Relationship between Bullying, Substance Use, Psychiatric Disorders, and Social Problems in a Sample of Kenyan Secondary Schools

  • Victoria N. Mutiso
  • Christine W. Musyimi
  • Pauline Krolinski
  • Charlotte M. Neher
  • Abednego M. Musau
  • Albert Tele
  • David M. NdeteiEmail author


We aimed to investigate how direct bullying and victimization relate with substance use, the presence of psychiatric disorders, poor school performance, disruptive behaviors, and social problems among secondary school students. A cross-sectional study was conducted in 20 randomly selected mixed-day secondary school students in forms one to three in Machakos County, equivalent to students in grades 1 to 11. From a random starting point, every sixth student in the class was invited to participate. The Drug Use Screening Inventory (revised) (DUSI-R) and the Olweus Bully/Victim Questionnaire (OBVQ) were administered in a classroom-setting by trained research assistants with experience in data collection. Four categories, i.e., bully only, bully-victim, victim only, and neither bully nor victims (neutrals) were developed and problem density scores computed. Descriptive statistics, bivariate, and multinomial logistic regression analysis summarized the findings. Of the 471 students, 13.6% had not experienced bullying problems. Bully-victim was the most prevalent form of bullying. No significant gender differences were reported across categories. Bully-victims reported significant higher problem density scores in eight out of the nine problem domains, and effect sizes of the differences in problem scores between neutrals and bully-victims were larger compared with other categories. Behavioral and family system problem scores retained a significant relationship with bully-victim category (p < 0.001). A high prevalence of bullying problems was documented in both genders. However, bully-victims had a higher risk of multiple negative individual and environmental and social problems. Assessment of bullying problems is an indirect route to identifying significant youth problems. Bullying interventions should be multifaceted to address psycho-socio-behavioral problems.


Direct bullying Substance use Psychiatric disorders School performance Kenya 




Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interest.

Ethical Approval

Ethical approval was sought from the Ethics Board of the University of Nairobi and Kenyatta National Hospital in Kenya. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Permission to conduct the study was obtained from the headmasters of the participating schools. Parents or guardians were requested to provide informed consent for children under the age of 18. All children whose parents or guardians consented were also requested to participate by providing a written assent. Only those who had both parental consent and a written assent were involved. Informed consent was obtained from all individual participants included in the study. Children absent on the day of assessment were excluded from the study.


