Left Out

Whatever facts emerge about his mental health, his videotaped remarks put an unsmiling, and unusually violent, face on a problem faced in smaller ways by many young people.

Over the past two decades, scientists have produced an increasingly fine-grained picture of children8217;s social lives, using diaries, surveys and videotapes to gain understanding of how social skills develop and affect mental health.

This month, the Archives of Pediatrics 038; Adolescent Medicine published a Finnish study of over 2,500 teenage boys, followed since they were 8. It said those who had been frequent bullies or victims, were responsible for a disproportionate share of crimes.

New brain scan research, including a 2003 study in Science, shows that social rejection activates the same brain regions that are involved in feelings of physical pain. Sandra Graham, professor of psychological studies in education at UCLA, notes such research shows that rejection 8220;goes very deep and has some serious long-term consequences8221;.

In a species in which for most of our evolution, exclusion from social group could mean death, such biological responsiveness to rejection makes sense.

In childhood, short periods of peer rejection are common and not always a reason for concern. When researchers poll elementary schoolchildren about their friends, about 10 per cent are not named as pals by any one. A year later, about 40 to 50 per cent of rejected children are still left out; about 30 per cent will have problems, according to research by Antonius Cillessen, psychology professor at the University of Connecticut.

What makes long-term rejection most likely? An inability to regulate behavior and emotions, which may be expressed in numerous ways. Many tend to reinforce each other: For example, the child who is initially left out because she cried easily becomes a target, increasing her isolation and thereby reducing her chances of practicing social skills.

Failure to be friendly and welcoming to others is another common reason, according to Steven Asher, professor of psychology and neuroscience at Duke University. Children poorly accepted by peers, he says, often have 8220;an absence of positive social skills like being cooperative, helpful and kind8221;. Shy kids may be too timid to be friendly; bossy kids may not know the importance of cooperating.

Kids who engage in disruptive behavior, making strange noises or acting in an unpredictable way, also alienate peers.

Competence, in academics, sports or other activities, is generally protective. Though teens sometimes label conspicuously smart kids geeks or nerds, intelligence itself does not place a child at risk for rejection. What does isolate them is a lack of common interests.

8220;A gifted child whose interests are not shared widely by other kids, misses out on this basis for connection,8221; Asher says. Aggressiveness is a more variable risk factor. In smaller children, violence often intimidates peers and leads to isolation. But later, some gain status by using aggression deliberately.

How children perceive their friendships is also critical to their mental health. The tendency to see ambiguous events as negative can increase risk for depression and anxiety.

Shifra Gassner, a teacher at Manhattan8217;s East Village Community School, describes 8220;one little guy8221; who sang at funny times and was very easy to tick off. One day, 8220;the new guy was belting his heart out and this other kid was pointing at him and laughing.8221; The other kids didn8217;t join in, and the boy who made fun admitted to Gassner that it was a mistake. The new boy came to her later and said how he wasn8217;t sure whether the child who made fun of him 8220;was his friend8221;. 8220;That8217;s a real emotional gain for him,8221; Gassner says.

A 2005 study in the Journal of Clinical Child and Adolescent Psychology found how kids respond to rejection depends on sex and perception. Boys tend to lash out, girls tend to blame themselves and keep quiet.

In designing interventions, researchers have learned it8217;s critical to take perceptions, responses and reality into account. Improving 8220;emotional regulation8221; is also critical, says Cillessen. 8220;Teaching things like 8216;Slow down. Count to 10. What am I feeling? What can I do to solve this problem?8217; That8217;s a very powerful component.8221; And practicing these skills helps develop the frontal cortex, part of the brain that puts brakes on behavior.