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Article

Childhood Teasing Experiences and Adult Emotional Distress: The Mediating Role of Social Anxiety and Self-Esteem

by
Vasiliki Varela
1,2,*,
Kyriaki Gavrielidou
3,
Despina Savidou
3,
Meropi Simou
2,4 and
Gregoris Simos
2,3,*
1
1st Department of Psychiatry, University Mental Health Research Institute (UMHRI/EPIPSI), Eginition Hospital, Medical School, University of Athens, Soranou tou Efesiou 2, 10679 Athens, Greece
2
Greek Association of Cognitive Behavioral Psychotherapies, Fragini 9, 54624 Thessaloniki, Greece
3
Department of Educational and Social Policy, University of Macedonia, 54636 Thessaloniki, Greece
4
Department of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
*
Authors to whom correspondence should be addressed.
Psychiatry Int. 2025, 6(2), 42; https://doi.org/10.3390/psychiatryint6020042
Submission received: 15 January 2025 / Revised: 17 March 2025 / Accepted: 31 March 2025 / Published: 15 April 2025
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Abstract

:
Previous research consistently identified depression and anxiety as leading contributors to the global disease burden. Recognizing risk and protective factors that lead to or guard against negative mental health outcomes therefore remains a research priority. The present study examined mediation models for the often-cited association between childhood verbal victimization and adult depression and anxiety symptomatology. Specifically, we investigated whether memories of childhood teasing related to adult adverse mental health outcomes indirectly via the mediated effects of self-esteem and social anxiety. Three hundred sixty-four (64.8% female) adult participants took part in a retrospective study by completing the Teasing Questionnaire—Revised; epidemiological scales of depression, anxiety, stress, social phobia, and social interaction anxiety; and a self-esteem measure. Memories of childhood teasing were indeed positively related to depression, anxiety, stress, social interaction anxiety, and social phobia scores and negatively related to current self-esteem, i.e., the individual’s subjective evaluation of their worth. Self-esteem and recalling being teased for one’s social skills were consistent predictors across all adult outcomes (depression, anxiety, stress, social anxiety, and social phobia). Lastly, self-esteem was found to be a partial mediator of the relationship between the memories of childhood teasing and depression and anxiety in adulthood, while social interaction anxiety partially mediated the relationship between teasing and anxiety, but not depression. These findings highlight the long-term psychological impact of childhood teasing and underscore the critical role of self-esteem and social anxiety as pathways through which early verbal victimization contributes to adult mental health outcomes, emphasizing the need for targeted interventions to foster resilience and mitigate lasting effects.

