação entre perpetração de bullying e depressão em crianças e adolescentes no contexto escolar. As pesquisas foram realizadas nas bases PsycInfo, Medline, PsycArticles e Scopus, com o recorte temporal dos últimos 5 anos. Ao todo foram encontradas 315 publicações e após triagem 26 foram incluídas. Dentre os resultados, identificou-se a relação preditora bidirecional e correlacional entre perpetração e depressão. Além disso, outras variáveis intra e interindividuais parecem estar relacionadas a esse contexto. Indica-se que intervenções antibullying para perpetradores incluam estratégias para identificação e mitigação de sofrimento psicológico, especificamente a depressão.
Palavras-chave: perpetração de bullying; depressão; crianças; adolescentes; bullying.
Abstract:
This study represents a scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. The aim of this research was to explore the relationship between bullying perpetration and depression among children and adolescents in the school context. Searches were conducted in the PsycInfo, Medline, PsycArticles, and Scopus databases, with a temporal scope of the last five years. A total of 315 publications were initially identified, and after screening, 26 were included. Among the findings, a bidirectional and correlational predictive relationship between perpetration and depression was identified. Furthermore, other intra- and interindividual variables appear to be related to this context. It is suggested that antibullying interventions for perpetrators should include strategies for the identification and mitigation of psychological distress, specifically depression.
Keywords: perpetration of bullying; depression; children; adolescents; bullying.
Resumen:
Este estudio consiste en una revisión de alcance de acuerdo con los protocolos de Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Así, la investigación tuvo como objetivo evaluar la relación entre la perpetración de bullying y la depresión en niños y adolescentes en el contexto escolar. Se llevaron a cabo búsquedas en las bases de datos PsycInfo, Medline, PsycArticles y Scopus, con un límite temporal de los últimos 5 años. En total, se encontraron 315 publicaciones y, tras la selección, se incluyeron 26. Entre los resultados, se identificó una relación predictiva bidireccional y correlacional entre la perpetración y la depresión. Además, otras variables intra e interindividuales parecen estar relacionadas con este contexto. Se indica que las intervenciones antibullying para los perpetradores deben incluir estrategias para identificar y mitigar el sufrimiento psicológico, específicamente la depresión.
Palabras clave: perpetración del bullying; depresión; niños; adolescentes; bullying.
Recebido: 18/07/202
Aceito: 27/09/2023
O bullying pode ser entendido a partir da perspectiva do abuso de poder físico ou psicológico entre pares que é manifestado por meio de comportamentos e ações que envolvam prepotência e dominação pelo agressor e sentimento de impotência, medo, raiva, humilhação e submissão pela vítima (Olweus, 2013; Walters, 2020). Especificamente no contexto escolar, as ações ocorrem por meio de comentários maldosos, agressões físicas, exclusão social dos pares, apelidos, humilhação, dentre outras formas que podem afetar negativamente a vida acadêmica das vítimas (Granado et al., 2021; Hutzell & Payne; 2018). Em suma, o bullying pode ser caracterizado seguindo três critérios, a saber: ações comportamentais agressivas e propositalmente nocivas; praticadas de modo persecutório e repetitivo; estabelecidos por meio de uma relação entre pessoas de modo desigual, caraterizado por dominação (Monteiro et al., 2017; Olweus, 1994, 2011).
Ademais, as práticas de bullying podem caracterizar-se como diretas (e.g. insultos, apelidos, comportamentos agressivos, dentre outros), que pode ser subdividido pelas agressões físicas (aqueles relativos a ameaças ou contato físico direto) e verbais (no qual o perpetrador evoca comentários pejorativos com o intuito de difamar a imagem da vítima e (Cho & Lee, 2018). Já de maneira indireta, pode se manifestar de através do bullying relacional (exclusão e isolamento de uma pessoa do grupo e disseminação de fofocas de modo a prejudicar a imagem da vítima) (Granado et al., 2021; Kennedy, 2019) e do cyberbullying (considerado por alguns autores como um tipo de bullying que ocorre em ambientes virtuais) (Kennedy, 2019; Walters, 2020; Xie et al., 2023) que surgiu com advento da tecnologia da informação.
Na prática do bullying, observam-se diferentes atores socias que são caracterizados como: a) autores/perpetradores, aqueles que só praticam o bullying (Chicoine et al., 2021); b) aqueles que sofrem e são alvos do bullying, ou seja, as vítimas; aqueles que sofrem e praticam, caracterizados como como vítimas /perpetradores de bullying; e por fim, as testemunhas que convivem no ambiente onde a prática ocorre, presenciando-a, mas não sofrem e nem praticam bullying (Palomares-Ruiz et al, 2019; Zych et al., 2020).
Estudos prévios apontam possíveis consequências do envolvimento com bullying a exemplo de: diminuição do rendimento escolar, agressividade, automutilação, depressão, dentre outros problemas de ordem individual e relacional (Bokhari et al., 2022; Hutzell & Payne, 2018). Por exemplo, Santos et al. (2015) investigaram fatores relacionados ao bullying na percepção de professores e alunos do ensino fundamental e identificaram quatro categorias de consequências do bullying: aspectos físicos, aspectos psicológicos impactos na aprendizagem e problemas interpessoais. Além disso, tem se verificado que os efeitos do bullying vivenciado na infância e adolescência podem se estender por anos, chegando até a vida adulta (Monteiro et al., 2020; Nikolaou, 2021; Ttofi et al., 2011).
