Louisville Medicine Volume 69, Issue 4 | Page 18

TAKING A STAND AGAINST BULLYING
( continued from page 15 ) palpitations , chest pain , dizziness and disordered eating are often experienced by targets of bullying , singly or in combination .
For the bystanders , stress is related to witnessing the violence , and also fear of retaliation by the perpetrator if they intervene . Bystander support is most commonly exhibited by support of the target after the episode of violence but not during . 1 For the perpetrators , mental health issues often predate the violence , but committing the violent acts also negatively impacts their mental health . Suicidality among perpetrators of the violence is higher when compared to same age peers . More research is needed , but risk-taking behaviors such as drug and alcohol use , sexual activity and gun violence occur more in both the target and perpetrator groups of youth impacted by bullying . 1 Higher rates of carrying a weapon and of harm-inducing altercations are also associated with both perpetrators and targets of bullying . 5 Targeted interventions for the perpetrator must include providing mental health support , which is essential to the wellbeing of the perpetrator and to stop the violence .
Some youth are at higher risk for being the target of this violence . Evidence suggests that youth with developmental disorders such as autism , with physical disabilities , and those who are experiencing homelessness are more likely to be targets . Youth who are LGBTQIAS + also experience violence as targets of bullying more often than their peers . 1
Bullying and cyberbullying impact youth so significantly in part because of their social emotional developmental stages . Key social emotional development for youth includes establishment of close peer relationships , which bullying destroys . Youth also have less developed self-regulation and are susceptible to peer pressure , which are factors that can intensify bullying . Adult bullying and cyberbullying also have immediate and long-term negative consequences .
Many community partners in Louisville work to prevent and mitigate the negative consequences of bullying . School systems continue to struggle to meet the complex needs of youth who are targets , perpetrators and bystanders of bullying . Youth and families struggle to deal with the adverse impacts of bullying .
Adults play vital roles in preventing and supporting youth who are targets of this violence , as parents , family members , community members and medical professionals . Evidence based approaches have shown effectiveness in preventing youth violence , including bullying and cyberbullying . 6 We can identify and reach out to youth who are at high risk for being bullied , ask about their experiences and discuss what to do if they are bullied . We must carefully assess youth for bullying if they have physical or psychological symptoms suggestive of being a target , perpetrator or bystander . We should speak with family members and other adults about how common and dangerous bullying is , and how they can support the youth in their lives . 3 Talk tech : explain the specifics of cyberbullying to youth and families , to help them develop a plan to be safer . 4 We all play a role in breaking down the harmful myth that bullying and cyberbullying are “ just a normal part of childhood ” with no serious consequences .
My last patient of the day ( also hypothetical ) is a 17-year-old boy here for follow-up of obesity and high blood pressure . He reports that he has been doing well , exercising more and eating less fast food . On exam , he has shown a steady drop in his weight over the last six months and his blood pressure is now back in the normal range . His father says they are in a hurry because they have to go to court that afternoon . They are in court proceedings against a 16-year-old who has been bullying his son for the last two years at school and after school . The perpetrator has been known to the community as a bully for many years , since elementary school . Since the court proceedings started , the father states his son has been feeling better , and his grades have come up from C ’ s to A ’ s .
As a mother and a pediatrician , I am aware of the health issues of childhood and adolescence . If any other disease harmed 1 out of 3 kids , and caused significant morbidity and mortality , I ’ d do everything in my power to prevent it . This is exactly the situation we face with bullying and cyberbullying . It is highly prevalent and deadly . But far too many adults are woefully unaware of the magnitude of this crisis , much less how to address it . Each of us must ask more questions , listen to youth and support and fund the experts in our community who are doing this life saving work .
Learn more at www . stopbullying . gov and at www . aap . org The Resilience Project . And pay attention when a child acts differently and you keep wondering why .
Editor ’ s comments :
If only docs for adults would remember that cyberbullying hurts grownups too ! Despite the encyclopedia of preventive items we must address , take care to scrutinize the patient whom you cannot cheer up : the hangdog ones , the ones obsessed with a litany of minor , never-better complaints that make you grind your teeth , repeatedly . Have you asked them if anyone is being mean to them ? Haunting them online ? Try it : it may be the only thing that helps .
References
1
National Academies of Sciences , Engineering , and Medicine 2016 . Preventing Bullying Through Science , Policy , and Practice . Washington , DC : The National Academies Press .
2
Nixon CL . Current Perspectives : the impact of cyberbullying on adolescent health . Adolescent Health , Medicine and Therapeutics . 2014 ; 5:143-158 .
3
Gini G , Pozzoli T . Bullied Children and Psychosomatic Problems : A Meta-Analysis . Pediatrics . 2013 ; 132 ; 720-729 .
4
O ’ Keefe GS , Clarke-Pearson K , et al . The Impact of Social Media on Children , Adolescents , and Families . Pediatrics . 2011 ; 127 ; 800-804 .
5
Committee on Injury , Violence and Poison Prevention . Role of the Pediatrician in Youth Violence Prevention . Pediatrics . 2009 ; 124 ; 393-402 .
6
David-Ferdon C , Vivilo-Kantor AM , Dahlburg LL , Marshal KJ , Rainford N , Hall JE . A Comprehensive Technical Package for the Prevention of Youth Violence and Associated Risk Behaviors . National Centers for Injury Prevention and Control , Centers for Disease Control and Prevention .
Dr . Richerson , MD , FAAP is a pediatrician at Family Health Centers - Iroquois . ( non-member )
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