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4 Consequences of Bullying Behavior
Pages 113-178

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From page 113...
... , mental, and behavioral health consequences. The committee also examines consequences for academic performance and achievement and explores evidence for some of the mechanisms proposed for the psychological effects of bullying.
From page 114...
... Physical Health Consequences The physical health consequences of bullying can be immediate, such as physical injury, or they can involve long-term effects, such as headaches, sleep disturbances, or somatization.1 However, the long-term physical consequences of bullying can be difficult to identify and link with past bullying behavior versus being the result of other causes such as anxiety or other adverse childhood events that can also have physical effects into adulthood (Hager and Leadbeater, 2016)
From page 115...
... It is critical to understand that this study, or other studies assessing correlations between behavior and events, cannot state that the events caused the behavior. Future research might build on this large multisite longitudinal study and obtain more in-depth evidence on individuals' physical health as a consequence of bullying.
From page 116...
... and psychological and physical health, as well as academic performance, of 931 students in grades 6 through 12 living in rural Pennsylvania. Students were asked how often in the past 4 weeks they experienced 10 physical health symptoms, with scores across these 10 symptoms averaged to provide an overall health index (higher scores equal more health problems)
From page 117...
... In summary, it is clear that children and youth who have been bullied also experience a range of somatic disturbances. There are also gender differences in the physical health consequences of being bullied.
From page 118...
... FIGURE 4-2  Cortisol responses to a psychosocial stress test (PST) in the total sample and according to maltreatment/bullying victimization.
From page 119...
... The critical importance of the massive over-activation of the stress system producing a blunted stress response is clinically relevant since it is associated with posttraumatic stress disorder and other psychiatric disorders (Heim et al., 1997)
From page 120...
... . Animal models suggest that the extended cortisol response begins in pre-puberty and indicate that recovery from stressful events is more challenging during this age range (Romeo, 2015)
From page 121...
... Together, the research on both humans and animals suggests that stress is beneficial when it is experienced at low-to-moderate levels, whereas prolonged or repeated stress becomes toxic by engaging a unique neural and molecular cascade within the brain that is thought to initiate a different developmental pathway. Indeed, from animal models, brain architecture is altered by chronic stress, with amygdala activity being enhanced, hippocampal function impaired, and medial prefrontal cortex function being reduced, leading to increased anxiety and aggression and decreased capacity for self-regulation, as well as a more labile mood (Chattarji et al., 2015; McEwen and Morrison, 2013; McEwen et al., 2015)
From page 122...
... Therefore, the examples used below to assess brain function rely not on monitoring actual instances of bullying behavior but on monitoring components of behaviors that are thought to occur during a bullying incident. Second, fMRI monitors a large brain area, which is composed of many smaller brain areas, each of which is involved in many, many behaviors, many of which are not yet fully understood.
From page 123...
... While no brain imaging study has directly addressed this issue, a longitudinal study investigating the risk factors of depression found that being a child who was bullied at ages 11 and 12 was associated with a decreased response to reward in the medial prefrontal cortex at age 16, although it was unclear if these brain differences were present before the bullying experiences or developed after them (Casement et al., 2014)
From page 124...
... . There is also evidence that stressful events, such as might occur with bullying experiences, impact emotional brain circuits, an inference that is supported by changes in amygdala architecture and function described earlier in animal models in adulthood but more robust changes in brain structure are produced by stress during early life and around adolescence (Chattarji et al., 2015; McEwen and Morrison, 2013; McEwen et al., 2015)
From page 125...
... In terms of understanding the prolonged and repeated stress associated with bullying, this research suggests that greater experience with being bullied and repeated exposure as a target of bullying produces a neural signature in the brain that could underlie some of the behavioral outcomes associated with being bullied. Psychosocial Consequences In this section, the committee examines what is known about the psychosocial consequences of being bullied.
From page 126...
... 244) defined peer victimization as taking "various forms, including direct bullying behaviors (e.g., teasing, physical aggression)
From page 127...
... found that internalizing problems in grades 5 and 7 predicted increased self-reported bullying behavior the following year. They noted that these findings provide evidence for the "symptom-driven pathway" across time with increased internalizing problems predicting greater self-reported peer victimization.
From page 128...
... . In another longitudinal study using two large population-based cohorts from the United Kingdom (the ALSPAC Cohort)
From page 129...
... Psychotic Symptoms Evidence from the broader research on childhood trauma and stress indicates that earlier adverse life experiences, such as child abuse, are associated with the development of psychotic symptoms later in life (Institute of Medicine and National Research Council, 2014b)
From page 130...
... . Academic Performance Consequences A growing literature has documented that targets of bullying suffer diminished academic achievement whether measured by grades or standard 7 Nonclinical psychotic symptoms are symptoms that do not meet the clinical definition for those psychotic disorders associated with such symptoms.