Tais achados evidenciam a gravidade dos impactos causados por esse fenômeno. No contexto do presente estudo cabe depreender maior atenção aos aspectos relativos à depressão que compreende a perda do interesse e prazer na realização das atividades cotidianas, seguido pela baixa autoestima e pelo sentimento de tristeza e em casos mais graves comportamento suicida (Babae et al., 2021; Ceballos-Ospino et al., 2019). Essa definição corrobora com o que é apontado pelos manuais diagnósticos como a CID-10 (OMS, 1994) e o DSM-5-TR (APA, 2023) que apontam alguns sintomas relacionados a depressão como humor deprimido, vazio ou irritável, seguido de alterações somáticas, perda de prazer e energia.
Cabe salientar que a depressão se apresenta como um dos transtornos mais comuns na população adolescente (OMS, 2019). Uma revisão sistemática realizada com 23 estudos e dados de 57.927 crianças e adolescentes identificou uma prevalência de depressão em 29 % da amostra (Ma et al., 2021). Ademais, deve-se considerar que a depressão nessa população é motivo de preocupação, tendo em conta que os sintomas são duradouros e causam prejuízos no processo de desenvolvimento humano, afetando várias funções e provocando danos psicossociais (Clayborne et al., 2019; Couto et al., 2021).
Diante do exposto, cabe acrescentar que a maioria dos estudos realizados não tem como foco de investigação as consequências do bullying para os perpetradores. No estudo de revisão conduzido por Lutrick et al. (2020) os autores investigaram a prevalência de sintomas depressivos em vítimas de bullying. Foram selecionados 17 estudos. Todos os estudos encontrados demonstraram relação entre vitimização de bullying e depressão em crianças e adolescentes. Além disso, a literatura destaca a relação bidirecional entre bullying e depressão, em que o envolvimento com bullying pode aumentar os sintomas depressivos o que pode deixar o indivíduo vulnerável a novos casos de bullying (Klomek et al., 2019).
Esses dados, evidenciam a necessidade de explorar as pesquisas científicas dos últimos anos que tem abordado como objeto de estudo a prevalência de depressão em perpetradores de bullying. Nesse sentido, a presente revisão busca responder a seguinte pergunta de pesquisa: qual a relação entre bullying e depressão em perpetradores de faixa etária infantil e adolescente no contexto escolar? Assim, o objetivo geral desse estudo é conhecer a relação entre perpetração de bullying e depressão em crianças e adolescentes no contexto escolar.
Materiais e Método
O desenho do estudo foi realizado através da estratégia mnemônica População, Conceito e Contexto (PCC), que auxilia na identificação dos principais tópicos da pesquisa (Parker et al., 2021). A partir da PCC definiu-se a pergunta de pesquisa desse estudo: em População elencou-se as crianças e adolescentes; o Conceito englobou a relação entre perpetração de bullying e depressão; e o Contexto publicações de pesquisas nos últimos 5 anos (2018-2022). Nesses termos, para atender a proposta do estudo foi desenhado o procedimento metodológico de revisão de escopo (scoping review) em consonância com o protocolo de Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Assim, a scoping review é um tipo de estudo que visa realizar um levantamento da literatura disponível sobre uma temática específica (Grant & Booth, 2009).
Fontes de informação
Para a etapa de busca na literatura foram estabelecidas as bases de dados: PsycInfo, Medline, PsycArticles e Scopus. Os artigos que não estavam disponíveis na íntegra foram solicitados diretamente aos autores através do Researchgate. A busca mais recente foi realizada no dia 03 de maio de 2022.
Estratégia de busca
A estratégia de busca utilizada foi: (perpetrators OR agressor) AND (bullying OR cyberaggression OR Cyberbullies OR bull*) AND (depression) AND (adolescente OR children) AND (educational OR school OR students).
Critérios de elegibilidade
Utilizou-se como critério de exclusão as publicações enquadradas nas seguintes características: teses de doutorado, dissertações de mestrado, trabalhos de conclusão de curso, capítulos de livro, estudos com participantes da amostra apresentando idade acima de 18 anos, revisões em geral e estudos de caso. Os critérios de inclusão foram: pesquisas que abordam diretamente o contexto escolar; estudos que falam da relação direta entre perpetração/perpetração-vitimização de bullying e depressão em crianças e adolescentes. Foi estabelecido também a coorte temporal em que os artigos foram publicados: últimos cinco anos (2018 a abril de 2022). O período de interesse justifica-se pela necessidade de averiguar o que tem sido publicado a respeito da temática na atualidade, sendo provável que as publicações de anos anteriores constem em outras revisões.
Seleção de fontes de evidência
O resultado das buscas foi exportado para o software Rayyan-Intteligent Systematic Review, especializado no tratamento de dados para estudos de revisão. Na primeira etapa da seleção foi realizado a exclusão dos artigos duplicados. Na segunda etapa, dois revisores avaliaram independentemente títulos e resumos. Após isso, o texto na íntegra dos artigos considerados relevantes ou pouco claros foram avaliados por dois revisores usando um formulário padronizado, as discrepâncias foram resolvidas por consenso ou por terceiros.
Itens dos dados e síntese dos resultados
Os principais dados extraídos foram nome dos autores, ano, tamanho da amostra, idade dos participantes, contexto do bullying (bullying tradicional ou cyberbullying), instrumentos utilizados para coleta de dados, tipo de estudo e país de origem. Os resultados foram apresentados conforme dois eixos temáticos: relação preditora e bidirecional entre perpetração de bullying e depressão e associações entre perpetração de bullying e depressão.
Resultados
As buscas foram realizadas em cada uma das bases de dados de acordo com os critérios supracitados, o que gerou como resultados iniciais 315 publicações, sendo 80 artigos pela PsycInfo; 146 artigos pela Medline e 86 artigos pela Scopus. Ao fim do processo de localização e filtragem dos artigos, observou-se que dos 315 artigos, 96 artigos estavam duplicados, e por esse motivo foram excluídos, restando 219 publicações. Após a leitura de títulos e resumos, e atendendo aos critérios de seleção do material encontrado, restaram 53 publicações científicas, 43 foram lidas na íntegra e 10 foram excluídas por estarem indisponíveis. Assim, 26 artigos foram considerados adequados para o estudo atual (Figura 1).
