Female Aggression and Mental Health: A Systematic Review

This systematic review synthesizes findings on female-to-female aggression and its mental health consequences across the lifespan. Although bullying among females represents a significant public health concern, the literature has historically underexamined how relational forms of aggression, including social exclusion, gossip, and peer manipulation, affect women over time. Three research questions organized the review: (a) How do negative social groups affect women? (b) What are the longer-term consequences of childhood bullying for women in adulthood? (c) What outcomes are associated with aggressive female social dynamics? Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, a systematic search was conducted across PubMed/MEDLINE, PsycINFO (accessed via EBSCOhost), Google Scholar, ScienceDirect, JSTOR, and SciSpace. Inclusion criteria required articles to be peer-reviewed, published between 1992 and 2024, focused on female participants or gender-disaggregated data, and reporting mental health outcomes related to bullying or hostile social dynamics. A total of 42 studies met inclusion criteria, comprising 27 quantitative, 14 qualitative, and 1 mixed-method study. The strongest evidence, drawn from high-quality longitudinal and cohort studies, supported associations between childhood bullying victimization and depression, anxiety, suicidal ideation, social isolation, and interpersonal difficulties extending into adulthood. Moderate-to-strong evidence indicated associations with post-traumatic stress symptoms, eating disorders, body image disturbances, emotional dysregulation, and substance-related problems. Intersectional factors including race, sexual orientation, and socioeconomic status were associated with variability in mental health outcomes. Given the predominance of cross-sectional and retrospective designs across the included literature, all findings should be interpreted as associational rather than causal. These patterns point to a need for gender-sensitive, trauma-informed clinical and policy responses that address female-specific forms of aggression throughout the lifespan.