There has been an increased awareness of bullying and the promotion of strategies to combat it in recent years. However, bullying is still a common problem in the United States and throughout the world. In the recent Nevada Youth Risk Behavior Survey published this year, almost 20%, or 1 out of 5 high school students reported that they were bullied on school property in the 12 months prior to the survey. Fifteen percent reported that they were bullied electronically and 11% of Nevada’s high school students did not go to school because they felt unsafe at school or on their way to and from school. This shows us the problem is quite pervasive and requires the attention of parents, schools, medical professionals, mental health professionals, and policy makers as the effects of bullying can be quite far-reaching.
Types Of Bullying
The definition of bullying used most often is an aggressive behavior that is repeatedly and intentionally carried out against a defenseless victim. There are various types of bullying:
Physical bullying — the use of physical aggression to hurt and/or to intimidate the victim.
Verbal bullying — the use of language to hurt and/or to intimidate the victim.
Relational/Indirect bullying — hurting the victim through damaging social relationships, such as by exclusion or spreading rumors.
Cyberbullying — the use of electronic means to hurt or intimidate.
Studies have shown that boys are much more likely to engage in physical and verbal bullying, while girls are more likely to engage in relational bullying. There are also studies to suggest that overall girls are more likely to engage in cyberbullying.
In recent years there have been many publicized cases of children and adolescents committing suicide after having been bullied, often after cyberbullying. Bullying use to be only in the context of personal contact—physical, verbal, and relational, but now with the availability of social media, cyberbullying has become commonplace. While the jury is still out, cyberbullying in many ways may be more toxic. As we know things can quickly “go viral” on the internet and as a result become more public. In addition to being more public, cyberbullying has an added feature of the bullying often being anonymous. It has been shown, in one study, that kids perceived cyberbullying to be worse because of it being more public and especially when it was anonymous.
Effects of Bullying
Based on the currently available research, we know a lot about some of the possible mental health and physical health consequences in childhood, adolescence, and early adulthood. Some of the psychological problems associated with bullying include increased rates of depression, anxiety, suicidal behavior, and some of the physical health issues include, for example, headaches, stomachaches, and backaches. However, what we are also learning is that childhood bullying can have effects into middle age and possibly longer. A recent study followed a group of children until what is now their middle age. In this study, many of participants who reported being bullied as children experienced physical, psychological, and social consequences far into adulthood.
…almost 20%, or 1 out of 5 high school students reported that they were bullied on school property… Fifteen percent reported that they were bullied electronically…
The physical consequences — When the people in this study were screened, they reported poorer overall health in adult life. They also self-reported poor general health at ages 23 and 50, and on testing they were found to exhibit poorer cognitive functioning, for example poorer recall on memory testing.
The psychological consequences —They reported higher psychological distress at ages 23 and 50. There was also an effect based on the frequency of the bullying. Those who reported being frequently bullied were at increased risk of depression, anxiety, and suicidality suicide. It is important to note that it has also been identified that the psychological effects of bullying are similar to those with a history of childhood abuse and severe neglect.
The social consequences — Those with a history of being bullied had lower educational levels at midlife, were more likely to be unemployed and to earn less than their peers, and were less likely to have met up with friends in the recent past. They were also less likely to have access to social support if they were sick. They also had lower perceived quality of life at age 50 and lower satisfaction with life so far, and those who had been frequently bullied also anticipated less life satisfaction.
Another recent study gives some insight into why children and adults who are or were bullied may have more health problems. The answer may be in a chemical called C-reactive protein (CRP). This protein has been implicated in risk for heart disease, as well as other diseases, and indicates a level of inflammation. In the study it was noted that individuals who had been bullied had greater increases in CRP than those who had not been bullied. This translated to more low-grade systemic inflammation in those who had been bullied, which lasted from childhood to young adulthood. This study again gives evidence that the effects of bullying last into adulthood.
Risk Factors and Warning Signs
There are numerous risk factors that have been implicated in putting children at increased risk of being bullied. Some of these factors include being both academically advanced or academically behind students. Other factors include being perceived as different in any way or being perceived as weaker. It has been noted that children with low self-esteem, those who have few friends, or those with poor social skills are also at risk. This is by no means an exhaustive list, but it should be kept in mind so that parents, teachers, physicians, and other people who work closely with children can be aware of the need to be more vigilant in helping victims of bullying.
It is essential to note that many children may not report being bullied so it is important to recognize the warning signs. Some of the warning signs for a child who is being bullied include a child returning from school with injuries, with their things damaged, or with reports of personal belongings being “lost.” Another possible sign is a child who comes home after school exceptionally hungry; this may be because someone has taken their lunch or their lunch money. A number of children may report many physical symptoms such as stomachaches, headaches, trouble with sleep, or bedwetting. A child who may have been previously invested in school may start to become disengaged, exhibit school avoidance, and have lower school performance. Children may show signs of anxiety and depression, and may talk about suicide. They may exhibit increased isolation, including from social media and texting, as this may be where some of the bullying is occurring. Some kids may also start engaging in negative behaviors, such as using drugs and alcohol, running away, or physically hurting themselves.
It is important to identify these warning signs. If you believe your child is being bullied or your child reports being bullied, it is vital that you address these concerns with the school or other involved entities and people. It is equally important to seek additional help from mental health providers if you notice your child experiencing emotional distress. Taking a child’s report seriously and addressing it helps the child to feel heard and empowered.
It is crucial for parents to keep the lines of communication open with their children in order to help them feel safe and heard. Parents are their children’s strongest advocate to have the issue of bullying addressed in the school or in other places where they may be being bullied. They are also the best advocates for getting their children treatment for any physical and mental health care needs. Schools need to establish programs to identify and prevent bullying, which may overflow to the community in general. Teachers need to be watchful to identify possible bullying, especially since bullying often occurs when the bully believes no one is watching. Because of the fact that kids often present with physical symptoms, primary care doctors also have to be vigilant in order to recognize the warning sign of bullying. Child psychiatrists and mental health counselors likewise need to identify suspected bullying in children presenting with depression and anxiety, as well as those presenting with other emotional difficulties.
Dr. Michelle A. Fontenelle-Gilmer, MD is the medical director at Life Bridge Kids, a direct care psychiatric practice in Summerlin, dedicated to helping children, adolescents and their families manage mental, emotional and behavioral disorders. Dr. Fontenelle-Gilmar can be reached at (702) 765-4965.