4. DEFINITION
● Aggressive, intentional actions carried out by one or more persons
repeatedly and over time against a victim who cannot easily defend
themselves (Olweus, 1994),
● Deliberately and repeatedly perpetrated by a perpetrator(s) who has more
power than the victim (Gladden, Vivolo-Kantor, Hamburger, & Lumpkin,
2014).
● It can include physical, verbal, and social abuse, and is a significant
adolescent health issue: Victims have poorer social, emotional, academic,
and health development
● While perpetrators are more likely to exhibit delinquent (Andershed, Kerr, &
Stattin, 2001) and aggressive behaviors (Loeber & Hay, 1997) into late
adolescence compared to uninvolved peers.
9. INTRODUCTION
Bullying in childhood is a global public health problem that impacts on child,
adolescent and adult health.
► Bullying exists in its traditional, sexual and cyber forms, all of which impact on
the physical, mental and social health of victims, bullies and bully–victims.
► Children perceived as ‘different’ in any way are at greater risk of victimisation.
► Bullying is extremely prevalent: one in three children globally has been
victimised in the preceding month.
► Existing bullying prevention interventions are rarely evidence-based and
alternative approaches are urgently needed.
10.
11. PSYCHOLOGY BEHIND BULLYING- BULLYING TRIANGLE
● Bully , victim & bystander.
● These are dialectically determined roles, not people, and can
switch around often very rapidly.
● Bystander is the audience for bully victim drama
● Bully needs applause as it increases the humiliation of victim &
makes bully feel more powerful, thus bystander enhancing
bullying.
12. THE CHICKEN AND EGG STORY
● Aggressive youth/conduct disorder/ bully others because of a predisposing
trait related to the diagnosis.
● Alternatively, youth who are “rewarded” for bullying behaviors (e.g., through
enhanced status or popularity, access to goods) may continue bullying, de-
velop further aggressive behaviors, and eventually meet criteria for a
diagnosis of conduct disorder.
● Shy youth might appeal more vulnerable, making them appealing targets of
victimization.
● Alternatively, someone who is bullied may develop a shy and withdrawn,
perhaps anxious, demeanor as a result of such treatment.
16. PREVALENCE OF BULLYING
● Almost one in three (32%) children globally has been the victim of bullying on
one or more days in the preceding month, and that 1 in 13 (7.3%) has been
bullied on six or more days over the same period.
● Direct physical and sexual bullying being dominant in low-income and middle-
income countries, and indirect bullying being the most frequent type in high-
income regions.
● Regional variations
● 1 in 20 adolescent girls and 1 in 50 adolescent boys reporting cyberbully
victimisation over the previous 2 months.
19. CONSEQUENCES OF BULLYING-SELF HARM
● Both traditional and cyber bullying increases risk of self harm beahviour, non
suicidal self injury, suicidal ideations and attempt in adolescents and youth till
25 years of age.
20. CONSEQUENCES OF BULLYING-ADULT
● Frequently bullied adolescents are twice as likely to develop depression in
early adulthood compared with non-victimised peers, and is seen in both men
and women.
● 29% of the adulthood depression burden could be attributed to victimisation
by peers in adolescence.
21. CYBERBULLYING -THE NEW ERA
Definition
● the sender must intend to harm the receiver;
● there is a power imbalance between the sender and receiver (e.g., age, social
status, anonymity, physical strength);
● acts of aggression are usually repeated;
● a personal computer, mobile phone, or other electronic device is used to
communicate (Garret et al. 2016).
The media through which cyberbullying can occur are equally diverse, including
instant messaging (e.g. through Viber, Skype, Messenger, etc.), e-mail, text
messages, web pages, chat rooms, blogs, social networking sites, digital
images and online games (Kowalski et al. 2014).
22. TRADITIONAL VERSUS CYBERBULLYING
● Bullying through electronic media is indirect, without physical interaction, the
victim does not have opportunities to defend and is available at every
moment, while chances of identifying and punishing perpetrators are
minimal (Bili et al. 2014).
● Cyberbullying perpetrators often perceive themselves to be anonymous.
Perpetrators who remain anonymous can say and do more harmful things
than they would face-to-face.
● Perpetrators can not see,hear or feel victim’s emotion, feelings and body
language which do not lead to generation of empathy or remorse in
cyberbullying.They do not deter from further bullying.
● Availability of victim in cyberbullying is 24*7. But traditional bullying usually
occurs at school.
23. HOW IS CYBERBULLYING DIFFERENT?
● Although the victims can remove themselves from the online site, the message
continues to accumulate.
● Abuse content sent via electronic media is difficult to remove.
● Victims can be abused in the security of their home, without the simple
ability to escape from the perpetrator.
