The Autism Society Event and Education Recordings Archive

It is estimated that nearly 30% of U.S. youth are involved in bullying, whether as a bully, a target of bullying or both (Nansel et al., 2001). Between 15-25% of U.S. students report being bullied with some frequency ("sometimes or more often"), whereas 15-20% report that they bully others with some frequency (Melton et al., 1998; Nansel et al., 2001). Bullying has been defined as repeated negative actions against a distressed target involving intent to harm and an imbalance of either physical or psychological power (Heinrichs, 2003).  Bullying occurs in direct and indirect forms and may be physical, verbal, social or educational in nature. Bullying may involve physical violence, teasing or name-calling, intimidation through gestures, social exclusion, or harassment via mobile phone or the Internet (see www.stopbullyingnow.hrsa.gov/adults/what-do-we-know.aspx). This session will begin by highlighting current research and knowledge related to bullying behavior. 

How does bullying impact mental health?

It is well established that being a target of bullying is associated with significant negative effects on mental health and well-being. These effects may continue long after the bullying has stopped, often persisting into adolescence and adulthood (Rigby, 2001).Youth and teens who are bullied tend to have difficulty concentrating in school and are more likely to engage in school avoidance. Victims of chronic bullying are at increased risk for developing impaired self-esteem, anxiety, depression and suicidality (Coggan et al., 2003; Fekkes, Pijpers & Verloove-Vanhorick, 2004; Zimmerman et al., 2005). Significant symptoms of post-traumatic stress have also been identified in individuals who have experienced chronic bullying (Tehrani, 2004; Weaver, 2000).

Why are individuals with ASDs particularly vulnerable to bullying?

Research indicates that youth with special health-care needs are at increased risk for being bullied when compared to typical peers (Van Cleave & Davis, 2009). As a result of the social, emotional and communicative difficulties specifically associated with ASDs, these youth may be at greater risk, even among the special health-care needs population. In particular, the presence of social skills deficits and a tendency to be socially isolated and perceived as not fitting in with peers are some difficulties associated with ASDs that may increase the likelihood that these individuals will be bullied (Hoover et al., 1992; Nansel et al., 2001). This session will highlight characteristics associated with ASDs that place these individuals at greater risk for becoming targets of bullies.

How does chronic bullying impact the mental health of adolescents and young adults with ASDs?

Due to patterns of thinking and difficulties with emotion regulation often associated with ASDs, these adolescents and young adults are highly vulnerable to developing mental health difficulties related to a history of being bullied. The experience of being bullied persistently can profoundly impact the self-esteem and self-worth of individuals with ASDs, and engender a perception of the social world as dangerous. Many of the adolescents and young adults treated at our clinic present with significant symptoms of depression, anxiety and post-traumatic stress related to their experiences of being bullied. These symptoms are often severe and, for some individuals, include avoidance of situations or places associated with the bullying incidents, re-experiencing of the incidents themselves and even thoughts of self-harm. This session will provide descriptions of actual clinical cases to illustrate the development of mental health difficulties related to experiences of chronic bullying.

What strategies may be used to help individuals with ASDs cope with the mental health consequences of chronic bullying?

In our clinic, we utilize a cognitive behavioral approach to assess and treat symptoms associated with chronic bullying experiences. Cognitive behavioral therapy (CBT) is an evidence-based form of psychotherapy that is structured and goal oriented. It was originally developed for the treatment of depression, but has been successfully adapted for the treatment of a wide range of issues. CBT focuses on the thoughts, feelings and behaviors that contribute to an individual’s distress. Treatment is modified for each individual based on his or her strengths, weaknesses and preferred learning styles. This session will use clinical case examples to demonstrate how cognitive behavioral treatment progresses in individuals with ASDs who have experienced chronic bullying. Some examples of aspects of CBT that will be discussed are:

·         Rapport building

·         Assessing current symptoms and history of bullying experiences

·         Addressing avoidance behavior

·         Understanding the connection between thoughts, feelings and behaviors

·         Discriminating between helpful and unhelpful thoughts

·         Correcting unhelpful thoughts and using coping skills

·         Exposure treatment

Participants in this session will learn the significant impact of bullying on the overall mental health and well-being of individuals with ASDs, and how these effects can last into adulthood. Specific characteristics of ASDs that create vulnerabilities will be discussed. To illustrate the symptoms associated with chronic bullying as well as effective treatment strategies, we will share case examples of applications from our clinic.