What’s a Bully-Victim? (page 3)

Children who have bullied others and been bullied themselves are called bully-victims. A large body of research has documented the difficulties associated with being bullied and with bullying other children. For instance, children who are bullied suffer more greatly from anxiety, depression, loneliness, and post-traumatic stress than do other children, and they have a heightened risk of suicide (1). Children who bully are more likely than other youngsters to experience peer rejection, conduct problems, anxiety, and academic difficulties, and to engage in rule-breaking behavior (2, 3).

Recent research has shown that a substantial number of children have been victimized by bullying and have bullied others in turn. In one recent study, about one third of the children who either bullied others or were bullied themselves were identified as bully-victims (1). Schwartz and his colleagues (4) have suggested that a distinguishing feature of bully-victims is that they struggle to control their emotions. For example, bully-victims may unintentionally prompt children to bully them again by reacting very emotionally to teasing, threats or physical aggression, and may have similar problems controlling feelings of anger and frustration, predisposing them to retaliatory aggression.

Bully-Victims Often Experience Behavioral And Emotional Difficulties

Given that they experience a broader range of behavioral and emotional difficulties than do children who are either purely involved in bullying or the victims of bullying, it is perhaps not surprising that bully-victims show social and emotional problems that are frequently present in victims of bullying, such as anxiety, depression, peer rejection, and a lack of close friendships, as well as the cognitive and behavioral difficulties often apparent in children who bully, including a greater acceptance of rule-breaking behavior, hyperactivity and a tendency toward reactive aggression (1, 4).

In addition, children with a combination of behavioral and emotional problems are at greater risk for psychiatric disorders and criminal offences in young adulthood (5) than are children dealing with only one of these problems, and have proven less responsive to a comprehensive school-based program for children with severe emotional disturbances (6). Consequently, it is of the utmost importance that these individuals receive support and services that address the full spectrum of their needs.

The Importance Of Recognizing The Bully-Victim's Needs

When parents and teachers are faced with trying to help a bully-victim, one difficulty might be recognizing and attending to their full range of needs, rather than focusing on only the most salient problems. Specifically, the behavioral problems may garner the lion’s share of attention since they can be so disconcerting, in light of the physical and emotional injuries that bullies can inflict on victims, the disruption to other students in the classroom, and the substantial challenges that parents and educators face in attempting to manage this troublesome behavior. However, although less visible and distressing to others, internalizing problems such as anxiety and depression can also be debilitating, and deserve an equal amount of attention.

Programs That Address Children's Behavioral Problems

Programs designed to address children’s behavioral problems (7) have been developed separately from comparable interventions for emotional problems relating to anxiety and depression (8). There is very little research on the integration of these interventions for children such as bully-victims who struggle with both behavioral and emotional issues (see 9), for an exception on the treatment of children with anxiety disorders and co-occurring conduct problems).

• Cognitive restructuring or reframing techniques have been used to deal with aggression, anxiety, and depression (8, 10, 11). The central feature of cognitive restructuring is to identify thoughts that increase anger, anxiety or sadness, challenge their accuracy, and replace them with interpretations that are more realistic and less harmful. With regard to anxiety, a student may learn to recognize that his anxiety levels rise when he assumes that all of his classmates would “think he is stupid” if he were to give an incorrect answer in class. Instead, he may be encouraged to take a more realistic view, recognizing that everyone makes mistakes, and that when other people make mistakes, he does not usually think badly of them. To reinforce this perspective, the student might use some encouraging self-talk, such as “It’s OK to make mistakes; it’s how we learn.” Applied to address behavioral difficulties, cognitive restructuring techniques are often used to emphasize that there is more than one way to explain the actions of other children. For instance, because children who bully do not often give other children the benefit of the doubt, they may be inclined to see teasing as mean-spirited, which would increase anger and the likelihood of an aggressive response. However, it is equally likely that teasing may be good-natured, and in teaching bully-victims to be open to this possibility, the number of peer conflicts that result in episodes of bullying may be reduced.
• Problem-solving skills training is a second technique common to cognitive-behavioral programs targeting behavioral or emotional problems (11, 12, 13). Children are helped to think of several possible solutions to a given problem, and to reflect on the positive and negative consequences of each in order to choose the strategy that will maximize positive consequences in both the short and long term. Children who bully rely too heavily on aggressive solutions, whereas anxious or depressed youngsters often default to avoiding their difficulties; problem-solving skills training can be used in either case to broaden the repertoire of constructive coping strategies and enhance decision-making. Decreasing depression and anxiety related to being bullied would be beneficial in itself for bully-victims, but it may have the added benefit of reducing negative moods that render children vulnerable to engaging in explosive, emotional and reactive aggression (14, 15).
• Self-control strategies have been used in the treatment of both aggressive and anxious children (8, 10), and given the difficulty that bully-victims have controlling these emotions, it may be advisable to make this deficit a key target of interventions for this group of children. Children develop better self-control over their emotions by learning to recognize the physical signs of anxiety or anger (e.g., muscle tension), by practicing self-statements (e.g., “OK, I should stop and think”), and the utilization of relaxation techniques (e.g., muscle relaxation and deep breathing) to reduce emotional arousal and delay an immediate response to a stressful situation. This will permit careful reflection (e.g., problem solving, cognitive restructuring) prior to taking action.

Bully-victims face a complicated array of social and emotional challenges, and it is imperative that concerned parents, educators or mental health practitioners recognize the full extent of their difficulties, and tailor interventions to match their complex needs. More research is urgently needed to create and evaluate program materials that integrate cognitive-behavioral strategies for the treatment of both behavioral and emotional problems. In the meantime, educators and clinicians may broaden the focus of existing school-based or clinic-based interventions by flexibly applying techniques such as cognitive restructuring, problem-solving skills training and self-control skills, along the lines described above. Parents may play a key role in advocating for children who are bully-victims, seeking referrals where appropriate to mental health centres where individual therapy may be provided, as this may be a particularly appropriate context to tailor interventions to the specific needs of bully-victims.