Does childhood bullying predict eating disorder symptoms? A prospective, longitudinal analysis.
OBJECTIVE
Bullying is a common childhood experience with enduring psychosocial consequences. The aim of this study was to test whether bullying increases risk for eating disorder symptoms.


METHODS
Ten waves of data on 1,420 participants between ages 9 and 25 were used from the prospective population-based Great Smoky Mountains Study. Structured interviews were used to assess bullying involvement and symptoms of anorexia nervosa and bulimia nervosa as well as associated features. Bullying involvement was categorized as not involved, bully only, victim only, or both bully and victim (bully-victims).


RESULTS
Within childhood/adolescence, victims of bullying were at increased risk for symptoms of anorexia nervosa and bulimia nervosa as well as associated features. These associations persisted after accounting for prior eating disorder symptom status as well as preexisting psychiatric status and family adversities. Bullies were at increased risk of symptoms of bulimia and associated features of eating disorders, and bully-victims had higher levels of anorexia symptoms. In terms of individual items, victims were at risk for binge eating, and bully-victims had more binge eating and use of vomiting as a compensatory behavior. There was little evidence in this sample that these effects differed by sex. Childhood bullying status was not associated with increased risk for persistent eating disorder symptoms into adulthood (ages 19, 21, and 25).


CONCLUSIONS
Bullying predicts eating disorder symptoms for both bullies and victims. Bullying involvement should be a part of risk assessment and treatment planning for children with eating problems.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
William E
WE
Copeland
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Cynthia M
CM
Bulik
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
Nancy
N
Zucker
Department of Psychology and Division of Mental Health and Well-Being, University of Warwick, Coventry, United Kingdom.
Dieter
D
Wolke
Department of Psychology and Division of Mental Health and Well-Being, University of Warwick, Coventry, United Kingdom.
Suzet Tanya
ST
Lereya
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
Elizabeth Jane
EJ
Costello
D000293:Adolescent; D000856:Anorexia Nervosa / Q000523:psychology*; D052018:Bulimia Nervosa / Q000523:psychology*; D058445:Bullying; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009657:North Carolina; D011446:Prospective Studies; D012307:Risk Factors
adolescence; body image; bullying; childhood; eating behavior; epidemiology; psychosocial; stress