Relationship between Bullying, Substance Use, Psychiatric Disorders, and Social Problems in a Sample of Kenyan Secondary Schools.

We aimed to investigate how direct bullying and victimization relate with substance use, the presence of psychiatric disorders, poor school performance, disruptive behaviors, and social problems among secondary school students. A cross-sectional study was conducted in 20 randomly selected mixed-day secondary school students in forms one to three in Machakos County, equivalent to students in grades 1 to 11. From a random starting point, every sixth student in the class was invited to participate. The Drug Use Screening Inventory (revised) (DUSI-R) and the Olweus Bully/Victim Questionnaire (OBVQ) were administered in a classroom-setting by trained research assistants with experience in data collection. Four categories, i.e., bully only, bully-victim, victim only, and neither bully nor victims (neutrals) were developed and problem density scores computed. Descriptive statistics, bivariate, and multinomial logistic regression analysis summarized the findings. Of the 471 students, 13.6% had not experienced bullying problems. Bully-victim was the most prevalent form of bullying. No significant gender differences were reported across categories. Bully-victims reported significant higher problem density scores in eight out of the nine problem domains, and effect sizes of the differences in problem scores between neutrals and bully-victims were larger compared with other categories. Behavioral and family system problem scores retained a significant relationship with bully-victim category (p < 0.001). A high prevalence of bullying problems was documented in both genders. However, bully-victims had a higher risk of multiple negative individual and environmental and social problems. Assessment of bullying problems is an indirect route to identifying significant youth problems. Bullying interventions should be multifaceted to address psycho-socio-behavioral problems.