Bullying is a very common, complex and potentially damaging form of violence among children and adolescents. Bullying is defined as unwanted, aggressive behavior, which involves a real or perceived social power imbalance. The behavior is repeated, or has the potential to be repeated, over time (therefore, the definition excludes occasional or minor incidents). These actions are purposeful and intended to hurt or make the victim uncomfortable.[1]
Bullying may manifest itself in many forms. It can be physical, verbal, relational, or cyber; it can be subtle and elusive. The most common form of bullying both for boys and girls is verbal bullying such as name-calling. Although bullying is more common in schools, it can occur anywhere. It often occurs in unstructured areas such as playgrounds, cafeterias, hallways, and buses. In recent years, cyber-bullying has received increased attention, as electronic devices have become more common. Bullying through electronic means, although prevalent, ranks third after verbal bullying and physical bullying. In general, bullying is a common type of social experience that children refer to as “getting picked on.”
The etiology of bullying is complex and may depend on multiple issues including individual, social, and family issues. It is important to understanding these hidden causes that increase the risk of bullying.[2]
Victims
Although there are many causes of bullying, certain risk factors may attract bullies to their victims.
Bullies
These children may have the following characteristics:
It is not necessary that a bully is stronger or bigger than their victim. The power imbalance can be due to many things including popularity, strength, or cognitive ability. Bullying behavior may be used to gain social status.[3]
According to the National Center for Educational Statistics (2013), 1 in 3 children (27.8%) report being bullied during the school year. Bullying is reported to be more prevalent among boys than girls. It occurs with greater frequency among middle school children. For boys, both physical and verbal bullying is common, whereas, for girls, verbal bullying and rumors are more common. African Americans youth report being bullied significantly less frequently than white or Hispanic youth.[4] Bullying peaks in early adolescence and then gradually declines as adolescence progresses, although recent research suggests that this is for more overt forms of bullying, whereas covert bullying continues through adolescence.
The issue of bullying in children is a complex problem that emerges from social, physical, institutional and community contexts, as well as the individual characteristics of the children who are bullied and victimized. A bullying interaction occurs not only because of individual characteristics of a particular child who is bullying, but also because of actions and attitudes of peers, teachers and school staff, and physical characteristics of that particular environment. Family dynamics, cultural factors, and even community response also play a role in the occurrence of the bullying interaction.
Certain signs may indicate that a child has been a victim of bullying, including:
Bullying is a serious problem for both the bully and the victim. The first step is recognizing bullying as a problem for a child. It is also important to identify bullying interactions at an early stage.
Assessment of bullying: There are many tools available to assess bullying and determine the frequency and locations of bullying behavior. See the Centers for Disease Control and Prevention's compendium for measuring bullying, victimization, and bystander experience.
It may also be important to assess other risk and protective factors, such as depression, suicide risk, sources of internal and external resilience, to best determine the interventions and supports needed.
Since bullying is a very complex problem there is no “quick fix” to prevent or intervene with this issue. It is important to understand the issues that are unique to the individual and the context in order to develop and implement interventions. Here we describe important elements for intervention to address this issue.
To stop bullying, remember prevention is the best intervention.
Addressing bullying is a multi-step process.[5]
Be aware that punishment based strategies (suspension and expulsion) should be reserved for severe disruptive and aggressive behavior. These may not be the most effective strategies.
Engaging the victim
Engaging bullies
Explore the basis of bully’s behavior: it is also important not to label them as a bully.
Team approach: Many researchers believe that bullying is a group process and therefore interventions against bullying should be targeted at the peer-group level rather than at individual bullies and victims. Research has shown that the most successful programs are those that use multi-level interventions.[6]
Bullying is a learned behavior that may be preventable. School-based interventions have shown a significant reduction in bullying by up to 20%. These interventions included the following[7]:
Bullying is not primarily a law enforcement issue, but because of its ramification, all fifty states in the United States have developed school anti-bullying legislation or policies. Bullying may also appear in the criminal code of a state, or may relate to other crimes, such as aggravated harassment or stalking, and may apply to juveniles.
Bullying is a serious societal problem, often very difficult to diagnose. The entire interprofessional team must be aware of signs and symptoms. Often a child will open up to a nurse that opens the communication to the entire team. Usually, social workers, nurses, and clinicians need to work together to assist the child or adolescent. Usually, parents and sometimes school officials will need to become involved. The best outcome is achieved with an interprofessional team. [Level V]
[1] | Bullying at school: basic facts and effects of a school based intervention program., Olweus D,, Journal of child psychology and psychiatry, and allied disciplines, 1994 Oct [PubMed PMID: 7806605] |
[2] | Bullying among schoolchildren: differences between victims and aggressors., Garcia-Continente X,Pérez-Giménez A,Espelt A,Nebot Adell M,, Gaceta sanitaria / S.E.S.P.A.S, 2013 Jul-Aug [PubMed PMID: 23416025] |
[3] | Assessment and management of bullied children in the emergency department., Waseem M,Ryan M,Foster CB,Peterson J,, Pediatric emergency care, 2013 Mar [PubMed PMID: 23462401] |
[4] | Bullying behaviors among US youth: prevalence and association with psychosocial adjustment., Nansel TR,Overpeck M,Pilla RS,Ruan WJ,Simons-Morton B,Scheidt P,, JAMA, 2001 Apr 25 [PubMed PMID: 11311098] |
[5] | Adolescents' perception of bullying: who is the victim? Who is the bully? What can be done to stop bullying?, Frisén A,Jonsson AK,Persson C,, Adolescence, 2007 Winter [PubMed PMID: 18229509] |
[6] | Framing public policy and prevention of chronic violence in American youths., Dodge KA,, The American psychologist, 2008 Oct [PubMed PMID: 18855489] |
[7] | Anti-bullying intervention: implementation and outcome., Salmivalli C,Kaukiainen A,Voeten M,, The British journal of educational psychology, 2005 Sep [PubMed PMID: 16238877] |