Cited by 291Bullying, Victimization, and AggressionChild Abuse and TraumaHealth disparities and outcomes

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Childhood bullying involvement predicts low-grade systemic inflammation into adulthood

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Copeland, William E., Wolke, Dieter, Lereya, Suzet Tanya, Shanahan, Lilly, Worthman, Carol, Costello, E. Jane·2014·Proceedings of the National Academy of Sciences

DOI 10.1073/pnas.1323641111PMC PMC4040559

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Abstract

Significance: Bullying is a common childhood experience that affects children at all income levels and racial/ethnic groups. Being a bully victim has long-term adverse consequences on physical and mental health and financial functioning, but bullies themselves display few ill effects. Here, we show that victims suffer from greater increases in low-grade systemic inflammation from childhood to young adulthood than are seen in others. In contrast, bullies showed lower increases in inflammation into adulthood compared with those uninvolved in bullying. Elevated systemic low-grade inflammation is a mechanism by which this common childhood social adversity may get under the skin to affect adult health functioning, even many years later.

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Associations of bullying victimisation in different frequencies and types with suicidal behaviours among school-going adolescents in low- and middle-income countries
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“…of bullying during vulnerable developmental adolescent periods leads to neurobiological (Shonkoff et al., 2009; Li et al., 2021) and inflammatory (Copeland et al., 2014) changes that then cause mental illness (Shonkoff et al., 2009); then, they attempt to selfmedicate their distress and negative…”
Background
The Impact of Early and Recent Life Stress on Trajectories of Inflammatory Biomarkers in a Diverse Sample of Adolescents
Kautz, M. M., McArthur, B. A., Moriarity, D. P., Ellman, L. M., Klugman, J., Coe, C. L., Abramson, L. Y., & Alloy, L. B. (2023) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-023-01026-3 · Cited by 8
“When inflammation has been measured repeatedly during adolescence, higher cumulative childhood adversity predicted elevated levels of CRP across time (Copeland et al., 2014; Slopen et al., 2013).”
Examination of proinflammatory activity as a moderator of the relation between momentary interpersonal stress and suicidal ideation
Defayette, A. B., Esposito-Smythers, C. L., Cero, I., Kleiman, E. M., López, R., Harris, K. M., & Whitmyre, E. D. (2023) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12993 · Cited by 9
The Relations between Incivility and Adolescent Health and Wellbeing
Volk, A. A., Marini, Z. A., & Dane, A. V. (2016) · Advances in Social Sciences Research Journal · doi:10.14738/assrj.39.2224 · Cited by 8
School Violence and Bullying
Holt, M. K., & Reid, G. M. (2016) · Wiley eBooks · doi:10.1002/9781118303092.ch13 · Cited by 9
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“, 2008), (b) increased inflammation (Copeland et al., 2014; Takizawa, Danese, Maughan, & Arsenault, 2015), and (c) epigenetic alterations such as DNA methylation (Ouellet-Morin et al.”
Background
The biological embedding of social adversity: How adolescent housing insecurity impacts inflammation over time
Keen, R., Chen, J. T., Slopen, N. B., Sandel, M. T., Copeland, W., & Tiemeier, H. W. (2024) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2024.05.008 · Cited by 7
Self-citation
Trajectories of internalising and externalising symptoms and inflammation in the general child population
Flouri, E., Lewis, G., & Francesconi, M. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.104723 · Cited by 10
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Rok-Bujko, P. (2021) · Postepy psychiatrii neurologii · doi:10.5114/ppn.2021.106818 · Cited by 8
“The GSM study showed correlation between bullying, aggression at school and the incidence of eating disorders [18].”
Background
Benefits of Bullying? A Test of the Evolutionary Hypothesis in Three Cohorts
Kretschmer, T., la Roi, C., van der Ploeg, R., & Veenstra, R. (2021) · Journal of Research on Adolescence · doi:10.1111/jora.12675 · Cited by 7
Attachment relationships and psychological distress in young adults: The mediating role of self-esteem
Imran, S., & Jackson, S. (2022) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2022.100328 · Cited by 7
Bullying-Erfahrungen bei PatientInnen einer Ambulanz für Kinder- und Jugendpsychotherapie – eine besonders gefährdete Gruppe?
Kranhold, A.-L., Voigt, B., Dieter Wolke, C., Krause, K., Friedrich, S., Margraf, J., & Schneider, S. (2020) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000761 · Cited by 7
Peer victimization and associated alcohol and substance use: Prospective pathways for negative outcomes
Tretyak, V., Huffman, A., & Lippard, E. (2022) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2022.173409 · Cited by 9
Evidence of individual differences in the long-term social, psychological, and cognitive consequences of child maltreatment
Wong, R. S. M., Tung, K. T. S., Chan, K. L., Wong, W. H. S., Tsang, H. W., Chow, C. H. Y., Chua, G. T., Tso, W. W. Y., Yam, J. C. S., Wong, I. C. K., et al. (2022) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-022-00524-4 · Cited by 6
“This finding is consistent with a previous study demonstrating an association between childhood bullying and low-grade systemic inflammation into young adulthood [37].”
Result
Longitudinal Links between Early Adolescent Temperament and Inflammation among Young Black Adults
Brody, G., Yu, T.-Y., Miller, G., & Chen, E. (2023) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2023.106077 · Cited by 6
Childhood adversities and the comorbidity between mood and general medical disorders in adults: Results from the WHO World Mental Health Survey Portugal
