SEARCH

SEARCH BY CITATION

Keywords:

  • aggression;
  • violence;
  • cognition;
  • school connectedness;
  • school absenteeism;
  • child and adolescent health;
  • coordinated school health programs;
  • academic achievement;
  • achievement gap;
  • socioeconomic factors

Abstract

  1. Top of page
  2. Abstract
  3. OVERVIEW AND DISPARITIES
  4. CAUSAL PATHWAYS AFFECTING EDUCATIONAL OUTCOMES
  5. WHAT CAN SCHOOLS DO TO REDUCE AGGRESSION AND VIOLENCE?
  6. PROVEN OR PROMISING APPROACHES
  7. SUMMARY
  8. REFERENCES

OBJECTIVES: To outline the prevalence and disparities of aggression and violence among school-aged urban minority youth, causal pathways through which aggression and violence adversely affects academic achievement, and proven or promising approaches for schools to address these problems.

METHODS: Literature review.

RESULTS: Recent national data indicate that among students aged 12-18, approximately 628,200 violent crimes and 868,100 thefts occurred. Physical fighting was more commonly reported by Blacks and Hispanics (44.7% and 40.4%, respectively) than Whites (31.7%). In-school threats and injuries were nearly twice as prevalent in cities as in suburbs and towns or rural areas (10% vs 6% and 5%, respectively). Associations between exposure to and exhibition of aggression and violence and unfavorable educational outcomes are well documented. Causal pathways through which aggression and violence impede learning include cognition, school connectedness, and absenteeism. Disruptive classroom behavior is a well-recognized and significant impediment to teaching and learning. Compelling research has shown that various school-based programs can significantly reduce the nature and extent of aggressive and violent behaviors.

CONCLUSIONS: Violence and aggressive behavior are highly and disproportionately prevalent among school-aged urban minority youth, have a negative impact on academic achievement by adversely affecting cognition, school connectedness, and absenteeism, and effective practices are available for schools to address this problem. Once the domain of criminal justice, aggression and violence are now recognized as an appropriate and important focus of the education and public health systems. Implementing evidence-based school policies and programs to reduce aggression and violence must be a high priority to help close the achievement gap.


OVERVIEW AND DISPARITIES

  1. Top of page
  2. Abstract
  3. OVERVIEW AND DISPARITIES
  4. CAUSAL PATHWAYS AFFECTING EDUCATIONAL OUTCOMES
  5. WHAT CAN SCHOOLS DO TO REDUCE AGGRESSION AND VIOLENCE?
  6. PROVEN OR PROMISING APPROACHES
  7. SUMMARY
  8. REFERENCES

Exposure to aggression and violence has extreme noxious effects on development and quality of life for US youth. Exposure is pervasive through audio and visual media. Direct exposure can occur within the community, school, peer groups, and family. Many factors underlie the problem of societal aggression and violence, including unequal access to education, health care and social services, housing and employment, and policies and actions exemplifying discrimination based on race, sex, sexual orientation, and disabilities. Cumulative exposure to aggression and violence, from early childhood to adolescence and adulthood, adversely affects youth in every segment of American society, but consequences are especially harmful for urban minority youth. The present focus is on implications for educational outcomes in urban minority youth.

When it comes to youth aggression and violence, the education and public health systems clearly share mutual goals. Educators recognize that disruptive behavior by some students (in and out of the classroom) severely hampers effective teaching and learning for all students. Public health specialists recognized that aggression and violence can result in injury, disability, or death, and adversely affect mental and emotional well-being. Both fields have identified prevention as a central and high-priority goal. Descriptive statistics, while dramatic and disturbing, can only begin to communicate the magnitude, severity, and urgency of this problem.

Homicide rates among youth are much higher in the United States than in other countries with similar economies.1 In 2006, homicide was the fourth leading cause of death among 5- to 9-year-olds, the third leading cause among 10- to 14-year-olds, and the second leading cause among 15- to 19-year-olds.2 For male teens, Blacks are over 10 times more likely to die from homicide than Whites.3

Homicide remains a rare event in school settings. Less than 1% of homicides among 5- to 18-year-olds occur in school.4 Nationwide, a total of 14 homicides occurred at school between July 1, 2005, and June 30, 2006. School-associated violent deaths are more likely to occur among males (vs females), high school students (vs those in earlier grades), and students in urban areas.4