1. Introduction

In the latest Global Burden of Diseases, Injuries, and Risk Factors Study [1,2], depression and anxiety were ranked as the 13th and 24th leading causes of disability-adjusted life-years (DALYs), respectively. Moreover, and despite the increased recognition and implementation of prevention and treatment strategies in several countries, the study showed that the prevalence of mental disorders doubled in the decades between 1990 and 2019. These numbers are expected to rise further, as the COVID-19 pandemic intensified risk factors that trigger psychopathology in all age groups [3,4,5], making a coordinated response by both the academic community and policy-makers not only a priority but also an urgent need [6,7].
Within the ongoing research effort to identify causal pathways between mental health disorders, genetic vulnerabilities, and other environmental life circumstances, stressful early experiences have consistently been recognized as possible predictors of adult psychopathology [8,9,10,11]. Within the context of this literature, the focus of the present study was on exploring whether malicious teasing, an early adverse peer-victimization experience, can act as a vehicle to adulthood depression and anxiety. As the commonest form of peer victimization across gender [12], teasing is a form of bullying characterized by a power differential between the culprit and victim and an intention to inflict harm to the latter by the former [13]. It is this expectation to emotionally injure the other that differentiates teasing from harmless, playful joking, which is often utilized constructively by children and adults alike for the enhancement of social bonds [14,15,16,17].
The pathogenic effect of childhood teasing comes largely as a consequence of the message of social rejection it confers [10,18,19,20]. By depriving the recipient of their fundamental human need to belong [19,21], malicious teasing can result in trauma over and above that of physical assault, sexual victimization, or harassment [18,22]. It comes, therefore, as no surprise that early experiences of teasing was shown to relate to a number of adverse psychosocial outcomes in the externalizing and internalizing domains, not only near the time of the experience but also later in life [23,24,25,26], with distress ranging from somatic complaints, social anxiety, depression, low self-esteem, and eating disorders to problems in interpersonal functioning, suicidal, and anti-social behavior [13,20,27,28,29,30,31,32,33,34,35,36].
Within the context of cognitive vulnerability models, it was suggested that the association between childhood verbal victimization and adult depression and anxiety symptomatology is mediated by psychological reserves, like self-esteem or risk predispositions, like social anxiety. Self-esteem refers to an individual’s subjective evaluation of their worth, shaped by both internal and external factors [37]. It encompasses how people perceive their abilities, values, and relationships, and is closely tied to emotional well-being [38,39]. Higher self-esteem is associated with greater resilience; positive self-regard; an adaptive response to challenges; and a wealth of positive life outcomes, such as psychosocial adjustment, prosocial behavior, educational and occupational attainment, and overall health. Low self-esteem, on the other hand, is often linked to negative self-perceptions, feelings of inadequacy, and vulnerability to psychological distress [38,39,40,41,42,43,44,45]. More specifically, the protective effects of heightened self-esteem against the development of anxiety and depression have been widely documented in both cross-sectional and longitudinal studies (for reviews, see [38,46]), with no evidence to suggest that the relationship is bi-directional in nature: self-esteem acts as a buffer, predicting the presentation of anxiety and depression symptoms; anxiety or depression episodes, on the other hand, do not predict lowered self-esteem. Within the context of the diathesis–stress model, a negative representation of the self is seen as a causal vulnerability factor that can interact with environmental stressors to produce symptom onset and maintenance [46,47,48]. Low self-esteem has also been recognized as a risk factor in the development of anxiety disorders, albeit with smaller reported effect sizes than those found between self-esteem and depression [46,47,48,49]. The present study explored the contribution of adult self-esteem to depression and anxiety symptomatology and investigated its role as a mediator of the relationship between childhood teasing experiences and psychopathology.
Depression and anxiety, as the commonest forms of psychiatric disease, also frequently co-occur in three out of four patients, with comorbidity related to a heavier overall burden and prognosis, e.g., [11,50,51,52,53,54]. In those patients with comorbidity, research established a specific temporal pattern of symptom emergence, where most studies reported anxiety being prodromal to depression (e.g., [31,55,56,57]). In an effort to explore these unidirectional effects of anxiety, it was claimed that one potential contributor to this sequential association are social skills deficits, often found in anxious children and teens [58,59]. Anxious children, especially those whose fears evolve around social life (i.e., social anxiety), often engage in avoidance strategies in order to escape perceived fearful situations, thereby minimizing opportunities for age-appropriate social skills development. This avoidance, in turn, leads to limited and less positive peer interactions, and ultimately, social withdrawal and depression [59,60,61,62,63,64,65,66]. Simultaneously, a different line of research showed that children with social skills impairments are more likely to be rejected by their peers and/or become victims of peer aggression [23,42,65,66,67,68,69,70,71,72]. Based on those findings, we proposed that teasing experiences associated specifically with the victim’s social skills are predictive of later depression and anxiety symptoms. Moreover, we also proposed that the relationship between malicious teasing experiences and psychopathology are mediated by trait social interaction anxiety.
Taken together, it could be proposed that both in the case of self-esteem and in the case of poor social skills, attributions of blame, i.e., cognitions, might play an important role in determining whether malicious teasing by peers would contribute to the emergence or increases of psychopathological symptoms. Given the importance of peer evaluations in the development of healthy self-esteem levels, it would come as no surprise if such negative, aggressive interactions that focus on the victim’s social skills deficits would elicit negative self-views and attributions of blame to oneself. Prinstein and colleagues [73] showed, for example, how causal, critical self-referent attributions made by a victim of peer aggression were related to depression, social anxiety, and loneliness in a sample of kindergarten children and adolescents alike, supporting such a cognitive vulnerability model.
The present study investigated the long-term impact of childhood verbal teasing on adult depression and anxiety, an area where significant gaps exist in understanding the underlying psychological mechanisms. While early peer victimization has been linked to adverse outcomes, like depression, anxiety, and low self-esteem [23,24,25,26,27,28,29,30,31,32,33,34,35,36], the roles of mediators, such as self-esteem and social anxiety, in this relationship remain underexplored. By examining these mediators, this research aimed to enhance our understanding of how childhood teasing contributes to adult psychopathology, providing insights into potential intervention strategies. Addressing self-esteem and social anxiety in individuals with a history of teasing could help alleviate the long-term psychological burden, particularly in light of the high comorbidity between anxiety and depression [50,51,52,53,54]. This study, therefore, aimed to explore the relationships between memories of childhood teasing, emotional distress (depression, anxiety, social phobia, and social anxiety), and current self-esteem in an adult sample, with a focus on whether self-esteem and social anxiety mediate the relationship between childhood teasing and adult mental health symptoms.

2. Materials and Methods

2.1. Participants

A snowball sampling technique was used, where this study was simultaneously advertised using several social media outlets (WhatsApp, Twitter, Facebook, and Instagram) and mailing lists of students at the University of Macedonia, Thessaloniki, Greece. A total of 431 people agreed to take part in this study between September and December 2023. Of the collected responses, a Missing Values Analysis revealed that 59 cases (13.7%) had between 20 and 55% of the data missing in the variables of concern and were deleted from the sample. The data patterns were first examined to assess whether the missing data were “missing completely at random” (MCAR). Little’s MCAR indicated that the observed pattern of missing data was not significantly different from a random pattern (chi2 = 3068.847, df = 9122, p = 1.000). Since the data were missing completely at random, those cases that had more than 20% of missing values were excluded from the sample. The remaining 372 cases displayed a variety of distributions of completed data and were subjected to data imputation using the Expectation Maximization (EM) imputation method, a statistical technique that iteratively estimates missing values based on the relationships between the available data points, e.g., [74]. Lastly, 8 multivariate outliers were also identified via the Machalanobis distance procedure, which were also deleted from the dataset. The final sample consisted of 364 participants (64.8% female). The mean age of the sample was 22.81 (SD = 4.83), with an age range of 17 to 67 years. A total of 95% of the sample were 30 years old or younger.

