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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

Minding Your Mind Minding Your Mind

Taking on the School Bullies

November 25, 2013

By Michael Craig Miller M.D.

Harvard Medical School

The subject of bullying has come up in the wake of some well-publicized suicides of gay teens. It is hardly a new problem. The pain caused by bullying doesn't go away. It's chronic, as many people who have been bullied can tell you. (These tragedies prompted one Fort Worth, TX councilman to publicly share his personal experiences with being bullied.)

Many Americans dismiss bullying as a childhood rite of passage, but it is now recognized as a form of aggression. Suicide is a rare and tragic response, but, short of that devastating outcome, bullying can also have long-lasting psychological effects for both the victims and the bullies.

In 2009, 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.

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What is Bullying?

Bullying takes many forms. It can be subtle and psychological (spreading rumors or excluding someone), verbal (making threats or demeaning someone), or physical (slamming someone against the wall).

Cyber bullying is a new form of harrassment. In one highly-publicized case from 2010, a student at Rutgers University in New Jersey committed suicide after fellow students used a web-camera to stream an intimate moment over the internet. In a 2013 case in Florida, a young girl committed suicide after classmates bullied her in person and online through a social network.

Whatever its form, bullying involves certain core attributes:

  • It is intended to harm someone else.
  • It usually occurs repeatedly.
  • It involves a stronger person attacking one who is weaker (physically, psychologically, or both).

Boys usually bully in physical ways, such as hitting someone. Girls, on the other hand, use indirect forms of bullying, such as spreading rumors.

Much research on bullying comes from Australia and Europe. Rates of frequent bullying range from 2% of youths in a sample in Ireland to 19% in a sample in Malta.

In the United States, a nationally representative study of 15,686 students, grades 6 through 10, reported that 9% of students bullied others at least once a week, while 8% themselves were bullied 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.

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The Psychosocial Toll

Victims and bullies — and bystanders who witness their interaction — all suffer, just 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, if it's because of the bullying, or if it's some combination of the two. 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, bystanders may play an active, if indirect, role in encouraging bullying. 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 other experts have noted that the most helpful interventions are those directed not only at bullies and victims, but also at bystanders who want to do the right thing, but don't know how.

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How To Help

Many resources to prevent bullying are now available to help students, parents and school administrators with this issue. (See Information and Resources.)

In general, school-based efforts to prevent bullying try to:

  • Empower victims to stand up to bullies
  • Encourage parents, teachers and other bystanders to report bullying incidents rather than overlook them
  • Create a school environment that prevents bullying or deals strictly with bullies

Some programs are designed to help reduce aggression at home by providing training to parents who may yell, hit or otherwise act aggressively toward their children. Because abuse at home is linked to bullying behavior, helping parents be less aggressive may also help reduce bullying behavior at school. It's unclear how much these programs help, partly because they are so diverse and studies vary in design. But there's plenty of research that supports efforts to help children and adolescents withstand bullying behaviors — and other types of stress — by making them more resilient.

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Information and Resources

Stop Bullying Now!
From the U.S. Department of Health and Human Services, Health Resources and Services Administration, this site provides information (in English and Spanish) for children, parents and school staff.
This is another website managed by the U.S. Department of Health and Human Services. It includes advice, news and a blog, among other resources. 

Connected Kids: Safe, Strong, Secure
The American Academy of Pediatrics has a clinical guide and 21 handouts aimed at building resilience.

This online blog from the U.S. Department of Education from time to time contains information on bullying and bullying prevention in schools. 

Olweus Bullying Prevention Program
Cited by the American Association of Pediatrics as one of the most effective intervention models, this program targets bullies, victims and bystanders.

Adults and Children Together Against Violence
This site from the American Psychological Association provides educational materials for teaching problem-solving skills to children up to age 8.

The Trevor Project
This national organization focuses on crisis and suicide prevention efforts among lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth.

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Michael Craig Miller, M.D. is editor-in-chief of the Harvard Mental Health Letter and an assistant professor of psychiatry at Harvard Medical School. Dr. Miller has an active clinical practice and has been on staff at Beth Israel Deaconess Medical Center for more than 25 years.

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