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Tonja R. Nansel, PhD; Mary D. Overpeck, DrPH; Denise L. Haynie, PhD; W. June Ruan, MA; Peter C. Scheidt, MD, MPH

Arch Pediatr Adolesc Med. 2003;157:348-353.

Objective  To determine the extent to which bullying and being bullied, both in and away from school, is associated with involvement in violent behavior.

Design, Setting, and Participants  A US representative cross-sectional sample of 15 686 students in grades 6 through 10 in public and private schools completed the World Health Organization's Health Behaviour in School-aged Children survey in 1998.

Main Outcome Measures  Self-report of weapon carrying, weapon carrying in school, physical fighting, and being injured in a physical fight.

Results  Involvement in each of the violence-related behaviors ranged from 13% to 23% of boys and 4% to 11% of girls. Bullying others and being bullied were consistently related to each violence-related behavior for both boys and girls. Greater odds of involvement occurred with bullying others than being bullied, and greater odds of involvement occurred with bullying that took place away from school than that occurring in school. For example, the adjusted odds ratio for weapon carrying associated with being bullied in school weekly was 1.5, for bullying others in school 2.6, for being bullied away from school 4.1, and for bullying others away from school 5.9.

Conclusion  Bullying should not be considered a normative aspect of youth development, but rather a marker for more serious violent behaviors, including weapon carrying, frequent fighting, and fighting-related injury.

From the Department of Health and Human Services, National Institute of Child Health and Human Development, Division of Epidemiology, Statistics, and Prevention Research (Drs Nansel, Haynie, and Scheidt and Ms Ruan), and Health Resources and Services Administration, Maternal and Child Health Bureau (Dr Overpeck), Bethesda, Md.

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