'But that’s ancient history. . .'

Most weeks there are a few interesting news items that spark an idea for the weekly posting – but this week there’s a superabundance of material in a supplement to the Journal of Adolescent Health’s July edition. The supplement focuses on the manifold aspects of bullying on the health of the bullied, the bullying and those who witness it.

Societal attitudes towards bullying have been transformed in recent years.  It used to be taken for granted; it was ‘part of growing up’, something that kids did, and ‘no big deal’. In some ways it was accepted the way racial segregation or sexism or discrimination against homosexuality was widely accepted until the 20th century — ‘That’s just the way things are.’ Only after a few courageous individuals began making the point these “things” were wrong on many levels and destructive in ways that people never imagined, did we even begin to reject the acceptance. I think that same process is now beginning with bullying.

The articles in the referenced supplement address the problem from many vantage points.  The following quote from the lead editorial, “Bullying and Suicide: A Public Health Approach,” is particularly important:

Involvement in bullying can also have long-lasting, detrimental effects months or even years after the bullying occurs. Young people who are bullied are more likely than uninvolved youth to develop depression and anxiety and report abdominal pain and feeling tense over the course of a school year.

One study examining the impact of bullying victimization of those who were between 9, 11, and 13 years of age when they were victimized found, that over a 7-year period, youth who were bullied were more likely to develop generalized anxiety and panic disorder as adults while bully-victims were more likely to subsequently suffer from depression, panic disorder, and suicidality.

Another longitudinal study found that those who were perpetrators of bullying at age 14 were more likely to receive a diagnosis of antisocial personality disorder, to have low job status at age 18 years, and to use drugs at ages 27 – 32 years.

Footnotes in original text are omitted but can be found here.

So why is this interesting to us at PRMS?  It seems to us that this research adds another element to taking a good psychiatric history of a patient you’re seeing for the first time, and perhaps questioning existing patients  about their history of bullying.  Given the mounting evidence that many patients’ ‘ancient history’ can continue to twist their lives for years afterwards, we would suggest that it cannot be ignored.

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