Thursday August 9th 2012 - NYBH Staff
Theories About Origins of Bullying
Bullying is a universal phenomenon, not unique to particular cultures and regions. Developmental psychologists Volk, Camilleri, Dane, & Marini (2012) note this fact and attempt, through research, to counter traditional beliefs that bullying results from maladaptive development. Rather, they postulate that the prevalence and universality of bullying could indicate the opposite: An adaptive and calculated response, on behalf of certain adolescents, to a social environment. Their analysis reveals a seemingly controversial addition to the cannon of research available on bullying, emphasizing potential social and somatic benefits of bullying. Further, the team of researchers prompts clinicians, parents, and program administrators to carefully assess the motivations behind bullying and to tailor their interventions accordingly.
Adolescents’ Evolutionary Goals
Volk et al. (2012) believe adolescents have two primary evolutionary goals:
“Growth/health/survival and securing appropriate mating opportunities,” (p. 223). For the purposes of this review, the former will be examined more thoroughly. The subsequent conclusions are drawn from a series of studies and data including historical records of bullying across global empires, modern data on bullying, and supplemental data on bullying in contemporary hunter-gatherer tribes such as Brazil’s Yanomamo. The investigators are careful to attribute the unveiled adaptive functions of bullying only to what is termed a “pure bully” (a bully who is not also a victim of bullying). Bullying on the part of bully-victims (victims who, in turn, bully others) is believed to serve a more “reactive function and may be a product of dysregulation” (p. 224).
Goal Reduced to Dominance
Primarily, Volk et al. (2012) explore the somatic benefits of bullying, noting that, while there is no direct evidence that bullying causes greater or faster physical growth, there is evidence that bullies (particularly male bullies) tend to be “larger and stronger than non-bullies” (p. 224). Hunter-gatherers may account for the most prominent example of somatic benefits, particularly in circumstances of scarcity. The researchers note evidence of this among the Ik, a group of displaced hunter-gatherers, “who experienced extreme resource deprivation, and whose adolescents (and even younger children) were highly involved in bullying over life-and-death physical resources” (p. 224). This sort of bullying can also be seen in the pursuit of professional success, or rather another ticket to more tangible resources, in fields with high lucrative rewards and limited enrollment. Dominance of power and resources is cited to reduce bullies’ stress levels, resulting in better general health outcomes as well.
Bullies Seen as Popular and Powerful
Interestingly, despite previous research indicating high potential for depression among both bullies and victims, Volk et al. (2012) note some positive effects on mental health: Bullying is directly related to “positive mental health traits such as theory of mind ability, cognitive empathy, leadership, social competence, and self-efficacy” (p. 225). These characteristics are typically beneficial for achieving social dominance, which has been found to be positively associated with both bullying and peer/teacher-reported popularity and power (p. 227).
Costs and Benefits of Bullying
Finally, the researchers consider an important question: If bullying is truly a general adaptive behavior, then why are all adolescents not bullies? To address it, Volk et al. (2012) propose that bullying is a facultative adaptation, meaning, “an adaptation that is expressed only under certain environmental circumstances” (p. 231). They further reason that bullying, as with any behavior, comes with costs as well as benefits; certain adolescents may make decisions, in response to a particular environment, that allow for more immediate rewards (i.e., social capital). Another adolescent, under different material and psychological circumstances, may make a different choice.
Focus on Adaptive Behaviors
Based upon these conclusions, Volk et al. (2012) ultimately urge clinicians, teachers, and parents to implement interventions that offer more severe disciplinary consequences to bullying behaviors, thereby upping the “costs” and reducing perceived social rewards. They draw attention to results of a recent meta-analysis indicating the non-significant effects of anti-bully interventions and suggest that interventions can be improved, in their expert opinion, by shifting the focus on bullying behaviors from maladaptive to adaptive reactions.
Volk, A., Camilerri, J., Dane, A., Marini, Z. (2012) Is adolescent bullying an evolutionary adaptation? Aggressive Behavior, 38, p. 222-238
Tuesday August 7th 2012 - NYBH Staff
School Age Bullies, Victims of Bullying, and Bully-Victims
Taylor et al. (2010) endeavor to better understand the connection between bullying and school age youth with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) to support the hypothesis that they are particularly vulnerable to both bullying and victimization. The urgency for targeted intervention and prevention programs is stressed by Taylor et al., with an estimate of between 5%-9% of school age children meeting the diagnostic criteria for ADHD (p. 60). ADHD, characterized by impulsivity, inattention, a low frustration tolerance and hyperactivity can often result in behaviors incongruent with social norms such as aggression, rule breaking, and more. Peers may ostracize children with a diagnosis of ADHD, as a result of these behaviors. Youth with ADHD are also hypothesized to bully more frequently than their peers, and often become bully-victims. A bully-victim is an individual who is bullied and in turn, bullies. Research consistently demonstrates that bully-victims are among the highest risk for externalizing negative behaviors and poor mental health outcomes. Taylor et al. (2010) also hypothesize that children with ADHD who engage in bullying in any capacity (as a bully, a victim, or both) are also at a higher risk of developing more severe emotional and behavioral problems as a consequence.
