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(CNN)Every generation has tales of bullying, but perhaps today's adults are not as familiar with what it means now for a kid to be bullied.
Physical bullying — like confrontations involving hitting or shoving — actually showed very little association with a risk for mental distress, according to a new study.
"For adults doing this research, you kind of assume that bullying consists of being stuffed in a locker and beaten up on the playground," said lead study author John Rovers, professor and John R. Ellis Distinguished Chair in Pharmacy Practice at Drake University in Des Moines, Iowa. "We found out that that really has remarkably little effect."
Researchers took data from the 2018 Iowa Youth Survey of sixth, eighth and 11th graders to see whether there was an association between bullying and mental health and suicidal ideation, according to the study published Wednesday in the journal PLOS ONE.
The results showed different forms of bullying did have an impact on feelings of sadness or hopelessness or thoughts of suicide — but that they did not impact students equally.
Identity bullying, which includes bullying based on sexual orientation or gender identity as well as sexual jokes, was correlated with significant feelings of distress or suicide attempts, the study said.
Cyberbullying and social bullying — leaving someone out or turning peers against them — followed identity bullying on degree of impact.
The study is limited in that the sample did not include a high level of racial and religious diversity, but it does show "a theme very consistent with recent surveys as well as what I'm seeing in my clinical practice," said child and adolescent psychiatrist Dr. Neha Chaudhary, chief medical officer at BeMe Health who is in the faculty at Massachusetts General Hospital and Harvard Medical School. Chaudhary was not involved in the research.
The teachers and school administrators surveyed were worried most about physical bullying, however, according to the study.
"This is a good learning for schools and families as they think about anti-bullying initiatives and how to talk to young people about the effects of bullying," Chaudhary said.
Who is bullied most
It makes sense that identity would be a particularly painful form of bullying.
"Identity is so incredibly important for kids and teens as they develop, and not being able to be themselves without fear of judgement or bullying from others is not only isolating, it can significantly alter their confidence, peace of mind, and ability to see a future for themselves that's free of pain," Chaudhary said in an email. "People just want to be themselves, and be loved for who they are."
The survey data reviewed by the study team revealed a troubling statistic when it came to the state of adolescent mental health.
"About 70,000 students responded to this survey. Five percent of them had attempted suicide in the last year," Rovers said. "That's 3,500 kids."