text:
- Research
- Open Access
Bullying behaviour in schools, socioeconomic position and psychiatric morbidity: a cross-sectional study in late adolescents in Greece
© Magklara et al; licensee BioMed Central Ltd. 2012
- Received: 21 August 2011
- Accepted: 12 February 2012
- Published: 12 February 2012
Bullying is quite prevalent in the school setting and has been associated with the socioeconomic position and psychiatric morbidity of the pupils. The aim of the study was to investigate the association between bullying and socioeconomic status in a sample of Greek adolescents and to examine whether this is confounded by the presence of psychiatric morbidity, including sub-threshold forms of illness.
5,614 adolescents aged 16-18 years old and attending 25 senior high schools were screened and a stratified random sample of 2,427 were selected for a detailed interview. Psychiatric morbidity was assessed with a fully structured psychiatric interview, the revised Clinical Interview Schedule (CIS-R), while bullying was assessed with the revised Olweus bully/victim questionnaire. The following socio-economic variables were assessed: parental educational level and employment status, financial difficulties of the family and adolescents' school performance. The associations were investigated using multinomial logit models.
26.4% of the pupils were involved in bullying-related behaviours at least once monthly either as victims, perpetrators or both, while more frequent involvement (at least once weekly) was reported by 4.1%. Psychiatric morbidity was associated with all types of bullying-related behaviours. No socioeconomic associations were reported for victimization. A lower school performance and unemployment of the father were significantly more likely among perpetrators, while economic inactivity of the mother was more likely in pupils who were both victims and perpetrators. These results were largely confirmed when we focused on high frequency behaviours only. In addition, being overweight increased the risk of frequent victimization.
The prevalence of bullying among Greek pupils is substantial. Perpetration was associated with some dimensions of adolescents' socioeconomic status, while victimization showed no socioeconomic associations. Our findings may add to the understanding of possible risk factors for bullying behaviours in adolescence.
- Bullying
- Adolescents
- Socioeconomic status
- Psychiatric morbidity
- Victims
- Perpetrators
Bullying is quite prevalent in the school setting and has important adverse effects on many areas of the adolescents' life. It is a specific type of aggression in which an intension to harm or disturb can be identified, occurs repeatedly over time and there is an imbalance of power, with a more powerful person or group attacking a less powerful one [1]. According to a widely used research definition of bullying a student is being bullied or victimized when he or she is exposed, repeatedly and over time, to negative actions on the part of one or more other students [2]. Negative actions are further defined as when someone (the "perpetrator") intentionally inflicts, or attempts to inflict, injury or discomfort upon another (the "victim"). Negative actions can be verbal, including threatening, taunting, teasing, or name-calling, or physical, such as hitting, kicking, pushing, shoving or pinching. Being a victim of bullying has been associated with lower self-esteem [3], depressive symptomatology [4–7], anxiety [3], physical and psychosomatic symptoms [8–10], suicidal ideation [11, 12] and suicide [13]. On the other hand, being a perpetrator has been associated with aggression [14], antisocial personality, criminality and substance abuse [15]. As regards the direction of causality, studies have shown that bullying appears to be a potential risk factor for mental health problems, since it usually precedes the onset of emotional difficulties [5].
A large number of studies conducted in different countries indicate that bullying at school occurs all over the world and is not confined to any geographical region, socioeconomic or cultural group. The prevalence, however, of bullying varies considerably between countries. Studies show prevalence rates of the overall phenomenon between 8% in Germany [16] and 29.9% in the United States [17], 30% in Italy [18] and 40% in Korea [19]. Prevalence rates of perpetrators vary between 4% and 50% [20], while rates of victims of bullying vary between 4.1% for girls in Sweden and 36.3% for boys in Lithuania [21]. A recent international study which investigated the prevalence of bullying victimization in 66 countries and territories reports that on average 32,1% of the children were bullied at school at least once within the past 2 months, while 37,4% of children were bullied at least one day within the past 30 days [22]. Boys are more often perpetrators than girls [23], while rates of victimization may not differ between the two genders [17, 24, 25]. Both behaviors appear to be more common in younger ages [17, 26, 27].
According to Craig et al. the prevalence of bullying combined (i.e., bullying others, being bullied and being both a bully and a victim) in Greece was 41.3% and Greece occupied the third place among 40 countries in the number of adolescent students being involved in bullying-related behaviours [23]. Possible explanations of this relative high prevalence are the lack of national policies against bullying in Greece, as well as a number of cultural variations, for example the way bullying is conceptualized and understood [28].
The cross-national variations in the prevalence of bullying may reflect the different distribution of culture-specific risk factors among countries and the different methods used in research. Regarding socioeconomic status, lower parental education [26] and poorer academic achievement of the student in school have been associated with bullying [17]. Recently, an international study showed that being a victim was more common among adolescents from families of lower socioeconomic position and this association appeared to be relatively strong across several countries [29]. Another study, which investigated socioeconomic associations of bullying using a sample of preschool children, has also shown that children from families with lower educational level present an increased risk of victimization [30] A study conducted in Germany and England has also reported associations between social class and both victims and perpetrators [16]. Moreover, not only the presence but also the persistence of bullying over time has been associated with lower socioeconomic status of the family [31]. A recent review suggests that bullying is not only a socially patterned life experience, but it tracks over time and there are indications of a socially differential vulnerability to its effects. Exposure to bullying may be an element of a pathway through which socioeconomic position in adolescence contributes to adult health inequalities [32]. At the school level, Whitney and Smith (1993) reported that junior and middle schools with higher proportions of families from lower social classes had a higher prevalence of bullying [24]. Finally, at the country level countries with higher income inequality had a higher prevalence of bullying among preadolescents than countries with lower income inequality [33].
As described in the previous paragraphs psychiatric morbidity has been associated with bullying-related behaviours. In addition previous studies have shown a strong association between several socioeconomic variables and psychiatric morbidity [34–36]. Therefore, an important confounding variable in the association between socioeconomic status and bullying is the presence of psychiatric morbidity. Not all previous studies have adjusted for the full spectrum of psychiatric morbidity including sub-threshold forms of illness. It is likely that a more detailed assessment of psychiatric morbidity including also sub-threshold forms of illness could explain part of the confounding and could reduce possible associations between bullying and socioeconomic status. It is noted that confounding is an important issue irrespective of the study design and could influence the results of both cross-sectional and longitudinal studies. Clarifying whether low socioeconomic status is associated with bullying after adjustment for all potential confounding factors may contribute to the discussion about possible causal pathways of bullying-related behaviours.
The aim of the present study was to investigate the association between bullying-related behaviours (being either a victim or a perpetrator or both) and socioeconomic status in a sample of adolescents attending senior high schools in Greece. Since the burden of psychiatric morbidity is significant in adolescence [37], we explored possible effects of the full spectrum of psychiatric morbidity on the association between bullying and socioeconomic indicators. We made the hypothesis that socioeconomic indicators would be independently associated with bullying-related behaviours after adjusting for psychiatric morbidity. We have also investigated the association of obesity problems with bullying-related behaviours, since there is evidence that obesity or overweight may be associated with both bullying and socioeconomic status [38–40].
Description of the data set
The data reported here are derived from the "Epirus School Project" [35] which is a cross-sectional survey carried out in selected upper secondary schools in Greece. The study was approved by the Ethical committee of the Ministry of Education and the Greek Pedagogical Institute (decision number: 61390/g2/19-06-2006) and was conducted according to the Helsinki declaration. The study was also approved by the Head of each participating School. The principal aim of the survey was to investigate the prevalence and associations of common mental disorders in late adolescence.
Secondary education in Greece
Secondary education in Greece is distinguished into lower secondary (grades 7-9; ages 13-15 years; attendance is compulsory) and upper secondary (grades 10-12; ages 16-18 years; attendance is not compulsory). Upper secondary schools are further distinguished into senior high schools (Lyceum) and technical vocational schools with the majority of students (75%) attending senior high schools. In the "Epirus School Project" only senior high schools were selected (age of pupils 16-18 years). At the time of the design of the study approximately 75,000 students attended 1,193 senior high schools.
Sampling of schools and pupils
Schools were selected according to the following rules: a) all senior high schools of the major cities in the north-western part of Greece (regions of Epirus and Aetoloakarnania) due to the proximity of this area to the University of Ioannina, b) all senior high schools in one randomly selected district of the Athens Metropolitan Area (the district of Kallithea was selected), c) all senior high schools of the island of Paros in the Aegean Sea (the island was conveniently selected). A total of 25 schools took part in the study. The median number of participants per school was 225 pupils ranging from 138 to 425. The main fieldwork took place between January 2007 and April 2008. All students in the selected schools were invited to participate in the study, while the participation was voluntary. Consent was actively obtained from both the participants and their parents.
Design of the study and data collection procedure
The study used a two-phase design [41]. In the first phase, all consenting students (N = 5,614, response rate 82%) were administered a brief screening instrument in the classroom. The screening instrument of the first phase was developed from the revised clinical interview schedule (CIS-R) used in the second phase of the study. Students were selected for the second phase psychiatric interview using a stratified random sampling procedure according to the scores on the screening questionnaire: 100% of those scoring high on the screening instrument (> 75th percentile), 30% of those scoring in the middle and 10% of those scoring low (< 25th percentile). The second phase (N = 2,431, response rate 95%) consisted of the computerized version of a fully-structured psychiatric interview (see next section) and was carried out in the computer laboratories of the schools. It is noted that in two schools (both in the island of Paros) all consenting students were interviewed (that is the two phases were merged into one). The reason was the availability of the fieldworkers of the island of Paros, which allowed us to provide the instrument of the CIS-R interview in full to all consenting students. From the remaining 1,960 pupils who were selected according to the stratified random sampling procedure, 926 (47.2%) were on the 100% stratum, 866 (44.2%) on the 30% stratum and 168 (8.6%) on the 10% stratum. Four out of the 2,431 selected pupils had missing values on the sociodemographic questions (administered in the first phase of the study) and therefore 2,427 pupils were used in the final analysis.
