The Journal of School Nursing2021, Vol. 37(3) 202-208© The Author(s) 2019Article reuse guidelines:sagepub.com/journals-permissionsDOI: 10.1177/1059840519863845journals.sagepub.com/home/jsn
Bullying and sexual harassment are considered widespread public health concerns because they may have negative effects on physical and mental health. However, more studies are necessary that relate these forms of victimization and their overlap with subjective well-being. This study explores the prevalence and association between different forms of bullying victimization, sexual harassment, and life satisfaction using a sample of 47,114 students aged 16–18 years and from 646 Peruvian educational institutions. Face-to-face bullying was the most reported type of victimization, followed by cyberbullying. There was a large degree of overlap between these two forms of bullying as well as between traditional bullying and sexual harassment. This overlap causes a decrease in life satisfaction in late adolescents. Thus, the need of preventing the negative dynamics of violence in order to prevent the overlapping of different violence forms in adolescence is discussed. Finally, implications for school nurses are outlined.
traditional bullying, cyberbullying, sexual harassment, life satisfaction, late adolescents, school nurses
To date, Peru is still suffering the consequences of the terrorist attacks perpetrated from 1980 to 2000 by the organization Shining Path, in which civilians were subjected to extreme violence (Kalyvas, 2006; Mealy & Austad, 2012). Such a long civil war has caused violence to be embedded in the social structures of the country, affecting the lives, livelihoods, and social relations of Peruvian citizens (Shannon et al., 2017). In this sense, constant exposure to violence in low- and middle-income countries like Peru makes different segments of the population feel violence as a normal pattern in society (Nguyen, Bradshaw, Townsend, & Bass, 2017). Moreover, different studies have shown that exposure to violence in school environments can perpetuate peer violence at schools (Butcher, Holmes, Kretschmar, & Flannery, 2016; Schmidt, Pierce, & Stoddard, 2016). For example, in a recent study conducted on adolescents in Peru, violence perceived by adolescents in their neighborhoods was directly related to bullying in schools (Oriol et al., 2017). Bullying refers to a phenomenon that implies a repeated harmful action in a “systematic abuse of power” by the bully against a victim (Hase, Goldberg, Smith, Stuck, & Campain, 2015). Two types of bullying can be found in the literature: traditional and cyberbullying. Traditional bullying implies face-to-face violent behavior and is divided into verbal (insults, intimidation) and physical (hitting, kicking), while cyberbullying takes places through electronic devices (e.g., insult someone through social media platforms; Wang, Nansel, & Iannoti, 2011). Recent studies show a strong prevalence of bullying and cyberbullying in Peruvian teenagers (Miranda, Oriol, & Amutio, 2019; Oriol et al., 2017). As a consequence, the Peruvian government developed a strategy for reducing school violence, which consisted of an anonymous virtual platform called SiSeVe used to report violent situations at schools (Gutierrez, Molina, & Ñopo, 2018). Although this tool has helped authorities to visualize the magnitude of the bullying problem in Peruvian schools, preventive actions are still lacking, as well as qualified professionals working on the prevention of this problem (Merino, Carozzo, Benites, & Morales, 2011; Miranda et al., 2019).
In addition to bullying, another form of interpersonal violence that occurs frequently and repeatedly in both the Peruvian school community and society in general is sexual harassment (Amerson, 2018). Sexual harassment involves unwanted sexual behavior that can be either verbal or physical (Espelage, Hong, Rinehart, & Doshi, 2016; Turner, Finkelhor, & Ormrod, 2010). Sexual harassment is considered different from bullying, albeit interrelated (Espelage et al., 2016; Espelage & Holt, 2007). For example, during puberty, in early adolescence, bullying has been observed to often become more sexual, turning into sexual harassment (Espelage, Basile, & Hamburger, 2012). In this line, more research on the co-occurrence of these different types of interpersonal victimization among adolescents is necessary (Leemis, Espelage, Basile, Mercer Kollar, & Davis, 2019). In addition, research has shown the repercussions of these forms of violence on adolescent physical and mental health (e.g., Gruber & Fineran, 2008; Rinehart, Espelage, & Bub, 2017). However, more studies should be conducted that relate interpersonal victimization to self-report well-being measures, including satisfaction with life (Fullchange & Furlong, 2016).
