How Bullying’s Effects Reach Beyond Childhood

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More research is documenting the lasting legacy of bullying on its victims in nearly every part of their lives, from emotional wellbeing to career success.

The death of 12-year old Rebecca Sedwick, who was apparently the victim of an online bullying campaign for more than a year, demonstrated the ever-widening reach of the destructive behavior, beyond social media into apps that touch young students in the harshest and most personal ways. At the same time, research is documenting how devastating the practice can be for survivors as well, with studies showing that kids who were bullied have a harder time holding down a job, and can suffer from psychiatric troubles into adulthood compared to children who were not bullied.

(MORE: Childhood Bullying’s Lasting Impact on Employment)

The latest analysis from researchers at the University of Padua in Padua, Italy, sadly confirms the obvious — that children who were bullied suffered from issues with self-esteem, poor grades, and physical health problems that had a direct impact on the state of their health as adults.

The study, published in the journal Pediatrics, reviewed data from 30 studies that investigated the association between being bullied and so-called psychosomatic problems that include headaches, backaches, abdominal pain, skin problems, sleeping problems, bed- wetting, or dizziness. The results revealed that kids who were bullied were twice as likely to have psychosomatic symptoms compared to their non-bullied peers.

(MORE: Lasting Legacy of Childhood Bullying: Psychiatric Problems In Adulthood)

The severity and influence of bullying is certainly amplified by the variety of online avenues by which bullying can take place, which extends it beyond the school to students’ private lives, making it harder for kids to ignore, overcome and move on. Studies document higher rates of anxiety and panic attacks among victims of bullying, and these are snowballing into mental health and behavior problems later in life. That could translate into unstable professional and personal lives as well; a recent study reported that bully victims are two times less likely to hold down a job and also have difficulty maintaining meaningful social relationships.

The psychosomatic symptoms, however, may also represent an opportunity — sometimes the first and only one — for doctors or parents to recognize bullying and intervene. The researchers say, for example, that pediatricians can play a larger role in identifying bully victims during check-ups if such symptoms are persistent and long-lived. Discussing these warning signs with parents, as well as counseling them on how to handle bullying when it occurs can help to promote assertiveness and in some cases diffuse the situation. “Pediatricians’ suggestions are likely to be particularly effective given the high confidence that parents usually put in these professionals, the authors write.

For more advice on how to support bullying victims, see TIME’s post on how victims cope, here.