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A large body of research has documented the difficulties associated with being bullied and with bullying other children.For instance, children who are bullied suffer more greatly from anxiety, depression, loneliness, and post-traumatic stress than do other children, and they have a heightened risk of suicide (1).

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However, although less visible and distressing to others, internalizing problems such as anxiety and depression can also be debilitating, and deserve an equal amount of attention.

Programs designed to address children’s behavioral problems (7) have been developed separately from comparable interventions for emotional problems relating to anxiety and depression (8).

This risk can be increased further when these kids are not supported by parents, peers, and schools.

Children who have bullied others and been bullied themselves are called bully-victims.

Many issues contribute to suicide risk, including depression, problems at home, and trauma history.

Additionally, specific groups have an increased risk of suicide, including American Indian and Alaskan Native, Asian American, lesbian, gay, bisexual, and transgender youth.

For example, bully-victims may unintentionally prompt children to bully them again by reacting very emotionally to teasing, threats or physical aggression, and may have similar problems controlling feelings of anger and frustration, predisposing them to retaliatory aggression.

Given that they experience a broader range of behavioral and emotional difficulties than do children who are either purely involved in bullying or the victims of bullying, it is perhaps not surprising that bully-victims show social and emotional problems that are frequently present in victims of bullying, such as anxiety, depression, peer rejection, and a lack of close friendships, as well as the cognitive and behavioral difficulties often apparent in children who bully, including a greater acceptance of rule-breaking behavior, hyperactivity and a tendency toward reactive aggression (1, 4).

In addition, children with a combination of behavioral and emotional problems are at greater risk for psychiatric disorders and criminal offences in young adulthood (5) than are children dealing with only one of these problems, and have proven less responsive to a comprehensive school-based program for children with severe emotional disturbances (6).

Consequently, it is of the utmost importance that these individuals receive support and services that address the full spectrum of their needs.

Teens who are bullied have a greater risk of developing mental health issues, including depression, panic attacks, anxiety, and agoraphobia, as adults.

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