School Bullying with a Severe Consequence . Case Report and Literature Review

3 Dunarea de Jos University of Galati, Romania. Abstract: This paper presents a fully documented rare case of school bullying in which one of bullies has suffered traumatic injuries which were incompatible with life. The authors present judicial, social, clinical, morphological, somatic and mental medical data. The data from specialized literature of high scientific quality is analyzed, the aim being to improve the prediction and prophylaxis of the phenomenon.


Introduction
The UN Child's Rights Convention, ratified by Romania no.18 law (Parlamentul României, 1990), requires state authorities to provide the necessary protection and care for the child's welfare, the imperative being reiterated also by the scientific society Hart & Glaser, 2011;Jones, LaLiberte, & Piescher, 2015).
Through the expert analysis of the traumatic lesions morphology and the psycho-pathological aspects evaluation with legal values, medicine in general and forensic medicine in particular, have theoretical and practical concerns (Fulga, Perju-Dumbrava, & Crassas, 2008;Perju-Dumbravă et al., 2019) in highlighting bullying cases, but also contributing among sociologists, lawyers, pediatric psychologists and victimologists, to help in prediction and prophylaxis of this phenomenon.
This paper presents a fully documented rare case of school bullying in which one of bullies suffers traumatic injuries incompatible with life. The authors present judicial, clinical, morphological, somatic and mental medical data. The data from specialized literature of high scientific quality is analyzed, aiming to improve the prediction and prophylaxis of the phenomenon.

Judicial investigation data
Judicial investigation data shows that a 17 year old student is under criminal investigation for murder and possession of dangerous objects, consisting in the fact that, during classes, nearby the school, after being attacked by three people, he retaliated and stabbed one of them with a 17 cm long hunting knife, which was in his possession. Two stab wounds were applied: one to the thoraco-abdominal region and the other to the lumbar region. Death occured shortly after in the hospital, and the forensic autopsy report established that the cause of death was the hemorrhagic shock following the penetrating stab wounds involving splenic vessels and the mesenteric artery, the injuries being produces by repeated hitting with a stinging-cutting object.
The student stated that he has been systematically persecuted, beaten, deprived of property and money, humiliated by the deceased, who was an adult with a criminal record that regularly went to school accompanied by friends. During the last meetings, the student warned him June, 2020 Artificial Intelligence and Neuroscience Volume 11, Issue 1, Sup.2 that if he did not leave him alone, he would resort to radical measures. Seeing that instead of a decreasing attack intensity, the frequency of humiliations has increased, he decided to take a hunting knife from his father's collection without his consent, in order to defend himself.

Medical data
Immediately after the fact, the minor was urgently examined at the hospital, being established the diagnosis of acute closed cranio-cerebral trauma, affirmative with loss of consciousness, thoracic excoriation, spontaneously remitted epistaxis and hetero-aggression. Imaging examinations reveal a left temporal arachnoid cyst, the patient being conscious, slightly overwhelmed, cooperative and tension-balanced. No thoracic and neurosurgical injuries were found at the time of examination.
After being hospitalized for two weeks in the psychiatric ward of the penitentiary hospital, a general psychiatric examination was requested by the prosecutor's office,. A patient without a psychiatric history, is hospitalized for psychiatric forensic examination. He was examined psychologically at the National Forensic Medicine Institute. The neurological consultation does not show conscious or cooperative deficits, also no signs of intracranial hypertension, signs of lateralization, signs of myelo-radicular suffering, only a subjective diagnosis of an intermittent headache, being established the diagnosis of cephalic syndrome, arachnoid cyst with minimal mass effect. Following the presentation in front of the forensic examination commission, the diagnosis of socialized conduct disorder was established, also of an arachnoid cyst without mental clinical disorders at the time of examination. It was appreciated that he had a discernment kept in relation to the content and consequences of his act in relation to being underaged, that he does not simulate and conceal mental illnesses, as well as no medical safety measures were required.

Social investigation.
The child came from a middle high class family, his father being a prosperous businessman; his parents were divorced and he was living with his father and his concubine. The child showed affection and respect for his father, also he was a highschool student with medium school performance, also the relationship with his collegues and teachers were marked by the financial gap.
Bullying carries on to be a common and important problem in schools around the world. A UNESCO shows in 2019 that about 32% of students worldwide report being bullied (Paez, 2020).
This behavioral ways have huge social and economic costs for society, due to the low level of professional and social integration, as well as the quality of perpetrators' and victims' lifes (Frick, 2012). Some examples of severe consequences of peer victimization include suicidal thoughts and attempts (Hinduja & Patchin, 2010). The case presented by us differs by consuming and act on extreme violence behaviour with lethal consequences on the part of the bully-victim directed against the bullies.
Bullying can occur in school, at work, in the army. School bullying includes four forms: physical, cyberbullying and verbal relational . In the USA, the incidence of the four forms was: verbal 53.6%, relational 51.4%, physical 20.8% and cyber 13.6% (Wang, Iannotti & Nansel, 2009). In the present case, the elements from the first and third category are obvious, the data regarding the other categories was not provided by the authorities, although they cannot be excluded. Olweus (1993) classified: 1) violent bullies, which are impetuous (Omizo et al., 2006); 2) submissive bullies, which accompany aggressive bullies and, as a result, always remain insecure, 3) bully-victims, which alternate as bullies as well as victims. Victims are too classified into passive victims, who are fragile and frightened and do not provoke; 2) defiant victims (Nansel et al., 2001) and 3) bully-victims.
Several studies show that involvement in bullying increases the incidence of homicidal behavioral manifestations. Su et al. (2019) has discovered that this bully-victim nature in middle school and high school is a rick factor for the idea of criminal behavior. The case presented by us no longer discusses homicidal ideation, which differs by reaction to bullying with behavioral manifestations of extreme violence with lethal consequences.
Methods to combat the phenomenon of school bullying were inspired by Olweus Prevention Bullying (OBPP) research program (Olweus, 1993), later adopted in the countries from Scandinavia, then in the United Kingdom, Netherlands, France, Germany, but also in North America. It is unfortunate that in the high quality scientific literature there are few works June, 2020 Artificial Intelligence and Neuroscience Volume 11, Issue 1, Sup.2 by authors from Central and Eastern European countries, but there is still hope that governmental and non-governmental entities in these countries put advanced methods into practice for combating this harmful phenomenon to present and future society. In Romania, the answear is still fragmented (Chiţescu et al., 2018, Perju-Dumbrava et al., 2010, Perju-Dumbrava et al., 2013.
In conclusion, through this presentation of rare school bullying cases in which one of the bullies suffers traumatic injuries incompatible with life and data analysis from high scientific literature, we desired to boost scientific society, professionals in the field of child psychology, socio-legal and medical authorities, government and non-government organizations, to a multidisciplinary, effective response, according to the magnitude of the phenomenon.