Childhood bullying has become a major public health issue, resulting in health issues; social problems and poor educational outcomes for the child or adolescent. The issues related to bullying do not only affect the child-victim, but also the bully who at one time may have been bullied themselves. The issues related to being bullied are now viewed as being apparent even into adulthood if not addressed. [1] There are a variety of forms that bullying takes on, such as: physical abuse- hitting, punching; verbal abuse- name-calling; social abuse- spreading false rumors; group isolation; damaging the property of another child; and cyberbullying - utilizing the internet to spread false information about an individual.
Bullying has become a major problem in schools across the United States. It has consequences for all youth involved including the child bullied, the bully themselves, and those who witness the act without getting involved.[2] The groups most likely to be bullied are those who do not appear to conform to the school makeup, they include: individuals who are viewed as being "different" through a variety of ways including sexual orientation; race and ethnicity; physical appearance, such as with outstanding physical characteristics/disabilities; immigrants; and those who are younger or appear weaker.[3]
Creation of a bully
Bullying behavior comprises individual, social, and environmental issues. Children who are exposed to unhealthy or unsafe environments are more prone to bully other children. Children who are labeled as bullies tend to indulge in antisocial behavior, which includes drugs and alcohol consumption. They also may have been bullied themselves at one time. The common aspects of bullies include:
Acting as an aggressor
Feelings of frustration
Lack of empathy
Poor impulse control
Seek to blame others for their shortcomings
Unable to view themselves as being responsible for their actions
Competitive
Seek to dominate another
View others as being a threat
Associate with other bullies
Bullies do not necessarily need to be physically stronger than the victim, the issue has more to do with feelings of power/powerlessness. These feelings account for popularity as well as, societal factors such as wealth, and cognitive issues. In some cases bullying another is viewed by peers as increasing in status among the group, they also may not see themselves as being a bully.[3]
Consequences of being bullied
Healthcare providers have the unique situation of dealing with bullying issues as part of the well-child exam. With knowledge regarding the current aspects of bullying and the effects on the child, they may be able to identify the issues revolving around the child's experience and aid in prevention of lifelong issues. Being able to rely on healthcare providers capable of identifying the aspects that impact the child is important.[3]
A child who has been bullied may present with such health issues as depression (which can last into adulthood if not addressed), anxiety, psychosomatic illnesses, and suicide. Studies have shown that the result of being bullied increases the likelihood of the child internalizing their problems, they also tend to self-isolate with few to no friends. They will view the world as being competitive and they are incapable of functioning properly among others, this view is related to seeing oneself as less than other children.[4]
The Academy of Pediatrics recommends that beginning at age six the healthcare provider should initiate screening for aspects of bullying in the well-child visit. This includes being able to ascertain when a child is showing a reluctance to speak about any aspect of bullying, such as shying away from the topic or showing a sense of anxiety. The identification and prevention of bullying is viewed as being a multi-disciplined approach involving the school as well as healthcare providers.
When the clinician establishes that a child has been the victim of bullying they need to perform an evaluation for mental health issues, including post-traumatic stress disorder, poor school performance, absenteeism, and a lack of concentration. Some aspects may extend to adulthood primarily when the abuse has been severe, they may also have suicidal thoughts. Cyberbullying can be associated with both physical and psychological problems, such as anxiety, depression, suicide, self-harm, and drug abuse all of which can extend into adulthood.[3]
Programs aimed at controlling bullying
It is possible to prevent bullying, this may occur by addressing the issues that lead a child to bully another or become a victim. The behaviors that require addressing include family, school, community, and societal, as potential factors towards violent behavior. There is a need for a universal form of school-based anti-bullying campaign, this will exhibit how to improve upon the skills children develop to maintain relationships, and views of being different in some way, that a bully will take advantage.[1]
There are local, national, and online anti-bullying groups who seek to provide parents, children, teachers, and health professionals, with free advice for addressing bullying. Some such programs include: Ditch the Label, and Anti-Bullying Alliance. The school nurse acts as a liaison between the school and healthcare provider, as well as the parent encompassing a multi-disciplinary management team addressing childhood bullying. [4]
In summary, the effects of childhood bullying can have lasting effects if not addressed. This issue will only worsen unless it is properly addressed, beginning with the schools and healthcare providers working in tandem to find a solution. Since the aspect of violence and antisocial behavior can extend into later life for bullies and victims alike, law enforcement and lawmakers must also become involved in working out a standard program to address this epidemic. We need to find a central, established, proven program that will work to the benefit of all children, as well as society as a whole.
Sources:
Bullying in children: impact on child health. R. Armitage. BMJ. 2021;5(1).
2. Fast Facts: Preventing Bullying
3. Identifying and Addressing Bullying
4. Bidirectional association between bullying perpetration and internalizing problems among youth.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285807 Assessed and Endorsed by the MedReport Medical Review Board
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