Background: Bullying is a common violence in school and has become a major public health and global concern. Bullying influences mental health and is identified as a leading factor of depression. Therefore, this study aimed to identify bullying prevalence and its association toward psychological disturbances (stress, anxiety, and depression).

Methods: This cross-sectional study was conducted in three secondary schools in Kuantan. After obtaining consent from parents/guardians, participants were asked to answer a self-administered questionnaire, including School Climate Bullying Survey, Depression Anxiety Stress Questionnaire-21, Patient Depression Questionnaire, and Generalized Anxiety Disorder. Demographic data were self-reported. Data were analyzed using SPSS version 20.0, and chi-square and correlation tests were conducted for variables.

Results: A total of 207 students were included in this study. Of respondents, 50.7% were boys and 49.3% girls, and the majority (92.8%) were Malays. Of students, 63.2% were involved in bullying problems through the school years, with verbal bullying as the highest (55.1%). Bullying is significantly associated with stress (p = 0.045), anxiety (p = 0.018), and depression (p = 0.012).

Conclusions: School children in Kuantan continue to be involved in bullying. The current study supported that involvement with any bullying activity was associated with psychological disturbances including anxiety, stress, and depression.


  1. Antiri KO. Types of bullying in the senior high schools in Ghana. J Educ Pract. 2016;7:131–8.
  2. Hymel S, Swearer SM. Four decades of research on school bullying: An Introduction. Am Psychol. 2015;70:293–9.
  3. Cornell DG, Huang FL, Konold TR, Shukla K, Malone M, Datta P, et al. Development of a standard model for school climate and safety assessment: Final report. Charlottesville, VA: Curry School of Education, University of Virginia; 2016
  4. David-Ferdon C, Vivolo-Kantor AM, Dahlberg LL, Marshall KJ, Rainford N, Hall JE. A comprehensive technical package for the prevention of youth violence and associated risk behaviors. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2016.
  5. Copeland WE, Wolke D, Angold A, Costello EJ. Adult psychiatric outcomes of bullying and being bullied by peers in childhood and adolescence. JAMA Psychiatry. 2013;70:419–26.
  6. Juvonen J, Graham S. Bullying in schools: The power of bullies and the plight of victims. Annu Rev Psychol. 2014;65:159–85.
  7. Abdalqader MA, Ariffin IA, Ghazi HF, Baobaid MF, Fadzil MA. The prevalence of bullying and it’s associated factors among one of high school students in Selangor, Malaysia. Malaysian J Public Heal Med. 2018;18:52–6.
  8. Nasheeda A, Hassan NC, Hassan A. Relationships between bullies, victims and mental health issues among adolescents. Maldives Natl J Res. 2017;5:23–44.
  9. Menesini E, Salmivalli C. Bullying in schools: The state of knowledge and effective interventions. Psychol Heal Med. 2017;22:240–53.
  10. Ibrahim N, Mohd Sidik S, Cheng Kar P, Mukhtar F, Awang H, Jin Kiat A, et al. Prevalence and predictors of depression and suicidal ideation among adolescents attending government secondary schools in Malaysia. Med J Malaysia. 2017;72:221–7.
  11. Raosoft.com. Sample size calculator by Raosoft, Inc. Seattle, WA: Raosoft, Inc.; 2004.
  12. Klein J, Cornell D, Konold T. Relationships between bullying, school climate, and student risk behaviors. Sch Psychol Q. 2012;27:154–69.
  13. Nordin R, Kaur A, Soni T, Kean Por L, Miranda S. Construct validity and internal consistency reliability of the Malay version of the 21-item depression anxiety stress scale (Malay-DASS-21) among male outpatient clinic attendees in Johor. Med J Malaysia. 2017;72:264–70.
  14. Jordan P, Shedden-Mora MC, Löwe B. Psychometric analysis of the Generalized Anxiety Disorder scale (GAD-7) in primary care using modern item response theory. PLoS One. 2017;12:e0182162.
  15. Sherina MS, Arroll B, Goodyear-Smith F. Criterion validity of the PHQ-9 (Malay Version) in a primary care clinic in Malaysia. Med J Malaysia. 2012;67:309–15.
  16. Ang JK, Phang CK, Mukhtar F, Osman ZJ, Awang H, Sidik SM, et al. Association between perceived parental style and depressive symptoms among adolescents in Hulu Langat District, Malaysia. Int J Adolesc Med Health. 2018;30:20160130.
  17. Wolke D, Lereya ST. Long-term effects of bullying. Arch Dis Child. 2015;100:879–85.
  18. Chen L, Ho SS, Lwin MO. A meta-analysis of factors predicting cyberbullying perpetration and victimization: From the social cognitive and media effects approach. New Media Soc. 2017;19:1194–213.
  19. Zhou Y, Guo L, Lu CY, Deng JX, He Y, Huang JH, et al. Bullying as a risk for poor sleep quality among high school students in China. PLoS One. 2015;10:121602.
  20. Estévez E, Estévez JF, Segura L, Suárez C. The influence of bullying and cyberbullying in the psychological adjustment of victims and aggressors in adolescence. Int J Environ Res Public Health. 2019;16:2080.
  21. Thomas HJ, Connor JP, Lawrence DM, Hafekost JM, Zubrick SR, Scott JG. Prevalence and correlates of bullying victimisation and perpetration in a nationally representative sample of Australian youth. Aust N Z J Psychiatry. 2017;51:909–20.
  22. Nurumal MS, Zainal Abidin R, Ibrahim WN, Md Isa ML, Che Hasan MK. Obesity is associated with depression in Malaysian schoolchildren: A cross-sectional study. Makara J Health Res. 2020;24:8–12.
  23. Rankin J, Matthews L, Cobley S, Han A, Sanders R, Wiltshire HD, et al. Psychological consequences of childhood obesity: Psychiatric comorbidity and prevention. Adolesc Health Med Ther. 2016;7:125–46.
  24. Shetgiri R. Bullying and victimization among children. Adv Pediatr. 2013;60:33–51.
  25. Lutrick K, Clark R, Nuño VL, Bauman S, Carvajal S. Latinx bullying and depression in children and youth: A systematic review. Syst Rev. 2020;9:126.
  26. Garcia-Hermoso A, Oriol-Granado X, Correa-Bautista JE, Ramírez-Vélez R. Association between bullying victimization and physical fitness among children and adolescents. Int J Clin Heal Psychol. 2019;19:134–40.
  27. Sampasa-Kanyinga H, Willmore J. Relationships between bullying victimization psychological distress and breakfast skipping among boys and girls. Appetite. 2015;89:41–6.
  28. AlBuhairan F, Abou Abbas O, El Sayed D, Badri M, Alshahri S, de Vries N. The relationship of bullying and physical violence to mental health and academic performance: A cross-sectional study among adolescents in Kingdom of Saudi Arabia. Int J Pediatr Adolesc Med. 2017;4:61–5.
  29. Goldweber A, Waasdorp TE, Bradshaw CP. Examining the link between forms of bullying behaviors and perceptions of safety and belonging among secondary school students. J Sch Psychol. 2013;51:469–85.
  30. García-Hermoso A, Hormazabal-Aguayo I, Oriol-Granado X, Fernández-Vergara O, del Pozo Cruz B. Bullying victimization, physical inactivity and sedentary behavior among children and adolescents: A meta-analysis. Int J Behav Nutr Phys Act. 2020;17:114.
  31. Patton DU, Hong JS, Patel S, Kral MJ. A Systematic review of research strategies used in qualitative studies on school bullying and victimization. Trauma Violence Abuse. 2017;18:3–16.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.