Assessment of psychiatric morbidity: the revised clinical interview schedule (CIS-R)
Psychiatric symptoms were assessed with the revised clinical interview schedule (CIS-R), a fully structured psychiatric interview designed to be used by trained lay interviewers [42]. The CIS-R was the main instrument used in the national psychiatric morbidity surveys in the UK [43] and has been used in several other similar surveys around the world. A computerized version has also been developed and found to be comparable with the regular interview [44]. The CIS-R was originally designed to assess symptoms in participants above 16 years old but has been previously used in teenagers above 14 years old in Australia [45]. The CIS-R assesses the presence and severity of common psychological symptoms (somatic symptoms, fatigue, concentration/memory problems, sleep problems, irritability, depressive mood, depressive ideas, general worry, worry about physical health, free-floating anxiety, phobias, panic anxiety, compulsions and obsessions). Two screening questions in each section ask about the presence of the symptom during the past month and then there is a more detailed assessment of the presence, frequency, duration and severity of the symptom during the past seven days. Based on the above-mentioned characteristics of the symptoms each one of the 14 symptoms is rated with an individual score on a scale ranging from 0 to 4 (except depressive ideas scored from 0 to 5).
In the first phase of the study we used the screening questions of the several symptom sections of the CIS-R. To simplify the screening we excluded the somatic symptoms section, the depressive ideas section (since it is branched through the depression section), and the panic section (it is branched through the anxiety section). We used the main screening question for the symptoms of fatigue, concentration problems, memory problems, worry about physical health, free-floating anxiety, phobias, obsessions, and compulsions (eight questions) and the two screening questions for the symptoms of sleep problems (one question for difficulty sleeping and one for sleeping more than usual), irritability, depression (depressed mood and loss of interest) and anxiety (eight questions). Therefore the screening instrument consisted of 16 yes-no questions. The full interview was taken by those students selected for the second phase of the study.
The Greek version of the CIS-R was translated and back-translated using the procedure recommended by the World Health Organization http://www.who.int/substance_abuse/research_tools/translation/en/index.html. The psychometric properties of the Greek version of the CIS-R including its factor structure and internal consistency have been reported by Skapinakis et al. 2010 [46]. An internal consistency reliability analysis showed that item-test correlations ranged from 0.42 to 0.74, item-rest correlations ranged from 0.30 to 0.67 and Cronbach's alpha ranged from 0.84 to 0.87 with an overall alpha for CIS-R of 0.86. A test-retest reliability of the CIS-R was carried out in a subset of the present data set (two schools of the city of Ioannina with an interval between assessments of 2 weeks) and was found to be 0.84 [35].
For the purposes of the present study psychiatric morbidity can be assessed either in a dimensional way, using the total score on the CIS-R (by adding-up all 14 symptom dimensions), or in a categorical form using diagnostic categories. We chose to use the total score in our analyses because in that way we are able to adjust for the full spectrum of psychiatric morbidity including sub-threshold forms of illness. To better illustrate the association of bullying with the severity of psychiatric morbidity we defined four groups of severity: "no/minimal symptoms" (CIS-R score = 0-5), "subthreshold symptoms" (CIS-R score = 6-11), "mild symptoms" (CIS-R score = 12-17) and "severe symptoms" (CIS-R score > = 18). A score of 12 or above on the CIS-R indicates caseness [42, 47], a score of 6-11 indicates some symptoms of mental disorder, a score of 0-5 indicates little evidence of mental disorder [47], while a score of 18 or more has been used as an indicator of severe morbidity [48].
Assessment of school bulling
Involvement in bullying either as a perpetrator (bully others) or as a victim (being bullied by others) was investigated in the second phase of the study. We used two questions, one for being bullied and one for bullying others, taken from the revised Olweus Bully/Victim Questionnaire [49] which was also used in a WHO youth health study [50]. An introductory sentence defined bullying as follows:
"The next questions are about bullying. We say a pupil is being bullied when another pupil, or a group of pupils, says or does nasty and unpleasant things to him or her. It is also bullying when a pupil is teased repeatedly in a way he or she doesn't like. But it is not bullying when two pupils of about the same strength quarrel or fight."
The respondents were further asked how frequently they had been bullied or had bullied others during the last 2 months in school. The possible answers were: "many times a week", "about once a week", "2 or 3 times a month", "about once a month" and "not at all". Based on these responses we classified participants into the following groups: a) Not involved in bullying related behaviours, either as victims or perpetrators; b) being a victim but not a perpetrator; c) being a perpetrator but not a victim; d) being both a victim and perpetrator. Regarding the cut-off for frequency, we defined two variables, one including all instances of bullying-related behaviours (i.e. at least once a month) and the other focusing on high frequency only (i.e. at least once a week).
Socioeconomic variables
We have used the following socioeconomic variables:
a) Parental Education
We assessed the educational status of both parents separately, since evidence shows that maternal socioeconomic characteristics have an equally, or even more, significant impact on child and adolescent health [51]. Pupils were asked to report their parents' highest educational level attained.
b) Parental Employment
Regarding employment, we chose to use the variable "employment type", which discriminates/distinguishes not only between employment status (employed--unemployed), but also between the different sectors of employment (self-employed, private or public sector employees). More specifically "employment type" was divided into six groups: "public sector employee"; "private sector employee"; "self-employed"; "pensioner"; "unemployed"; and "housewife" (as regards the mother's employment type) or "inability to work" (as regards the father's employment type). A residual category was also allowed ("else"). In Greece the legislative framework relating to the combination of family life and career (i.e. maternity leave, leave for breast-feeding/child bearing/illness, child/family allowances etc.) differs significantly between public and private sector [52]. Greek social research employs this kind of typology which links to the institutions and the way public life is organized in Greece. As a result the distinction between self-employed, private and public sector employees appears as very important for the country, since it determines in a great extent the way families live and function. Moreover, it is expected that the information lost by failing to ask the exact occupation, could be substituted by the information carried by the variable of education [53].
c) Financial status
We asked the adolescents to express their subjective view on any financial difficulties their family might experience recently. The specific question asked was: "How do you think that your family is doing financially?" The possible answers included: "My family experiences no financial difficulties", "My family experiences very few financial difficulties", "My family experiences some financial difficulties" and "My family experiences a lot of financial difficulties". This type of question takes into account adolescents' subjective view of their family's economic position.
d) School performance
In Greece, where typical 16-18 years-old adolescents have not yet entered the labour market, neither have they completed their education, own educational level or occupation cannot be used as a measure of personal social position. Academic performance in school has been often used in the literature as a measure of the position of the pupils in school [36, 54, 55]. We therefore included academic performance in our socioeconomic indicators by asking the participants to rate their school performance (based on their recent marks) in a scale with four choices ("excellent"; "very good"; "good"; "fair").
Sociodemographic and other variables
In the first phase of the study information was selected from the students about several sociodemographic variables (grade the pupil is currently attending, gender, parent's age, parent's marital status, number of brothers and sisters). We also obtained adolescents' self-reports on their current body weight and height, we calculated the body mass index (BMI: kg/m2) for each student and we included this in our analyses as a categorical variable (BMI < 19, 19-22, 22-25, 25-30, > = 30) in order to be able to highlight any potential non-linear associations.
Statistical analyses
The analyses were all conducted using the statistical software package STATA 10.0 (StataCorp, College Station, Texas). To take into account the potential effect of clustering of our data (since adolescents were nested into 25 schools) we first carried out a two-level logistic model (level 1: individuals, level 2: schools) in Stata using the gllamm command [56]. We also performed the models with the survey commands of Stata using school as the stratum. Results were very similar with both models and therefore in the paper we present the results using the survey commands because their use is more widespread in the literature. It should be noted that the effect of schools was negligible with an intraclass correlation coefficient close to zero (< 0.08). In all analyses we have used probability weights to take into account the stratified random sampling procedure.
The associations between involvement in bullying-related behaviours and psychiatric morbidity, socioeconomic and other variables were investigated using multinomial logistic regression models in Stata ("mlogit" command using the "svy" prefix" to obtain robust standard errors). The dependent variable was involvement in bullying (all frequencies, i.e. at least once per month) and the reference group was "not involved in bullying-related behaviours". We also present the analysis of the high frequency involvement only (i.e. at least once weekly) for comparison reasons and to check the sensitivity of our results in the change of the frequency cut-off. However, in the latter analysis, due to the small number of pupils with bullying-related behaviours in the fourth group of victims-perpetrators, odds ratios could not be calculated, therefore we only present odds ratios for victims vs. not involved and perpetrators vs. not involved.
Finally, since we have used categorical variables in our study, we have additionally calculated adjusted Wald tests in order to test the overall significance of our variables in the regression models, using the post-estimation command "test" in Stata.
Description of the sample
Overall 5,614 students took part in the first phase of the study (55% girls, 41% 10th grade, 31% 11th grade, 28% 12th grade), while 2,431 students were interviewed in the second phase (59% girls, 39% 10th grade, 32% 11th grade, 29% 12th grade). A detailed table of the sociodemographic characteristics of the whole sample in both phases of the study is given in Additional file 1: Table S1. Due to the stratified sampling procedure there were more female than male students in the second phase.
Prevalence of bullying behaviours
Prevalence of bullying-related behaviours (at least once monthly or more) in Greek adolescents 16-18 years old attending senior high schools (N = 2,427)
Not Involved
Victims only
Perpetrators only
Victims & Perpetrators
Prevalence of bullying-related behaviours (at least once weekly or more) in Greek adolescents 16-18 years old attending senior high schools (N = 2,427)
Not Involved
Victims only
Perpetrators only
Victims & Perpetrators
Association between bullying-related behaviours (all frequencies) and socioeconomic status variables
Associations of bullying-related behaviours (at least once monthly) with socioeconomic variables and psychiatric morbidity.
