Prevalence and Stability of Anxiety in Children

While feelings of anxiety are normal during childhood, anxiety disorders are characterized by anxiety levels that are high enough to impair a child’s daily functioning (7 & 8). Evidence suggests that approximately one out of every 16 children meet criteria for at least one anxiety disorder (1& 2) and researchers have found that anxiety disorders are among the most prevalent psychological disorders in children (2 & 7).

Anxiety disorders can last for years and are associated with a variety of short- and long-term negative effects. Studies, for example, have found the following:

  • In the absence of treatment, children who were experiencing clinical levels of anxiety in kindergarten continued to experience similar levels of anxiety in the sixth grade (3).
  • By age 20, those who had experienced chronically high levels of anxiety during childhood were significantly less likely to have graduated from high school than their peers.
  • Children with high anxiety levels also report lower levels of social acceptance and self-esteem (5).

Given the duration and negative effects of anxiety disorders, researchers have sought to learn more about how anxiety disorders develop in order to better prevent and treat them.

Anxiety and Bullying

One potential risk factor for the development of anxiety disorders is the experience of being bullied. Evidence suggests that being bullied is significantly associated with feelings of anxiety. Studies, for example, have found the following:

  • Victims of bullying are more likely to be anxious than students who are not bullied (9, 10, & 11).
  • Students who are bullied and bully others (bully-victims) have been found to have higher levels of anxiety than students otherwise involved in bullying or not involved (11 & 12).
  • Students who reported that they were victims or bully-victims on a frequent basis endorsed significantly higher levels of anxiety than their peers (11)
  • Students who were bullied less frequently also reported elevated levels of anxiety (11)

Some researchers have explored the relationship between anxiety and various forms of bullying. It appears as though some forms of bullying are more strongly linked to anxiety than other forms. Researchers in the field have made the following findings:

  • Overt victimization (i.e., experiencing attempts or threats to harm one’s physical well being), and relational victimization (i.e., experiencing attempts or threats to harm one’s peer relationships), were both associated with heightened levels of social anxiety for males and females ages 13-16 (14).
  • Students who were bullied in multiple forms endorsed higher social anxiety levels than those who reported one form of victimization.
  • Students who reported relational victimization endorsed social anxiety levels similar to those endorsed by students who reported relational and overt victimization, which suggests that perhaps relational victimization is more strongly linked to social anxiety.
  • Boys 14-18 years of age who were bullied by being called “gay” endorsed higher levels of anxiety than their peers who were bullied for other reasons (13). Thus, being called “gay” seemed to be more strongly linked to anxiety than other forms of victimization.

A Word of Caution

When considering the evidence linking victimization to anxiety, two cautions are necessary. First, one’s risk of developing anxiety disorders does not depend only on whether and how one is bullied; rather, we must also consider factors such as genetics, culture, and environment (7). For example, one study found that bullies, victims, and bully-victims who reported receiving moderate social support from peers also endorsed the lowest anxiety levels (6). Thus, many factors may contribute to, or protect one from, the development of anxiety disorders.

Secondly, the studies that have been discussed here have only explored the relationship between victimization and anxiety and cannot make any causal claims. While the experience of being bullied may cause or contribute to the development of anxiety disorders, it may also be the case that individuals experiencing heightened levels of anxiety may be more vulnerable to subsequent victimization (14). Thus, we cannot conclude that being bullied leads to the development of anxiety disorders or that having an anxiety disorder leads someone to being victimized.

Summary and Future Research Directions

Evidence suggests that anxiety disorders are associated with the experience of being bullied, though some forms of bullying may be more strongly linked to anxiety than other forms. Yet, little is known about factors that may mediate or moderate the association between anxiety and bullying (4). This information is critical since a better understanding of the relationship between being bullied and anxiety may lead to better methods of assessing a student’s risk of developing anxiety disorders as well as more effective bullying prevention and intervention efforts.

References

1. Benjamin, R. S., Costello, E. J., & Warren, M. (1990). Anxiety disorders in a pediatric sample. Journal of Anxiety Disorders, 4, 293-316. doi: 10.1016/0887-6185(90)   90027-7.

2. Chavira, D. A., Stein, M. B., Bailey, K., & Stein, M. T. (2004). Child anxiety in primary care: Prevalent but untreated. Depression and Anxiety, 20, 155-164. doi: 10.1002/da.2039

3. Duchesne, S., Vitaro, F., Larose, S., & Tremblay, R. E. (2008). Trajectories of anxiety during elementary-school years and the prediction of high school          noncompletion. Journal of Youth and Adolescence, 37, 1134-1146. doi: 10.1007/s10964-007-9224-0

4. Espelage, D. & Swearer, S. (2003). Research on school bullying and victimization: What have we learned and where do we go from here? School Psychology Review, 32, 365-383. 

5. Ginsburg, G. S., La Greca, A. M., & Silverman, W. K. (1998). Social anxiety in children with anxiety disorders: Relation with social and emotional functioning. Journal of Abnormal Child Psychology: An official publication of the International Society for Research in Child and Adolescent Psychopathology, 26, 175-185. doi: 101023/A:1022668101048

6. Holt, M. K. & Espelage, D. L. (2007). Perceived social support among bullies, victims, and bully-victims. Journal of Youth and Adolescence, 36, 984-994. doi: 10.1007/    s10964-006-9153-3

7. Huberty, T. J. (2008). Best practices in school-based interventions for anxiety and depression. In A. Thomas & J. Grimes (Eds.), Best practices in school        psychology: Vol. 5 (pp. 1473-1486). Bethesda, MD: National Association of School Psychologists.

8. Kendall, P. C. & Suveg, C. (2006). Treating anxiety disorders in youth. In P. C. Kendall (Ed.), Child and adolescent therapy: Cognitive-behavioral procedures (3rd edition; pp. 243-294). New York, NY: Guilford Press.

9. Rigby, K. (2003). Consequences of bullying in schools. Canadian Journal of Psychiatry, 48, 583-590.

10. Slee, P. T. (1994). Situational and interpersonal correlates of anxiety associated with peer victimization. Child Psychiatry & Human Development, 25, 91-107. doi: 10.1007/BF02253289

11. Swearer, S. M., Siebecker, A. B., Johnsen-Frerichs, L. A. & Wang, C. (2010). Assessment of bullying/victimization: The problem of comparability across studies. In S. R. Jimerson, S. M. Swearer and D. L. Espelage, (Eds.), Handbook of bullying in schools: An international perspective (pp. 305-328).New York, NY: Routledge.

12. Swearer, S. M., Song, S. Y., Cary, P. T., Eagle, J. W., & Mickelson, W. T. (2001). Psychosocial correlates in bullying and victimization: The relationship between depression, anxiety, and bully/victim status, pp. 95-121. In R. Geffner, M. Loring, and C. Young (Eds.) Bullying behavior: Current issues, research, and interventions. Binghamton, NY: Haworth Maltreatment and Trauma Press/The Haworth Press.

13. Swearer, S. M., Turner, R. K., Givens, J. E. & Pollack, W. S. (2008). “You’re so gay!”:  Do different forms of bullying matter for adolescent males? School Psychology Review, 37, 160-173.

14. Storch, E. A., Brassard, M. R., & Masia-Warner, C. L. (2003). The relationship of peer victimization to social anxiety and loneliness in adolescence. Child Study Journal, 33, 1-18.