Skip to main content Accessibility help

Sibling bullying in middle childhood and psychotic disorder at 18 years: a prospective cohort study

  • Slava Dantchev (a1), Stanley Zammit (a2) (a3) and Dieter Wolke (a1)



Being bullied by a sibling has been recently identified as a potential risk factor for developing depression and self-harm. It is unknown whether this risk extends to other serious mental health problems such as psychosis. We investigated whether sibling bullying victimization or perpetration in middle childhood was prospectively associated with psychotic disorder in early adulthood.


The current study investigated 6988 participants of the Avon Longitudinal Study of Parents and Children, a UK community-based birth cohort. Sibling bullying was reported at 12 years and psychotic disorder was assessed via a semi-structured interview at 18 years.


Involvement in sibling bullying was associated with psychotic disorder in a dose-response fashion, even after controlling for a range of confounders. Those involved several times a week were 2–3 times more likely to meet criteria for a psychotic disorder [odds ratio (OR); 95% confidence interval (CI)]: victimization (OR 2.74; CI 1.28–5.87); perpetration (OR 3.16; CI 1.35–7.41). Categorical analysis indicated that particularly victims (OR 3.10; CI 1.48–6.50) and bully-victims (OR 2.66; CI 1.24–5.69) were at increased risk of psychotic disorder. Involvement in both sibling and peer bullying had a dose-effect relationship with a psychotic disorder, with those victimized in both contexts having more than four times the odds for a psychotic disorder (OR 4.57; CI 1.73–12.07).


Parents and health professionals should be aware of the adverse long-term effects of sibling bullying.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Sibling bullying in middle childhood and psychotic disorder at 18 years: a prospective cohort study
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Sibling bullying in middle childhood and psychotic disorder at 18 years: a prospective cohort study
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Sibling bullying in middle childhood and psychotic disorder at 18 years: a prospective cohort study
      Available formats


Corresponding author

Author for correspondence: Dieter Wolke, E-mail:


