ABCs of Child Psychiatry

Real info about children's mental health

Can Being Bullied Make You Sick?

Chronic inflammation linked to bullying status
Michael Friedman, Ph.D.
This post is a response to Knowing Why Bullies Bully Is Key to Stopping the Trend by Michael Friedman, Ph.D.

It is becoming more and more apparent that being bullied in childhood can have profound and long-lasting negative effects.  A number of studies have now shown the impact of bullying on adult behavior and a few have demonstrated that physical health can be affected as well.  Dr. Michael Friedman recently offered an excellent post about why bullies bully and how that behavior can be reinforced.  In the post, he refers briefly to a recent study by Bill Copeland and others from Duke that looks at a potential pathway, chronic inflammation, that may connect the dots between being a bully victim to having poorer health outcomes.  This important research deserves a little extra attention.

The study uses data from the Great Smoky Mountain Study (GSMS).  While many people not familiar with child mental research may have never heard of this, the GSMS has tracked the lives of a group of children living in rural North Carolina for many years, and has been a very important source of data regarding the prevalence of emotional-behavioral problems and their development over time. 

Like any large group of kids, most of them were not involved in bullying, some were chronic bully victims, some were primarily bullies themselves, and another group could be both bullies and bully victims (bully-victims).  These subjects are now young adults and their blood was drawn to measure levels of something called C-reactive protein (CRP), which is known to be a marker for how much chronic low grade inflammation a body experiences.

Across childhood and adolescence, CRP levels tend to rise for everyone,  However, those who were bullied more often were found to have higher than expected CRP levels compared to those uninvolved in bullying.  Perhaps even more unexpected, however, was that those who tended to bully others had lower CRP levels.  Finally, individuals who went back and forth between being a bully and being a victim had CRP levels that were no different than those not involved with bullying.

Copeland and his coauthors concluded that chronic inflammation may be a key factor involved in the poor mental and physical health that has been documented among victims of bullying.  They hypothesized that the increased inflammation might be due to bully victims experiencing less of the anti-inflammatory effects of cortisol which can become less responsive under conditions of chronic stress.

One thing that did not fit so well in this study was that their group of bully-victims had the same CRP levels of those uninvolved in bullying.  This group, according to other published studies, often has been shown to have the worst mental and physical health of all, so one might expect that they would have had high inflammation as well.

Could being a bully be good for your health?  That is one provocative finding from the study.  Certainly, a strategy of bullying others may not work so well as an adult (subjects were only 21 years old when this study was published).   Also, there may be many other ways for a child to be successfully social that don’t involve hurting others.

On a side note, the study also beautifully illustrates how the worlds of physical and mental health are so interconnected. 

@copyright by David Rettew, MD

David Rettew is author of Child Temperament: New Thinking About the Boundary Between Traits and Illness and a child psychiatrist in the psychiatry and pediatrics departments at the University of Vermont College of Medicine.

Follow him at @PediPsych and like PediPsych on Facebook.

David Rettew, M.D., is a child psychiatrist at the University of Vermont and author of Child Temperament: New Thinking about the Boundary between Traits and Illness.

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