A team of Yale Medicine investigators is examining what causes bullying and how to stop it—to help kids on both sides of these conflicts.
What inspires bullies to act the way they do? What makes certain people likelier targets for bullying than others? Most important, how do we make it stop?
These questions are at the core of research under way at the Yale Medicine Child Study Center, where a team of investigators is working to untangle the interactions between bullies and their victims and redirect them in more positive ways.
The team includes Denis Sukhodolsky, PhD, an associate professor in the Yale Child Study Center and expert in anger and aggression in children. He and his colleagues are examining the biological and environmental forces that underlie the use of force or power to harm, humiliate or intimidate others. Their goal: to identify ways to help all children and adolescents navigate relationships more smoothly—and, ultimately, to make bullying as rare as possible.
This is urgent work: One in four children in the United States is bullied each year. Indeed, bullying is a public health crisis. Research links being bullied in childhood with a long list of physical and mental health challenges, including obesity, depression and higher risk of chronic disease. The adverse health effects of bullying may be more harmful, overall, than having been mistreated by an adult as a child, according to some studies. Others link a history of being bullied with lower lifelong income and a poorer quality of life.
Sukhodolsky agrees with those findings. “The magnitude effect of bullying on anxiety, depression and low self-esteem is remarkably high,” he says—something that is true for bullies and victims alike. “Bullies feel the negative effects of their behavior,” he says, citing as examples confusion, embarrassment and social isolation. Many bullies do not know how else to behave, he says. “Nobody in their lives has explained to them what it means to hurt another person’s feelings.”
Two sides of the same coin
Using evidence-based personality measurement tools, Sukhodolsky and his colleagues have found that many bullies score high in “callous/unemotional” traits. The term is neither a value judgment nor pejorative. Rather it describes an inability to recognize signs that another person is upset. Such people, says Sukhodolsky, are “impaired in their ability to perceive another person’s distress.” These kids tend to have difficulties with anger management and aggression. Many have had life experiences that probably contribute to their behavior.
Researchers using functional magnetic resonance imaging (fMRI) have found brain differences in children with a tendency to bully others. Other studies have found that some parenting styles and early trauma can impair social and emotional development.
A lack of social awareness is a trait that bullies often share with their victims, who typically have their own interpersonal difficulties. The Child Study Center offers individual psychotherapy to children and teens, including those who bully and those who are bullied. One example might be a child who is mocked because he has unappealing habits, such as picking his nose. When treating this bullied child, therapists work on their social skills and awareness. Sometimes these children lack appropriate role models at home or have mental health challenges such as autism, tics or attention-deficit/hyperactivity disorder (ADHD). Often they are not even aware that some of their behaviors are seen as inappropriate or may bring unwelcome attention.
Kerry: A case in point
The experiences of “Kerry,” (names changed to protect privacy) a tall 17-year-old who plays on her Connecticut high school’s soccer team, illustrate how this can play out. While Kerry has ADHD and anxiety, “Elaine,” her mother, describes her daughter as happy and social. Kerry sees herself as popular, her mom says, but in reality “she has had real bouts and instances of being bullied and, unfortunately, of her being the bully” since she was very young.
Elaine says that Kerry is a “funny, endearing and outgoing kid,” but she struggles with anger and is often insensitive to others’ feelings. Says Elaine: “She goes from 0 to 60 when she doesn’t get what she wants.” And: “She crosses the line and has no idea she has done anything wrong.”
Kerry takes medication for ADHD and has seen therapists for more than a decade. But she made little progress until recently, when she began to work with the Child Study Center as part of a clinical trial examining the efficacy of cognitive behavioral therapy (CBT) for irritability and behavior problems, including bullying. “For the first time, Kerry is accepting the therapy and we’re seeing real progress,” Elaine says.
In addition to weekly counseling sessions, Kerry can call the Child Study Center for support or if questions or problems arise. Several months into the program, Kerry is learning to contain her temper, her mom says, and she interacts in more socially acceptable ways with her peers. “She’s getting along much better with her coach, has a part-time job and is focusing on going to college,” Elaine says. “I think she feels more secure and more in control of her destiny. She’s making real strides.”
What works for the bullied works for the bully
People who hear about bullying often give—and get—the advice to “just ignore it,” but this often is not the most beneficial option, experts say. At the Child Study Center, treatment begins with a comprehensive psychological assessment that includes not only interviews with the child and parents but also conversations with teachers, school administrators and others involved in the child’s life.
In addition to addressing underlying issues related to mental health, such as ADHD or anxiety, “treatment” typically takes the form of cognitive behavioral therapy, which is intended to solve specific problems by changing problematic thinking and behaviors. In the context of bullying, we set specific goals and, with the help of the parents, work on strategies to help the kids learn how to manage their anger and aggression.
Kids who are being bullied are encouraged to look at how their reaction may fuel the bully’s behavior, including examining the response and if it might make further bullying more likely. Furthermore, we address social skills, and things that happened before, during and after a specific incident and talk about what can be done to improve the situation.
Many of the children who may act as bullies have long histories of disruptive behavior, experts say, which are often rooted in difficulties in their lives or mental health challenges such as ADHD. The goal is to help children and teens become aware not only of what sets off their behaviors but also to predict what happens afterward—a strategy that leads to making better choices.
Friendships, not fights
Sukhodolsky emphasizes that there is no single or simple solution to bullying but says there has been progress since the issue came into focus in the early 1990s, after a number of teen suicides. Today, several states have laws aimed at preventing bullying, he says. “Schools are now mandated to have an action plan and to offer services for kids who are either at risk of being bullied or at risk of being the bullies,” he says. And it seems to be helping. Data show that reports and rates of bullying are beginning to decline.
The best solutions are those that address the developmental difficulties and learning differences among children, Sukhodolsky says. Those require support from schools and families, he says, noting that children might be encouraged to discuss social difficulties (such as those that accompany autism) and to help one another. For example, he says: “A child who is on the spectrum might be teamed with a socially competent child to spend time together at lunch or on the playground. One could help the other learn the social ropes.”
The best way to beat bullying, he says, is by helping people learn to accommodate one another’s differences. “You can’t replace bullying with isolation,” Sukhodolsky says. “You have to replace it with friendships.”