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Bullying
ORIGINAL CONTRIBUTION

Bullying Behaviors Among US Youth
Prevalence and Association With Psychosocial Adjustment
Tonja R. Nansel, PhD Mary Overpeck, DrPH Ramani S. Pilla, PhD W. June Ruan, MA Bruce Simons-Morton, EdD, MPH Peter Scheidt, MD, MPH
ULLYING AMONG SCHOOL-AGED youth is increasingly being recognized as an important problem affecting well-being and social functioning. While a certain amount of conflict and harassment is typical of youth peer relations, bullying presents a potentially more serious threat to healthy youth development. The definition of bullying is widely agreed on in literature on bullying.1-4 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 (eg, name-calling, threats), physical (eg, hitting), or psychological (eg, rumors, shunning/exclusion). The majority of research on bullying has been conducted in Europe and Australia. Considerable variability among countries in the prevalence of bullying has been reported. In an international survey of adolescent healthrelated behaviors, the percentage of students who reported being bullied at least once during the current term ranged from a low of 15% to 20% in

Context Although violence among US youth is a current major concern, bullying is infrequently addressed and no national data on the prevalence of bullying are available. Objectives To measure the prevalence of bullying behaviors among US youth and to determine the association of bullying and being bullied with indicators of psychosocial adjustment, including problem behavior, school adjustment, social/emotional adjustment, and parenting. Design, Setting, and Participants Analysis of data from a representative sample of 15686 students in


