Research has consistently shown that the consequences of bullying are severe and range from impaired academic performance to increased risk for suicide. A smaller, but not less influential, line of research has examined the association between severe psychotic disorders (for example schizophrenia) and history of abuse. This research has shown that adults who experience psychotic disorder are more likely than non-affected adults to have a history of childhood trauma, including peer victimization. Could this mean that bullying may increase the risk for developing schizophrenia?

One way to start to examine this question would be to explore whether childhood victimization predicts the presence of early signs of psychotic disorders. This is the strategy employed by a team of British researchers who published their findings in this month’s issue of the prestigious Archives of General Psychiatry. This population-based study examined over 6,000  children at the ages of 8, 10, and 12 who were participating in a longitudinal study of human development in England. The authors measured the history of victimization at age 8 and 10 as predictors of psychotic symptoms at age 12. Psychotic symptoms included the presence of hallucinations (e.g., seeing or hearing things that are not there) or delusions (e.g., believing that people can read you thoughts).

The results:

  1. How common is bullying? 2,823 children, or 46% of the sample reported experiencing some type of bullying. 14% of the sample reported chronic victimization.
  2. Being victimized during middle childhood doubled the risk of experiencing definite psychotic symptoms in early adolescence (OR 1.94).
  3. The frequency of bullying was a key predictor of psychotic symptoms. Specifically, experiencing chronic bullying increased the risk of having psychotic symptoms by 252%.
  4. The type of bullying also played a role. While all types of bullying predicted an increase in the risk for psychotic symptoms, experiencing overt victimization (being beaten) combined with experiencing relational victimization (social exclusion, spreading rumors, etc) increased the risk of psychotic symptoms by 360% when compared to those who did not experience victimization.
  5. These findings remained stable after controlling for a number of potential explanatory variables, such as prior psychopathology, family adversity, and IQ.

Do these results indicate that victimization cause psychotic symptoms? No. The results are consistent with the hypothesis that victimization may lead to psychotic symptoms, but the nature of the study prevents us from making statements about causation. Although we use the terms “increase the risk for developing x”, this terminology is actually statistical terminology that refers to the probability for finding a specific outcome at a specific time. For example, in regards to the finding #2, being victimized in middle childhood increased the probability that the child would have psychotic symptoms at age 12. This does not address the question of “why or how” such probability is increased.

The authors correctly discussed this issue. Specifically, there is the possibility that children who were on path to developing psychotic disorders also engaged in behaviors during early childhood that made them more likely to be victims of bullying. In such a case, being victimized does not cause the psychotic symptoms. Instead, being victimized may have been the result of factors (such as extreme shyness) associated with later development of psychotic symptoms.

However, it is interesting that the authors found a “dose response”. That is, the more bullying the child experienced the higher the possibility of experiencing psychotic symptoms.  Although one could argue that those at greater risk for developing psychotic symptoms elicited more frequent and severe bullying episodes, dose response effects are usually observed mostly in situations whether the predictor (in this case bullying) has a causative role in the outcome (psychotic symptoms). So this ‘dose effect’ supports the notion that peer victimization may contribute to the development of psychotic symptoms in childhood and adolescence.
The reference: Schreier, A., Wolke, D., Thomas, K., Horwood, J., Hollis, C., Gunnell, D., Lewis, G., Thompson, A., Zammit, S., Duffy, L., Salvi, G., & Harrison, G. (2009). Prospective Study of Peer Victimization in Childhood and Psychotic Symptoms in a Nonclinical Population at Age 12 Years Archives of General Psychiatry, 66 (5), 527-536 DOI: 10.1001/archgenpsychiatry.2009.23ResearchBlogging.org

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11 Responses to Bully victims may be at risk for developing psychotic symptoms

  1. PennyBright says:

    Interesting. In my personal experience, I got bullied over my “differences”, which were the first expressions of my mental illness.

    I suspect that this study has cued on both correlation (I was weird, so I got bullied), and causation (my mental illness worsened because I was being bullied).

