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Dr. Harold Koplewicz

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The Psychiatric Issues Behind Cyberbullying

Posted: 07/28/10 08:00 AM ET

Children and teens want to be normal, and when they struggle with psychiatric issues, they tend to have difficulty "fitting in." Differences make these kids vulnerable to bullying experiences and attendant emotional turmoil. And those who experience cyberbullying may be at even higher risk for mental health problems. A study forthcoming in the Archives of Suicide Research found that youth who have been victims of cyberbullying are almost twice as likely as victims of traditional bullying to have attempted suicide.

Whatever more research can show us, it's clear that to effectively deal with cyberbullying, we need to address the psychiatric problems that both motivate it and are exacerbated by it.

Peer aggression is never normal. While it doesn't cause a child to develop a psychiatric disorder, it is a red flag for preexisting mental health problems and can contribute to depression, low self-esteem, irritability and feelings of hopelessness. Bullies usually have problems with impulse control and hyperactivity. Many of them have Attention-Deficit/Hyperactivity Disorder (ADHD) and a co-occurring conduct disorder.

Victims, on the other hand, are more likely than their peers to feel low self-worth and experience depression. Their feelings of low self-worth can be compounded when any form of bullying occurs, but their emotional response to cyberbullying may be especially devastating.

Since cyberbullying occurs in virtual space (and without physical contact), victims can experience the double anguish of being powerless to stop their harassment and unable to prove who's harassing them. As for cyberbullies, they can be more vicious, their feelings of empathy minimized, since they don't see the impact of their meanness.

Amid the whirlwind of complex questions on how to deal with cyberbullying, many parents feel helpless, and schools are unsure where they fit in the solution. The problem can seem too large and bewildering for individuals to address.

But we can all do something about this problem, first by being more vigilant about our children's mental health (a preventative step that may sound obvious in the context of this article, but as a matter of public interest, child mental health has repeatedly received too little, too late).

Fewer than half of the 15 million children and teens with psychiatric disorders in this country ever receive clinical attention, and while approximately one in five teens experiences depression before adulthood, less than 33 percent of depressed teens ever get treatment. Depressed teens, whose symptoms usually include extreme irritability and rejection sensitivity, are the most vulnerable to cyberbullying -- and they are 12 times more likely to commit suicide.

Each of us can make an enormous difference simply by watching for signs of mental health problems in our children and teens. Behavioral changes are the most easily recognized sign of trouble and include angry and tearful outbursts, new patterns of eating and sleeping, a loss of interest in activities once enjoyed, a sudden change in social groups or clothing style and withdrawal from family and friends.

Parents should also talk to their children about normal emotional and physical changes. This conversation should be ongoing and encourage self-respect, self-acceptance, and empathy toward others. Parent-child communication is especially important during the middle school years, because at that time, more than any other, a child's identity and self-worth revolves around peer relationships.

For any child, being "normal" ultimately means feeling good about one's self. It means having the ability to resist peer aggression, make good choices, and acquire independence. We certainly need new anti-bullying policies to help keep our kids safe, but with respect to cyberbullying--and most other pressures kids confront--we can make the most significant progress by first prioritizing children's mental health.

Harold S. Koplewicz, M.D.
President, The Child Mind Institute
Director, Nathan S. Kline Institute for Psychiatric Research
http://childmindinstitute.com

 
 
 

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Children and teens want to be normal, and when they struggle with psychiatric issues, they tend to have difficulty "fitting in." Differences make these kids vulnerable to bullying experiences and atte...
Children and teens want to be normal, and when they struggle with psychiatric issues, they tend to have difficulty "fitting in." Differences make these kids vulnerable to bullying experiences and atte...
 
 
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GinaPera
03:04 PM on 08/09/2010
Thank you, Dr. Koplewicz, for this important article and for your years of devotion to the care of children with psychiatric conditions.

Gina Pera, author
Is It You, Me, or Adult A.D.D.?
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organicconnect
05:22 PM on 07/31/2010
It always worries me when a psychiatrist gets involved with an issue like this. This is a profession notorious for a lack of any results whatsoever, while somehow maintaining an air of authority. We are living in a culture where the guidelines of proper behavior among humans is taught by violent video games, movies and the evening news. Add to this a plethora of drugs pumped into schools through the collusion of psychiatry and BigPharma. There are effective programs to combat bullying in any form. The most notable is the Happy House Good Choices program. It teaches children quite simply how to make their OWN good choices in life. Far from the psychiatric datum that "man must be restrained from his harmful impulses," this program works extremely well by addressing the real-world fact that the vast majority of people are basically good. http://goodchoicesprogram.org
11:03 AM on 07/29/2010
Hello from Montana:

Thanks for this insightful article. I am doing a book on cyberbullying right now and it is amazing to interview not only those who have been bullied but the bully too. Somehow they have not been taught empathy, which is an important part of a full life.