Description of Sample and Instrumentation
The study carried out by Taylor et al. (2010) was a retrospective analysis of data provided by families participating in an Institutional Review Board (IRB) protocol at primary care and specialty pediatric clinics. Participants included children with a verifiable ADHD diagnosis only, a verifiable ADHD diagnosis with comorbidities (e.g., depression, anxiety), and children with no mental health diagnoses. Participants and their parents were asked to self-report using W. M. Reynolds’ (2003) Bully-Victimization Scale (BVS) questionnaire, designed to assess for bullying and victimization, the CBCL-Parent Report (Achenbach & Rescorla, 2001), and Kovacs’ (1992) brief Children’s Depression Inventory (CDI) to assess participants for depression.
Bullying Prevention and Treatment Plans Critical for Children with ADHD
The results of this research support the hypothesis that youth with ADHD may be at a higher risk for victimization by bullies. Subsequently, when bullying does occur within this vulnerable population, higher levels of internalized and externalized difficulties are reported. Essentially, for children already struggling with emotional and behavioral regulation, bullying can increase and exacerbate said difficulties and result in further interpersonal and educational difficulties. It is essential for parents, teachers, administrators, and clinicians to understand and address bullying and its consequences on youth diagnosed with ADHD and take a proactive approach to its prevention and treatment. Children with ADHD may benefit from programs tailored to specifically address pre-existing tendencies and which offer guided alternative solutions to negative behaviors.
Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4–18 and 1991 pro?le. Burlington, VT: University of Vermont, Department of Psychiatry.
Achenbach, T. M. & Rescorla, L. A. (2001). Manual for the ASEBA School-Age
Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.
Kovacs, M. (1992). Children’s Depression Inventory: Manual. North Tonawanda, NY: Multi-Health Systems, Inc.
Reynolds, W. M. (2003). Reynolds’ Bully-Victimization Scales for schools. San Antonio, TX: Psychological Corporation.
Taylor, L., Saylor, C., Twyman, K., Macias, M. (2010). Adding insult to injury: Bullying experiences of youth with Attention Deficit Hyperactivity Disorder. Children’s Health Care, 39: p. 59-72.
Monday July 30th 2012 - NYBH Staff
Epidemic of Insufficient Sleep
According to 2012 information from the Centers for Disease Control and Prevention (CDC), approximately 50 to 70 million American adults have a sleep-wakefulness disorder. In fact, insufficient sleep has been categorized as a public health epidemic.
Types of Sleep Disorders
The American Psychiatric Association identifies three categories of sleep disorders. These are:
1. Dysomnias: These sleep disorders impact the amount, quality, and/or timing of sleep. This class of disorders includes insomnia (inability to sleep), hypersomnia (getting too much sleep), and circadian rhythm sleep disorder.
2. Parasomnias: These sleep disorders lead to undesirable behavioral or physiological events that occur while sleeping; they are commonly divided into those that are present during Rapid Eye Movement (REM) sleep, and those that are present during Non-REM (NREM) sleep. This class of disorders includes nightmare disorder, sleep terror disorder, and sleep walking disorder.
3. Secondary sleep disorders: These sleep disorders are caused by a physical illness or psychological distress, or are substance induced.
Insomnia is one of the most common sleep disorders in the U.S.; it is present in approximately 30–40% of the general population, and in up to 66% of the primary care and psychiatric population. In simple terms, insomnia is the inability to get sufficient quality sleep in an efficient manner; it presents itself as having difficulty falling asleep, experiencing frequent or prolonged awakenings during sleep time, and/or having short overall sleep durations (Hales, Yudofsky & Gabbard, 2008). Not only does insomnia affect a person’s sleep, but it also impacts his/her waking life through lack of sleep, as evidenced by some of the common complaints that insomniacs have, including depression, fatigue, and trouble concentrating.
Most of us are familiar with the existence of sleeping pills. But did you know that sleeping pills, although proven effective, should only be taken with precaution and they can have several serious side effects? So, for those who are experiencing trouble sleeping and would rather try a non-pharmacological approach, there are some suggestions.
Behavioral and Psychological Treatment
While there may be a wide variety of behavioral and psychological treatments available for insomnia patients, in the last decade there seems to be substantial evidence for the efficacy of cognitive-behavioral therapy for insomnia, or CBT-I (Smith and Perlis, 2006). CBT-I is an empirically validated cognitive-behavioral intervention that incorporates several facets:
· Stimulus control, which entails reconditioning the bedroom environment in order to reinforce its purpose as a place for sleep.
