BOSTON – Children singled out for abuse either in person or through cyberbullying are more prone to long-term depression, significantly poorer mental and physical health, and suicidal thoughts and actions than their peers who are spared from bullying, said investigators at the annual meeting of the American Academy of Psychiatry and the Law.
Children seen as outsiders by their peers – those with developmental disabilities, mental health problems, and gays or lesbians – are the most common targets of bullies both in the schoolyard and online, said Dr. Eileen P. Ryan from the University of Virginia in Charlottesville.
With cyberbullying – a term that encompasses remote, electronic bullying done on e-mail, role-playing game sites, YouTube, Facebook, and other online venues – the perpetrator doesn’t need to be in the same room or the same town as the victim. In addition, the bully can be physically weaker than his target.
"This is where the little red-headed, freckled, pale child is able to bully the quarterback of the high school football team," said Dr. Bradley Freeman of Vanderbilt University in Nashville, Tenn.
Dr. Ryan cited a definition of bullying by Dan Olweus, Ph.D., a Swedish psychologist and bullying expert: "A person is bullied when he or she is subjected repeatedly and over time to negative action on the part of one or more people."
The U.S. attorney general’s office defines cyberbullying as "use of electronic devices and information such as e-mail instant messaging, text messages, mobile phones, pager, and websites to send or post cruel or harmful messages or images about an individual or group."
Both forms of bullying can have severe mental health consequences for both the victim and the bully, Dr. Ryan said. Although it is widely thought to become less prevalent with age, 20%-30% of 8th through 12th graders have reported frequent involvement in bullying as a victim, bully, or both. A 2001 study from the National Institute for Child Health and Human Development found that nearly 30% of a representative sample of 15,686 6th through 10th graders reported moderate or frequent involvement in bullying: 13% as bullies, 10.6% as victims, and 6.3% as both, with boys more frequently being both the bully and the bullied (JAMA 2001;285:2094-100).
In the Pittsburgh Youth Study, a prospective cohort study of 503 boys followed from ages 6 through 19, being a bully at age 10 was the strongest predictor of delinquency. The study showed that 32.6% of bullies become delinquents, compared with 22.5% of nonbullies. In addition, being a victim at age 19 was the strongest predictor of depression, with 32% of victims having depression, compared with 22.7% of nonvictims, Dr. Ryan said (J. Aggress. Confl. Peace Res. 2011 June 9 [10.1108/17596591111132882]).
A recent meta-analysis from investigators at the University of Cambridge (England), found that the probability of being depressed up to 36 years later was much higher among people who had been bullied at school, compared with nonvictims. The authors also found that the probability of offending up to 11 years later was much higher for school bullies than noninvolved students, she noted (Crim. Behav. Ment. Health 2011;21:80-9).
Girls who bully, even infrequently, appear to be at increased risk for suicide, while among boys, only those who bully frequently are at increased risk.
"Suicidal behavior among male bullies may be a function of psychopathology rather than bullying, per se," Dr. Ryan said.
Equal Opportunity Bullies
Cyberbullies often carry out their abuse anonymously, but according to a 2004 survey of Internet users, 84% of cyberbullies knew their victim in person, and 31% of victims said they knew the bullies.
Cyberbullying increases with age, with males about twice as likely as females to be the electronic bullies (22% to 12%, respectively), Dr. Freeman said. He pointed to a 2007 studywhich found that 38% of cyberbullies said they participated in the activity for fun, 25% for retaliation, and 6% because they felt bad about themselves (J. Adolesc. Health 2007;41[6 suppl. 1]:S1-5).
As with old-fashioned bullying, victims might experience loss of self-esteem, depression, hopelessness, psychosomatic symptoms, or attempted or actual suicide.
At least 23 states have enacted laws directing school districts to draft policies against bullying, harassment, and intimidation among students; seven states require schools to have disciplinary procedures or consequences, said Dr. Karen Rosenbaum, of New York University.
Many of the laws have been enacted in response to high profile cases of teens who committed suicide after being bullied online and in person.