Doesn't Take Sticks & Stones to Hurt You

Bullying linked to poor mental health and risky behaviors in victims later on

/ Author:  / Reviewed by: Robert Carlson, M.D

Sticks and stones will break your bones but names will never hurt you. Except they do. And not just your mental health. Bullying affects your physical health too.

Even though awareness of bullying has come more into focus in recent years, most people still focus just on the immediate effects. Bullying may lead to long term mental health issues and even links to suicide risks.

"Being bullied? Ask for help."

But the effects of bullying may not stop there. More research is finding that victims of bullying may suffer more in other ways even years after the bullying has passed.

One recent study produced at the Crime Victims' Institute at Sam Houston State University found various links to long-term negative physical and mental health. The study also found that being bullied is linked to riskier behaviors, such as drinking or smoking, in young adulthood.

The study was authored by Maria Koeppel, a PhD candidate in criminal justice at Sam Houston State University, and Leanna A. Bouffard, PhD, the director of the Crime Victims' Institute.

The data came from the National Longitudinal Survey of Youth, 1997, which tracks a nationally representative group of US residents born between 1980 and 1984. A total of 4,834 adolescents were interviewed in 1997 when they were 12 to 14 years old.

When the children were asked whether they had been bullied before they were 12 years old, 19 percent said they had been subjected to repeated bullying in early childhood. Five years later, the same individuals were interviewed again when they were 18 to 21 years old.

During the second interview, researchers asked the young adults about their physical health, their mental health and their involvement in high-risk behaviors, such as smoking or drinking, risky sexual behavior and violent behavior.

Bullied Individuals Report Poorer Health

The results revealed that children who had been bullied early in life were more likely to report their physical health as "fair" or "poor" when they were young adults.

While only 6 percent of non-victims considered their physical health fair or poor, 10 percent of the bullied individuals did.

While both bullied and non-bullied respondents had about the same rates of health insurance coverage, there was a small difference in how the different groups used health care.

Only 12 percent of non-victims had gone more than two years without a routine check-up, compared to 17 percent among victims.

In addition, slightly more bullied individuals (31.9 percent compared to 29.5 percent) reported being sick or injured but not seeking medical treatment on at least two occasions in the past year.

Engaging in Risky Behaviors or Future Victimization

The report also found that those who had been bullied had higher rates of participation in risky behaviors of all sorts.

Bullying victims drank only slightly more on average than non-bullied individuals (3.16 drinks daily compared to 2.59 drinks daily), but they engaged in more binge drinking too: 33 percent of victims compared to 29 percent of non-victims.

Smoking showed a much bigger gap. Half of those who had been bullied reported smoking, compared to only 39 percent of those who did not report being bullied.

But more disturbing what that being bullied as a child was linked to a higher risk of being victimized again when they were teens.

Bullied kids were about twice as likely to be victimized later compared to the other children. While 10 percent of bullied children experienced violence later, only 5 percent of non-bullied ones did.

Similarly, children who experienced bullying were more likely to be homeless, even if for only a few days, in their adolescence.

While only 0.9 percent of the non-bullied respondents had spent two more nights in a homeless shelter in the intervening five years, 3.3 percent of those who had been bullied did.

Long-Term Mental Health Issues Greater

There were also significantly higher rates of mental health disorders and eating disorders among those who had been bullied.

The participants in the study were not assessed using psychological or psychiatric tools to determine the state of their mental health. However, they were asked questions about their feelings, such as how often they felt calm, peaceful, depressed, happy and other emotions.

The average score of negative mental health was a little higher among those who had been bullied than among those who hadn't.

In addition, 1.4 percent of those who had been bullied reported having an eating disorder compared to 0.5 percent of those who hadn't been bullied. It is possible that weight issues were linked to the bullying, but this was not explored in this study.

Finally, respondents who had been bullied also reported higher rates of emotional or mental conditions that interfered with school or work. A total of 3.4 bullied victims reported these conditions, compared to only 1.8 percent of those who hadn't been bullied.

More Than Meets the Eye

The authors concluded that these long-term effects mean that the consequences of bullying are important to consider — they go beyond the immediate pain.

"Bullying victimization that occurs early in life may have significant and substantial consequences for those victims later in life," the authors wrote. "Thus, the adverse health consequences of victimization are much more far reaching than just immediate injury and trauma."

Because all these questions were self-reported, it is possible that children who felt they were bullied as kids may be more likely to report other problems.

However, there were multiple patterns that were seen across the large population. Further, even the perception of a problem can then become a problem, so bullying should be taken seriously if it is having adverse effects on a child.

What Can We Do About It?

As you've always heard, acknowledging the problem is the first step. But then it's time to take action. According to LuAnn Pierce, a social worker in Colorado, that first step can begin with ourselves. Children learn from adults.

"Adults have a lot of responsibility for what kids learn," Pierce said. "We teach them directly with our guidance and rules, but often forget they are watching and listening to us in our every encounter."

But the behaviors may not even be the activities you think. Sometimes it is the way adults express their everyday annoyances that teaches children unhealthy emotional habits.

"When adults are yelling at the referees (or the television set) about how stupid they are for making what is perceived as the wrong call, lying to the caller on the telephone, ranting about the idiots in traffic or speaking to their spouse or partner in a way that is demeaning, the kids are listening," Pierce said.

"It is this behavior they are most likely to mimic – our authentic, uncensored casual encounters. If they only paid attention to our lectures and 'do as I say, not as I do' speeches, many of us would have pretty well-behaved, well-adjusted kids," she added.

Pierce offers a list of brief, simple tips that adults can keep in mind to have a positive influence on children around them:

  • Change your own behavior.
  • Be a better role model.
  • Treat people kindly.
  • Stop berating people who make mistakes or do things differently than you.
  • Give others the benefit of the doubt.
  • Live a life that models the behaviors you want your child to emulate.
  • Keep your negative opinions and judgments to yourself.
  • Learn to live and let live.

And then she offers this last bit of advice: "Before you speak or act, ask yourself this: 'Is this something I want my child to say or do in front of my mother/our minister or priest/their teacher?'"

Reviewed by: 
Review Date: 
November 9, 2012