Figura 1: Fluxograma da seleção dos estudos
Os 26 estudos selecionados para análise foram selecionados de acordo com os critérios de elegibilidade. A avaliação e síntese das informações referentes ao material da presente revisão serão demonstradas na Tabela 1.
Tabela 1: Descrição dos estudos
No que diz respeito ao contexto de bullying, 9 estudos avaliaram especificamente o cyberbullying, 13 apenas o bullying tradicional (ou face a face) e 5 cyberbullying e bullying tradicional juntos. No que tange ao papel de bullying, selecionou-se estudos que tratam de dois tipos, perpetrador (exceto, Huang et al., 2021) e perpetrador-vítima (indivíduos que assumem os dois papéis; Chou et al., 2020; Le et al., 2019; Hong et al., 2019; Huang et al., 2021; Wu et al., 2021). Vale ressaltar que apenas 1 estudo (Huang et al., 2021) analisou apenas a perpetração-vitimização, todos os demais analisaram essa variável e a perpetração em conjunto ou apenas a perpetração.
Quanto ao tipo de estudo e de bullying, os estudos mostraram-se diversificados. Desse modo, no tipo de estudo, 18 são quantitativos, sendo que 17 são transversais e 1 caso-controle (Uçary et al., 2020). Ademais, 9 estudos são longitudinais (Turliuc et al., 2020; Wu et al., 2021; Walters & Espelage, 2018; He et al., 2022; Chicoine et al., 2021; Zhang et al., 2020; Le et al., 2019; Huang et al., 2021; Hong et al., 2019).
Com relação a origem dos estudos, identificaram-se diferentes locais: China (He et al., 2022; Huang et al., 2021; Tian et al., 2018; Wang et al., 2020; Wu et al., 2021; Zhang et al., 2020); Romênia (Boca-Zamfir & Turliuc, 2020; Turliuc et al., 2020); Estados Unidos (Benton et al., 2021; Walters & Espelage, 2018); Turquia (Uçary et al., 2020); Canadá (Chicoine et al., 2021; Holfeld et al., 2019); Espanha (Cañas et al., 2019; Estevez et al., 2019); Paquistão (Mansoor & Shahzad, 2020; Naveed et al., 2019); Itália (Donato et al., 2021); Taiwan (Chou et al., 2020; Hu et al., 2019; Liu et al., 2021) ; Suécia (Hellfeldt et al., 2020); Bolívia (Garaigordobil et al., 2020); Vietnã (Le et al., 2019); Coreia do Sul (Hong et al., 2019); País Vasco (Garaigordobil & Larrain, 2020).
Quanto as categorias de análise foram selecionadas duas: 1. Relação preditora e bidirecional entre perpetração de bullying e depressão; 2. Associações entre perpetração de bullying e depressão. Os detalhes podem ser analisados na Tabela 2.
Tabela 2: Categorias de análise obtidas a partir dos resultados dos estudos
Relação peditora e bidirecional entre perpetração de bullying e depressão.
Nessa categoria foram incluídos 10 artigos que avaliaram as relações bidirecionais entre perpetração de bullying na depressão e vice e versa: perpetração-vitimização predizendo depressão (Le et al., 2019; Wu et al., 2021); perpetração predizendo depressão (He et al., 2022; Liu et al., 2021; Tian et al., 2018; Turliuc et al., 2020; Wu et al., 2021; Zhang et al., 2020); depressão predizendo perpetração (He et al., 2022; Turliuc et al., 2020; Walters & Espelage, 2018; Zhang et al., 2020); depressão predizendo perpetração-vitimização (Huang et al., 2021).
Associações entre perpetração de bullying e depressão.
Nessa categoria foram incluídos 16 estudos que identificaram associações entre as variáveis: perpetração-vitimização e depressão (Chou et al., 2020; Hong et al., 2019); perpetração e depressão (Benton et al., 2021; Boca-Zamfir & Turliuc, 2020; Cañas et al., 2019; Chou et al., 2020; Donato et al., 2021; Estevez et al., 2019; Garaigordobil et al., 2020; Garaigordobil & Larrain, 2020; Hellfeldt et al., 2020; Holfeld et al., 2019; Hong et al., 2019; Hu et al., 2019; Mansoor & Shahzad, 2020; Naveed et al., 2019; Uçary et al., 2020; Wang et al., 2020).
Discussão
Muita atenção vem sendo dada a questão do bullying em crianças e adolescentes, nesse cenário, a relação entre perpetração do bullying e depressão se mostra relevante. Nos 26 estudos incluídos nessa revisão houve considerável variação nas medidas e resultados citados. Nas pesquisas, as análises de dados são quantitativas. Além disso, as amostras são, em sua maioria, de adolescentes.
A relação preditora entre perpetração e depressão se apresentou de forma bidirecional. A perpetração/perpetração vitimização como variável preditora da depressão, foi identificada (He et al., 2022; Le et al., 2019; Liu et al., 2021; Turliuc et al, 2020; Wu et al., 2021; Zhang et al., 2020). Esses dados estão de acordo com o modelo de risco interpessoal que em síntese aponta que o envolvimento com bullying leva a depressão (Krygsman & Vaillancourt, 2017; Ttofi et al., 2011). A depressão como variável preditora de perpetração/perpetração vitimização obteve resultados significativos (Huang et al., 2021; Zhang et al., 2020) e estão em consonância com o modelo orientado por sintomas, que afirma que primeiro os jovens ficam deprimidos para só depois se envolverem em bullying (Wu et al., 2021; Krygsman & Vaillancourt, 2017). Mas, apenas Zhang et al. (2020) identificaram relações bidirecionais significativas em um único estudo. Esse resultado é coerente com o modelo transacional em que perpetração/perpetração vitimização e depressão se predizem mutuamente (Kaltiala-Heino et al., 2010; Krygsman & Vaillancourt, 2017).
