WEDNESDAY, March 24, 2004 (HealthDayNews) -- The ancient art of bullying is alive and well in the 21st century.
And the toll -- physical and emotional -- is incalculable.
"Bullying is very prevalent in U.S. schools and is often invisible," says Dr. Robert Bidwell, an associate professor of pediatrics at the University of Hawaii School of Medicine. "We didn't know that until a couple of years ago."
Recent surveys bear Bidwell out.
Almost one in four young U.S. teens -- out of a survey sample of almost 2,000 children -- were identified as either a bully or a victim in a study published last year in the journal Pediatrics.
Another study, in the Journal of the American Medical Association, surveyed more than 15,000 sixth to 10th graders and found almost a third said they'd been involved in "moderate or frequent" bullying.
There's also anecdotal evidence to suggest the phenomenon is increasing and perhaps getting more violent.
"There's a kind of general consensus that the severity of the acts might be getting worse, which is what's getting the attention," says Susan Swearer, an associate professor of school psychology at the University of Nebraska-Lincoln, and co-editor of Bullying in American Schools.
"There have also been a number of incidences of kids that have been bullied and other kids watching and not doing anything about it," she says.
Adds Ellen deLara, an assistant professor of social work at Syracuse University: "Teachers who have worked in schools for 20 or 30 years used to have to worry about gum. Now they have to worry about being injured themselves."
Some heartbreaking recent examples include Daniel Scruggs, a 12-year-old from Meriden, Conn., who hanged himself in his bedroom closet in 2002. He'd been picked on so badly at school that he had missed 44 days of class that year.
And in 1999, a 14-year-old boy from Anchorage, Alaska, tried to kill himself because he'd been the victim of relentless harassment. Now 19, he remains physically and mentally handicapped.
Researchers have long known that bullying can have devastating -- even fatal -- consequences for victims. But abusers don't escape unscathed. Both bullies and their targets have higher rates of depression and suicide, experts say.
"Kids who are targets have poor psychosocial functioning, higher levels of depression, anxiety, poorer self esteem and they miss a lot of school because they're afraid to go to school," Swearer says. "There are some pretty significant psychological consequences all the way to suicide."
They can also suffer from headaches, stomach aches and even infectious problems such as colds, studies have found.
What's less well known is that bullies can have higher rates of depression and suicide. They're also more likely to engage in substance abuse, and are four times more likely to be convicted of a crime by the time they reach their 20s, Swearer says.
Efforts to curb bullying have often been unsuccessful. Part of the problem is that, despite all the headlines, most schools don't have effective policies or programs to address bullying, Bidwell says.
What's more, not everyone agrees on what bullying is, and, therefore, how to address it.
Adults and children will often define the term differently, says deLara, co-author of And Words Can Hurt Forever: How to Protect Adolescents from Bullying, Harassment and Emotional Violence.
Traditionally, she notes, society has thought of a bully as someone who is older or somehow more powerful than the victim, and of bullying as something that is chronic.
"Kids don't hold with that particular definition," deLara says. "For them, it doesn't have to be a chronic event."
Even one disturbing episode in a school hallway can qualify if it causes the victim to avoid the bully and feel anxious all the time, she says.
Bullying can also encompass a broad range of unacceptable behaviors, including physical violence, verbal abuse, sexual harassment and hazing.
Coming to grips with a definition is the first step to dealing effectively with the problem.
"If we're going to figure out how to come up with interventions that actually work, we need to be asking kids what they see as bullying and what they consider to be harassment," deLara says.
While many anti-bullying programs focus on interpersonal and peer relationships, a new school of thought embraces a so-called "systemic approach."
"I try to look at a school as a system. How might the school inadvertently be enabling a hostile environment?" deLara says. This approach shifts the focus from the students to the adults who might somehow be inadvertently supporting an environment conducive to bullying.
Anti-bullying efforts also need to be long-term. "Systemic interventions will work as long as everybody in the school stays committed. It's not a one-time shot," says deLara. A "caring community approach" should involve talking to kids about respectful behavior before bullying occurs, and also holding discussions with teachers and administrators.
"There's an assessment that happens on an ongoing basis. What you see when schools implement that is that the attendance rate goes up, the drop-out rate goes down because kids feel cared about in the schools and feel that adults are not being hypocritical," deLara says. "If you really want a true change in a school, it has to involve the entire school, all of the adults, from bus drivers, cafeteria workers, teachers, administrators and kids."
Adds Swearer: "Children need to be able to report problems about bullying with the knowledge that something's going to get done about it."