Bullying in schools: doctors' responsibilities

摘要

Bullying is the intentional, unprovoked abuse of power by one or more children to inflict pain on or cause distress to another child on repeated occasions. It includes several different activities: hitting, pushing, spreading slanders, provoking, making threats, extortion, and robbery. A common, international phenomenon, it occurs to some extent in all schools. Whitney and Smith's study of more than 6000 pupils in 23 schools in Sheffield found that 27% of junior and middle school pupils and 10% of secondary school pupils said that they had been bullied sometimes or more often that term; 10% of junior and middle school pupils and 4% of secondary school pupils were being bullied at least once a week. Most had not told a teacher or anyone at home. Bullying can be considered to be a form of child abuse: peer abuse. Like other forms of abuse, it is an abuse of power and is surrounded by fear, secrecy, and a misplaced loyalty to the perpetrator(s). Victims suffer adverse effects in the short and long term. Victims of regular bullying lack confidence, have lower self esteem, regard themselves as less competent,' and have fewer close friends than children who are not bullied." Distress and preoccupation with their predicament may affect their concentration on their schoolwork. Bullying may be a contributory factor in why some children harm themselves or commit suicide, although this has not been systematically studied. When bullied children grow up they may be vulnerable to anxiety, depression, and loneliness (A H N Gillessen, annual convention of American Psychological Association, 1992) and may have difficulties with heterosexual relationships. Because bullying is usually unseen teachers, parents, and other adults often underestimate its prevalence and effects.