Hide All
Arseneault, L, Cannon, M, Fisher, HL, Polanczyk, F, Moffitt, TE and Caspi, A (2011) Childhood trauma and children's emerging psychotic symptoms: a genetically sensitive longitudinal cohort study. The American Journal of Psychiatry 168, 6572.
Bebbington, RE, Bhugra, D, Brugha, T, Singleton, N, Farrell, M, Jenkins, R et al. (2004) Psychosis, victimisation and childhood disadvantage. British Journal of Psychiatry 185, 220226.
Bowes, L, Wolke, D, Joinson, C, Lereya, ST and Lewis, G (2014) Sibling bullying and risk of depression, anxiety, and self-harm: a prospective cohort study. Pediatrics 134, e1032e1039.
Boyd, A, Folding, J, Macleod, J, Lawlor, DA, Fraser, A, Henderson, J et al. (2013) Cohort profile: the ‘children of the 90s’-the index offspring of the avon longitudinal study of parents and children. International Journal of Epidemiology 42, 111127.
Buist, KL, Dekovic, M and Prinzie, P (2013) Sibling relationship quality and psychopathology of children and adolescents: a meta-analysis. Clinical Psychology Review 33, 97106.
Campbell, ML and Morrison, AP (2007) The relationship between bullying, psychotic-like experiences and appraisals in 14–16-year olds. Behavioral Research Therapy 4, 6579.
Clemmensen, L, van Os, J, Drukker, M, Munkholm, A, Rimvall, MK, Væver, M et al. (2016) Psychotic experiences and hyper-theory-of-mind in preadolescence – a birth cohort study. Psychological Medicine 46, 87101.
Collip, D, Wigman, JTW, Myin-Germeys, I, Jacobs, N, Derom, C, Thiery, E et al. (2013) From epidemiology to daily life: linking daily life stress reactivity to persistence of psychotic experiences in a longitudinal general population study. PLoS ONE 8, e62688.
Cox, JL, Holden, JM and Sagovsky, R (1987) Detection of postnatal depression. Development of the 10-item edinburgh postnatal depression scale. British Journal of Psychiatry 150, 782786.
Cunningham, T, Hoy, K and Shannon, C (2016) Does childhood bullying lead to the development of psychotic symptoms? A meta-analysis and review of prospective studies. Psychosis 8, 4859.
Eriksen, S and Jensen, V (2009) A push or a punch. Distinguishing the severity of sibling violence. Journal of Interpersonal Violence 24, 183208.
Finkelhor, D, Turner, H and Ormrod, R (2006) Kid's stuff: the nature and impact of peer and sibling violence on younger and older children. Child Abuse & Neglect 30, 14011421.
Fisher, HL, Jones, PB, Fearon, P, Craig, TK, Dazzan, P, Morgan, K et al. (2010) The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychiatric disorder. Psychological Medicine 40, 19671978.
Fraser, A, Macdonald-Wallis, C, Tilling, K, Brody, A, Golding, J, Davey-Smith, G et al. (2013) The avon longitudinal study of parents and children: ALSPAC mothers cohort. International Journal of Epidemiology 42, 97110.
Garety, PA, Kuipers, E, Fowler, D, Freeman, D and Bebbington, PE (2001) A cognitive model of positive symptoms of psychosis. Psychological Medicine 31, 189195.
Goodman, R (2001) Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry 40, 13371345.
Goodman, R, Ford, T, Richards, H, Gatward, R and Meltzer, H (2000) The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology and Psychiatry and Allied Disciplines 41, 645655.
Hepgul, N, Pariante, CM, Dipasquale, S, DiForti, M, Taylor, H, Marques, TR et al. (2012) Childhood maltreatment is associated with increased body mass index and increased c-reactive protein levels in first-episode psychosis patients. Psychological Medicine 42, 18931901.
Hodgins, S (2008) Violent behaviour among people with schizophrenia: a framework for investigations of causes, and effective treatment, and prevention. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 363, 25052518.
Hodgins, S, Cree, A, Alderton, J and Mak, T (2008) From conduct disorder to severe mental illness: associations with aggressive behaviour, crime and victimization. Psychological Medicine 38, 975987.
Holtzman, CW, Trotman, HD, Goulding, SM, Ryan, AT, Macdonald, AN, Shapiro, DI et al. (2013) Stress and neurodevelopmental processing in the emergence of psychosis. Neuroscience 249, 172191.
Horwood, J, Salvi, G, Thomas, K, Duffy, L, Gunnell, D, Hollis, C et al. (2008) IQ and non-clinical psychotic symptoms in 12-year-olds: results from the ALSPAC birth cohort. British Journal of Psychiatry 193, 185191.
Kelleher, I, Harley, M, Lynch, F, Arseneault, L, Fitzpatrick, C and Cannon, M (2008) Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample. British Journal of Psychiatry 193, 378382.
Kennedy, JL, Altar, CA, Taylor, DL, Degtiar, I and Hornberger, JC (2014) The social and economic burden of treatment-resistant schizophrenia. International Clinical Psychopharmacology 29, 6376.
Knack, JM, Jensen-Campbell, LA and Baum, A (2011) Worse than sticks and bones? Bullying is associated with altered HPA axis functioning and poor health. Brain and Cognition 77, 183190.
Lardinois, M, Lataster, T, Mengelers, R, Van Os, J and Myin-Germeys, I (2011) Childhood trauma and increased stress sensitivity in psychosis. Acta Psychiatrica Scandinavica 123, 2835.
Lereya, ST, Copeland, WE, Zammit, S and Wolke, D (2015) Bully/victims: a longitudinal, population-based cohort study of their mental health. European Child & Adolescent Psychiatry 24, 14611471.
Little, RJA and Rubin, DB (2002) Statistical Analysis with Missing Data, 2nd edn. New York, NY: Wiley.
