Bullying and Pediatric Pain
If you are a parent, the idea of bullying is frightening. It’s hard enough to launch your child into the world, let alone fear for all the forms of bullying they may encounter at school and online. You’re worried that you will hear about it, and you are worried that you won’t.
Factor in chronic pain in your child, and that fear is probably infinitely multiplied. There is so much uncertainty about the complexity of social situations, how it may be affecting or affected by your child’s pain, and knowing what to do about it.
Fortunately, researchers have been taking bullying in pediatric chronic pain seriously. Just this month, an article was published in the Journal of Pain that significantly advanced our knowledge and provided some directions for what parents and mental health providers can focus on. Here’s what you need to know:
Why care about childhood bullying and pain?
Adverse or traumatic childhood experiences have been associated with pediatric chronic pain. In other words, children and teens who come into pediatric pain clinics often report that they have also experienced negative events such as bullying or mistreatment.
However, it’s difficult to understand this relationship. Is it because bullying is just so common in general? Did bullying somehow increase a child’s risk for pain, or were they bullied because of their pain?
Until recently, most research had been cross-sectional. That means that they only asked children and teens about their pain and bullying at the same time. This made it difficult to understand the timeline.
This month, a group of researchers in Portugal published innovative research where they did find a way to examine these relationships over time.
Bullying and Pain- Chicken or the Egg?
Quick facts about how they completed the study:
They looked at data from a larger longitudinal study that had tracked children from birth.
They looked specifically at reports from ages 10 and 13, in which parents and adolescents completed many questionnaires included some about pain and some about bullying.
When the children were 13, they were also invited to come into their lab to complete some tests of their pain processing with methods called quantitative sensory testing.
They used a pressure cuff to measure pain detection, pain threshold, temporal summation of pain, and conditioned pain modulation (if you want to know more about these, just ask!).
Here are some the highlights of what they found:
Overall, bullying was quite common. At both ages, about half of children reported being involved in bullying in some form. This could include being a victim, being an aggressor, or both.
At age 10 and age 13, bullying was associated with pain reports. This is what researchers expected to find because of previous research showing similar patterns.
Pain at age 10 was not significantly associated with bullying at age 13.
That means that if a child reported chronic or high pain when they were 10 years old, they were no more likely than children without pain to report that they were involved in bullying when they were 13.
In contrast, bullying at age 10 was significantly associated with pain at age 13.
This means that if a child reported that they were involved in bullying at age 10, particularly if they were a victim, they were significantly more likely to experience pain at age 13.
Being involved in bullying also seemed to affect some aspects of pain processing.
The most dramatic findings were that those who were victims of bullying at age 10 had lower pain detection and pain tolerance thresholds.
That means that they felt pain with less pressure in the cuff, and reached their maximum tolerance sooner.
What does this all mean?
In summary, the authors concluded that bullying, especially being a victim, is more likely to lead to negative reported pain experiences. They surmise that victimization may have a long term influence. Often, bullying is experienced repeatedly over time, and this repeated exposure can alter a child’s psychological and physiological functioning.
What can we do to help children and teens with pain and bullying?
The authors of the research study point to social support as one of the strongest areas to focus on in the case of bullying and pain.
They highlight that other research has shown that pain reports can depend on satisfaction with one’s social support network. They also remind us that high quality social support has been shown to improve pain outcomes in adolescents and in adults.
Here are some practical take-aways to consider:
Ask: Ask your child about their experiences in bullying.
Use neutral and non-judgmental language, and be open to different forms of how they may experience or witness bullying.
Check in on this from time to time.
Ask: About their social network.
Who do they count on their team?
How do they experience social support- what do they notice supports them the best?
Have there been any changes among their friends or family?
Talk: Find opportunities to chat about ways that social relationships, in person and online, affect us positively and negatively.
Social support: Find ways to help your child nurture existing relationships or expand their social networks.
Sometimes, it’s more about having just 1 or a few close friends, or sometimes it’s creatively finding ways to meet new people.
Model your own social support: Too often, parents neglect their own social lives for the sake of their children’s schedules and the never-ending to do lists.
Model showing and receiving social support between the family and among adult friendships and relationships.
Seek psychological support: If your child is experiencing bullying and/or chronic pain, it may be helpful for them to speak with a supportive but more neutral adult.
In pain psychology, we can introduce techniques that help with physiological, cognitive, and emotional aspects of pain and bullying and develop resilience for life.
If you are interested in learning more through a free consultation call, click the Get Started button at the top right of the screen.
Reference:
Lucas, R., Talih, M., Soares, S., & Fraga, S. (2024). Bullying involvement and physical pain between ages 10 and 13 years: reported history and quantitative sensory testing in a population-based cohort. Journal of Pain, 25(4), 1012-1023.