{'fraction_non_alphanumeric': 0.0227011021549597, 'fraction_numerical': 0.009541042934693206, 'mean_word_length': 4.913910505836576, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 1, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Bullying in School-Age Children

Bullying is a phenomenon in the form of negative actions against peers with the aim of hurting, done repeatedly, accompanied by physical or verbal aggression, relational disorders, which are hurting others by social manipulation, and malicious rumors. Bullying is a major public health problem should not be tolerated because it has a psychological impact on perpetrators and victims. The impact of bullying is increasingly widespread, it can even lead to suicide. Bullying in schools is the forerunner of violence in society. Emotional Mental Health Impacts caused by Bullying include symptoms of depression, anxiety, psychotic symptoms, ADHD symptoms, problems conduct, ASPD disorders, and suicide attempts. In addition, bullying also has an impact on substance abuse, crime, and delinquency. Seeing the magnitude of the impact, it is necessary tackle bullying in a holistic and comprehensive manner. The treatment consists of handling the whole school level, classroom level, and individual level, one of which is through CBT and parent training.


Introduction
Bullying is a disorder that often occurs in school-age children. Victims

Characteristics of individuals involved in bullying
In  normally associate with peers who also is an actor and they have a susceptibility to peer pressure. 16 The impacts associated with behavior bullying were loneliness, poor academic achievement, difficulty in social adjustment, increased risk of drug and alcohol use, involvement in criminal acts, 12 and depression susceptibility compared to other children who were not involved in bullying. 16 Research also states that there is a relationship with violent behavior that will occur in adulthood. Some of these abusers act aggressively towards their partners, use harsh physical discipline on their children, and their children then have a tendency to become bullies. 12

Characteristics of observers
There is a study which states that 85% of bullying in schools generally occurs accompanied by the presence of other peer groups. 12 Classmates are those who are often observers. Observers often end up supporting the perpetrator for fear of becoming the victim of bullying. 16 The role of supporter was as an assistant of bullies, such as making threats, strengthen, or encourage bullying. On the other hand, there are also children who act as defenders of victims, who try to stop them, or 201 outsiders/observers who choose not to be involved. 12

Characteristics of bullies/victims
There are 6% of bullies are victims of someone who ended up being bullies. 16  Research shows that some victims usually come from overprotective family and also experience bullying from their siblings. Children with physical disabilities also have a vulnerability to become victims. 12 The act of friendship acts as a protective factor: having a number of close friends can lower a person's risk of becoming a victim. Other protective factors include high social competence, low aggression, and low anxiety. 12 The effects of childhood bullying can last for a long time. Some adults who have experienced bullying in the past report experiencing depression, low self-esteem, and interpersonal difficulties as adults. They are also more prone to have suicidal ideation or attempts, or to retaliate. 12

Factors affecting the event of bullying
There are several theories that describe the causes of bullying.
Existing theories include the deviation hypothesis, bully/victim's problems, and the child's biopsychosocial environment. 16 In the 1970s, the popular view of bullying, is deviation hypothesis where it was stated that the victims were people who did have deviation. 16 The study also showed that other factors are more important than previous theories. Olweus (1993)  and have physical weaknesses, they will soon be found by the bullies. Gradually, the 'scapegoat' will become more isolated from his peers. 16 In several studies, a relationship was found between poor parenting and bullying. Craig, Peters and Konarski  16 Harachi, Catalano and Hawkins found that incidence of bullying were higher in boys whose parents used corporal punishment or violence. Junger-Tas and van Kesteren state that parents who spank and apply strict discipline have children who are more likely to be bullies.
Olweus studied male school children who were quiet and isolated; He found that bullying was linked to overprotective mothers and critical and distant fathers.
Rigby showed that boys who were bullied reported poor relationships with their fathers, and girls who were bullied had poor relationships with their mothers. 16

Mangklara et al. conducted a study in Greece with
results stating that being a bully is related to several dimensions regarding the socioeconomic status of parents, while being a victim of bullying has no relationship with socioeconomic status. This study indicates that lower socioeconomic status is associated with an increased risk of a child becoming a bully. 17 In general, the level of parental education is not In addition, poor academic performance in school, which is an indicator of adaptability in school, is associated with an increased risk of being a bully.
However, there is other evidence which also states that there is a relationship between an increased risk of being a bully and good performance at school when a bully is bullied. This can be explained that someone who has extreme academic achievement feels that he is not part of the average group of their peers. This perception can lead to stress, antisocial behavior, such as bullying. 17 There are also other interesting findings in the study

Symptoms of depression
Of all the other psychiatric symptoms, symptoms of depression associated with bullying are the most studied topic. A prospective study showed that there was a 4. showed that repeated victimization at the age of 13 was a 2.6-fold risk factor for anxiety at the age of 14 in girls, but not in boys. 8 There is a cross-sectional study that found that being a bully causes a 3.8-fold risk of anxiety, while being a bully/victim has a 6.4-fold risk. Another prospective study also showed that bullying/victimization at the age of 8 years increased the risk of developing an anxiety disorder 5.2-fold in young adults. 8