  1. Alex-Hart, B. A., Okagua, J., & Opara, P. I. (2015). Prevalence of bullying in secondary schools in Port Harcourt. International Journal of Adolescent Medicine and Health, 27(4), 391–396 JOUR.CrossRefGoogle Scholar
  2. Arseneault, L., Bowes, L., & Shakoor, S. (2010). Bullying victimization in youths and mental health problems: “much ado about nothing”? Psychological Medicine, 40(5), 717–729. Scholar
  3. Baldry, A. C. (2004). The impact of direct and indirect bullying on the mental and physical health of Italian youngsters. Aggressive Behavior, 30(5), 343–355.
  4. Brownlee, K., Martin, J., Rawana, E., Harper, J., Mercier, M., Neckoway, R., & Friesen, A. (2014). Bullying behaviour and victimization among aboriginal students within Northwestern Ontario. First Peoples Child & Family Review, 9(1), 38–52 JOUR.Google Scholar
  5. Brunstein Klomek, A., Marrocco, F., Kleinman, M., Schonfeld, I. S., & Gould, M. S. (2007). Bullying, depression, and suicidality in adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 46(1), 40–49. Scholar
  6. Chesang, R. K. (2013). Drug abuse among the youth in Kenya. International Journal of Scientific & Technology Research, 2(6), 126–131.Google Scholar
  7. Dalla-Déa, H. R. F., De Micheli, D., & Souza Formigoni, M. L. O. (2003). Effects of identification and usefulness of the Lie Scale of the Drug Use Screening Inventory (DUSI-R) in the assessment of adolescent drug use. Drug and Alcohol Dependence, 72(3), 215–223. Scholar
  8. De Micheli, D., & Formigoni, M. L. O. S. (2004). Drug use by Brazilian students: associations with family, psychosocial, health, demographic and behavioral characteristics. Addiction, 99(5), 570–578. Scholar
  9. Due, P., Holstein, B. E., Lynch, J., Diderichsen, F., Gabhain, S. N., Scheidt, P., & Currie, C. (2005). Bullying and symptoms among school-aged children: international comparative cross sectional study in 28 countries. European Journal of Public Health, 15(2), 128–132. Scholar
  10. Fidalgo, T. M., Tarter, R., da Silveira, E. D., Kirisci, L., & da Silveira, D. X. (2010). Validation of a short version of the revised drug use screening inventory (DUSI-R) in a Brazilian sample of adolescents. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 19(4), 364–367. JOUR. Scholar
  11. Fite, P. J., Stoppelbein, L., & Greening, L. (2009). Proactive and reactive aggression in a child psychiatric inpatient population. Journal of Clinical Child and Adolescent Psychology : The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 38(2), 199–205. JOUR. Scholar
  12. Fleming, L. C., & Jacobsen, K. H. (2009). Bullying among middle-school students in low and middle income countries. Health Promotion International, 25(1), 73–84. Scholar
  13. Georgiou, S. N., & Stavrinides, P. (2013). Parenting at home and bullying at school. Social Psychology of Education, 16(2), 165–179. JOUR. Scholar
  14. Glew, G. M., Fan, M.-Y., Katon, W., Rivara, F. P., & Kernic, M. a. (2005). Bullying, psychosocial adjustment, and academic performance in elementary school. Archives of Pediatrics & Adolescent Medicine, 159(11), 1026–1031. Scholar
  15. Glick, P., & Sahn, D. E. (2010). Early academic performance, grade repetition, and school attainment in Senegal: a panel data analysis. World Bank Economic Review, 24(1), 93–120. Scholar
  16. Gonçalves, F. G., Heldt, E., Peixoto, B. N., Rodrigues, G. A., Filipetto, M., & Guimarães, L. S. P. (2016). Construct validity and reliability of Olweus bully/victim questionnaire – Brazilian version. Psicologia: Reflexão E Crítica, 29(1), 27. JOUR. Scholar
  17. Holt, M. K., & Espelage, D. L. (2007). Perceived social support among bullies, victims, and bully-victims. Journal of Youth and Adolescence, 36(8), 984–994. Scholar
  18. Hong, J. S., & Espelage, D. L. (2012). A review of research on bullying and peer victimization in school: An ecological system analysis. Aggression and Violent Behavior, 17(4), 311–322 JOUR.CrossRefGoogle Scholar
  19. Kenya National Bureau of Statistics. (2009). Kenya integrated household budget survey (KIHBS): Basic report 2005/06 (revised edition). In Nairobi.Google Scholar
  20. Kirisci, L., Tarter, R., Mezzich, A., & Reynolds, M. (2008). Screening current and future diagnosis of psychiatric disorders using the revised drug use screening inventory. The American Journal of Drug and Alcohol Abuse, 34(5), 653–665. JOUR. Scholar
  21. Knous-Westfall, H. M., Ehrensaft, M. K., Watson MacDonell, K., & Cohen, P. (2012). Parental intimate partner violence, parenting practices, and adolescent peer bullying: A prospective study. Journal of Child and Family Studies, 21(5), 754–766. JOUR. Scholar
  22. Kyriakides, L., Kaloyirou, C., & Lindsay, G. (2006). An analysis of the revised Olweus bully/victim questionnaire using the Rasch measurement model. The British Journal of Educational Psychology, 76(Pt 4, 781–801. Scholar
  23. Liang, H., Flisher, A. J., & Lombard, C. J. (2007). Bullying, violence, and risk behavior in south African school students. Child Abuse & Neglect, 31(2), 161–171. Scholar
  24. Lyznicki, J. M., Mccaffree, M. A., Robinowitz, C. B., & Dickinson, B. D. (2004). Childhood bullying: Implications for physicians. American Family Physician, 70(9), 1723–1730.Google Scholar