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“Specifically, while we evaluated a wide range of childhood adversities on a large population-representative sample, collection of data regarding childhood bullying was not performed, despite its association with adult inflammation (Copeland et al., 2014).”
Background
Does escaping victimization in elementary school lead to improved health in high school: a comparison of victimization profile groups
Jensen‐Campbell, L. A., Boyd, E. Q., Araña, A. A., & Lee, S. L. (2017) · Journal of Applied Biobehavioral Research · doi:10.1111/jabr.12074 · Cited by 6
Bullying und psychische Gesundheit
Dieter Wolke, C. (2018) · Springer eBooks · doi:10.1007/978-3-662-57369-3_54 · Cited by 6
Psychobiological mechanisms underlying the association between early life stress and depression in adolescence
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Hegemonic Views of Masculinity and Bullying: Clinical Work with Men Who were Bullied as Children
Miehls, D. (2016) · Clinical Social Work Journal · doi:10.1007/s10615-016-0581-6 · Cited by 5
Substance Use and Sexual Risk Taking in Emerging Adults with a History of Bullying Victimization
Provenzano, D. A., & Boroughs, M. (2021) · International Journal of Bullying Prevention · doi:10.1007/s42380-020-00087-y · Cited by 5
The Capacity to Intervene: Bullying, Social Pain, and Bystander Empathy
Martocci, L. (2019) · Sociological Inquiry · doi:10.1111/soin.12288 · Cited by 5
Integrating Bullying Prevention in Early Childhood Education Pedagogy
Repo, L., & Repo, J. (2016) · Emerald Group Publishing Limited eBooks · doi:10.1108/978-1-68123-598-120251018 · Cited by 5
Associations between social behaviour and proinflammatory immune activation are modulated by age in a free-ranging primate population
Cooper, E. B., Whalen, C., Beeby, N., Valle, J. E. N.-D., Phillips, D., Snyder‐Mackler, N., Brent, L. J. N., & Higham, J. P. (2024) · Animal Behaviour · doi:10.1016/j.anbehav.2024.10.035 · Cited by 5
Exploring health influences and the moderating role of authentic leadership in workplace bullying: A cross‐sectional study among hospital nurses
Fang, L., Hsiao, L., & Fang, S. (2025) · International Nursing Review · doi:10.1111/inr.13100 · Cited by 4
Alcohol and Immunity
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Diagnosis in Young Children: The Use of the DC:0-5™ Diagnostic Classification of Mental Health and Developmental Disorders in Infancy and Early Childhood
Mulrooney, K., EGGER, H. L., Wagner, S., & Knickerbocker, L. (2019) · Springer eBooks · doi:10.1007/978-3-030-10635-5_8 · Cited by 5
Safety and Predictors of Sexual Minority Youth Carrying Weapons
Streed, C. G., Turner, B., Beach, L. B., Marro, R. L., Felt, D., Wang, X., & Phillips, G. (2020) · Journal of Interpersonal Violence · doi:10.1177/0886260520978183 · Cited by 5
“As noted generally, experiencing bullying has been linked to increased risk of negative physical and mental health as well as poor academic performance that may persist beyond the bullying incident (Copeland et al., 2013; Copeland et al., 2014; Pham & Adesman, 2017; Pham et al., 2017).”
Background
The IARA Model Proved Effective in Emotional Literacy, Characters Strengths Awareness, and Cohesion among Italian Children
Maulini, C., Kuvačić, G., Savani, W., Zanelli, V., Padovan, A. M., Bocciolesi, E., & Giorgio, A. D. (2021) · Education Sciences · doi:10.3390/educsci11110657 · Cited by 4
“This latter factor, bullying, can cause immediate consequences in a child’s life [19] and adverse outcomes in adulthood [20,21].”
Background
Adverse Childhood Events, Post-Traumatic Stress Disorder, Infectious Encephalopathies and Immune-Mediated Disease
Bransfield, R. C. (2022) · Healthcare · doi:10.3390/healthcare10061127 · Cited by 4
“Adverse childhood events, as well as PTSD acquired in adulthood, are associated with increased levels of CRP [3,4].”
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El ciberacoso y la estabilidad psicológica: estudio con adolescentes de Rocafuerte, Manabí, Ecuador
Cedeño, J. J. C., Ponce, M. E. B., & Cobeña, E. I. D. (2022) · Revista PSIDIAL Psicología y Diálogo de Saberes · doi:10.33936/psidial.v1i2.4351 · Cited by 4
The Interplay of Peer Victimization and Parasympathetic Nervous System Activity on Acute Inflammatory Stress Responses in Adolescence
Lorenz, T. I., Schreuders, E., Stuldreher, I. V., Thammasan, N., Brouwer, A.-M., & Giletta, M. (2023) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-023-01156-8 · Cited by 4
“For example, peer victimization in childhood and adolescence has been associated with higher levels of C-reactive protein, pointing towards low-grade systemic inflammation over both short and long periods of time (Arana et al., 2018; Copeland et al., 2014; Takizawa et al., 2015 ).”
Forest Plots: Linear or Logarithmic Scale?
Retamozo, X. C., Ghezzi, D. P., & Pereyra‐Elías, R. (2017) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2017.07.025 · Cited by 4
Evolutionary Perspectives on Bullying
Elizabeth, A., & Volk, A. A. (2021) · Wiley eBooks · doi:10.1002/9781118482650.ch72 · Cited by 4
Profiles of childhood maltreatment and bullying victimization and their associations with posttraumatic stress disorder symptoms in chinese college students: the mediating role of self-compassion
Liu, M., Liu, S., Liu, A., Yu, X., & Wu, X. (2026) · Current Psychology · doi:10.1007/s12144-026-09053-1 · Cited by 3
“Repetitive verbal or physical harassment or exclusion from peers might have long-term effects, independent of other childhood adversities (Copeland et al., 2014).”
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Roberts, E., Francesconi, M., & Flouri, E. (2025) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-025-02836-0 · Cited by 4
“Therefore, it is possible that inflammation, associated with childhood stressors in general [7, 18], but also peer victimisation specifically [13, 46], could be a mediator.”

