The Impact of Peer Victimization

Abstract

 

Previous research has linked victimization to increased internalizing problems (Hawker & Boulton, 2002).  However, little is known about whether victimization influences increased internalizing problems more for girls than for boys. It is also possible that the type of bullying (e.g., social versus physical) influences the magnitude of the victim-internalizing problems relationship.  Building upon the work of Hawker and Boulton (2002), approximately 32 studies were used to exam the link between peer victimization and the internalizing problems of depression, anxiety, and loneliness. Findings revealed a moderate positive relationship for all three types of internalizing problems. Additionally, this study found that type of victimization and gender positively moderated the relationship between peer victimization and increased internalizing problems. Results of this study add to previous literature showing the grave consequences experienced by chronic peer victims.

 

The Impact of Social and Relational Victimization on Depression, Anxiety, and Loneliness: A Meta-Analytic Review

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Accounts of peer victimization in schools are a common occurrence for many around the world. In the United States, approximately 10% to 30% of adolescents report being the recipient of repeated aggressive acts by their peers (Grills & Ollendick, 2002; Nansel et al., 2001). This is similar to the percentage of peer victimization reported in secondary schools in 27 countries in Western and Eastern Europe (Molcho et al., 2009; Olweus, 1996; Rigby, 2002, Rigby & Smith, 2011). The consequences (e.g. emotional distress, anxiety, and depression) experienced by peer victims are often long lasting and detrimental (Konchenderfer-Ladd & Wardrop, 2001). The additive influence of these consequences in regards to their magnitude for overall mental health still requires current systematic exploration.  The current study built upon the framework of Hawker and Boulton 2002, and extended their work to explore the influence of both type of peer victimization (social or physical) and gender (male or female) as moderators in the relationship between peer victimization and increased internalizing problems.

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Definition of Peer Victimization

                                                                                                       

The definition of peer victimization fundamentally encompasses a component of frequency in which the peer victimization must occur (Olweus, 2010). Being a peer victim involves being the repeated recipient of aggressive acts from one’s peers over time (Olweus, 2001). The definition of peer victimization has come to not include (1) peers of similar status arguing or fighting with one another; (2) children or adolescents who tease or poke fun at one another in a good-natured manner; or (3) a child or adolescent being the occasional recipient of an aggressive act (Andreou, 2004). With the inclusion of the above criterion, peer victimization is best considered as a continuum lying on a spectrum of no abuse to frequent peer abuse.

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Types of Peer Victimization

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Peer victimization is an umbrella term used to encompass several different facets of mistreatment and includes a broad spectrum of actions and behaviors from an overt, noticeable, physical act of aggression, to a more understated, subtle, consistent occurrence of a social act of aggression (Feinberg & Robey, 2008). A child being repeatedly pushed by another child into a locker and a child having malicious rumors continuously being spread about them are both experiencing peer victimization. What differs is the delivery of that victimization. As a result, peer victimization has often been categorized as being either physical (e.g. direct) or social (e.g. indirect) in nature (Underwood, 2003).

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Physical acts of victimization evoke the use of verbal or physical threats, assaults, and insults meant to harm another’s physical being, property, or status (Coie & Dodge, 1998; Putallaz et al., 2007). Behaviors like shoving, pushing, hitting, pinching, or kicking as well as breaking or stealing a person’s belongings can all be consider acts of physical victimization. Hawker and Boulton (2002) aptly described physical victimization as the attacking of one’s physical integrity.

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Social victimization includes acts of isolation or exclusion and often manifests itself as ostracism, harmful gossip, and deliberate manipulation of social bonds in order to cause irreparable damage to personal relationships (Putallaz et al., 2007). Social victimization is thought to be internalized by an individual as being just as distressing as a more physical form of victimization (Kowalski, Limber, & Agatston, 2008; Williams & Nida, 2009).

The peer victimization literature suggests that all types of victimization have psychological consequences (Paquette & Underwood, 1999). However, a comparison of types of victimization, and its contribution to increased internalizing problems in a meta-analyses format, has yet to be explored. To fill this gap, the current meta-analysis will examine whether social versus physical forms of victimization are more detrimental to adolescent’s internalizing problems.  Given that social forms of victimization are hypothesized to be more internalized by the victim, we propose that social forms of peer victimization will be more strongly associated with internalizing problems than will more physical forms.

