A/HRC/43/39 with peer bully victims suffering the greatest adult consequences, including both more internalizing and externalizing disorders.35 55. Peer victimization has been specifically associated with an elevated risk of anxiety disorders, depression, self-harm, suicidal ideation and suicide attempts, even after accounting for other major childhood risk factors, trauma and genetic liability.36 Research on a sample of over 6,900 children from the Avon longitudinal sample of parents and children in the United Kingdom of Great Britain and Northern Ireland found that sibling bullying increased the risk of depression, anxiety and self-harm twofold, with results remaining similar in strength for depression and self-harm even after accounting for a range of childhood confounders.37 56. The effects of sibling and peer bullying were found to be cumulative for depression, suicidal ideation and suicidal self-harm. Peer and sibling bullying are traumas that should be considered on a par with traumas such as physical or sexual abuse.38 57. Those who witness or are victims of violence can show symptoms of post-traumatic stress disorder similar to those of soldiers coming back from war, with the distress symptoms increasing according to the number of violent acts witnessed or experienced. Symptoms included distractibility, intrusive and unwanted fears, and thoughts and feelings of not belonging.39 58. As regards impairments to cognitive functioning, evidence shows that physical punishment negatively impacts intellectual learning. School violence can severely hamper a child’s ability to learn and adversely affect their development.40 Previous studies conducted in East Africa indicated that harsh punishment was related to negative consequences, including internalizing and externalizing problems, poor cognitive functioning and poor school performance.41 Researchers are also finding that physical punishment is linked to slower cognitive development and adversely affects academic achievement. In addition, physical punishment can cause alterations in the dopaminergic regions associated with vulnerability to the abuse of drugs and alcohol. 59. Children and adolescents exposed to chronic childhood trauma show a significant risk of increasing mental health disorders with subsequent poor academic achievement.42 Exposure to community violence inversely affects school engagement and performance when mental health disorders are included.43 Mental health symptoms and disorders that predict poor academic achievement are post-traumatic stress disorder, anxiety, aggressive behaviour and depression. Reviews show that there are elevated levels of violence experienced within institutions and negative cognitive effects associated with 35 36 37 38 39 40 41 42 43 See Slava Dantchev and others, “The independent and cumulative effects of sibling and peer bullying in childhood on depression, anxiety, suicidal ideation, and self-harm in adulthood”, Frontiers in Psychiatry, vol. 10 (2019). Ibid. Ibid. Ibid. See Silje Kolltveit and others, “Risk factors for PTSD, anxiety, and depression among adolescents in Gaza”, Journal of Traumatic Stress, vol. 2, No. 2 (April 2012). See Soraya Lester, Cayleigh Lawrence and Catherine L. Ward, “What do we know about preventing school violence? A systematic review of systematic reviews”, Psychology, Health & Medicine, vol. 22, supplement No. 1 (2017). See Tobias Hecker and others, “Child neglect and its relation to emotional and behavioral problems: a cross-sectional study of primary school-aged children in Tanzania”, Development and Psychopathology, vol. 31, special issue No. 1 (February 2019). See Melissa K. Holt, David Finkelhor and Glenda Kaufman Kantor, “Multiple victimization experiences of urban elementary school students: associations with psychosocial functioning and academic performance”. Child Abuse and Neglect, vol. 31, No. 5 (May 2007). See Danielle R. Busby, Sharon F. Lambert and Nicholas S. Ialongo, “Psychological symptoms linking exposure to community violence and academic functioning in African American adolescents”, Journal of Youth and Adolescence, vol. 42, No. 2 (February 2013). 11