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Vol. 75, No. 1, 2006
Issue release date: 2006
Psychother Psychosom 2006;75:47–55

Bullying Girls – Changes after Brief Strategic Family Therapy: A Randomized, Prospective, Controlled Trial with One-Year Follow-Up

Nickel M. · Luley J. · Krawczyk J. · Nickel C. · Widermann C. · Lahmann C. · Muehlbacher M. · Forthuber P. · Kettler C. · Leiberich P. · Tritt K. · Mitterlehner F. · Kaplan P. · Pedrosa Gil F. · Rother W. · Loew T.
aClinic for Psychosomatic Medicine, Inntalklinik, Simbach am Inn, Germany; bUniversity Clinic for Psychiatry 1, PMU, Salzburg, Austria; cDepartment of Psychosomatic Medicine, University Clinic, Regensburg, and dPsychosomatic Ambulance, Medicine Clinic, Ludwig-Maximilians-University, Munich, Germany

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Background: Many girls bully others. They are conspicuous because of their risk-taking behavior, increased anger, problematic interpersonal relationships and poor quality of life. Our aim was to determine the efficacy of brief strategic family therapy (BSFT) for bullying-related behavior, anger reduction, improvement of interpersonal relationships, and improvement of health-related quality of life in girls who bully, and to find out whether their expressive aggression correlates with their distinctive psychological features. Methods: 40 bullying girls were recruited from the general population: 20 were randomly selected for 3 months of BSFT. Follow-up took place 12 months after the therapy had ended. The results of treatment were examined using the Adolescents’ Risk-taking Behavior Scale (ARBS), the State-Trait Anger Expression Inventory (STAXI), the Inventory of Interpersonal Problems (IIP-D), and the SF-36 Health Survey (SF-36). Results: In comparison with the control group (CG) (according to the intent-to-treat principle), bullying behavior in the BSFT group was reduced (BSFT-G from n = 20 to n = 6; CG from n = 20 to n = 18, p = 0.05) and statistically significant changes in all risk-taking behaviors (ARBS), on most STAXI, IIP-D, and SF-36 scales were observed after BSFT. The reduction in expressive aggression (Anger-Out scale of the STAXI) correlated with the reduction on several scales of the ARBS, IIP-D, and SF-36. Follow-up a year later showed relatively stable events. Conclusions: Our findings suggest that bullying girls suffer from psychological and social problems which may be reduced by the use of BSFT. Expressive aggression in girls appears to correlate with several types of risk-taking behavior and interpersonal problems, as well as with health-related quality of life.

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  1. Steiner H, Saxena K, Chang K: Psychopharmacologic strategies for the treatment of aggression in juveniles. CNS Spectr 2003;8:298–308.
  2. Forero R, McLellan L, Rissel C, Bauman A: Bullying behavior and psychosocial health among school students in New South Wales, Australia: Cross-sectional survey. BMJ 1999;319:344–348.
  3. Nansel TR, Overpeck M, Pilla RS, Ruan WJ, Simons-Morton B, Scheidt P: Bullying behaviors among US youth: Prevalence and association with psychosocial adjustment. JAMA 2001;285:2094–2100.
  4. Smith-Kuri E, Iachan R, Scheidt PC, Overpeck MD, Gabhainn SN, Pickett W, Harel Y: A cross-national study of violence-related behaviors in adolescents. Arch Pediatr Adolesc Med 2004;158:539–544.
  5. Kaltiala-Heino R, Rissanen A, Rimpela M, Rantanen P: Bulimia and impulsive behaviour in middle adolescence. Psychother Psychosom 2003;72:26–33.
  6. Lee E, Kim M: Exposure to media violence and bullying at school: Mediating influences of anger and contact with delinquent friends. Psychol Rep 2004;95:659–672.
  7. Spivak H, Prothrow-Stith D: The need to address bullying: An important component of violence prevention. JAMA 2001;285:2131–2132.
  8. Coker AL, McKeown RE, Sanderson M, Davis KE, Valois RF, Huebner ES: Severe dating violence and quality of life among South Carolina high school students. Am J Prev Med 2000;19:220–227.
  9. Turgay A, Binder C, Snyder R, Fisman S: Long-term safety and efficacy of risperidone for the treatment of disruptive behavior disorders in children with subaverage IQs. Pediatrics 2002;110:e34.