(base = Not involved in bullying-related behaviours)
Female Gender
0.56 (0.37-0.85)
0.22 (0.15-0.33)
0.33 (0.20-0.55)
0.80 (0.49-1.29)
1.39 (0.95-2.04)
1.37 (0.77-2.43)
0.63 (0.39-1.00)
1.09 (0.71-1.70)
0.49 (0.26-0.90)
Father's Educational Level
Secondary Basic
1.04 (0.52-2.06)
1.00 (0.52-1.93)
1.30 (0.57-2.96)
Secondary Complete
0.75 (0.43-1.32)
1.04 (0.56-1.93)
0.84 (0.40-1.79)
Technological degree
0.65 (0.30-1.42)
0.98 (0.48-2.01)
0.34 (0.13-0.93)
University degree
0.95 (0.50-1.81)
1.22 (0.59-2.50)
0.98 (0.45-2.15)
Mother's Educational Level
Secondary Basic
0.94 (0.48-1.83)
1.34 (0.67-2.67)
1.95 (0.81-4.67)
Secondary Complete
0.73 (0.42-1.27)
1.14 (0.63-2.07)
1.10 (0.51-2.37)
Technological degree
0.48 (0.22-1.02)
0.52 (0.24-1.15)
1.66 (0.65-4.24)
University degree
0.70 (0.29-1.67)
0.94 (0.45-1.96)
1.58 (0.62-4.05)
Financial Difficulties
Very few
1.38 (0.85-2.23)
1.18 (0.79-1.76)
1.14 (0.67-1.95)
Some/A lot
1.22 (0.71-2.11)
1.33 (0.77-2.30)
1.41 (0.72-2.76)
School Performance
2.05 (0.90-4.66)
0.53 (0.26-1.11)
1.35 (0.61-3.01)
Very good
1.41 (0.83-2.39)
0.53 (0.33-0.86)
0.86 (0.43-1.71)
1.41 (0.85-2.36)
0.79 (0.52-1.21)
1.23 (0.68-2.21)
Father's Employment Type
Public sector employee
Private sector employee
1.02 (0.58-1.78)
0.87 (0.51-1.49)
0.70 (0.38-1.27)
1.21 (0.76-1.91)
1.61 (0.99-2.63)
0.92 (0.51-1.68)
0.77 (0.31-1.92)
0.32 (0.14-0.71)
0.89 (0.22-3.60)
2.28 (0.86-6.05)
2.32 (1.19-4.51)
0.73 (0.24-2.26)
Mother's Employment Type
Employee (public or private)
1.41 (0.72-2.76)
1.08 (0.63-1.88)
2.01 (0.84-4.78)
0.63 (0.29-1.39)
0.87 (0.41-1.88)
1.39 (0.47-4.10)
Looks after house
0.67 (0.40-1.11)
1.00 (0.65-1.57)
2.11 (1.20-3.69)
0.47 (0.21-1.06)
0.86 (0.39-1.91)
2.53 (1.16-5.52)
< 19
0.80 (0.48-1.33)
1.41 (0.84-2.37)
0.89 (0.47-1.69)
0.85 (0.47-1.55)
1.32 (0.73-2.41)
1.05 (0.51-2.13)
1.28 (0.59-2.79)
1.10 (0.57-2.13)
2.00 (0.94-4.22)
> = 30
2.42 (0.49-11.98)
1.85 (0.57-5.99)
1.41 (0.33-6.01)
Psychiatric Symptoms
No symptoms
Subthreshold symptoms
2.15 (1.03-4.50)
1.65 (1.04-2.60)
4.52 (1.94-10.54)
Mild symptoms
3.06 (1.43-6.52)
1.92 (1.22-3.03)
3.77 (1.67-8.52)
Severe symptoms
6.32 (3.30-12.09)
1.75 (1.08-2.86)
7.57 (3.33-17.23)
Associations of bullying-related behaviours (at least once weekly or more) with socioeconomic variables and psychiatric morbidity.
(base = Not involved in bullying-related behaviours)*
Female Gender
0.89 (0.38-2.07)
0.08 (0.04-0.19)
0.55 (0.26-1.18)
1.25 (0.61-2.56)
0.34 (0.15-0.77)
0.25 (0.10-0.61)
Father's Educational Level
Secondary Basic
1.87 (0.68-5.10)
1.63 (0.51-5.19)
Secondary Complete
0.85 (0.30-2.38)
1.09 (0.34-3.47)
Technological degree
0.21 (0.04-0.92)
0.67 (0.19-2.31)
University degree
1.05 (0.32-3.41)
0.60 (0.19-1.88)
Mother's Educational Level
Secondary Basic
0.59 (0.19-1.80)
0.65 (0.18-2.30)
Secondary Complete
0.75 (0.30-1.84)
0.24 (0.07-0.77)
Technological degree
0.59 (0.15-2.35)
0.53 (0.13-2.20)
University degree
0.74 (0.17-3.14)
0.50 (0.11-2.25)
Financial Difficulties
Very few
0.91 (0.41-2.02)
2.08 (0.94-4.59)
Some/A lot
1.50 (0.58-3.86)
2.93 (0.97-8.81)
School Performance
1.79 (0.49-6.52)
0.86 (0.28-2.65)
Very good
0.66 (0.25-1.74)
0.21 (0.08-0.55)
0.83 (0.34-2.00)
0.62 (0.30-1.30)
Father's Employment Type
Public sector employee
Private sector employee
1.73 (0.64-4.70)
1.30 (0.44-3.83)
1.16 (0.47-2.85)
4.62 (1.91-11.19)
0.41 (0.05-3.40)
0.65 (0.13-3.26)
2.06 (0.56-7.62)
1.62 (0.32-8.08)
Mother's Employment Type
Employee (public or private)
0.50 (0.12-2.07)
0.69 (0.22-2.17)
0.21 (0.02-1.95)
1.53 (0.33-7.15)
Looks after house
1.15 (0.47-2.81)
0.63 (0.26-1.50)
0.22 (0.02-2.45)
0.20 (0.04-1.11)
< 19
0.77 (0.31-1.90)
4.94 (1.75-13.94)
1.02 (0.38-2.77)
3.13 (1.06-9.28)
0.62 (0.19-2.01)
5.49 (1.48-20.38)
> = 30
8.86 (1.89-41.77)
0.50 (0.05-5.68)
Psychiatric Symptoms
No symptoms
Subthreshold symptoms
1.52 (0.46-5.07)
3.00 (1.11-8.06)
Mild symptoms
1.24 (0.34-4.55)
3.39 (1.21-9.50)
Severe symptoms
4.67 (1.51-14.47)
4.54 (1.52-13.56)
Associations with victims
Victimization was significantly associated with psychiatric morbidity and male gender. From the socioeconomic indicators studied none was significantly associated in the adjusted model.
Associations with perpetrators
Being a perpetrator was significantly associated with psychiatric morbidity and male gender. From the socioeconomic indicators studied a lower school performance (Adjusted Wald test: F3,2400 = 2.57, p = 0.05; odds ratio for linear term: 1.31, p = 0.008) and father's employment status (Adjusted Wald test: F4,2400 = 5.92, p = 0.0001) were associated with being a perpetrator. For employment this was mainly due to the unemployment of the father that was associated with an increased risk of being a perpetrator and retirement of the father that was associated with a lower risk.
Associations with victims-perpetrators (both behaviours occurring at the same time)
Male gender and psychiatric morbidity were significantly associated with an increased risk of showing both behaviours at the same time (victims and perpetrators). In addition, being a younger pupil (attending 10th grade) was also associated with an increased risk (Adjusted Wald test: F2,2400 = 5.47, p = 0.004)
Regarding the socioeconomic indicators, mother's employment status was associated with being a victim-perpetrator (Adjusted Wald test: F4,2400 = 2.54, p = 0.04). This was mainly due to a higher risk for those pupils whose mothers were looking after the house or were retired. There was a non-significant trend for father's educational level to be associated with victims-perpetrators (Adjusted Wald test: F4,2400 = 2.10, p = 0.07), mainly due to a lower risk of being a victim-perpetrator in the category "technological degree" of father's educational level.
Associations with socioeconomic status variables in high frequency only
As mentioned in methods we also present results for involvement in bullying in a higher frequency (i.e. at least once weekly) to check the sensitivity of our results in the change of the frequency cut-off.
Regarding victims the following variables were found to be associated with an increased risk: being a younger pupil (Adjusted Wald test: F2,2400 = 3.42, p = 0.03), having higher psychiatric morbidity (Adjusted Wald test: F3,2400 = 3.45, p = 0.02) and having a higher BMI (Adjusted Wald test: F4,2400 = 3.20, p = 0.01), mainly due to an increased risk of the overweight pupils (BMI > = 30). None of the socioeconomic indicators were found to be associated with an increased risk.