· Sleep restriction therapy, which initially increases sleep deprivation in order to train the body to maintain adequate sleep efficiency (total sleep time/time in bed).
· Relaxation skills, which reduce sleep-inadequate states of arousal.
· Multi-component CBT-I, which commonly integrates other behavioral interventions with cognitive restructuring techniques in order to modify maladaptive sleep-related beliefs.
Have you ever had any of these sleep-related problems? Maybe you experience chronic sleeplessness or you’ve even been diagnosed with a sleep disorder. Perhaps someone close to you suffers from insufficient sleep, which can affect the wellbeing of everyone around him or her. Does CBT-I or any of the techniques it incorporates sound like something that might be helpful to you or anyone you know?
Hales, R.E., Yudofsky, S.C. & Gabbard, G.O. (2008). Textbook of Psychiatry, 5th ed. The American Psychiatric Publishing: Arlington, VA.
Smith, M.T. & Perlis, M.L. (2006). Who is a candidate for cognitive behavioral therapy for insomnia? Health Psychology, 25, 15-19.
Wednesday July 18th 2012 - NYBH Staff
Importance of Sleep
Sleep is something we do quite often, but do we really understand how critical it is to our health and wellbeing? The sleep-wake cycle is a fundamental process in our lives. It has been equated with several functions, including physical restoration, the optimization of waking neurocognitive and emotional functioning, and the overall promotion of health and survival.
Sleep and the Body’s Rhythms
Like most physiological and psychological functions that we humans depend on, our sleep demonstrates a rhythm. Each of our body’s rhythms is unique in terms of the time it takes to complete one cycle. For example, we have some very short rhythms (like our cardiac rhythm), and other very long ones (like the menstrual cycle). Sleep follows a circadian rhythm, which means that the cycle has an approximate length of 24 hours. An interesting fact is that circadian rhythms, which are intrinsic to humans, are not necessarily dependent on the presence of a light-dark cycle in our environment. Granted, we tend to synchronize the two, but circadian rhythms are expressed even when we humans are isolated from any temporal or environmental cues (Hales, Yudofsky & Gabbard, 2008).
Types of Sleep
It is easy for us to distinguish when someone is awake or asleep, but did you know that we have different kinds of sleep, and that while we are asleep we alternate between sleep types every 90 to 100 minutes? The two primary states of sleep are (1) rapid eye movement (REM) sleep, and (2) non-rapid eye movement (NREM) sleep.
REM sleep: In the average young adult, REM sleep represents approximately 25% of time slept. REM sleep is characterized by rapid and random eye movements, as well as by low muscle tone (which actually paralyzes our bodies in order to prevent us from acting out our dreams) and by rapid but low–voltage brain waves that are very similar to those observed when we are awake. REM sleep is also the sleep stage in which dreaming primarily occurs. The REM stage gets progressively longer and more intense as the night progresses.
NREM sleep: The NREM sleep state is further divided into four stages that range from high arousability to low arousability.
o Stage 1: In the average young adult, Stage 1 NREM sleep occupies only about 5% of sleep time. This stage is seen only during sleep onset and following the brief awakenings that occur throughout the sleep period.
o Stage 2: In the average young adult, Stage 2 NREM sleep occupies about 50% of sleep time. During this sleep stage, we are no longer conscious or aware of our environment.
o Stages 3 and 4: These NREM sleep stages are also known as ‘slow wave sleep.’ In the average young adult, these stages occupy about 20% of sleep time. They are characterized by presenting the slowest of brain waves (delta waves). These stages of sleep tend to occur early on in sleep, and diminish in length and intensity as the night progresses. The average person will have few indications of these two sleep stages during the second half of their sleep time.
Effects of Sleep Deprivation
The need for sleep in all of its stages is compelling. However, in today’s busy world, people are rarely getting the sleep they need. We must remain aware of the many negative effects that continuous sleep deprivation has, including changes in our emotions, behaviors, and mental processes, as well as negative biological effects (Moorcroft, 2003).
Do you feel you are sleep deprived sometimes or perhaps all the time? If so, what sort of effects do you think it has on your physical and emotional wellbeing? Based on the information about types and stages of sleep provided herein, of what kinds of sleep do you believe you get a sufficient amount? Is there a particular sleep type or stage in which you feel you are experiencing deprivation? What changes can you make in your life that might help you to get more of this kind of sleep? Or simply to get more sleep in general?
Hales, R.E., Yudofsky, S.C., & Gabbard, G.O. (2008). Textbook of Psychiatry, 5th ed. American Psychiatric Publishing: Arlington, VA.