Psychotic Symptoms
Four out of five studies suggest that victims of bullying have a higher risk of experiencing psychotic symptoms or psychotic-like symptoms than those who have never been involved. A prospective study showed that individuals who were victims of bullying at the age of 8 or 10 years had an almost 1.9 times risk of experiencing psychotic symptoms at age 12 than those who were not involved. In addition, a long exposure relationship was also found as a risk factor for psychotic symptoms, which was 4.6 times in victims bullying of chronic or severe. Bullying is considered severe when the victim experiences both types of bullying: overt, for example direct verbal and physical aggression, and relational, for example social exclusion. 8 The risk of psychotic symptoms in bullies and 204 bullies/victims was 9.9 times higher than in other individuals who were not involved. The risk for bullies to experience psychotic-like symptoms is 1.3 times compared to individuals who are not involved. 8

Symptoms of Attention-Deficit Hyperactivity
Disorder (ADHD), conduct problems, and Antisocial

Personality Disorder (ASPD)
Being a bully has consistently been found to be associated with conduct problems.

Attempted suicide
Suicide is one of the leading causes of death for young people in many countries. Bullying is one of the risk factors associated with suicide. According to a study, victims of bullying have a 1.5-5.4-fold increased risk of attempting suicide. Bullies also have a higher risk as the victim, that is 2.3 to 9.9-fold. The risk of having suicidal ideation in bullies/victims is the greatest compared to other groups, which is 1.9-10 times. 8 The relationship between suicidal behavior related to sex has also been investigated. A prospective study showed that bullying in boys was not associated with suicide. In girls, being a victim of bullying is a risk factor for suicide. Another study conducted by Eisenberg et al.
confirmed that and female victims have a higher risk of committing suicide than men. 8

Holistic and comprehensive bullying management
The management of bullying should begin through an assessment of the problem size of the components in the schools involved (using an anonymous questionnaire).
Comparison of the findings with other studies provides a starting point for addressing the problem with the involvement of all school staff, government, parents, and students. The interventions carried out should be divided into three levels, namely at the overall school level, the classroom level, and the individual level. 3,19 Both at the school level as a whole and in the classroom, there must be an explicit policy stating that bullying is not allowed in schools. This policy must be adhered to by all staff, government, parents, and all students. Student opinions should be scrutinized from the outset of policy-making planning. 3,19 Bullying requires sanctions for wrongdoing. This could take the form of meeting the bullies face-to-face with regard to their behavior and depriving them of privileges if necessary. As in all other cases, it is important that the sanctions imposed do not inconvenience the staff more than the perpetrators.
Attention needs to be given to avoid overly punitive attitudes that will later become a model of revenge behavior which is actually the initial problem. Young bullies tend to have serious problems with antisocial tendencies. Guidance and supervision are needed and parental support is also needed to direct the child to behave prosocially. 3,19 Not all things can be achieved through the improvement of the school environment alone. Bullying is a serious, silent, vicious process, which must be thoroughly addressed as soon as possible. For this to be achieved, bullies must be confronted and interviewed so that they are fully aware that their behavior is intolerable. In addition, the immediate task in this regard is to offer protection to the victim in order to prevent 205 further attacks. All protective measures must be taken with the knowledge and consent of the victim. Victims often ask their parents not to do anything to stop the abuse. In this case, the steps that can be taken are to build children's confidence, develop their abilities, and encourage them to mingle with the right peers. 3,19 A cognitive-behavioral (CB) approach combined with parental training is the best way to promote positive change in students with special needs who have peer problems. CB interventions focus on reducing problematic behaviors (such as aggression and impulsivity) and increasing positive behaviors (such as social skills, problem solving). Instructions that focus solely on behavior or cognition alone are not effective with these students. This CB approach was developed based on the belief that thoughts, feelings, and actions are interrelated. Behavior is related to thoughts and beliefs, which are acquired through experience.
Therefore, both experience and interpretation of experience can be changed. 3,20

Conclusion
Bullying is a major public health problem. Bullying should not be tolerated because it has a psychological impact on perpetrators and victims of serious problems.
The impact of bullying is increasingly widespread, it can even lead to suicide. Bullying in schools is the forerunner of violence in society. Emotional Mental Health impacts caused by bullying include symptoms of depression, anxiety, psychotic symptoms, ADHD symptoms, conduct problems, ASPD disorders, and suicide attempts. In addition, bullying also has an impact on substance abuse, crime, and delinquency. Seeing the magnitude of the impact, it is necessary to immediately tackle bullying in a holistic and comprehensive manner. The treatment consists of handling the whole school level, classroom level, and individual level, one of which is through CBT and parent training.