2.2. Ethical Considerations

All aspects of this study complied with the Declaration of Helsinki. This study received approval from the Institutional Review Board (IRB) or Ethics Committee at the University of Macedonia, Greece, to ensure that this research met ethical standards for studies involving human participants. The committee reviewed and granted ethical clearance after evaluating this study’s design, methods, and participant protection measures to ensure that this research adhered to established principles of confidentiality, informed consent, and data protection. More specifically, informed consent was obtained from all the participants prior to their involvement in this study. The participants were fully informed about this study’s objectives, procedures, potential risks, and benefits, as well as their right to withdraw from this study at any time without penalty. Furthermore, authorization for the use of assessment instruments, such as psychological scales and questionnaires, was obtained in accordance with the relevant legal and ethical guidelines. All instruments used in this study were validated for research purposes and were chosen for their relevance to the research objectives.

2.3. Measures

The following broad categories of information were collected: (1) demographic information (age, gender), (2) questions related to the degree of teasing experienced during childhood, and (3) psychological and health impact ratings (anxiety, stress, depression, self-esteem, social phobia, and social anxiety). The Teasing Questionnaire—Revised (TQ-R) [42] was used to examine memories of childhood teasing experiences. The scale consists of five subscales that concern teasing experiences regarding the participants’ performance, academics, social behavior, family background, and appearance. The 29-item scale is assessed on a 5-point forced-choice scale, ranging from 0 (“I was never teased about this”) to 4 (“I was always teased about this”). The TQ-R was translated and validated for use in the Greek language [75].
The following scales were used to assess the psychological and health impacts of the pandemic:
  • Depression, Anxiety, and Stress Scale (DASS-21) [76]: The depression (7 items), anxiety (7 items), and stress (7 items) subscales of the DASS-21 were used to assess the symptom severity. The scales are scored on a 4-point Likert scale, and the total scores for each subscale are interpreted as follows: for depression, normal levels (0–9), mild levels (10–13), moderate (14–20), severe (21–27), and extremely severe levels (>21); for anxiety, normal levels (0–7), mild (8–9), moderate (10–14), severe (15–19), and extremely severe (20+); and for stress, normal (0–14), mild (15–18), moderate (19–25), severe (26–33), and extremely severe (>34). The scale was translated and validated for the Greek population in a study that involved 12,868 Greek adults aged 18 to 65 [77]. Satisfactory reliability and validity indices were found, with internal consistency coefficients (Cronbach’s alpha) reported as 0.83 for depression, 0.78 for anxiety, and 0.83 for stress, indicating good reliability. Additionally, the factorial structure of the Greek DASS-21 aligns with those found in previous international studies, supporting its construct validity.
  • The Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) [78] measure two components of social anxiety fears. The SPS assesses the fears respondents have of being criticized doing routine activities (e.g., writing, drinking, eating), while the SIAS assesses fears of social interaction. The Greek version of the scales [79] contains 6 items for each measure, which are rated on a 5-point Likert scale (0—“not at all characteristic or true of me” to 4—“extremely characteristic of true of me”). The scale was translated and validated for the Greek population and the combined scale yielded strong internal consistency (Cronbach’s alpha = 0.92) [79].
  • Rosenberg Self-Esteem Scale (RSES) [37] contains 10 items scored on a 4-point Likert scale (0—“strongly disagree” to 3—“strongly agree”). The scale was validated in Greek populations, demonstrating strong psychometric properties. The scale showed good internal consistency, with Cronbach’s alpha coefficients that ranged from 0.80 to 0.89, and its factor structure was supported by studies, including both one-factor and two-factor models [80,81]. Additionally, the RSES demonstrated good concurrent validity, correlating positively with self-concept measures and negatively with stress levels, which confirmed its reliability and suitability for use in Greek-speaking populations [80,81].

2.4. Procedure

This study was performed online. A link on the advertisement took interested participants to the SurveyMonkey website, which hosted the survey. They first had to read an information sheet and then were asked to provide informed consent before completing the survey.

2.5. Data Analytic Approach

Once the data were collected, they were exported from the survey platform to the statistical program SPSS version 26 (IBM Corp., Chicago, IL, USA). Descriptive statistics were calculated for all outcome variables (see Table 1). The data were initially checked for violations of the test assumptions and all outcomes were found to be normally distributed (Kolmogorov–Smirnov > 0.05). A correlation matrix was created to show the bivariate relationships between the demographic and outcome variables (Table 2). Following this, five hierarchical stepwise multiple linear regressions with depression (DASS-21), anxiety (DASS-21), stress (DASS-21), social phobia (SPS), and social interaction anxiety (SIAS) as the outcome variables were calculated (Table 3). In each regression, Step 1 included predictors from the childhood teasing scale (TQ-R). Step 2 included the participants’ self-esteem ratings (RSES). In order to test the hypothesized multiple mediation models seen in Figure 1, the SPSS process macro (Model 4) [82] was used. Five thousand samples were resampled via the bootstrap method, and 95% confidence intervals (CIs) were calculated to examine the two mediators simultaneously. The two outcome measures were depression and anxiety rates, as measured by the DASS-21 (Figure 2 and Figure 3).