    External Resources

  10. Nickel M, Nickel C, Mitterlehner F, Lahmann C, Lieberich P, Tritt K, Rother W, Loew T: Treatment of aggression in female borderline personality disorder patients: A double-blind, placebo-controlled study. J Clin Psychiatry 2004;65:1515–1519.
  11. Spoth RL, Redmond C, Shin C: Reducing adolescents’ aggressive and hostile behaviors. Arch Pediatr Adolesc Med 2000;154:1248–1257.
  12. Rother W, Nickel M: A concept for the psychosomatic clinic in Bad Aussee. Wien Med Wochenschr 2002;152:516–520.
  13. Nickel M, v. Bohlen I, Nickel C, Mitterlehner F, Rother W: Parent-child ward as a family therapy treatment concept in a treatment setting for patients with borderline personality disorder. Psychodyn Psychother 2004;4:247–251.
  14. Buka SL, Stichick TL, Birdthistle I, Earls FJ: Youth exposure to violence: prevalence, risks, and consequences. Am J Orthopsychiatry 2001;71:298–310.
  15. Szapocznik J, Kurtines WM, Perez-Vidal A, Hervis OE, Foote F: One-person family therapy; in Wells RA, Gianetti VJ (eds): Handbook of the Brief Psychotherapies. New York, Plenum, 1989, pp 493–510.
  16. Szapocznik J, Rio AT, Murray EJ, Cohen R, Scopetta MA, Rivas-Vasquez A, Hervis OE, Posada V, Kurtines WM: Structural family versus psychodynamic child therapy for problematic Hispanic boys. J Cons Clin Psychol 1989;57:571–578.
  17. Robbins MS, Szapocznik J: Brief strategic family therapy. Juv Justice Bull 2000;1:2–11.
  18. Muellner M: Evidence-Based Medicine. Wien, Springer, 2002.
  19. Schwenkmezger P, Hodapp V, Spielberger CD: Das State-Trait-Ärgerausdrucks-Inventar. Bern, Huber, 1992.
  20. Horowitz LM, Rosenbery SE, Baer BA, Ureno G, Villasenor V S: Inventory of interpersonal problems: Psychometric properties and clinical applications, J Consult Clin Psychol 1988;56:885–892.
  21. Bullinger M, Kirchberger I: SF-36 Health Survey (Fragebogen zum Gesundheitszustand, SF-36). Göttingen, Hogrefe, 1998.
  22. Janssen I, Craig WM, Boyce WF, Pickett W: Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics 2004;113:1187–1194.
  23. Juvonen J, Graham S, Schuster MA: Bullying among young adolescents: The strong, the weak, and the troubled. Pediatrics 2003;112:1231–1237.
  24. Litt IF: Drugs in adolescent girls. J Adolesc Health 2003;32:1–2.
  25. Mazur J, Kowalewska A, Woynarowska B: Alcohol drinking and other risk behaviours among adolescents aged 11–15 years. Med Wieku Rozwoj 2003;7:75–89.

    External Resources

  26. Kuntsche EN: Hostility among adolescents in Switzerland? Multivariate relations between excessive media use and forms of violence. J Adolesc Health 2004;34:230–236.
  27. Coatsworth JD, Santisteban DA, McBridge CK, Szapocznik J: Brief Strategic Family Therapy versus community control: engagement, retention, and an exploration of the moderating role of adolescent symptom severity. Fam Process 2001;40:313–332.
  28. Santisteban DA, Coatsworth JD, Perez-Vidal A, Kurtines WM, Schwartz SJ, La Perriere A, Szapocznik J: Efficacy of brief strategic family therapy in modifying Hispanic adolescent behavior problems and substance use. J Fam Psychol 2003;17:121–133.
  29. Alpert JE, Petersen T, Roffi PA, Papakostas GI, Freed R, Smith MM, Spector AR, Nierenberg AA, Rosenbaum JF, Fava M: Behavioral and emotional disturbances in the offspring of depressed parents with anger attacks. Psychother Psychosom 2003;72:102–106.
  30. Fabbri S: Family intervention to loss of clinical effect during antidepressant treatment. Psychother Psychosom 2004;73:124.
  31. Reinares M, Vieta E, Colom F, Martinez-Aran A, Torrent C, Comes M, Goikolea JM, Benabarre A, Sanchez-Moreno J: Impact of a psychoeducational family intervention on caregives of stabilized bipolar patients. Psychother Psychosom 2004;73:312–319.
  32. Tonies H: Psychiatric diseases in general practice. Wien Med Wochenschr 2003;153:366.

    External Resources

  33. Nickel M, Nickel C, Leiberich P, Mitterlehner F, Tritt K, Lahmann C, Rother W, Loew T: Inpatient treatment of women with depressive disorders due to stress: Does inclusion of the partner in treatment influence outcome? Wien Med Wschr 2004;154:878–882.
  34. Nickel M, Nickel C, Tritt K, Leiberich P, Mitterlehner F, Lahmann C, Rother W, Loew T: In-patient treatment of mothers with depressive disorders – does joint admission of their children have a negative effect on the results of treatment? A randomised, prospective, controlled trial. Psychother Psychosom 2005;74: 366–370.
  35. Burdsal C, Buel CL: A short-term community based early stage intervention program for behavior problem youth. J Clin Psychol 1980;36:226–241.
  36. Borowsky IW, Mozayeny S, Stuenkel K, Ireland M: Effects of a primary care-based intervention on violent behavior and injury in children. Pediatrics 2004;114:e392–e399.

    External Resources

  37. Stevens V, De Bourdeaudhuij I, Van Oost P: Bullying in Flemish schools: An evaluation of antibullying intervention in primary and secondary schools. Br J Educ Psychol 2000;70:195–210.
  38. Stevens V, De Bourdeaudhuij I, Van Oost P: Anti-bullying interventions at school: aspects of programme adaptation and critical issues for further programme development. Health Promot Int 2001;16:155–167.
  39. Wong DS: School bullying and tackling strategies in Hong Kong. Int J Offender Ther Comp Criminol 2004;48:537–553.
  40. Smith PK, Ananiadou K, Cowie H: Interventions to reduce school bullying. Can J Psychiatry 2003;48:591–599.

    External Resources

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