Outros dados relevantes são apontados nos estudos. He et al. (2022) identificou a perpetração como preditora de menores níveis de depressão e maior qualidade de sono. Isso pode ser explicado por um status positivo associado a perpetração (Palomares-Ruiz et al., 2019; Wu et al., 2021), que levaria a melhores índices de saúde mental (Valera-Pozo et al., 2021). No que tange aos papeis no bullying, apesar de a literatura distinguir vítimas de perpetradores, alguns autores afirmam que no decorrer do tempo os papéis no bullying tendem a se sobrepor uns aos outros (Demaray et al., 2021; Zych et al., 2020). Nesse sentido, Huang et al. (2021) identificou que a depressão é preditora da transição entre papéis de bullying.
A associação significativa entre perpetração/perpetração-vitimização de bullying e depressão foi identificada (Mansoor & Shahzad, 2020; Wang et al., 2020). Alguns estudos identificaram: maiores níveis de perpetração de cyberbullying associada a maior depressão (Cañas et al., 2019); maiores níveis de depressão em perpetradores quando comparados a não perpetradores (Garaigordobil et al., 2020; Hong et al., 2019); maiores índices de depressão em perpetradores-vítimas (Chou et al., 2020); maior depressão em vítimas quando comparados aos perpetradores (Donato et al., 2021; Estevez et al., 2019). Notadamente, existem pesquisas que evidenciam os efeitos à saúde mental nos indivíduos (Baier et al., 2018) em todos os papeis, quais sejam vítimas, perpetradores, perpetradores-vítimas e testemunhas.
Além disso, foram identificadas relações com outras variáveis: maior depressão em vítimas e perpetradores não heterossexuais quando comparados aos heterossexuais (Garaigordobil & Larrain, 2020); angústia no funcionamento psicossocial como variável mediadora entre perpetração-vitimização e depressão (Naveed et al., 2019); apoio social da família, amigos e professores reduzindo a probabilidade de sintomas depressivos em perpetradores-vítimas e vítimas (Hellfeldt et al., 2020). Esses resultados são corroborados em estudos que indicam relações entre o bullying e aspectos diversos como características familiares, transtornos psicológicos, sexualidade, gênero e dificuldades psicossociais que resultam em implicações diretas à saúde mental de estudantes (Gower et al., 2022; Luo et al., 2022; Nocentini et al., 2019; Ringdal et al., 2020).
Outras pesquisas reportaram níveis altos de perpetração de bullying em adolescentes com depressão. Foram encontrados níveis mais altos de envolvimento com bullying (Benton et al., 2021), vícios em internet e jogos virtuais em adolescentes deprimidos (Uçary et al., 2020). Na literatura, o uso problemático de internet é diretamente relacionado ao cyberbullying (Vessey et al., 2022) e variáveis como o desengajamento moral podem estar relacionadas (Maftei et al., 2022).
Dentre os estudos, incluídos nessa revisão alguns apontaram relações não significativas entre as variáveis de interesse (Boca-Zamfir & Turliuc, 2020; Chicoine et al., 2021; He et al., 2022; Holfeld et al., 2019; Hu et al., 2019; Le et al., 2019; Tian et al., 2018; Turliuc et al., 2020; Walters & Espelage, 2018; Zhang et al., 2020). Esses resultados podem estar relacionados a presença de variáveis intervenientes que podem impactar os desfechos como problemas de sono (He et al., 2022), regulação emocional (Turliuc et al., 2020), apoio social (Chicoine et al., 2021) e vitimização anterior (Walters & Espelage, 2018).
Conclusões
Este estudo, teve como objetivo realizar um estudo exploratório por meio de uma revisão de escopo com o intuito de conhecer a relação entre perpetração de bullying e depressão em crianças e adolescentes no contexto escolar. A pesquisa se mostra relevante pois apesar de haver revisões que abordam saúde mental e bullying (Hamm et al., 2015; Lutrick et al., 2020), nenhuma revisão sobre perpetradores e depressão foi encontrada.
A análise dos estudo revelou que perpetração de bullying e depressão se associam de diferentes maneiras, preditiva e correlacional. Além disso, questões sexuais e de gênero, angústia no funcionamento psicossocial e apoio social se apresentaram como variáveis relacionadas a esse contexto.
Esta revisão fornece informações importantes para profissionais da saúde e educação sobre a relação entre perpetração de bullying e depressão em crianças e adolescentes que podem ajudar a subsidiar estratégias de intervenção. Assim, esse estudo chama a atenção para a presença de processos de adoecimento psicológico no perpetrador de bullying. Nesse sentido, intervenções antibullying para perpetradores devem incluir estratégias para identificação e mitigação de sintomatologia depressiva. Por exemplo, propostas que incentivem o apoio social podem ser incluídas, visto que, a literatura aponta para seu potencial mitigador no envolvimento com bullying (Tzani-Pepelasi et al., 2019; Zych et al., 2021) e na depressão associada a perpetração de bullying (Hellfeldt et al., 2020).
