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March 25, 2006

About Bullying

Bullying has been around for a long time and around in many places. The earliest reference to it in the English language goes back over three hundred years and involves grown men who are compared to a woman killing her man. Like their English predecessors, girls today as well as boys are involved in bullying. Bullying is a world wide phenomenon as will be seen by reports from Norway, England, South Korea and the United States.

Bullying for too long had been viewed as just a phase of growing up that would pass. Professor Dan Olweus in Norway was the first to seriously study bullying, starting in 1970. In 1983, after three Norwegian boys committed suicide, he was commissioned to conduct a research and intervention project on bully/victim problems. He developed a Bullying Prevention Program which is in use now in many countries including the United States.

The program requires school intervention on three levels: schoolwide intervention, including development of schoolwide rules against bullying; classroom level intervention, including classroom meetings about bullying and peer relations; and individual-level interventions, including individual meetings with bullies and victims and their parents. The Olweus program has been adopted by the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services as a model program that has resulted in a 30-70% reduction in student reports of bullying.

There has been an increasing psychiatric interest in bullying and a recognition of how widespread and serious it is. In 1993 The Anna Freud Centre in London held a one-day conference on bullying and published the results. In 2001 the Journal of the American Medical Association published an article on bullying behaviors among U.S. youth and its association with difficulties in psychosocial adjustment.

In October, 2005 at the annual meeting of the American Academy of Child and Adolescent Psychiatry there was a three hour panel on bullying. The panelists discussed bullying from the developmental, social and psychiatric/medical symptoms points of view. It is important to identify and help students who are at high risk for bullying not only for the sake of the present but also because they may transfer their interactional style to other relationships across the lifespan. Nine percent of adult workers in Europe reported being bullied by other adults.

A significant number of girls bully and/or are bullied, usually by other girls, in physical as well as verbal and isolative fashion. Bullies, victims and bullies who have formerly been victims reported physical and emotional symptoms such as headaches, stomach aches, dizziness, nervousness and sleeping difficulties. Suicide continues to be a possible outcome of bullying. Psychiatric treatment, including psychotherpy, is sometimes necessary for both perpetrator and victim.

Related Links:

Olweus Bullying Prevention Program at Clemson University -- US website for the Olweus Bullying Prevention Program

Posted by admin at 09:25 AM

Work Place Discrimination Not a Delusion

A recent article in Psychiatric Services reports on "Perceived and measured stigma among workers with serious mental illness". Using data from the National Health Interview Survey - Disability Supplement they found that 20% of workers with mental illness reported some experience with employment-related stigma (refused hiring, promotion, transfer, or access to job training). Those who had functional limitations (problems with memory or concentration) were more likely to experience that discrimination.

They also found:

"...when we compared workers who reported experiencing stigma with those with no mental illness, the results showed adjusted wages that were about two-thirds as large. The results strongly suggest that workers know when they are being discriminated against."

The article suggests that some employer initiatives are needed: education, policy changes, sensitivity training for supervisors and other workers to provide a fairer more humane workplace environment for the benefit of all.

Related Links:

"ABSTRACT: Perceived and measured stigma among workers with serious mental illness," Marjorie L. Baldwin, Ph.D. and Steven C. Marcus, Ph.D., Psychiatric Services, March 2006, pp388-392.
"FULL TEXT: Perceived and measured stigma among workers with serious mental illness," Marjorie L. Baldwin, Ph.D. and Steven C. Marcus, Ph.D., Psychiatric Services, March 2006, pp388-392.
Psychiatric Services: A Journal of the American Psychiatric Association

Note: A subscription is required to retrieve the full text of this article on the Psychiatric Services website.

Posted by admin at 09:05 AM

Photographs of the Mentally Ill

Since 2003, images and voices of 55 mentally ill people have been on exhibit at museums and medical schools around the country. The creator of the exhibition, entitled "Fine Line: Mental Health/Mental Illness," is Michael Nye.

His purpose is to show the human being underneath the illness, and each picture is accompanied by an audio recording of the person telling his/her story. That story often resonates with the viewer's own story, and in that way tends to bring the viewer and the viewed together.

Each black and white photo tries to capture the essence of Nye's subjects, who include professors, parents, writers, artists, and war veterans. The collection took four years to put together. Information about the exhibit and the possibility of obtaining it is contained on his web site.

Related Links:

Fine Line: Mental Health/Mental Illness, A documentary of voices, stories and portraits by Michael Nye

Posted by admin at 08:59 AM

New York Times Examines Depression in Pregnant Women

A New York Times article, "The Dilemma of Depression for Mothers-to-Be," by Jane E. Brody (February 21, 2006) explores the issues in treating pregnant women for depression. Perhaps 10 to 20 per cent of pregnant women suffer from depression during pregnancy, which translates to about 80,000 women per year in the United States. Many are not treated, either because they are ashamed to reveal their symptoms, believing they should be happy when expecting a baby, or because the diagnosis is not made.

The general medical advice to women has been to avoid all medications during pregancy, but it has become gradually apparent that in the case of depression, an exception should be seriously considered. Each individual case needs to be assessed according to risks and benefits. Untreated depression has been linked to higher rates of miscarriage, stillbirths, premature deliveries, intrauterine growth restriction and low-birth-weight babies.

Depression can lead to damage to the woman's relationship to her spouse and other children. Those women already on medication who stop for the first trimester have an increased likelihood of a recurrence of depression, and prepartum depression is likely to continue after birth, leading to problems in establishing a healthy relationship with the baby.

But there are risks. A recent study of 60 newborns exposed in utero to S.S.R.I antidepressants showed that 18 had mild to severe signs of "neonatal absinence syndrome," including high pitched crying, disturbed sleep, feeding difficulties, tremor and muscular stiffness lasting a week or two. Another study showed an increased risk for a rare but serious lung disease. An earlier study showed that 1 per cent of babies exposed in the last trimester of prenancy to antidepressants developed serious respiratory problems.

The long term and immediate risks should be carefully evaluated in deciding about the use of antidepressants during pregnancy.

Related Links:

"The Dilemma of Depression for Mothers-to-Be," Jane E. Brody, New York Times, February 21, 2006.

NOTE: New York Times articles are available for a short period before moving into archives requiring payment to read.

Posted by admin at 08:50 AM