Regarding perpetrators, male gender, younger pupils and a higher psychiatric morbidity were also associated with an increased risk. BMI was associated in a non-linear way with a lower risk in the two extremes (Adjusted Wald test: F4,2400 = 3.18, p = 0.01). From the socioeconomic indicators studied a lower school performance (Adjusted Waldt test: F3,2400 = 3.30, p = 0.02) and father's employment (Adjusted Wald test: F4,2400 = 5.34, p = 0.0003) were found to be associated with an increased risk as was the case in the "all frequencies" analysis. However, for father's employment this was mainly due to the self-employment category of father and not that of unemployed. It should be noted that a linear term for financial difficulties (i.e. using the variable as a continuous one) had an odds ratio of 1.67 (95% CI: 1.01-2.84, p = 0.047) which was marginally significant. However, using the variable in a categorical form this was not significant (Adjusted Wald test F2,2400 = 2.04, p = 0.13)
Main findings
In a sample of late adolescents attending senior high schools in Greece 26.4% of the pupils were involved in bullying-related behaviours either as victims, perpetrators or both. The prevalence of being a perpetrator was approximately twice that of being a victim, while approximately 18% of the pupils who were involved in bullying showed both behaviours. Frequent bullying (at least once weekly) was less common. In our study we confirmed the strong association of psychiatric morbidity with all types of bullying-related behaviours. The association with socioeconomic status however seems to be more complex. In victims we did not find any evidence for an association with the socioeconomic variables studied. In contrast there was some evidence that perpetrators (pupils who bully others) are more likely to come from families with an unemployed father. On the other hand, father's retirement was associated with a lower risk of perpetration. In addition the personal social position of the pupil in the school, as reflected in their school performance, is more likely to be lower in perpetrators. Economic inactivity of the mother (either housekeeping or retirement) was associated with an increased likelihood of being both a victim and perpetrator. These results were generally confirmed when we changed the cut-off of bullying frequency (from once monthly to once weekly), although in that case there was an association of bullying others (perpetrators) with self-employment of the father rather than unemployment. Of note, financial difficulties in the family did not seem to be associated with bullying-related behaviours, although in the case of the high frequency bullying there was a marginal result concerning financial difficulties and the likelihood of being a perpetrator.
Comparison with other studies
Our study indicates that bullying is an important problem for Greek youth. As mentioned above, there is considerable variability among countries in the prevalence of bullying, which has been partly attributed to sociodemographic and cultural differences and partly to methodological inconsistencies [16]. Our results are consistent with studies conducted in different countries, which used similar instruments and a similar recall period [17]. Differences in the prevalence of bullying could also be explained by the fact that bullying is more prevalent among younger pupils [17]. Several studies report age differences in pupils' understanding of the term and experience of bullying [57, 58] and results may not be comparable between studies using different age samples.
A strong and graded association was reported between psychiatric morbidity and both bullying behaviours. Similar associations have been presented by previous studies [21, 59]. The cross-sectional design of our study does not allow us to draw any conclusions on the direction of this association. It could be argued that both directions of causality are possible. As a result the debate remains as to whether bullying-related behaviours precede the onset of mental health problems or whether people with emotional problems tend to get more involved in such behaviours. Longitudinal studies have shown that a history of bullying-related victimization predicts the onset of emotional problems, while previous emotional problems are not significantly associated with future victimization [5].
Our study has pointed out some interesting associations between socioeconomic indicators and the likelihood of being a perpetrator. Parental employment type and adolescent's school performance showed associations which are independent of the presence of psychiatric morbidity. Studies investigating bullying behaviours have often controlled for mental health problems using simple self-reported questionnaires [17, 26]. In our study we used a fully structured psychiatric interview assessing a broad range of common psychological symptoms. As a result there is strong evidence that the socioeconomic associations reported here are independent of any possible psychiatric problems including sub-threshold symptoms.
Parental unemployment, especially of fathers, has been negatively associated with various aspects of adolescents' health and well-being [60], which may explain the associations found in our sample. Another possible mechanism mediating this association might be parental support, since parental unemployment reduces perceived parental support [61], which has been associated with less involvement in bullying-related behaviours [62]. As regards the association with the self-employment of the father, which has arisen in the analysis of the high frequency of the variables, it can be argued that self-employment in Greece is characterized by long and flexible working-hours, flexible holidays and considerable temporal income-variations, which may cause significant insecurity in the family context and also reduce perceived parental support.
Poorer academic achievement in school, which could be considered as an indicator of school adjustment and adolescents' own position in the school setting, has been previously associated with an increased risk of being a perpetrator [17]. In our study, a lower school performance was associated with an increased risk of perpetration, while there was some evidence of a J-type association in the high frequency only, with both fair and excellent school performance being associated more strongly with frequent perpetration. It can be argued that adolescents, who think that their school performance belongs to the extreme ends of the range, may feel that they do not belong to the average group when compared to their peers, a perception which could be very stressful for the adolescent, leading perhaps to antisocial behaviours like bullying.
Parental education as an overall variable was not associated with bullying perpetration or victimization. However, some subgroups of the variable were associated with bullying-related behaviours. The category "technological degree" of father's educational level was associated with a lower risk of being a victim-perpetrator and being a frequent victim, while the category "secondary complete" of mother's educational level was associated with a lower risk of being a frequent perpetrator. Associations with parental education have been reported by previous studies that also used pupils' self-reports, as well as with studies that used parental reports [63].
Financial difficulties of the family have been often used in studies investigating socioeconomic health inequalities of children and adults [34, 64] and several studies confirm a relationship between low parental socioeconomic status and being a victim or a perpetrator [16, 24]. In our study we did not find evidence that financial difficulties may be associated with bullying-related behaviours when all frequencies of bullying are included. When we focused however in high frequency (perhaps pointing to a more severe range of the spectrum) there was a trend for more financial difficulties in the family to be associated with an increased risk of being a perpetrator. However, this was dependent on the analysis (there was a marginally significant association only when the variable was treated as a continuous variable) and therefore we are unsure whether financial difficulties may have a negative impact on pupil's behaviour.
Regarding sociodemographic factors we confirmed that boys, overweight, obese and younger pupils are more frequently involved in bullying behaviours either as victims or as perpetrators [17, 26, 38, 39]. An interesting finding in our study was the nonlinear relationship between the BMI and being a victim of bullying behaviours. Severe obesity (BMI > 30) was found to be associated with victimization only in the high frequency analysis.
Limitations of the study
When interpreting the above mentioned findings the cross-sectional nature of our study should be taken into account, since it does not allow us to make any causal inference about the association between bullying and the socioeconomic indicators studied. Furthermore, our sample did not include adolescents attending technical vocational schools but only those attending senior high schools (approximately 75% of the school-attending adolescents of this age). Parental employment status was based on adolescents' self-report, which may result in some misclassification. However, this kind of misclassification is expected to be random. Moreover, the question about parental employment status did not include information about the exact occupation and as a result an official "occupational status" classification was not possible.
In order to calculate the body mass index of the students we have used adolescents' self-reports of their current body weight and height. Research has shown that adolescents' self-reports of height, weight and BMI are on the average valid representations of their measured counterparts. However, even when they occur, systematic errors in self-reported height, weight and BMI are negatively associated with the corresponding measured dimension and the prevalence of overweight based on BMI from self-reported measures is expected to be systematically underestimated relative to measured values [65]. As a result, even if these errors influence the results, this will be towards the null value, i.e. against our hypotheses.
Moreover, in this study we have used the variable of self-reported school performance and not variables based on objective data, such as official school grades or national examinations, which are expected to be more accurate measures of pupils' school performance. However, our objective in the current study was not to distinguish between academically good and worse students or investigate possible effects on adolescents' academic achievements, but to use a measure, which could reflect adolescents' own perceptions about their current position in the field where they are mainly active. This was the reason why we chose to use a subjective measure reported by the adolescent rather than objective data. We would like to note though that perceived academic achievement has been often used also in studies about bullying in schools [17].
Finally, we have used a subjective socioeconomic variable, namely adolescents' self-reports on the financial difficulties of their families. It has been suggested that directly questioning adolescents about their family's income can be unreliable [54]. In the literature financial difficulties of the family have been often used as a socioeconomic indicator in studies investigating socioeconomic health inequalities in populations of children and adults [34, 64]. These studies have shown that more subjective indicators (such as financial difficulties, financial strain etc.) may be equally or even more important compared to more objective indicators of socio-economic status [64].
Bullying in school is a substantial problem for Greek youth. This study has shown that perpetration was independently associated with some dimensions of adolescents' socioeconomic status, while victimization showed no socioeconomic associations. Our findings indicate that lower socioeconomic status as expressed by typical and other measures is related to an increased risk of being a perpetrator. The current findings may add to our understanding of possible risk factors for bullying behaviours in adolescence. The identification of potential risk factors plays a decisive role in the design of effective anti-bullying programmes. Several countries have adopted anti-bullying measures in schools and some of them have been found to be effective at least in the short-term [66]. More has to be done, however, to maintain the results over longer periods. Greece has only recently started discussing the implementation of a national policy against bullying. International experience combined with relevant research findings could contribute significantly to the organisation of effective anti-bullying programmes in the school setting, the benefits of which are expected to appear not only in adolescence but also in later life [67].
The authors would like to acknowledge the support of the Ministry of National Education which partly funded the study under the Pythagoras II research program (European Community Support Framework 2000-2006). Pythagoras II project was co-funded by the European Social Fund (75%) and National Resources (25%).