Judy H Wright aka Auntie Artichoke, family relationship author and keynote speaker
http://www.cyberbullyinghelp.com
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GinaPera
03:09 PM on 08/09/2010
Judy,

Yes, it is important to teach children about compassion and reciprocity and to point to the importance of empathy.

But, make no mistake, some people (including children) suffer from brain conditions that reduce empathy -- that is, a brain-based ability to empathize and act on those feelings of empathy.

With ADHD, for example, children with untreated symptoms are more likely to BULLY as well as to be BULLIED.

In some people with neurocognitive disorders, medical treatment can improve their ability to act on empathic feelings. But in others, such as those on the autistic spectrum, empathy can only be approximated with guidelines on courtesy and reciprocal behavior.
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BlackJAC
It's better to be a black king than a white knight
08:32 AM on 07/29/2010
Whose benchmark is being used to define "normal?"
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HUFFPOST SUPER USER
chardonnay48
10:15 PM on 07/28/2010
You could just turn off the computer and go outside. Hence no cyberbullying.
10:44 AM on 07/29/2010
It is important to ensure that young people spend time away from these technologies--get outside, get together in person with friends. But to expect to resolve the challenge of cyberbullying by telling the younger generation "no technologies" is not reasonable. They are and will continue to be the "net generation." Frequently they do not report these incidents because they fear adults will overreact and "excommunicate" them.
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HUFFPOST BLOGGER
Vivian Diller, Ph.D.
Psychologist and author of "Face It: What Women Re
05:46 PM on 07/28/2010
This is an important topic that needs to be better understood by parents who are ultimately responsible for teaching their children (with or without clearly diagnosed psychiatric problems) good values and proper behavior toward others. Thanks Dr. Koplewicz for your insightful article.
HUFFPOST SUPER USER
healthy blogging
05:02 PM on 07/28/2010
Bullying in any form whether physical intimidation and fighting or the psychological taunting that takes place in Cyberspace have long term psychological effects on the target of such harassment. Although many bullies may suffer from mental illness, it's also important to acknowledge that there are also people who revel in cruelty and mistreatment of others. They bully others out of sheer enjoyment. There are tell-tale signs of bullying behavior and indicators for those who are the targets of bullying.

http://www.livingfithealthyandhappy.com/2010/05/bullies.html

Moreover this behavior if left untreated will worsen over time. Indeed adults also engage in bullying behavior and mistreat co-workers, neighbors, etc. Parents, educators, health care professionals and the general public must work together to bring an end to bullying and harassment in all of its forms. All people deserve the right to be treated with respect and dignity.

-healthy_blogging

Published daily, "Living Fit, Healthy and Happy" is a family-friendly health and wellness resource website with articles on fitness, anti-aging, obesity, diabetes, eating disorders, cardiovascular and respiratory health, mental illness and many other health related issues. There's always something for you at "Living Fit, Healthy and Happy".

Living Fit, Healthy and Happy
The website for people who are SERIOUS about leading a healthy life!

http://www.livingfithealthyandhappy.com
04:26 PM on 07/28/2010
I was thinking something was wrong about the data cited in this article and realized I have a copy of this forthcoming study. This study is by my colleagues Sameer Hinduja and Justin Patchin - who are very excellent researchers, making an incredibly valuable contribution to this field. The findings of this study are not as Dr. Koplewicz stated. Here from the actual study:

"(T)raditional bullying victims were 1.7 times more likely and traditional bullying offenders were 2.1 times more likely to have attempted suicide than those who were not traditional victims or offenders. Similarly, cyberbullying victims were 1.9 times more likely and cyberbullying offenders were 1.5 times more likely to have attempted suicide than those who were not cyberbullying victims or offenders."

Thus relatively similar trends related to bullying and suicide - traditional or online - offender or target.

It is exceptionally important that we understand that the youth who engage in harmful behavior are also troubled and need our assistance. Too often, the disciplinary responses to bullying situations fail to recognize this. Simply suspending a student who has engaged in aggressive behavior--without getting to the root cause of such behavior--will not remedy the overall situation.

Comments related to the importance of witness actions are very sound. Electronic aggression is most often occurring in environments where there are no responsible adults. Providing young people with skills in resolving interpersonal conflict can assist in empowering peers to effectively intervene -- or report to an adult.
10:09 PM on 07/28/2010
Thanks for clarifying the actual empirical data. Citation? "Archives of Suicide Research" (as
noted by Dr. Koplewicz)?