From page 131...
... . Cross-sectional research indicates that children who are bullied are at increased risk for poor academic achievement (Beran, 2009; Beran and Lupart, 2009; Beran et al., 2008; Glew et al., 2005; Neary and Joseph, 1994; see also meta-analysis by Nakamoto and Schwartz, 2010)
From page 132...
... . The authors found that poor writing performance in third grade predicted increased bullying behavior in fifth grade that was stable until the end of eighth grade.
From page 133...
... Unfortunately, most research on the short- and long-term outcomes of perpetrating bullying behavior has not taken into account this heterogeneity when considering the impact to children and youth who have bullied their peers. Psychosomatic Consequences Findings from cross-sectional studies that reported data on individuals who bullied others have shown that these individuals are at risk of developing psychosomatic problems (Gini, 2008; Srabstein et al., 2006)
From page 134...
... Additional research is needed to examine the involvement in perpetrating bullying behavior and its short- and long-term psychosomatic consequences. Psychotic Problems Using a population-based cohort study, Wolke and colleagues (2014)
From page 135...
... That is, although there is a rich literature on aggressors and the outcomes of being aggressive, there are few studies examining bullying perpetration specifically, taking into account the power imbalance, repetition, and intentionality that differentiates aggression from bullying from other forms of peer aggression. As discussed in Chapter 2, the available research on the prevalence of bullying behavior focuses almost entirely on the children who are bullied.
From page 136...
... examined the association of direct and relational bullying experience with common health problems and found that students ages 6-9 who bullied others and were also bullied by others had more physical health symptoms than children who were only perpetrators or were not involved in bullying behavior. Hunter and colleagues (2014)
From page 137...
... in studies. School shootings are a violent externalizing behavior that has been associated with consequences of bullying behavior in the popular media (see Box 4-2 for additional detail)
From page 138...
... suicide attempts associated with bullying behavior (both perpetration and being a target) in cross-sectional studies ranged from 1.4 to 10.0 and in longitudinal studies ranged from 1.7 to 11.8.
From page 139...
... Focusing solely on bullying as a causal factor would ignore the many other influ ences that contribute to youth suicides. aLongitudinal studies were included in this meta-analysis, but only if the association be tween bullying involvement and suicidal ideation/behaviors was captured at the same time point" (Holt et al., 2015, p.
From page 140...
... Few studies or reviews have specifically examined incidents of school shootings related to any formal definition of bullying or bullying-related behavior. Given the limited number of cases and the reliance on qualitative post-hoc investigations of shootings, the association between mental health issues and how these contribute to the behavior of shooters are not yet fully understood, particularly issues that may be related to bullying behavior (as victim or perpetra tor)
From page 141...
... felt bullied, persecuted or injured by others prior to the attack." With respect to the implications related to this observation, they further stated that "Bullying was not a factor in every case, and clearly not every child who is bullied in school will pose a risk for targeted violence in school. Nevertheless, in a number of the incidents of targeted school violence studied, attackers described being bullied in terms that suggested that these experiences approached torment." These findings about the potential role of bullying in school shootings are generally consistent with examinations of shootings conducted at that time by the Federal Bureau of Investigation (O'Toole, 2000)
From page 142...
... While there is clear consensus that no reliable profile or set of risk factors exists for predicting who will become a school shooter, there is as yet no such consensus on the role that prior bullying experience plays in these in cidents. While being the target of bullying may play an important contributing role in the motivation for many school shooters, focusing solely on bullying as a causal factor would ignore the many other influences that contribute to school shootings.
From page 143...
... MECHANISMS FOR THE PSYCHOLOGICAL EFFECTS OF BULLYING In the following sections, the committee describes five potential mechanisms for the psychological effects of bullying behavior for both the children who are bullied and children who bully. These include self-blame, social cognition, emotional dysregulation, genetic predisposition to mental health outcomes and bullying, and telomere erosion.13 12 This section is adapted from Rose (2015, pp.
From page 144...
... documented that sixth grade students with reputations as targets made more characterological self-blaming attributions for harassment than behavioral self-blaming attributions. Characterological self-blame, in turn, partly mediated the relationship between victim status and psychological maladjustment as measured by depression and social anxiety.
From page 145...
... This framework characterizes the inputs, the routes, the proximal processes, and the outcomes associated with aggressive behavior and either being targeted by or perpetrating bullying behavior (Kowalski and Limber, 2013; Vannucci et al., 2012)
From page 146...
... There has been exploration of links between these beliefs and both reactive and proactive aggression. However, there has been relatively limited research specifically focused on bullying behavior.
From page 147...
... . Subsequent research from this same sample of adolescents showed that emotion dysregulation also mediated the prospective relationship between peer victimization and subsequent aggressive behavior (Herts et al., 2012)
From page 148...
