Int J Adolesc Med Health 2015; 27(1): 85–91
Cameron Lister*, Ray M. Merrill, David Vance, Joshua H. West, P. Cougar Hall
and Benjamin T. Crookston
Predictors of peer victimization among Peruvian
adolescents in the young lives cohort
Abstract
Background: Bully-victimization is a widespread public
health issue with significant negative effects on both
social function and psychological well-being. Exist-
ing research in Peru shows high prevalence of bullying.
However, researchers have yet to fully understand the
phenomenon of victimization in developing regions.
Objectives: The purpose of this study was to characterize
victimization patterns over time, along with the predic-
tors of victimization from a cohort of Peruvian adolescents
enrolled in the young lives (YL) study.
Materials and methods: This study examined data from
YL, a longitudinal study of poverty, health, and develop-
ment, which examined data from the older cohort of chil-
dren in Peru across three rounds (ages 8, 12, and 15 years).
The sample consisted of 714 children from 74 communities
that represent 20 districts in Peru.
Results: After adjusting for urban/rural setting, there
remained a significantly lower wealth index for children
who were bullied at ages 8 and 12 years. Exploratory anal-
ysis showed that although those in the lowest quartile of
body mass index (BMI) were significantly more likely to be
bullied at age 8 years, this association waned over time.
A worse caregiver assessment of child’s health compared
with others was associated with a significantly greater risk
of bully-victimization. At age 8 years, caregiver education
was significantly lower among those bullied compared
with those who were not bullied.
Conclusion: This study showed several factors as the pre-
dictors of victimization in the early years, including being
male and having low BMI, low socioeconomic status, and
low parental/caregiver education. Further longitudinal
studies should be conducted to determine the extent to
which these predictors vary in significance over time.
*Corresponding author: Cameron Lister, Department of Health
Science, Brigham Young University, 213 Richards Building, Provo,
UT 84602, USA, E-mail: camearlister@gmail.com
Ray M. Merrill, David Vance, Joshua H. West, P. Cougar Hall and
Benjamin T. Crookston: Department of Health Science, Brigham
Young University, Provo, UT, USA
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Keywords: adolescent health; Peru; victimization.
DOI 10.1515/ijamh-2014-0012
Received February 25, 2014; accepted June 6, 2014; pre­viously pub-
lished online September 9, 2014
Introduction
Bully-victimization is a widespread public health issue
with significant negative effects on both social function
and psychological wellbeing (1, 2). Children who are
bullied are nearly twice as likely to have psychosomatic
problems compared with peers who are not bullied (3).
Further, victimization is also predictive of internalizing
disorders (e.g., sadness, anxiety, etc.) (4). Victims are
more likely than their peers to suffer from anxiety disor-
ders later in life (5) and to feel abandoned, lonely, or sui-
cidal (6). Evidence indicates depressive symptoms may
last for years after bullying has ended (7).
Previous research has also found internalizing symp-
toms to be predictors of future bully-victimization (4).
Students who are victimized often have trouble interact-
ing with other students and struggle with anxiety (8, 9).
Other studies have shown that bullies tend to victimize
children who lack the skills to fight back or stand up for
themselves (10, 11), thriving on an imbalance of power
(12, 13). In addition, more males are involved in bullying
and victimization than females (14).
Many studies have focused on measuring bullying
and victimization over time, with the aim of longitudinally
establishing rates and trends. Longitudinal studies have
shown that victimization decreases over time as children
transition from primary to secondary school (15). This
has been established in multiple settings, including the
US (16, 17), and European countries (18). Approximately
10% to 30% of youth in these regions report either being
a bully, a victim, or both (2, 14, 17–19). Yet, few of these
longitudinal studies have been conducted in developing
countries and resource-poor regions, leaving a dearth of
data on trends and predictors of bullying and victimiza-
tion in these parts of the world.
86      Lister et al.: Predictors of peer victimization
The existing research in Peru shows high prevalence
of bullying, with approximately half of Peruvian teens
being involved in some form of bullying (20–23). However,
these studies are largely cross-sectional and do not allow
for examining changes in victimization patterns over the
course of childhood and adolescence. The purpose of this
study was to characterize victimization patterns over time
along with the predictors of victimization from a cohort
of Peruvian adolescents enrolled in the young lives (YL)
study.
Materials and methods
Study design and background
This study examines data from YL, a study of poverty, health, and