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Gender differences in Peer Victimization

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Initially, research indicated that boys were more aggressive in nature than girls (Coie & Dodge, 1998). This finding however has been scrutinized at length since the 1990s. It has since been found that girls and boys may evidence different types of aggression (i.e. boys more physical vs. girls more social victimization) (Bjorkqfvist, 1992; Bjorkqvist, 1994; Carbone-Lopez, Esbensen, & Brick, 2010; Underwood, 2003). A meta-analysis by Card, Stucky, Sawalani, & Little (2008) found that although the gender differences associated with females engaging in more social forms of victimization were significantly related to one other, the actual impact of this relationship was rather small. It was found that gender did not actually moderate the relationship between social or physical forms of aggression and subsequent adjustment outcomes.

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Underwood (2003) suggests that although the impact of the relationship between gender and social aggression may be slight, the significance of such differences may affect boys and girls in essential ways. Underwood & Rosen (2011) further suggests differences in social aggression is evidenced by differences in social processes, functions, and consequences that each gender experiences. Research by Slee (1995a) found that peer victimization in both adolescent boys and girls was highly related to depression and unhappiness in being at school. Further, Craig (1998) found that adolescent girls tended to report more depression as a result of peer victimization than did adolescent boys.  It would seem that although both boys and girls experience depression as a result of exposure to chronic peer victimization, girls might be more susceptible to internalizing problems when peer victimized than are boys.  As such, this meta-analysis also attempted to assess possible gender differences in internalizing problems for adolescent boys and girls who experience peer victimization.

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Consequences of Peer Victimization

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Research has indicated that being peer victimized is associated with emotional distress, anxiety, and depression (Kochenderfer-Ladd & Wardrop, 2001), as well as later psychological maladjustment and loneliness (Crick & Grotpeter, 1995; Crick & Bigbee, 1998; Crick, Casas, & Ku, 1999; Nansel et al., 2001; Prinstein, Boergers, & Vernberg, 2001). These relationships have been noted cross culturally. Bullied children between the ages of 9 -12 years old in Greece (Andreou, 2001) and South Korea (Schwartz, Farver, Chang, & Lee-Shin, 2002) reported lower feelings of self-worth and academic functioning in comparison to their non-bullied peers. Research conducted in England (Mynard, Joseph, & Alexander, 2000) and Australia (Rigby, 2000) found that victimization was related to increased psychological distress (e.g., depression, loneliness, and anxiety) for peer victimized adolescents. In the United States, Smithyman, Fireman, & Asher (2014) found that both previous and present perceptions of peer victimization were negatively associated with current adjustment outcomes (i.e. more psychological distress, poorer life satisfaction, decreased school connectedness and school performance, and increased somatic complaints. Bond et al. (2001) found that in addition to the association between anxiety and victimization, individuals who had a history of victimization and poor social relationships were more likely to report emotional problems in adolescence. A meta-analysis conducted by Hawker & Boulton (2002) revealed that peer victimized individuals reported more negative thoughts and feelings concerning themselves in comparison to those individuals who were not victimized by their peers. They found that victimized adolescents were consistently found to evidence lower self-esteem, report higher instances of loneliness, and increased feelings of anxiousness.

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Peer Victimization and Internalizing Problems

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Internalizing problems are one class of psychological outcomes that have been associated with victimization. Internalizing problems consists of factors related to personal distress as well as self-control issues, and behavioral inhibition (e.g. anxiety, depression, loneliness, somatization, and social withdrawal) (Weiss, Jackson, & Susser, 1997).  Chronic adolescent peer victimization has been found to be repeatedly associated with increases in internalizing problems over time (Crick & Bigbee, 1998; Crick, Casas, & Ku, 1999; Crick & Grotpeter, 1995; Janosz et al., 2008). Kochenderfe-Ladd and Skinner (2002), found that peer victimized school age children were at increased risk for developing the internalizing problems of childhood depression, loneliness, and anxiety. More recently, Schwartz, Lansford, Dodge, Pettit, & Bates (2014) found that experiencing peer victimization in middle school was a primary marker of both internalizing problems and moderate links to unipolar depressive disorders in later adolescence. Similarly, Zwierzynska, Wolke, and Lereya (2013) found that even after controlling for previous psychopathology, early family adversity, gender and IQ, peer victimization experienced in childhood predicted increased internalizing problems in adolescence.  Baumeister and Leary (1995) have suggested that individuals innately need to form and maintain meaningful relationships. According to Baumeister and Leary, peer victimization threatens this fundamental need, and as such, can lead to anxiety, loneliness, and depression.