Por fim, apesar das contribuições essa pesquisa não é isenta de limitações. Indica-se que os estudos não foram avaliados quanto a qualidade metodológica. Além disso, os dados não foram avaliados quanto ao impacto de variáveis intervenientes. Por fim, a maioria dos estudos utilizou medidas de autorelato que podem produzir vieses de resposta. Esses aspectos podem alterar a relação entre perpetração e depressão identificada nessa pesquisa. Portanto, esse estudo deve ser compreendido a luz de seu objetivo geral que foi realizar uma revisão exploratória sobre o tema. Nessa linha, sugere-se que outras revisões mais robustas (e.g., revisão sistemática e metanálise) sejam realizadas incluindo análise crítica dos estudos e a identificação de possíveis variáveis mediadoras e moderadoras da relação com vistas a avançar na compreensão do fenômeno.
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Como citar: de Araújo, G. R., Rodrigues da Costa, W., de Assis Freire, S. E., Negreiros, F., & Medeiros, E. D. (2023). Perpetração de bullying e depressão em crianças e adolescentes: uma revisão de escopo. Ciencias Psicológicas, 17(2), e-2952. https://doi.org/10.22235/cp.v17i2.2952
Participação dos autores: a) Planejamento e concepção do trabalho; b) Coleta de dados; c) Análise e interpretação de dados; d) Redação do manuscrito; e) Revisão crítica do manuscrito.
G. R. A. contribuiu em a, b, c, d, e; W. R. C. em a, b, c, d, e; S. E. A. F. em a., e; F. N. em a, e; E. D. M. em e.
Editora científica responsável: Dra. Cecilia Cracco.
10.22235/cp.v17i2.2952
Original Articles
Perpetration of bullying and depression in children and adolescents: a scoping review
Perpetração de bullying e depressão em crianças e adolescentes: uma revisão de escopo
Perpetración del bullying y depresión en niños y adolescentes: una revisión de alcance
Gleyde Raiane de Araújo1, ORCID 0000-0002-0680-1250
Wesley Rodrigues da Costa2, ORCID 0000-0001-9124-2248
Sandra Elisa de Assis Freire3, ORCID 0000-0003-1083-6963
Fauston Negreiros4, ORCID 0000-0003-2046-8463
Emerson Diógenes de Medeiros5, ORCID 0000-0002-1407-3433
1 Universidade Federal do Delta do Parnaíba, Brazil, gleydearaujo@hotmail.com
2 Universidade Federal do Delta do Parnaíba, Brazil
3 Universidade Federal do Delta do Parnaíba, Brazil
4 Universidade de Brasília, Brazil
5 Universidade Federal do Delta do Parnaíba, Brazil
Abstract:
This study represents a scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. The aim of this research was to explore the relationship between bullying perpetration and depression among children and adolescents in the school context. Searches were conducted in the PsycInfo, Medline, PsycArticles, and Scopus databases, with a temporal scope of the last five years. A total of 315 publications were initially identified, and after screening, 26 were included. Among the findings, a bidirectional and correlational predictive relationship between perpetration and depression was identified. Furthermore, other intra- and interindividual variables appear to be related to this context. It is suggested that antibullying interventions for perpetrators should include strategies for the identification and mitigation of psychological distress, specifically depression.
Keywords: perpetration of bullying; depression; children; adolescents; bullying.
Resumo:
O presente estudo consiste em uma revisão de escopo em consonância com o protocolo de Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Assim, a pesquisa objetivou conhecer a relação entre perpetração de bullying e depressão em crianças e adolescentes no contexto escolar. As pesquisas foram realizadas nas bases PsycInfo, Medline, PsycArticles e Scopus, com o recorte temporal dos últimos 5 anos. Ao todo foram encontradas 315 publicações e após triagem 26 foram incluídas. Dentre os resultados, identificou-se a relação preditora bidirecional e correlacional entre perpetração e depressão. Além disso, outras variáveis intra e interindividuais parecem estar relacionadas a esse contexto. Indica-se que intervenções antibullying para perpetradores incluam estratégias para identificação e mitigação de sofrimento psicológico, especificamente a depressão.
Palavras-chave: perpetração de bullying; depressão; crianças; adolescentes; bullying.
Resumen:
Este estudio consiste en una revisión de alcance de acuerdo con los protocolos de Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Así, la investigación tuvo como objetivo evaluar la relación entre la perpetración de bullying y la depresión en niños y adolescentes en el contexto escolar. Se llevaron a cabo búsquedas en las bases de datos PsycInfo, Medline, PsycArticles y Scopus, con un límite temporal de los últimos 5 años. En total, se encontraron 315 publicaciones y, tras la selección, se incluyeron 26. Entre los resultados, se identificó una relación predictiva bidireccional y correlacional entre la perpetración y la depresión. Además, otras variables intra e interindividuales parecen estar relacionadas con este contexto. Se indica que las intervenciones antibullying para los perpetradores deben incluir estrategias para identificar y mitigar el sufrimiento psicológico, específicamente la depresión.
Palabras clave: perpetración del bullying; depresión; niños; adolescentes; bullying.
Received: 18/07/2022
Accepted: 27/09/2023
In recent years, bullying has become a public health issue due to its impact on school-age children and adolescents, leading to serious health consequences. This phenomenon constitutes a subcategory of violence, characterized by intentional aggressive and repetitive behavioral actions, often involving an imbalance of power (Olweus, 2011, 2013). Bullying is a prevalent issue worldwide; for example, a study conducted in 65 countries identified a prevalence rate of 32.03 % (Man et al., 2022). In Brazil, the literature review by Garaigordobil et al. (2019) indicates that bullying involvement rates reach 49.9 % for victims and 34.9 % for perpetrators.
