Adult psychiatric outcomes of bullying and being bullied by peers in childhood and adolescence
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Context: Both bullies and victims of bullying are at risk for psychiatric problems in childhood, but it is unclear if this elevated risk extends into early adulthood. Objective: To test whether bullying and being bullied in childhood predicts psychiatric and suicidality in young adulthood after accounting for childhood psychiatric problems and family hardships. Design: Prospective, population-based study of 1420 subjects with being bullied and bullying assessed four to six times between ages 9 and 16. Subjects were categorized as bullies only, victims only, bullies and victims (bully-victims), or neither. Setting and population: Community sample. Main Outcome Measure: Psychiatric outcomes included depression, anxiety, antisocial personality disorder, substance disorders, and suicidality (including recurrent thoughts of death, suicidal ideation, or a suicide attempt) were assessed in young adulthood (ages 19, 21, and 24/25/26) by structured diagnostic interviews. Results: Victims and bully-victims had elevated rates of young adult psychiatric disorder, but also elevated rates of childhood psychiatric disorders and family hardships. After controlling for childhood psychiatric problems or family hardship, victims continued to have higher prevalence of agoraphobia (odds ratio (OR), 4.6; 95% confidence interval (CI), 1.7–12.5, p <0.01), generalized anxiety (OR, 2.7; 95% CI, 1.1–6.3, p <0.001), and panic disorder (OR, 3.1; 95% CI, 1.5–6.5, p <0.01), and bully-victims were at increased risk of young adult depression (OR, 4.8; 95% CI, 1.2–19.4, p <0.05), panic disorder (OR, 14.5; 95% CI, 5.7–36.6, p <0.001), agoraphobia (females only; OR, 26.7; 95% CI, 4.3–52.5, p <0.001), and suicidality (males only: OR, 18.5; 95% CI, 6.2–55.1, p <0.0001). Bullies were at risk for antisocial personality disorder only (OR, 4.1; 95% CI, 1.1–15.8, p < 0.04). Conclusion: The effects of being bullied are direct, pleiotropic and long- lasting with the worst effects for those who are both victims and bullies. (Author Abstract)