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April 19, 2013 3:20 PM Childhood Bullying: Not a Big Deal?

By Bill Gardner

Children have been bullied since — well, since we’ve had childhood. There are now widespread movements to prevent school bullying. It’s clear that bullying was tragic for girls like Rehtaeh Parsons, who committed suicide after first being raped and then cyberbullied by the perpetrators, who sent pictures of the assault to her classmates. But this is an extreme event. Is the focus on bullying yet another overreach of the nanny state? Or is childhood bullying a significant mental health threat?

There is a timely study on the adult consequences of childhood bullying in the current JAMA: Psychiatry by William Copeland, Dieter Wolke, Adrian Angold, and Jane Costello. Reviewing the literature, the authors found that being a victim of bullying is associated with childhood “physical health problems,… depression, psychotic symptoms,… poor school achievement[, and]… an increased risk of suicide ideation and suicide attempts.”

However, as the authors note with ill-concealed bitterness, “bullying is still commonly viewed as just a harmless rite of passage or an inevitable part of growing up.”

Angold and Costello are the leaders of a study that has been following a cohort of children in a region of Western North Carolina from childhood into young adulthood. Copeland and his colleagues use these data to look at whether being a victim of bullying as a child, or being a bully, is associated with adult mental health problems. Are the psychiatric consequences of bullying transient problems of childhood, or do they persist into adulthood?

Angold and Costello’s data are ideal for this question because they recruited a random sample of all children in the region. Many studies gather data from children who are seen in clinics or children attending school. Children found in these settings will differ systematically from the population as a whole; so Copeland and his colleagues are better able to describe the effects of bullying on all children.

The first notable finding is that bullying is widespread: an estimated one in four (26.1%) of children in Western North Carolina reported being bullied at least once, with boys and girls reporting similar rates of bullying. Overall, victims of bullying in childhood had more anxiety disorders in adulthood. The association was surprisingly strong, as shown in the following Figure.

The first column represents the rate of anxiety disorders in the adults who were neither bullies nor victims in childhood. The second and third are those who were just bullies or just victims, and the last is the rate of disorder among adults who were both bullies and victims of bullying. Although anxiety is a universal experience, an anxiety disorder is a severe and potentially disabling condition. The rate of such disorders is almost four time as high among victims as among those with no experience of bullying, and nearly five times as high among those who were both bullies and victims. In addition, Copeland et al. found that

those who were both victims and perpetrators were at increased risk of adult depression and panic disorder. Female bullies/victims were at risk for agoraphobia, and male bullies/victims were at increased risk for suicidality. These effects were maintained even after accounting for preexisting psychiatric problems or family hardships. This suggests that the effects of victimization by peers on long-term adverse psychiatric outcomes are not confounded by other childhood factors… bullies were only at risk for antisocial personality disorder in adulthood.

We can’t be wholly certain about causality here. Although it is very plausible that the trauma of being bullied would promote anxiety disorders, it is also plausible that bullies would target children with a predisposition to anxiety. If the latter is true, even a completely successful campaign against bullying would not eliminate the risk of adult anxiety disorders among these children.

What we do know, however, is that the mental health problems associated with bullying are not transient problems of childhood. I think that the authors are correct to conclude that

Bullying is not just a harmless rite of passage or an inevitable part of growing up. Victims of bullying are at increased risk for emotional disorders in adulthood. Bullies/victims are at highest risk and are most likely to think about or plan suicide. These problems are associated with great emotional and financial costs to society. Bullying can be easily assessed and monitored by health professionals and school personnel, and effective interventions that reduce victimization are available. Such interventions are likely to reduce human suffering and long-term health costs and provide a safer environment for children to grow up in.

[Originally posted at The Incidental Economist]

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Bill Gardner is a psychologist who studies the mental health service system for children. He is a professor of pediatrics at Dalhousie University (Nova Scotia) and the Ohio State University. Bill blogs at Inequalities. Follow him on Twitter at @Bill_Gardner.

