Why Children Bully: New Research Links Bullying to Mental Health Problems

A great deal of research over the years has focused on the devastating effects of bullying on the mental health of its victims. However, a recent study also suggests that children with mental disorders such as attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and depression are much more likely to engage in bullying behavior toward others.

Lead author Dr. Frances Turcotte-Benedict, a Brown University masters of public health student and a fellow at Hasbro Children’s Hospital in Providence, presented the findings at the American Academy of Pediatrics’ national conference in New Orleans on October 22. Turcotte-Benedict and her colleagues reviewed data provided by parents and guardians on mental health and bullying in the 2007 National Survey of Children’s Health, which included nearly 64,000 children ages 6 to 17 years.

In the survey, 15.2 percent of children were identified as a bully by their parent or guardian. Children with a diagnosis of depression or ADHD were three times as likely to be identified as bullies; children diagnosed with ODD were identified as bullies six times more often than children with no mental health disorders. The study found no noticeable differences between boys and girls—both were at increased risk for bullying when a mental health disorder was present.

Traits associated with ODD, such as aggression and revenge-seeking, appear to be clear risk factors for bullying. The connection between bullying and ADHD may be less obvious. “Even though, by definition, these children [with ADHD] aren’t angry or aggressive toward their peers, they do display traits that would increase the likelihood of having impaired social interactions,” explains Dr. Steven Myers, a professor of psychology at Roosevelt University in Chicago, in an October 22 interview with the Huffington Post. “If you’re not really thinking through the consequences of your actions on the playground, you might not have the self-monitoring or restraint to hold back from bullying.”

“These findings highlight the importance of providing psychological support not only to victims of bullying, but to bullies as well,” concludes Turcotte-Benedict. “In order to create successful anti-bullying prevention and intervention programs, there certainly is a need for more research to understand the relationship more thoroughly, and especially, the risk profile of childhood bullies.”

What do you think? Should bullying prevention programs do more to address the mental health problems of the bully? PAR wants to hear from you, so leave a comment and join the conversation!

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Can Men and Women Ever Just Be Friends?

It’s an age-old question, but now there’s science to give us an answer.

No, men and women cannot just be friends.

However, the reasons may be more complicated than you imagine. According to researchers at the University of Wisconsin-Eau Claire and published in the Journal of Social and Personal Relationships, attraction between members of cross-sex friendship is a common event. Furthermore, these “platonic” friendships have potential negative consequences for the individuals’ long-term romantic relationships.

Researchers surveyed more than 80 male-female pals and found that men were more attracted to their female friend than women were to their male friend. Men also tended to consistently (and mistakenly) believe that their female friend was more attracted to them than they actually were. Even if the woman in the pair was involved in a romantic relationship with another person, this did not deter most men – even if their gal pal was taken, this had no impact on their attraction.

Women, though, reported much less desire to date their male friends if they were already involved in a relationship. Younger females and middle-aged participants who reported more attraction to an opposite-sex friend also reported less satisfaction in their current romantic relationship.

In another survey conducted by the researchers, men reported that there was more to gain from attraction in friendships, while women felt that there was more to lose.

Do you have a successful cross-gender platonic friendship? Do you think that men and women can ever really just be friends?

The Marshmallow Test Grows Up

New research has made the famous 1972 marshmallow test even more compelling. The original Stanford University study on delayed gratification, which promised children an extra marshmallow if they could resist the one in front of them for 15 minutes, analyzed whether a child’s ability to delay gratification had any correlation on future success. Today, researchers have taken that information a step farther – finding that a child’s ability to resist temptation isn’t innate, but highly influenced by environment.

Researchers from the University of Rochester gave five-year-olds used crayons and one sticker to decorate a piece of paper. One group of children was told they would receive a new set of art supplies, but never received it. For the second group, however, researchers made good on their promise and provided the children with new crayons and better stickers. Both groups were then given the marshmallow test.

The children who were promised the supplies and never received them waited an average of three minutes before eating their marshmallows. The children who had received the supplies promised resisted temptation for an average of 12 minutes, leading researchers to believe that experience plays into a child’s ability to delay gratification. Wait times reflected not just the child’s self-control abilities, but suggest a child’s reasoning of the stability of the world around them and their understanding of whether waiting to delay gratification would ultimately pay off. According to researcher Celeste Kidd, delaying gratification is only a rational choice if the child believes that the second marshmallow is likely to appear. Though children do not monitor every single action of the adults around them, they do have an overall sense of the reliability or unreliability of the people around them.

The group found that children may have more sophisticated decision-making abilities based on their environments than originally thought.

New CPT Billing Codes for Psychotherapy Go Into Effect January 1

The CPT code numbers that mental health professionals use for billing psychotherapy services to insurance carriers will change on January 1, 2013. In addition to the code changes, Medicare reimbursement rates will also be revised. The AMA will publish the new codes and rates later this fall.

The American Psychological Association’s Practice Central Web site outlines some of the anticipated changes, which include:

1.  Outpatient and inpatient psychotherapy codes will be replaced by a single set of codes that can be used in both settings.
2.  The new psychotherapy codes will have specified times rather than ranges:

  • 30 minutes, not 20-30 minutes
  • 45 minutes, not 45-50 minutes
  • 60 minutes, not 75-80 minutes

3.  The single psychiatric diagnostic evaluation code will be replaced by two codes: one for a diagnostic evaluation and the other for a diagnostic evaluation with medical services.

What practical steps do you need to take now in order to prepare for these changes? According to the American Psychiatric Association, the pharmacologic management code will no longer exist, so it is important for practitioners to start familiarizing themselves with the medical evaluation and management (E/M) codes for medication management. Practitioners should also review any contracts they have with insurers to make sure that the contracts don’t limit them to specific codes in the psychiatry section that may be replaced as of January 1. HIPPA requires that insurers use current CPT codes, so these companies should be updating contracts in the coming months.

For the latest information about these changes and how they may affect your practice, visit the American Psychological Association’s Practice Central Web site or call its Practitioner Helpline at 1.800.374.2723.

PAR Author Lisa Firestone Hosts CE Webinar on Violence Prevention

On October 15, PAR author Lisa Firestone, PhD, will be hosting a CE Webinar with violence expert Dr. James Gilligan on the topics of understanding and preventing violence. For more information on the Webinar, visit Dr. Firestone’s blog. To register for the Webinar, click here.

Individuals with Disabilities 286% More Likely to be a Victim of Violence

Adults with disabilities, particularly mental illness, have been found to be at an increased risk of being a victim of violence, according to a study funded by the World Health Organization’s Department of Violence and Injury Prevention and Disability. This finding, a meta-analysis of 21 studies, found that one in four people with a mental illness experience some type of violence in a given year – a much higher rate than that experienced by the general population.

The chance that a person with a mental illness will experience physical, sexual, or domestic violence was found to be 3.86-fold higher than the odds of an adult without any disabilities at all. However, violence against individuals with other disabilities was common – it was found that individuals reporting any disability were 50 percent more likely to experience physical, sexual, or intimate partner violence in the prior 12 months than those individuals without a disability, and 60 percent higher for people with intellectual impairments.

Researchers believe that their inclusion criteria probably underestimated the prevalence of violence against people with disabilities because many of the studies were based in high-income countries with lower reported rates of violence. Furthermore, there were no studies of violence against individuals with intellectual disabilities in institutional settings or studies of individuals with sensory impairments included in the analysis.

Approximately 15 percent of adults worldwide have a disability.