development in a total of 12,000 children living in countries that
include Peru, Ethiopia, India, and Vietnam. Each country sample
is comprised of two cohorts; an older cohort beginning among chil-
dren aged 8 years, and a younger cohort of children enrolled in 2002
around 1 year after birth. To date, YL participants have been assessed
three times at approximately 4-year intervals.
For the purposes of studying bullying in Latin America, this
study only examined data from the older cohort of children in Peru.
The older cohort consists of a total of 714 children from 74 communi-
ties, representing 20 districts in Peru. Children and their caregivers
were surveyed at enrollment (round 1) and again at ages 12 (round 2)
and 15 (round 3) years. Detailed information on YL methods for sam-
pling, recruitment, and interviewing can be found at http://www.
younglives.org.uk and www.ninosdelmilenio.org. Approval for this
study was received by the institutional review board at a Brigham
Young University.
Measures
Measures of victimization: First round variables included caregiver
report of child being bullied (“Is NAME picked on or bullied by other
children”?); the second round included both the caregiver report and
child report of being bullied (“Pupils in my class never tease me at
school” and “Has NAME ever been bullied by peers”?); and the third
round included a child report of being bullied (“Other pupils in my
class tease me at school”). Children who were reported to have been
bullied at rounds 1 or 2 through the self-report or caregiver report,
but did not report being bullied at a subsequent round (rounds 2 or 3)
were characterized as outgrowing victimization. Children and adults
were interviewed in their preferred language.
Child and household characteristics: Child measures included
sex, age, health, and body mass index (BMI) of child. Household
indicators included wealth index, and caregiver education, includ-
ing maternal, paternal, and other caregiver educational attainment
levels. Measures of the highest educational attainment level were
obtained from the child’s mother (M = 7.3, SD =4.2), father (M = 8.8,
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SD = 3.8), and primary caregiver (M = 7.1, SD =4.3). Grade level was
measured as none (0), individual grades (1 to 11), some technical
college (12), completed technical college (13), some university (14),
and completed university (15). Caregivers were asked to evaluate the
children’s health at ages 8 and 12 years as the same, better, or worse
than other children of a similar age. A wealth index ranging from 0 to
1 was constructed using household information on consumer dura-
bles, housing quality, and services. The higher the index score, the
wealthier a household was considered. A social ladder question was
also used to determine the child’s and caregiver’s perception of qual-
ity of life. The child or caregiver was asked: “There are nine steps
on this ladder. Suppose we say that the ninth step, at the very top,
represents the best possible life for you and the bottom represents
the worst possible life for you. Where on the ladder do you feel you
personally stand at the present time”?
Data analysis
Means and percentages were used to summarize and describe the
data. Independent group means were compared for equality using
the t statistic. Regression analysis was used to evaluate the asso-
ciation between grade level and victimization. Trends in the wealth
index were compared by the victimization variables. These were then
assessed using Wilks’ lambda. Trends were also assessed using the
Mantel-Haenszel χ2-test for trends. The McNemar test was used to
evaluate whether there was a significant relationship between being
bullied at age 8 years and at age 15 years. Two-sided tests of hypoth-
eses were evaluated using a p < 0.05 level of significance. Analyses
were performed using the Statistical Analysis System (SAS) software,
version 9.3 (SAS Institute Inc., Cary, NC, USA, 2010).
Results
Participants
Of 714 children in this study (54% male and 46% female),
47% of the 8-year-olds were reported by the primary car-
egiver to have been bullied. At ages 12 and 15 years, 32%
and 22% of children reported being bullied by other chil-
dren, respectively. There was no statistically significant
difference in the percentage of males and females bullied
at ages 8 or 15 years, although at both ages more males
reported being bullied. However, a significant difference
was found at age 12, with significantly more males being
bullied than females (38% vs. 25%, 13.27, p = 0.0003).
Approximately 5% of children were victimized throughout
childhood and adolescence (victimized at all three ages)
while 21% were victimized at two of the ages surveyed,
and 42% were victimized at one of the ages surveyed.
Nearly one-third (32%) never reported being victimized.
Information about bully-victimization at both ages 8 and
15  years was available for 680 children. There was a posi-
tive association between victimization status at ages 8 and
 Lister et al.: Predictors of peer victimization      87