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One common psychological distress or internalizing problems that has frequently been noted in the research literature is depression (Kaltiala-Heino, Rimpela, Marttunen, Rimpela, Rantanen, 1999; Neary & Joseph, 1994). A meta-analysis conducted by Hawker & Boulton, (2002) found that peer victimization was most strongly related to depression, more so then any other component of psychological distress. Indeed, adolescents who are victimized are more likely to exhibit decreased self-esteem, and increased feelings of loneliness, anxiety and depression than those adolescents who were not victimized by their peers (Callaghan & Joseph, 1995; Hodges & Perry, 1996; Schwartz, Lansford, Dodge, Pettit, & Bates, 2014; Slee, 1994; Swearer, Song, Cary, Eagle, & Mickelson; 2001; Zwierzynska, Wolke, Lereya, 2013). The links between the co-morbidity of depression and poor self-esteem in victimized adolescents is not surprising, when one considers the fact that those adolescents with lower self-esteem are more likely to be depressed (Harter, 1993; Lewinsohn, Roberts, Seeley, Rohde, Gotlib, & Hops, 1994; Swearer, Song, Cary, Eagle, & Mickelson; 2001).

In addition to depression, anxiety, also an internalizing problem has often been found to be predictive of an individual’s emotional maturity (Asher & Wheeler, 1985; Crick & Ladd, 1993; Hymel, Franke, & Freigang, 1985). As peer victimization occurs in the presence of others and embodies in a negative form, a social relationship, it would not be uncommon for individuals who are peer victimized to experience anxiety. Within this line of research, it has been suggested that individuals who experience both physical and social victimization tend to report higher levels of social anxiety in comparison to those that experience only one type of victimization (Prinstein, Boergers, & Spirito, 2001; Storch & Masia-Warner, 2004). Further, Storch, Masia-Warner, Crisp, & Klein (2005) found that social anxiety in conjunction with social phobia in boys, was positively related to increased social victimization overtime. More recently, Lexine et al. (2014) found that frequent peer victimization in adolescents was related to a two or three time increase in development of adult anxiety disorders.

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Loneliness has also been an internalizing problem frequently associated with peer victimization. Its expression is often seen as a result of disturbance to intimate and/or social needs (Cacioppo et al. 2000) To this end, Storch, Brassard, and Masia-Warner (2003) found that social forms of victimization (i.e. overt and relational) were associated with increased feelings of loneliness. Further, Kochenderfer & Ladd (1996) found that peer victimization was a precursor to children’s self-reports of loneliness and subsequent school avoidance. Moreover, the instability experienced by peer-victimized children predicted trajectories of loneliness and social satisfaction into early and late adolescence (Kochenderfer-Ladd & Wardop. 2001).

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The strong relationship between peer victimization and adolescent internalizing problems (i.e. depression, anxiety, and loneliness) creates the necessity to study the differences in magnitudes of these relationships.  This meta-analysis will attempt to replicate and extend the findings of Hawker & Boulton (2002) to assesse whether peer victimization continues to most strongly be related to depression over other types of internalizing problems (i.e. anxiety and loneliness).

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Why Study Adolescents?

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Although individuals are developing throughout the lifespan, it is important to address the time period of adolescence. Specifically, friendships during this time period become exceedingly important. Adolescents that have an inability to maintain close friendships maybe at increased risk for suffering from the negative outcomes associated with peer victimization. Research indicates that peer victimized children without a best friend are more likely to evidence both internalizing and externalizing problems as compared to those adolescents with a best friend who are also peer victimized (Hodges, Boivin, Vitaro, & Bukowski, 1999).

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Additionally, the onset of mental illnesses, such as depression, anxiety disorders, and mood disorders, increases substantially during adolescence as a result of a greater vulnerability to stress that occurs as the adolescent goes through major physiological changes (e.g., Paus et al., 2008).  In sum, it is during this period, when adolescents are going through major physiological changes and are the most vulnerable to depression and anxiety problems that can persist into adulthood, that they are also most likely to become victims of peer abuse.