● The perpetrators of bullying through electronic media do not attract the
attention of parents and teachers so they remain undetected for long time
(Kowalski et al. 2014).
● Larger audience for cyberbullying as compared to traditional
● Multiple victimization
24. PREVALENCE OF CYBERBULLYING
● Prevalence of cyberbullying exposure from 4.8% to 73.5%. (Hamm et al.
2015).
● 15% and 35% of young people have been victims of cyberbullying and
between 10% and 20% of individuals admit to having cyberbullied others
(Hinduja & Patchin 2010).
● Meta- analysis -traditional bullying victimization - 36%, while the
prevalence of cyberbullying victimization was about 15% (Modecki et al.
2014).
25. CYBERBULLYING AND AGE
● Cyberbullying tends to occur at a later age, around 14 years, when children
spend increasingly more time on their mobile phones and social
networking sites (Kowalski & Limber 2007).
● Williams and Guerra found in their research that cyberbullying increases
after fifth grade and peaks during eighth grade (Williams & Guerra 2007).
● Smith et al. observed that text messaging, picture/video clip bullying and
instant messaging were more frequent with older than younger
adolescents (Smith et al. 2008).
● 30% of youth claimed that their first experience with cyberbullying was in
college. (Kowalski et al. 2012).
26. CYBERBULLYING AND GENDER
● When compared to gender, boys are more involved in direct physical
contact while girls engage in indirect forms of bullying, including
cyberbullying (Kowalski et al. 2014).
● In research conducted by Sourander et al., it was concluded that boys are
more likely than girls cyberbullying perpetrators, while girls are more
likely to be victims of cyberbullying (Sourander et al. 2010). The results of
the research conducted in Canada also confirm that girls are twice as likely
to be victims of cyberbullying and that the more time young people
spend on electronic media they are more likely to be cyberbullying
victims (Sampasa-Kanying et al. 2014).
27. ● The results indicate that 68.5% of adolescents experienced some negative
emotions such as anger, upset, worry, stress, fear and depressive feelings
(Ortega et al. 2012).
● In a review study conducted by Reed et al. on adolescents aged 12 to 18 years,
was found a positive correlation between depressive symptoms and
cyberbullying (Reed et al. 2016).
● Adolescents who reported experiences of cyberbullying, particularly those who
suffered frequent attacks (two or more times a month), had more severe
depressive symptoms when compared with adolescents exposed to other
forms of bullying (Schneider et al. 2012).
CONSEQUENCES OF CYBERBULLYING
28. CONSEQUENCES OF CYBERBULLYING
● The feelings of helplessness and powerlessness to defend themselves
from incidents of cyberbullying can increase the sense of fear and
emotional distress, contributing to the emergence of depressive symptoms
(Bottino et al. 2015).
● Cyberbullying may have even more harmful outcomes to adolescents’ mental
health, including substance abuse, unsafe sexual behavior, violent and
suicidal behavior (Litwiller & Brausch 2013).
● In a meta- analyses involving 156386 children and adolescents, it was
concluded that cyberbullying victims are at a greater risk than nonvictims
of self-harm and suicidal behavior (suicidal ideation, suicide plans and
suicide attempts). To a lesser extent, perpetrators of cyberbullying are at risk
of suicidal behaviors when compared with nonperpetrators (John et al. 2018).
34. BULLYING PREVENTION
● School-based interventions- Whole school approaches (multiple disciplines
and high level of staff engagement)> curriculum-based and targeted social
skill training
● Olweus Bullying Prevention Programme (OBPP)- comprehensive, school
wide programme.
● Cooperative learning-positive peer interaction, carefully structure group based
learning activities.
● School based health centres- school nurses
● UNESCO- International Day Against Violence and Bullying at School
including Cyberbullying- first Thursday of November
35. BULLYING PREVENTION
● Creative ways to incorporate bullying prevention learning at school throughout
the year
● Include all components of bullying definition.
● Advise victims to use effective and appropriate bystander intervention
programmes
● Increase reporting of bullying at school by ‘safe line ‘ method of reporting or
using app anonymously
● Systematic involvement of parents.
● Deep breathing and counting to ten helps in stressful situations.
● Socio-emotional learning including anger management skill training for
students.
37. HOW TO PREVENT CYBER BULLYING
● Provide information (http://www.stopbullying.gov/ cyberbullying/index.html;
http://www.cyberbullying.ca/; http://www.prevnet.ca/)
● Ortega-Ruiz et al. further argued that effective programs require the following
strategies:
● 1) proactive policies, procedures, and practices;
● 2) raising school staff’s and youths’ individual awareness and online
social competence;
● 3) promoting protective school environment; and
● 4) school-family-community partnerships to promote cooperation
between school staff, families, and local organisations.
