The association of school bullying with symptoms and diagnosis of PTSD: An updated systematic review and meta-analysis

School bullying has been linked to lower academic achievement and increased mental health problems, making it a critical concern for the field of educational psychology. Understanding the psychological consequences of bullying is essential for educators, school psychologists, and policymakers to develop effective interventions that support students’ well-being and learning outcomes. One ongoing debate is whether bullying qualifies as a traumatic event that may lead to post-traumatic stress disorder (PTSD) symptoms and diagnosis. A previous meta-analysis revealed a significant association between bullying and PTSD symptoms, highlighting their prevalence among both children and adults who have been bullied. Our meta-analysis updates and expands these findings by focusing on the association between bullying and PTSD symptoms and diagnosis specifically among school children and youth. A comprehensive systematic literature search across seven databases identified 38 eligible studies in line with the a priori defined inclusion criteria. The frequency of PTSD symptoms above the cut off scores varied between 12.1% to 65.8%. The overall pooled effect size was (r= .237, 95% CI [.173, .299], p < .001), using the correlated-hierarchical effects model with robust variance estimation method. The results were heterogeneous with a 95% PI [-.155, .563]. Our updated meta-analysis confirms and extends previous findings on the significant association between bullying and PTSD symptoms among school children and youth, and reveals significant moderators (e.g., mean age of the sample, type of group: victims, bullies, bully/victims) in this link. However, we cannot rule out alternative explanations, such as other diagnoses. The implications have been discussed. • Bullying is linked to PTSD symptoms in bullies, victims, and bully/victims. • This association is strongest among victims and bully/victims. • No clear evidence links bullying to a formal PTSD diagnosis.