3. Results

3.1. Preliminary Analysis

The means, standard deviations, and inter-correlations between all the variables of interest can be seen in Table 1 above. The subjects reported mild levels of depression (M = 10.64, SD = 9.1) and anxiety (M = 8.16, SD = 7.4) and normal levels of stress (M = 14.04, SD = 7.9) on the DASS-21. The male and female participants differed in a number of outcome measures. On the Teasing Questionnaire, the females (M = 0.63, SD = 0.69) reported more experiences of childhood teasing associated with their academic performance than the males (M = 0.44, SD = 0.64, t(359) = −2.51, p = 0.013). The women also reported higher rates of depression, stress, social interaction anxiety, and lower self-esteem than their male counterparts (all p < 0.05, see Table 2 for summary statistics).

3.2. Self-Reported Teasing Experiences Effects

Not surprisingly, retrospective memories of teasing (TQ-R total score) were positively related to depression, anxiety, stress, social interaction anxiety, and social phobia scores, and negatively related to self-esteem scores, all with correlations of moderate effect size. Likewise, the TQ-R performance, social, and appearance subscale scores yielded significant, moderate-effect-size correlations for all the aforementioned mental health outcome measures. The academics subscale scores of the Teasing Questionnaire were also significantly correlated to the depression, anxiety, stress, self-esteem, social interaction anxiety, and social phobia scores, with small-to-moderate effect sizes, while the family background subscale scores were correlated with depression, anxiety, stress, and social interaction anxiety with small-to-moderate effect sizes, but were not related to the self-esteem and social phobia scores.
Five two-step hierarchical linear regression analyses were conducted to evaluate the prediction of global measures of psychological functioning (i.e., depression, anxiety, stress, social interaction anxiety, and social phobia) from the scores on the five sub-domains of teasing experiences (Step 1) and the same five teasing domains plus self-esteem (Step 2). The full results can be viewed in Table 3 and are also described in detail in the next paragraph. In summary, the memories of childhood teasing related to one’s social ability and adult self-esteem were significant predictors of all mental health outcomes. The more such memories one reported and the lower the adult self-esteem, the more increased the scores on the outcome scales.
Looking at the depression symptomatology first (DASS depression), the prediction models calculated using scores from the teasing subscales (Step 1: F(5358) = 15.59, p < 0.001, r2 = 0.18) and the full model (Step 2: F(6357) = 42.91, p < 0.001, r2 = 0.42) were statistically significant. By examining the weights of each significant predictor in Step 1, it can be seen that the memories of being teased about social behavior and appearance were significant predictors of adult depression. In Step 2, the full model, the addition of the last factor (self-esteem as an adult) did add to the predictive power (Fchange = 147.53, p < 0.001, r2change = 0.24), with the variables that were found to be significant predictors in order of magnitude of contribution to the final model being self-esteem (β = −0.521, p < 0.001), and remembering being teased about social behavior (β = 0.153, p = 0.004). The remaining teasing domains measured via the TQ-R subscales were not significant predictors of adult depression.
Regarding anxiety, again, both models were significant (Step 1: F(5358) = 14.56, p < 0.001, r2 = 0.17, and the full model Step 2: F(6357) = 22.1, p < 0.001, r2 = 0.27). In Step 1, teasing experiences regarding participants’ social behavior and family background were found to be significant predictors of anxiety scores later in life. The full model (Step 2) had a significantly improved fit, which explained more of the variance in the anxiety scores (Fchange = 49.9, p < 0.001, r2change = 0.10). In order of magnitude, adult self-esteem (β = −0.339, p < 0.001), the memories of teasing about social behavior (β = 0.154, p = 0.01), and family background (β = 0.132, p = 0.01) were significant predictors of adult anxiety levels.
When testing the prediction models for adult stress levels, both the memories of teasing experiences (Step 1: F(5358) = 14.56, p < 0.001, r2 = 0.17) and the teasing experiences plus adult self-esteem (the full model Step 2: F(6357) = 22.1, p < 0.001, r2 = 0.27) were found to be significant contributors. Looking at the first step separately, the experiences of childhood teasing related to social ability, appearance, and academic performance were significant predictors that explained 17% of the variance in the stress scores. The addition of adult self-esteem (full model) added to the predictive power (Fchange = 72.7, p < 0.001, r2change = 0.14). Once again, self-esteem appeared to be the best predictor in the final model (β = −0.39, p = 0.001), followed by the teasing memories about one’s academic performance (β = 0.13, p = 0.008) and social ability (β = 0.11, p = 0.048).
The fourth hierarchical regression concerned social interaction anxiety. The memories of the various types of teasing experienced during childhood were a significant predictor of adult scores in the SIAS (Step 1: F(5358) = 13.58, p < 0.001, r2 = 0.16). In step 1, the memories of being teased as a child about social ability and appearance were predictive of adult social phobia. When self-esteem was added to this in Step 2, the full model remained significant (F(6357) = 25.48, p < 0.001, r2 = 0.30; Fchange = 71.5, p < 0.001, r2change = 0.14), with the variables that were found to be significant predictors in order of magnitude of contribution to the final model being self-esteem (β = −0.398, p < 0.001) and remembering being teased about social behavior (β = 0.191, p = 0.001). The remaining teasing domains measured via the TQ-R subscales were not significant predictors of adult social interaction anxiety.
Lastly, prediction models were examined for adult social phobia scores. Both models were significant (Step 1: F(5358) = 8.69, p < 0.001, r2 = 0.11, and the full model Step 2: F(6357) = 18.7, p < 0.001, r2 = 0.24). From the TQ-R subscales, only the one concerning the participant’s social ability came up as significantly contributing to the prediction model. In Step 2 (the full model), the addition of the last factor (self-esteem as an adult) did add to the predictive power (Fchange = 61.2, p < 0.001, r2change = 0.13). Looking at the predictor weights in the final model, self-esteem was the best predictor of the adults’ social interaction anxiety levels (β = −0.38, p < 0.001), along with the teasing memories about social ability (β = 0.16, p = 0.011) following.