I take issue with scientific writing which attempts to boggle the mind with superlatives,
e.g. your 4th paragraph. "It is EXCEPTIONALLY important. . . ." Wouldn't "especially
important" be more accurate? Why is an "understanding" of "exceptional" importance?
10:40 AM on 07/29/2010
Bullying, Cyberbullying, and Suicide 
Authors: Sameer Hindujaa; Justin W. Patchin
Published in: Archives of Suicide Research, Volume 14, Issue 3 July 2010 , pages 206 - 221
http://www.informaworld.com/smpp/content~content=a924722304~db=all~jumptype=rss

Abstract: Empirical studies and some high-profile anecdotal cases have demonstrated a link between suicidal ideation and experiences with bullying victimization or offending.
The current study examines the extent to which a nontraditional form of peer
aggression—cyberbullying—is also related to suicidal ideation among adolescents.
In 2007, a random sample of 1,963 middle-schoolers from one of the largest school
districts in the United States completed a survey of Internet use and experiences.
Youth who experienced traditional bullying or cyberbullying, as either an offender
or a victim, had more suicidal thoughts and were more likely to attempt suicide than
those who had not experienced such forms of peer aggression. Also, victimization was
more strongly related to suicidal thoughts and behaviors than offending. The findings
provide further evidence that adolescent peer aggression must be taken seriously both
at school and at home, and suggest that a suicide prevention and intervention component is essential within comprehensive bullying response programs implemented in
schools.

Note one of the difficulties in this area is the incredible delay between conducting research and the publication of findings in an academic journal.
This user has chosen to opt out of the Badges program
04:05 PM on 07/28/2010
What's your take on the "commentary bullying" that takes place regularly on these posts? (I guess it would also be called "right bashing") What are the psychiatric implications of this behavior?
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02:43 AM on 07/29/2010
Oh come on, no comparison!
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BlackJAC
It's better to be a black king than a white knight
08:38 AM on 07/29/2010
Such a condition would be called "political correctness" by the same people who call it "right bashing" had their political opposite numbers claimed it was "bashing."
02:43 PM on 07/28/2010
"Peer aggression is never normal"? I'm sure people have been bullying longer than people have been psychiatrists.
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02:49 AM on 07/29/2010
Doesn't make it right!
11:41 AM on 07/29/2010
Being wrong doesn't make it normal.
11:41 AM on 07/29/2010
Being wrong doesn't make it *abnormal*
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Paros
01:46 PM on 07/28/2010
I find it interesting that you identify children with ADHD and co-morbid disorders as the pool of bullies. My child who has ADHD and is quite sensitive has been the object of cruel bullying by a group of boys in his classroom. One of them used my sons reactivity and impulsivity against him by provoking him and them pretending that he was the victim. This happened over and over through the year.

How did I know? Because I had other children tell me on several occassions.

I know you are writing about cyber bullying but I would argue the that culture of bullying begins before the children move to the cyber arena. We live in an upper-middle class suburb and the unkindnesses are not reserved to the children, their parents participate in it as well in a cloaked form by being selective about whom they and their children will speak to and be allowed to interact with. It is quite an astonishing thing to witness.
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require accountability
02:05 PM on 07/28/2010
Thank you for sharing that. Children with ADHD certainly can have many difficulties on both sides of the bullying issue. I think the bullies who have ADHD do kind of a pre-emptive strike to prevent people from picking on them, and the victims might as well have targets painted on their back.

I am somewhat heartened by other children telling you about abuses your son has suffered. I'm not an educator, but I think a key to this involves promoting positive bystander behavior - having other kids stick up for the victims and inform adults when things start to get serious.
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Over40
03:53 PM on 07/28/2010
I absolutely agree that bystander behavior is key. All of us must find the courage and inate morality to confront bullying as the criminal behavior it is and not to just sit back - and we must teach our children to do the same.
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Paros
03:57 PM on 07/28/2010
Thank you for your thoughtful reply.
I very much appreciate this article as I find it essential to be on top of this issue as my child moves into this phase of life.
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GinaPera
03:14 PM on 08/09/2010
Paros -- I'm sorry to hear this is happening to you son, but as I mentioned elsewhere, children with ADHD are more likely to BULLY and to be BULLIED.

For some bullies, provoking others to emotional reactions is "self-medicating" -- it gives them pleasure because it is stimulating. (Note that the first-line medical treatment for ADHD is the stimulant class of medications.)