  2. Anonymous says:

    I was bullied on a daily basis growing up due to physical deformity. I had plastic surgery to correct it at age 13, but was still bullied daily until I graduated from high school. After that in college no one knew about it and I was treated normally. I was also very shy. Fortunately, I sought help about my shyness after I got out into the real world. While I did not suffer from any psychotic issues, it does seem to me frequency and kind of bullying has something to do with it. I was bullied daily, and maybe 30% of it physical, 70% verbal. Did not suffer from gossip or exclusion, did have small circle of friends, and bullies were not those I would have chosen to associate with anyway. Still, it is an interesting study, I count myself lucky that it did not impact me in a very negative way other than extreme shyness (which I’ve overcome) and unease in social situations. MOstly have overcome that, but at the oddest times it will manifest itself, also do not really enjoy malls or other crowded places – reminds me too much of hallways in school where most bullying occurred between classes.

  3. Brittany says:

    i have gotten bullied before also it was horrible i couldnt take it. but i wouldn’t do suicied at all. suicide will do nothing to you. my physical beating was 10% and my verbal beating 90%. i was sick and tired of it. i didn’t do anything but ignore them. but after all of that i went threw they suspended me from school for no reason at all.

  4. Penny Waller says:

    When a reader facebooks this, this tagline appears under the article heading, to be posted to the page. “A landmark study shows that victims of bullying are at an increased risk to develop psychotic symptoms.”

    Careful. I Love studies; however, correlations, though worth noting, are not necessarily cause and effect. ‘…May Cause…’ in your headline is accurate, but your facebook tagline ‘…shows…’ is misleading and undermines your point.

  5. Penny Waller says:

    (Btw, I understand that it ‘shows’ that it ‘may’… it’s still misleading. )

  6. Penny Waller says:

    Thank you for posting this. I am not surprised that relational aggression is specified as types in this study. Unfortunately, it is the least easy to spot in the classroom. Love this posting – I hope those who read the tagline on facebook actually click to read it in full.

  7. Great article Nestor, both of our young children are just finishing pre-school and it’s certainly been interesting watching their development and problem handling skills improve when dealing with other class mates. We had some ‘history’ of bullying when younger (which actually had a positive impact at the end of the day, although we have seen negative impacts) and set up an online multimedia resource to help children aged between 4-8 understand the impact of bullying before they head to school, and it appears to have worked well. I would be interested in your feedback.. http://www.bullyinginschool.org (no plug intended) more that we are keen to recieve feedback and suggestions for improvement.

    Thanks

    Kath

  8. AnthonyF says:

    As a male bullied in middle school, my perspective – my various quirks (which were noteworthy perhaps to another middle schooler) probably contributed to my victimization. But I believe that symptoms I continue to suffer in my 40′s are primarily due to damage from the peer relationships (as opposed to underlying common-cause issues). Perhaps boys are less likely to exhibit symptoms right away than girls… maybe because they perceive that its not socially acceptable to do so as boys. I know that I worked very hard to cover up the impacts on me, including hiding bruises from my parents. I still wear mainly long sleeve shirts to this day…

    It would be interesting to repeat this research in a different cultural setting with different gender norms, to see if the results were similar.

  9. Alex G S says:

    I am also interested in a variance of this study. I am divorced and remember seeing my son lovingly look up at his mum who was standing over him while she stated “you are nothing more than a nasty little boy who can do nothing except make a mess and break things”. I believe she fits 90% of the characteristics of a narcissist.

    I wonder how much of early rejection or abuse creates psychotic symptons. My son is having social difficulties and was diagnosed as HF aspergers and now only as having a learning disorder. His language is extremely advanced (runs in the family) but social skills are poor and focus is almost null.

  10. Thing is that not all kids (or adults) who are bullied have existing mental issues which make them a target. That accounts for some, but not all, in my experience growing up. What about those who are bullied because they have strengths. social skills/popularity and abilities that the bully envies, and it is their helpful, sensitive nature (to others) that causes them to be an easy target?

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