3.3. Testing for Parallel Multiple Mediation Effect

Last, but not least, we were interested to see whether the effects of teasing on depression and anxiety were mediated by the self-esteem (SE) and social interaction anxiety (SIAS) scores. In both cases, self-esteem emerged as a partial mediator of the relationship between the memories of childhood teasing and depression/anxiety. Specifically, starting with depression (DASS-D, Figure 1), the self-reported teasing was a significant negative predictor of self-esteem (path a1, b = −0.14, 95% CI [−0.187, −0.093], t = −5.86, p = 0.00001, r2 = 0.87, se = 0.024). Teasing was also a significant predictor of social interaction anxiety (path a2, b = 0.11, 95% CI [0.079, 0.142], t = 6.92, p = 0.00001, r2 = 0.12, se = 0.0159). The direct effect of teasing on depression (c′) was statistically significant (b = 0.179, 95% CI [0.109, 0.249], t = 5.016, p = 0.00001, se = 0.036). Self-esteem was also a significant predictor of depression (path b1, b = −0.859, 95% CI [−1.018, −0.701], t = −10.67, p = 0.00001, se = 0.08). Social interaction anxiety, however, was not a significant predictor of depression (path b2, b = 0.183, 95% CI [−0.054, 0.421], t = 1.517, p = 0.0.13, se = 0.121). The unstandardized indirect effect of self-reported teasing on depression via self-esteem was 0.1205 and was statistically significant, given that 0 did not fall in within the bootstrapped 95% CI [0.07, 0.179]. The unstandardized indirect effect of self-reported teasing on depression via social interaction anxiety was 0.02, but was not statistically significant, as 0 fell within the bootstrapped 95% CI [−0.009, 0.051].
The same parallel multiple mediation analysis was carried out for the outcome of adult anxiety symptoms (DASS-A, Figure 2). Self-reported teasing was found to be a significant negative predictor of self-esteem (path a1, b = −0.14, 95% CI [−0.187, −0.093], t = −5.86, p = 0.00001, r2 = 0.87, se = 0.024). The memories of teasing were also a significant predictor of social interaction anxiety (path a2, b = 0.11, 95% CI [0.079, 0.142], t = 6.92, p = 0.00001, r2 = 0.12, se = 0.0159). The total direct effect (c) of teasing experiences significantly predicted anxiety. The direct effect of teasing on anxiety (c′) was statistically significant (b = 0.168, 95% CI [0.104, 0.232], t = 5.16, p = 0.00001, se = 0.033). Self-esteem was also a significant predictor of anxiety (path b1, b = −0.42, 95% CI [−0.561, −0.272], t = −5.67, p = 0.00001, se = 0.073), as was social interaction anxiety (path b2, b = 0.231, 95% CI [0.0145, 0.448], t = 2097, p = 0.0.036, se = 2098). The unstandardized indirect effect of self-reported teasing on anxiety via self-esteem was 0,0585 and was statistically significant, given that 0 did not fall within the bootstrapped 95% CI [0.029, 0.098]. The unstandardized indirect effect of self-reported teasing on depression via social interaction anxiety was 0,0255, but was not statistically significant, as 0 fell within the bootstrapped 95% CI [−0.0004, 0.0565].