And it doesn't stop when they grow up, if left untreated., They can become bullies on the job, in relationships, and with their own children. I think the current "political discourse" in this country, not to mention the surfeit of Internet trolls, demonstrates clearly that many American adults "self-medicate" with provocation, anger, and bullying.

Gina Pera, author
Is It You, Me, or Adult A.D.D.?
01:19 PM on 07/28/2010
My book, Cyberbullying and Cyberthreats, published in 2007, set forth a comprehensive school-based approach to address this concern. Schools are not yet implementing any real concerted efforts.

There is confusion about the legal standards over when school officials can respond to off-campus speech. There should really be no confusion. Regardless of geographic origin, if the speech of a student(s) is making it impossible for another student to safely come to school, school officials can - and must - respond. The case law supports this basic premise.

In the last decade the focus of school officials has been solely on NCLB and making annual yearly progress - with no focus on the social emotional well-being of youth. When Obama/Duncan came into office they slashed the safe school funds by 40%. So at the time it is imperative for schools to refocus their efforts on this new challenge, the very professionals who have the basis of understanding to do so are receiving pink slips.

It is not appropriate to lump young people into separate groups of "bullies" and "victims." This is a spectrum of behavior that is associated with challenges in interpersonal relationships - which will not be remedied with drugs. Young people who do not feel loved and supported and do not gain the values and abilities to effectively deal with interpersonal conflict will be more at risk of engaging in or being targeted by aggression.

Nancy Willard, M.S., J.D.
Center for Safe and Responsible Internet Use
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Paros
01:49 PM on 07/28/2010
I am so thankful to have read your post. I am making a note of your publication and look forward to reading it and sharing it with my school systems' adminstration and some of my friends with school aged children. What an important work.

I am particularly drawn to your comments about the need for development of interpersonal relationships and the inappropriateness of grouping "bullies" and "victims".


Excellent post. Thank you.
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GinaPera
03:16 PM on 08/09/2010
I take strong issue with your statement "will not be remedied with drugs."

You cannot be much of an expert on this topic if you don't understand the role of untreated psychiatric orders in the phenomenon of cyber-bullying.
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01:14 PM on 07/28/2010
IMO, the victims of bullying are not only the tormentor, but also the tormented. Children who bully are self-soothers. They don't possess the know-how to deal with their own internal struggles and don't feel that they can voice their struggles to another person without fear of ridicule or without appearing weak. Projecting the emotions they do not understand and are unable to cope with onto another through violence/abuse it is nothing more than an attempt to relieve their own anguish and torment. It is my belief that positive self-image begins in the home with the parents. Children who know they have unwavering support from those closest to them are much more likely to verbalize their emotions. Without that support, the teach themselves how to cope and it sometimes manifests itself through bullying. I was never bullied myself but I do have a sister who was a bully and when she finally spoke, BOY did she speak!
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GinaPera
03:18 PM on 08/09/2010
Great point, Dante. Thank you.

Not only are they experiencing emotions they don't understand, but some bullies suffering from brain-based emotional dysregulation. Most people do not realize that ADHD is only superficially about attention. It is at its core about self-regulation, and the inability to regulate emotions is a huge problem for many people with untreated ADHD.
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Steven Barnes
Author, life coach, martial artist
12:49 PM on 07/28/2010
Fear is your body preparing you for action. Cyberbullying removes the capacity for direct response, and that hormone cascade can turn against the victim, becoming chronic anxiety, feelings of worthlessness and helplessness, and a kind of destructive deep anger that can explode against self and others. We must help our children, and ourselves, find healthy ways of dealing with these feelings. Once the pure emotional energy strikes the prism of perceptual experience, it splits into love and fear, which compete for room in our hearts. The value of introspection, meditation, self-expression and self-acceptance cannot be overrated. We must find these values and skills in our own lives--only then can we pass them to our children.

www.diamondhour.com
12:14 PM on 07/28/2010
I agree here with Dr. Koplewicz. Bullyiing of any kind should be solved on an individual level (rather than by authorities teachers, schools or the law) because the damage from bullying is internal, pervasive and can lead to problems that slow development and low self esteem later on.

The only problem with leaving it up to parents to care for and monitor their children is that many cannot provide the support their kids need. Kids need support systems (not to deliver punishments) but to educate, encourage and evaluate kids who are targets and give them the self esteem and skills they need to cope.

Its well documented that many bullied teens become low achievers, earn lower salaries, have more conflicts at work and suffer more from preventable stress (that assertiveness training can change) and this problem should not be ignored as a "phase" or the kids will learn in time. I beleive this problem significantly impacts the lives as much as drug or alcohol abuse and should be given more priority within our society.