By Kathryn Doyle
NEW YORK (Reuters Health) - A variety of symptoms that can seem vague or mysterious may signal that a child is being bullied and having trouble coping, according to a new analysis of research on the topic.
In the review of studies from 15 countries, complaints of headache, backache, abdominal pain, skin problems, sleeping problems, bed-wetting or dizziness were more than twice as common among kids who were victims of bullying, researchers found.
The results are in line with previous studies, and suggest that pediatricians and parents should be on the lookout for signs that a child is being victimized, the authors write in the journal Pediatrics.
Symptoms were sometimes long lasting, and often went along with low self-esteem.
It's important to recognize that the link remained over time, since that "speaks to the long term consequences of bullying," said Gianluca Gini, of the Developmental and Social Psychology department at the University of Padua in Italy, who led the study.
"The most serious consequence of bullying is suicide, but these health problems can negatively impact the quality of life of many children for several years," Gini told Reuters Health.
Gini and a coauthor reviewed data from 30 studies that examined links between being bullied and psychosomatic problems in children and adolescents, and compared those children to peers who were not bullied.
The included studies measured victimization among kids and teens as reported by the children themselves, parents or teachers.
Overall, bullied children were between 2.17 and 2.39 times more likely to report pains and other physical symptoms as well as nervousness, sleeplessness, feeling tired and poor appetite.
The more boys relative to girls in a study, the stronger the connection between bullying and physical symptoms seemed to be.
"A possible explanation might deal with the fact that a school or classroom environment with a higher proportion of male students is a context in which bullying behavior is more likely to happen, and where supportive and helping behaviors in favor of the bullied pupils are less frequent," Gini said.
"This is not surprising at all, but it is a very well done study," said Dr. Stephen Leff, co-director of the Violence Prevention Initiative at The Children's Hospital of Philadelphia.
The difference between boys and girls could also be explained by gender differences in aggression and victimization, Leff told Reuters Health.
"These studies may have defined bullying in a more physical way, instead of a social way," he said. Researchers once thought that boys were more aggressive than girls, but have recently found that aggression among girls manifests more as gossiping and "leaving-out" than physical violence, he said.
"In any case, it's interesting, and deserves more study," he said.
Of course, not every child who is bullied will develop these symptoms, and not every child with these symptoms has necessarily been bullied, Gini said. He and Leff agreed it is also possible that kids with more physical ailments are more likely to be bullied, which might at least partly explain the connection.
Nevertheless, keeping an eye out for physical troubles could be a useful tool for adults for spotting kids at risk for bullying, Leff said.
"This really speaks to taking warning signs seriously," he said. "Kids may not be communicating with adults or even other kids about their bullying problems, and physical things like this can be important warning signs we don't want to miss."
SOURCE: http://bit.ly/14cnViE Pediatrics, online September 16, 2013.