4. Discussion

The present study had two objectives: we first explored the nature and strength of the relationships between memories of malevolent childhood teasing experiences and estimates of self-esteem and emotional distress in adulthood via the use of multiple psychopathology indices (depression, anxiety, stress, social phobia, social anxiety) (hypothesis #1). Next, we sought to test whether the association between childhood verbal victimization, adult depression, and anxiety symptomatology is mediated by risk predispositions, like social anxiety (hypothesis #2), or psychological reserves, like self-esteem (hypothesis #3).
In terms of the first hypothesis, the results of the present study unequivocally agree with previous literature in describing how adverse peer victimization in the form of malicious teasing during childhood might act as a cause of adult psychopathology. Participants’ responses on the TQ-R clearly showed positive correlations between the frequency of teasing experiences and symptom endorsement in depression, stress, anxiety, social phobia, and social interaction anxiety, and a negative correlation with current self-esteem. In simpler words, with more teasing experiences remembered during childhood, more psychopathology symptoms and lower self-esteem were reported in adulthood, in line with other relevant studies [20,34,36]. Furthermore, and in addition to the overall effect, the TQ-R subscales allowed for a comparison of the differential psychological impact of teasing around various domains (performance, academics, social ability, family background, and appearance). Specifically, memories of childhood teasing related to one’s social ability emerged as a significant predictor of all mental health outcomes. Note that the exact items that pertained to the social teasing scale included “I was teased because I was shy around other kids”, “… because I was not good at conversation”, “… because I wasn’t very cheerful”, “… because I often looked nervous”, “… because I was crying easily or acting like a baby”, and “… because I had speech problems such as stuttering”. The more such memories one reported, the higher the scores on all adverse psychological outcome scales. Similar findings have been reported by Storch et al. [24], where teasing someone in the social domain was found to have the greatest impact on depression, anxiety, and loneliness ratings in later life. Edwards and colleagues [83], for example, found that a fear of being teased in the social domain was related to a specific subtype of social phobia termed gelotophobia. Leadly et al. [20] reported a relationship between being teased about interpersonal (social) difficulties and attachment difficulties in both genders later in life. A vicious circle can easily be discerned, where difficulties in interpersonal functioning would lead to being teased about social awkwardness, which, in turn, would exacerbate symptoms, leading to more teasing, avoidance of social relationships, and potentially social phobia.
Related to the above line of thinking and based on interpersonal models, e.g., [64], we also proposed that trait social interaction anxiety would be implicated as a mediator variable within the teasing experiences and psychopathology relationship (hypothesis #2). If an anxious, shy child stays away from social situations that would provide opportunities for age-appropriate social skills development, then this avoidance would lead to limited and negative peer interactions; increased vulnerability; and ultimately, to adverse mental health outcomes, such as clinical depression or anxiety. Several studies that looked at the developmental trajectories of psychopathology showed, for example, the primacy of social anxiety over depression in middle-to-late childhood and adolescence, e.g., [31,57,84,85]. Our mediation model confirmed that social interaction anxiety partially mediated the relationship between childhood teasing experiences and anxiety in later life. However, no comparable mediating effect was observed for depression. This latter finding contradicts a recent result by Mei et al. [31], who recruited almost 3000 middle school children and gave them measures of depression, social anxiety, and a bullying victimization scale. Among other findings, the authors reported a mediating effect of social anxiety on the relationship between bullying experiences and depression. Our study results therefore provide a contradiction to the proposed developmental trajectories for depression that have been documented in the literature presented above. One possibility for the discrepant findings could be that the participants in our study only experienced mild levels of depression and social anxiety overall. In other words, it could be that the mediation effects might have emerged if symptomatology was in the clinical range, in line with studies that compared clinical and community samples, e.g., [31,50,86]. Additionally, the discrepant result could be explained by differences in instruments used between the studies. Here, we utilized the Social Interaction Anxiety Scale (SIAS), which only measures one component of social anxiety (namely, social interaction difficulties) and leaves out social phobia. Had we used the whole scale in the mediation model (a combined SIAS and SP score), this would have potentially made the results of this study more in line with others, where social anxiety scales were used. A final possibility is that social anxiety might indeed be a proximal risk factor for developing depression symptoms in children who experienced peer victimization, but that this effect wears off distally in a retrospective design such as ours. This explanation accounts for the findings observed in studies such as Mei et al.’s [31], where social anxiety mediated the relationship between bullying experiences and depression in children and calls for a more comprehensive examination of both the distal and proximal risk factors linking depression to childhood teasing.
Apart from having experienced malicious teasing in the social domain, the other unique predictor of adulthood mental health outcomes was perceived self-esteem. In accordance with our hypothesis, a person’s subjective sense of self acts as a psychological reserve, promoting psychological adjustment in the face of adverse experiences, such as teasing. From this line of thinking stemmed our third hypothesis (#3), namely, that self-esteem would act as a mediator in the relationship between childhood teasing experiences and psychopathology in later life. This hypothesis was also supported, as higher self-esteem evaluations led to lower depression and anxiety rates in light of peer victimization experiences. These protective effects of self-esteem have been documented across the lifespan in the literature, e.g., [38,45,87], and emphasize the need for effective and timely interventions, especially in those belonging to high-risk vulnerability groups. This is especially true in light of recent findings describing the temporal pattern of symptom emergence, which highlight a causal and unidirectional relationship between self-esteem, anxiety, and depression: lower perceived self-esteem is a predictor of anxiety and depression symptoms, but those symptoms, in turn, are not predictors of lower self-esteem [41,45]. In summary then, it can be concluded from both mediation models that only self-esteem evaluations mediated the effect of childhood teasing on adult depression levels, while both self-esteem and social interaction anxiety evaluations mediated the effect of childhood teasing on adult anxiety levels.
One of the merits of retrospective designs, such as the one used in the present study, is the opportunity they do provide to examine causal contributors to current functioning within a long developmental window without having to face the challenges of a longitudinal study. This same merit is also the main limitation of our present conclusions: a retrospective study such as this relied on participants’ memories of past events that might suffer from inaccuracies, misinformation, and biases. In the same vein, the outcome measures used here were from self-report questionnaires and would not necessarily reflect the assessment of symptoms conducted by a trained clinician. Future research should encourage longitudinal designs as the only vehicle for establishing the causality of the claims presented here. Other lines of study should also be followed to identify the exact developmental mechanisms that translate early peer victimization to poor psychological and social outcomes, as well as other mediators between those early adverse experiences and adult psychopathology since the ones presented here were found to partially contribute to the models.
Despite the abovementioned limitations, there are several important clinical implications raised by our findings. This and other studies highlight childhood teasing in the social domain as a contributor to both short- and long-term negative outcomes, potentially increasing negative ruminative thinking, which, in turn, affects self-identity, self-efficacy, social apprehension, withdrawal, and possible revictimization (e.g., [31,35,88,89] and others mentioned above). In light of these detrimental consequences, biological, social, temperamental, and situational risk mechanisms identified in the literature should be the targets of both prevention and intervention programs. Self-esteem interventions and social skills training, for example, might directly reduce the likelihood of developing anxiety and depression in high-risk groups and promote social and emotional adjustment (see [43,45]).
The above results are also important in light of the recent pandemic: emerging research has been documenting rises in both traditional and cyberbullying behaviors among children and teens during the lockdowns, which is likely due to increased stress and changes in schooling in comparison with pre-pandemic times [90,91]. Studies also showed that those who experienced cyberbullying but experienced higher levels of parental and social support showed lower levels of symptoms of psychological distress [92]. These results, together with our findings, further highlight the need for targeted approaches that might mitigate these risks while fostering resilience and social adjustment. A final word worth re-iterating is the separation between malicious teasing, which was the subject of the present research, and affiliative teasing. The two should not be confused since the former can deteriorate into bullying (with all the abovementioned consequences for the recipient), while the latter demonstrably confers positive social and emotional benefits by expressing affection and intimacy, increasing social cohesion and solidifying group identity [93].

5. Conclusions

The present study offered valuable insights into how childhood verbal victimization, particularly in the form of malicious teasing, can contribute to the development of mental health problems in adulthood. Our findings underscore the significant role that self-esteem and social interaction anxiety play in mediating the relationship between early peer victimization and adult psychopathology. Specifically, higher self-esteem acted as a protective factor, reducing the impact of childhood teasing on depression and anxiety symptoms, while social anxiety mediated the relationship between teasing and anxiety. These results highlight the importance of early intervention strategies aimed at enhancing self-esteem and addressing social anxiety, particularly in high-risk individuals who have experienced social-domain teasing. While this study’s retrospective design limits the ability to draw causal conclusions, it provides important directions for future research, including the need for longitudinal studies to confirm these findings and explore additional mediators. Ultimately, these findings have significant clinical implications, emphasizing the importance of targeted prevention and intervention programs to mitigate the long-term effects of childhood teasing and promote resilience in those affected.

Author Contributions

Conceptualization, G.S.; methodology, G.S. and V.V.; data collection, K.G. and D.S.; formal analysis, V.V.; data curation, V.V.; writing—original draft preparation, V.V.; writing—review and editing, V.V., G.S. and M.S.; supervision, G.S. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of the University of Macedonia, Greece (Approval Code: 17) on 14 July 2020.

Informed Consent Statement

Informed consent was obtained from all the subjects involved in this study.

Data Availability Statement

The data presented in this study are available upon request from the corresponding author. The data are not publicly available due to privacy reasons.

Conflicts of Interest

The authors declare no conflicts of interest.

