The association of bullying and self-esteem with psychotic-like experiences and clinical high risk for psychosis symptoms

Child Adolesc Psychiatry Ment Health. 2025 May 9;19(1):51. doi: 10.1186/s13034-025-00900-w.

ABSTRACT

BACKGROUND: Bullying has become a significant global health problem due to its high prevalence worldwide and long-term consequences on mental health, including the onset of psychotic symptoms. This study focuses on exploring the prevalence of bullying across three groups of Mexican individuals with different levels of psychosis risk symptoms: non-psychosis risk (non-PR), psychotic-like experiences (PLEs), and at clinically high-risk for psychosis (CHR-P). In addition, we compare sociodemographic features, self-esteem, and self-reported bullying between the groups and then examine whether these variables are associated with the probability of belonging to the PLEs or CHR-P groups compared to the non-PR.

METHODS: A general population sample completed the Prodromal Questionnaire-Brief (PQ-B) to determine the presence of PLEs. Those meeting the PQ-B cut-off threshold were assigned to the PLEs group (n = 490), while those who scored below the cut-off comprised the non-PR group (n = 1,125). The CHR-P group (n = 45) was an independent clinical sample meeting the criteria established by the Comprehensive Assessment of At-Risk Mental States. All participants completed self-reports of sociodemographic characteristics, bullying, and self-esteem.

RESULTS: The CHR-P group had a higher percentage of men, single participants, and lower levels of education than the PLEs and the non-PR groups. PLEs and CHR-P participants reported a lower socioeconomic status, lower self-esteem, and higher prevalence of bullying than the non-PR group. The multinomial logistic regression indicated that the factors associated with belonging to the CHR-P group were lower education, being a man, and being single. Furthermore, being younger, having lower self-esteem, and having experienced bullying were associated with belonging to the PLEs and CHR-P groups. Among all these variables, bullying emerged as a robust risk factor associated with psychosis risk symptoms since it increased the odds of being CHR-P by threefold compared to the non-PR group, and it also increased the risk of PLEs compared to the non-PR group.

CONCLUSIONS: Findings highlight the relevance of prioritizing anti-bullying school-based programs to provide a safer school environment, as well as strengthening self-esteem (potential protective factor) in vulnerable individuals to reduce the risk of developing psychosis and minimize the long-term impact of bullying victimization on further mental health conditions.

PMID:40346561 | DOI:10.1186/s13034-025-00900-w