We were interested to read the two recent two research papers on the
psychological effects of bullying in schools (1, 2). Most studies to date
in this area have been cross sectional studies, often of school
populations, which have combined measures that estimate prevalence of
bullying with screening measures of anxiety, depression and self esteem
(e.g. 3) as well as measures of loneliness and self concept. It seems
likely that victims of bullying are more anxious and depressed than their
peers and are more likely to feel lonely and have low self esteem, whilst
bullies may be at increased risk specifically of depression (2, 3) and
suicidal ideation (3).
Recently interest has turned to the link between bullying in schools and
the increased probability of referral to child and adolescent mental
health services (4). Our own clinical impression is that when adolescents
who have been bullied present to our outpatient services, depression is
the diagnosis in a high proportion of cases. It is recognised that it is
currently difficult to prevent depression in adolescents (5) as well as to
prevent suicide and suicide attempts. Implementation of effective anti-
bullying strategies in schools may begin address these issues. The bullies
themselves present a particular challenge as they are not generally
recognised as being depressed and their behaviours, both anti-social and
self-harmimg, are often impulsive and may be associated with drug or
alcohol use. It is possible that anti-bullying strategies currently in
place in many schools are effective in reducing some types of bullying
more than others (3). More research into impact of existing strategies on
the different types of bullying which occur in schools might be helpful in
identifying any gaps and considering measures to address them.
Interagency efforts to address the problem of bullying in schools are
in fact already up and running. The 'Bullying Task Group' is an
interagency working group in Swansea with representatives from Education,
Child Psychiatry, the Police and Social Services, which has been set up
specifically to pool resources, ideas and experience and inform anti-
bullying strategies and policy at a local level. It remains to be seen
whether or not such initiatives prove beneficial or not.
Gill Salmon Senior Lecturer in Child and Adolescent Mental Health,
Welsh Institute of Health and Social Care, University of Glamorgan,
Pontypridd.
Anthony James, Consultant in Child and Adolescent Psychiatry,
Highfield Family and Adolescent Unit, Warneford Hospital, Oxford.
(1) Forero R, McLellan L, Rissel C, Baumann A. Bullying behaviour and
psychosocial health among school students in New South Wales, Australia.
BMJ 1999;319:344-8.
(2) Kaltiala-Heino R, Rimpela M, Marttunen M, Rimpela A, Rantenan P.
Bullying, depression, and suicidal ideation in Finnish adolescents: school
survey. BMJ 1999;319:348-51.
(3) Salmon G, James A, Smith DM. Bullying in schools: self-reported
anxiety, depression and self-esteem in secondary school children. BMJ
1998;317:924-5.
(4) Kumpulainen K, Rasanen E, Henttonen I, Almqvist F, Kresanov K,
Linna S, Moilanen I, Piha, J, Puura K, Tamminen T. Bullying and
psychiatric symptoms among elementary school-age children. Child Abuse and
Neglect 1998; 22:705-717.
(5) Harrington R, Clark A. Prevention and early intervention for
depression in adolescence and early adult life. European Archives of
Psychiatry and Clinical Neuroscience 1998; 248:32-45.
Rapid Response:
Bullying papers
We were interested to read the two recent two research papers on the
psychological effects of bullying in schools (1, 2). Most studies to date
in this area have been cross sectional studies, often of school
populations, which have combined measures that estimate prevalence of
bullying with screening measures of anxiety, depression and self esteem
(e.g. 3) as well as measures of loneliness and self concept. It seems
likely that victims of bullying are more anxious and depressed than their
peers and are more likely to feel lonely and have low self esteem, whilst
bullies may be at increased risk specifically of depression (2, 3) and
suicidal ideation (3).
Recently interest has turned to the link between bullying in schools and
the increased probability of referral to child and adolescent mental
health services (4). Our own clinical impression is that when adolescents
who have been bullied present to our outpatient services, depression is
the diagnosis in a high proportion of cases. It is recognised that it is
currently difficult to prevent depression in adolescents (5) as well as to
prevent suicide and suicide attempts. Implementation of effective anti-
bullying strategies in schools may begin address these issues. The bullies
themselves present a particular challenge as they are not generally
recognised as being depressed and their behaviours, both anti-social and
self-harmimg, are often impulsive and may be associated with drug or
alcohol use. It is possible that anti-bullying strategies currently in
place in many schools are effective in reducing some types of bullying
more than others (3). More research into impact of existing strategies on
the different types of bullying which occur in schools might be helpful in
identifying any gaps and considering measures to address them.
Interagency efforts to address the problem of bullying in schools are
in fact already up and running. The 'Bullying Task Group' is an
interagency working group in Swansea with representatives from Education,
Child Psychiatry, the Police and Social Services, which has been set up
specifically to pool resources, ideas and experience and inform anti-
bullying strategies and policy at a local level. It remains to be seen
whether or not such initiatives prove beneficial or not.
Gill Salmon Senior Lecturer in Child and Adolescent Mental Health,
Welsh Institute of Health and Social Care, University of Glamorgan,
Pontypridd.
Anthony James, Consultant in Child and Adolescent Psychiatry,
Highfield Family and Adolescent Unit, Warneford Hospital, Oxford.
(1) Forero R, McLellan L, Rissel C, Baumann A. Bullying behaviour and
psychosocial health among school students in New South Wales, Australia.
BMJ 1999;319:344-8.
(2) Kaltiala-Heino R, Rimpela M, Marttunen M, Rimpela A, Rantenan P.
Bullying, depression, and suicidal ideation in Finnish adolescents: school
survey. BMJ 1999;319:348-51.
(3) Salmon G, James A, Smith DM. Bullying in schools: self-reported
anxiety, depression and self-esteem in secondary school children. BMJ
1998;317:924-5.
(4) Kumpulainen K, Rasanen E, Henttonen I, Almqvist F, Kresanov K,
Linna S, Moilanen I, Piha, J, Puura K, Tamminen T. Bullying and
psychiatric symptoms among elementary school-age children. Child Abuse and
Neglect 1998; 22:705-717.
(5) Harrington R, Clark A. Prevention and early intervention for
depression in adolescence and early adult life. European Archives of
Psychiatry and Clinical Neuroscience 1998; 248:32-45.
Competing interests: No competing interests