158255 What are the health risks for adolescent bullies and how do they differ for bully-victims?

Wednesday, November 7, 2007: 2:45 PM

Lisa A. Prokop, BA , Adolescent/Young Adult Medicine, Children's Hospital Boston, Boston, MA
Sion Kim Harris, PhD , Center for Adolescent Substance Abuse Research, Harvard Medical School, Boston, MA
Lydia Shrier, MD, MPH , Adolescent/Young Adult Medicine, Harvard Medical School, Boston, MA
S. Bryn Austin, ScD , Adolescent Medicine, Children's Hospital Boston, Boston, MA
Bullying perpetration is an increasingly recognized problem in schools and is associated with poor psychosocial functioning, lower academic achievement, substance use, and violent behavior. Bully-victims, perpetrators of bullying who are also victims themselves, may represent a group at particularly high risk. Using self-report data collected in 2003 from a multiethnic sample of 418 9th-11th grade students (56.9 % female, 31% Latino, 26% black, 16% white, 22% other race/ethnicity) in two urban high schools, we examined the health risk profiles for bullies and bully-victims. Multivariable logistic models controlled for sex, race/ethnicity, grade, and school. Compared to students with no bullying involvement, perpetrators of bullying reported lower school connectedness and greater sexual assault victimization, substance use, and eating disorder symptoms. Within the subgroup of students reporting having bullied others, bully-victims were at higher risk across a range of domains. Compared to students who were bullies only, bully-victims were more likely to report depressive symptoms (OR 2.7; 95% CI 1.2-6.4), skipping school because they felt unsafe (OR 6.4; 95% CI 1.3-32.4), having been a victim of forced sexual contact (OR 2.7; 95% CI 1.0-7.3), using drugs other than alcohol or marijuana (OR 4.0; 95% CI 1.3-12.6), and eating disorder symptoms (OR 3.8; 95% CI 1.3-11.1). Bully-victims are a distinct subgroup of bullying perpetrators with a particularly poor health risk profile. While bullies are often referred to the school disciplinary system for intervention, understanding the unique vulnerabilities of bully-victims may be important for developing effective school-based interventions.

Learning Objectives:
1. Describe associations between bullying perpetration and adolescent health and psychosocial functioning. 2. Identify how health risk profiles differ for adolescents who are bullies only and those who both bully others and are also victims themselves. 3. Recognize the need for further research to clarify differences between bullies and bully-victims in ways that may inform the development of effective school-based interventions.

Keywords: Adolescent Health, School Health

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.