Childhood bullying involvement predicts low-grade systemic inflammation into adulthood

  1. William E. Copelanda,1,
  2. Dieter Wolkeb,
  3. Suzet Tanya Lereyab,
  4. Lilly Shanahanc,
  5. Carol Worthmand, and
  6. E. Jane Costelloa
  1. aDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27713;
  2. bDepartment of Psychology and Division of Mental Health and Wellbeing, University of Warwick, Coventry CV4 7AL, United Kingdom;
  3. cDepartment of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599; and
  4. dDepartment of Anthropology, Emory University, Atlanta, GA 30322
  1. Edited by Thomas W. McDade, Northwestern University, Evanston, IL, and accepted by the Editorial Board April 7, 2014 (received for review January 1, 2014)


Bullying is a common childhood experience that affects children at all income levels and racial/ethnic groups. Being a bully victim has long-term adverse consequences on physical and mental health and financial functioning, but bullies themselves display few ill effects. Here, we show that victims suffer from greater increases in low-grade systemic inflammation from childhood to young adulthood than are seen in others. In contrast, bullies showed lower increases in inflammation into adulthood compared with those uninvolved in bullying. Elevated systemic low-grade inflammation is a mechanism by which this common childhood social adversity may get under the skin to affect adult health functioning, even many years later.


Bullying is a common childhood experience that involves repeated mistreatment to improve or maintain one’s status. Victims display long-term social, psychological, and health consequences, whereas bullies display minimal ill effects. The aim of this study is to test how this adverse social experience is biologically embedded to affect short- or long-term levels of C-reactive protein (CRP), a marker of low-grade systemic inflammation. The prospective population-based Great Smoky Mountains Study (n = 1,420), with up to nine waves of data per subject, was used, covering childhood/adolescence (ages 9–16) and young adulthood (ages 19 and 21). Structured interviews were used to assess bullying involvement and relevant covariates at all childhood/adolescent observations. Blood spots were collected at each observation and assayed for CRP levels. During childhood and adolescence, the number of waves at which the child was bullied predicted increasing levels of CRP. Although CRP levels rose for all participants from childhood into adulthood, being bullied predicted greater increases in CRP levels, whereas bullying others predicted lower increases in CRP compared with those uninvolved in bullying. This pattern was robust, controlling for body mass index, substance use, physical and mental health status, and exposures to other childhood psychosocial adversities. A child’s role in bullying may serve as either a risk or a protective factor for adult low-grade inflammation, independent of other factors. Inflammation is a physiological response that mediates the effects of both social adversity and dominance on decreases in health.


Freely available online through the PNAS open access option.