May 3, 2011 (Denver, Colorado) — A survey of school-aged children has identified a cluster of factors that is associated with bullying, and more than one third of children fit the definition of a bully, according to the study, presented here at the Pediatric Academic Societies and Asian Society for Pediatric Research 2011 Annual Meeting.

Being a school bully can lay the framework for miseries in later life that include depression, suicidal thoughts or attempts, and misbehavior that can result in arrest and imprisonment. This information could be valuable in developing more focused and effective antibullying programs.

"In the past, studies have focused on bullying victims, not on the perpetrators, and most bully prevention programs are directed at everyone, not those most at risk of becoming a bully. Our results indicate that students who both fight and carry weapons are at the highest risk of being bullies," Rashmi Shetgiri, MD, from the division of general pediatrics at the University of Texas Southwestern Medical School in Dallas, told Medscape Medical News.

In the United States, 30% of adolescents are victims of the taunting, verbal ridicule, physical violence, and ostracism that are the hallmarks of bullying inflicted by 13% of their peers.

Traditionally, antibullying campaigns are directed at all school-aged adolescents. In an effort to aid in the development of more targeted programs, Dr. Shetgiri and colleagues sought to identify clusters of risk factors that would identify those most prone to bullying.

The study used data from the 2001/02 Health Behavior in School-Aged Children, a national survey of more than 13,000 American students in grades 6 to 10. The analyses of the survey data involved bivariate analysis, in which 2 variables were analyzed to determine if they were related, and recursive partitioning analysis, which linked together the different factors in a "decision tree" to generate a cluster of factors that were linked to an increased likelihood of bullying.

Of the 13,710 students surveyed, 37% fit the criteria for bullying (which included verbal and physical hallmarks and their frequency of occurrence, and more prevalent feelings of irritation and sadness in the perpetrators).

Bullies were more likely than nonbullies to have been in a physical fight in the previous 12 months (53% vs 28%), to have carried a weapon in the previous month (26% vs 10%), to be a current smoker (24% vs 10%), and to have ever used illicit drugs (65% vs 29%).

When the various factors were clustered together in the recursive partitioning analysis, those most apt to bully carried a weapon and had physically fought (67%), followed by those who did not carry a weapon but who had been in a physical fight, smoked, and used drugs (62%), those who had fought but who did not carry a weapon or use drugs (38%), and those who had not been in a physical fight in the previous year (28%).

"Our data indicate that bullying treatment and prevention interventions might be most effective when targeted at risk clusters rather than at individual risk factors in isolation. Such interventions should focus on students who fight, carry weapons, smoke, and use drugs," Dr. Shetgiri told Medscape Medical News.

"These are important data. It does seem to me, though, that adolescent depression would be another important factor to look at, particularly for males. The attributes of feeling low or irritable may not adequately reveal depression," session moderator Ruth Stein, MD, from the Department of Pediatrics at Albert Einstein College of Medicine, Bronx, New York, told Medscape Medical News.

"The analysis starts off by separating participants by fighting or not fighting. I don't get that partitioning. Maybe it would be better to separate by gender, since fighting in the past 12 months accounted for only 53% of the students," James Sargent, MD, professor of pediatrics at Dartmouth Medical School, Lebanon, New Hampshire, told Medscape Medical News.

Dr. Shetgiri, Dr. Stein, and Dr. Sargent have disclosed no relevant financial relationships.

Pediatric Academic Societies (PAS) and Asian Society for Pediatric Research 2011 Annual Meeting: Abstract 1185.4. Presented April 30, 2011.


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