Bullying is the common term for a range of physical and non-physical behaviors that center on the use of aggression to demean others and assert power and social control. Current estimates indicate that 20 percent to 30 percent of teenagers and younger children in the U.S. are exposed to at least some of these behaviors. According to the results of a study published in May 2013 in the Journal of the American Academy of Child & Adolescent Psychiatry, those bullied in early childhood have sharply increased risks for participating in some form of damaging self-harm during their teenage years. Bullying Basics Broadly speaking, a child can be bullied through physical means, verbal means or social means. Children exposed to physical bullying experience acts of aggression such as punching, hitting, smacking, tripping, spitting and forceful theft of personal property. Children exposed to verbal bullying experience acts of aggression such as threats of violence, teasing, taunting, demeaning sexual commentary and labeling with derogatory names. Children exposed to social bullying experience acts of aggression such as rumor campaigns, purposeful social isolation, purposeful embarrassment and purposeful exclusion from specific activities. Children exposed to cyberbullying over cell phones or the Internet may experience both verbal\/written forms of aggression and social forms of aggression. Self-Harm Basics Self-harm is the act of injuring oneself without the conscious goal of attempting to commit suicide. The American Psychiatric Association (APA) refers to this type of behavior as a condition called nonsuicidal self-injury or NSSI. This condition does not have full status as a diagnosable mental disorder; however, in 2013, the APA included it in a special category designed for potentially diagnosable disorders that need further investigation from the research community. Actions that qualify as forms of self-harm include cutting or carving your own skin, burning your own skin, ripping or flaying your own skin, punching yourself, banging your head against hard objects, biting yourself, ripping out your hair, purposefully breaking your bones and purposefully interfering with your body\u2019s ability to heal from previously inflicted wounds. There are a number of potential motivations for self-harming behaviors. Examples of these motivations include a desire to avoid painful emotional states, a desire to feel a sense of personal control, a desire to offset a sense of emotional emptiness, a desire to feel less anxious or stressed, an urge toward self-punishment and a desire to make others aware of painful or highly unpleasant feelings. Previously identified risks for participating in self-harm include being a teenager, having self-harming peers, being a girl or woman, using drugs or alcohol, having a traumatic or troubled personal history and having a history of mental illness. Effects of Childhood Bullying During the first stage of the study published in the Journal of the American Academy of Child & Adolescent Psychiatry, a team of British researchers assessed the bullying histories of nearly 5,000 children between the ages of 7 and 10. Years later, when the same children were either age 16 or 17, the researchers used interviews to determine their involvement with various forms of self-harm. Almost 17 percent of these teenagers had harmed themselves in the 12 months prior to being interviewed. Although self-harming behaviors don\u2019t necessarily evolve into suicide attempts, roughly 27 percent of those who self-harmed told the researchers that they actively contemplated dying. After comparing teens with a history as targets of bullying to teens with no such history, the study\u2019s authors concluded that teens bullied between the ages of 7 and 10 engage in some form of self injury almost 400 percent more often than teens who were not bullied during this timeframe. This conclusion held true even when the research team excluded other prominent, underlying factors that can increase risks for self-harm, such as domestic violence within the household, a generally chaotic home environment and a childhood history of mental illness. Teenage girls in the study had a higher rate of self-injury than teenage boys; girls also had a higher rate for significant symptoms of depression. Considerations The authors of the study in the Journal of the American Academy of Child & Adolescent Psychiatry note that many of the children exposed to bullying never mention that exposure to their parents or any other authority figures. For this reason, they recommend that adults and mental health professionals consider bullying as an underlying cause whenever a teenager or younger child participates in self-harming behaviors.