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Figure 1. Hypothesized parallel mediation models: path diagrams of the relationship between the retrospective memories of teasing (TQ-R total score) and depression/anxiety.
Figure 1. Hypothesized parallel mediation models: path diagrams of the relationship between the retrospective memories of teasing (TQ-R total score) and depression/anxiety.
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Figure 2. Path diagram of the parallel multiple mediation model showing that the effect of memories of childhood teasing on adult depression was partially mediated by self-esteem but not social interaction anxiety.
Figure 2. Path diagram of the parallel multiple mediation model showing that the effect of memories of childhood teasing on adult depression was partially mediated by self-esteem but not social interaction anxiety.
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Figure 3. Path diagram of parallel multiple mediation model showing that the effect of memories of childhood teasing on adult anxiety was partially mediated by self-esteem but not social interaction anxiety.
Figure 3. Path diagram of parallel multiple mediation model showing that the effect of memories of childhood teasing on adult anxiety was partially mediated by self-esteem but not social interaction anxiety.
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Table 1. Descriptive statistics and correlation matrix between demographic variables and health outcomes.
Table 1. Descriptive statistics and correlation matrix between demographic variables and health outcomes.
MeanSD123456789101112
1Age22.814.8-
2TQ-R performance1.421.50.06-
3TQ-R academics3.414.1−0.010.27 **-
4TQ-R social2.583.20.080.56 **0.30 **-
5TQ-R family background1.111.70.14 **0.29 **0.21 **0.33 **-
6TQ-R appearance5.424.80.11 *0.43 **0.37 **0.49 **0.45 **-
7TQ-R total13.9311.10.100.63 **0.68 **0.74 **0.56 **0.84 **-
8DASS depression10.649.10.060.23 **0.18 **0.38 **0.23 **0.34 **0.39 **-
9DASS anxiety8.167.40.100.29 **0.17 **0.37 **0.26 **0.30 **0.38 **0.60 **-
10DASS stress14.047.90.040.29 **0.27 **0.37 **0.20 **0.33 **0.42 **0.68 **0.70 **-
11Social interaction anxiety (SIAS)3.523.6−0.11 *0.28 **0.16 **0.37 **0.11 *0.28 **0.34 **0.40 **0.34 **0.31 **-
12Social phobia (SPS)3.553.8−0.100.23 **0.10 *0.30 **0.040.20 **0.25 **0.35 **0.42 **0.32 **0.57 **-
13Rosenberg self-esteem20.65.30.11 *−0.19 **−0.13 **−0.31 **−0.10−0.26 **−0.29 **−0.60 **−0.43 **−0.48 **−0.48 **−0.44 **
* Correlation was significant at the 0.05 level (2-tailed). ** Correlation was significant at the 0.01 level (2-tailed).
Table 2. Results of independent t-test exploration of gender differences on study outcomes.
Table 2. Results of independent t-test exploration of gender differences on study outcomes.
OutcomeMalesFemalest(359)pCohen’s d
MSDMSD
TQ-R performance0.430.510.500.52 ns
TQ-R academics0.440.640.630.69−2.5070.010.14
TQ-R social0.350.430.380.47 ns
TQ-R family0.360.560.380.57 ns
TQ-R appearance0.510.480.560.48 ns
TQ-R total12.5011.3514.6710.92 ns
DASS depression9.348.6411.349.26−1.990.040.23
DASS anxiety7.226.698.687.75 ns
DASS stress12.727.8814.747.83−2.320.020.26
Social interaction anxiety2.983.353.803.65−2.080.030.23
Social phobia3.113.653.823.95 ns
Self-esteem21.415.4420.155.152.160.030.24
Note: ns = not significant.
Table 3. Results of multiple regression analyses by outcome.
Table 3. Results of multiple regression analyses by outcome.
Predictor VariableDASS
Depression		DASS
Anxiety		DASS
Stress		Social Phobia
Scale		Social Interaction Anxiety Scale
βpβpβpβpβp
Step 1
TQ-R performance−0.0260.6680.0730.2260.0740.2120.0840.1800.0740.219
TQ-R academics0.0260.6230.0210.6960.1330.011−0.0010.9900.0180.730
TQ-R social0.2780.0000.2350.0000.2090.0010.2490.0000.2870.000
TQ-R family Background0.0580.2890.1120.0410.0220.681−0.1100.053−0.0640.244
TQ-R appearance0.1810.0030.0980.1140.1420.0210.0900.1580.1290.038
Step 2
TQ-R performance−0.0240.6290.0740.1920.0750.1660.0850.1430.0750.173
TQ-R academics0.0180.6840.0150.7540.1270.008−0.0060.8990.0120.799
TQ-R social0.1530.0040.1540.0100.1140.0480.1560.0110.1910.001
TQ-R family Background0.0890.0530.1320.0100.0460.354−0.0870.098−0.0400.424
TQ-R appearance0.0920.0770.0400.4940.0750.1840.0250.6760.0610.286
Rosenberg self-esteem−0.5210.000−0.3390.000−0.3940.000−0.3840.000−0.3980.000
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Varela, V.; Gavrielidou, K.; Savidou, D.; Simou, M.; Simos, G. Childhood Teasing Experiences and Adult Emotional Distress: The Mediating Role of Social Anxiety and Self-Esteem. Psychiatry Int. 2025, 6, 42. https://doi.org/10.3390/psychiatryint6020042

AMA Style

Varela V, Gavrielidou K, Savidou D, Simou M, Simos G. Childhood Teasing Experiences and Adult Emotional Distress: The Mediating Role of Social Anxiety and Self-Esteem. Psychiatry International. 2025; 6(2):42. https://doi.org/10.3390/psychiatryint6020042

Chicago/Turabian Style

Varela, Vasiliki, Kyriaki Gavrielidou, Despina Savidou, Meropi Simou, and Gregoris Simos. 2025. "Childhood Teasing Experiences and Adult Emotional Distress: The Mediating Role of Social Anxiety and Self-Esteem" Psychiatry International 6, no. 2: 42. https://doi.org/10.3390/psychiatryint6020042

APA Style

Varela, V., Gavrielidou, K., Savidou, D., Simou, M., & Simos, G. (2025). Childhood Teasing Experiences and Adult Emotional Distress: The Mediating Role of Social Anxiety and Self-Esteem. Psychiatry International, 6(2), 42. https://doi.org/10.3390/psychiatryint6020042

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