Far from having benign or fleeting effects, bullying creates lasting damage that is as devastating to those it impacts as family dysfunctions like abuse. Both bullies and the people they victimize suffer psychiatric problems that can go on for years, even well into adulthood, according to new research.

“We were surprised at how profoundly bullying affects a person’s long-term functioning,” said William E. Copeland, Ph.D., assistant clinical professor in the Department of Psychiatry and Behavioral Sciences at Duke University and lead author of the study, in a written statement. “This psychological damage doesn’t just go away because a person grew up and is no longer bullied. This is something that stays with them. If we can address this now, we can prevent a whole host of problems down the road.”

"The experience of bullying in childhood can have profound effects on mental health in adulthood, particularly among youths involved in bullying as both a perpetuator and a victim," Catherine Bradshaw, deputy director of the Center for the Prevention of Youth Violence at Johns Hopkins University, told the New York Times. She was not involved in the research.

For the study, just published in the journal JAMA Psychiatry, the researchers followed more than 1,420 children from North Carolina, assessing them four to six times between ages 9 and 16. They were grouped by status: bullies, victims, bullies who were also victims and children who were not touched by bullying.

By interviewing the children each year until they were 16 and then periodically after, they found that those who had been bullied as children were more than 4.3 times more likely to have an anxiety disorder when they became adults. In each pre-16 interview, each child and caregiver were asked if they had been teased or bullied or if they had bullied others in the previous three months.

The results indicated that about 26 percent of the children having been bullied at least once and boys and girls bullied at roughly equal rates. Not quite 10 percent said they'd bullied others, bullies only outnumbering those who'd also been victimized.

The researchers noted that previous studies, such as one from Finland, showed mixed results, with few lasting problems for boys but long-term harm for girls. Their own research was not divided.

Those who had been both bully and victim fared the worst: They were 14.5 times more likely to develop panic disorder as adults and 4.8 times as likely to experience depression, when they were compared to those whose lives were not impacted by bullying. Men in that dual bully-role category were 18.5 times more likely to have suicidal thoughts when they became adults, while their female counterparts were 26.7 times more apt to develop fear of going out in public.

Even bullies who had not been victimized themselves were four times more likely to have antisocial personality disorder than those never exposed to bullying, the researchers said.

Both groups of bullies were at greater risk for psychiatric disorders, compared to peers, while those who had been only victims were more likely to suffer depressive disorders, anxiety, panic disorders and agoraphobia.

The results held after they'd controlled for pre-existing psychiatric problems or factors that could contribute to them, like poverty or sexual abuse or family instability.

"Bullying is potentially a problem for bullies as well as for victims," said senior author E. Jane Costello, associate director of research at Duke's Center for Child and Family Policy. "Bullying, which we tend to think of as a normal and not terribly important part of childhood, turns out to have the potential for very serious consequences for children, adolescents and adults."

“Some people cope with (bullying) more successfully than others,” Bridgewater State University expert Elizabeth Englander told the Boston Herald. “But the question is, which people and why?”

The researchers told the New York Times that one limitation of the study was it did not analyze bullying frequency, nor did it distinguish between interpersonal and overt bullying. The assessment was limited, as well, to bullying at school, not in other venues.

"If the results of this study are dismaying because they indicate that bullying is permanently scarring, the findings also strengthen the argument for prevention," wrote Emily Bazelon, author of the book, Sticks and Stones, for Slate. She said Copeland told her the same thing.

“Consider me a reluctant convert, but I’m starting to view bullying the same way I do abuse in the home,” he said. “I honestly think the affects we’re observing here are just as potent. And that’s definitely not the way American researchers look at things. They want to know all about what parents are doing at home. Peers aren’t considered a priority. But these days, with all the time they spend on the Internet, kids are spending even more time with their peers, and that’s a factor we need to pay more attention to.”

Other researchers included Adrian Angold of Duke and Dieter Wolke of the University of Warwick, Coventry, England.

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