Life satisfaction is the cognitive component of subjective well-being (SWB) and thus refers to a general appraisal of a person’s own life (Pavot, Diener, Oishi, & Tay, 2018). Assessing life satisfaction in late adolescence is especially relevant because previous studies show that this component of SWB is related to adaptive psychosocial development and good mental health in this period of life (Cava, Buelga, & Musitu, 2014). Furthermore, some studies have shown that when adolescents suffer traditional forms of bullying, they experience less satisfaction with life (Kerr, Valois, Huebner, & Drane, 2011; Valois, Kerr, & Huebner, 2012) and, consequently, poorer school outcomes (Byrne, Vessey, & Pfeifer, 2018). Similar results have been observed in cyberbullying and life satisfaction, but research is scarce, and most studies are focused on early adolescence (Ramos Salazar, 2017).
Despite the decrease observed in the prevalence of bullying as the adolescent period progresses (Troop-Gordon, 2017), recent findings by Espelage, Basile, Leemis, Hipp, and Davis (2018) indicate that if no actions are taken to prevent bullying from early ages, the perpetuation of this phenomenon during early adolescence will lead to sexual harassment in late adolescence. This could cause the overlapping of different forms of violence, increasing the risk of having mental health problems like major depression (Turner, Shattuck, Finkelhor, & Hamby, 2017; Wang et al., 2011), which can lead to suicide (Alavi et al., 2017). Consequently, further research is needed for a better understanding of the different types of bullying, their overlap with each other, and their impact on SWB in late adolescence. This seems fundamental to set preventive strategies for tackling the perpetuation of different types of violence from early ages. Therefore, the objectives of this study are the following: (1) Examine the prevalence of different forms of bullying victimization, sexual harassment, and their overlap with each other in late adolescents in Peru, and (2) explore the associations between bullying victimization, sexual harassment, and life satisfaction in this adolescence stage.
This study is part of a secondary analysis of existing data from a national survey about school violence conducted by the Ministry of Education of Peru (MINEDU). The level of inference of the sample is of national character. To ensure compliance with ethical guidelines, the Ministry of Education supervised the study design and application by means of a specialized unit formed by different professionals who approved the study based on the recommendations of Helsinki for studies involving human subjects. In this line, protocols for monitoring data collection were created.
In total, 47,114 students from 646 educational institutions are part of this study: 50.9% are men and 49.1% woman between 16 and 18 years of age (M = 16.5, SD = 0.80). The MINEDU administered the questionnaire to high school students. Professionals from different fields went to the schools to administer the questionnaires, following the established protocols. Prior to administration, students signed informed consent forms explaining the objective of the study. MINEDU selected some students from the sample to assess their learning outcomes. The questionnaire was filled in handwriting.
Bullying and sexual harassment victimization. The School Violence Questionnaire (MINEDU) contains a dimension that assesses different types of interpersonal violence. To assess bullying, students are asked about violence episodes suffered during the previous month. Prevalence is calculated based on the following cutoff value: 2 to 4 times and 5 or more times. This is a conservative criterion followed by other studies (e.g., Kowalski & Limber, 2007; Rana, Gupta, Malhi, Grover, & Kaur, 2018) because bullying is a phenomenon recurrent over time. Therefore, the dimension assessing bullying asks adolescents whether they have suffered any form of bullying during the last week, namely traditional bullying (a student insulted you, a student made fun of you, a student hit you with an object, a student hit you without an object) and cyberbullying (a student made fun of you through social networks and a student insult you through social networks).
To assess sexual harassment, the questionnaire enquires about violence episodes suffered during the last year, and in contrast to bullying, prevalence does not imply that this type of violence is constant over time (Espelage, Basile, Leemis, Hipp, & Davis, 2018; e.g., you have been the victim of uncomfortable touching and a student forced you to have sexual intercourse). Responses are evaluated on a 4-point Likert-type scale (0 = none, 1¼ 1 time, 2 = 2 to 4 times, and 3 = 5 to more). Cronbach’s a reported is .79.
Life satisfaction. To measure this construct, the School Violence Questionnaire uses an adaptation of the Satisfaction With Life Scale for Children (Gadermann, Guhn, & Zumbo, 2011), which is composed of 5 items (e.g., In many senses, my life is similar to the life I would like to have). The responses are evaluated on a Likert-type scale ranging from 0 to 4 points (Cronbach’s a = .73) where 0 means totally disagree and 4 totally agree. To build the life satisfaction indicator, the mean base score obtained in each of the 5 items forming the scale was employed.
Cluster analysis was used to classify the reported life satisfaction scores. To categorize life satisfaction levels in an ordinal way, a k-means cluster analysis was conducted using SPSS v22. A Somers’ D was also employed to measure the effect size of a X2 test of independence because the indicators referred to situations of bullying, sexual harassment, and life satisfaction at the ordinal order level.
