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Bullying and School Violence


Douglas L. Vanderbilt, MD, Associate Professor of Clinical Pediatrics, Keck School of Medicine at the University of Southern California; Director, Developmental-Behavioral Pediatrics Fellowship Program, Children’s Hospital Los Angeles, Los Angeles


The following is a summary, not a verbatim transcript, of a lecture by Dr. Vanderbilt as presented by the Audio Digest Foundation, February, 2016.


What is school violence?

School violence can include actions such as slapping, punching, using weapons, or rape resulting in serious injury, including significant social or emotional injury; and in the extreme, can lead to death. School violence is defined as a crime when it occurs at school. The occurrence of cyberbullying now blurs the lines between school violence and bullying.


What is bullying?

Most authorities agree that bullying is the assertion of power through aggression, repeatedly and intentionally targeting a weaker child. Bullying is accomplished through social, emotional, or direct physical means. Its key features are power imbalance, intent to harm, and repetition of behavior directed at a weaker victim.


Direct bullying is usually perpetrated by boys as overt, physical aggression, e.g. hitting, stealing, or threatening with a weapon. It often includes verbal aggression (eg, name calling, public humiliation, intimidation).


Indirect bullying is more covert, interpersonal in nature, and occurs by rumor or social rejection. It can include exclusion from peer groups, ignoring, and cyberbullying.


What is teasing?

Teasing is mildly aggressive and  often occurs within a framework of humor. Teasing generates social embarrassment but without an intent to harm. If the teaser notices distress apparent in victim, the aggressor usually backs off, but if teasing escalates, it can transition into a bullying problem.


What risk factors can lead to bullying?

Bullying most often occurs in a permissive environment where there is  minimal supervision such as locations without adults (eg, playgrounds, hallways, or on way to and from school). There is often encouragement or lack of prohibition by family, peers, school, community, and media.


What risk factors promote becoming a victim?

Children who are passive, physically weaker, or emotionally vulnerable or who have special needs, such as having learning disability or autism are at higher risk of becoming victims of bullying. Children who may be  “provocative” types might react more easily and get into trouble, eg, child with attention-deficit/hyperactivity disorder or oppositional defiant disorder.


Children with conduct disorders and/or higher social status (entitlement) may be at higher risk of becoming the bully and may be avoided by peers or may be leaders among their peers. Highly stressed families might unknowingly encourage bullying behavior.


What are some clues that might help identify the victims of bullying?

Physical symptoms such as  insomnia, stomach aches, headaches, and new-onset enuresis (bed wetting) should lead adults to suspect a child might be experiencing bullying.


New-onset psychological symptoms such as depression or feeling of being disconnected or lonely, new-onset anxiety, avoidance of school, and suicidal thinking should raise suspicions.


Changes in behavior such as increased irritability, inattention, refusal to attend school, and substance use as well as school problems, e.g. academic failure, social problems, and lack of friends are suggestive of new stress.


Unique features that may lead to bullying include medical illness separating the child from a stable social group, physical deformity such as cleft lip and palate, move to special education, and poor social skills.


What can result from bullying?

Immediate effects from bullying can result in a drop in social status, greater social marginalization, poorer self-esteem, and isolation.


Long-term effects of bullying can result in depression, emotional disorders, psychosis, suicide, abusive relationships, and poorer physical health.


What clues might identify the bully?

Bullies often try to obscure their bullying behavior but may be aggressive or overly confident. They can lack empathy, and have oppositionality or conduct problems. Sometimes their families may practice or encourage physical punishment so the child learns that physical power is the preferred way to manage conflicts in life.


What can be the consequences of being a bully?

Bullies have a four times increased risk of committing crimes by their mid-20s. In addition they have an increased risk of depression or psychological distress if they self identify as a bully. They  may disconnect from school or drop out and if they lack alternative problem-solving strategies, may lead to carrying weapons, fighting, or drug abuse. Bullies may be less likely to be employed or have stable long-term romantic and social relationships.


Victims of bullying can then becomes perpetrators. They have the poorest peer relationships and highest rates of depression, substance use, psychosis, and weapon carrying. About 66% of individuals who perpetrated or intended to perpetrate school shootings have been bully victims.


What can we do for the bullied victim?

We can empathically listen, empower, and provide reassurance that the bullying will stop. We can advise the child to use their social networks to seek support from teachers and friends. If children lack social skills, we can provide social coaches and other support. We can counsel children to avoid situations where permissive environments exists and bullying may occur and to walk away, talk to someone, and tell someone. We can call this approach “walk, talk, and squawk”.


We can intervene with the bully by labeling bullying as serious behavior that has consequences for both bully and victim. We need to label the behavior, not the child, while acknowledging that bullying behavior is hurtful. We must provide accountability for the child’s behavior and look for risk factors within the family and the child's social environment.


We can try to stop bullying with a whole-school approach that include school-wide rules and sanctions, teacher training, classroom curriculum, conflict resolution training, and individual counseling when appropriate. In-school mentoring programs can be helpful and social workers can be enlisted to troubleshoot school issues if needed.


There is evidence that  school interventions to stop bullying need to include activation of bystanders, who represent the majority of children to buffer social interactions. Activating bystanders means expecting them to intervene and empowering them to affect their environment. Children require education on how to intervene and must also be educated that bullying is unacceptable, morally wrong, and has unfavorable health outcomes for all.


Schools can increase supervision in low-supervision environments and eliminate “unsafe” areas. This can be accomplished in collaboration with community organizations or parent groups.


To find out how your State scores on efforts to stop school bullying, go to


Dr. T


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