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Alarming upward trend in bullying: Local study

24 Oct 2021

  • One-third of children attending general paediatric and mental health clinics report being bullied
BY Ruwan Laknath Jayakody  An alarming trend is seen in that one third of children attending general paediatric, non-mental health settings, as well as in mental health settings, report bullying, a local study found. Therefore, local psychiatrists and psychologists called for community based studies to be conducted to establish the prevalence of bullying among children.  This finding and suggestion was made in an original paper on the “Prevalence and factors associated with bullying in children attending mental health clinics: A case control study” which was authored by S. Karunaratne (Registrar in Psychiatry), Prof. H. Perera (attached to the Colombo University’s Medical Faculty’s Psychological Medicine Department), W. Jayawardana (Senior Registrar in Psychiatry), A. Prabath (Registrar in Psychiatry) and C. Jeewandara (Lady Ridgeway Hospital for Children’s Medical Officer in Psychiatry) and published in the Sri Lanka Journal of Psychiatry’s Second Volume’s Second Issue in January 2012.  Bullying in children is defined by studies (K. Rigby’s “Bullying in schools and mental health of children” and P.K. Smith’s “Bullying: Recent developments”) as aggressive behaviour that is intentional and repeated against a victim who cannot readily defend themselves, and involves the systematic abuse of power and exploitation. Karunaratne et al. point out that bullying is thought to be highly prevalent in children. It is reported that fighting associated with bullying is reported more in children in lower grades and is less so with children in older age groups. Various methods of bullying are identified and categorised as direct (physical and verbal bullying) and indirect (isolating the child and causing the child to be a victim of rumours).  All bullying is known to cause significant and sometimes long lasting mental health problems in victims, which, according to D. Wolke, S. Woods, L. Bloomfield and L. Karstadt’s “The association between direct and relational bullying and behaviour problems among primary school children” includes hyperactivity, conduct-related problems and difficulties related to peer relationships.  Further, it is reported that the experience of bullying is high among children attending mental health services. In “Genetic and environmental influences on victims, bullies and bully victims in childhood”, H.A. Ball, L. Arseneault, A. Taylor, B. Maughan, A. Caspi and T.E. Moffitt found that there are certain temperamental and environmental risk factors that have been identified as making children more vulnerable to bullying.  Hence, Karunaratne et al. conducted a descriptive analytical study at a tertiary care children’s hospital in which the study sample was selected from those attending specialist mental health clinics during January 2011 and included all children attending as new referrals and those on follow up visits. Per D.F. Hay, A. Payne and A. Chadwic’s “Peer relations in childhood”, children with an intellectual disability, a physical disability and autism were excluded.  A structured questionnaire was administered to the child and the accompanying parent by an interviewer. The questionnaire focused on the type of the bullying experience using a checklist of known methods of bullying, the presenting mental health problem, any history, mental state and diagnosis arrived at from the clinical evaluation, and the temperamental characteristics of the child adapted from a standard classification.  Interestingly, while this study relied entirely on verbal reporting by parents and children on direct interviewing, according to P. Quinn’s “Bullying in schools: Detection in an adolescent clinic practice compared with questionnaire survey”, this method of verbal reporting based on direct interviewing detected underreporting (recall bias and the interviewing of only a parent and a child may have limited the identification of adult perpetrators within the family) while a higher prevalence of bullying was elicited when data collection was done via postal questionnaires.  For the purpose of this study, the experience of bullying was defined as intentional negative behaviour towards the child by another child including siblings or a known adult including those who are not family members, on more than two occasions during the previous six months, which caused substantial distress to the child. It was also ascertained whether the child who reported bullying had also acted as a bully in addition to being a victim. The control group was randomly selected from children including new referrals and those on follow up visits, attending general paediatric clinics during the same period. They were matched for age and sex and similar exclusion criteria were applied.  A total of 395 children participated in the study including 177 children in the five to 12 years age group (mean [average] and median [the middle number in a data set] ages were nine years), the majority of whom were male (116) while the control group included 218 children in the same age group (mean age being nine years and the median age being eight years), with the majority once again being male (131). Both the study and control samples were similar in terms of their socio-demographic dimensions such as the family income and parental educational level. Children attending mixed gender schools from the study group were 74%, and in the control group it was 71%.  In the total sample, bullying was reported by 141 children, of whom 69 were attending mental health clinics and 72 were from the control group. Among the total participants of the study, 69 were only victims of bullying, while 62 admitted to being a bully as well as a victim. The total duration of the bullying experience was more than one year in 78, while 21 experienced bullying for six months to one year.  Of the children who were bullied, 77.3% were male and 22.7% were female. The prevalence of bullying among males in the mental health clinic sample was 46% while in the general paediatric clinic sample, it was 42%. The prevalence of bullying among females in the mental health clinic sample was 26% while in the general paediatric clinic sample, it was 18%.  The methods of bullying that were reported were both direct (assault, spitting, kicking, stealing belongings, name calling, teasing, threatening, and using abusive language) and indirect (isolating the child, making false complaints against the child and preventing the child from interacting with others). However, modern methods of bullying such as cyber bullying and sexual bullying were not reported. Being subjected to physical methods of bullying was reported by 100 children compared to verbal bullying reported by 103 children, and some being bullied by both methods. Isolation of the victim was experienced by 25.  Of those who were bullied, 100 were bullied by a classmate while other perpetrators were older peers (20), siblings (17) and known adults including teachers (10). Bullying mostly occurred in a school setting (129) while other settings included the home (10) and in the neighbourhood. A percentage of victims of bullying (7%) also reported being an observer of others being bullied whereas none from the control group reported this behaviour.  In describing the temperament of the victim of bullying, the parents identified them as timid and shy (in 72). Those who were easily angered numbered 70. No temperamental difficulties were identified in 47.  The victims of bullying adopted different methods in response to bullying which included retaliation (68), the avoidance of the bully (31) and complaining to a parent or teacher (nine).  In the mental health clinic sample, behavioural problems (hyperactivity, irritability, aggressive behaviour towards others, disruptive behaviour in the classroom and outbursts of anger) were elicited in 41 and school related difficulties (academic underperformance and refusal to attend school) were elicited in 45. In the paediatric clinic sample, behavioural problems related to bullying were elicited in 21 and academic problems were elicited in 36. Other reported problems included somatic complaints, the refusal of food, bed wetting and social withdrawal.  In the total sample, 35.7% of the children reported experiencing bullying. A higher proportion of mental health clinic attendees (39%) reported bullying experiences compared to the paediatric clinic attendees (33%); however, this was not statistically significant. Also, the frequency of being bullied was significantly higher among mental health clinic attendees with many (22%) experiencing bullying on a daily basis. Behavioural problems associated with bullying were significantly higher in the mental health clinic sample. Male children were more likely to get bullied with a male to female risk ratio of 2:1. The prevalence rate found in this study is higher than most reported.


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