Consequences

Mental Health Consequences for Victims

Victims are targeted due to personal attributes, such as appearance, weight, height, religious background, socioeconomic status, race/ethnicity including immigrant status, and presence of a disability, among other traits. Any personal characteristic that singles a child out from the normative peer group can be used by a strategic bully; the bully’s power lies in identifying the victim’s vulnerability and magnifying it to cause social damage that separates that child from the normative peer group.

Some people pick on me because I’m big, ‘cause I’m Puerto [Rican], I’m Hispanic, from where I come from, when you’re young you have a lot of hair on your arms, so she picks on me ‘cause of [my arm hair] and my weight and I’m working on it. She picks on me because of my arm hair and the way I dress. I sometimes dress like, um, a boy, ‘cause when I dress like a tomboy she doesn’t recognize who I am. She doesn’t recognize and mess with me. I don’t tell my mom things because she has mental problems, she has strokes. I don’t want to stress her out, so I don’t tell her, but the girl bullying me keeps on and on and on. (Puerto Rican female fifth grader)

Across the board, youth who avoid involvement in the bullying dynamic consistently report better mental health outcomes compared to victims, perpetrators, or youth who fill both roles. Although any sort of involvement in the bullying dynamic, even witnessing bullying, is harmful, victims and bully-victims appear to suffer the most.

In general, victims of bullying become insecure and anxious, have low self-esteem, a negative self-image, and high rates of depression. It follows that victims and bully-victims reported higher rates of depression, anxiety, and withdrawal compared to bullies and noninvolved youth.

Researchers have found the worst mental health outcomes are among bully/victims, followed by victims, and then bullies. Research studies have reported that bullies were nearly three times more likely to report depression compared to non-involved youth; victims were more than four times more likely; and bully/victims were more than six times more likely to report depression than non-involved youth.

Victims face verbal and physical harassment day after day and often do not know when the next attack will come, leaving them on high alert, constantly waiting for the next slap or mean comment. This state of high alertness often follows an experience of trauma and is called hypervigilance and is commonly a sign of post traumatic stress disorder (American Psychiatric Association, 2013; National Institute of Mental Health, n.d.).

I’m missin’ a lot of work just because one person is bullying me. And I’m missin’ my education just because one person is bullying me. I don’t feel good. I just pretend to be sick just to go home so I don’t have to deal with it no more. Cause it comes the next day and it just starts all over again. I just stay away from her as far as I can, but everywhere I go, she’s right there… And it makes me feel like I shouldn’t be in school, I should be in some…in jail, locked up, just cause somebody’s makin me feel like that.  And I’m thinkin it’s not right that I have to put up with all of this and my mom said that my self-esteem has gone down.  I’m usually excited to go places. But one girl just keeps messin with me and it’s like [my excitement’s all gone], I’m not gonna actually have fun because I have all of this to worry about. When we go back to school she’s gonna go all over again… In class when I start to write, my hand starts to shake that somebody’s gonna come behind me and just hit me in the head.   And when she gets near me, that’s how I feel, I start to shake, and I can’t control when I start shakin my hands.  When she gets near me, I start shakin my hands and when she goes away, they stop.  It’s like when she comes near me, I start getting tense.

This constant state of stress is akin to what scientists refer to as chronic stress and it has serious negative physical and emotional consequences such as “learned helplessness”. Chronic stress causes the muscles in the body to remain tense, which can result in tension headaches or migraines (American Psychological Association, 2017). Normally the body’s stress response system turns off once the stressor is removed. However, with chronic stress, such as bullying, the stressor is constant and thus the stress response system stays turned on, overexposing the body to cortisol and other stress hormones and thus increasing the risk for many negative outcomes including anxiety, depression, digestive problems, headaches, sleep problems, and impaired concentration and memory (Mayo Clinic, 2016). It follows that compared to bullies and noninvolved youth, victims and bully/victims reported a higher likelihood of sleep problems, tension, fatigue, and dizziness. These symptoms are in part likely a result of the chronic stress caused by victimization. In addition, constantly being verbally and/or physically attacked (especially around one’s personal vulnerabilities) damages youths’ self-esteem, and causes them to feel sad, down, and lonely. It is no wonder that victimized youth feel depressed. Bullying can become such an all-encompassing experience and the ensuing depression can become so severe that youth choose death over dealing with the pain of ostracism and social rejection.

The cognitive attributions that form in victims’ minds from the internalized bullying messages (e.g., people hate me, I am alone and unwanted, why even try?) create a negative lens through which they interpret new experiences and interactions. Consequently, victims may move to a new social context by changing schools, for example, but remain at high risk for new victimization experiences. The power of these negative attributions may cause a disempowered world view wherein victims anticipate continued rejection and ultimately stop trying to forge positive relationships. This helps to explain why damage from the childhood bullying dynamic lasts far into adulthood. In extreme circumstances, these intense negative attributions can generate psychological pain that prompts victims to consider suicide or make plans for revenge that end in tragedy, as seen in incidents of school shootings.

Bullying is a form of social pain; social pain refers to actual or potentially damaged social connections via rejection or exclusion. Neurobiological research suggests that experiences of social pain include some of the same neurobiological substrates connected to physical pain. This means that certain regions of the brain related to physical pain are also activated when we experience social rejection, which partially explains why social rejection is such a physically uncomfortable and distressing experience.

A meta-analysis of 29 studies found that bullying victimization in childhood resulted in increased rates of depression that endured for up to 36 years post-victimization, with an average of 6.9 years post-victimization. Adult victims of childhood bullying are also at an increased risk for other internalizing disorders such as anxiety. Another meta-analysis of 51 reports of 28 longitudinal studies found that childhood victimization was associated with aggressive (e.g., fighting) and violent behavior (e.g., assault, robbery, rape) an average of 6 years following victimization. This finding suggests that victimization often results in subsequent violent behavior years later, heightening the risk for engagement with the juvenile justice system, criminality, and in some instances school shootings planned as revenge.

Mental Health Consequences for Bullies

Youth diagnosed with depression, anxiety, and Attention Deficit Hyperactivity Disorder (ADHD) had almost 3 times the odds of being identified as a bully compared to those without these diagnosis. These findings highlight the fact that although it is easy to vilify youth who perniciously bully their peers, they might actually be suffering themselves and are in need of support. This is not meant to excuse their egregious behavior, but simply meant to highlight the fact that adults should delve into the reasons why youth are bullying others.

Youth who bully others, might also be victims or witnesses of domestic and community violence. These youths might bully others because they are re-enacting the violence they have experienced and/or witnessed at home or in the community. Indeed, youth exposed to domestic violence have increased rates of internalizing and externalizing behavior (e.g., anxiety, depression, conduct problems, aggression) that can translate into bullying others.

Youth engaged in bullying perpetration also have negative long-term outcomes. For example, a meta-analysis of 28 studies that compared childhood bullies with non-bullies found that bullies displayed increased levels of criminal offending up to 11-years post-bullying. This finding suggests that the aggressive and anti-social behavior in which bullies engage, can become a somewhat permanent part of their behavior that endures years after school ends. Further, the behavior escalates from harassing peers to actual criminal offending.

Both victimization and bullying are associated with a host of long-term negative consequences (e.g., depression, anxiety, aggression, violence), highlighting the necessity of putting a stop to this harmful behavior.