Authors' Affiliations
- Boulton MJ, Underwood K: Bully/victim problems among middle school children. Br J Educ Psychol. 1992, 62: 73-87. 10.1111/j.2044-8279.1992.tb01000.x.View ArticlePubMedGoogle Scholar
- Olweus D: Bullying at School: What We Know and What We Can Do. 1993, Oxford: Blackwell PublishersGoogle Scholar
- Delfabbro P, Winefield T, Trainor S, Dollard M, Anderson S, Metzer J, Hammarstrom A: Peer and teacher bullying/victimization of South Australian secondary school students: prevalence and psychosocial profiles. Br J Educ Psychol. 2006, 76 (1): 71-90. 10.1348/000709904X24645.View ArticlePubMedGoogle Scholar
- Abada T, Feng H, Bali R: The effects of harassment and victimization on self-rated health and mental health among Canadian adolescents. Soc Sci Med. 2008, 67: 557-567. 10.1016/j.socscimed.2008.04.006.View ArticlePubMedGoogle Scholar
- Bond L, Carlin JB Thomas L, Rubin K, Patton G: Does bullying cause emotional problems? A prospective study of young teenagers. BMJ. 2001, 323 (7311): 480-484. 10.1136/bmj.323.7311.480.PubMed CentralView ArticlePubMedGoogle Scholar
- Glew GM, Fan MY, Katon W, Rivara FP, Kernic MA: Bullying, psychosocial adjustment, and academic performance in elementary school. Arch Pediatr Adolesc Med. 2005, 159 (11): 1026-1031. 10.1001/archpedi.159.11.1026.View ArticlePubMedGoogle Scholar
- Perren S, Dooley J, Shaw T, Cross D: Bullying in school and cyberspace: Associations with depressive symptoms in Swiss and Australian adolescents. Child Adolesc Psychiatry Ment Health. 2010, 4: 28-10.1186/1753-2000-4-28.PubMed CentralView ArticlePubMedGoogle Scholar
- Lien L, Green K, Welander-Vath A, Bjertness E: Mental and somatic complaints associated with school bullying 10th and 12th grade students from cross sectional studies in Oslo, Norway. Clinical Practise and Epidemiology in Mental Health. 2009, 5: 6-10.1186/1745-0179-5-6.View ArticleGoogle Scholar
- Williams K, Champers M, Logan S, Robinson D: Assotiation of common health symptoms with bullying in primary school children. BMJ. 1996, 313: 17-19. 10.1136/bmj.313.7048.17.PubMed CentralView ArticlePubMedGoogle Scholar
- Wolke D, Karstadt L: Physical and relational bullying in young children: distinguishing features. J Child Psychology Psychiatry. 2000, 41 (8): 989-1002. 10.1111/1469-7610.00687.View ArticleGoogle Scholar
- Herba K, Ferdinand R, Stijnen T, Veenstra R, Oldehinkel A, Ormel J, Verhulst F: Victimization and suicide ideation in the TRAILS study: specific vulnerabilities of victims. Journal of child and Psychology. 2008, 49 (8): 867-876. 10.1111/j.1469-7610.2008.01900.x.View ArticleGoogle Scholar
- Skapinakis P, Bellos S, Gkatsa T, Magklara K, Lewis G, Araya R, Stylianidis S, Mavreas V: The association between bullying and early stages of suicidal ideation in late adolescents in Greece. BMC Psychiatry. 2011, 11: 22-10.1186/1471-244X-11-22.PubMed CentralView ArticlePubMedGoogle Scholar
- Klomek AB, Sourander A, Niemelä S, Kumpulainen K, Piha J, Tamminen T, Almqvist F, Gould MS: Childhood bullying behaviors as a risk for suicide attempts and completed suicides: a population-based birth cohort study. J Am Acad Child Adolesc Psychiatr. 2009, 48 (3): 254-261. 10.1097/CHI.0b013e318196b91f.View ArticleGoogle Scholar
- Kim YS, Leventhal BL, Koh YJ, Hubbard A, Boyce WT: School bullying and youth violence: causes or consequences of psychopathology?. Arch Gen Psychiatry. 2006, 63 (9): 1035-1041. 10.1001/archpsyc.63.9.1035.View ArticlePubMedGoogle Scholar
- Sourander A, Jensen P, Ronning JA, Elonheimo H, Niemela S, Helenius H, Kumpulainen K, Piha J, Tamminen T, Moilanen I, Almqvist F: Childhood bullies and victims and their risk of criminality in late adolescence. Arch Pediatr Adolesc Med. 2007, 161: 546-552. 10.1001/archpedi.161.6.546.View ArticlePubMedGoogle Scholar
- Wolke D, Woods S, Stanford K, Schulz H: Bullying and victimization of primary school children in England and Germany: prevalence and school factors. Br J Psychol. 2001, 92 (4): 673-696. 10.1348/000712601162419.View ArticlePubMedGoogle Scholar
- Nansel TR, Overpeck M, Pilla RS, Ruan WJ, Simons-Morton B, Scheidt P: Bullying behaviors among US youth: prevalence and association with psychosocial adjustment. JAMA. 2001, 285 (16): 2094-2100. 10.1001/jama.285.16.2094.PubMed CentralView ArticlePubMedGoogle Scholar
- Baldry AC, Farrington DP: Brief report: types of bullying among Italian school children. J Adolesc. 1999, 22 (3): 423-426. 10.1006/jado.1999.0234.View ArticlePubMedGoogle Scholar
- Kim YS, Koh YJ, Leventhal BL: Prevalence of school bullying in Korean middle school students. Arch Pediatr Adolesc Med. 2004, 158: 737-741. 10.1001/archpedi.158.8.737.View ArticlePubMedGoogle Scholar
- Dake JA, Price JH, Telljohann SK: The nature and extent of bullying at school. J Sch Health. 2003, 73 (5): 173-180. 10.1111/j.1746-1561.2003.tb03599.x.View ArticlePubMedGoogle Scholar
- Due P, Holstein BE, Lynch J, Diderichsen F, Gabhain SN, Scheidt P, Currie C, Health Behaviour in School-Aged Children Bullying Working Group: Bullying and symptoms among school-aged children: international comparative cross sectional study in 28 countries. Eur J Public Health. 2005, 15 (2): 128-132. 10.1093/eurpub/cki105.View ArticlePubMedGoogle Scholar
- Due P, Holstein BE: Bullying victimization among 13-15 year old school children: results from two comparative studies in 66 countries and regions. Int J Adolesc Med Health. 2008, 20 (2): 209-222. 10.1515/IJAMH.2008.20.2.209.View ArticlePubMedGoogle Scholar
- Craig W, Harel-Fisch Y, Fogel-Grinvald H, Dostaler S, Hetland J, Simons-Morton B, Molcho M, de Mato MG, Overpeck M, Due P, Pickett W, HBSC Violence & Injuries Prevention Focus Group, HBSC Bullying Writing Group: A cross-national profile of bullying and victimization among adolescents in 40 countries. Int J Public Health. 2009, 54 (2): 216-224. 10.1007/s00038-009-5413-9.PubMed CentralView ArticlePubMedGoogle Scholar
- Whitney I, Smith PK: A survey of the nature and extent of bullying in junior/middle and secondary schools. Educ Res. 1993, 35: 3-25. 10.1080/0013188930350101.View ArticleGoogle Scholar
- Kaltiala-Heino R, Rimpela M, Marttunen M, Rantanen P, Rimpela A: Bullying, depression and suicidal ideation in finnish adolescents: school survey. BMJ. 1999, 319 (7206): 348-351. 10.1136/bmj.319.7206.348.PubMed CentralView ArticlePubMedGoogle Scholar
- Analitis F, Klein-Velderman M, Ravens-Sieberer U, Detmar S, Erhart M, Herdman M, Berra S, Alonso J, Rajmil L, European Kidscreen Group: Being bullied: associated factors in children and adolescents 8-18 years old in 11 European countries. Pediatrics. 2009, 123: 569-577. 10.1542/peds.2008-0323.View ArticlePubMedGoogle Scholar
- Glew G, Rivara F, Feudtner C: Bullying: children hurting children. Pediatr Rev. 2000, 21: 183-190. 10.1542/pir.21-6-183.View ArticlePubMedGoogle Scholar
- Smith PK, Cowie H, Olafsson R, Liefooghe APD: Definitions of bullying: a comparison of terms used, and age and sex differences, in a 14-country international comparison. Child Dev. 2002, 73: 1119-1133. 10.1111/1467-8624.00461.View ArticlePubMedGoogle Scholar
- Due P, Merlo J, Harel-Fisch Y, Damsgaard MT, Holstein BE, Hetland J, Currie C, Gabhainn SN, de Matos MG, Lynch J: Socioeconomic inequality in exposure to bullying during adolescence: a comparative, cross-sectional, multilevel study in 35 countries. Am J Public Health. 2009, 99 (5): 907-914. 10.2105/AJPH.2008.139303.PubMed CentralView ArticlePubMedGoogle Scholar
- Perren S, Stadelmann S, von Klitzing K: Child and family characteristics as risk factors for peer victimization in kindergarten. Schweizerische Zeitschrift für Bildungswissenschaften. 2009, 31 (1): 13-32.Google Scholar
- Kumpulainen K, Räsänen E, Henttonen I: Children involved in bullying: psychological disturbance and the persistence of the involvement. Child Abuse Negl. 1999, 23 (12): 1253-1262. 10.1016/S0145-2134(99)00098-8.View ArticlePubMedGoogle Scholar
- Due P, Krølner R, Rasmussen M, Andersen A, Trab Damsgaard M, Graham H, Holstein BE: Pathways and mechanisms in adolescence contribute to adult health inequalities. Scand J Public Health. 2011, 39 (6 suppl): 62-78. 10.1177/1403494810395989.View ArticlePubMedGoogle Scholar
- Elgar FJ, Craig W, Boyce W, Morgan A, Vella-Zarb R: Income inequality and school bullying: multilevel study of adolescents in 37 countries. J Adolesc Health. 2009, 45 (4): 351-359. 10.1016/j.jadohealth.2009.04.004.View ArticlePubMedGoogle Scholar
- Skapinakis P, Weich S, Lewis G, Singleton N, Araya R: Socio-economic position and common mental disorders. Longitudinal study in the general population in the UK. Br J Psychiatry. 2006, 189: 109-117. 10.1192/bjp.bp.105.014449.View ArticlePubMedGoogle Scholar
- Skapinakis P, Magklara K, Mpellos S, Gkatsa T, Mihalis G, Mavreas V: The association between socio-economic status and mental disorders in late adolescence: cross-sectional survey in the Northwestern part of Greece. Archives of Hellenic Medicine. 2007, 24 (1): 19-29.Google Scholar