Bullying can be understood from the perspective of the abuse of physical or psychological power among peers, manifested through behaviors and actions that involve dominance by the aggressor and feelings of helplessness, fear, anger, humiliation, and submission by the victim (Olweus, 2013; Walters, 2020). Specifically in the school context, these actions can take the form of hurtful comments, physical aggression, social exclusion, name-calling, humiliation, and other forms that can negatively affect the academic lives of victims (Granado et al., 2021; Hutzell & Payne, 2018). In summary, bullying can be characterized by three criteria: intentionally harmful aggressive behaviors; recurring persecution; and an unequal power dynamic between individuals, characterized by domination (Monteiro et al., 2017; Olweus, 1994, 2011).
Furthermore, bullying practices can be direct (e.g., insults, name-calling, physical aggression, among others), which can be further subdivided into physical (related to threats or direct physical contact) and verbal (where the perpetrator uses derogatory comments to defame the victim) (Cho et al., 2018). Alternatively, bullying can manifest indirectly through relational bullying (exclusion and isolation of an individual from the group and spreading rumors to harm the victim's reputation) (Granado et al., 2021; Kennedy, 2019) and cyberbullying (considered by some authors as a type of bullying that occurs in virtual environments) (Kennedy, 2019; Walters, 2020; Xie et al., 2023), which emerged with the advent of information technology.
In the practice of bullying, different social actors can be characterized as: a) authors/perpetrators, those who engage solely in bullying (Chicoine et al., 2021); b) those who suffer and are targets of bullying, i.e., the victims; those who suffer and engage in bullying, characterized as victim-perpetrators of bullying; and finally, witnesses who coexist in the environment where bullying occurs, witnessing it but neither suffering nor engaging in bullying (Palomares-Ruiz et al., 2019; Zych et al., 2020).
Previous studies point to possible consequences of involvement in bullying, such as decreased academic performance, aggressiveness, self-harm, depression, among other individual and relational problems (Bokhari et al., 2022; Hutzell & Payne, 2018). For example, Santos et al. (2015) investigated factors related to bullying from the perspective of elementary school teachers and students and identified four categories of bullying consequences: physical aspects, psychological aspects, impacts on learning, and interpersonal problems. Furthermore, it has been found that the effects of bullying experienced during childhood and adolescence can extend into adulthood (Monteiro et al., 2020; Nikolaou, 2021; Ttofi et al., 2011).
These findings highlight the seriousness of the impacts caused by this phenomenon. In the context of this study, greater attention should be given to aspects related to depression, which includes the loss of interest and pleasure in everyday activities, followed by low self-esteem and feelings of sadness, and, in more severe cases, suicidal behavior (Babae et al., 2021; Ceballos-Ospino et al., 2019). This definition aligns with what is indicated by diagnostic manuals such as ICD-10 (WHO, 1994) and DSM-5-TR (APA, 2023), which point to symptoms related to depression, such as a depressed or irritable mood, followed by somatic changes, loss of pleasure, and energy.
It is worth noting that depression is one of the most common disorders in the adolescent population (WHO, 2019). A systematic review conducted with 23 studies and data from 57,927 children and adolescents identified a prevalence of depression in 29 % of the sample (Ma et al., 2021). Moreover, depression in this population is a cause for concern, considering that the symptoms are long-lasting and cause disruptions in human development, affecting various functions and causing psychosocial harm (Clayborne et al., 2019; Couto et al., 2021).
Given the above, it should be added that most studies do not focus on investigating the consequences of bullying for the perpetrators. In the review study conducted by Lutrick et al. (2020), the authors investigated the prevalence of depressive symptoms in bullying victims. Seventeen studies were selected, and all of them demonstrated a relationship between bullying victimization and depression in children and adolescents. Furthermore, the literature highlights the bidirectional relationship between bullying and depression, where involvement in bullying can increase depressive symptoms, making the individual vulnerable to new cases of bullying (Klomek et al., 2019).
These data highlight the need to explore recent scientific studies focusing on studying the prevalence of depression in bullying perpetrators. In this regard, the present review seeks to answer the following research question: what is the relationship between bullying and depression in child and adolescent perpetrators in the school context? Thus, the general objective of this study is to understand the relationship between bullying perpetration and depression in children and adolescents in the school context.
Materials and method
The study design was based on the Population, Concept, and Context (PCC) mnemonic strategy, which helps identify the main research topics (Parker et al., 2021). Using the PCC strategy, the research question for this study was defined as follows: in Population, children and adolescents were included; Concept encompassed the relationship between bullying perpetration and depression; and Context included research publications from the last 5 years (2018-2022). Accordingly, to meet the study's objectives, a scoping review methodology was designed, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) protocol. A scoping review is a type of study that aims to survey the available literature on a specific topic (Grant & Booth, 2009).
Information sources
For the literature search, the following databases were used: PsycInfo, Medline, PsycArticles, and Scopus. Articles that were not available in full text were requested directly from the authors through Researchgate. The most recent search was conducted on May 3, 2022.
Search strategy
The search strategy used was: (perpetrators OR agressor) AND (bullying OR cyberaggression OR Cyberbullies OR bull*) AND (depression) AND (adolescente OR children) AND (educational OR school OR students).
Eligibility criteria
The exclusion criteria included publications that fell into the following categories: doctoral theses, master's dissertations, undergraduate final papers, book chapters, studies with participants over 18 years old, general reviews, and case studies. The inclusion criteria were studies directly related to the school context and addressing the direct relationship between bullying perpetration/perpetration-victimization and depression in children and adolescents. The temporal cohort for article publication was also established: the last five years (2018 to April 2022). This time frame was chosen to investigate recent publications on the topic, as earlier publications are likely covered in other reviews.
Selection of evidence sources
The search results were exported to the Rayyan – Intelligent Systematic Review software, specialized in data handling for review studies. In the first selection stage, duplicate articles were excluded. In the second stage, two reviewers independently assessed titles and abstracts. Afterward, the full text of articles considered relevant or unclear was assessed by two reviewers using a standardized form, with discrepancies resolved through consensus or by involving a third party.