Moorcroft, W.H. (2003). Understanding Sleep and Dreaming. Kluwer Academic-Plenum Publishers: New York, NY.
Tuesday July 10th 2012 - NYBH Staff
Need for Research on Adult Bullying
Baughman, Dearing, Giammaro, & Vernon (2012) conducted a study of the relationship between bullying behaviors and three distinct personality traits often referred to as The Dark Triad: Machiavellianism, sub-clinical narcissism, and sub-clinical psychopathy. The aim of the researchers was not only to better understand bullies, but also to attempt to create a Bullying Questionnaire appropriate for use with adult populations. They had noted a paucity of research that addressed bullying behaviors (besides workplace bullying) prevalent in adult interactions. Citing research by Huesmann et al. (1984), the team expressed support for the evidence and consequent conclusions that “bullying behavior is relatively stable from childhood to adulthood” and that “highly aggressive children continue to become highly aggressive adults” (Baughman et al., p. 574). Thus, the creation of adequate measurement tools was a critical ambition behind this study and an invaluable initial step taken toward improving the quality and availability of research on adult bullying.
Measurement of Personality Traits and Bullying Behaviors
Baughman et al. pioneered the specially created Bullying Questionnaire during this study. Participants, recruited at the University of Western Ontario and through Facebook and other online advertisements, were asked to rate the frequency of their engagement in 17 bullying behaviors on a 5-point Likert Scale (1=Never; 5=Always) over the course of a month. Personality traits were subsequently measured via the Short D-3 developed by Paulhus & Williams (2002) and consisting of 28 items measured on a Likert Scale and assessing for Machiavellianism, narcissism, and psychopathy.
Machiavellianism refers to a “tendency to manipulate and deceive others in social situations for personal gain” (Baughman et al., p. 572). It was chosen as a trait for this study because previous research has shown a positive relationship between Machiavellian traits and adolescent bullies, with an emphasis on relational aggression. Cognitive empathy, or the ability to predict and understand the emotional reactions of others, was also positively correlated to Machiavellianism.
Narcissism and Psychopathy
Narcissism is characterized as low self-esteem disguised as grandiosity. Studies have shown that, when an individual with narcissistic traits perceives his/her ego is under attack, he/she may retaliate with aggression, most often in direct or overt behaviors. The third and last personality trait addressed by the researchers is psychopathy, characterized as a combination of traits including impulsivity, narcissism, and callous-unemotional (CU) traits, all of which have been linked to “proactive and reactive aggression” (Baughman et al., p. 572).
Adult Bullying Similar to Childhood/Adolescent Bullying
The results yielded by the study of adult bullying behaviors concurred with those of previous research on bullying among adolescents in that males reported bullying more frequently than females. Of the three personality traits considered, psychopathy was the most strongly linked to bullying behaviors, followed by Machiavellianism, and then narcissism. Baughman et al. hope that their study, the first to investigate a direct relationship between “The Dark Triad” and bullying behaviors, will prompt further research into the specific personality traits most prevalent among bullies and also fuel increased investigation into bullying as a phenomenon not singular to childhood and adolescence.
Baughman, H., Dearing, S., Giammarco, E., & Vernon, P. (2012). Relationship between bullying behaviours and the dark triad: A study with adults. Personality and Individual Differences, 52: 571-575.
Huesmann, L. R., Eron, L. D., Lefkowitz, M. M., & Walder, L. O. (1984). Stability of aggression over time and generations. Developmental Psychology, 20: 1120–1134.
Paulhus, D. L. & Williams, K. (2002). The Dark Triad of personality: Narcissism, Machiavellianism, and psychopathy. Journal of Research in Personality, 36: 556-568.
Friday July 6th 2012 - NYBH Staff
Targeting Bullying Behaviors Early On
The notable and negative effects of bullying have been well researched and documented among children and adolescents; yet Kirves & Sajaniemi (2012) note a gap in research related to bullying in early educational settings. It is known that bullying throughout childhood and adolescence can lead to depression, anxiety, low self-esteem, and difficulty in relationships well into adulthood. The researchers highlight the onset of bullying in early educational settings through a study conducted in Finnish kindergarten classes in an attempt to identify and combat bullying behaviors at their inception. Early detection and intervention of early childhood bullying can improve a child’s adjustment to full-time school, future mental health and the quality of peer relationships. Therefore, Kirves & Sajaniemi (2012) encourage childhood mental heath prevention and intervention programs to target bullying behaviors as early as possible.
Defining Early Childhood Bullying
To define bullying in early childhood settings, Kirves & Sajaniemi (2012) first reference a commonly used definition for school bullying introduced by Olweus (1973): “A person is being bullied or victimized when he or she is exposed, repeatedly and over time, to negative actions on the part of one or more other persons” (p. 384). The researchers argue that Olweus’ (1973) definition for bullying among school age children can carry over into early childhood settings, such as preschool and daycare, with certain primary considerations understood.