- Magklara K, Skapinakis P, Niakas D, Bellos S, Zissi A, Stylianidis S, Mavreas V: Socioeconomic inequalities in general and psychological health among adolescents: a cross-sectional study in senior high schools in Greece. Int J Equity Health. 2010, 9: 3-10.1186/1475-9276-9-3.PubMed CentralView ArticlePubMedGoogle Scholar
- Sawyer MG, Arney FM, Baghurst PA, Clark JJ, Graetz BW, Kosky RJ, Nurcombe B, Patton GC, Prior MR, Raphael B, Rey J, Whaites LC, Zubrick SR: Mental Health of Young People in Australia. Child and Adolescent Component of the National Survey of Mental Health and Well-Being. 2000, Canberra: Commonwealth Department of Health and Aged CareGoogle Scholar
- Janssen I, Craig WM, Boyce WF, Pickett W: Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics. 2004, 113 (5): 1187-1194. 10.1542/peds.113.5.1187.View ArticlePubMedGoogle Scholar
- Bell LM, Byrne S, Thompson A, Ratnam N, Blair E, Bulsara M, Jones TW, Davis EA: Increasing body mass index z-score is continuously associated with complications of overweight in children, even in the healthy weight range. J Clin Endocrinol Metab. 2007, 92 (2): 517-522.View ArticlePubMedGoogle Scholar
- Brixval CS, Rayce SL, Rasmussen M, Holstein BE, Due P: Overweight, body image and bullying--an epidemiological study of 11-15-years olds. Eur J Public Health. 2011, doi:10.1093/eurpub/ckr010Google Scholar
- Dunn G, Pickles A, Tansella M, Vazquez-Barquero JL: Two-phase epidemiological surveys in psychiatric research. Br J Psychiatry. 1999, 174: 95-100. 10.1192/bjp.174.2.95.View ArticlePubMedGoogle Scholar
- Lewis G, Pelosi AJ, Araya R, Dunn G: Measuring psychiatric disorder in the community: a standardised assessment for use by lay interviewers. Psychol Med. 1992, 22: 465-486. 10.1017/S0033291700030415.View ArticlePubMedGoogle Scholar
- Singleton N, Bumpstead R, O'Brien M, Lee A, Meltzer H: Psychiatric morbidity among adults living in private households 2000. Int Rev Psychiatry. 2003, 15: 65-73. 10.1080/0954026021000045967.View ArticlePubMedGoogle Scholar
- Lewis G, Pelosi AJ, Glover E, Wilkinson G, Stansfeld SA, Williams P, Shepherd M: The development of a computerized assessment for minor psychiatric disorder. Psychol Med. 1988, 18: 737-745. 10.1017/S0033291700008448.View ArticlePubMedGoogle Scholar
- Patton GC, Coffey C, Posterino M, Carlin JB, Wolfe R, Bowes G: A computerised screening instrument for adolescent depression: population based validation and application to a two-phase case-control study. Soc Psychiatry Psychiatr Epidemiol. 1999, 34: 166-172. 10.1007/s001270050129.View ArticlePubMedGoogle Scholar
- Skapinakis P, Anagnostopoulos F, Bellos S, Magklara K, Lewis G, Mavreas V: An empirical investigation of the structure of anxiety and depressive symptoms in late adolescence: cross-sectional study using the Greek version of the revised Clinical Interview Schedule. Psychiatry Res. 2010, doi:10.1016/j.psychres.2010.08.023Google Scholar
- Singleton N, Lewis G: Better or Worse: A Longitudinal Study of the Mental Health of Adults Living in Private Households 2000. 2003, London: TSO (The Stationery Office)Google Scholar
- Patel V, Araya R, Chowdhary N, King M, Kirkwood B, Nayak S, Simon G, Weiss HA: Detecting common mental disorders in primary care in India: a comparison of five screening questionnaires. Psychol Med. 2008, 38 (2): 221-228.View ArticlePubMedGoogle Scholar
- Olweus D: The Revised Olweus Bully/Victim Questionnaire. 1996, Bergen, Norway: University of BergenGoogle Scholar
- WHO: Health and Health Behaviour Among Young People: Health Behaviour in School-Aged Children: A WHO Cross-National Study (HBSC): International Report. 2000, Copenhagen: Health Promotion and Investment for Health, World Health Organization Regional Office for EuropeGoogle Scholar
- van der Lucht F, Groothoff JW: Social inequalities and health among children aged 10-11 in the Netherlands: causes and consequences. Soc Sci Med. 1995, 40: 1305-1311. 10.1016/0277-9536(94)00185-V.View ArticlePubMedGoogle Scholar
- Ray R, Gornick JC, Schmitt J: Parental Leave Policies in 21 Countries: Assessing Generosity and Gender Equality. 2008, Washington DC: Centre for Economic and Policy Research, 2008Google Scholar
- Lahelma E, Martikainen P, Laaksonen M, Aittomaki A: Pathways between socioeconomic determinants of health. J Epidemiol Community Health. 2004, 58 (4): 327-332. 10.1136/jech.2003.011148.PubMed CentralView ArticlePubMedGoogle Scholar
- Currie CE, Elton RA, Todd J, Platt S: Indicators of socioeconomic status for adolescents: the WHO health behaviour in school-aged children survey. Health Educ Res. 1997, 12: 385-397. 10.1093/her/12.3.385.View ArticlePubMedGoogle Scholar
- Koivusilta LK, Rimpelä AH, Kautiainen SM: Health inequality in adolescence. Does stratification occur by familial social background, family affluence or personal social position?. BMC Publ Health. 2006, 6: 110-10.1186/1471-2458-6-110.View ArticleGoogle Scholar
- Rabe-Hesketh S, Skrondal A: Multilevel and Longitudinal Modelling Using Stata. 2008, College Station, TX: Stata PressGoogle Scholar
- Monks CP, Smith PK: Definitions of bullying: age differences in understanding of the term, and the role of experience. Br J Dev Psychol. 2006, 24 (4): 801-821. 10.1348/026151005X82352.View ArticleGoogle Scholar
- Smith PK, Cowie H, Olafsson RF, Liefooghe AP, Almeida A, Araki H, del Barrio C, Costabile A, Dekleva B, Houndoumadi A, Kim K, Olafsson RP, Ortega R, Pain J, Pateraki L, Schafer M, Singer M, Smorti A, Toda Y, Tomasson H, Wenxin Z: Definitions of bullying: a comparison of terms used, and age and gender differences, in a 14-country international comparison. Child Dev. 2002, 73 (4): 1119-1133. 10.1111/1467-8624.00461.View ArticlePubMedGoogle Scholar
- Kumpulainen K, Räsänen E, Puura K: Psychiatric disorders and the use of mental health services among children involved in bullying. Aggress Behav. 2001, 27 (2): 102-110. 10.1002/ab.3.View ArticleGoogle Scholar
- Bacikova-Sleskova M, Madarasova Geckova A, van Dijk JP, Groothoff JW, Reijneveld SA: Parental support and adolescents' health in the context of parental employment status. J Adolesc. 2011, 34 (1): 141-149. 10.1016/j.adolescence.2010.01.003.View ArticlePubMedGoogle Scholar
- Nordhagen R, Nielsen A, Stigum H, Köhler L: Parental reported bullying among Nordic children: a population-based study. Child Care Health Dev. 2005, 31 (6): 693-701. 10.1111/j.1365-2214.2005.00559.x.View ArticlePubMedGoogle Scholar
- Sleskova M, Salonna F, Geckova AM, Nagyova I, Stewart RE, van Dijk JP, Groothoff JW: Does parental unemployment affect adolescents' health?. J Adolesc Health. 2006, 38 (5): 527-535. 10.1016/j.jadohealth.2005.03.021.View ArticlePubMedGoogle Scholar
- Wang J, Iannotti RJ, Nansel TR: School bullying among adolescents in the United States: physical, verbal, relational, and cyber. J Adolesc Health. 2009, 45 (4): 368-375. 10.1016/j.jadohealth.2009.03.021.PubMed CentralView ArticlePubMedGoogle Scholar
- Piko BF, Fitzpatrick KM: Socioeconomic status, psychosocial health and health behaviours among hungarian adolescents. Eur J Public Health. 2007, 17 (4): 353-360. 10.1093/eurpub/ckl257.View ArticlePubMedGoogle Scholar
- Himes JH, Hannan P, Wall M, Neumark-Sztainer D: Factors associated with errors in self-reports of stature, weight, and body mass index in Minnesota adolescents. Ann Epidemiol. 2005, 15 (4): 272-278. 10.1016/j.annepidem.2004.08.010.View ArticlePubMedGoogle Scholar
- Mytton J, DiGuiseppi C, Gough D, Taylor R, Logan S: School-based secondary prevention programmes for preventing violence. Cochrane Database Syst Rev. 2006, 3: CD004606.PubMedGoogle Scholar
- Sourander A, Jensen P, Rönning JA, Niemelä S, Helenius H, Sillanmäki L, Kumpulainen K, Piha J, Tamminen T, Moilanen I, Almqvist F: What is the early adulthood outcome of boys who bully or are bullied in childhood? The Finnish "From a Boy to a Man" study. Pediatrics. 2007, 120 (2): 397-404. 10.1542/peds.2006-2704.View ArticlePubMedGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


text:
Metabo 1100 Watt electronic two-speed drill BDE 1100
Product features
- die cast aluminum gear housing
- Variospeed (V) electronics
- two-speed gear unit
- Metabo S-automatic torque limiting clutch
- clockwise and anticlockwise rotation
- geared chuck
- suitable for drilling with drill bits with large diameter (e.g. form drills) and for stirring thick liquid-like materials
- high torque
- comfortable operation and safety through auxiliary handle
- auto-stop carbon brushes
- 55 Nm/22 Nm
Drilling diameter in
- Steel - 16 mm/10 mm
- Softwood - 40 mm/25 mm
No-load speed
- 0 - 640/0 - 1.200 /min
Rated input power
Output power
Rated load speed
- 430/800 /min
Collar diameter
- 43 mm
Drilling spindle thread
Chuck capacity
- 3 - 16 mm
Weight (without mains cable)
- 3,8 kg
Metabo XXL 3 Year Warranty:
Our tools are built to last. Repair rates and turnaround times are amongst the lowest in the industry so as an added back-up we also offer you the extra long Metabo XXL Warranty.
