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Nansel, T. R., Overpeck, M., Pilla, R. S., Ruan, W. J., Simons-Morton, B., & Scheidt, P. C. (2001). Bullying behaviors among US youth: Prevalence and association with psychosocial adjustment. Journal of the American Medical Association, 285, 2094-2100.

Bullying is a specific type of aggression in which (1) the behavior is intended to harm or disturb, (2) the behavior occurs repeatedly over time, and (3) there is an imbalance of power, with a more powerful person or group attacking a less powerful one. This asymmetry of power may be physical or psychological, and the aggressive behavior may be verbal, physical, or psychological. Bullies and those bullied demonstrate poorer psychosocial functioning than their noninvolved peers. Youth who bully others tend to demonstrate higher levels of conduct problems and dislike of school, whereas youth who are bullied generally show higher levels of insecurity, anxiety, depression, loneliness, unhappiness, and low self-esteem.

Method: The Health Behavior of School-aged Children (HBSC) was utilized by 15,686 students in grades 6 through 10. Questions about bullying were preceded with the following explanation. We say a student is being bullied when another student, or a group of students, say or do nasty and unpleasant things to him or her. It is also bullying when a student is teased repeatedly in a way he or she doesn’t like. But it is not bullying when two students of about the same strength quarrel or fight. Participation in bullying was assessed by two parallel questions that asked respondents to report the frequency with which they bullied others/being bullied in school and away from school during the current term. Response categories were “I haven’t …,” “once or twice,” “sometimes,” “about once a week,” and “several times a week.” Additional questions asked respondents to report the frequency with which they were bullied in each of 5ways—belittled about religion/race, belittled about looks/speech, hit/slapped/pushed, subject of rumors or lies, and subject of sexual comments/gestures. Measures of psychosocial adjustment included questions about problem behaviors, social/emotional well-being, and parental influences. Alcohol use was measured by three items. The frequency of smoking, fighting, and truancy were assessed by one item each. Academic achievement was assessed by an item querying perceived school performance. Three items queried the frequency of feeling lonely, feeling left out, and being alone because others at school did not want to spend time with the person. One item assessed ease of making friends. Three items were used to assess relationship with classmates: “enjoy being together,” “are kind and helpful,” and “accept me.” School climate was measured by seven items related to the respondent’s perception of the school and teachers. Three items measured parental involvement in school, and one item assessed respondents’ perceptions about their parents’ attitudes toward teen drinking.

Results: 10.6% of the sample reported bullying others “sometimes” (moderate bullying) and 8.8% admitted to bullying others once a week or more (frequent bullying). Experiencing bullying was reported with similar frequency with 8.5% bullied “sometimes” and 8.4% bullied once a week or more. 29.9% reported some type of involvement in moderate or frequent bullying, as a bully (13.0%), a target of bullying (10.6%), or both (6.3%). Males bullied others and were bullied significantly more often than females. The frequency of bullying was higher among 6th through 8th-grade students than among 9th- and 10th-grade students. Hispanic youth reported marginally higher involvement in moderate and frequent bullying of others, whereas black youth reported being bullied with significantly less frequency overall. Males reported being bullied by being hit, slapped, or pushed more frequently than did females. Females more frequently reported being bullied through rumors or sexual comments. Being bullied through negative statements about one’s religion or race occurred with the lowest frequency for both sexes. Anyone involved in bullying demonstrated poorer psychosocial adjustment than noninvolved youth. Fighting was positively associated with all 3 outcomes. Alcohol use was positively associated with bullying and negatively associated with being bullied. Smoking and poorer academic achievement were associated with both bullying and bullying/being bullied; poorer perceived school climate was related only to bullying. Poorer relationships with classmates and increased loneliness, on the other hand, were associated with both being bullied and bullying/being bullied. Ability to make friends was negatively related to being bullied and positively related to bullying. A permissive parental attitude toward teen drinking was associated only with bullying/being bullied, while increased parental involvement in school was related to being bullied and bullying/being bullied.

Discussion: Verbal bullying through derogatory statements about one’s religion or race occurred infrequently for both sexes. This finding may reflect stronger social norms among adolescents against such behavior. That is, it may be more socially acceptable for a youth to taunt peers about their appearance than to make derogatory racial statements. Youth who are socially isolated and lack social skills may be more likely targets for being bullied. This is consonant with the finding by Hoover and colleagues that the most frequent reason cited by youth for persons being bullied is that they “didn’t fit in.” At the same time, youth who are bullied may well be avoided by other youth, for fear of being bullied themselves or losing social status among their peers. Those youth who reported both bullying and being bullied demonstrated poorer adjustment across both social/emotional dimensions and problem behaviors. Olweus found former bullies to have a 4-fold increase in criminal behavior at the age of 24 years, with 60% of former bullies having at least 1 conviction and 35% to 40% having 3 or more convictions. Conversely, individuals formerly bullied were found to have higher levels of depression and poorer self-esteem at the age of 23 years.