Myin-Germeys, O, Delespaul, P and van Os, J (2005) Behavioral sensitization to daily life stress in psychosis. Psychological Medicine 35, 733741.
Olweus, D (2007) The Olweus Bullying Questionnaire. Center City, MN: Hazelden.
Ouellet-Morin, I, Wong, CC, Danese, A, Pariante, CM, Papadopoulos, AS, Mill, J et al. (2013) Increased serotonin transporter gene (SERT) DNA methylation is associated with bullying victimization and blunted cortisol response to stress in childhood: a longitudinal study of discordant monozygotic twins. Psychological Medicine 43, 18131823.
Radford, L, Corral, S, Bradley, C and Fisher, HL (2013) The prevalence and impact of child maltreatment and other types of victimization in the UK: findings from a population survey of caregivers, children and young people and adults. Child Abuse & Neglect 37, 801813.
Read, J, Fosse, R, Moskowitz, A and Perry, PD (2014) The traumagenic neurodevelopmental model of psychosis revisited. Neuropsychiatry 4, 6579.
Schreier, A, Wolke, D, Thomas, K, Horwood, J, Hollis, C, Gunnell, D et al. (2009) Prospective study of peer victimization in childhood and psychotic symptoms in a nonclinical population at age 12 years. Archives of General Psychiatry 66, 527536.
Selten, J and Cantor-Graae, E (2005) Social defeat: risk factor for schizophrenia? British Journal of Psychiatry 187, 101102.
Shevlin, M, Houston, JE, Dorahy, MJ and Adamson, G (2008) Cumulative traumas and psychosis: an analysis of the national comorbidity survey and the British psychiatric morbidity survey. Schizophrenia Bulletin 34, 193199.
Sourander, A, Gyllenberg, D, Klomek, AB, Sillanmäki, L, Ilola, AM and Kumpulainen, K (2016) Association of bullying behaviour at 8 years of age and use of specialized services for psychiatric disorders by 29 years of age. JAMA Psychiatry 73, 159165.
Stowkowy, J and Addington, J (2012) Maladaptive schemas as a mediator between social defeat and positive symptoms in young people at clinical high risk for psychosis. Early Intervention in Psychiatry 6, 8790.
Swanson, JW, Van Dorn, RA, Swartz, MS, Smith, A, Elbogen, EB and Monahan, J (2008) Alternative pathways to violence in persons with schizophrenia: the role of childhood antisocial behavior problems. Law and Human Behavior 32, 228240.
Tippett, N and Wolke, D (2015) Aggression between siblings: associations with the home environment and peer bullying, Aggressive Behavior 41, 1424.
Trotta, A, Di Forti, M, Mondelli, V, Dazzan, P, Pariante, C, David, A et al. (2013) Prevalence of bullying victimisation amongst first-episode psychosis patients and unaffected controls. Schizophrenia Research 150, 117.
Tucker, CJ and Finkelhor, D (2015) The state of interventions for sibling conflict and aggression. Trauma, Violence, & Abuse 18, 396406.
Tucker, CJ, Finkelhor, D, Turner, H and Shattuck, A (2013) Association of sibling aggression with child and adolescent mental health. Pediatrics 132, 7984.
Tucker, CJ, Finkelhor, D, Turner, H and Shattuck, AM (2014) Sibling and peer victimization in childhood and adolescence. Child Abuse and Neglect 38, 15991606.
Van Nierop, M, Dorsselaer, S, Bak, M, Mayin-Gremeys, I and van Winkel, R (2014) Does social defeat mediate the association between childhood trauma and psychosis? Evidence from the NEMESIS-2 study. Acta Psychiatrica Scandinavia 129, 467476.
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W et al. (2012) Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective-and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661671.
Wechsler, D, Golombok, S and Rust, J (1992) WISC-III UK Wechsler Intelligence Scale for Children. Sidcup: Psychological Corp.
Wolke, D, Lereya, ST, Fisher, HL, Lewis, G and Zammit, S (2014) Bullying in elementary school and psychotic experiences at 18 years: a longitudinal, population-based cohort study. Psychological Medicine 44, 21992211.
Wolke, D and Samara, MM (2004) Bullied by siblings: association with peer victimisation and behaviour problems in Israeli lower secondary school children. Journal of Child Psychology and Psychiatry 45, 10151029.
Wolke, D and Skew, AJ (2011) Bullied at home and at school: relationship to behaviour problems and unhappiness. In McFall, S (ed.), Understanding Society: Early Findings From the First Wave of the UKs Household Longitudinal Study. London: Economic and Social Research.
Wolke, D, Tippett, N and Dantchev, S (2015) Bullying in the family: sibling bullying. The Lancet Psychiatry 2, 917929.
Wolke, D, Waylen, A, Samara, M, Steer, C, Goodman, R, Ford, T et al. (2009) Selective drop-out in longitudinal studies and non-biased prediction of behavioral disorders. British Journal of Psychiatry 195, 249256.
World Health Organization (1994) Schedules for Clinical Assessment in Neuropsychiatry. Washington DC: American Psychiatric Research.
Zammit, S, Kounali, D, Cannon, M, David, AS, Gunnell, D, Heron, J et al. (2013) Psychotic experiences and psychotic disorders at age 18 in relation to psychotic experiences at age 12 in a longitudinal population-based cohort study. American Journal of Psychiatry 170, 742750.


Related content

Powered by UNSILO
Type Description Title
Supplementary materials

Dantchev et al. supplementary material 1
Dantchev et al. supplementary material

 Word (36 KB)
36 KB

Sibling bullying in middle childhood and psychotic disorder at 18 years: a prospective cohort study

  • Slava Dantchev (a1), Stanley Zammit (a2) (a3) and Dieter Wolke (a1)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.