Introduction

Bullying is a phenomenon that mainly affects school-age children and adolescents around the world, being described as the most frequent form of school violence. Nowadays, it has established itself as a serious public health problem, due to its important short and long-term consequences for individual, family and community development, as well as for the human health itself. It is characterized by repetitive and intentional aggressions of various natures: psychological, sexual, physical, cyberbullying, among other types of manifestations. The acts of intimidation that configure bullying are systematically preconceived and repeatedly imposed on supposedly vulnerable and defenseless individuals, who are subject to these actions, which entails psychological and physical damage, isolation and marginalization, among other consequences. According to the Brazilian Ministry of Health (MS), adolescence is characterized by the period from 10 to 19 years old and is a biopsychosocial phase where physical, social, cognitive and emotional changes take place.^1-2

In Brazil, the occurrence of this phenomenon was mapped by the National Survey of School Health (PeNSE, as per its Portuguese acronym), which is a partnership between the Brazilian Institute of Geography and Statistics (IBGE) and the Brazilian Ministry of Health (MS). In its third edition held in 2015, it was found that about a fifth of the students practiced the act; in addition, it concluded that the aggressors have more health risk behaviors, such as consumption of tobacco, alcohol and other drugs, as well as early sexual intercourses. Moreover, they have problems related to mental health. These results raise concerns in the areas of psychology, education and health, since the consequences of bullying produce impacts on the health conditions and psychosocial development of students who are victims of the phenomenon at issue.^3-4

Victimization, low self-esteem, anxiety, fear, headache, enuresis, school truancy, depression, suicidal ideas and suicide are some of the effects that the latest investigations have revealed, which can affect the entire school life and the adult life itself of those involved with bullying, either as a victim or as an aggressor. In addition, bullying is considered as one of the indicators for the diagnosis of conduct disorders, thereby favoring the development of clinical pictures of anti-social and criminal behaviors. In light of the foregoing, further studies are needed to broaden pedagogical, social and health interventions.⁵

It is also known that the bullying phenomenon manifests itself differently between the genders. Studies highlight that girls who are victims of this act have lower self-esteem when compared to the opposite gender, and that they use more indirect and non-physical aggressions, defined as social aggression.⁶

Although boys practice more physical violence than girls, studies have proved that girls increasingly practice bullying, besides the fact that women who are victims of domestic violence tolerate it in their relationships and marriages. Those who suffer physical aggressions from their husbands claim that the practice started when they were bullied at school and never reacted. Moreover, the report on Violence and Injuries in Brazil showed that Brazilian estimates for violence between intimate partners were also higher and that they cause serious damage to the health of women, children and adolescents who experience and/or witness this context. The consequences range from scratches to death, which are expressed by different manifestations of violence, demanding alternatives from social and health services.⁷

It is worth emphasizing that the relations of inequality of power in the family may reveal a permissive home, where violence is used as a form of discipline, without any skills for conflict resolution, which leads children and adolescents to reproduce such behaviors with classmates and teachers.⁵

Given this scenario, this study becomes necessary and relevant due to the magnitude of the consequences of this phenomenon, which may be as varied as possible, where women are the main victims. In addition, the repercussions of this type of violence can entail profound marks of aggression, even for adulthood, thereby raising the need for psychological support to contribute to the overcoming of the problem. Accordingly, this work in question can provide means to contribute to health care of this population.

Starting from the premise that school is of fundamental importance in the development of the human being, the following question is asked: how often, who practices and what are the consequences of the bullying phenomenon among adolescent girls? In order to answer this question, we performed this study aimed to analyze whether the bullying phenomenon is frequently practiced among adolescent girls; and to identify who practices it and the consequences of this act.

Method

This study is part of a matrix project entitled: “Sexual education under the gaze of school adolescents, teachers and elementary school managers in Recife”. In order to achieve the objectives of this research, we performed an exploratory and cross-sectional study with a quantitative approach.

The research was conducted in a municipal school in the city of Recife-Pernambuco. The school has 734 regularly enrolled students, being 339 of elementary school I and 395 of elementary school II.

We included in the study adolescent girls aged between 10 and 19 years old, adolescent age group according to the Brazilian Ministry of Health,¹ regularly enrolled from the 7^th to the 9^th grade. We excluded those who did not present the Free and Informed Consent Form signed by their respective persons legally in charge.

For calculation and size purposes, we used a statistical calculator – Raosoft sample size calculator online, with establishment of a 5% error margin, 95% confidence interval and 85.8% problem prevalence. Thus, we obtained a total sample of 60 individuals. Data collection took place in the school installations on days and times determined by the coordination. Data were collected from February to March 2019.