38. ROLE OF MENTAL HEALTH CARE PROVIDERS
● Discuss the child’s experience at school
● Window approach
● Assess for instances of bullying – using effective tools
● Clinical assessment of psychopathology.
● Addressing emotional problems, building assertiveness and relationship
skills – Scope for early intervention.
● Anticipatory guidance.
● Parental support.
● Liaison with school.
● Promoting mental health literacy among educators.
39. EFFICACY OF SCHOOL BASED ANTI CYBERBULLYING PROGRAMMES
● US-developed I-SAFE curriculum includes 5 lessons (60 minutes) on Internet
safety, cybercommunity citizenship, cybersecurity, personal safety,
intellectual property, and law enforcement online. Lessons/teachers/class
time/offline/grades 5-8.
● Canadian program, The Missing Program/ interactive computer
game/youth/Internet safety.Youth/police officer/ find missing teen/ online series
of puzzles/cannot trust everyone online/chatroom conversations and emails.
● Help-Assert Yourself- Humor-Avoid-Self-Talk-Own (USA) Research
evidence found that the programs increased Internet safety knowledge but did
not affect risky online behaviour.
40. OTHER SCHOOL BASED PROGRAMMES
● Media Heroes (Medienhelden)
● ConRed is a school-based program developed and evaluated in Spain.
● KiVA- Finland
● Surf Fair- Germany
● promoting empathy, perspective taking, communication skills, problem
solving, friendship skills, and so forth. Lessons on cybersafety and
cyberbullying. However, schools need to be supported to implement these
programs through stronger legislation that addresses cyberbullying, and
health care providers need to be informed of the negative outcomes
associated with cyberbullying and how to effectively work with cyberbullying
victims.
47. CASE SCENARIO 1:
14 year old girl studying in 8th standard single child born to NCM, has congenital
short stature, with normal developmental history presented with complaints of
school refusal since 6 months, nightmares and sleep disturbances, easily getting
aroused and terrified, flashbacks of terrible events in past during day time,
sensitivity to even hug or touch with low self esteem and mistrust on elders as well
as peers.
On further history taking, she revealed that she was verbally, emotionally and
even physically bullied by her classmates as well as few teachers in school due to
her short stature and identification with LGBTQ community.
On offering to return back to school, she refuses including refusal to join new
school because she believes bullies will be there in new school too and her fate
will result in her getting bullied.
WHAT WILL YOU DO NEXT?????
48. CASE SCENARIO 2:
12 year old boy single child to NCM, studying in class 8, normal birth and
developmental history, presents with bed wetting at night and loneliness due to
lack of siblings. He passes urine 2-3 times/week in clothes on bed. He refuses to
play outside with peers of locality but enjoyed spending time at school playing with
friends.
On further interview, he reports that the boys in the locality tease him calling
“Chinese” because of his appearance and names “Chasmis” due to him wearing
spectacles. Despite complaining to their parents, they did not bother to discipline
their children. He continues to suffer in locality hence avoids playing with them
resulting in increased screen time and anxiety issues.
WHAT CAN BE DONE NOW????
49. CASE SCENARIO 3:
11 year old boy single child born to NCM, with normal growth and development,
presented with complaints of irrelevant talk, fearfulness, suspiciousness, food
refusal, screaming at top of voice, sleeplessness at night since 1 day. Father
reports 1 day back when he went to school to pick him up at 4PM in evening he
was informed that the son was bullied by senior students in school and he was
terrified because of that. Later on when he grew unmanageable at home after 5
days , he was brought to emergency , accidentally upon urine toxicology
screening, it was revealed that high concentration of THC was present in urine. He
responded well to T RISPERIDONE 2 mg in a week and diagnosis of cannabis
induced psychosis was made.
WHAT SHOULD BE DONE NEXT???
50. CASE SCENARIO 4:
14 year old boy, studying in Class 8, brought up by single mother, presents with cruel
and rude behaviour with her and family, gambling and smoking with friends, bunking
school and involved in gang activities to bully younger children since 5 years.
On detailed interview, he reveals that he was absolutely different before 5 years when
he used to be shy and timid and was bullied by elder peers for 2-3 years previously at
school. Finally, when he grew older he decided to displace his anger on other younger
children in school in a similar manner by bullying them when he was senior at school.
Due to deviant peer association, he started to enjoy involving in such activities and
continued to do so.
WHO MADE HIM LIKE THIS??? WHO IS RESPONSIBLE FOR THE CHANGE?? THE
BULLIES OR THE TRAUMA OR HE HIMSELF??