The three-year warranty applies to all machines, batteries, chucks and chargers which have been purchased new and registered online within the first four weeks of purchase. Metabo can offer such a warranty as over 90% of our products are still made in Germany.
This ensures that we can guarantee the customer never receives an inferior product, we know our expertise guarantees high quality and we know that each and every minute detail is checked and tested. On top of that we also ensure spare parts are available for machines eight years after being discontinued from the range. With that our customers know they can rely on us to provide high performance tools that last.
Metabo – Nothing to Hide.
Contact us for more details or to discuss any of your welding needs
Return to Electrical, Hand & Power Tools

subset: commoncrawl


text:
The Halo Disinfection System includes the choice of two proprietary hydrogen peroxide-based disinfectants, each created to provide effective results against today's disinfection challenges. Both healthcare-grade products are EPA-approved for use on hard, pre-cleaned, non-porous, non-food surfaces, and are bleach and PAA free. HaloMist™, is the first ever EPA-validated disinfectant fogging solution proven to kill 99.9999% of C. diff spores and is approved for whole-room disinfection. HaloSpray™ Multi-Purpose Surface Disinfectant is a broad-spectrum formula perfect for spot disinfection of surfaces that need to be sprayed or wiped, or used for adjunct fogging treatments.
The Halo Disinfection System also includes the HaloFogger™; a user-friendly, dry mist-dispensing device that delivers aerosolized disinfectant reaching into every nook, crevice and corner in a room to kill disease-causing pathogens where they hide.


text:
Under construction is a commercial premise leased to the supermarket.
- € 3 100 000
- Shop/Retail Space For Sale
- Total square 2 348 sq m
Under construction is a commercial premise leased to the supermarket Consum, in Valencia.
The total area is 2 348 sq.m., including 45 parking spaces. Consum is a large Spanish supermarket chain: there are departments of products, household chemicals, household goods.
The premise is located in the province of Valencia, in a village with a large number of inhabitants.
The cost of the object is 3 100 000 euro. The lease agreement is concluded for 25 years, with the possibility of extension. The contract of compulsory execution is 5 years. The annual rental income is 170,000 euros + VAT. Rental profitability (net) - 5.5% per annum. There is IPC indexing. The scheme of buying a supermarket under construction: 1.) The initial contribution is 8-10% of the cost, with the guarantee of bank aval. 2.) Construction, according to the project, will be completed in January 2018. 3.) The contract of sale is concluded upon receipt of the first month of the lease from Consum. A good offer for investors. The documents are ready for the deal. Additional information is available upon request.
- Listing status: Active
- Available from: May 17, 2017
- Listing #: 811764
Latitude / Longitude: 39.469750 / -0.377390
Member reviews Write a review »
Get more info
- Name: Dmitry
- Company name: Nord Investment
- Average visitors rating:


text:
E.W. Hannas has been a major supplier wooden flag poles and flag accessories to the largest US flag manufacturers since the 1940's without interruption. We offer superior value and added service based on the flag industry's changing needs. We give our focus to ensuring that we can deliver wood products that fulfill your exact needs – from 100% Made In America products, to exact specifications for government contracts - from small wooden dowels to large wood flag poles with full finishing. We stay ahead of the newest trends and needs of our customers, and then give our focus to ensuring the safe and timely delivery of those precision products. We also supply indoor and outdoor use plastic accessories for items such as stands, as well as eyelets and grommets. We can custom package your products to be put seamlessly into your production line.
Products include:


text:
RxMedsList.net provides Prescription - Free online access to Estrogen, FDA-approved drug. If you are looking for a way to buy Estrogen, RxMedsList.net is right for you. Purchase Estrogen and thousands of other prescription drugs at our Online Pharmacy. Prescription is not required to buy Estrogen online at our website - you can buy prescription drugs without prescription.
Estrogen uses: This medication is a female hormone and is usually given to women who no longer produce the amount of estrogen they produced before menopause. It is a very effective treatment for reducing a common menopause symptom (intense feelings of warmth and sweating known as hot flashes). If you need treatment only for vaginal menopause symptoms (e.g., vaginal dryness), products applied directly inside the vagina should be considered before medications that are taken by mouth, absorbed through the skin, or injected.Certain estrogen products may also be used to prevent bone loss (osteoporosis) in people at high risk who cannot take non-estrogen drugs. There are several other medications (e.g., raloxifene, bisphosphonates such as alendronate) that are safe and effective to prevent or treat bone loss. These medicines should be considered for use before estrogen treatment.Certain estrogen products may also be used to treat certain cancers in men and women (e.g., certain types of metastatic breast cancer, prostate cancer) and other conditions as determined by your doctor.How to use Conjugated Estrogens OralRead the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, consult your doctor or pharmacist.Take this medication by mouth as directed by your doctor. It may be taken with or without food. You may take it with food or immediately after a meal to prevent stomach upset.Take this medication regularly in order to get the most benefit from it. Remember to take it at the same time(s) each day as directed. Dosage is based on your medical condition and response to treatment. Follow your dosing schedule carefully.Inform your doctor if your condition does not improve or worsens.Conjugated Estrogens Oral is used to treat the following:Breast Cancer that has Spread to Another Part of the Body, Cancer of the Prostate Gland, Defective Internal Secretion of Ovaries, Primary Ovarian Failure, Low Estrogen After Operation to Remove Ovaries, Wasting of Tissues of the Vulva, "Change of Life" Signs, Vaginal Inflammation due to Loss of Hormone Stimulation, Post-Menopausal Osteoporosis PreventionConjugated Estrogens Oral may also be used to treat:Softening of the Bones Before Menopause
Q. Do I need to have the prescription for buying Estrogen?
A. No, you needn't the prescription for buying Estrogen.
Q. What guarantee do you offer that I will receive Estrogen?
A. You should provide our company with the correct delivery address. If Estrogen is not delivered we will offer the reshipment.
Q. What is the cost of shipping Estrogen?
A. Shipping Estrogen is FREE.
Q. Do you ship Estrogen internationally?
A. At this time we ship Estrogen to all countries around the world.
Common misspellings of Estrogen: rstrogen, istrogen, sstrogen, dstrogen, wstrogen, fstrogen, 3strogen, 4strogen, eqtrogen, eatrogen, edtrogen, ewtrogen, eetrogen, eztrogen, extrogen, es6rogen, esrrogen, esyrogen, es5rogen, esfrogen, esgrogen, eshrogen, estdogen, estfogen, esteogen, esttogen, estgogen, est4ogen, est5ogen, estragen, estr9gen, estrigen, estrpgen, estr0gen, estrkgen, estrlgen, estr;gen, estrohen, estroten, estrofen, estroyen, estroven, estroben, estroren, estrogrn, estrogin, estrogsn, estrogdn, estrogwn, estrogfn, estrog3n, estrog4n, estrogeg, estrogeh, estrogeb, estrogem, estrogej,
Thank for checking us out. Happy shopping for Estrogen!
|All © Copyright 2006 are reserved by RxMedsList.net
Prescription drugs


text:
Refresh page if animation is not looping
All of this brings the upcoming winter into question, creating what could be a whole new ballgame. If this El Nino fails to form, which is becoming more and more of a possibility with each passing week, we're looking at a drastically-altered landscape in terms of expected precipitation and temperature anomalies over North America.
This situation will be revisited in coming weeks.


text:
The domestic dog been recently with us for hundreds and hundreds of years and evolved into a multitude of breeds, by using distinct qualities. Among these breeds couple of of the most unusual and rare dogs in the earth including those listed drop some weight .. However, if you plan that you would like to give the a rare breed study as up to you can about the animal before purchase.
All this talk of fear with respect to dentist has grown into a thing of the past. Never will you have to concern yourself those ghastly images that pop into your head once you feel a painful tooth. From now on, all require it and it think of as happen to be bothered with that cavity, is the wonderful sights that spain zika virus has obtainable.
Rebecca Bross: Front handspring, front layout, double front with a decreased hop. Lasted! 1.5 to front double full, hop. But she's learning it. Clapping to the gypsy favorite music.Switch ring, switch half. Bross's leaps look really fantastic. But smile, Becca, your music is happy. Tourjete half. Nice turn with leg right up. 2.5 twist to end, form on legs via airplane and large step forward. Well, like Sloan, she made this method. Impressive for someone with a hurt shin, besides.
The past brings up an associated with subjects, your first girlfriend, space invaders, the 9/11 attacks on the twin systems. So what happens when you put two one together? You will find your girlfriend and invading her space would create a good story but more the correct combination now's it? Recently at the GH ART exhibit held at the Games Convention in Germany a piece was featured that depicted the 9/11 attack using space invaders.
Besides, Spain is an important place to travel. Statistics declare that in 2001 almost 70 million tourists visited this country, as well as a very important data considering the fact that each year Spanish tourism creates new jobs job opportunities. Who knows, maybe in foreseeable future you will finish up working in Spain? In addition to course, may be always much better to know region language.
Try sticking your goals list somewhere prominent an individual have a combination of space. My walls currently covered with A4 sheets of things need to recollect so my wardrobe will be the only space left.
When I finally emerged from dangerous room, I felt like a new fella. The steam experience itself seemed more intense than desire. I had sweat away a much more. My muscles were loose, relaxed, and my body felt completely rejuvenated. Web page . after that first time, I got use towards the hot humid heat so didn't sense you are I was burning additional. Although steam showers are suited to their medical, therapeutic, and holistic healing benefits, lots of people will use them for relaxation and stress relief. Give it a try, I suggest it.