  25. Machakos County. (2012). Machakos County strategic framework 2013–2017: from third world to first world in one generation. Machakos.Google Scholar
  26. Marini, Z. A., Dane, A. V., Bosacki, S. L., & CURA, Y. (2006). Direct and indirect bully-victims: Differential psychosocial risk factors associated with adolescents involved in bullying and victimization. Aggressive Behavior, 32(6), 551–569. JOUR. Scholar
  27. Nansel, T., Overpeck, M., RS, P., Ruan, W., Simons-Morton, B., & Scheidt, P. (2001). Bullying behaviors among us youth: Prevalence and association with psychosocial adjustment. JAMA, 285(16), 2094–2100 JOUR.CrossRefGoogle Scholar
  28. Ndetei, D. M., Ongecha, F. a, Khasakhala, L., Syanda, J., Mutiso, V., Othieno, C. J., … Kokonya, D. a. (2007). Bullying in public secondary schools in Nairobi, Kenya. Journal of Child and Adolescent Mental Health, 19(1), 45–55. doi: Scholar
  29. Palen, L.-A., Smith, E. a., Flisher, A. J., Caldwell, L. L., & Mpofu, E. (2006). Substance use and sexual risk behavior among south African eighth grade students. The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine, 39(5), 761–763. Scholar
  30. Patel, V., Flisher, A. J., Hetrick, S., & McGorry, P. (2007). Mental health of young people: a global public-health challenge. Lancet, 369(9569), 1302–1313. Scholar
  31. Poipoi, M. W., Agak, J. O., & Kabuka, E. K. (2011). Perceived home factors contributing to violent behaviour among public secondary school students in western province, Kenya. Journal of Emerging Trends in Educational Research and Policy Studies, 2(1), 30–40 JOUR.Google Scholar
  32. Radliff, K. M., Wheaton, J. E., Robinson, K., & Morris, J. (2012). Illuminating the relationship between bullying and substance use among middle and high school youth. Addictive Behaviors, 37(4), 569–572. JOUR. Scholar
  33. Roby, D. E. (2003). Research on school attendance and student achievement: a study of Ohio schools. Education Research Quarterly, 4–15.
  34. Salgado, F. S., Senra, L. X., & Lourenço, L. M. (2014).Effectiveness indicators of bullying intervention programs: a systematic review of the international literature. Estudos de Psicologia (Campinas), 31(2), 179–190.Google Scholar
  35. Seixas, S., Coelho, J., & Nicholas-Fischer, G. (2013). Bullies, victims and bully-victims: Impact on health profile. Educação, Sociedade & Culturas, 38, 53–75 JOUR.Google Scholar
  36. Shope, J. T., Waller, P. F., Raghunathan, T. E., & Patil, S. M. (2001). Adolescent antecedents of high-risk driving behavior into young adulthood: Substance use and parental influences. Accident Analysis and Prevention, 33(5), 649–658. Scholar
  37. Smokowski, P. R., & Kopasz, K. H. (2005). Bullying in school: An overview of types, effects, family characteristics, and intervention strategies. National Association of Social Workers, 17(2), 101–110. Scholar
  38. Solberg, M. E., & Olweus, D. (2003). Prevalence estimation of school bullying with the Olweus bully/victim questionnaire. Aggressive Behavior, 29(3), 239–268. Scholar
  39. Solberg, M. E., Olweus, D., & Endresen, I. M. (2007). Bullies and victims at school: Are they the same pupils? British Journal of Educational Psychology, 77(2), 441–464. Scholar
  40. Srabstein, J. C., & Leventhal, B. L. (2010). Prevention of bullying-related morbidity and mortality: A call for public health policies. Bulletin of the World Health Organization, 88(6), 403. Scholar
  41. Stein, J. A., Dukes, R. L., & Warren, J. I. (2007). Adolescent Male Bullies, Victims, and Bully-Victims: A Comparison of Psychosocial and Behavioral Characteristics. Journal of Pediatric Psychology, 32(3), 273–282 JOUR.CrossRefGoogle Scholar
  42. Wei, H. S., Williams, J. H., Chen, J. K., & Chang, H. Y. (2010). The effects of individual characteristics, teacher practice, and school organizational factors on students’ bullying: A multilevel analysis of public middle schools in Taiwan. Children and Youth Services Review, 32(1), 137–143. Scholar
  43. Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., et al. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the global burden of disease study 2010. Lancet (London, England), 382(9904), 1575–1586.CrossRefGoogle Scholar
  44. Wolke, D., & Lereya, S. T. (2015). Long-term effects of bullying. Archives of Disease in Childhood, 100(9), 879–885. Scholar
  45. Wolke, D., Copeland, W. E., Angold, A., & Costello, E. J. (2013). Impact of bullying in childhood on adult health, wealth, crime, and social outcomes. Psychological Science, 24(10), 1958–1970. Scholar

Copyright information

© Society for Prevention Research 2019

Authors and Affiliations

  • Victoria N. Mutiso
    • 1
  • Christine W. Musyimi
    • 1
    • 2
  • Pauline Krolinski
    • 3
  • Charlotte M. Neher
    • 3
  • Abednego M. Musau
    • 1
  • Albert Tele
    • 1
  • David M. Ndetei
    • 1
    • 4
    Email author
  1. 1.Africa Mental Health Research and Training FoundationNairobiKenya
  2. 2.Vrije UniversiteitAmsterdamNetherlands
  3. 3.Maastricht UniversityMaastrichtNetherlands
  4. 4.University of NairobiNairobiKenya

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