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Current Study

                                                                                                 

In 2002, Hawker and Boulton conducted a meta-analysis looking at peer victimization and internalizing problems. Their study looked at all research occurring before 1997.  Although research has found relationships between bullying and subsequent outcomes (e.g. internalizing problems), no study to date has looked at the overall effect sizes of these said outcomes for the past 15 years.  Moreover, no meta-analytic study to date has examined possible moderators of the victimization-internalizing problem association.  For example, does the type of bullying influence these associations?  Does social bullying lead to more problems than physical bullying?  Additionally, does the gender of the child influence the strength of this relationship?  That is, do girls have more adverse effects to bullying than do boys? With this in mind, this study will fill the gaps in the literature by conducting a meta-analysis to look at the strength of the influence of bullying on internalizing problems, specifically depression, loneliness, and anxiety. In addition, this study will attempt to replicate and extend the finding of Hawker & Boulton (2002). This meta-analysis will look at all articles dated until May 2012 concerning peer victimization and internalizing problems.  Studies will be limited to adolescent children (i.e., preschool, elementary school, and adult bullying will be excluded from this analysis).  Adolescence is defined as the age of 10-18.

 

As such, this paper will focus on several main research questions:

1. What is the strength of the relationship between peer victimization and these outcome measures?  Is the strength of the relationship between peer victimization and depression stronger than the relationships between peer victimization and loneliness or anxiety?

2. What type of peer victimization is most influential on psychological health?  That is, does physical or social victimization have more influence on internalizing problem outcomes?

3. 3.     Does the gender of the participant moderate the relationship between peer victimization and internalizing problem outcomes?  That is, are girls more likely to be affected by victimization than are boys?

 

Method

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Literature Search

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            We were interested in the effects of peer victimization on psychological outcomes. Specifically, the effects that peer victimization has on internalizing problems (i.e. depression, anxiety, and loneliness) (See table 1 for the dependent measure categories). Therefore, studies assessing externalizing problem behaviors. Or, those studies not containing analyses specifically assessing the link between peer victimization and depression, anxiety, or loneliness was excluded from the samples of studies.   

                             

Articles cited by Hawker and Boulton (2002) and used in their original meta-analysis were retrieved first.  Additional articles looking at peer victimization and internalizing problems that were published between 1978 and end of May 2012 were located for inclusion in this study. These dates were selected to include all articles located up until the study published by Hawker and Boulton (2002), as well as to include all studies published since that time.

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Published articles were found using various sources and databases such as PsycINFO, PsycARticles, and Google Scholar. Not to miss any relevant publications the key terms bullying, peer victimization with internalizing problems, depression, loneliness, and anxiety were used to locate all publications through the specified date. Additionally, both theses and dissertations were located to include in this study.   

Inclusion Criteria & Search Results. The search revealed a total of 156 articles fitting the specified age range looking at peer victimization and internalizing problems. However, after closer inspection of the articles found, many of these studies did not fit the criterion of assessing the link between peer victimization and types of internalizing problems. After looking through all located articles, in order to test moderation of sex and type of victimization, 32 articles were retained for use in analyses. Articles used along with type of internalizing problem being assessed can be found in (See appendix table 1).

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Coding Study Characteristics

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The variables coded in the meta-analysis for each study were as follows: (a) type of internalizing problem, (b) sample size (number of participants in each study) (c) proportion of boys vs. girls (percentage of females), (d) age range of participants, (e) type of victimization, and (f) calculation of effect sizes.

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Coding Procedure

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            The first author as well as several trained undergraduates followed a very methodical coding system detailing the criteria for inclusion of a study. To assess reliability, four coders were used for coding dependent measures into the specified categories, and for extracting the information necessary to calculate the desired effect sizes. The first author reviewed all articles and combined and made final decisions when discrepancies arose. Fine-tuning of the coding system became necessary when problems were detected with subtypes of the dependent variables (i.e. anxious depressed vs. anxiety vs. depression).

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Calculation of Effect Sizes

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            Results from studies were collected, and non-r effects were transformed to r values for aggregation purposes. Results of each study were calculated using the method outlined by Lipsey & Wilson (2000). If multiple effect sizes were found for a single study, r values were logarithmically transformed then averaged within study to prevent any given study from unduly influencing the final obtained results.

Procedure for Meta-Analyses and Checks for Sample Size Bias

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            For the current meta-analytic effort, the psychometric model proposed by Hunter and Schmidt (1990; 2004) was used. Specifically, the goal of the current effort was to obtain a better understanding of the true relationships between peer victimization and the internalizing problem behaviors of depression, anxiety, and loneliness, while controlling for sampling and measurement error.

Thus, effect sizes were weighted based on their individual sample size in order to correct for measurement error. Further, each correlation was corrected for attenuation as a result of unreliability in both reports of peer victimization and internalizing behaviors.  If however a study did not report a reliability coefficient, perfect relationships were assumed for analyses.

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Moderator Analyses

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            Two moderators were assessed in the current study. First the type of victimization (physical or social) was examined to determine if how one is victimized affects the relationship between peer victimization and internalizing problems. We also wanted to see if victim’s gender affected the relationship between the experiences of peer victimization on internalizing problems.

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Weighted least squares (WLS) multiple regression was used, with the attenuation corrected r values and inverse variance used. This method was chosen because of its known robustness and accuracy in comparison to other methods (Steel & Kammeyer-Mueller, 2002).  Finally, the correction proposed by Hedges and Olkin (1985) was applied to obtain the statistical significance based on the n values instead of the k values provided by the WLS regression. For comparison of the relationships for the specific types of victimization, the true corrected correlations (ρcorr ) were compared using log transformations. Z tests were then conducted based on the sample size (resulting in the same outputs that would have been obtained had bivariate comparisons been conducted using the previous approach).

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Results

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Is being bullied more strongly associated with depression than other types of internalizing problems? 

The first purpose of this study was to assess if peer victimization was the largest contributor to a specific internalizing problem.  Hawker and Boulton (2002) found that being bullied was more strongly associated with depression than with anxiety or loneliness.  Our meta-analytic results indicated that there was indeed a true positive relationship between peer victimization and anxiety (ρcorr = .29), depression (ρcorr = .35), and loneliness (ρcorr = .39). These represent moderate to large effects according to Cohen’s guidelines (Cohen, 1992). The fail-safe N (or the file drawer effect) was 81, 170, and 100 respectively. The fail-safe N indicates that 81, 170, and 100 null participants would be necessary to alter the reported statistically significant results to a non-significant finding (James, 2001). These values reported exceed previous guidelines that the fail-safe N should surpass 5k + 10 in order to confidently exclude possible threats to the validity of the findings (Rosenthal, 1979).  Table 2 lists the findings from the meta-analysis and include the overall sample size, overall number of correlations, the average uncorrected correlation coefficient, the standard deviation of the average uncorrected correlation, the average corrected correlation coefficient, the standard deviation of the average corrected correlation, and the 95% confidence intervals for each type of internalizing problem. More importantly, there was no evidence that these effect sizes differed in magnitude; being bullied was associated with all three types of internalizing problems, namely depression, anxiety, and loneliness.

Does social victimization lead to more internalizing problems than does physical victimization?

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This study attempted to extend the findings of Hawker and Boulton (2002) by analyzing the role that the type of victimization plays on the reports of internalizing problems. Specifically table 3 lists the correlations coefficients, sample sizes, reliabilities of the criterion variable (i.e., physical or social victimization), and reliabilities of the predictor variable for each study that were entered into the meta-analysis software. Varying effects in anxiety, depression, and loneliness based on type of victimization experienced were found. Specifically, results indicated that that there was a significant positive relationship between social victimization and anxiety (ρcorr = .43) and physical victimization and anxiety (ρcorr = .33). Similarly it was found that social victimization and depression (ρcorr = .43) and physical victimization and depression (ρcorr = .37) were significantly positively related. Finally, it was found that social victimization (ρcorr = .42) and physical victimization (ρcorr = .56) differentially contributed to loneliness. Tables 3 lists the findings from the meta-analysis and include the overall sample size, overall number of correlations, the average uncorrected correlation coefficient, the standard deviation of the average uncorrected correlation, the average corrected correlation coefficient, the standard deviation of the average corrected correlation, and the 95% confidence intervals for each type of victimization and internalizing problem. Overall, we found that social and physical victimization contributed to depression, anxiety, and loneliness differentially and as such, type of victimization was indeed a moderator in this study.

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Are girls more influenced by being bullied than are boys?

Gender was examined to discern if it affected the relationship between peer victimization and internalizing problem behavior differently. Results indicated that gender was significant in positively moderating the experience between victimization and internalizing problems for anxiety (β = 1.38, z =3.64, p < .01) and moderately for depression (β = .43, z =1.74, p = .08).  That is, girls were more likely to develop anxiety and depression when bullied than are boys.  However, results indicated that gender does not moderate the experience between peer victimization and loneliness (β = .45, z =1.06, p = .29) (See table 4). Boys and girls were equally likely to report being lonely when bullied.