Data items and synthesis of results
The main data extracted included author names, year, sample size, participants' age, bullying context (traditional bullying or cyberbullying), data collection instruments, study type, and country of origin. The results were presented based on two thematic axes: the predictive and bidirectional relationship between bullying perpetration and depression, and associations between bullying perpetration and depression.
Results
The searches were conducted in each of the databases according to the criteria mentioned above, which initially yielded 315 publications as results. Specifically, there were 80 articles from PsycInfo, 146 articles from Medline, and 86 articles from Scopus. After the process of locating and filtering the articles, it was observed that out of the 315 articles, 96 were duplicates and were therefore excluded, leaving 219 publications. Following the review of titles and abstracts, and in accordance with the selection criteria for the material we found, 53 scientific publications remained. Of these, 43 were read in full, and ten were excluded as they were unavailable. Consequently, 26 articles were deemed suitable for the current study (Figure 1).
Figure 1: Flowchart of Study Selection
The 26 studies selected for analysis were chosen based on eligibility criteria. The assessment and synthesis of information related to the material in this review will be presented in Table 1.
Table 1: Description of studies
Regarding the bullying context, nine studies specifically assessed cyberbullying, 13 focused solely on traditional bullying (or face-to-face bullying), and five examined both cyberbullying and traditional bullying together. Concerning the role in bullying, the studies selected addressed two types: perpetrator (except for Huang et al., 2021) and perpetrator-victim (individuals who assume both roles; Chou et al., 2020; Le et al., 2019; Hong et al., 2019; Huang et al., 2021; Wu et al., 2021). It is worth noting that only one study (Huang et al., 2021) analyzed only perpetration-victimization, while all others analyzed this variable and perpetration together or only perpetration.
Regarding the type of study and bullying, the studies were diverse. In terms of study type, 18 were quantitative, with 17 being cross-sectional and one case-control study (Uçary et al., 2020). Additionally, nine studies were longitudinal (Chicoine et al., 2021; He et al., 2022; Hong et al., 2019; Huang et al., 2021; Le et al., 2019; Turliuc et al., 2020; Walters & Espelage, 2018; Wu et al., 2021; Zhang et al., 2020).
Regarding the origin of the studies, various locations were identified: China (He et al., 2022; Zhang et al., 2020; Tian et al., 2018; Huang et al., 2021; Wang et al., 2020; Wu et al., 2021); Romania (Boca-Zamfir & Turliuc, 2020; Turliuc et al., 2020); United States (Benton et al., 2021; Walters & Espelage, 2018); Turkey (Uçary et al., 2020); Canada (Chicoine et al., 2021; Holfeld et al., 2019); Spain (Cañas et al., 2019; Estevez et al., 2019); Pakistan (Mansoor & Shahzad, 2020; Naveed et al., 2019); Italy (Donato et al., 2021); Taiwan (Chou et al., 2020; Hu et al., 2019; Liu et al., 2021); Sweden (Hellfeldt et al., 2020); Bolivia (Garaigordobil et al., 2020); Vietnam (Le et al., 2019); South Korea (Hong et al., 2019); Basque Country (Garaigordobil & Larrain, 2020).
Regarding the categories of analysis, two were selected: 1. Predictive and bidirectional relationship between bullying perpetration and depression; 2. Associations between bullying perpetration and depression. Details can be analyzed in Table 2.
Table 2: Categories of analysis derived from the results of the studies
Predictive and bidirectional relationship between bullying perpetration and depression
In this category, 10 articles were included, which examined bidirectional relationships between bullying perpetration and depression: perpetration-victimization predicting depression (Le et al., 2019; Wu et al., 2021); perpetration predicting depression (He et al., 2022; Liu et al., 2021; Tian et al., 2018; Turliuc et al., 2020; Wu et al., 2021; Zhang et al., 2020); depression predicting perpetration (He et al., 2022; Turliuc et al., 2020; Walters & Espelage, 2018; Zhang et al., 2020); depression predicting perpetration-victimization (Huang et al., 2021).
Associations between bullying perpetration and depression
In this category, 16 studies were included that identified associations between the variables: perpetration-victimization and depression (Chou et al., 2020; Hong et al., 2019); perpetration and depression (Benton et al., 2021; Boca-Zamfir & Turliuc, 2020; Cañas et al., 2019; Chou et al., 2020; Donato et al., 2021; Estevez et al., 2019; Garaigordobil et al., 2020; Garaigordobil & Larrain, 2020; Hellfeldt et al., 2020; Holfeld et al., 2019; Hong et al., 2019; Hu et al., 2019; Mansoor & Shahzad, 2020; Naveed et al., 2019; Uçary et al., 2020; Wang et al., 2020).
Discussion
Considerable attention has been devoted to the issue of bullying in children and adolescents, and in this context, the relationship between bullying perpetration and depression is of relevance. In the 26 studies included in this review, there was considerable variation in the measures and reported results. In these studies, data analyses are predominantly quantitative, and the samples consist mostly of adolescents.
The predictive relationship between perpetration and depression appeared to be bidirectional. Perpetration/perpetration-victimization as a predictor of depression was identified (He et al., 2022; Le et al., 2019; Liu et al., 2021; Turliuc et al., 2020; Wu et al., 2021; Zhang et al., 2020). These findings are in line with the interpersonal risk model, which suggests that involvement in bullying leads to depression (Krygsman & Vaillancourt, 2017; Ttofi et al., 2011). Depression, as a predictor of perpetration/perpetration-victimization, yielded significant results (Huang et al., 2021; Zhang et al., 2020) and is in line with the symptom-oriented model, in which young individuals become depressed before engaging in bullying (Krygsman & Vaillancourt, 2017; Wu et al., 2021). However, only Zhang et al. (2020) identified significant bidirectional relationships in a single study. This result is consistent with the transactional model in which perpetration/perpetration-victimization and depression mutually predict each other (Kaltiala-Heino et al., 2010; Krygsman & Vaillancourt, 2017).
