Bullied children at high risk of developing psychotic symptoms
Researchers in the UK and Australia have found that children who are chronically or severely bullied at school are up to four times more likely to develop psychotic-like symptoms (such as hallucinations, delusions or disorganised speech) by the time they reach early adolescence, and twice as likely to develop psychotic symptoms by early adolescence, than children who are not bullied. The results are published in the journal Archives of General Psychiatry. According to Dieter Wolke, Professor of Developmental Psychology at the University of Warwick in the UK, all children experience conflict occasionally, such as teasing and play-fighting with children of the same strength or with friends; they usually learn how to deal with conflict through the experience. Bullying is different. 'When we talk about bullying victimisation,' said Professor Wolke, 'it is repeated, systematic and [is] an abuse of power with the intent to hurt. Children who become targets have [fewer] coping skills, show a clear reaction (they cry, for example) and have few friends who can help them.' The study, led by Professor Wolke, was unique in that it followed a large cohort of 6,437 children in southwest England from pregnancy until around age 13. The cohort was considered to be a representative sample of children in the UK. Unlike previous studies, in which adults with psychotic symptoms or schizophrenia were interviewed about their past experiences, the current study interviewed the subjects regularly and also collected information from their parents and teachers. This reduced the chance of their data being biased. Starting at the age of seven and a half, the children were interviewed in person every year, and took psychological and physical tests. Parents completed postal questionnaires about their child's development and experiences. When the child reached 13 years of age, they were interviewed about experiences of psychotic symptoms, for example hallucinations or delusions. The researchers found that there was a direct relationship between how often the victim was bullied or how severe the bullying was and their chance of developing psychotic symptoms. They also found that although some children (who are very sensitive or withdrawn, for example) seem to be more prone to systematic exclusion or repeated verbal or physical attacks by their peers, the experience of bullying itself makes these children more prone to mental health problems. Interviews with the children revealed that 13.7% had experienced continual bullying over a number of years. Severe victimisation, where children are both physically and emotionally bullied, was reported by 5.2% of the children at age 10. The children who suffered physical or emotional bullying were twice as likely to develop psychotic symptoms by early adolescence as children who were not bullied. Children who experienced sustained bullying over a number of years had a much higher risk (up to four times) of developing psychotic-like symptoms. 'This indicates that adverse social relationships with peers is a potent risk factor for developing psychotic symptoms in adolescence and may increase the risk of developing psychosis in adulthood,' said Professor Wolke. The findings were not changed when other factors, such as family history of schizophrenia, were considered. 'Being a victim of bullying has a variety of documented adverse outcomes including physical health problems, increased anxiety and depression, school avoidance and in the most severe cases, suicide,' explained Professor Wolke. 'Even when we controlled for pre-existing other psychiatric problems, we showed that being victimised also can have serious effects on altering [the person's] perception of the world, such as hallucinations, delusions or bizarre thoughts, where the person's insight [into] why this is happening is reduced. 'A major implication is that chronic or severe peer victimisation has non-trivial, adverse, long-term consequences,' the study concludes. 'Reduction of peer victimisation and of the resulting stress caused to victims could be a worthwhile target for prevention and early intervention efforts for common mental health problems and psychosis. Clinicians should be aware of the importance of adverse interpersonal experiences with respect to psychosis, be adequately trained to deal with such experiences, and routinely ask users of mental health services about such events.'
Countries
Australia, United Kingdom