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Being left out puts youths with special needs at risk for depression

BOSTON The challenges that come with battling a chronic medical condition or developmental disability are enough to get a young person down. But being left out, ignored or bullied by their peers is the main reason youths with special health care needs report symptoms of anxiety or depression, according to a study to be presented Sunday, April 29, at the Pediatric Academic Societies (PAS) annual meeting in Boston.

Being bullied has been shown to increase students' risk for academic and emotional problems. Little research has been done specifically on how being a victim of bullying affects youths with special needs.

In this study, researchers led by Margaret Ellis McKenna, MD, senior fellow in developmental-behavioral pediatrics at Medical University of South Carolina, investigated the impact of bullying, ostracism and diagnosis of a chronic medical condition on the emotional well-being of youths with special health care needs.

Participants ages 8-17 years were recruited from a children's hospital during routine visits with their physicians. A total of 109 youths and their parents/guardians completed questionnaires that screen for symptoms of anxiety and depression. Youths also completed a screening tool that assessed whether they had been bullied or excluded by their peers.

The main categories of youths' diagnoses included attention-deficit/hyperactivity disorder (39 percent), cystic fibrosis (22 percent), type 1 or 2 diabetes (19 percent), sickle cell disease (11 percent), obesity (11 percent), learning disability (11 percent), autism spectrum disorder (9 percent) and short stature (6 percent). Several children had a combination of these diagnoses.

Results of the youths' answers on the questionnaires showed that being bullied and/or ostracized were the strongest predictors of increased symptoms of depression or anxiety. When looking at both parent and child reports, ostracism was the strongest indicator of these symptoms.

"What is notable about these findings is that despite all the many challenges these children face in relation to their chronic medical or developmental diagnosis, being bullied or excluded by their peers were the factors most likely to predict whether or not they reported symptoms of depression," Dr. McKenna said.

"Professionals need to be particularly alert in screening for the presence of being bullied or ostracized in this already vulnerable group of students," she added.

In addition, schools should have clear policies to prevent and address bullying and ostracism, Dr. McKenna suggested, as well as programs that promote a culture of inclusion and sense of belonging for all students.

Contact: Debbie Jacobson
American Academy of Pediatrics

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