Frequency vs. Intention
First, aggressive behavior can be common during early childhood; therefore a young child’s behavior should be considered bullying only when it is more frequently aggressive than others (p. 285). Additionally, Kirves & Sajaniemi (2012) highlight “level of awareness” as a historical pre-requisite to categorizing behavior as bullying (p. 385). Among young children, however, frequency and duration of aggressive behaviors are arguably more indicative of bullying than the intention behind said behaviors (p. 385).
How Kindergartners Perceive Direct and Indirect Bullying
Gathering data can be more challenging among young children, than in later school years. Kirves & Sajaniemi (2012) cite research by Alsaker (1993) and Monks et al (2003) that indicates children in kindergarten can identify bullies in a group, but have more difficulty identifying the targets of bullying. Furthermore, data show that young children more often equate bullies with overt acts of physical aggression (direct bullying) than with indirect bullying behaviors such as exclusion. It is, therefore, suggested that data be obtained through preschool teachers, daycare providers, or from direct observation.
Quantitative and Qualitative Data
Kirves & Sajaniemi (2012) obtained data both quantitatively and qualitatively. Quantitative data was obtained through a questionnaire given to all staff members working with kindergartens in the city of Vantaa, Finland and reflect 89% of children aged four to six in kindergartens participating in the study. Interviews with children, parents, and staff accounted for the qualitative portion of analysis.
The Bullies and the Bullied – Who They Are
The results of this study demonstrate that “7.1% of day care children bullied other children, while 3.3% were bullied by others and 2.2% were bully-victims,” indicating, “a total of 12.6% of the children in the study were directly involved in bullying” (p. 389). The data also show that immigrant children and children with special needs were more often the victims of bullying than their peers. Gender differences among bullies also emerged, showing that boys, at 64.3% were more often bullies than girls at 35.7%; boys were also shown to more often become bully-victims at 62.5% than girls at 37.3% (p. 390).
Bullying Behaviors Delineated
Interestingly, though most young children equate physical aggression with bullying, the survey results reflect it as the least common type of bullying among participants. According to survey results, “the most common form of bulling was psychological bullying,” such as exclusion (p. 393). “The second most common form of bullying turned out to be different kinds of verbal bullying (8.18%), including name-calling, pointing, and laughing; physical bullying was less common (7.45%)” (p. 393).
Important Population Left Out
In Finland, every school is required by law to have an action plan designed to protect its students from bullying and peer harassment. Unfortunately, no legislation exists to include and hold accountable early educational settings. Kirves & Sajaniemi’s (2012) study highlights the importance of early intervention and encourages preventative programs to direct increased attention to a critical young population.
Alsaker, F. (1993). Isolation and maltreatment by peers in kindergarten: how to measure these phenomena and what are their consequences? Enfance, 47, 241-260.
Kirves, L. & Sajaniemi, N. (2012). Bullying in early education settings. Early Child Development and Care, 182 (3-4): p. 383-400.
Monks, C., Smith, P. and Swettenham, J. (2003). Aggressors, victims, and defenders in preschool: Peer, self, and teacher reports. Merrill-Palmer Quarterly, 49, 453-469.
Olweus, D. (1973). Hackkycklingar och översittare: Forskning om skolmobbning [Chopper chicks and bullies: Research on school bullying]. Stockholm: Almqvist & Wiksell.
Wednesday June 27th 2012 - NYBH Staff
A Focus on Emotions
With somewhere between 5% and 30% of the European workforce plagued by an experience known as workplace bullying, a research team designed and conducted a study to examine the relationship between workplace bullying and victims’ emotional and physiological reactions. The investigators, Lokke Vie, Glaso, & Einarsen (2012) note previous studies demonstrating those who are the victims of bullying are more vulnerable to experience psychiatric, psychosomatic, and psychological difficulties. Therefore, they are seeking to better understand, through clinical research, why victims of bullying are at an increased risk for poor mental health outcomes. Lokke Vie et al. (2012) believe this is achieved by focusing on emotions and the powerful influence they have on an individual’s cognitions and behaviors.
Emotional Fluctuations Can Be Disruptive
Lokke Vie et al. (2012) argue that an understanding of the emotional impact of bullying is integral both for victims and for mental health professionals because emotional awareness opens a gateway to situational and cognitive reappraisal, whereby a victim may gain more control over a situation and subsequently cope more effectively. They distinguish between positive emotions and negative emotions and pose that a fluctuation in either can disrupt an individual’s well being.