Authors: Copeland, W. E., Wolke, D., Lereya, S. T., Shanahan, L., Worthman, C., & Costello, E. J.
Affiliations: Duke University (US)
Department of Psychology and Division of Mental Health and Wellbeing, University of Warwick, Coventry CV4 7AL, United Kingdom;
University of Warwick (GB)
University of North Carolina at Chapel Hill (US)
Emory University (US)
Corresponding author: Copeland, William E.
ORCID: Copeland, William E.
Lereya, Suzet Tanya
Shanahan, Lilly
Worthman, Carol
Costello, E. Jane
Venue: Proceedings of the National Academy of Sciences
Publisher: National Academy of Sciences
Published: 2014-05-12
Volume: 111
Issue: 21
Pages: 7570-7575
ISSN: 0027-8424 (ISSN-L)
1091-6490
DOI: 10.1073/pnas.1323641111
PMC: PMC4040559
OpenAlex: W2159691606
Cited by: 291
References: 62
Citations by year: 2026: 16 · 2025: 20 · 2024: 15 · 2023: 19 · 2022: 33 · 2021: 34 · 2020: 19 · 2019: 27 · 2018: 23 · 2017: 27 · 2016: 24 · 2015: 29 · 2014: 5
FWCI: 41.68
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Proceedings of the National Academy of Sciences (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
DukeSpace (Duke University) (submittedVersion, cc-by-nc-nd)
Funders: William T. Grant Foundation (MH63671, MH48085, DA/MH11301, MH63970)
National Alliance for Research on Schizophrenia and Depression (MH63970, MH48085, MH63671, DA/MH11301)
Economic and Social Research Council (ES/K003593/1)
National Institute of Mental Health (MH-63671, R01MH063970, R01MH048085, DA/MH11301, MH-63970, MH080230, MH63970, MH63671, MH48085, R03MH094605, and MH080230, MH-48085, K23MH080230, R01MH063671)
National Institute on Drug Abuse (MH63671, MH63970, MH48085, DA/MH11301, P30DA023026, R01DA011301, DA023026)
Topics: Social Sciences › Psychology › Social Psychology › Bullying, Victimization, and Aggression
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Health › Health disparities and outcomes
Keywords: childhood bullying, bullying victimization, bullying perpetration, C-reactive protein, low-grade inflammation, biological embedding, social adversity, dominance, psychosocial adversity, adolescent development, early adulthood, Great Smoky Mountains Study
MeSH terms: C-Reactive Protein, Child, Humans, Interviews as Topic, Longitudinal Studies, North Carolina, Prospective Studies, Fluoroimmunoassay, Models, Statistical, Systemic Inflammatory Response Syndrome, Bullying

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Childhood bullying involvement predicts low-grade systemic inflammation into adulthood

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