One of the first blockbuster media stories that linked being a victim of bullying to homicide was the school shooting at Columbine High School in Littleton, Colorado in 1999. In the wake of that shooting, the United States Secret Service conducted a study of school shootings that happened in the 1990s. That study concluded that bullying was a common, although not universal, factor in the background of school shooters: 71% of these homicidal kids felt that they had been victims of bullying or harassment. 2 These statistics stoke the fear that bullying could turn normal children into cold‐blooded killers. The Secret Service study did look to see if the school shooters appeared to be relatively normal; however, the study didn't probe for psychopathology, instead only checking for the most general indicators of functioning, like the shooters' grades. The study didn't detect any rampant signs of mental illness or significantly compromised functioning in these violent students. Most kids who became shooters were passing their classes, and some were even excelling academically. Socially, though, a few more problems emerged. More than half of the shooters showed signs of social problems, either being part of a disliked group of students, being “loners,” or experiencing social rejection. But even social problems weren't universal. Many school shooters had social problems, and many were probably bullied. But not all.
That study and others suggested the theory that bullying and social problems might be one factor that increased the likelihood of homicidal behavior. Bullying was more common among school shooters, but it wasn't always present in the histories of school shooters. By the way, this is a perfect example of why we can't precisely predict violence in human beings. Although we do know that some risk factors (like social problems and bullying) increase the odds that someone will be violent, not all violent people have histories of social problems or being bullied; and many individuals are bullied or have social problems but never become violent at all. Bullying is a risk factor, not a direct cause. 3 What we don't understand as well is why bullying may be associated with violence in some cases, while it isn't in so many. It's unsettling, but the fact remains that there is no exact recipe.
The risk of suicide among victims of bullying has received much more attention. Depending on what you've seen or read, you might come away with different impressions of this problem. The terrible suicides of Carl Walker‐Hoover and Phoebe Prince, 11‐ and 16‐year‐old victims of bullying from Massachusetts, provoked a firestorm of coverage in the media in 2009 and 2010. That media tsunami that followed their deaths featured a great deal of discussion about a possible link between suicide, bullying, and cyberbullying. Reading those and other news stories about teenagers who have committed suicide could lead anyone to conclude that suicide is not only associated with bullying, but strongly associated with it, and a perfectly happy child could abruptly decide to commit suicide after being bullied or cyberbullied possibly even just briefly. More authoritative voices have also underlined the possibility of this relationship. Medical News Today describes the link between bullying and suicide‐related behaviors as “close,” 4 and a study in the United Kingdom reported that more than one‐third of bullied teens were suicidal. 5
But take a step back, and you'll see that the knowledge just isn't so definitive. While some stories suggest a strong link, researchers have consistently found a more tempered and nuanced relationship between bullying, cyberbullying, and suicide. Bullying and cyberbullying do appear to have a relationship to suicide, but the nature of that relationship may be indirect and influenced by other factors. For example, it's hard to tease apart the role of bullying versus depression and other emotional problems in leading to suicide. Can bullying or cyberbullying lead to suicide even in the absence of other problems like depression? We may assume that the formula is “bullying ➔ depression ➔ suicide,” but there must be many cases where this deceptively simple formula doesn't really work. For example, can bullying ultimately can lead to suicide even in a child who is very healthy, emotionally and socially? What if a child is already depressed and possibly suicidal before they're bullied? Could the bullying be experienced as just another problem, or even as something insignificant compared to their preexisting depression and/or suicidality? Why do some depressed and bullied kids commit suicide while others don't?
A review in 2010 of the existing research found that most studies linking suicide and bullying either didn't take depression or psychopathology into account or, if they did, found that these emotional difficulties accounted for the relationship between bullying and suicidality. 6 In other words, these studies found that depression was a more powerful influence in leading to suicide than bullying per se. Having said that, most of the research in this area is conducted by measuring suicidality and bullying at the same point in time, which tells us these factors are related but doesn't give us much information about what causes what. This might seem silly – it can seem obvious that bullying can cause depression, which in turn can cause suicidality. But I can imagine a scenario in which, for example, depression causes a child to consider suicide and also causes them to bully others and to be bullied themselves. In that kind of case, depression would be the root cause of both bullying involvement and suicidality. I can also imagine a scenario where bullying combines with other stressors to cause both depression and suicidality.
Having complicated all this for you, there are some things we do know with some certainty. We know that depression can lead to suicide. And it's not hard to see how a combination of multiple stressors can increase the odds of suicide. Phoebe Prince was depressed and cutting herself before her peers piled on the bullying. 7 What's much less clear, though, is whether bullying by itself could lead to suicide in a child who's not depressed. Perhaps bullying can be unrelated to depression at the time of the bullying but leave the person more vulnerable to depression later in life. The pathway from bullying to suicide might even be different for different genders. A Finnish study found that being bullied frequently (not once) increased suicidality later in life for girls, regardless of the presence or absence of depression; but in boys, just being a victim wasn't related to later suicidality unless the boy was also a bully (often termed a bully/victim ), and had a conduct disorder, in which case there was a significantly increased risk of later suicidality. 8
How does all this help in any practical sense? We can say with some confidence that bullying may sometimes increase the risk of suicidal thoughts or actions, particularly in girls and particularly when other problems, such as depression, bullying others, or conduct disorders, are also present. Equally important, though, bullying and cyberbullying do not simply cause suicidality in everyone, or even in most people. Boys and girls seem to have different pathways of vulnerability. But how does that translate into risk for a parent who knows their child is being bullied (or is bullying) and is worried about the possibility of suicide? There are two big questions that I tend to hear in these circumstances.
3.1 Question #1: Can being bullied cause a child to begin thinking about suicide?
Thinking about suicide is called suicidal ideation , and suicidal ideation doesn't always lead to actual suicide; but it is a very important and serious risk factor. Any child who thinks about suicide – whether or not they've been bullied or bully others – should be immediately taken to see a healthcare professional. A number of studies have found that, particularly but not only in girls, being bullied can increase the chance of suicidal ideation even among those who are not depressed. 9 So the answer is a qualified yes: being bullied is sometimes associated with suicidal ideation; but it's important to remember that thinking about suicide and attempting suicide are two different things. Thinking about suicide is an urgent symptom that calls for a professional assessment. Attempting to commit suicide is a medical emergency – which leads to our second question.
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