Online and Health Risk Behaviors in High School Students

An Examination of Bullying

Meghan N. Long; Elizabeth B. Dowdell


Pediatr Nurs. 2018;44(5):223-228. 

In This Article



Forty-eight percent (n=1,013) of the data set sample reported experiencing bullying. After removing cases that had missing data, the final sample for our study consisted of 975 adolescents (48% female; n=468 and 52% male; n=507). The majority of adolescents (74.6%) were Caucasian, followed by 8.3% African-American, 6.3% Asian, 3.2% Hispanic, and 7.2% biracial. Ages ranged from 13 to 19 years , with a mean age of 16.4 years and consisted of adolescents spanning grades 9 to 12. More than half of the adolescents (51%) reported being an above average student (receiving A's and B's), while 46% of adolescents reported receiving grades of B's or below.

Three groups were identified based on inclusion criteria previously mentioned: bullies (32.3%; n=315), victims of bullying (28.6%; n=280), and those who reported both bully-victim experiences (39%; n=380). Within the groups, sex differences were noted especially in the bully group, where there were 1.2 male bullies for every female bully, and 41% of the males were more likely to report bullying others, while only 27.2% of females reported bullying others (p<0.0001). Males were also more likely to report being beaten up or bullied by others, with 36% males reporting these experiences compared to 28.7% of females (p<0.0001).

Health Risk Behavior

All three adolescent groups reported engaging in health risk behaviors. Bullies reported the most health risk taking, with more than 48% reporting they were smoking cigarettes compared to bully-victim (40.9%) and victims (19.3%) (χ2= 58.988, df = 2, p<.0001). Bullies also had higher reports of using illicit drugs (54.5%), compared to bully-victim (53.8%) and victims (24.4%) (χ2=70.959, df=2, p<0.0001). Adolescents who reported drinking alcohol at least once in the past 30 days were more likely to be bullies (58.2%), compared to bullyvictims (54.5%) and victims (22.1%) (χ2=100.517, df=12, p<0.0001) (see Table 1). Alcohol use was also associated with driving. When asked, During the past 30 days, how many times did you drive a car or other vehicle when you had been drinking alcohol?, the majority of adolescents reported not drinking and driving (n=836). However, those in the bully-victim group had the highest responses to driving under the influence of alcohol one time (n=19) compared to bullies (n=12) and victims (n=5). This finding continued with bully-victims also more likely to report driving under the influence of alcohol two to three times (n=13) compared to their peers. However, for six or more times, bullies (n=6) were slightly more likely than bully-victims (n=5) and victims (n=0) to report driving under the influence of alcohol (p<0.0001) (see Figure 1).

Figure 1.

Driving Under the Influence of Alcohol

Trouble at school was another significant finding for bullies as well as those who were a bully-victim (see Table 1). When asked, In the past 6 months, have you had trouble with a teacher?, more than half of the bullies (55.6%) and 51.6% the bully-victim group responded 'yes' compared to 37.6% of the victims (χ2= 20.846, df = 2, p<0.0001). When asked, In the past 6 months have you been suspended from school, bullies were slightly more likely (12.7%), compared to students who were bully-victim (10.3%) or only victims (5.4%) to report 'yes' (χ2= 9.447, df = 2, p<0.009). No significance was found between groups and the question, In the past 6 months have you had at least one failing "F" grade on a report card? (p<0.127), bullies (21.6%), bullyvictim (20.6%), and victims (15.4%) (see Table 1). However, bullies were more likely to vandalize property within the past six months compared to their peers (32.3%; χ2= 47.124, df=2, p<0.0001). Bully-victim students were more likely to report stealing (43.7%; χ2=47.124, df=2, p<0.0001) compared to bullies (43.6%) and victims (20.1%) (see Table 1). Overall, victims of bullying had the lowest reporting of all health risk behaviors compared to their bully and bully-victim peers.

Online Risk Behaviors

These adolescents reported routine use of the Internet and participation in online risk taking (see Table 2), with bullies more likely to report harassing someone online (24.2%) when compared to bully-victims (22.8%) and victims (6.3%) (χ2=50.726, df=4, p<0.0001). Nearly 60% of bullies reported viewing inappropriate material on the Internet (defined as viewing sexually suggestive or explicit pictures or websites), which was significantly more than victims (42.6%). However, both groups were surpassed by the bully-victims (66.5%) who reported engaging in this behavior more often (χ2=38.820, df=2, p<0.0001). Sex differences were also noted with more females (χ2=33.325, df=1, p<0.0001) reporting being sexually harassed online than males, and more likely to report having used the Internet to harass or embarrass someone than males (χ2= 6.080, df=2, p<0.05).

Adolescents who reported being a bully-victim were more likely to report sexting (defined as the creating and distributing of explicit or inappropriate pictures of oneself or peers) (46.3%; χ2=16.308, df=2, p<0.0001), playing jokes on others online (52.9%), going on purpose to inappropriate websites (42.4%), and staying online longer than intended (38.2%) compared to bullies and victims (see Table 2). When asked, How often do your parents check your online histories?, bullies (76.3%), victims (61.7%), and bully-victim (67.1%) reported that parents have "never" checked their online histories (χ2=24.106, df=8, p<0.002).