Table 1 Victimization status (Yes/No) at ages 8 and 15 years, according to selected variables.

  No/No   Yes/No   No/Yes   Yes/Yes   F Statistic

294 (43.2%) 237 (34.9%) 64 (9.4%) 85 (12.5%) p-valuea

  Mean   Mean   Mean   Mean  

Wealth index   0.60   0.55   0.65   0.59   0.0006
Body mass index   21.0   21.1   21.4   21.2   0.8440
Caregiver educationb   7.6   6.3   8.1   6.9   0.0020
Social ladder   5.9   6.0   6.2   6.0   0.8576
  %   %   %   %   χ2
          p-value
Perceived health as worse than   3.8   6.4   4.8   11.9   0.0087
other children their age

Note that the wealth index and BMI were available at age 15 years. Perception of their place on the social ladder (1 low and 9 high) and
health compared with other children their age was available at both ages 12 (parental report and child report). The education of the car-
egiver was recorded at age 12.
a
Based on type III sums of squares.
b
Caregivers education was measured as none (0), grades 1–11, some technical college (12), completed technical college (13), some univer-
sity (14), and completed university (15).

15 years (McNemar’s test = 99.43, p < 0.0001). The combination
of victimization at ages 8 and 15 years and how these com-
binations relate to selected variables are shown in Table 1.
Those bullied at both ages 8 and 15 years were more likely to
perceive their health as worse than other children their age.
Wealth index
An increasing trend in the wealth index was observed, from
ages 8 (M = 0.46, SD = 0.19) to 12  years (M = 0.52, SD = 0.23),
and on to the age of 15  years (M = 0.59, SD = 0.19) (Wilks’
lambda F = 2 82.9, p < 0.0001). On the one hand, those not
bullied at the age of 8 years, but bullied when they were
15 years old had the highest wealth index and highest car-
egiver level of education (wealth index was measured at
age 15 years, caregiver education at age age 12 years). On
the other hand, those bullied at the age of 8 years, but not
bullied when they were 15 years old had the lowest wealth
index and caregiver education. The wealth index was not
significantly associated with sex, but was significantly
lower among those bullied at ages 8 and 12, but not age 15
(Table 2). Bully-victimization was more common in rural
areas at ages 8 (55% vs. 45%, p = 0.0136) and 12 (38% vs.
29.5%, χ2 p = 0.0435), but less common in rural areas at age
15 (15% vs. 24%, χ2 p = 0.0100). After adjusting for urban/
rural setting, there remained a significantly lower wealth
index for children who were bullied at ages 8 and 12 years.
Body mass index (BMI) and health status of
children
The increasing trend in BMI from ages 8 (M = 16.8, SD = 1.8)
to 12 years (M = 19.1, SD = 3.0), and then to age 15 (M = 21.1,
SD = 3.0) (Wilks’ lambda p < 0.0001), did not significantly
vary according to victimization status, with both victims
and non-victims growing at comparable rates (Wilks’

Table 2 Mean wealth index according to bullying status at ages 8, 12, and 15 years.

  No   %   Mean   Standard   F statistic   Adjusted mean for   Adjusted F statistic

deviation p-value urban/rural setting p-value

Age 8              
 Bullied   338   47.3   0.42   0.17    < 0.0001   0.37    < 0.0001
 Not bullied   376   52.7   0.49   0.19     0.43  
Age 12              
 Bullied   217   31.6   0.43   0.18   0.0226   0.41   0.0024
 Not bullied   470   68.4   0.47   0.18     0.46  
Age 15              
 Bullied   149   21.9   0.48   0.17   0.1115   0.54   0.3431
 Not bullied   531   78.1   0.45   0.19     0.53  

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88      Lister et al.: Predictors of peer victimization

lambda p = 0.4827). Exploratory analysis showed that Table 5 Mean perceived place on the ladder according to bullying
those in the lowest quartile of BMI were significantly more status at the same age.