References: 1. Boulton MJ, Underwood K. Bully/victim problems among middle school children. Br J Educ Psychol. 1992; 62:73-87. 2. Olweus D. Aggression in the Schools: Bullies and Whipping Boys. Washington, DC: Hemisphere Publishing Corp; 1978. 3. Salmivalli C, Kaukiainen A, Kaistaniemi L, Lagerspetz KM. Self-evaluated self-esteem, peerevaluated self-esteem, and defensive egotism as predictors of adolescents’ participation in bullying situations. Pers Soc Psychol Bull. 1999;25:12681278. 4. Slee PT. Bullying in the playground: the impact of inter-personal violence on Australian children’s perceptions of their play environment. Child Environ. 1995;12:320-327. 5. King A, Wold B, Tudor-Smith C, Harel Y. The Health of Youth: A Cross-National Survey. Canada: WHO Library Cataloguing; 1994. WHO Regional Publications, European Series No. 69. 6. US Department of Education. 1999 Annual Report on School Safety. Washington, DC: US Dept of Education; 1999:1-66. 7. Borg MG. The extent and nature of bullying among primary and secondary schoolchildren. Educ Res. 1999; 41:137-153. 8. Kaltiala-Heino R, Rimpela M, Marttunen M, Rimpela A, Rantanen P. Bullying, depression, and suicidal ideation in Finnish adolescents: school survey. BMJ. 1999;319:348-351. 9. Menesini E, Eslea M, Smith PK, et al. Crossnational comparison of children’s attitudes towards bully/victim problems in school. Aggressive Behav. 1997;23:245-257. 10. Olweus D. Bullying at School: What We Know and What We Can Do. Oxford, England: Blackwell; 1993. 11. O’Moore AM, Smith KM. Bullying behaviour in Irish schools: a nationwide study. Ir J Psychol. 1997; 18:141-169. 12. Whitney I, Smith PK. A survey of the nature and extent of bullying in junior/middle and secondary schools. Educ Res. 1993;34:3-25. 13. Rivers I, Smith PK. Types of bullying behaviour and their correlates. Aggressive Behav. 1994;20:359-368. 14. Baldry AC. Bullying among Italian middle school students. Sch Psychol Int. 1998;19:361-374. 15. Austin S, Joseph S. Assessment of bully/victim problems in 8 to 11 year-olds. Br J Educ Psychol. 1996; 66:447-456. ing and peer aggression. This knowledge could then be used to create school and social environments that promote healthy peer interactions and intolerance of bullying. School-based interventions have demonstrated positive outcomes in Norway and England,40-43 with reductions in bullying of 30% to 50%. These interventions focused on changes within the school and classroom climate to increase awareness about bullying, increase teacher and parent involvement and supervision, form clear rules and strong social norms against bullying, and provide support and pro16. Bijttebier P, Vertommen H. Coping with peer arguments in school-age children with bully/victim problems. Br J Educ Psychol. 1998;68:387-394. 17. Forero R, McLellan L, Rissel C, Bauman A. Bullying behaviour and psychosocial health among school students in New South Wales, Australia: cross sectional survey. BMJ. 1999;319:344-348. 18. Byrne BJ. Bullies and victims in a school setting with reference to some Dublin schools. Ir J Psychol. 1994;15:574-586. 19. Kumpulainen K, Rasanen E, Henttonen I, et al. Bullying and psychiatric symptoms among elementary school-age children. Child Abuse Negl. 1998;22:705717. 20. Rigby K. Peer victimisation at school and the health of secondary school students. Br J Educ Psychol. 1999; 68:95-104. 21. Slee PT, Rigby K. The relationship of Eysenck’s personality factors and self-esteem to bully-victim behaviour in Australian schoolboys. Pers Individual Differences. 1993;14:371-373. 22. Salmivalli C, Lappalainen M, Lagerspetz KM. Stability and change of behavior in connection with bullying in schools. Aggressive Behav. 1998;24:205218. 23. Salmon G, James A, Smith DM. Bullying in schools: self reported anxiety, depression and self esteem in secondary school children. BMJ. 1998;317:924-925. 24. Slee PT, Rigby K. Australian school children’s self appraisal of interpersonal relations: the bullying experience. Child Psychiatry Hum Dev. 1993;23:273-282. 25. Williams K, Chambers M, Logan S, Robinson D. Association of common health symptoms with bullying in primary school children. BMJ. 1996;313:17-19. 26. Haynie DL, Nansel TR, Eitel P, et al. Bullies, victims, and bully/victims: distinct groups of youth atrisk. J Early Adolescence. 2001;21:29-50. 27. Health Behaviour in School-aged Children: research protocol for the 1997-98 survey. Available at: http://www.ruhbc.ed.ac.uk/hbsc/protdesc.html. Accessibility verified March 26, 2001. 28. Olweus D. The Nature of School Bullying: A CrossNational Perspective. London, England: Routledge; 1999. 29. Shah BV, Barnwell GG, Bieler GS. SUDAAN User’s Manual, Release 7.5. Research Triangle Park, NC: Research Triangle Institute; 1997. 30. McCullah P. Regression models for ordinal data. J R Stat Soc.1980;42:109-142. tection for individuals bullied. This type of approach has not been tested in the United States. Author Contributions: Study concept and design: Nansel, Overpeck, Pilla, Simons-Morton, Scheidt. Acquisition of data: Overpeck, Scheidt. Analysis and interpretation of data: Nansel, Overpeck, Pilla, Ruan, Simons-Morton, Scheidt. Drafting of the manuscript: Nansel, Overpeck, Pilla. Critical revision of the manuscript for important intellectual content: Nansel, Overpeck, Pilla, Ruan, Simons-Morton, Scheidt. Statistical expertise: Nansel, Overpeck, Pilla, Ruan, Simons-Morton. Obtained funding: Overpeck, Simons-Morton, Scheidt. Administrative, technical, or material support: Nansel, Overpeck, Pilla, Simons-Morton, Scheidt. Study supervision: Overpeck, Simons-Morton. 31. Zeger SL, Liang KY. Longitudinal data analysis for discrete and continuous outcomes. Biometrics. 1996; 42:121-130. 32. Hoover JH, Oliver R, Hazler RJ. Bullying: perceptions of adolescent victims in the Midwestern USA. Sch Psychol Int. 1992;13:5-16. 33. Hoover JH, Oliver RL, Thomson KA. Perceived victimization by school bullies: new research and future direction. J Hum Educ Dev. 1993;32:76-84. 34. Farrington DP. The development of offending and antisocial behaviour from childhood: key findings from the Cambridge Study in Delinquent Development [The Twelfth Jack Tizard Memorial Lecture]. J Child Psychol Psychiatry. 1995;36:929-964. 35. Farrington DP. Childhood aggression and adult violence: early precursors and later-life outcomes. Child Aggression Adult Violence. 1996:5-29. 36. Pellegrini AD. Bullies and victims in school: a review and call for research. J Appl Dev Psychol. 1998; 19:165-176. 37. Pellegrini AD, Bartini M, Brooks F. School bullies, victims, and aggressive victims: factors relating to group affiliation and victimization in early adolescence. J Educ Psychol. 1999;91:216-224. 38. Huttunen A, Salmivalli C, Lagerspetz KM. Friendship networks and bullying in schools. Ann N Y Acad Sci. 1996;794:355-359. 39. Olweus D. Bullying among schoolchildren: intervention and prevention. In: Peters RD, McMahon RJ, Quinsey VL, eds. Aggression and Violence Throughout the Life Span. London, England: Sage Publications; 1992:100-125. 40. Olweus D. Bullying at school: long-term outcomes for the victims and an effective school-based intervention program. In: Huesmann LR, ed. Aggressive Behavior: Current Perspectives. New York, NY: Plenum Press; 1994:97-130. 41. Olweus D. Bully/victim problems among school children: basic facts and effects of a school based intervention program. In: Pepler D, Rubin KH, eds. The Development and Treatment of Childhood Aggression. Mahwah, NJ: Lawrence Erlbaum Associates Inc; 1991:411-448. 42. Smith PK. Bullying in schools: the UK experience and the Sheffield Anti-Bullying Project. Ir J Psychol. 1997;18:191-201. 43. Sharp S, Smith PK. Bullying in UK schools: the DES Sheffield Bullying Project. Early Child Dev Care. 1991; 77:47-55.
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