Editorial
Why be happy when you could be normal?
Who wouldn’t want to be normal? The concept suggests on adult mental health outcomes than maltreatment by
conventionality, the ordinary and typical, perhaps even adults, including sexual and physical abuse.
reassuring dullness. But, as in a David Lynch film, all sorts The authors of this Series have made a powerful case
of things might lurk behind the white picket fence of so- for bullying prevention as a potential method to increase
called normality. “Normal” isn’t necessarily a desirable mental wellbeing and reduce the burden of mental illness
state; it can conceal sinister currents, and for those on in both children and adults. However, to fully appreciate
the wrong side of the fence, the popular idea of “normal” the meaning of social factors such as bullying, we need
Grady Reese/Corbis
might even be threatening. to look at both “normal” behaviours and harms from the
Such is the case with bullying. Few would argue that point of view of young people themselves.
bullying is a desirable thing to happen to children, but it’s For example, peer groups and subcultures are significant
often accepted as an inevitable (if unfortunate) aspect of to adolescents’ self-conceptualisation, but are rarely See Series pages 917 and 930
a normal childhood. Bullying seems to excite interest only explored as important factors in their mental health. A For more on the prevalence of
bullying see J Adolesc Health
when it happens through new modalities, such as via the recently published paper by Lucy Bowes and colleagues 2014; 55: 602–11
internet or text messaging. The sheer scale of bullying— explored subculture identification in teenagers and the For the paper by Gennaro
Catone and colleagues see
with a prevalence of about 35% for victimisation and association with depression and self-harm; teenagers
Articles Lancet Psychiatry 2015;
perpetration in adolescents—might explain some of who identified with goth subculture were at particularly 2: 618–24
the apathy towards it; is it even possible to address such increased risk of meeting clinical thresholds for both. For the paper by Suzet Lereya
and colleagues see Articles
common behaviour? Isn’t bullying normal? This painstaking work used operational definitions of Lancet Psychiatry 2015; 2: 524–31
In this issue of The Lancet Psychiatry, a Series on subcultures derived from qualitative work with young For the paper by Lucy Bowes
bullying explores some of the consequences of peer people themselves; assessed clinically relevant measures and colleagues see Articles
Lancet Psychiatry 2015;
victimisation and maltreatment during childhood. of psychopathology; and controlled for existing risk 2: 793–800
Bullying, defined as repeated victimisation within a factors present before the young people identified with For the Good Childhood Report
see http://www.childrenssociety.
relationship that has a perceived power imbalance, subcultures. The social risk and protective effects of peer org.uk/what-we-do/resources-
encompasses a wide range of frequencies and aggression groups are complex, and identifiable risk markers for and-publications/the-good-
childhood-report-2015
levels, ranging from teasing or name-calling to very depression and self-harm in young people are desperately
serious physical, verbal, and social abuse resulting needed to inform interventions. The paper’s findings were
in severe psychological distress. Dieter Wolke and not universally well-received, with some commentators
colleagues assess sibling bullying, while Anat Klomek suggesting that not only were the findings obvious,
and colleagues look at the adult outcomes of childhood but also that the research topic was trivial. Beyond
peer bullying in terms of psychopathology, suicidality, the implication that youth culture is not worth taking
and criminality. Both papers point to serious harms seriously and that severe mental health problems are
resulting from bullying. Sibling bullying, experienced simply teenage angst, there is perhaps an unspoken
by up to 40% of siblings, is associated with increased assumption—why can’t they just be normal?
distress, self-harm, and depression both in childhood Research priorities in child and adolescent mental health
and early adulthood. Peer bullying, meanwhile, also has should not be based on an externally imposed view of
serious mental health consequences, with peer victims normality, but should actively involve young people
at increased risk of suicidality and affective disorders, in defining the outcomes that matter to them. In their
and perpetrators at increased risk of suicidal ideation, annual Good Childhood Report, the Children’s Society
depression, and criminal offending. Previous research emphasise the importance of using young people’s views
by Gennaro Catone and colleagues has shown bully– as the basis for research into childhood wellbeing. It is
victims to be at increased risk of psychotic phenomena more important that frameworks and practices accurately
(eg, persecutory ideation and hallucinations) and reflect the way young people are, than the way older
diagnosis of psychosis, whereas evidence from members of society would like them to be. If anyone
Suzet Lereya and colleagues suggests that childhood should redefine the meaning of normal, it should be the
bullying victimisation by peers could have more impact young people living it. ■ The Lancet Psychiatry
www.thelancet.com/psychiatry Vol 2 October 2015 851
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