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The Childhood Bullying/Victimization Experience. Tom Tarshis M.D., M.P.H. Bay Area Children’s Association. Introduction – I. What is bullying? Historically : Overt aggression (hitting, kicking, pushing) in males. More recently, recognition of other forms of bullying:
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The Childhood Bullying/Victimization Experience Tom Tarshis M.D., M.P.H. Bay Area Children’s Association
Introduction – I • What is bullying? • Historically : Overt aggression (hitting, kicking, pushing) in males. • More recently, recognition of other forms of bullying: • Relational aggression: “harming others through purposeful manipulation and damage of peer relationships”. • Direct and Indirect Bullying
Introduction - II Quick Definition: “The systematic abuse of power” Standard definition: (3 key criteria):` • The bully exhibits behavior directed towards the victim that is designed to hurt, harm, or damage the victim physically, socially or emotionally. 2) The behavior only occurs when there is an imbalance of power between the bully and the victim (bully having more) 3) The bullying behavior happens repeatedly over time
How do we Measure Bullying? • Self-Report • Peer Nomination • Teacher Report • Parent Report • School Reports Issue in United States : Stricter Policy on Conducting School Research
Prevalence I • United States Data (Nansel et al, 2001) In 1998, Survey completed by 15,686 students in 6th through 10th grades • 29.9% with moderate or frequent involvement in bullying • 13.0% identified as bullies • 10.6% as victims • 6.3% both bully and victim Weekly involvement: Bullies: 8.8% Victims: 8.4%
Prevalence II – International Data Involvement in bullying more than twice during the current school term in 25 countries Nansel, T. R. et al. Arch Pediatr Adolesc Med 2004;158:730-736.
Prevalence III – Younger Children • N= 264, Data collected from 1 public and 1 private school in CA, 1 public school in AZ • Grades 3-6, Spring 2004 – “In the past week..” Bullied Victimized Teased: 11.0% 34.9% Push, Hit: 7.2% 23.9% Mean Things: 11.1% 37.1%
Mental Health Correlations - I Being Victimized • Depression • Generalized Anxiety • Social Anxiety • Loneliness • Low Self-esteem • Suicidal Ideation
Mental Health Correlations - II Being a Bully • Depression • Suicidal Ideation • ADHD • Predictive of future adult criminal activity
Mental Health Correlations - III Younger Kids (4th-6th graders) P < 0.01 for all associations
Interventions I True or False: There are over 300 published violence-prevention school-based programs… True
Interventions II True or False: None of the 300 interventions meet full criteria for being an effective evidence-based program True
Interventions - III There are 5 interventions that ALMOST meet criteria (“possibly efficacious”), just lacking replication by an independent study group….
Role of Child Psychiatrist - I Rate of Bullying in Child Psychiatry Clinics? …No data published - Suspect Very High • What to do when a patient tells you they are being bullied?
Role of Child Psychiatrist - II Assessment Child Parent School Intervention Child Parent School
Take Home Message • Being a bully or being victimized is associated with serious mental health consequences, especially for children who are Bully-Victims • Future research should include finding reliable, valid measures of bullying (direct and indirect) and victimization and manualized and empirically tested school-based interventions. • We need prospective studies beginning from very young (pre-school/kindergarten) ages to track patterns of bullying, victimization and mental health problems over time
Resources Excellent Website www.StopBullyingNow.hrsa.gov Recent Book Bullying in American Schools Edited by Dorothy Espelage and Susan Swearer