In order to outline the profile of the participants, we used socioeconomic data such as: religion, maternal education, and use of alcohol and other drugs. In order to investigate bullying, we used the Kidscape questionnaire, which defines categories and classifications about bullying. It is a questionnaire that was standardized by the English institution in 1985, which has the same name as child psychologist Michelle Elliot. The questionnaire is self-administered and has 17 objective questions. Initially, it introduces questions aimed to know whether the student has already been bullied and ends up with questions seeking to identify whether the participant has already practiced bullying. The Kidscape questionnaire does not have an adaptation for Brazil, being only translated, which undermines the results with regard to prevalence, but allows the understanding of the Brazilian school scenario from this perspective.⁷

The questions seek to identify whether the victims suffered aggression, intimidation or harassment, when and how they happened and whether they suffered what the consequences were, besides investigating what solutions the victims can propose to solve this problem.⁷

The questionnaire was applied after signature of the Free and Informed Consent Form for people over 18 years old and for parents/guardians of those under 18 years old. The Free and Informed Consent Form was also applied to adolescents of a lower age group signed by parents/ guardians.

After data collection, we prepared a file with the data coding in an Excel 2010 XP spreadsheet. Following this procedure, we performed calculations of percentage and frequency of each of the variables, with subsequent preparation of tables and exposure of results.

The development of this study complied with the guidelines of Resolutions 466/2012 and 510/2016 of the National Health Council, thereby obtaining approval from the Ethics and Research Committee of the Hospital Complex of the University of Pernambuco, registered under opinion nº 2.315.612, on October 5^th, 2017.

Results

This study was attended by 60 girls aged between 10 and 19 years, where the average age was 14 years, considering the age group from 12 to 15 years or more. The brown skin color was the most prevalent (58.33%), followed by the black (23.33%). Regarding the schooling level, (38.33%) were in the 8^th grade, (36.66%) in the 7^th grade and (25%) in the 9^th grade. When the question was about income, (38.33%) of the adolescent students did not know how to inform family income and (35%) reported income of up to one minimum wage. The evangelical religion was the most answered with (46.44%), followed by Catholic (26.66%). With regard to smoking, use of alcohol and other drugs, the result was the same for the three substances, where 43% of the participants said that they used.

In this continuity, the first result to be pronounced corresponds to the prevalence of the bullying phenomenon, where the students were asked whether they had already suffered some type of intimidation, aggression and harassment. Of the 60 research participants, (68.4%) answered yes. When students were asked at what age they were when the phenomenon happened, there was a predominance of 45% at the age range from 11 to 14 years. Students aged less than 5 years old and more than 14 years old showed a lower index, with 3.3% and 13.3%, respectively.

When asked about the last time the students suffered some kind of intimidation, aggression or harassment, 13.3% reported having suffered on the same day of data collection, while 41.6% answered that it was a year or more ago. Regarding the number of times the students had already suffered intimidation, aggression or harassment, 33.3% reported that it was several times and 16.6% almost every day, as can be seen in Table 1.

Table 1 – Frequency of the aggression and the number of times in a municipal school. Recife, Brasil, 2019

When	Frequency of the aggression	%	Number	Frequency of the aggression	%
Today	08	13,3	Only once	23	38,3
30 days	12	20,0	Several times	20	33,3
6 months ago	15	25,0	Almost everyday	10	16,7
1 year ago or more	25	41,7	Many times a day	07	11,7

Source: Primary data. It was prepared by the authors.

In this study, bullying acts mostly took place in another site (35%), followed by on the way to school (26.6%), classroom (23.3%), courtyard (8.3%), bathroom (5%) and lunchroom (1.6%). Another concern was the feeling they felt at the time of the aggressions, where 22 (36.6%) of the students answered that they felt bad about the attitudes coming from their colleagues, 12 (20%) did not mind and five (8.3%) answered that they were afraid to go again to school.

This study investigated what were the consequences of the intimidation, aggression or harassment suffered by the surveyed students. In Table 2, we can see that 16 (26.6%) answered that they had bad consequences and 4 (6.6%) needed to move to another school.

Table 2 – Frequency of the consequences of intimidation, aggression or harassment and the thinking about who practices intimidation, aggression or harassment in a municipal school. Recife, Brasil, 2019

Consequences	Frequency	%	Thinking	Frequency	%
None	28	46,7	Nothing	12	20,0
Bad consequences	16	26,6	I am sorry	26	43,3
Dire consequences	12	20,0	I like them	21	35
It led me to change school	04	6,7	I do not like them	01	1,7

Source: Primary data. It was prepared by the authors.

