Bullying may be connected to factors including family violence, alcohol and drug use, and increased suicidal tendencies, according to results from the 2009 Massachusetts Youth Health Survey released April 22.
The randomized population-based survey was administered during one class period to 138 middle schools and high schools (2,859 middle school students and 2,948 high school students). Through the paper-and-pencil survey, students were asked about their experience being bullied or bullying their peers (MMWR 2011;60:465-71).
Those who responded that they had been bullied before during the last 12 months were categorized as victims; those who responded that they had bullied or pushed someone around in the last 12 months were categorized as bullies. Students who responded that they had experienced both were categorized as bully-victims.
The most striking finding was the frequency by which bullies and bully-victims had been exposed to domestic violence, said Dr. Robert Sege, chief of ambulatory pediatrics at Boston Medical Center.
In the survey, 23% of bully-victims in middle school and 20% of high school bully-victims reported they’d been physically hurt by a family member in the last 12 months. This compared with 19% for bullies and 14% for victims in middle school; the figures for high school were 14% and 13%, respectively.
"Previous studies have shown the bullies themselves are likely to have poorer long-term outcomes and this sort of provides some nuance into that phenomenon," Dr. Sege said in an interview. Additional findings showed bullies-victims were more likely to be dealing with feelings of sadness or hopelessness.
A total of 25% of middle school bully-victims reported they had seriously considered suicide in the past 12 months, compared with 16% bullies and 12% victims. For high school students, the results were 23%, 13%, and 20% respectively. About 5% of middle school victims, 11% of bullies, and 17% of bully-victims actually did attempt suicide, as did 10% of high school victims, 6% of bullies, and 11% of high school bully-victims. Additionally, 41% of bully-victims in middle school and 29% of high school bully-victims reported intentionally hurting themselves (but not attempting suicide).
While parents and teachers are often on the forefront of discovering issues of bullying among youth, Dr. Sege said pediatricians can also play a part. Victims of bullying may exhibit frequent injuries. In addition, children showing sudden symptoms of ADHD, with no previous issues with attention, could be a victim of bullying.
Many pediatricians feel unprepared to screen for or manage forms of violence other than child maltreatment, according to the American Academy of Pediatrics. Parenting styles that offer emotional support and cognitive stimulation can help prevent future bullying behavior, according to a 2009 AAP policy statement.
"Promotion and reinforcement of such parenting skills plus recognition, screening, and appropriate referral as secondary prevention strategies are essential ways that pediatricians can collectively contribute to this aspect of youth violence prevention," according to the statement.
Dr. Sege said he had no relevant financial disclosures.