WASHINGTON – Pediatricians need to understand the different types of bullying, as well as its risk factors and consequences, according to Dr. Adiaha I.A. Spinks-Franklin, a developmental and behavioral pediatrician at Baylor College of Medicine in Houston.
Knowing how to address bullying and act as a community antibullying advocate is essential as well, Dr. Spinks-Franklin said at the annual meeting of the American Academy of Pediatrics.
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The first step to understanding the problem is understanding the lingo. Bullying is more than making fun of other people. It’s “aggressive behavior that is intentional, repeated over time, and involves an imbalance of power or strength,” Dr. Spinks-Franklin explained. That power imbalance can be physical, social, economic, or involve some power differential. Although the perpetrator is always called the bully, the victim also may be called a “target,” and some children are “bully-victims,” both perpetrators and targets. A third group is the bystanders or witnesses, who also can experience trauma from seeing bullying.
About a third of U.S. children experience bullying, which peaks in middle schools, but that does not mean it’s a normal, acceptable aspect of growing up, Dr. Spinks-Franklin said.
“A lot of teachers think bullying is a normal part of childhood and won’t say anything,” but speaking up can make a difference, Dr. Spinks-Franklin said. “If a child intervenes for another child, the bullying drops. And when an adult intervenes, the effect is even stronger.”
Types of bullying
Most people are familiar with physical bullying – hitting, punching, destruction of physical property or some other physical contact – and verbal bullying such as name-calling or harsh teasing aimed at humiliating the victim. Just as damaging are the other two types of bullying: social or relational bullying and cyberbullying. Boys tend to engage in cyberbullying, verbal bullying, and physical bullying more often than girls, but girls are social bullies more often than are boys.
Social bullying involves excluding someone, spreading rumors about them, or otherwise intentionally interfering with their relationships or their ability to build relationships. Cyberbullying can involve any digital technology, from social media to email to phone texting. With cell phones in the pockets of 75% of teens and an average of 71 texts buzzing those phones each day, according to 2011 and 2015 data, cyberbullying can be deeply intrusive.
Dr. Spinks-Franklin made special mention of a cultural practice called “the Dozens,” or, basically, “trash talk” among African-American children and teens.
“The Dozens is an old tradition of talking smack to your friend. It’s all about verbal comedic talk and coming up with the most incredible insults,” she explained. “There’s timing involved, there’s cadence involved, and you have to maintain emotional regulation or you lose. If you don’t have a good comeback, you lose.”
Examples include classic “Yo Mama” jokes traded back and forth, which she enthusiastically demonstrated to laughter among attendees. But her point was a serious one: If children are shouting insults back and forth and laughing in a group, that’s not verbal bullying. But if a group of children are all taunting a single child who’s not participating or seems distressed, that is verbal bullying.
Consequences of bullying
No one involved is immune to negative effects when bullying is involved, Dr. Spinks-Franklin explained. Victims of bullying have a higher risk of depression, anxiety, poor academic performance, and somatic complaints, particularly on Sunday evenings before they return to school for the week. They also have an increased risk of suicidal thoughts and attempts, which has given rise to the term “bullycide” – a suicide caused by the effects of bullying. On the more extreme end, victims of bullying are at higher risk for violent retaliation, such as attempting or executing mass killings, Dr. Spinks-Franklin said.
Bullies have a different set of risks, starting with a higher risk of alcohol or substance abuse and a greater likelihood to start having sex sooner than peers. Bullies are more likely to get into fights, drop out of school, and vandalize property. As adults, bullies are more likely to rack up traffic citations and criminal convictions and to abuse others, such as romantic partners and children.
Even bystanders who witness bullying suffer, with twice the rate of depression, compared with those who don’t witness bullying. Bystanders also have about a 65% greater odds of anxiety disorders and more than twice the odds of attempting suicide.
Bullying risk factors
Both victims and bullies have identifiable risk factors that are helpful for pediatricians to know about. As individuals, having behavioral problems or depression is a risk factor for being a bully.