By Maia Szalavitz
Special to The Washington Post
Tuesday, June 19, 2007
Across the nation, school doors are closing on one of the bloodiest year in U.S. history, with scores of violent deaths on both school and college campuses. The end of classes also means the end, for this term, of uneven school efforts to prevent the social rejection that may lie behind some of the violence.
Once dismissed as just part of growing up, peer rejection has in recent years been linked with a host of problem behaviors, possibly including an individual's chances of developing mental illness.
Scientists say that while repeated and deliberate rejection by one's peers may result in little lasting harm for some young people, in others it causes alienation, withdrawal, depression, anxiety and even violent outbursts such as school shootings.
An extreme example is Seung Hui Cho, who fatally shot 32 people at Virginia Tech on April 16 before committing suicide. In messages he left to be viewed after his death, Cho said his rampage flowed from a long history of being socially isolated and bullied.
Whatever facts finally emerge about Cho's mental health, his videotaped remarks put an unsmiling -- and unusually violent -- face on a problem faced in smaller ways by many young people.
Over the past two decades, scientists have produced an increasingly fine-grained picture of children's social lives, using diaries, surveys and videotapes of playground and lunchroom behavior to gain new understanding of how social skills develop and affect mental health.
Just this month the Archives of Pediatrics & Adolescent Medicine published a Finnish study of more than 2,500 16- to 20-year-old boys, followed since they were 8; it showed that those who had been frequent bullies or victims of bullies were responsible for a disproportionate share of juvenile crimes during the four-year study period.
Scientists have also designed initiatives ranging from social skills groups to school counseling to try to stop emotionally hurtful patterns. But the complexity of the issue has stymied easy fixes, and competing educational priorities have left little time for schools to practice and refine interventions.
New brain scan research, including a 2003 study in the journal Science, shows that social rejection activates the same brain regions that are involved in feelings of physical pain. Sandra Graham, professor of psychological studies in education at UCLA, notes such research shows that rejection "goes very deep and has some serious long-term consequences."
In a species in which for most of our evolution exclusion from our social group could mean death, such biological responsiveness to rejection makes sense.
In childhood, short periods of peer rejection are common and not always a reason for concern. When researchers poll elementary school children about their friends, about 10 percent are not named as pals by any classmates.
A year later, only about 40 to 50 percent of rejected children are still left out; about 30 percent will have ongoing social problems, according to research by Antonius Cillessen, psychology professor at the University of Connecticut.
What makes long-term rejection most likely? An inability to regulate behavior and emotions that may be expressed in numerous ways.
Many tend to reinforce each other: For example, the child who is initially left out because she cried easily becomes a target of bullies, increasing her isolation and thereby reducing her chances of practicing social skills. This makes early intervention critical.
Failure to be friendly and welcoming to others is one common reason for exclusion, according to Steven Asher, professor of psychology and neuroscience at Duke University. Children who are poorly accepted by peers, he says, often have "an absence of positive social skills like being cooperative, helpful and kind."
Shy kids may be too timid to be friendly; bossy kids may not recognize the importance of taking turns and cooperating. Kids who engage in disruptive behavior -- making strange noises or acting in an unpredictable way -- also alienate peers, says Asher, putting children with such disabilities as attention-deficit disorder and Tourette's syndrome at especially high risk.
Competence -- either in academics or in sports or other activities -- is generally protective. Though teens sometimes label conspicuously smart kids geeks or nerds, intelligence itself does not place a child at high risk for rejection, Asher says.
What does isolate many bright children is a lack of common interests. "A gifted child whose interests are not shared widely by other kids misses out on this basis for connection," he says.
Aggressiveness is a more variable risk factor. In preschool and elementary school children, impulsive violence often intimidates peers and leads to isolation, research shows. But once kids reach middle school, some gain status by using aggression deliberately -- for example, pushing others around to win dominance.
How children perceive their friendships is also critical to their mental health and behavior. For sensitive children, the tendency to see ambiguous events as negative can increase risk for depression and anxiety: Perceived rejection is more closely connected with depression than the real thing.
A 2005 study of 159 adolescents in the Journal of Clinical Child and Adolescent Psychology found that being bullied while also being sensitive to rejection was linked with symptoms of depression.
Whether kids act out in response to rejection tends to differ by sex and perception. According to Cillessen's research, boys who feel especially excluded tend to lash out; rejection-sensitive girls tend to blame themselves and keep quiet. By contrast, girls who don't seem especially sensitive to rejection but experience a lot of it tend to externalize their response and behave poorly.
In designing interventions, researchers have learned it's critical to take perceptions, responses and reality into account. Whether a child actually has no friends or simply believes that matters greatly in terms of what will help, according to Cillessen.
School cultures also influence outcomes. In the course of working at five schools, former New York social worker Jessie Klein, now assistant professor of sociology and criminology at Adelphi University, learned that to be effective, programs must be integrated into a whole-school focus on inclusiveness, community and tolerance.
Ethnic balance also matters: Schools in which no one racial or ethnic group dominates tend to have less bullying and students who feel more connected to school, Graham's research found.
Improving "emotional regulation" is also critical, says Cillessen: "Teaching things like 'Slow down. Count to 10. What am I feeling? What can I do to solve this problem?' That's a very powerful component." And repeatedly practicing these skills helps develop the frontal cortex, the part of the brain that puts the brakes on behavior.
Parents can help by modeling these techniques and by pushing schools to be sensitive to children's emotional development. "Attachment to school is important," Cillessen says, noting that a feeling of belonging has repeatedly been linked to higher academic performance and fewer behavior problems.
Unfortunately, many stepped-up security measures, such as searches, metal detectors and "zero tolerance" policies that result in rapid expulsion, can undermine children's connections to their schools.
Having difficulty recognizing rejection also makes a child more vulnerable.
Shifra Gassner teaches a combined second- and third-grade class at Manhattan's East Village Community School, whose staff aims to deepen students' sense of connection to the school. She describes "one little guy" who came in late in the year and was having trouble with emotional control. "He sings at funny times and is very easy to tick off," she says.
One day, "the new guy was belting his heart out and this other kid was looking at him, pointing at him and laughing." The other kids didn't join in, and the boy who made fun admitted to Gassner that he had made a mistake. The new boy came to her later and admitted how he wasn't sure whether the child who made fun of him "was his friend."
"That's a real emotional gain for him," Gassner says, noting that in the past he would not have recognized what was going on. "If you want children to know something, you have to teach them." ·
Maia Szalavitz is co-author with Bruce Perry of "The Boy Who Was Raised as a Dog And Other Stories From a Child Psychiatrist's Notebook" and a senior fellow at Stats.org. Comments:firstname.lastname@example.org.