When asked about whose fault it was in relation to the intimidation, aggression or harassment received, most indicated that it was the aggressor, 39 (65%). Of the total, 9 (15%) and 8 (13.3%) answered that the parents of the aggressors and the school management were blamed, respectively. A very relevant aspect that had a minimum percentage of one (1.6%) was that they stated that the victim was blamed for the aggressions. In addition, three answered that the blame should be attributed to other students and none answered that it should be to the teacher. When asked about who bullied, attacked or harassed, 46 (76.6%) answered that it was a boy.

Moreover, in Table 3, we can see that, when asked about what the students thought about those who practice intimidation, aggression or harassment at school, 26 (43.3%) stated that they felt sorry for the practitioners and one (1.6 %) reported not liking the aggressors.

Table 3 – Distribution of the type of intimidation, aggression or harassment in a municipal school. Recife, Brasil, 2019

Type	Frequency	%
Physical	06	10
Verbal	19	31,7
Emotional	12	20
Sexual	07	11,7
Racist	16	26,6

Source: Primary data. It was prepared by the authors.

Another important point analyzed and that is exposed in Table 3 was related to the types of bullying that the students claimed to have suffered. The verbal form was the most cited among the surveyed students, with 19 (31.6%). In addition, seven (11.6%) said that they had received sexual intimidation, aggression or harassment.

When the interviewees were asked whether they had already practiced intimidation, aggression or harassment, 19 (31.6%) answered that they had practiced and 41 (68.4%) answered that they had never practiced. As a last question and no less important, it was about the solutions that the interviewees proposed to solve the problem of bullying. Thus, we perceived that 14 (23.3%) reported that the best solution would be to arrest the aggressors. In addition, 23 (38.3%) understood that the school management should solve the problem, 10 (16.6%) proposed that parents should intervene and 13 (21.6%) believed the students who suffered the bullying process should solve it, not accepting the aggressions.

Discussion

The research results signalize a high prevalence of aggression, which can be confirmed after that 68.4% of the interviewees answered that they had suffered bullying. These data have also been confirmed by recent studies in the city of Recife. A research performed in Florianópolis, in 2014, shows a prevalence of 29.5% for victims of bullying in the age group between 10 and 14 years old.²

The national literature signalizes similar frequencies of victimization and bullying between the genders, although, according to the same research, several previous studies showed the male gender as a risk factor for practicing such act. This fact is related to the characteristics of bullying between boys and girls, which differ when it comes to physical aggression, with boys being more aggressive, while girls are more subtle in their aggressions, using humiliation, intrigues and rumors as the least noticeable way to the practice, which is in line with data from the National Survey of School Health of 2015, which also found a similar prevalence between the genders.^2-3

Faced with a high result of bullying in this study, we should emphasize the greatness of the role of the teacher in relation to the practice of conversation to favor evocations and/or feelings oriented towards aggression that allow responsible attitudes without discrimination and that can mitigate this problem. To that end, the adolescent needs to be heard, while the legal guardians should also report some different practice that may be associated with bullying.^8-9

In sequence, based on the results obtained, it was possible to find a higher occurrence of victimization of bullying in adolescents when they were between 11 and 14 years old (45%), and 13.3% declared to suffer bullying when they were over 14 years old. Nevertheless, a study performed in Paraíba, in 2018, with 277 girls from the public school system, revealed a higher prevalence of the occurrence of bullying in girls over 14 years of age (32.95%), and lower (28.97%) in girls between 10 and 14 years old. Accordingly, the Brazilian Ministry of Health, in the National Survey of School Health of 2012, also described the age range up to 14 years as the most prevalent for the bullying phenomenon. This can be justified by the fact that students over 14 years of age have greater freedom and social autonomy within the school context, which protects them from aggressions.^2-3

It is worth emphasizing that the prevalence of age shown in the results of this study may be related to the maturity of students, as well as to machismo, which is still very present in the social context and also in the way of life that these adolescents have in their family environment, among other factors. Moreover, we can see that girls between 10 and 14 years of age are more likely to be bullied, either by boys or girls, and that this age group coincides with the pubertal period, and then it is often possible that symptoms of social isolation, depression, insomnia and stress are confused by parents and teachers with this biological phase of the adolescent life.