... . Far fewer studies have examined the role of potential genetic influences as mediators between life experiences such as bullying and mental health outcomes.
From page 149...
... This very prolonged period of brain develop ment means that the type of environment one lives in can interact with genetic factors to produce a brain that is better suited to living in certain conditions, such as the cold climate of Alaska, the heat of Florida, or an arid desert. This interaction between brain development and the environment has enabled humans to expand their geographic territory.
From page 150...
... the nonshared environment component or the aspect of the environment that is unique to each twin, such as the classroom if twins are in different classes. Studies that decompose the unique effects of the environment and genetics on bullying behavior are best illustrated by two examples.
From page 151...
... There are several reasons for discrepancies between and within studies of the genetic contribution to bullying behavior. One reason is related to how peer victimization is assessed.
From page 152...
... , in which the moderating role of a functional polymorphism in the promoter region of the serotonin transporter gene 5-HTTLPR was examined in relation to exposure to maltreatment in childhood and depression in adulthood. Results indicated that depression rates were far greater among abused individuals if they had two copies of the short allele.18 Among individuals with a long allele, depression rates were lower, suggesting that the long allele was protective, while the short allele was a risk factor for depression in the face of adversity.
From page 153...
... To the committee's knowledge, there are no studies that have examined bullying perpetration in relation to serotonin transporter polymorphisms, although there are studies that have examined this polymorphism in aggressive and non-aggressive children. For example, Beitchman et al.
From page 154...
... Even though genes appear to modulate humans' response to being a target or a perpetrator of bullying behavior, it is still unclear what aspects of these experiences are interacting with genes and which genes are implicated to produce the variability in outcomes. Human genes and environment interact in a very complex manner: what biological events a particular gene influences can change at different stages of development.
From page 155...
... In this section, the committee focuses on studies examining how genetic susceptibility can make certain individuals more sensitive to negative environmental influences. Although a person's DNA is fixed at conception (i.e., nonmalleable)
From page 156...
... . In summary, it is important to note that there is no gene for being a perpetrator or a target of bullying behavior.
From page 157...
... It also examined the potential mediating mechanisms of, and the genetic predisposition to, mental health outcomes associated with childhood and youth experiences of bullying behavior. Most studies are cross-sectional and thus provide only associations suggestive of a possible causal effect.
From page 158...
... and unsuccessful emotion regulation (i.e., emotion dysregulation) mediate relationships between bullying and adverse outcomes.
From page 159...
... It is not known whether bystanders are at increased risk of suicidal ideation or suicide attempts. Finding 4.14: There is not enough evidence to date to conclude that being the target of bullying is a causal factor for multiple-homicide tar geted school shootings, nor is there clear evidence on how experience as a target or perpetrator of bullying, or the mental health and behavior issues related to such experiences, contribute to school shootings.
From page 160...
... Conclusion 4.9: Although genes appear to modulate humans' response to being either a target or a perpetrator of bullying behavior, it is still unclear what aspects of these experiences are interacting with genes and which genes are implicated to produce the variability in outcomes. Examining the role of genes in bullying in the context of the environ ment is essential to providing meaningful information on the genetic component of individual differences in outcomes from being a target or a perpetrator of bullying behavior.
From page 161...
... . A longitudinal investigation of self- and peer reports of bullying victimization across middle school.
From page 162...
... . What can be done about school shootings?
From page 163...
... . Bullying victimization, emotional problems and cognitive emotion regulation in adolescence.
From page 164...
... . The role of medial prefrontal cortex in memory and decision making.
From page 165...
... . The role of mother involvement and father involvement in adolescent bullying behavior.
From page 166...
... . The longitudinal effects of peer victimization on physical health from adolescence to young adulthood.
From page 167...
... . Emotion dysregulation as a mechanism linking stress exposure to adolescent aggressive behavior.
From page 168...
... . Childhood bullying behaviors as a risk for suicide attempts and completed suicides: A population-based birth cohort study.
From page 169...
... . Teasing, rejection, and violence: Case studies of the school shootings.
From page 170...
... . Emotion dysregulation as a mechanism linking peer victimization to internalizing symptoms in adolescents.
From page 171...
... . Cross-national consistency in the relationship between bullying behaviors and psychosocial adjustment.
From page 172...
... DNA methylation is associated with bullying victimization and blunted cortisol response to stress in child hood: A longitudinal study of discordant monozygotic twins. Psychological Medicine, 43(09)
From page 173...
... . Risky families: Family social environ ments and the mental and physical health of offspring.
From page 174...
... . Bystanders matter: Associations between reinforcing, defending, and the frequency of bullying behavior in classrooms.
From page 175...
... . Morbidities associated with bullying behaviors in adolescents.
From page 176...
... . The relationship be tween power and bullying behavior.
From page 177...
... A 5-year longitudinal study. Social Development, 24, 748-765.


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