Other relevant findings are noted in the studies. He et al. (2022) identified perpetration as a predictor of lower levels of depression and improved sleep quality. This may be explained by a positive status associated with perpetration (Palomares-Ruiz et al., 2019; Wu et al., 2021), leading to better mental health outcomes (Valera-Pozo et al., 2021). Regarding roles in bullying, although the literature distinguishes between victims and perpetrators, some authors assert that over time, roles in bullying tend to overlap (Demaray et al., 2021; Zych et al., 2020). In this regard, Huang et al. (2021) identified that depression predicts transitions between bullying roles.
Significant associations between bullying perpetration/perpetration-victimization and depression were identified (Mansoor & Shahzad, 2020; Wang et al., 2020). Some studies found higher levels of cyberbullying perpetration associated with greater depression (Cañas et al., 2019); higher levels of depression in perpetrators compared to non-perpetrators (Garaigordobil et al., 2020; Hong et al., 2019); higher rates of depression in perpetrator-victims (Chou et al., 2020); and greater depression in victims compared to perpetrators (Donato et al., 2021; Estevez et al., 2019). Notably, a number of studies has demonstrated the mental health consequences of bullying in individuals (Baier et al., 2018) who perform all roles, including victims, perpetrators, perpetrator-victims, and bystanders.
Moreover, relationships with other variables were identified: greater depression in non-heterosexual victims and perpetrators compared to heterosexual individuals (Garaigordobil & Larrain, 2020); psychosocial functioning distress as a mediating variable between perpetration-victimization and depression (Naveed et al., 2019); social support from family, friends, and teachers, thus reducing the likelihood of depressive symptoms in perpetrator-victims and victims (Hellfeldt et al., 2020). These results are corroborated by studies indicating relationships between bullying and various factors such as family characteristics, psychological disorders, sexuality, gender, and psychosocial difficulties that result in direct implications for the mental health of students (Gower et al., 2022; Luo et al., 2022; Nocentini et al., 2019; Ringdal et al., 2020).
Other studies have reported high levels of bullying perpetration in adolescents with depression. Higher levels of involvement in bullying (Benton et al., 2021), internet and virtual gaming addiction in depressed adolescents (Uçary et al., 2020) were found. In the literature, problematic internet use is directly related to cyberbullying (Vessey et al., 2022), and variables such as moral disengagement may be associated (Maftei et al., 2022).
Among the studies included in this review, some found non-significant relationships between the variables of interest (Boca-Zamfir & Turliuc, 2020; Chicoine et al., 2021; He et al., 2022; Holfeld et al., 2019; Hu et al., 2019; Le et al., 2019; Tian et al., 2018; Turliuc et al., 2020; Walters & Espelage, 2018; Zhang et al., 2020). These results may be related to the presence of intervening variables that can impact outcomes, such as sleep problems (He et al., 2022), emotional regulation (Turliuc et al., 2020), social support (Chicoine et al., 2021), and prior victimization (Walters & Espelage, 2018).
Conclusions
This study aimed to conduct an exploratory investigation through a scoping review to understand the relationship between bullying perpetration and depression in children and adolescents within the school context. This research is relevant due to the fact that, despite existing reviews addressing mental health and bullying (Hamm et al., 2015; Lutrick et al., 2020), no previous review specifically focusing on perpetrators and depression was found.
The analysis of the studies revealed that bullying perpetration and depression are associated in various ways, including predictive and correlational relationships. Furthermore, issues related to sexuality and gender, distress in psychosocial functioning, and social support emerged as variables relevant to this context.
This review provides valuable insights for healthcare and education professionals regarding the relationship between bullying perpetration and depression in children and adolescents. These insights can help inform intervention strategies. Thus, this study draws attention to the presence of psychological health issues in bullying perpetrators. In this regard, antibullying interventions for perpetrators should incorporate strategies for identifying and mitigating depressive symptoms. For example, approaches that encourage social support may be included, as the literature suggests its potential in reducing involvement in bullying (Tzani-Pepelasi et al., 2019; Zych et al., 2021) and depression associated with bullying perpetration (Hellfeldt et al., 2020).
Finally, despite its contributions, this paper is not without limitations. It is noted that the studies were not assessed for methodological quality. Additionally, the data were not assessed for the impact of intervening variables. Lastly, most studies used self-report measures, which can result in response biases. These aspects may influence the relationship between perpetration and depression identified in this research. Therefore, this study should be interpreted in light of its overarching goal, which was to conduct an exploratory review on the topic. Along these lines, it is recommended that more robust reviews (e.g., systematic reviews and meta-analyses) be conducted, including critical analysis of studies and the identification of potential mediating and moderating variables in the relationship, with the aim of advancing the understanding of this phenomenon.
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How to cite: de Araújo, G. R., Rodrigues da Costa, W., de Assis Freire, S. E., Negreiros, F., & Medeiros, E. D. (2023). Perpetration of bullying and depression in children and adolescents: a scoping review. Ciencias Psicológicas, 17(2), e-2952. https://doi.org/10.22235/cp.v17i2.2952
Authors’ participation: a) Conception and design of the work; b) Data acquisition; c) Analysis and interpretation of data; d) Writing of the manuscript; e) Critical review of the manuscript.
G. R. A. has contributed in a, b, c, d, e; W. R. C. in a, b, c, d, e; S. E. A. F. in a., e; F. N. in a, e; E. D. M. in e.
Scientific editor in-charge: Dra. Cecilia Cracco.