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Monday, February 25, 2013

Adult Psychiatric Effects of Childhood Bullying

Unlike decades ago, today there are significant efforts in place to decrease bullying in school. This mainly takes the form of bullying prevention programs that teach children to be friendly to one another, to pledge not to be a bully, and to take a strict disciplinary approach to a child who physically or emotionally bullies another child.

RECOMMENDED BOOK: Bullying Prevention and Intervention: Realistic Strategies for Schools

While these efforts are laudable, bullying can extend beyond school grounds where school officials have limited to no influence. In some instances, such as cyber bullying, school officials can sometimes intervene, but in other cases such as bullying at the neighborhood playground, there may be nothing they can do. While parents should take responsibility to prevent bullying, there are too many broken households and irresponsible parents who do not effectively teach their children right from wrong. In fact, children’s anger regarding issues related to their parents (e.g., witnessing domestic violence, being the victim of parental abuse, parental divorce) is part of what can lead some children to become bullies towards others to release their own anger.

I have always firmly believed that childhood experiences are critical to developing our personalities and that the effects of these childhood experiences typically last into adulthood in some way, shape, or form. Although we are all born with a certain biological temperament, childhood experiences affect the way we learn to interact with others (e.g., outgoing versus shy), how we think about others (e.g., trust or mistrust), our motivational desires (e.g., to fit in or stand out), and shape our self-identity.

Since it is also known that victims of bullying and being a bully are associated with increased risks of psychiatric problems in childhood, there is good reason to believe that such problems extend into adulthood. In an upcoming research study to be published in JAMA Psychiatry, researchers tested this hypothesis with 1420 young adults who had been assessed for being the victim of bullying and/or being a bully four to six times between ages 9 and 16.

The results showed that the effects of being bullied are direct, have multiple effects, last into adulthood, and that the worst effects were for people who were both victims of bullying and bullies (bullies/victims). Specifically, victims of bullying and bullies/victims had increased rates of psychiatric disorders in childhood and adulthood as well as family hardships.

The researchers found that even after controlling for the effects of childhood psychiatric illness and family hardships that victims of bullying had higher rates of agoraphobia, generalized anxiety disorder, and panic disorder in young adulthood. Agoraphobia is fear of being in places or situations from which escape may be difficult (or embarrassing) or in which help may not be available in the event of having a panic attack or panic-like symptoms.

Even after controlling for the effects of childhood psychiatric illness and family hardships, bullies/victims were at increased risk for young adult depression, panic disorder, suicidality (males only), and agoraphobia (females only). How about bullies only? They were more likely to develop antisocial personality disorder. Antisocial personality disorder is a more serious behavioral and emotional disorder that involves a pattern of disregarding the rights of others since age15. Overall, these results show that being a victim of bullying has more negative psychiatric effects (particular those associated with being anxious, which make sense) than being a bully.

Related Blog Entry: Cyber Bullying to a Dying Child with Huntington's Disease: A New Low for Society

Reference: Copeland WE, Wolke D, Angold A, Costello EJ. (2013, in press). Adult Psychiatric Outcomes of Bullying and Being Bullied by Peers in Childhood and Adolescence. JAMA Psychiatry.

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