Bullying Victimization and Complex Trauma: A Systematic Review of CPTSD and DTD Symptoms

A meta-analysis published in 2015 demonstrated a significant association between bullying victimization (BV) in school and workplace settings and the onset of post-traumatic stress disorder (PTSD) symptoms. However, a recent theoretical review showed that the consequences of BV are much more complex than the traditional PTSD criteria. The authors argue that two potential diagnoses ought to be considered in the context of BV: developmental trauma disorder (DTD) and complex post-traumatic stress disorder (CPTSD). This systematic review aims to synthesize the results regarding the relationship between BV and these two complex trauma symptoms. Following PRISMA guidelines, systematic searches were conducted in seven electronic databases in March 2024. We searched for Portuguese or English quantitative published studies, or unpublished quantitative master's or doctoral theses. In total, 1056 studies were identified, and 12 were considered eligible. Ten were cross-sectional, and two were longitudinal. Five had youth samples, whereas seven had adult samples. Most studies presented a low risk of bias. No studies were found that aimed to assess the relationship between BV and DTD symptoms. In contrast, a significant positive relationship between BV and CPTSD symptoms in youth and adult populations was found. BV was particularly associated with CPTSD, but not with PTSD in both populations. Only one study found that BV was not a predictor of CPTSD status in a Danish adult population. The results reveal that BV might be associated with a more complex symptomatology. However, it is still not possible to assert the causal link between BV and DTD/CPTSD.