The Effects of a Clinical Prevention Program on Bullying, Victimization, and Attitudes toward School of Elementary School Students.

School bullying is a negative phenomenon that affects the life of numerous students worldwide. Research findings indicate that the percentage of school bullying varies as a function of age as well as across countries, from 6% in Sweden up to rates that in some cases exceed 50% in Lithuania and certain countries of Africa (Analitis et al., 2009; Due et al., 2005; Due, Holstein, & Soc, 2008; Nansel, Craig, Overpeck, Saluja, & Ruan, 2004). Research in Greece shows that approximately 7% to 15% of students have experienced victimization at school and that more than 5% of students have engaged in bullying behavior (Giannakopoulou et al" 2010; Kokkevi, Stavrou, Fotiou, & Kanavou, 2011; Konstantinou & Psalti, 2007; Pateraki & Houndoumadi, 2001). The most common type of school bullying in primary Greek schools appears to be verbal bullying, whereas in secondary schools, forms commonly observed are sexual bullying, spreading rumors, and cyber bullying (Giannakopoulou et al., 2010; Kokkevi et al., 2011; Pateraki & Houn-doumadi, 2001; Sapouna, 2008). Variation in percentages reported in Greek studies possibly reflects differences in age, sample characteristics, and methodologies employed in the various studies.School bullying refers to violent and aggressive behaviors that are manifested by students in an intentional repetitive manner and aim at producing physical or psychological pain to other students inside or outside school grounds (Olweus, 1993; Rigby, 2002). School bullying and victimization lead to a wide range of physical and psychological health problems. Students who have experienced victimization have increased risk of developing headaches, stomachaches, depressed mood, sleep difficulties, nervousness, depression, anxiety, and posttraumatic stress disorder symptoms (Due et al., 2005, Hawker & Boulton, 2000; Idsoe, Dyregrov, & Idsoe, 2012) as well as severe academic deficits (Juvonen, Nishina, & Graham, 2000; Nishina, Juvonen, & Witkow, 2005; Schwartz, Gorman, Nakamoto, & Toblin, 2005). School bullying has been continually acknowledged as an issue affecting school students since the 1970s, when Dan Olweus, a pioneer in school bullying research, started to develop antibullying prevention programs in Scandinavian countries.Those anti-bullying programs that are most commonly found to be effective implement a holistic approach (Olweus, 1993; Vreeman & Carroll, 2007). Their philosophy is based on a social-ecological perspective, under which multiple factors are responsible for the etiology of the phenomenon (J. D. Smith, Schneider, Smith, & Ananiadou, 2004). These types of programs view the school environment as a system of social relationships and networks that can be improved while aiming at changes on multiple levels concerning the entire school population (Cowie & Jenifer, 2008). By setting bullying prevention as a main objective, the actions that are implemented aim at strengthening the relationships between the members of the school community and enhancing the feeling of security in the school environment (Newman-Carlson & Horne, 2004). For instance, awareness raising and involvement of the whole school network that includes students, educators, parents, and members of the broader community are seen as significant aims (Swearer, Espelage, Vallancourt, & Hymel, 2010). Common elements of these programs involve training educators in recognizing and successfully intervening at bullying incidences, educating students at changing their attitudes toward bullying, and involving parents (Mishna, 2008; Newman-Carlson & Horne, 2004). Indicatively, the Olweus Bullying Prevention Program, which has been widely applied in Europe and the United States, aims at improving interpersonal relationships in a safe school environment and reducing bullying incidents by intervening at the school, classroom, and individual level. Also, a holistic approach is followed by the KiVA anti-bullying prevention program that has as its main objectives the development of attitudes against bullying, increased empathy levels of the students who are bystanders in bullying incidences, and active supports to the students who have experienced victimization (Kama et al. …