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Study finds surprising links between bullying and eating disorders

What do you think of this NIMH article?: "DUKE UNIVERSITY MEDICAL CENTER IMAGE: ILLUSTRATION BY MARK DUBOWSKI FOR DUKE MEDICINE. CREDIT: ILLUSTRATION BY MARK DUBOWSKI FOR DUKE MEDICINE Being bullied in childhood has been associated with increased risk for anxiety, depression and even eating disorders. But according to new research, it's not only the victims who could be at risk psychologically, but also the bullies themselves. Researchers at Duke Medicine and the University of North Carolina School of Medicine were surprised to find that in a study of 1,420 children, those who bullied others were twice as likely to display symptoms of bulimia, such as bingeing and purging, when compared to children who are not involved in bullying. The findings are published in the December issue of International Journal of Eating Disorders. "For a long time, there's been this story about bullies that they're a little more hale and hearty," said lead author William Copeland, Ph.D., associate professor of psychiatry and behavioral sciences at Duke University School of Medicine. "Maybe they're good at manipulating social situations or getting out of trouble, but in this one area it seems that's not the case at all. Maybe teasing others may sensitize them to their own body image issues, or afterward, they have regret for their actions that results in these symptoms like binge eating followed by purging or excess exercise." The findings come from an analysis of interviews from the Great Smoky Mountains Study, a database with more than two decades of health information on participants who enrolled at age 9. The data is considered a community sample and not representative of the U.S. population, but offers clues to how children ages 9 to 16 could be affected. Participants were divided into four categories - children who were not at all involved in bullying; victims of bullying; children who sometimes were victims and sometimes were instigators; and children who were solely bullies, repeatedly abusing other children verbally and physically, socially excluding others, and rumor mongering, without ever becoming a victim themselves. The researchers were not surprised to find that victims of peer abuse were generally at increased risk for eating disorders. Children who were victims of bullying were at nearly twice the risk of displaying symptoms of anorexia (11.2 percent prevalence compared to 5.6 percent of children who were not involved in bullying) and bulimia (27.9 percent prevalence compared to 17.6 percent of children not involved in bullying). Children who were both bullies and victims had the highest prevalence of anorexia symptoms (22.8 percent compared to 5.6 percent of the children not involved in bullying) and also the highest prevalence of binge eating (4.8 percent of children as compared to less than 1 percent of uninvolved children) and vomiting as a way to maintain their weight. But the impact of bullying behavior on those who were bullies was also significant, with 30.8 percent of bullies having symptoms of bulimia compared to 17.6 percent of children not involved in bullying. All of these behaviors can have devastating effects on the long-term health of children, said Cynthia M. Bulik, Ph.D., a distinguished professor of eating disorders at the UNC School of Medicine and a co-author on the findings. "Sadly, humans do tend to be most critical about features in other people that they dislike most in themselves," Bulik said. "The bullies' own body dissatisfaction could fuel their taunting of others. Our findings tell us to raise our vigilance for eating disorders in anyone involved in bullying exchanges -- regardless of whether they are the aggressor, the victim, or both." Although many children experience lifelong effects, many appear to cope and succeed after such experiences, Copeland said. He and colleagues are examining myriad factors, including looking at financial and educational outcomes, and even if bullying or being victimized is associated with genetic biomarkers. "We want to do a better job of understanding why some people are able to experience the same things as others and be able to get through them without the same consequences," Copeland said. "We really need to understand the resilience in those who have been bullied. That can help us determine the children who are going to need the most attention, and how we can promote those traits in others to increase their resilience." ### In addition to Copeland and Bulik, study authors include Nancy Zucker; Dieter Wolke; Suzet Tanya Lereya; and Elizabeth Jane Costello. The study was sponsored by the National Institute of Mental Health (MH63970, MH63671, MH48085, MH080230); the National Institute on Drug Abuse (DA/MH11301); the William T. Grant Foundation; and the Economic and Social Research Council in the United Kingdom (ES/K003593/1). Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system" For more information mental health topics, please visit our course listing mental health continuing education

Happy head, happy heart: Positive emotions may promote heart-healthy behaviors

What do you think of this article by NIMH? "People with heart disease may benefit from maintaining positive emotions, according to health researchers. Over the course of five years the researchers tracked more than 1,000 patients with coronary heart disease. Patients who reported higher positive psychological states were more likely to be physically active, sleep better and take their heart medications and were also less likely to smoke, compared to patients with lower levels of positive states. "Negative emotions and depression are known to have harmful effects on health, but it is less clear how positive emotions might be health-protective," said Nancy L. Sin, postdoctoral fellow in the Center for Healthy Aging and in the department of biobehavioral health at Penn State. "We found that positive emotions are associated with a range of long-term health habits, which are important for reducing the risk of future heart problems and death." The researchers assessed psychological well-being of participants at baseline and again at a five-year follow-up by asking the participants to rate the extent that they had felt 10 specified positive emotions, including "interested," "proud," "enthusiastic" and "inspired." Physical activity, sleep quality, medication adherence and alcohol and cigarette use were also measured at baseline and again five years later. The researchers report their findings in the today's (Oct. 2) issue of the journal Psychosomatic Medicine. "Higher levels of positive emotions were associated with less smoking, greater physical activity, better sleep quality and more adherence to medications" at baseline, said the researchers. They found no correlation between positive emotions and alcohol use. The results took into account patients' demographic factors, depressive symptoms and the severity of their heart conditions. Though positive emotions at baseline did not predict changes in health behaviors five years later, increases in positive emotions across the five-year period were associated with improvements in physical activity, sleep quality and medication adherence. There are a number of reasons why positive emotions are linked to optimal health habits, the researchers suggest. People with greater positive well-being may be more motivated and persistent in engaging in healthy behaviors. They might have more confidence in their abilities to maintain routines such as physical activity and sleep hygiene. Positive emotions may also enable people to better adjust their health goals and to proactively cope with stress and setbacks. "Efforts to sustain or enhance positive emotions may be promising for promoting better health behaviors," said the researchers. This research sets the stage for future work on interventions to improve health habits, Sin noted. Further research with other chronic disease populations and with electronic tracking of health behaviors should be conducted, she said. ### Judith Tedlie Moskowitz, professor, medical social sciences at the Feinberg School of Medicine, Northwestern University, and Mary A. Whooley, professor, medicine, epidemiology and biostatistics at the University of California San Francisco and physician at the San Francisco Veterans Affairs Medical Center, also worked on this research. The National Institute on Aging, the National Institute of Mental Health, the department of Veterans Affairs, the National Heart, Lung and Blood Institute, the Robert Wood Johnson Foundation and the American Federation for Aging Research supported this work. Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system." For more on this and other mental health subjects, please visit our course listing page Continuing Education Online Courses