From Exposure to Psychological Harm: A Socioecological and Trauma-Informed Narrative Review of Bullying, School Violence, and Youth Mental Health

Abstract

Bullying and school violence are preventable exposures and potentially modifiable risk factors for adverse youth mental health and educational outcomes. This critical narrative review integrates epidemiological, longitudinal, genetically informed, quasi-experimental, meta-analytic, and intervention evidence on bullying, cyberbullying, selected forms of school violence, and their psychological sequelae. The evidence base available at the original submission was reassessed during revision through a complete structured rerun of PubMed/MEDLINE, APA PsycINFO, ERIC, Scopus, Web of Science Core Collection, Google Scholar, major publisher platforms, and authoritative organizational sources from 15 to 27 August 2026, followed by a final update on 8 September 2026; reporting was guided by the Scale for the Assessment of Narrative Review Articles (SANRA). Evidence supports robust associations with depression, anxiety, trauma symptoms, loneliness, sleep disturbance, self-harm, suicidality, substance use, and externalizing difficulties, although effect estimates differ in design, metric, and certainty. We propose an evidence-informed, not prospectively validated, mechanism-to-action framework. Within the reviewed corpus, direct prospective mediation evidence was identified for interpersonal distrust and school belonging; longitudinal evidence supports a rumination-sleep sequence; and threat appraisal, humiliation/shame, and social defeat remain theory-supported candidate mechanisms. Socioecological theory organizes influences across individual, peer, school, family, community, policy, and digital levels. Trauma-informed principles are used as an interpretive and ethical lens; evidence for whole-school trauma-informed models remains limited. Whole-school anti-bullying programs modestly reduce exposure, but average effects on internalizing symptoms are small and heterogeneous. Systems should therefore coordinate exposure prevention with assessment, treatment, and follow-up of psychological harm. Progress should be judged by safety, equity, belonging, functioning, and recovery, not incident counts alone.