Bullies are healthiest, while victims suffer worse health, study finds

In the stories that tend to percolate through popular culture, school bullies find themselves washed up in dead-end jobs and go-nowhere lives, while their former nerd victims launch world-changing tech empires and wallow in the rewards that follow.

Real-life narratives are rarely so satisfying. Further proof comes from a new study published online in the Proceedings of the National Academy of Sciences last week. It found the victims of bullying had higher levels of a blood marker associated with inflammation and a greater risk of health problems such as metabolic syndrome and cardiovascular disease later in life. But the bullies themselves appeared even healthier than those not involved in bullying at all, at least by one measure of inflammation.

The finding carries unpleasant suggestions: Does bullying, by conferring higher social status to the perpetrators, buffer against inflammation and related health problems? That’s one possibility highlighted by the study, conducted by researchers at Duke University, the University of North Carolina at Chapel Hill, Emory University and the University of Warwick in England.

The research draws on data from the Great Smoky Mountains Study, a longitudinal study that tracked more than 1,400 randomly selected North Carolina youngsters ages 9 to 13, beginning in 1993. Regular interviews over the following decades included questions on kids’ experiences with bullying, and blood tests allowed researchers to measure C-reactive protein levels (CRP). Higher CRP levels are associated with inflammation, and the blood test is one-way doctors evaluate risk for illnesses such as coronary artery disease.

“CRP levels are affected by a variety of stressors, including poor nutrition, lack of sleep and infection, but we’ve found that they are also related to psychosocial factors,” said lead author William E. Copeland, associate professor of psychiatry and behavioral sciences at Duke University Medical Center, in a statement. “By controlling for participants’ pre-existing CRP levels, even before involvement in bullying, we get a clearer understanding of how bullying could change the trajectory of CRP levels.”

According to the team’s analysis of the data, the more times a child or teen was bullied, the higher the levels of CRP. While the blood protein increased for all as they grew older, the bullies actually had lower increases than the kids who were neither bullies nor bullied.

It seems as though inflammation is the key route by which bullying takes a toll on the health of the maltreated. From the study:

A child’s role in bullying may serve as either a risk or a protective factor for adult low-grade inflammation, independent of other factors. Inflammation is a physiological response that mediates the effects of both social adversity and dominance on decreases in health.

That makes sense intuitively. But what about the bit about bullies actually having healthier blood inflammation readings than everyone else? Copeland doesn’t shy from an admittedly dark conclusion, but immediately tries to soften the blow:

 Enhanced social status seems to have a biological advantage. However, there are ways children can experience social success aside from bullying others.

It’s worth pausing for a minute to appreciate just how grim and morally frustrating that finding is: Building yourself up by beating others down, literally or figuratively, confers not just higher status during childhood, but potentially better health later in life as well.

Of course, it could be that another unrelated factor – what statisticians call a “confounding variable” – is responsible for the patterns in CRP levels. But the researchers say the trends held up even after such potential effects were accounted for. “This pattern was robust, controlling for body mass index, substance use, physical and mental health status and exposures to other childhood psychosocial adversities,” they report.

This latest study builds on research Copeland published last year in JAMA Psychiatry that found bullying produces serious mental health problems as bullied kids reach adulthood. That study found that victims of bullying were more likely to suffer from anxiety disorders, depression, panic attacks and agoraphobia. Those findings were also based on data from the Great Smoky Mountains Study. “We were surprised at how profoundly bullying affects a person’s long-term functioning,” Copeland said at the time.

In the wake of last week’s study, Louise Arseneault, a professor of developmental psychology at the Institute of Psychiatry at King’s College London, responded in The Conversation by pointing to bullying’s links to CRP and inflammation as evidence that it shouldn’t be seen as just a normal part of growing up. “Instead, bullying should be considered as another form of toxic stress with potentially profound effects on mental and physical health,” she writes.

Toxic stress and adverse childhood experiences (ACEs) are most often associated with a child’s caretakers and family life (negligence or child abuse, for example). Research has found that both toxic stress and ACEs can lead to a host of serious health problems later in life. But if bullying can be seen as yet another form of toxic stress, then the threat it poses becomes that much more serious. Improving parenting skills and kids’ home lives – popular ways of combating toxic stress – may be necessary, but not enough to forestall unwanted health effects for kids who bear the brunt of bullying.

After all, even the most ardent helicopter moms can’t always be there to intervene when bullying gets bad. And the ubiquity of social media among kids and teens means the bully’s slings and arrows don’t stop at the front door the way they once might have.

Photo by Thomas Ricker via Flickr.