Types of Data Collected
To conduct the study, employees at a Norwegian bus company were asked to anonymously self-report on the frequency of experienced bully behaviors over the last six months on a scale of 1-5 (1 = no; 2 = yes, occasionally; 3 = now and then; 4 = once a week; 5 = several times per week). Correspondingly, positive and negative affect states were measured over the course of a two-week period using the Positive and Negative Affect Schedule (PANAS). Finally, musculoskeletal complaints were measured with the Bergen Health Checklist (BHC) and assessed participants for somatic complaints such as backache, headache, neck ache, foot pains, and hand pains.
Negative Emotions and Their Consequences
The results of the study supported the researchers’ first hypothesis, that victims of bullying experience more negative emotions than their non-bullied counterparts (p. 170). The victims did indeed report higher levels of negative emotion than their non-bullied counterparts, leaving them more often feeling “afraid, upset, angry, guilty, nervous, hostile, frustrated, ashamed, scared, and stressed” (p. 170). Interestingly, a significant difference in the experience of positive emotions, excluding “interest” was not noted between self-reported victims and non-victims. Lokke Vie et al. (2012) do, however, suspect the marked decrease in “interest” experienced or maintained by victims of bullying to be the result of social withdrawal induced by a decrease in positive feelings toward those within a respective social environment.
Connection to Disease and Medical Conditions
Additionally, Lokke Vie et al. (2012) reveal results in support of their second hypothesis that both positive and negative emotions, especially stress, mediate the relationship between exposure to bullying and musculoskeletal complaints. Investigators cite Lazarus’ (1999) explication of stress as, “A feeling experienced once an encounter is appraised as being a threat to the person’s well-being, and when the person perceives that stressors or demands imposed upon the individual exceed his or her personal and social coping resources” (p. 171). The results support previous research connecting negative emotions to the development of physiological diseases like hypertension, asthma, diabetes, and cardiovascular disease.
Consequences of the Long-Term Stress of Continued Bullying
Further, Lokke Vie et al. (2012) echo The Cognitive Activation Theory of stress (CATS 2004), in suggesting the experiences of sustained hopelessness and helplessness may incite chronic levels of anxiety and depression, thereby increasing an individual’s likelihood of participating in smoking or substance abuse, which over time may produce increased musculoskeletal complaints. Thus, emotions play an integral role in how an individual reacts cognitively, behaviorally, and physiologically to bullying. Increased research aimed toward identifying and understanding the relationship between specific emotions and mental health outcomes for victims of bullying will better serve both clients and clinicians.
Einarsen, S., Raknes, B. I., Matthiesen, S. B. & Hellesøy, O. H. (1994). Mobbing og harde personkon?ikter. Helsefarlig samspill på arbeidsplassen. [Bullying and severe interpersonal conflicts. Unhealthy interaction in the workplace.] Soreidgrend: Sigma Forlag.
Lazarus, R. (1999). Stress and emotion: A new synthesis. NY: Springer Publishing Co.
Lokke Vie, T., Glaso, L., & Einarsen, S. (2012). How does it feel? Workplace bullying, emotions and musculoskeletal complaints. Personality and Social Psychology, 53: p. 165-173.
Ursin, H. & Eriksen, H. (2004). The cognitive activation theory of stress: A review. Psychoneuroendocrinology, 29: 567–592.
Watson, D., Clark, L. A. & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS Scale. Journal of Personality and Social Psychology, 54:1063–1070.
Monday June 25th 2012 - NYBH Staff
ADHD Not Just for Boys
Sciberras, Ohan, and Anderson (2011) reveal evidence that adolescent girls with Attention Deficit/Hyperactivity Disorder (ADD/ADHD) are at an increased risk for strained social relationships and victimization by bullies. Gender specific research about the social impairments and relational effects of ADHD is relatively scarce, due to the historical misconception that ADHD primarily affects males. However, what little research exists reveals that girls with ADHD have fewer friends, higher levels of aggression, and more relational difficulties than their peers without ADHD.
The Femininity Factor
Therefore, the researchers stress the importance of examining the behaviors and social interactions, with particular attention paid to gender expectations and the construct of femininity, among girls diagnosed with ADHD.
Behaviors Characteristic of ADHD
ADHD is characterized by three main criteria: inattention, hyperactivity, and impulsivity; each of these characteristics can translate into behaviors that significantly impair an individual’s ability to relate positively with others. For example, a child with ADHD may be more “aggressive, talkative, and rule violating,” and thereby irritate or annoy peers.
Greater Consequences for Girls
Sciberras et al. (2011) draw attention to a discrepancy in the social acceptability of such behaviors between genders, and note, “girls who are more overtly aggressive are more likely to be rejected by their peers” (p. 255). Additionally, the investigators point out the emphasis of higher levels of peer attachment in female friendships; thus behaviors with the potential to interrupt this attachment can have more severe relational consequences for females than for their male counterparts.