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Discussion

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            The purpose of this study was to better understand the relationship between peer victimization and internalizing problems of (anxiety, depression, & loneliness) across studies. In addition, this study replicated and extended previous findings by Hawker and Boulton (2002) by examining possible moderators. Research has suggested that internalizing behaviors are a severe consequence experienced by peer victims (Crick & Grotpeter, 1995; Crick & Bigbee, 1998; Crick, Casas, & Ku, 1999; Nansel et al., 2001; Prinstein, Boergers, & Vernberg, 2001).  In fact, a recent meta-analysis by Reijntjs and colleagues (2010) found that overall, victims of bullying were highly distressed and in addition, the internalizing problems they experienced could function both as an antecedent as well as a consequence of chronic victimization. Their meta-analysis assessed only longitudinal studies, and did not include the differential influence of moderators (type or gender) in their study. However, there work does continue to suggest the importance and necessity of studying the relationship between internalizing problems and peer victimization. More importantly, research must also look at the contributions of peer victimization to types of internalizing problems. Analyses from this study indicate important differences from the previous study conducted by Hawker and Boulton (2002). Specifically, in their meta-analysis, they reported that peer victimization most largely predicted depression, more so than any other type of internalizing problem.  The results of this study indicated that there is a moderate relationship between peer victimization and anxiety (ρ = .29), depression (ρ = .35) and loneliness (ρ = .39) and, that peer victimization is rather consistently related to all three of these outcomes. Moreover, this meta-analysis undertook a psychometric approach by correcting for unreliability. The removal of this error allows us to better understand the true relationship obtained between peer victimization and the internalizing problems.  These findings are particularly note-worthy because they suggest that anxiety, depression and loneliness are all outcomes associated with peer victimization.

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Second, this study assessed whether the type of victimization differently influenced the effect of victimization on internalizing problems. These moderating analyses revealed that social victimization had a stronger association with anxiety (ρ =. 43) and depression (ρ = .43) than did physical victimization (ρ = .33, .37 for anxiety and depression, respectively). These results suggest that in terms of anxiety and depression, social victimization may differentially predict internalizing behaviors. Specifically, results from this meta-analysis suggest that social victimization may be more harmful than more physical types of victimization. The old adage that  “stick and stones may break my bones but words will never hurt me,” may not be entirely correct. In fact, this study suggest that words are in fact equally, if not more harmful in its contribution to depression and anxiety.  Physical victimization was more strongly related to loneliness (ρ = .55) than social victimization (ρ = .42) suggesting the type of victimization may influence the likelihood of whether one experiences anxiety and depression versus loneliness when bullied.

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Finally, this study assessed whether girls were more likely to develop internalizing problems when victimized than were boys.  Results revealed that gender significantly moderated the relationship between the experience of peer victimization and reports of anxiety (p < .01), and moderately for depression (p=.08). Girls reported more anxiety and depression when victimized than did boys. The extension of this framework is a fairly new area of interest. However the idea of differentially experiencing and interpreting peer victimization based on gender makes sense when one considers the differing contextual framework in which victimization occurs for boys and girls. Particularly Underwood, Galen, & Paquette (2002) postulate that social peer victimization for girls occurs within groups and is used to damage relationships versus independent episodes by a few individuals of physical aggression for boys. The large emphasis that girls place on social relationships and the negative ramifications occurring as a result of social exclusion may indicate why the experience of peer victimization is more likely to be internalized by girls verse boys. Moreover the results of this study support much of the literature suggesting that mood disorders are more frequent in females than males (Palanza, 2001) and may be one reason why the outcomes of depression and anxiety after experiencing peer victimization are differentially reported and experienced by males and females.  Finally, gender did not moderate the relationship between the experience of peer victimization and loneliness (p=.28) suggesting that both males and females are equally likely to report loneliness as a result of experiencing chronic peer victimization.

Future Research and Limitations

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            Although moderate to large relationships were noted between peer victimization and anxiety, depression, and loneliness, research should still strive to address the mechanisms through why these relationships are noted. In fact, little research has been conducted to determine why these relationships are found. Although significant, these results should be interpreted with caution. The increases in effect sizes reported in this study from those found in Hawker and Boulton (2002) suggest that mean levels on scales as well as the frequency of peer victimization beyond once or twice a month needs to be examined. That is, these results may be more suggestive of the relationship between peer victimization and internalizing problems than what type of consequence is more strongly associated with peer victimization. Moreover, the relatively few studies included in the moderating analyses should be reassessed with additional studies to see if the relationships continue to hold over time. Overall, the above study is quite promising and continues to reinforce the literatures consistent findings of the association between peer victimization and internalizing problems and suggest the importance of looking at type of victimization and gender as moderators in research.

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