Bullying can take many forms. A child may be physically threatened or hurt, his possessions may be snatched out of his hands in a game of "keep away," she may be excluded from a playground peer group, or whispered about in her presence. The common denominator of bullying is that the bully holds the power, the victims are unable to defend themselves, and the hostile actions occur repeatedly. In the short term, the victims of bullying feel sad, afraid, anxious, and lonely. Being a bully makes a child feel powerful, and the center of attention. Often a child, who is victimized by one group, acts out against a less powerful group and becomes both a victim and a bully. Children can also become bullies because they experience difficult relationships at home with their parents and siblings. Bullies and victims both need attention and help.

Boys who were both bullies and victims and girls who were victims were at the highest risk of later psychiatric illness.

But what about later on in life? How does being a bully or being a victim affect a children's emotional health as they grow into adolescence and adulthood? A Finnish study, reported in the September issue of the Archives of General Psychiatry, followed 5038 children born in 1981, from age 8 years through age 24. They used parent, teacher, and child questionnaires to determine whether the children were frequent bullies, victims of bullies, or both. They assessed the children's mental health at age 8 years, and used records of psychiatric hospital treatment and use of psychiatric medications between ages 13 and 24 to find out how their mental health had changed.

Males and females were evaluated separately. The researchers looked at both groups to determine how many were bullies, victims, or both when they were 8 years old, and how many developed mental health problems between 13 and 24.

When the children were 8 years old, 6.0% of boys within the study population were bullies, 6.4% were victims, and 2.8% were both bullies and victims. Of the girls in the study, 3.6% were victims, while less than 1% were bullies, or both bullies and victims. Boys and girls differed in their bullying behavior. While boys were often bullies, bully/victims, or victims, girls were rarely bullies but were often victimized. Among the boys, bullying was more physical, while among the girls it was a more subtle kind of emotional mistreatment, such as being excluded from a group or being the subject of gossip.

Boys who were both bullies and victims and girls who were victims were at the highest risk of later psychiatric illness. Of the boys who were both bullies and victims, 17% later required treatment in a psychiatric hospital and 32% were treated with psychiatric medications for depression, anxiety or psychosis. Of the boys who were only bullies, 9% required hospital treatment, and 18% required medication treatment. Among the frequent victims, 10% required hospital treatment and 15% required medication. These figures contrast with the group of boys who were neither bullies nor victims. Of these only 5% required treatment in a psychiatric hospital while 12% required medication therapy.

Among the girls, 12% of the victims required hospital treatment and 32% required psychiatric medication as compared to the control group of whom, 4% required hospital treatment and 16% required medication therapy. The covert relational type of bullying most commonly experienced by girls has been found to be more likely to cause depression and loneliness than the overt victimization experienced by boys. The researchers suggested that the negative feelings experienced by the girls might translate into physiologic changes in the neurochemical systems responsible for the development of depression.

Girls were found to be less likely to be bullies than boys, but when they were bullies they were more likely to have psychiatric conditions at age 8 years. This may be explained by the fact that girls are raised to control their aggressive and physical behaviors more than boys are. When they are unable to do so, their inability to control themselves is likely to be the result of a pre−existing psychiatric problem. Boys are given wider latitude with aggression and physicality and are less likely to have a psychiatric condition as the cause of their poor behavior.

When children were identified as having psychiatric illness at the time they were acting out as bullies, the risk of future psychiatric problems was notably high. The researchers suggested that children who are bullies should be screened for psychiatric problems to determine whether they would benefit from early mental health interventions. When no psychiatric illness is present, a focus on appropriate school behavior and improving peer relationships is recommended to address bullying actions. Because those boys who are bullies, or who are both bullies and victims, and girls who are victims have a higher risk than the normal population to develop psychiatric issues in adolescence and early adulthood, they should be monitored closely for signs of emerging mental health problems.

What can parents do if their child is a victim or a bully? First of all, parents should take their child's reports of their school day experiences seriously and consult with their teachers about their concerns. If their child is acting unusually sad, withdrawn, or irritable, or sleeping and eating poorly, they should investigate school day and after school experiences. Often children will not reveal their victimization to their parents for fear of getting into trouble, inviting more bullying, or being laughed at. Although it can be hard for parents to admit that their child is a bully, bullying others is often a sign of underlying insecurity or of being victimized by someone else. It is important to for parents to get their child, whether bully, victim, or both, the professional evaluation and help that they need.

If parents wish to read more about bullying, they following websites contain information for both parents and children: