BULLYING IN CHILDREN AND ADOLESCENTS Jassin M. Jouria, MD Dr. Jassin M. Jouria is a medical doctor, professor of academic medicine, and medical author. He graduated from Ross University School of Medicine and has completed his clinical clerkship training in various teaching hospitals throughout New York, including King’s County Hospital Center and Brookdale Medical Center, among others. Dr. Jouria has passed all USMLE medical board exams, and has served as a test prep tutor and instructor for Kaplan. He has developed several medical courses and curricula for a variety of educational institutions. Dr. Jouria has also served on multiple levels in the academic field including faculty member and Department Chair. Dr. Jouria continues to serve as a Subject Matter Expert for several continuing education organizations covering multiple basic medical sciences. He has also developed several continuing medical education courses covering various topics in clinical medicine. Recently, Dr. Jouria has been contracted by the University of Miami/Jackson Memorial Hospital’s Department of Surgery to develop an e-module training series for trauma patient management. Dr. Jouria is currently authoring an academic textbook on Human Anatomy & Physiology. Abstract Bullying in children and adolescents is not a new problem and has traditionally been overlooked as a serious threat to an individual. This study considers the history of bullies and known social beliefs underlying its prevalence and the way social groups and organizations, such as schools, address the pattern of bully and victim. The impacts of bullying upon individuals are addressed, as well as solutions to prevent bullying and options for victims and families. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 1 Policy Statement This activity has been planned and implemented in accordance with the policies of NurseCe4Less.com and the continuing nursing education requirements of the American Nurses Credentialing Center's Commission on Accreditation for registered nurses. It is the policy of NurseCe4Less.com to ensure objectivity, transparency, and best practice in clinical education for all continuing nursing education (CNE) activities. Continuing Education Credit Designation This educational activity is credited for 4 hours. Nurses may only claim credit commensurate with the credit awarded for completion of this course activity. Statement of Learning Need Violence and aggression among children and adolescents are a growing and concerning occurrence, causing school and health professionals as well as public officials and policy makers to seek solutions. Bulling is defined as many things, however key concepts include the repeated attempt of person(s) to exert power over another individual or group of individuals. Common characteristics of bullying include physical to subtle forms of aggression that health professionals must understand in order to help both victim and perpetrator recognize acts of aggression and address them. Course Purpose To provide health clinicians with knowledge of bullying, its forms and effects upon children and adolescents, as well as ways to prevent it and to support healing. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 2 Target Audience Advanced Practice Registered Nurses and Registered Nurses (Interdisciplinary Health Team Members, including Vocational Nurses and Medical Assistants may obtain a Certificate of Completion) Course Author & Planning Team Conflict of Interest Disclosures Jassin M. Jouria, MD, William S. Cook, PhD, Douglas Lawrence, MA, Susan DePasquale, MSN, FPMHNP-BC – all have no disclosures Acknowledgement of Commercial Support There is no commercial support for this course. Please take time to complete a self-assessment of knowledge, on page 4, sample questions before reading the article. Opportunity to complete a self-assessment of knowledge learned will be provided at the end of the course. nursece4less.com nursece4less.com nursece4less.com nursece4less.com 3 1. Bullying is defined as __________________ that is aimed at a less powerful target. a. any singular abusive act b. physical contact c. calculated, ongoing abuse d. random physical contact 2. Labeled gateway behaviors are a. socially inappropriate behaviors. b. appropriate behaviors used for an inappropriate purpose. c. non-psychological methods of bulling. d. used only in cyberbullying. 3. True or False: Research shows that most bullying today does not involve physical contact. a. True b. False 4. Social bullying occurs when a a. person is bullied by a group. b. a person is bullied by socially accepted conduct. c. person is bullied on social media. d. person’s relation to his or her community is endangered. 5. What percentage of high school bullying involved electronics, such as computers or cellular telephones? a. 47% b. 97% c. half d. 65% nursece4less.com nursece4less.com nursece4less.com nursece4less.com 4 Introduction Bullying among school children is certainly a very old phenomenon. For many years, however, bullying was considered a necessary evil — an unpleasant, unavoidable rite of passage through childhood. It was not until the early 1970s that it was made the object of systematic research. Research indicates that bullying is harmful and there are no beneficial effects for the target, the perpetrator, or even bystanders; bullying cannot be explained as merely a normal part of growing up. Research into bullying also lead to changes in the definition of bullying. In order to understand and deal with bullying it is important to define and sometimes redefine bullying, to identify the factors leading to bullying, to answer how prevalent is bullying, and to review the specific aspects of bullying in the school setting. History Of Bullying Historically, bullying was not seen as a problem that needed attention, but was accepted as a fundamental and normal part of childhood. Bullying is deeply embedded in our culture. There are bullies not only on the school playgrounds but bullying tactics are routinely used in both the public and private sector.26-28 Bullies may be company CEOs, university presidents, politicians, teachers, police chiefs, or religious leaders. Bullies may achieve results in business by increasing profits, dominating markets or maintaining positions of power. In the last two decades, however, the attitudes toward bullying have been changing. The emergence of cyberbullying has affected attitudes. Additionally, school bullying has come under intense public and media scrutiny recently amid reports that it may have been a contributing factor in shootings at Columbine High School in Littleton, Colorado, in 1999, at nursece4less.com nursece4less.com nursece4less.com nursece4less.com 5 Santana High School in Santee, California, in early 2001, and in other acts of juvenile violence, including suicide. There has also been an increased concern internationally about school bullying over the last thirty years. This concern is rooted in human rights. It has been evidenced by an awareness of, and legislation against, forms of discrimination based on sex, race, age, religion, disability and sexual orientation. As a result of these trends, schoolyard bullying and cyberbullying are seen as serious problems that warrant attention. Numerous anti-bullying programs and zero-tolerance policies have proliferated as schools attempt to reduce and control bullying.29,30 In order to develop and implement effective anti-bullying programs, it is important to define bullying. What Is Bullying? Although there is no universally agreed definition, there is some consensus, at least in the western research tradition on defining bullying. Bullying is defined as the calculated, ongoing abuse that is aimed at a less powerful target. A school violence specialist with the School of Social Work at Michigan State University, defined a bully as an individual who seeks to control, dominate and terrorize the life of another. The important parts of this definition are that bullying is repeated behavior, intended to harm another, and that involves a disparity of power. A disparity of power may be viewed from different angles: target cannot defend himself or herself or the aggressor is seen to have more power than his or her target. It involves a real or perceived imbalance of power, with the more powerful child or group attacking those who are less powerful.14,15 Nevertheless, the two criteria of repetition and power imbalance are still not universally accepted. They face nursece4less.com nursece4less.com nursece4less.com nursece4less.com 6 particular resistance in the context of cyberbullying, and with the “intent to cause harm” criterion. Bullying is a relationship and goes beyond individual incidents which by themselves can seem petty and insignificant, but bring great pain and torment to the victims. The dynamics of violence and school playground bullying are very similar. As mentioned, it is an issue of power. The essence of bullying is not in the actions of the bully but in his or her intentions: Will they bring harm? Is there intention to control? Bullying is distinct from general aggression because of the additional element that it involves aggression with a real or perceived imbalance of power. In order for a study on bullying to provide meaningful information, it must evaluate aggression in the context of an imbalance of power. Bullying often involves a minimum of two people, one the perpetrator and the other the victim. A large number of people may be involved