text:
Scariest Moment in Gaming?
Pages 1 2 3 NEXT
My personal one is the mid-way level in Fable 3. Despite the silliness of the rest of the series, being trapped in that cave with what you find in there and Walter being attacked is honestly horrifying. What's your scariest moment?
There's a part in Silent Hill 3 that got me so bad I literally fell off of my bed. No, it wasn't the manequin part. I'm talking about the part in the amusement park where you meet "Danny." Oh man...jumped so bad.
The haunted hotel in VtM:B. Whoever did the sound design for that section is a master
Comment removed due to spoilers and I think I misread the thread title.
The Dunwich building.
I felt that they messed it up by having him sing.
Having him hum a tune was fine. It showed that he was completely relaxed and at peace with what he was about to do, but the singing was just silly. It felt like fan service. "Hey, remember this?!"
Incidentally, have you seen what happens if you betray him and the Krogan and fail to talk him down? It's brutal. Oh yeah, and then Wrex finds out...
The damn Giant Ants in Fallout 3... That scuttling sound that they make really scares me. Yes they're low level but they are fucking scary when you don't know where they are.
That one dungeon near Megaton, the school that has a nest of them underneath it. I fucking had to leg it out of there in a blind panic just because I couldn't find the last few ants that were making that infernal noise.
Probably because they just made the noise continue anyway after all the ants are dead just to freak you out. It was an entire nest of them after all.
Also Mirelurks, fucking scary bastards. Yet I oddly enjoyed the mission where you have to sneak into a lair to plant a beacon amongst their eggs without killing any of them. Y'know a Mirelurk hater's worst nightmare. Funny that.
I think good scary sections in non-horror games are worse than the scares in actual horror games. Like you don't expect it to just go bam! Scary section activate! At least in horror games you know what you're getting yourself into.
I gotta agree with you here, I cannot stand the Ant Queen, won't even do the quest anymore.
I got the other one, where he says "Genophage cured...new future...for us all."
Wait... what?
How did you do that?
I have no idea how the game decided which one you get.
Scariest moment ever? So this is bound to be pretty personal, but two titles scared the shit out of me when I was younger. The first Quake, and System Shock 2.
Oh, man, those possessed guys with the tweaked voices who moaned nonsense at you while hitting you with a steam pipe... I was fucking traumatized, I swear.
Non-horror-game examples:
"What can change the nature of a man?"
Assembling a fresh batch of rookies around a downed sectoid ship, not knowing if you've got enough meat to jam up the grinder.
"Don't trust the skull."
The sound of a poison headcrab (even though I have never, ever died as the result of one).
I'm happy to find that I'm not the only big-ass pansy who found that even a little terrifying :D
The Path's atmosphere is quite scary. When you wander into the woods and heart beat starts going, or if you are readily approaching your wolf of that level. Play it at night.
The first monster in Amnesia: The Dark Descent; and every subsequent monster encounter.
Being unable to fight back (at all) increases the terror by several magnitudes, to the extent that I had to stop frequently because my hands were shaking too hard and my nerves were wrecked.
If it makes you feel better, dear:
Captcha: 'teh inter webs'
Oh, and also Ao Oni whenever you're trying to run away from the Ao Oni. Sob.
Thief 3's Cradle level.
Thanks alot for the spoiler.
OT: Let's see, almost every single second of the Condemned demo? Whenever I wasn't fighting, I could hear how I were surrounded, and one step in the wrong direction would get me attacked.
The first Max Payne game, where you are drugged and having a nightmare fueled by your own imagination.
That was pretty fucked up.
In Fallout 3's expansion, Point lookout. The part where you are once again drugged (reaccuring theme) and have a pretty fucked up dream.
In addition to that warehouse room full of those creepy-ass manaquin doll heads. Their was mines hidden under the sea of them, adding to the tension.
Other than that? Being an 8 year old me seeing resident evil 2's licker for the first time.
Recently I was playing Metro 2033 where you have to go above the surface and fight Nazi Rangers. I killed one on a catwalk with my silenced carbine and slaughtered a bunch with my Kalash as they were coming down. I could hear there was one left but I didn't know where to find him. I looked everywhere but I couldn't find him.
As I continued the search my friend beside me accidentally triggered a very, very loud song on a webpage he was viewing and I nearly broke my keyboard in half.
Scariest ever? Metroid Fusion was so scary for me as a kid that I traded away the game so I wouldn't have to face the SA-X again. That game got under my skin.
And, there is always...
That song always freaked me out as a kid and even now, years later, I still feel anxious hearing it.
"This door leads to Ravenholm... we don't go there anymore."
Guess where you're going 4 or 5 hours later?
This is gonna sound dated, but for me it was the opening play through of the first Silent Hill. Keep in mind that I was 11 when I first played it (borrowed it from a friend), and it was maybe a year after it was originally released (so the graphics were just kinda shitty instead of mostly shitty).
Anyway: Opening cutscene, daughter is missing, snowing, surrounded by fog, yadda yadda given control. After I get used to the controls, I begin the process of exploring the town. My only gaming experience up to this point was classic Nintendo, arcade games, and point and click adventure games, so this exploration thing is new to me. I hear a dog barking in the background and a nearby gate swing shut, so naturally I open it and follow it into an alleyway right? Camera perspectives get a little wonky from here on out and shift drastically when I round corners, but the alleyway is surprisingly well lit (despite the fog) so I move on forward through a chain link gate. I hear the faint call of an air raid siren in the distance as night starts to fall on me. Luckily, my character seems to have a lighter on him so the screen isn't completely dark. As I move through the alleyway, the camera draws nearer and... is it my imagination or does the alleyway seem narrower than before? Only sound aside from the siren seems to be my footsteps. A few rounded corners later I pick up the squeak of a wheel turning, and sure enough I pass by a rusty wheelchair turned on its side. Odd. Pass by it as the squeak follows me around the next corner before fading away, what used to be falling snow has suddenly turned into a light drizzle. A few steps later and I'm face to face with a bloodstained hospital gurney over a pool of blood. This shouldn't be out here... flies are swarming the gurney, so I step around it and pass along a high chain linked fence topped with barbwire. Area seems to get darker now and the siren is getting louder, must be nearing its source. Traded the alleyway for a passage made entirely of the chain linked fence, the blood pools from before are growing more frequent. Blood also appears to be splattered on the fence walls too. The fence passage twists and turns in on itself, it appears as if I'm heading towards the center of a maze of fences. Even as the siren grows louder, I can still hear the resounding sound of my footsteps. Every corner of the fence maze I round, the camera turns violently and drunkenly so that it always faces me and not my destination. Passages become shorter and bloodier as I near the center, I hurry forward despite myself. Round the final corner, heart is racing to match the tempo of my clattering footsteps. Camera arrests my attention for a moment as it centers on the scene before me. A bloodied figure lies strung up a fence and suspended off the ground in a tangle of barbed wire. There's something definitely wrong with this town and I'm not sticking around to find out, daughter or no daughter. I turn to leave and...
Well, if you've played the game you know what happens next. Doesn't even seize control from you like modern games tend to do. "We know you're too stupid to point your camera at this specific spot at this specific moment for a jump scare, so we'll do it for you while the camera zooms in on this brightly lit hellspawn! Are you scared yet?!"
Edit: Oh, and I suppose Amnesia the Dark Descent. Great atmospheric pacing up to the point you first meet your stalker. Made me afraid to round corners or go through open passageways even when it hadn't shown itself yet.
Don't know if you've seen the Dunwich building but...yeah....Fuck that place.
Wow, thanks. Havnt played the game yet.
OT: Well since i have recently played through silent hill 2 again on the HD collection its freshn in my mind :D
Rapetime with pyramid head.
Or the ghost in the prison, he made weird noises.
Or at the bottom of a stairway in the hospital. A terrible squeaking noise for NO DAMN REASON.
This. Had to turn off the game a couple times there, freaked the hell outta me.
I know someone already said this. Dunwich Building in Fallout 3. Also, the very first subway that you have to go through.
Fallout 3 is one of my favorite games though<3
I'm playing through System Shock 2 right now and earlier I had a moment where I opened a door and there was a Hybrid standing right on the other side. Never jumped so goddamn much in my entire life.
The one time I was battling the Champion in Pokemon Pearl, I was down to my last Pokemon who happened to be weak against like two or three of the moves her last Pokemon could use, and didn't know which was faster, mine or hers, while challenging myself with a limit of 3 L50 Pokemon.
I was so tempted to use a Max Revive. So. Tempted.
You know, i've never actually found that place before. I've seen loads of people going on about how it's the scariest thing in the game but to be honest I couldn't tell you where to find it. XD
Oh and the Librarians in Metro. I must have lucked through most of that particular mission the first time since I never noticed the whole "maintain eye contact, back the fuck away" mechanic and just shotgunned my way through all of them. It's a nice little enemy nuance for a horror game.
Towards the start of Bioshock where you pick up the shotgun. As soon as you grab it, the lights flash off except for the cone of light around you. Then you get attacked and man...screw that game. So many parts made me jump.
And then...the unsuspecting teenagers logged onto their favorite gaming news site...and they saw...
that Too Human was getting a sequel!!!
Thankfully that hasn't happened yet, but it's important to stay aware >_>
Oh yeah, and this. SO MUCH THIS.
Anyone who says anything else is flat out wrong. This is the most terrifying scene to ever grace a game. Almost everything else is a walk in the sunshine compared to this.
This or watching the snuff movie always creeps me out.
Also the one special meet up with scarecrow in Batman: AA made me jump up the first time.
The first xlab in Shadow of Chernobyl.
Every moment for about 80% of Amnesia: The Dark Descent.
|Pages 1 2 3 NEXT