Comments

  • Sgt. Gym Bunny on April 19, 2013 4:27 PM:

    While I do like that we as a society are starting to take school-aged bullying seriously, I do wish we can take two steps back and ask a few questions first.

    When we talk about "bullying", just what, specifically, are we talking about? From this post, I can't find an exact definition, but maybe it's addressed in the study itself, though I couldn't find much about their working definition of "bullying" from the abstract.

    Are we talking about anytime another kid says something mean or are we talking about constant use of social and/or physical power against a student? While I can attest that the former happened at least once to me, I can't say that the latter ever happened. But are both instances of bullying? Does it matter whether the victim feels as though they were or were not bullied despite the actual the nature of the incident?

    If people are hesitant to do anything about stopping bullying, maybe it's because "bullying" hasn't really been defined well enough to convince us that it is a problem that can be solved. As of now, I get the impression that anything said or done that can be interpreted as "mean" is considered bullying--and that's pretty damn broad. No wonder people are a bit slow to act.

  • Crissa on April 19, 2013 9:00 PM:

    Of course 'bullying' isn't defined rigidly. That's because the activities that make up bullying vary wildly, from repeated use of microagressions to aggravate to actual physical harm.

    Bullying is any pattern of behavior used to force conflict and belittle a specific person. The ullies each may do nothing particularly egregious, but it's the combination of their actions in a whole.

  • zandru on April 20, 2013 11:33 AM:

    My limited knowledge and experience about the recent crackdown on bullying is that educators emphasize how critical it is that the bullied children immediately contact a teacher or administrator about it. That is, they run to the nearest adult: there is nothing they can do on their own to protect themselves.

    I'm looking forward to studies that address this sort of learned victimhood and the need to appeal to higher authorities for help. Do these lead to bad outcomes in adulthood? Frankly, I have no idea. But it's worth looking into.

  • Al on April 20, 2013 5:49 PM:

    I'm sorry, but unless we{re talking about actual aggression (assault, harassment, tantalizing, etc), WTF are they suggesting? Because it seems now that ANYTHING that anybody may find unpleasant can be construed as bullying.

    Which is BS. Grow a ticker skin!!!

    For the abovementioned problems, there are already laws and guidelines right (even for internet harassment)? At least in my school even the nerds knew how to fight back (they would wisely team up), and I personally came to blows with an idiot once. Guess what? It pretty much always ended there.

    Then again I was raised in Mexico.

    Kids today are just too afraid to stand their own ground. Unless we're talking gangbangers carrying knifes/guns, anyone can produce a baseball bat if it comes to that. Why kids today can't deal with their problems and either suicide or go postal? Is it something in the water?

  • Califa on May 01, 2013 10:01 AM:

    "Victims of bullying are at increased risk for emotional disorders in adulthood."

    Two words: Adam Lanza

  • Anonymous on May 01, 2013 10:32 AM:

    "Is the focus on bullying yet another overreach of the nanny state? Or is childhood bullying a significant mental health threat?"

    Couldn't it be both? The fact that childhood bullying might be a significant mental health threat doesn't mean government intervention in this area is necessary. Or that it would work. Some problems can't be solved by policy.

  • Emily on May 02, 2013 12:23 PM:

    zandru says: My limited knowledge and experience about the recent crackdown on bullying is that educators emphasize how critical it is that the bullied children immediately contact a teacher or administrator about it. That is, they run to the nearest adult: there is nothing they can do on their own to protect themselves.

    I'm looking forward to studies that address this sort of learned victimhood and the need to appeal to higher authorities for help. Do these lead to bad outcomes in adulthood? Frankly, I have no idea. But it's worth looking into.

    The kids who can already protect themselves don't get bullied. Bullies pick on the weak person. They have surely learned through trial and error who is likely to punch their lights out and who isn't.