In their 2011 study, Sciberras et al. examine the prevalence of bullying, both overt and relational, as well as victimization, in adolescent girls with and without ADHD. Sciberras at al. (2011) also seek to better understand the relationships among bullying, ADHD, and a potential co-morbidity of Oppositional Defiant Disorder (ODD). ODD is characterized by highly aggressive and defiant behaviors.
Types of Information Gathered
To obtain data, several measurement tools were used in a sample of nearly equal numbers of adolescent girls with ADHD (and their primary caregivers) and adolescent girls without ADHD (and their primary caregivers). Parent-reported ADHD and ODD symptoms were recorded for the girls, using the ADHD IV Rating Scale and the Oppositional Defiant Disorder Rating Scale. Both parents and their adolescents filled out the Social Experience Questionnaire and the Children’s Social Behavior Scale to assess for peer victimization and bullying behavior. Participants were then screened for cognitive ability and general social problems.
Behaviors Linked to ODD, ADHD
Both the self and the parent reports of adolescent girls with ADHD reveal higher incidents of social problems and more overt and relational victimization than the reports on adolescents without ADHD. Findings also demonstrate that adolescent girls with ADHD more often engage in overt and relational bullying than those without ADHD. Sciberras et al. (2011) carefully note that, although these findings are meaningful and consistent with emerging data, the results are not statistically significant and require further scientific inquiry for substantiation. Further, they point out that ODD symptoms are more strongly predictive of overt and relational bullying than are ADHD symptoms. Conversely, peer victimization is more closely linked to ADHD symptoms than to ODD symptoms.
Implications for Interventions
The findings of this study are critical for mental health practitioners treating adolescent girls with ADHD and a wide range of existing co-morbidities. Impaired social functioning in childhood is often perpetuated into adolescence and adulthood, creating or exacerbating further clinical concerns. Clinical interventions should screen for and target underlying relational difficulties and social impairment to improve mental health outcomes in female adolescents diagnosed with ADHD. Further, Sciberras et al. (2011) note that developmental models suggest girls rely more on satisfactory peer relationships to cope with life’s difficulties than do their male counterparts. Thus, girls with ADHD, who may struggle to build and maintain such relationships, are at a potential disadvantage that is clinically significant and, to this date, largely ignored.
Sciberras, E., Ohan, J., & Anderson, V. (2012). Bullying and peer victimisation in adolescent girls with attention-de?cit/hyperactivity disorder. Child Psychiatry Human Development, 43: p. 254-270.
Monday June 18th 2012 - NYBH Staff
Types of Bullies
Wang et al. delineated three classes of bullies in order to categorize and better understand the relationship between cyber bullies and traditional bullies and their potential resulting externalized problems. The categories included (1) the all-type bully, (2) the verbal/social bully, and (3) the non-involved “bully.”
The researchers utilized data obtained from a nationally represented sample provided by the 2005-2006 Health Behavior in School-Age Children Survey (HBSC; Eaton, D., Kann, L., Kinchen,S., Shanklin, M., Ross, M., Hawkins, J., William, H., Lowry, R., McManus, T., Chyen, D. Lim, C., Whittle, L., Brener, N., Wechsler, H., 2010). Youth Risk Behavior Suveillance. Morbidity and Mortality Weekly Report, Center For Disease Control, 59 (SS-5). to create these three classifications of bullying and to assess for three potential externalized behaviors: bullying behaviors, substance abuse, and weapon carrying.
Participants were assessed for bullying behaviors through questions adapted from the Olweus Bully/Victim Questionnaire. Substance abuse was measured through a screening on drugs, tobacco, and alcohol that accounted for use within the last 30 days; and weapon carrying was determined through questions drawn from the Youth Risk Behavior Survey. Wang et al. conducted this study to better understand the connection between cyber-bullies and traditional characteristics of bullying in the hopes of improving treatment interventions and mental heath outcomes of bullies and their victims.
Gender and Category Differences in Externalizing
The researchers found that Class 1, or all-type bullies, are among the highest at risk for developing externalized problems. Males were categorized as all-type bullies more frequently than females; thus, males were also more likely to abuse substances and carry weapons. Class 2, or verbal/social bullies posed a medium level of risk and Class 3, the non-involved participants, represented the least amount of risk for externalizing problems.
Wang et al. also concluded that students’ roles in traditional bullying predicted roles in cyber bullying. All-type bullies were more likely to engage in cyber bullying, which was attributed to a group of highly aggressive adolescents who practice all types of bullying and are at the highest risk for elevating externalized problems. Therefore, the investigators encourage targeting interventions toward a population that represents the highest risk for developing externalized problem behaviors: cyber bullies.