It is also worth highlighting that bullying is a phenomenon that manifests itself by its repetition. A research involving school adolescents performed in Sergipe showed that 19.1% of the students suffered bullying due to the frequency that they reported the aggressions, and not only considering the existence of a single, or few episodes, of which 55.9% were girls. However, in this study, we can note an even higher prevalence of 49.9% of victims of bullying, according to the frequency of exposure to aggressions (it should be taken into account that the sample of this research is composed only of girls). These values corroborate with the research carried out by the United Nations with more than 100 thousand children and young people from 18 countries, which showed that, on average, half of them have already been bullied.^2-10

Literature reveals the school as the main site where bullying takes place. In contrast, this study showed that (35%) of the adolescents were bullied in another environments, other than the school. Other studies show that more than half of the victims of bullying suffer aggression in the schoolyard, since it is an environment with less supervision by teachers. Nevertheless, most interviewees in this research stated that they suffered violence in the classroom. This may be related, once again, to the fact that the characteristics of bullying among girls are less noticeable, being present silently in all school environments, making it even more difficult to fight it.^10-11

A comparative study held among young Brazilian and Portuguese young students showed a higher prevalence of bullying in the Brazilian school environment when compared to the Portuguese, with percentiles of 60.75% and 20.31% respectively.¹² A study showed that adolescents in the Portuguese sample show a greater sense of generosity and concern for the one that is being attacked, which can justify the lower percentile, where the authors associate the higher prevalence of bullying in the Brazilian schools with the lack of empathy and solidarity with the victims, as it was possible to note in the results of the present result too. It is believed that the practice of bullying is associated with the desire of the adolescent to become more popular and powerful in the school environment.¹²

Continuing on the various sites that the bullying process may happen, it is worth emphasizing that these scenarios may be associated, again, with the maturity of the adolescent. In this context, the fragile knowledge of the aggressor about what the phenomenon is and the consequences that the practice can entail favors the fragility in the formation of affective bonds and harmony in the daily life.

Another point considered important in the questionnaire was about the feelings of the victims. The literature showed that victims of bullying and witnesses to this practice had impaired school performance, such as, for example, in reading and writing, according to the score applied.¹⁰ These feelings favor the physical and psychological changes of adolescents, but, also, such physical changes may not happen because they do not depend on the will of the student, but on his/her biotype; however, it is also worth highlighting that, possibly, psychological changes will take place and be revealed in his/her body.

When it comes to the blame of intimidation, aggression and harassment, the results show that (65%) of the interviewees stated that they were the very aggressors, followed by the parents of the aggressor (15%). Amidst these data, similar results were found in another study where the researcher suggests that the State is responsible, since it should establish public policies with regard to school violence, and also brings the family and the entire school community as co-responsible for the practice of bullying.¹⁰

Although the largest part of the adolescents who took part in this research believe that the bullying is a fault of the aggressor, it is important to bring to light the responsibility of the entire school community. Thus, we can encourage them to claim from the school the compliance with the Law that institutes the Program to Combat Systematic Intimidation (Bullying).

According to the survey, 76.6% of girls are bullied by boys, although the prevalence of equality between boys and girls who practice the phenomenon has been increasingly proven. We should take into account that the typical male practice is more noticeable and that boys attack both girls and boys. However, girls, when aggressors, attack girls more frequently.²

Bullying is manifested by several typologies; according to the data obtained in this investigation, the most common type of bullying was verbal, reaching 31%. This type of act is also the most prevalent in other groups, as identified in studies with obese adolescents, reaching a rate of 95%. In a study performed in Rio Grande do Sul, verbal bullying reached a prevalence of 92% in girls and 84% in boys. In the present study, bullying expressed in the form of racism was expressive, reaching 26.6%, being above emotional bullying, unlike other studies, which reveal that the verbal type is usually followed by the emotional or psychological type. Sexual bullying had a percentage of 11.6%, lower when compared to other studies.^9,13

Even though racism is not yet consistent in the literature as a prevalent form of bullying, studies have noted that the victimization of bullying in Brazil is prevalent among students of skin color declared as black and/or brown, but the white skin color reveals itself as a protective factor. In other words, according to several studies, most victims of bullying are black or brown, but the type of bullying is not identified as racism, unlike the present research that brings racism as the second cause of bullying in school adolescents of the female gender.^2-3,7

Although 20% of the interviewees claim to suffer more emotional bullying, this number was far from recent investigations that reach 70% frequency of emotional bullying in girls. Possibly, it happens because racism may be used as a form of emotional or psychological bullying. Regarding the practice of bullying, 68.4% of the interviewees answered that they had never practiced it, but a more current study showed that there was no difference in the participation of boys and girls. The big difference permeates the manifestations of different typologies. The research also suggests that access to digital communication has favored an increase in bullying among girls. These results are probably due to the fact that physical bullying is not the most prevalent form among girls.¹⁴

The interviewed adolescents proposed solutions to the problem of bullying practiced in schools. It is worth emphasizing that a large part understands that the school management is responsible for solving the problem. Another important and impacting point is that about 23.3% stated that the arrest of aggressors would be the best solution to the bullying phenomenon. Law nº 13.185, in force since 2016, classifies bullying as systematic intimidation. This law sets standards and goals for schools to combat bullying, but it is not clear about punishments for parents, students or teachers.¹⁵

In this sense, we see the importance of support networks to deal with the bullying phenomenon and also the greatness of promotion and prevention actions. It becomes relevant to mention that the accomplishment of educational actions capable of sensitizing the general population, aiming to decrease the number of cases (racism, prejudice, verbal aggressions, among others). Based on this understanding, we can disseminate information to the public and also contribute as a way to encourage positive attitudes that help everyone to fight the problem.

Moreover, it is necessary to recognize bullying situations, to offer help as well as to train teachers, health professionals and families. These actions may respond to the Sustainable Development Goals, specifically those that refer to Peace, justice and effective institutions and, in an articulated way, to Health and welfare, Quality education, Gender equality and Reduction of inequalities.¹⁶

Currently, there are a large number of international studies examining adverse health and psychosocial problems derived from bullying, which is still a global public health problem.¹⁷ The role of nursing in fighting bullying should be focused on the implementation of public policies and the promotion of an equal relationship among human beings.¹⁸

The nursing professional can act by identifying vulnerable groups and organizing strategies to deal with violence. Therefore, we should consider its relationship with society and, in this case, with violence in its most diverse typologies and as a public health problem.¹⁹It is worth emphasizing the importance of the performance of nursing in the School Health Program (PSE, as per its Portuguese acronym), since it is based on the principles of intersectoriality and territoriality, seeking to contemplate an integral formation and the development of citizenship of adolescent students of elementary education. Moreover, PSE establishes the school and the primary health unit as spaces for social coexistence that favor the consolidation of positive links to health promotion – health education.²⁰

Conclusion

The study achieved the proposed objective by analyzing whether the bullying phenomenon is frequently practiced among adolescent girls aged from 10 to 19 years old. As for the high prevalence of the bullying phenomenon, it was possible to find the frequency of the types of this violence. Verbal violence was the most common, followed by racism, which may be even greater, since it can be understood as emotional or psychological violence. Bullying stands out as a violence that manifests itself in different ways with respect to sex and gender, both on the part of the victims and on the part of the aggressors.

In this investigation, bullying in girls was identified as more frequent in classrooms, where there is the presence of the teacher, thereby characterizing bullying in girls as a silent enemy, since, as previously seen from the present study, the presence of the teacher does not intimidate or decrease the frequency of bullying among girls. Therefore, it is important that teachers are attentive to the behavior of these adolescents, since adolescence alone is a phase of meaningful changes and adaptations.

We should emphasize the importance of the commitment of the family, the school community, as well as the health and education authorities, in order to break social paradigms, racism, machismo and greater female vulnerability from an early age. Nursing should also be present with health promotion actions, in such a way as to turn adolescent girls into allies in combating violence, thereby enabling that this cycle of acceptance can be broken and, consequently, preventing it from lasting until their adult life. Moreover, interventions in several areas are necessary, in the family and school context of these adolescents, so that they are increasingly confident, independent and free.

This study was limited by the fact that it was held in only one municipal school. Accordingly, we suggest that further studies focused on this topic be carried out in other schools of the investigated town for a better understanding of the prevalence of the bullying process of the Brazilian population, in such a way as to enrich the evidence about the process and the consequences of the phenomenon.

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Corresponding author

Daniela de Aquino Freire

E-mail: daniela_ 3439@hotmail.com

Address: Rua Doutor Otávio Coutinho – Santo Amaro, Recife - PE

ZIP Code: 52171-011

Author Contributions

1 – Daniela de Aquino Freire

Conception and planning of the research project, as well as writing and critical review.

2 – Raquel Rufino da Silva

Conception and planning of the research project, obtaining and analyzing the data, as well as writing.

3 – Thaís da Silva Oliveira

Data analysis, as well as writing and critical review.

4 – Kydja Milene Souza Torres

Critical writing and review.

5 – Juliana da Rocha Cabral

Critical writing and review.

6 – Maria Lúcia Menezes

Project design and planning, as well as critical review.

How to cite this article

Freire DA, Tavares RR, Oliveira TS, Torres KMS, Cabral JR, Menezes ML. The practice of bullying in adolescents of the female gender. Rev. Enferm. UFSM. 2020 [Acesso em: Anos Mês Dia]; vol.10 e40: 1-19. DOI:https://doi.org/10.5902/2179769239002