likely to be bullied at age 8 years. Those in the lowest

  Mean   Standard   F statistic   Adjusted   Adjusted f
quartile of BMI continued to show increased risk of vic-
deviation p-value mean for statistic
timization at ages 12 and 15 years, albeit at a lower level. urban/rural p-value
Caregivers were asked to evaluate the children’s setting
health conditions at the ages of 8 and 12  years as the
Child perception of place on the ladder (age 12)
same, better, or worse than other children of a similar age  Bullied   5.5   2.23    < 0.0001   5.5    < 0.0001
(Table 3). When the caregiver evaluated the child’s health  Not Bullied  6.2   1.88     6.2  
compared with others, a worse assessment was associated Parent perception of place on the ladder (age 12)
with a significantly greater risk of bully-victimization.  Bullied   4.5   2.04   0.0065   4.5   0.0085
 Not Bullied  5.0   2.03     5.0  
Child perception of place on the ladder (age 15)
 Bullied   6.0   1.77   0.5087   5.5    < 0.0001
Caregiver education

At age 8 years, caregiver education was significantly lower

among those bullied compared with those who were not
Table 3 Bullying according to personal health.
  Bullied   Not bullied  
bullied (Table 4). At the age of 12, there continued to be a
greater risk of victimization with lower caregiver educa-
tion. However, when a child reaches the age of 15 years,
caregiver education was no longer significantly associated
with victimization.

Perceived health compared   No.   %   No.   %   χ2

with other children p-value Social ladder
Age 8 yearsa          
 Same   184   54.4   225   59.8   0.0086 Children who were victimized when they were 12 years
 Better   106   31.4   124   33.0   old viewed themselves as being significantly lower on
 Worse   48   14.2   27   7.2  
the social ladder than their peers (Table 5). However, by
Age 12 yearsa          
 Same   135   62.5   292   62.5    < 0.0001 the time they reached 15 years, there was no longer a
 Better   52   24.1   154   33.0   significant difference between victims and non-victims.
 Worse   29   13.4   21   4.5   Adjusting for urban/rural setting did not affect the
Age 12 yearsb           results.
 Same   130   60.2   297   63.6   0.1924
 Better   69   31.9   149   31.9  
 Worse   17   7.9   21   4.5  
Age 15 yearsb
 Same
 
  82
 
  54.3
 
  284
 
  54.8
 
  0.7325
Discussion
 Better   62   41.1   217   41.9  
 Worse   7   4.6   17   3.3   The current study focused primarily on demographic
predictors of victimization. A number of demographic
Note: because of missing data, not all numbers for a given age
and physical factors were found to be predictive of vic-
group sum to 714.
a
Question asked to caretaker. timization, although the strength of some associations
b
Question asked to child. waned with increasing age. Overall, victimization stead-
ily decreased with age from 47% at age 8 years, to around
Table 4 Bullying according to the education level of the mother, 20% at age 15 years. Males were more likely to be bullied
father, or caregiver.
than females. This is similar to other studies, which
reported that bullying decreases with age (14, 15), and
  Mother’s education   Father’s education
that males are more prone to bully and to be victimized
Bullied   Slope (SD)   T Statistic   Slope (SD)   T Statistic (15, 24). Those from the poorest households were more
p-value p-value
likely to be bullied at younger ages, and were also more
Age 8   –1.19 (0.32)   0.0002   –0.72 (0.20)   0.0143 likely to have parents/caregivers with low educational
Age 12   –1.52 (0.35)    < 0.0001   –1.31 (0.31)    < 0.0001 attainment. Additionally, those with a lower BMI were at
Age 15   0.26 (0.39)   0.5011   0.28 (0.35)   0.4252
higher risk of victimization.

