Bullying May Affect Girls More Than Boys
News Author: Janis Kelly
Andre Sourander, MD, PhD, from Turku University Hospital, Turku, Finland, and colleagues studied associations between bullying and victimization in childhood (at age 8 years) and later psychiatric hospitalization and treatment with antipsychotic medication (from ages 13 to 24 years) in 5038 Finnish children who participated in the nationwide Finnish 1981 Birth Cohort Study. Information was gathered from parents, teachers, participants’ self-reports, and a national register of hospital and medication records.
The researchers defined bullying as “an aggressive act embodying an imbalance of power in which the victims cannot defend themselves accompanied by an element of repetition.”
According to the researchers, this is the first population-based study to examine late adolescence or adult outcomes of childhood bullying in both boys and girls.
Fewer Long-Term Effects in Boys
The researchers found that 6% of 8-year-old boys bullied others frequently but were not victims themselves, 6.4% of boys were frequently victims but not bullies, and 2.8% of boys were frequently both bullies and victims.
Rates among girls were much lower: 0.6% were bullies but not victims, 3.6% were victims but not bullies, and 0.2% were both bullies and victims.
The investigators used the Rutter Scale at age 8 years to screen children for emotional and behavioral problems. In the study, a child who scored above 13 on the parental scale or 9 on the teacher scale was classified as having possible psychiatric disturbance.
“When the analyses were adjusted with the total psychopathology score at age 8 years (sum score of symptoms using pooled information from parent and teacher ratings), only female frequent victim status predicted psychiatric hospital treatment,” Dr. Sourander said in a statement. Frequent victim status also predicted use of psychiatric medication, antipsychotics, antidepressants, or anxiolytics among girls.
“When the analysis was controlled with total psychopathology score at age 8 years, frequent bully, victim or bully-victim status did not predict any psychiatric outcomes among males,” Dr. Sourander said.
Not surprisingly, the investigators conclude that boys and girls are different with respect to the prevalence and outcome of bullying behavior. “Compared with boys, very few girls were frequent bullies or bully-victims,” the authors write.
“Second,” they add, “girls who are frequently victimized are at risk of long-term psychiatric outcome regardless of their psychiatric statuses at baseline. Third, it was male bully-victims who were at greatest risk of a wide range of psychiatric outcomes.”
Gender Paradox
In an interview with Medscape Psychiatry, Dr. Sourander said it was interesting to note that frequent bullying had a lesser effect on boys, whereas girls who were frequent bullies often had poor outcomes.
“In other words, despite lower prevalence of being a bully among girls, those who are involved often have severe problems. This is a gender paradox — while girls are less likely to be frequent bullies, when they are bullies they have more severe impairment [than] their male counterparts,” he said.
The authors note that almost all of the boy bully-victims already showed evidence of psychopathology at age 8 years.
The authors suggest that targeting frequent bullies, victims, or bully-victims for psychiatric screening will be more cost-effective than universal screening for psychiatric problems.
Effect of Bullying May Be Underestimated
Louise Arsenault, PhD, who has also studied adjustment problems related to bullying in young children, told Medscape Psychiatry that the Sourander study is important because it uses data from one of the longest-standing cohorts looking at bullying and because it relies on one of the best measures of bullying victimization in childhood — events reported by several informants (self, mothers, and teachers).
However, Dr. Arsenault, who is from the Institute of Psychiatry in London, United Kingdom, cautioned against overinterpreting the data. One caveat is that the outcome measures are an approximation of mental health problems in early adulthood and may underestimate the effect of being bullied in childhood. In addition, although baseline childhood psychopathology was controlled for, other factors, such as maltreatment, might have affected the outcomes.
Both experts agree that childhood bullying is not benign. “Bullying is not just part of growing up. When it is frequent, it should be considered interpersonal violence. Unfortunately, the negative effects of being frequently bullied may not disappear with time,” said Dr. Sourander.
“The education systems are of central importance in the early detection of bullying as a warning sign of later severe problems. Failure of the school system to take preventive action should be considered as a failure to discharge the school authority’s duty of care,” he added.
This study was supported by a grant from the Finnish National Social Insurance Institution and the Sigrid Juselius Foundation, Finland. The authors have disclosed no relevant financial relationships.
Arch Gen Psychiatry. 2009;66:1005–1012.
Courtesy of Medscape (http://cme.medscape.com/)
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