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How Safe Are Your Patients From Bullying?

By: Michele R. Berman, MD | August 12, 2011

Rebecca Black may now be laughing all the way to the bank, but her new found fame has come at a price. The 14-year-old is now being home-schooled by her mother because of bullying at school.

It's been a roller coaster year for Black, who became a YouTube sensation with her song " Friday" went viral after its release in March. At last count, the video has had over 167 million hits -- almost half the US population! But unfortunately, the video's fame centered around being billed as the "Worst Song Ever?"

Soon there were parody videos everywhere and even celebrities such as
Jimmy Fallon and Conan O'Brien had their own versions. A number of celebrities, most notably Lady Gaga and Katy Perry, came to her defense, with Perry even inviting Black to be in her video "Last Friday Night (TGIF)". Those two celebrities, as well as others including Demi Lovato and Christina Aguilera, are well aware of the difficulties faced by Black, having all admitted to being bullied before becoming superstars.

According to the
American Academy of Child and Adolescent Psychiatry, "bullying is a common experience for many children and adolescents. Surveys indicate that as many as half of all children are bullied at some time during their school years, and at least 10% are bullied on a regular basis." Bullying involves 3 things:

1. Imbalance of Power: people who bully use their power to control or harm, and the people being bullied may have a hard time defending themselves

2. Intent to Cause Harm: actions done by accident are not bullying; the person bullying has a goal to cause harm

3. Repetition: incidents of bullying happen to the same the person over and over by the same person or group

Bullying is not only physical, but can also take verbal (name-calling, teasing), social (spreading rumors, leaving people out on purpose, breaking up friendships) and "cyber" forms (using the Internet, mobile phones or other digital technologies to harm others).

Bullying can cause serious and lasting harm. While these effects may also be caused by other factors, research has found bullying has significant effects for those who are bullied, those who bully others, and those who witness bullying.

People Who are Bullied:

  • Have higher risk of depression and anxiety, including the following symptoms, that may persist into adulthood:
    • Increased feelings of sadness and loneliness
    • Changes in sleep and eating patterns
    • Loss of interest in activities
  • Have increased thoughts about suicide that may persist into adulthood. In one study, adults who recalled being bullied in youth were 3 times more likely to have suicidal thoughts or inclinations.
  • Are more likely to have health complaints. In one study, being bullied was associated with physical health status 3 years later.
  • Have decreased academic achievement (GPA and standardized test scores) and school participation.
  • Are more likely to miss, skip, or drop out of school.
  • Are more likely to retaliate through extremely violent measures. In 12 of 15 school shooting cases in the 1990s, the shooters had a history of being bullied.

People Who Bully Others:

  • Have a higher risk of abusing alcohol and other drugs in adolescence and as adults.
  • Are more likely to get into fights, vandalize property, and drop out of school.
  • Are more likely to engage in early sexual activity.
  • Are more likely to have criminal convictions and traffic citations as adults. In one study, 60% of boys who bullied others in middle school had a criminal conviction by age 24.
  • Are more likely to be abusive toward their romantic partners, spouses or children as adults.

People Who Witness Bullying:

  • Have increased use of tobacco, alcohol or other drugs.
  • Have increased mental health problems, including depression and anxiety.
  • Are more likely to miss or skip school.

Source: Stopbullying.gov

So what can we do as healthcare professionals?

1. Incorporate questions into your routine exams that might give you clues that bullying is occurring.

2. Consider bullying as a contributing factor when patients come in with symptoms of:

  • headaches
  • abdominal pain
  • feeling sad or very sad
  • bed wetting
  • sleeping difficulties

3. Familiarize yourself with a number of resources available to health care professionals:

  • The American Academy of Pediatrics has a program called Connected Kids:Safe, Strong, Secure to provide a comprehensive, logical approach to integrating violence prevention efforts in practice and the community.
  • Stopbullying.gov - An official U.S. government Web site managed by the Department of Health & Human Services in partnership with the Department of Education and Department of Justice.
  • A compendium of assessment tools, published by the CDC, for measuring bullying victimization, perpetration and bystander experiences
  • LGBT (Lesbian, Gay, Bisexual and Transgender) patients are at especially high risk for bullying. Ask adolescents about their sexual history and whether they have been victims of bullying.

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