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Wealth
In the study population, victims had a lower average
wealth index than peers at ages 8 and 12 years. In addition,
a lower wealth index was significantly correlated with vic-
timization at age 8 years. Given that childhood exposure
to poverty is often associated with higher risk of stunt-
ing (25), this higher risk of victimization among youth of
lower socioeconomic status (SES) might be explained by
nutritional deficiencies, which in turn, give adolescents
smaller frames and mark them as easier targets for victim-
ization. In addition, disadvantaged youths might be more
socially ostracized than their wealthier classmates, and
therefore, are more likely to be victimized.
However, by age 15 years, the wealth index of victims
was higher than that of non-victims, and a lower position
on the wealth index was no longer significantly corre-
lated with victimization. One possible explanation could
be that victimized students who were low on the wealth
index experienced an increase in wealth, which in turn,
raised the average wealth index of victims. An alternative
explanation is that, given that income inequality has been
shown to be a predictor of increased levels of bully-victim-
ization (11, 24, 26), it is possible that the overall increase
in wealth over the course of the study helped alleviate
some of the socioeconomic contributors to victimization.
Finally, it could be possible that less wealthy adolescents
were able to “outgrow” the factors that caused their vic-
timization. Further studies are needed to determine
whether such “outgrowing” is possible, especially given
that an international study of 162,305 European and North
American students reported that low SES was signifi-
cantly correlated with bullying victimization across three
age groups (ages 11, 13, and 15 years), with no indication
of victimization outgrowth (27).
Caregiver education
Children of caregivers with lower education levels were
found to be more likely to experience being bullied at
ages 8 and 12 years. However, the current study demon-
strated a decreasing predictive strength of parental or
caregiver education as a predictor of victimization at later
ages. This is an interesting and important finding given
that an international study of children and adolescents
found no significant link between parental education
and victimization (27). However, other studies have found
a link between students who come from families with a
low SES and child victimization (11, 24, 26). Research has
also shown that having a non-intact family (i.e., divorced
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Lister et al.: Predictors of peer victimization      89
or separated parents) is also predictive of victimization
(28), in addition to a poor family environment, or frequent
marital and/or family disputes (14). Considering the sig-
nificant link between educational status and SES, it could
be assumed that wealth and educational status are com-
pounding variables in regards to risk of victimization.
BMI and health status
Results indicated that children with lower BMI were at
higher risk of victimization at age 8 years, as has been
demonstrated in other studies (29, 30). It is possible that
their smaller size marks these children as easier targets
for bullying. However, in the current study, the predictive
power of low BMI declined between the ages of 12 and 15
years, which could be attributed to the fact that smaller
children develop coping mechanisms, which enable them
to better avoid being victimized by bullies. An alternative
explanation is that the general increases in wealth index
and BMI over the course of the study raised part of the
lowest quartile out of malnourishment, thus decreasing
their risk of victimization. However, previous studies in
other countries have shown a correlation between being
obese or overweight and higher likelihood of being victim-
ized (28, 29, 31).
A low caregiver assessment of child health was also
significantly associated with victimization. It is possible
that less-healthy kids are bullied more if their poor health
makes them easier targets for bullies. Many studies have
researched this correlation, showing that those who
are victims are more likely to be physically weaker than
their peers (9, 32). It is also possible that victimization
adversely affects child health, making poor health an
outcome of bullying rather than a risk-factor. Hodges and
Perry showed that victimization may be a self-sustaining
peer rejection cycle, suggesting that factors that cause or
precede victimization may also be consequences of bully-
ing (32).
Limitations
This study has several limitations. First, the YL study is
focused primarily on childhood poverty, not on bullying
and victimization. Hence, questions related to victimiza-
tion varied across the three rounds of surveys. Second, it
is left to the parents and adolescents to designate whether
behavior occurred based on their own definitions of “bul-
lying” or being “victimized”. In general, that is, in media
and school surveys, there is a weakness in the terminology
90      Lister et al.: Predictors of peer victimization
or in the concept of either bullying or victimization. Fur-
thermore, this study is limited in not having standard-
ized diagnoses available on the youth group studied. The
rating scale approach offers useful information given the
rather large number of subjects in the present study, but
lacks the specificity and additional depth that structured
or semi-structured psychiatric interviews might provide.
Conclusion
Bully-victimization is a trend that has both short- and
long-term negative consequences on child and adolescent
social and psychological wellbeing. Victimization preva-
lence has been shown to be high among Peruvian children
and adolescents, thus requiring national attention and
evidence-based interventions to reduce the occurrences
and impacts of bullying. This study showed several factors
that serve as the predictors of victimization in the early
years, including being male as well as having low BMI,
low SES, and low parental/caregiver education. Further
longitudinal studies should be conducted to determine
the extent to which these predictors vary in significance
over time.
Acknowledgments: The data used in this study come from
Young Lives, a 15-year survey investigating the changing
nature of childhood poverty in Ethiopia, India (Andhra
Pradesh), Peru and Vietnam (www.younglives.org.uk).
Young Lives is core-funded by UK aid from the Depart-
ment for International Development (DFID) and co-
funded from 2010 to 2014 by the Netherlands Ministry of
Foreign Affairs. The findings and conclusions contained
within are those of the authors and are not necessarily
those of Young Lives, the University of Oxford, DFID or
other funders.
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