Eaton, D., Kann, L., Kinchen,S., Shanklin, M., Ross, M., Hawkins, J., William, H., Lowry, R., McManus, T., Chyen, D. Lim, C., Whittle, L., Brener, N., Wechsler, H. (2010). Youth Risk Behavior Suveillance. Morbidity and Mortality Weekly Report, Center For Disease Control, 59 (SS-5).
Wang, J., Iannotti, R., & Luk, J. (2012). Patterns of adolescent bullying behaviors: Physical, verbal, exclusion, rumor, and cyber. Journal of school psychology: p. 1-14.
Tuesday June 12th 2012 - NYBH Staff
Alternative Diet Therapies
In the previous post, several diet therapies addressing symptoms of attention deficit hyperactivity disorder (ADHD) were presented. The discussion of alternative dietary treatments for ADHD continues herein.
The expression “sugar rush” or “sugar high” has become very common and, although parents of children with ADHD frequently express concerns that sugar heightens hyperactive symptoms, the majority of controlled studies suggest that, in general, sugar does not produce significant adverse effects. Nonetheless, for a small group of children, sugar intake seems to increase inattention and duration of characteristic aggression. Thus, removing sugar from the child’s diet, cutting back on it, or reserving its place in the diet for special occasions is something parents might want to try, if their child’s hyperactive symptoms are problematic. This action is also likely to produce benefits completely unrelated to ADHD (e.g., prevention of tooth decay and obesity).
ADHD and Sugar Level
Millichap and Yee (2012) explain the relationship between sugar and ADHD, particularly the cognitive impairments and inattention symptoms, by referencing studies that show children’s vulnerability to present with reactive hypoglycemia. Low blood sugar levels (hypoglycemia) negatively influence electrical activity of the cerebral cortex by causing slow rhythms to appear. As with other attempts to link sugar intake and ADHD, this explanation only posits mixed results with possible benefits that still require additional studies.
Zinc Supplement Diet
Recently, studies looking into the role of trace elements have examined the relationship between zinc and ADHD. Bilici, Yildrim & Kandil (2004) report the following:
· Zinc deficiency plays a major role in hyperactivity.
· Human zinc deficiency syndrome leads to concentration impairments and jitters.
· In some studies, zinc, as well as fatty acids, was found to be significantly deficient in subjects with ADHD, compared to controls.
Zinc’s Effect on ADHD Symptoms
This study, a DBRPC (double-blind, randomized, placebo-controlled) study of 72 girls and 328 boys conducted in the Department of Psychiatry of Karadeniz University in Turkey, tested the hypothesis that zinc administration (150 mg) would lead to significantly greater reduction in ADHD symptoms than would placebo, as determined by using the Attention Deficit Hyperactivity Disorder Scale (ADHDS). Their results were as follows:
· Zinc was well tolerated by patients.
· Compared with placebo, zinc treatment produced sustained improvement from baseline in the outcome measures of the ADHDS scale scores.
· Specifically, it showed improvement in hyperactivity, impulsivity, and socialization scores with no positive effect on attention deficiency scores.
Millichap and Yee (2012) report that, while zinc supplements can be of value in treatment of Middle Eastern children with ADHD associated with endemic zinc deficiency, the integration of zinc as part of ADHD treatment in the United States is still debated.
Trying Alternative Therapies
The alternative diet therapies for ADHD presented in the past two posts of this blog are just a few of the many that exist. The quest to find a substitute or supplement to pharmacological and behavioral treatments is still in the developmental stages and, unfortunately for anxious parents searching for solutions, no definite conclusions have been reached. Nonetheless, Millichap and Yee (2012), suggest that there are reasonable circumstances that might indicate trying out some of these diet therapies. They include, among others, the following:
· medication failure or adverse reactions,
· parent or patient preference,
· symptoms or signs of mineral deficiencies, and
· need for substitution of an ADHD-free healthy diet for an ADHD-linked diet.
When evaluating these diets as potential options, it is important to do so with the help of a physician. It is also important to understand that some of these diets are harder to implement than others. For instance, elimination and additive-free diets are often disruptive to the household and complicated to follow, while supplemental diets are usually easier and less time-consuming to implement.
Do you or does someone close to you have ADHD? In your experience, what, if anything, has helped to reduce negative symptoms of ADHD? Are behavior therapy and medication the best options for treating ADHD? What do you think about alternative diet therapies for ADHD? Have you heard or read about others (besides the diets described in this and the previous post)?
Bilici, M., Yildirim, F., Kandil, S., Bekaroglu, M., Yildirmis, S., Deger, O., Ulgen, M., Yildiran, A. & Aksu, H. (2004). Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 28, 181-190.
Millichap, J. G., & Yee, M. M. (2012). The diet factor in attention-deficit/hyperactivity disorder. Pediatrics, 129, 2011-2199.