In addition, ordinal logistic regression was performed to assess the effect of reported aggression forms over life satisfaction cluster groups. Odds ratios and corresponding 95% CIs and p values were calculated for all associations. First, four regressions were conducted, one for each type of violence, taking nonexperienced aggression as a basis to observe how each aggression form affect life satisfaction levels. Second, the same regressions were once more carried out but with student characteristics (sex) and school characteristics (school location and school dependence) as control variables. These variables were included as part of the study conducted by MINEDU.
Sociodemographic data show that sex is almost equally distributed in the sample and that most students are between 16 and 17 years of age. Seventy-four percent of these students attend public schools and 93.5% of them do so in rural areas (Table 1).
Traditional bullying is the most reported type of victimization (22.2%), followed by cyberbullying (8.1%). Additionally, 10.5% of the sample reported having suffered sexual harassment. Regarding the overlap of reported violence, 85.2% of students who suffered cyberbullying also reported being victims of traditional bullying victimization. Moreover, 46.3% of respondents who expressed having experienced sexual harassment claimed to have also suffered traditional bullying victimization simultaneously.
Table 2 shows the prevalence of each type of victimization. For example, in the case of traditional bullying, 30.4% of respondents reported having suffered this type of aggression in isolation, that is, not accompanied by other types of aggression (i.e., cyberbullying or sexual victimization). Likewise, 10.9% expressed having suffered traditional bullying and cyberbullying simultaneously, but not sexual harassment.
Finally, 0.5% of the participants expressed having suffered all types of victimization. Significant differences according to gender are found across types of victimization, with men reporting a higher prevalence in most of the cases, except from cyberbullying. Regarding school location, significant differences are seen between traditional bullying and bullying in general, with urban schools presenting higher levels of this type of violence compared to rural schools. In the case of traditional bullying and sexual harassment, higher levels are reported in public schools, whereas higher cyberbullying levels are found in private schools.
Regarding the segmentation of life satisfaction, the k-media cluster analysis suggests that the first group (n = 13,083; cluster center = 0.74) corresponds to students with a low mean in life satisfaction. The second group (n = 26,032; cluster center = 1.60) consists of students with an average score in life satisfaction, and the third group is formed by students with the highest scores on the Life Satisfaction Scale (n = 7,999; cluster center = 2.87).
As shown in Table 3, students who experienced some type of victimization are more likely to be part of the group with the lowest levels of life satisfaction. Also, by comparing the results between the model without adjustment and the model with the proposed control variables, small differences are found in the results. In the case of students who experienced cyberbullying compared to those who did not suffer any type of aggression, the former is more likely to belong to the group with lower life satisfaction level (OR = 1.78, CI [1.65, 1.91]). The same is true for traditional bullying (OR = 1.82, CI [1.78, 1.86]). Additionally, OR is greater for students who experienced both types of bullying victimization as compared to students experiencing a single form of bullying (OR = 2.09, CI [2.03, 2.15]). Finally, when there is an overlap between different forms of bullying and sexual harassment, there is a 2.5 times greater probability of experiencing less satisfaction with life.
This study is the first to investigate the associations between bullying victimization, sexual harassment, and life satisfaction by means of a secondary analysis of the existing national data on late adolescent students in Peru. Most of the research on bullying has focused on elementary and middle school students, and approaches to intervention in cases of peer sexual harassment have been largely overlooked (Espelage, Low, Ryzin, & Polanin, 2015). Hence, this study aims to contribute data on the different types of interpersonal violence during these years of adolescence, filling a gap in the existing literature.
Our data show a lower prevalence of both traditional bullying and cyberbullying in comparison with that observed in early adolescents in previous studies conducted in Peru (Miranda et al., 2019; Oriol et al., 2017). However, these data still represent a medium to high prevalence of both forms of bullying, considering also that the prevalence peaks of bullying victimization occur in early adolescence and decrease progressively as the adolescent period progresses (Byrne et al., 2018). Although Peru has important problems of male sexual aggression against women as well as femicide (Moyano, Monge, & Sierra, 2017), our study shows only a 10% prevalence of sexual harassment. This might be due to the fact that Peruvian society is still a very patriarchal society where men’s violent behavior toward women is implicitly justified (Aiquipa, 2015). Specifically, the estimated percentage of social tolerance to violence against women in Peru is 54.8% (Instituto Nacional de Estadística e Informática, 2016).
Traditional bullying is the type of victimization that showed the highest prevalence followed by cyberbullying and sexual harassment in late adolescence. It is noteworthy the existing high overlap between different forms of traditional bullying and cyberbullying, and between traditional bullying and sexual harassment. In this sense, it is especially concerning that more than 90% of adolescents who reported having suffered sexual harassment claimed to have suffered traditional bullying victimization simultaneously.
Results for this sample show that although in many studies both types of victimization are considered separately, there is an important overlap between bullying and sexual harassment in this adolescence stage. Additionally, when adolescents suffer any type of victimization, their perception of life satisfaction worsens in comparison with adolescents who have not suffered victimization. Moreover, victims of traditional bullying showed a greater negative impact on life satisfaction than victims of cyberbullying, and these results worsen when observing the overlap between both forms. Furthermore, when different forms of bullying and sexual harassment overlap, life satisfaction is lower than when adolescents experience only one type of victimization.
Following the considerations proposed by the bullysexual violence pathway theory (Espelage et al., 2018), parents, school staff, and health-care professionals need to intensify the efforts to decrease bullying victimization in childhood in order to avoid the overlap between different forms of interpersonal violence in late adolescence (Doty, Gower, Rudi, McMorris, & Borowsky, 2017; Espelage et al., 2016; Miranda, Oriol, Amutio, & Ortuzar, 2019).
It should be noted that the data provided come from a secondary analysis of the existing national data and thus data collection was restricted. In future research, traditional bullying should be assessed considering a bigger quantity of items for each bullying type to enhance data robustness. A second limitation is that the instrument does not comprise other core element of bullying, particularly power imbalance. Additionally, more comprehensive instruments are needed to assess sexual harassment, that is, instruments that take into account its different forms as pointed out in other studies (Vega-Gea, Ortega-Ruiz, Sánchez, 2016). Relying on students to disclose that they are being bullied is also likely to result in an underestimate of the incidence of actual bullying behavior (Lee, 2018; Smith & Norris, 2018). Finally, more studies are needed on the relationship between overlapped forms of victimization and the components of SWB.
The results of this study provide insights for health professionals at schools. The repercussions of different types of interpersonal violence and their overlap with SWB in late adolescence make it necessary to implement preventive policies at school from early ages. This is key to stop the progressive decrease in SWB during adolescence. In this sense, health professionals face important challenges, which are (1) obtaining deep knowledge of different types of violence such as bullying and sexual harassment (including dating abuse) to build close relationships with adolescents, identify these situations, and make effective interventions in case of them; (2) increasing the awareness of SWB in the educative community, specifically targeting parents, teachers, management, and school staff, so they understand the need of reducing the risk factors for this construct—for example, the different types of violence studied in this article—and potentiating the factors that promote SWB. In connection, health professionals can also engage in prevention and contribute to change school culture, promoting a good and safe school climate, for instance, by assisting the design of policies and protocols that can help reduce victimization rates.
In countries like Peru, where there is a high prevalence of interpersonal violence such as bullying and sexual harassment in the contexts in which adolescents socialize, professionals should participate in the educational system to develop preventive strategies such as the ones above. Furthermore, incorporating professionals from new fields like school nurses would also be helpful, as they stand in a unique position to identify the impact of bullying and sexual harassment on the physical and mental health of victims (Hendershot, Dake, Price, & Lartey, 2006). In addition, they can establish bonds of trust to build close relationships with the victims because they do not fulfill any authoritarian or academic role (Pigozi & Jones Bartoli, 2016).
This information was available at the First National Contest “Investigating School Violence in Peru” promoted by the Ministry of Education of Peru.
We would like to thank the Ministry of Education of Peru and think tank Group for the Analysis of Development (GRADE) for sharing this database for promoting more Peruvian research about this topic.
All authors contributed to the conception of the article, acquisition as well as analysis of the data, drafting of the article along with the critical revisions. All agree to be accountable for all aspects of work ensuring integrity and accuracy.
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Xavier Oriol, PhD https://orcid.org/0000-0001-7130-7729
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Xavier Oriol, PhD, is an associate professor at Universidad Andres Bello.
Rafael Miranda, PhD, is an assistant professor at Universidad Continental.
Alberto Amutio, PhD, is an associate professor at Universidad del País Vasco.
1 Faculty of Education and Social Science, Universidad Andres Bello, Santiago, Chile
2 Department of Psychology, Universidad Continental, Huancayo, Peru
3 Department of Social Psychology and Methodology, Universidad del País Vasco, Leioa, Spain
Corresponding Author:Xavier Oriol, PhD, Faculty of Education and Social Science, Universidad Andres Bello, Fernández Concha, 700, Santiago, Chile.Email: xavier.oriol@unab.cl
