Prolonged Stress, PTSD, and Depression among School Aggressors and Victims

Exposure rates to school aggression as an aggressor, victim, aggressive victim, or a bystander is high, with large numbers of school-aged children reporting being subjected to verbal or physical violence. We hypothesized that all 3 clusters of the DSM-IV designation of posttraumatic stress disorder (PTSD; Criterion B: Intrusive recall, Criterion C: Avoidance, and Criterion D: Hypervigilance) would be experienced by pure victims, pure aggressors, and aggressive victims. We also anticipated that PTSD symptoms would lead to depression, primarily for victims. Questionnaires were given to 1,398 students, yielding 1,116 valid questionnaires (80% response rate). Respondents were enrolled in the general education system, from 9 different schools in Israel. Following calibration of the research instruments using exploratory and confirmatory factor analyses, a series of structural equation and reflection models were examined. The path through some of the symptoms of PTSD and depression was apparent only for victims. For the victims, the indirect model through avoidance predicted depression only for relational victimization. No clear linkage was found among aggression, PTSD, and depression for aggressors. For aggressors, physical aggression was linked with the 3 clusters of PTSD symptoms, but not with depression.