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How Well Do We Understand the Long-Term Health Implications of Childhood Bullying?

Zarate-Garza, Pablo Patricio MD; Biggs, Bridget K. PhD; Croarkin, Paul DO; Morath, Brooke BSc; Leffler, Jarrod PhD; Cuellar-Barboza, Alfredo MD; Tye, Susannah J. PhD

doi: 10.1097/HRP.0000000000000137

Once dismissed as an innocuous experience of childhood, bullying is now recognized as having significant psychological effects, particularly with chronic exposure. Victims of bullying are at risk for a number of psychiatric disturbances, and growing evidence suggests that the pathophysiological effects of bullying, as with other forms of trauma and chronic stress, create additional health risks. We review the literature on the known sequelae of bullying, including psychiatric and physiological health effects, with a focus on implications for the victim. In addition, since it is now well established that early and chronic exposure to stress has a significant negative impact on health outcomes, we explore the implications of this research in relation to bullying and victimization in childhood. In particular, we examine how aspects of the stress response, via epigenetic, inflammatory, and metabolic mediators, have the capacity to compromise mental and physical health, and to increase the risk of disease. Research on the relevant mechanisms associated with bullying and on potential interventions to decrease morbidity is urgently needed.

From the Department of Psychiatry, Autonomous University of Nuevo Leon (Mexico) (Drs. Zarate-Garza and Cuellar-Barboza); Departments of Psychiatry and Psychology (Drs. Zarate-Garza, Biggs, Croarkin, Leffler, and Tye, and Ms. Morath), and of Molecular Pharmacology and Experimental Therapeutics (Dr. Tye), Mayo Clinic, Rochester, MN; Department of Psychiatry, University of Minnesota (Dr. Tye).

Supported by National Institute of Mental Health K23 grant no. MH100266 (Dr. Croarkin) and State of Minnesota Mayo-Minnesota Partnership Award (Dr. Tye).

Correspondence: Susannah J. Tye, Department of Psychiatry & Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905. Email:

© 2017 President and Fellows of Harvard College
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