In a search for something entirely different, I came upon this and thought you might find it of value.
AMA recognizes bullying as public health problem
Abuse of children by other children may contribute to violent behavior, addiction, criminal activity and other ills of society.
By Victoria Stagg Elliott, AMNews staff. July 9/16, 2001.
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Chicago -- Nearly every report of extreme violence in a school setting -- most notably the massacre at Columbine High School in Littleton, Colo., two years ago -- has been linked to bullying. The perpetrators, usually former victims, turn violent and take revenge -- delineating a tragic cycle in which a bully's physical intimidation leads to tragic consequences.
Public health advocates, however, are increasingly recognizing that the death toll from these incidents is just the tip of the iceberg in terms of negative implications -- both for those victimized and those who victimize.
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Bullying is being looked at as a factor in many of society's ills, including smoking, underage drinking, mental illness and drug addiction. It's also being seen as the root of more violent behavior, particularly among adults.
"Terrorism, violence and other acts are all related to one another -- including domestic violence and child abuse," said Mary Anne McCaffree, MD, a pediatrician and Oklahoma delegate from Oklahoma City. "Bullying is an issue that needs to be addressed."
Since Columbine, several medical organizations have increased the attention paid to bullying. Most recently, the American Medical Association announced that it would address bullying as part of its anti-violence program.
The Association also will support research on the subject and prepare materials that will help people and institutions deal with the issue, according to a new policy adopted by the AMA's House of Delegates last month in Chicago.
Part of the challenge, though, is to overcome the common view that bullying is a normal part of childhood and adolescence.
Quantifying the consequences
"The prevailing thought in schools is that this is the way the world works," said Kevin Fleming, MD, an alternate delegate from the American Medical Directors Assn. and internist from Rochester, Minn. "It is our role as the AMA to start looking into this issue and bring it forth to the schools."
Specifically, studies are increasingly showing that bullying can have lifelong consequences that are not normal.
The impact can range from lower grades to an increased risk of suicide. Several studies have found that bullies and those bullied do less well academically and are more likely to experience psychiatric problems, including depression, anxiety and psychosomatic illnesses.
In addition, a study published in the April 25 issue of the Journal of the American Medical Association examined bullying among sixth through 10th graders and found that bullies were more likely to drink and smoke. Other research has suggested that bullies are more likely to grow to abuse their spouses and are more likely to engage in criminal behavior.
"People who are bullied often become bullies," Dr. Fleming said. "People who are bullied can become killers. People who are bullied may kill themselves. We wonder where spousal abuse comes from. This is where it comes from."
And part of the reason it is regarded as normal is because it is an incredibly common experience.
The JAMA study, which is the largest to date and involves more than 15,000 students, found that 10% of those surveyed had been bullied. Thirteen percent said they had bullied others, and 6% said they had been both the victims and perpetrators.
"Being bullied is not just an unpleasant rite of passage through childhood," said pediatrician Duane Alexander, MD, director of the National Institute of Child Health and Human Development, in a statement issued just after these findings were published. "It's a public health problem that merits attention."
Although research is starting to emerge about bullying's prevalence and consequences, there are still questions about how to stop it. Studies in Europe have found that school-based programs to raise awareness, increase adult involvement and supervision, set clear rules against bullying and provide support for those bullied can cut incidents by one-third to one-half. Studies have yet to be done in the United States. The AMA Council on Scientific Affairs will prepare a report on possible interventions to present at a future meeting.
One possible intervention, according to several AMA delegates, is the use by youth organizations of nondiscrimination policies -- including sexual orientation.
"Exclusion tends to validate bullying behavior on the part of others," said Michael Macko, MD, president of the Rhode Island Medical Society. "Exclusionary policies are wrong."
To address this, the AMA will ask youth organizations to reconsider any policies that exclude people on the basis of sexual orientation, according to a new policy advanced by Dr. Macko and adopted at this year's meeting.
Although not specifically mentioned in the resolution, the policy is meant to target the Boy Scouts of America, which has long had a policy banning homosexuals.
The move by the AMA is being seen as a means of addressing the difficulties of gay and lesbian youth who, according to several studies, are more likely to be victims of violence and are at a higher risk for suicide. One of the objectives of Healthy People 2010 is to lower the suicide rate of gay and lesbian youth.
"Homophobia is a health hazard," said Thomas L. Hicks, MD, an alternate delegate from Florida and family physician from Tallahassee. "If the physicians of the AMA are dedicated to the health of America, then we should get behind this."
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ADDITIONAL INFORMATION:
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JAMA abstract, "Bullying Behaviors Among U.S. Youth, Prevalence and Association With Psychosocial Adjustment", April 25 (vol. 285, no. 16) (http://jama.ama-assn.org/issues/v285n16/abs/joc01746.html)
Bullying fact sheet from the American Academy of Child and Adolescent Psychiatry (http://www.aacap.org/web/aacap/publications/factsfam/80.htm)
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Copyright 2001 American Medical Association. All rights reserved. |
