II. Epidemiology
-
Incidence of Bullying in school children
- Up to 20% of children reported Bullying in prior year at school
- Up to 16% of children reported Cyberbullying in prior year
- Kann (2016) MMWR Surveill Summ 65(6): 1-174 [PubMed]
- Bullying associated with weapons in school Grades 6-10
- Bullies: 500% more likely to bring weapon to school
- Victims: 60% more likely to bring weapon to school
- Nansel (2003) Arch Pediatr Adolesc Med 157:348-53 [PubMed]
- School violent deaths often caused by Bullying victim
III. Definition
- Aggressor repeatedly, intentionally attacks or intimidates victim to cause fear, distress or harm
- Based on an imbalance of power between the bully and the victim
- Common forms of Bullying
- Harassment or threatening behavior
- Name calling, teasing, racist or sexual remarks
- Bully circulates rumors
- Bully takes victims belonginings
- Physical harm (hitting, kicking, slapping)
- Isolation from group or manipulation of friends
- Cyberbullying (even a single instance of Bullying via electronic means)
IV. Characteristics: Bully
- Bully characteristics
- Aggressive behavior with teachers, parents, siblings
- Impulsive and easily frustrated
- Dominant personality
- May witness Violence as used at home
- May lack parental nurturing and supervision
- Normal or over-inflated self-esteem
- Misperceives threats
- No anxiety or insecurity over behavior
- Does not relate to emotional experiences of others
- Uses Violence as a tool of power and domination
- Reinforcement: Control, prestige, material goods
- Associated psychiatric illnesses
- Antisocial Personality disorder
- Oppositional Defiant Disorder
- Attention Deficit Hyperactivity Disorder (ADHD)
- Major Depression and Suicidal Ideation
- Substance Abuse
- Truancy
- Criminality (shoplifting, vandalism, assault)
V. Characteristics: Bullying victim
- Victim characteristics
- Victim perceived as unassertive and unable to defend self
- Victims sense weaker, helpless position
- Physically smaller and weaker than peers
- Sensitive, quiet children who are socially isolated
- React to Bullying with crying and withdrawal
- Child feels like a failure and are ashamed
- Poor self worth: Believe they are stupid or ugly, and may feel they deserve to be teased or harassed
- Provocative victim (Bully Victim) characteristics
- Victim as above, but are more aggressive
- Tease bully to incite more Bullying
- Irritate others and incite social tension
VI. Risk factors (victim of Bullying)
- Chronic illness (e.g. Asthma, Diabetes Mellitus)
- Physical deformity
- Outlier body habitus (e.g. Obesity or underweight)
- Learning Disorder
- Behavioral disorder
- Children in special education classes
- Children with difficult social skills
- Clumsy children
- LGBT (lesbian, gay, bisexual, Transgender)
VII. Symptoms (victim of Bullying)
- Insomnia
- Depressed mood
- Nocturnal Enuresis
- Eating Disorder
-
Somatic symptoms
- Recurrent Abdominal Pain
- Chronic Headache
- Dizziness
VIII. Associated conditions (victim of Bullying)
- Low self esteem
- Social isolation and loss of friends
- School avoidance or Truancy
- Decreased school performance and poor grades
- Anxiety Disorder
- Major Depression
- Violent retaliation by victim
IX. Prevention
- Screen for Bullying at routine clinic visits (start at 6 years old)
- Are you ever teased at school?
- What have you been teased about?
- What do you do when you are teased?
- Have you told anyone about this? What happened?
- Other screening questions
- Do you feel safe at school?
- Do you get along well with teachers and other students?
- Have you ever been bullied at school or on Social Media?
- Is there someone at home or school you can talk to if you are bullied or feel unsafe?
- Victims and their families
- Reinforce supportive environment
- Caring adults with close family relationships (optimize parent-child relationship)
- Foster connections to healthy school environment
- Role play on projecting sense of confidence
- Stand straight and make eye contact
- Arms and hands should appear relaxed
- Use strong voice to sound secure
- Participate in activities that promote confidence
- Activity should be free of Bullying
- Child should have interest in activity
- Examples of positive peer groups
- Drama club (may also learn to act confident)
- Sports participation
- Respond to Bullying event: Talk, Walk, Squawk
- Talk briefly to bully with confidence
- Example: "You don't scare me"
- Do not provoke further Bullying
- Walk (not run) away from the scene
- Squawk to an adult about event
- Adult should be pre-identified to speak with
- Tell about event when it happens
- Talk briefly to bully with confidence
- Parental response
- Parents of the victim should not confront the parents of the bully
- Associated with worsening the situation
- Freeman (2012) Psychiatr Clin North Am 35(4): 877-900 [PubMed]
- Respond with support and involve the school and mental health resources
- Parents should not minimize the Bullying
- Parents of the victim should not confront the parents of the bully
- Reinforce supportive environment
- Bullies and their families
- No tolerance policy
- Eliminate reinforcements (power and social influence)
- Consider school psychologist involvement
- Provide strong role models with positive attitudes
- School-wide program development
- Olweus Bullying Prevention Program (Norway program)
X. Resources
- U.S. Dept Health and Human Services StopBullying.gov
- National Education Association on Bullying
- PACERs National Bullying Prevention Center
- AACAP Bullying
- Secondstep Bullying Prevention Unit