Taking on school bullies

Although Americans sometimes dismiss it as a childhood rite of passage, bullying in school is now recognized as a form of aggression that may have long-lasting psychological ramifications - for both victims and perpetrators.

In response, the American Academy of Pediatrics (AAP) revised its policy statement about preventing youth violence to include, for the first time, information about how to recognize and address bullying.

Bullying takes many forms. It can be subtle and psychological (such as spreading rumors or excluding someone), verbal (making threats or demeaning someone), or physical (slamming someone against the wall). As electronic media use has grown, so too has a new form of harassment, cyber-bullying.

Whatever its form, bullying involves certain core attributes: it is intended to harm someone else, usually occurs repeatedly, and involves a stronger person attacking one who is weaker (physically, psychologically, or both). In males, bullying is usually physical (such as hitting someone), whereas female bullying tends to be indirect (such as spreading rumors).

Most research on bullying has been done in Australia and Europe, where rates of frequent bullying range from 2% of youths in a sample in Ireland to 19% in a sample in Malta. A nationally representative study of 15,686 U.S. students, grades 6 through 10, reported that 9% of students bullied others at least once a week, while 8% were victimized that frequently.

Victims of weekly bullying were 1.5 times as likely to carry a weapon as other students, while the bullies themselves were 2.6 times as likely to carry a weapon.

The psychosocial toll

Victims and bullies - and bystanders who witness their interaction - suffer, albeit in different ways.

Victims.

Children and adolescents who are victims of bullying suffer the sort of low-grade misery usually described as "poor psychosocial adjustment" in the literature. It remains unclear if this is because they are more at risk to begin with, because of the bullying, or some combination. Often singled out for being "different," they find it hard to make friends, tend to be lonely and isolated, and suffer emotionally and socially. As a result, they may skip classes or avoid school, or use drugs or alcohol to numb themselves emotionally.

Victims of chronic bullying are also at risk for longer-term problems. They are more likely to develop depression or think about suicide later on. And a prospective study in England, based on health data and annual interviews with 6,437 children, found that those who were repeatedly bullied at ages 8 or 10 were almost twice as likely as others to experience psychotic symptoms as adolescents.

Bullies.

Perpetrators of bullying behavior also suffer in the long-term. They are more likely than other students to drink alcohol or smoke cigarettes. One of the few long-term studies found that, by age 24, 60% of former school bullies had already been convicted at least once on a criminal charge.

Bystanders.

Witnesses to bullying include students, parents, and teachers. Far from being passive onlookers, such bystanders may play an active, if indirect, role in encouraging bullying, depending on their own psychological profiles.

Some bystanders may be afraid to speak up for fear of becoming victims themselves, while others identify with the bully and enjoy watching someone else suffer. Both types of bystanders contribute to an atmosphere that condones bullying.

The AAP and others have noted that the most helpful interventions are those directed not only at bullies and victims, but also at the vast majority of bystanders, who want to do the right thing - but need advice about how to intervene productively.

Information and resources

About Bullying

Features interactive games and quizzes for children and teens.
http://mentalhealth.samhsa.gov/15plus/aboutbullying.asp

Adults and Children Together Against Violence Educational materials for teaching problem-solving skills to children up to age 8.
http://actagainstviolence.apa.org

Connected Kids: Safe, Strong, Secure

A clinical guide and 21 handouts aimed at building resilience.
www.aap.org/connectedkids

Exploring the Nature and Prevention of Bullying

An online course about implementing bullying prevention programs in school.
www.ed.gov/admins/lead/safety/training/bullying

Olweus Bullying Prevention Program

Cited by the AAP as one of the most effective intervention models, this program targets bullies, victims, and bystanders.
www.olweus.org

Stop Bullying Now!

Provides information (in English and Spanish) for children, parents, and school staff.
www.stopbullyingnow.hrsa.gov

How to help

A number of resources to prevent bullying are now available, often free of charge, to help students, parents, and school administrators address this issue. In general, school-based bullying prevention efforts aim at empowering victims to stand up to bullies; encouraging parents, teachers, and other bystanders to report bullying incidents rather than overlook them; and creating a school environment that prevents or censures bullying.

Finding ways to reduce aggression at home - by providing training to parents who may yell, hit, or otherwise act aggressively toward their children - may also help reduce bullying behavior at school. For this reason, some programs are designed for home use. (For a sampling of online resources, see above.)

It remains unclear how much these programs help, partly because they are so diverse and studies vary in design. But a robust amount of research supports efforts to instill resilience in children and adolescents, as a way of helping them withstand bullying behaviors and other types of stress they will encounter through life. The various bullying prevention programs available can't hurt youngsters - and they may even help build such resilience.

Reprinted with permission from the Harvard Mental Health Letter

American Academy of Pediatrics. "Policy Statement - Role of the Pediatrician in Youth Violence Prevention," Pediatrics (July 2009): Vol. 124, No. 1, pp. 393-402. Schreier A, et al. "Prospective Study of Peer Victimization in Childhood and Psychotic Symptoms in a Nonclinical Population at Age 12 Years," Archives of General Psychiatry (May 2009): Vol. 66, No. 5, pp. 527-36.

Stueve A, et al. "Rethinking the Bystander Role in School Violence Prevention," Health Promotion Practices (Jan. 2006): Vol. 7, No. 1, pp. 117-24. For more references, please see www.health.harvard.edu/mentalextra.

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