Mariam is Emirati, although her mother happens to be from Britain. The more cruel children in her class call her “Mariam the mongrel”. These bullies often persecute Mariam; it has become something of a class ritual. Once, they hid her new school bag. Searching in all the wrong places, 10-year-old Mariam’s inquiries were met with conspiratorial silence. The missing bag was eventually recovered, but only after a teacher had intervened to bring an end to this "harmless" prank.The problem is that name-calling and pranking are not all that harmless. Experiences of victimisation in childhood are often an important factor in the development of enduring mental health problems in later life.
Psychologists have explored the different ways we explain these victimisation experiences to ourselves. Some of us will tend to provide internal explanations, telling ourselves that “they hid my bag because I’m stupid and weak”. While others will come up with more externally focused explanations: “They hid my bag because people are mean.” These experiences, coupled with negative explanatory styles, appear to be associated with the development of severe mental health problems, specifically delusions.
Delusions are basically false beliefs that are highly resistant to contradictory evidence. They tend to focus on a small number of themes: grandiosity, guilt, love and jealousy. But the most common delusion of all is paranoia, the persecutory belief that other people are planning to do you harm. It’s not surprising that defensive explanatory styles are particularly characteristic of patients experiencing paranoid delusions. It is also easy to see how repeated victimisation experiences might lead to low self-esteem and the development of increasingly defensive and suspicious explanatory styles.
Numerous large-scale surveys undertaken across several nations, including Mexico, Germany and the Netherlands, all suggest that childhood victimisation experiences are predictive of paranoia. In the UK, people of Afro-Caribbean and Asian origin are disproportionately more likely to be diagnosed as suffering from paranoid delusions. Similarly, people of Afro-Caribbean descent living in predominantly white areas of the UK appear to be at greater risk of paranoid delusions than those living in Afro-Caribbean areas. One explanation for this pattern is that victimisation experiences are likely to be more frequent among minority groups who may often experience harassment and discrimination.
In spite of the potential utility of these psychosocial insights, research and clinical practice have remained overly fixated on biological approaches to severe mental health problems. The quest to solve the ancient puzzle of madness is overly concerned with the hunt for predisposing genes structural brain abnormalities, and neurochemical imbalances. While these explorations may yet yield fruit, it makes sense for us to implement what we already know. Victimisation experiences increase the risk of severe mental health problems.
Knowing the role of victimisation in the pathway to psychosis provides us with a target for prevention and mental health promotion. The school is the obvious environment for such efforts, with parental participation an essential element also. Reducing bullying and other peer-directed delinquent behaviours are worthwhile goals in and of themselves, however, and will contribute greatly to reducing the incidence of severe and enduring mental health problems in our societies.
Thankfully, Mariam survived her many victimisation experiences. She grew up to be a happy, healthy, and compassionate individual. She now works as a school counsellor and is keen to ensure that this generation of children experience the same kind of gains in mental health, that her parents’ generation made in terms of physical health and life expectancy.
Dr Justin Thomas is an associate professor of psychology at Zayed University and author of Psychological Well-Being in the Gulf States
On Twitter: @DrJustinThomas