Dr. Wagner is Professor and Chair, Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX.
Recent studies have demonstrated the wide-reaching adverse effects of being bullied in childhood. These effects range from impaired academic performance to interest in cosmetic surgery.
Mundy and colleagues1 examined the relationship between bullying and academic performance. The study was made up of 965 third-grade children from public and private schools in Australia; 44.8% of the students were male. Bullying was assessed by child self-report on a bullying scale. The items on the scale included physical and verbal victimization. Reponses were yes or no; if yes, then information was obtained on the frequency of being bullied. Academic performance was assessed via a national achievement test that measured academic performance on 5 domains: reading, writing, numeracy, spelling, and grammar/punctuation.
Just over one-quarter (27%) of the girls and one-third (33%) of the boys reported being frequently bullied (defined as occurring once a week or on most days) during the past month. For boys, physical victimization was associated with lower numeracy scores compared with non-bullied peers. Boys who experienced both verbal and physical victimization had lower reading scores than boys who had not been victimized. For girls, verbal victimization was associated with lower writing and grammar/punctuation scores compared with those who were not bullied. Girls who experienced physical victimization had lower numeracy and writing scores. Girls who experienced both verbal and physical victimization had overall lower academic performance scores. In general, the academic delays were equivalent to approximately 6 to 9 months of learning for students who had experienced bullying compared with children who had not been bullied.
On the basis of these findings, the researchers recommend that prevention of bullying should be a major priority for primary schools. The findings suggest that teachers and parents should consider bullying as one possible explanation for their students performing below their academic expectation.
Depressive symptoms and substance use
Earnshaw and colleagues2 examined the longitudinal association of bullying and substance abuse, as well as the role of depressive symptoms, in their study of 4297 5th-grade students. Students who completed baseline assessments and were evaluated in 7th and 10th grade were included in the study sample. Bullying (peer victimization) was assessed by use of a self-report questionnaire with items such as “How often do kids kick or push you in a mean way?” and “How often do kids tell nasty things about you to others?” in the past 12 months. Students were asked about their use of tobacco, alcohol, and marijuana in the past 30 days. Depressive symptom scores were obtained from items on a diagnostic interview depression subscale.
Students who reported being bullied frequently in 5th grade reported greater depressive symptoms in 7th grade. There was a positive correlation between 7th-grade depressive symptoms and 10th-grade alcohol use, marijuana use, and tobacco use. Overall, the experience of being bullied in 5th grade was associated with use of substances in 10th grade via the mediator of 7th-grade depressive symptoms. These findings were similar for girls and boys.
The results of this study demonstrate the lasting impact of bullying in elementary school into high school. Based on these findings, the researchers recommend that all youths be screened for bullying, depressive symptoms, and substance use.
Access to a loaded gun
Simckes and colleagues3 evaluated the association between bullying and access to a loaded gun without adult permission. Data were obtained from 10,704 students, aged 12 to 18 years, who completed the 2011 and 2013 School Crime Supplement (SCS) to the National Crime Victimization Survey. The SCS assessed school-based bullying during the current school year. Students reported whether they were bullied via traditional bullying (direct and indirect physical and verbal violence, social exclusion, and property damage) or cyberbullying (unsolicited sharing of private information online, social exclusion in electronic format, and threats or insults received via different cyber media). Access to a loaded gun without permission was obtained by self-report during the student’s current school year. Responses were yes, no, or don’t know to the following question: “Could you have gotten a loaded gun without adult permission either at or away from school?”
Access to a gun without adult permission was reported by 4.2% of the students. Students who experienced school-based bullying were 3 times more likely to report access to a loaded gun without adult permission than those students who are not bullied: 5.2% of those students who experienced traditional bullying; 9.2% of those who experienced cyberbullying; and 15.0% of those students who experienced both types of bullying reported access to a loaded gun without adult permission compared with 2.8% who experienced no bullying.
Given these findings, the researchers recommend that access to firearms be specifically addressed in evaluation of adolescents who report being bullied. This intervention may reduce the likelihood of self-inflicted injuries in adolescents who have been bullied.
Lee and colleagues4 examined the association between bullying and interest in cosmetic surgery. Students from grades 7 through 11 were screened for bullying involvement (N = 2782). Bullying role (victim and/or perpetrator) was assessed by use of a self-report scale and peer nominations (adolescents identified other students who were perpetrators or victims of bullying). Psychological functioning was assessed using scales that measured self-esteem, body esteem, and emotional problems. Seven hundred fifty-two students (53.3% female) who screened positive for bullying involvement were assessed for their desire for cosmetic surgery. The evaluations were based on students’ responses to the following items:
1 “I would like to have cosmetic surgery so that others would find me more attractive.”
2 “I would consider having cosmetic surgery as a way to change my appearance so that I would feel better about myself.”
3 “If I was offered cosmetic surgery for free, I would consider changing a part of my appearance that I do not like.”
Responses to these items ranged from not at all to very much.
Bullying role and percentages were as follows: bully-victim (those who are bullied but also bully others; 39.1%); bully (19.5%); victim (18.2%; 67.6% of these were girls). Psychological functioning was significantly poorer for victims and bully-victims than for bullies and adolescents without a bullying role. Victims of bullying had the lowest self-esteem and lower body esteem than the other groups. Adolescents who had any role in bullying were significantly more interested in cosmetic surgery than adolescents uninvolved in bullying. The desire for cosmetic surgery was highest in victims and in girls compared with boys. Poor psychological functioning was associated with being bullied, which in turn led to increased desire for cosmetic surgery.
The researchers suggest that screening tools be used to assess bullying for individuals who seek cosmetic surgery. Treating the mental health impact of bullying may reduce the desire for cosmetic surgery and possibly unnecessary procedures.
1. Mundy LK, Canterford L, Kosola S, et al. Peer victimization and academic performance in primary school children. Acad Pediatr. June 2017; Epub ahead of print.
2. Earnshaw VA, Elliott MN, Reisner SL, et al. Peer victimization, depressive symptoms, and substance use: a longitudinal analysis. Pediatrics. 2017; 139:e20163426.
3. Simckes M, Simonetti JA, Moreno MA, et al. Access to a loaded gun without adult permission and school-based bullying. J Adolesc Health. 2017;61:329-334.
4. Lee K, Guy A, Dale J, Wolke D. Adolescent desire for cosmetic surgery: associations with bullying and psychological functioning. Plast Reconstr Surg.