Alternative indicators of aggression and violence include threats, attacks, and injuries to teachers and students, violent and nonviolent crimes, discipline problems, gang activity, bullying, physical fighting, weapon carrying, perceived safety, and school avoidance due to fear. Data on these indices are available from the National Center for Education Statistics' Indicators of School Crime and Safety: 2007.5

In 2005, among students aged 12–18, there were 628,200 violent crimes and 868,100 thefts at school; 8% of 9th through 12th graders reported being threatened or injured with a weapon in the preceding 12 months; 28% reported being bullied at school in the past 6 months. Among those being bullied, 53% were bullied once or twice in the past 6 months, 25% once or twice a month, 11% once or twice a week, and 8% almost daily. In 2005–2006, 24% of public school principals reported daily or weekly bullying as a problem; 18% reported student acts of disrespect for teachers and 9% reported verbal abuse of teachers as a problem. Seventeen percent of principals (and 24% of students) reported gang activity at their schools.

Verbal aggression is an insidious and harmful aspect of the problem. In 2005, among students aged 12–18, 11% reported that hate words were directed to them (ie, words about race, ethnicity, religion, gender, sexual orientation, and/or disability). Almost 40% reported the presence of hate-related graffiti at their schools. Black and Hispanic students were more likely to report having had race-related hate words used against them than White students (7% and 6%, respectively, vs 3%). Urban students were more likely than suburban students to report being called hate words (12% vs 9%). Students in public schools were almost twice as likely to report being called hate words (12% vs 7%) and seeing hateful graffiti (39% vs 18%) as private school students.

Another source of data is the Youth Risk Behavior Survey, coordinated by the Centers for Disease Control and Prevention, which collects data from a nationally representative sample of high school students. These data further illustrate the large proportion of all youth, and especially minority youth, who are adversely affected.6 As an example, almost 1 in 10 students (7.8%) reported being forced to have sexual intercourse (an outcome more than twice as likely for females).

From the same source: In the past year, 35.5% reported being in at least 1 physical fight, a more common experience among Blacks and Hispanics than Whites (44.7% and 40.4%, respectively, vs 31.7%) (Figure 1); 27.1% reported having their property deliberatively damaged or stolen on school property (more common among males); and 10% reported dating violence in the form of being hit, slapped, or physically hurt by their partner.6 In this age group, theft is more likely to occur within rather than away from school.5 In the past month, 18% reported carrying a weapon, 9% of males and 2.7% of females doing so on school property; 5.2% reported carrying a gun; 5.5% had missed 1 or more of the past 30 school days because of feeling unsafe at school or while traveling to or from school. Absenteeism due to fear was more commonly reported by Hispanics and Blacks than Whites (9.6% and 6.6%, respectively, vs 4.0%; Figure 2).

image

Figure 1. Percentage of High School Students in the United States Who Were in a Physical Fight* by Race/Ethnicity** *On at least 1 day during the 30 days before the survey. **H > B > W. Source: CDC, National Youth Risk Behavior Survey, 2007.

Download figure to PowerPoint

image

Figure 2. Percentage of High School Students in the United States Who Did Not Go to School Because They Felt Unsafe at School or on Their Way to or From School*, by Race/Ethnicity** *On at least 1 day during the 30 days before the survey. **H > B > W. Source: CDC, National Youth Risk Behavior Survey, 2007.

Download figure to PowerPoint

More males than females reported being in at least 1 physical fight in the past year; this was true within every race/ethnicity group. Physical fights were more prevalent among 9th than 12th graders (40.9% vs 28%). Racial/ethnic disparities were greater among female than male students; Hispanic females were 56% more likely and Black females 83% more likely to have been in a physical fight in the past year than White females. For both sexes, Blacks were more likely to report dating violence than Whites (females: 13.2% vs 7.4%; males: 9.3% vs 5.2%). Black females were more likely to report being threatened or injured with a weapon on school property within the past year than White female students (8.1% vs 4.6%).6 These data demonstrate an alarming magnitude of direct exposure to physical violence and aggression, particularly among high school students.

Aggressive behaviors in school disrupt both teaching and learning. In the school year 2003–2004, 1 in 10 teachers in the nation's urban schools was threatened with injury or physically attacked.5 In-school threats and injuries are almost twice as prevalent in cities as in suburbs and towns or rural areas (10% vs 6% and 5%, respectively). Public school teachers in cities were 6 times more likely to be threatened with injury (12% vs 2%) and 5 times more likely to be physically attacked (5% vs 1%) than private school teachers in cities.

Nationally representative data for elementary school children in the United States are not available,7 but local data strongly suggest that aggressive experiences in school are commonplace.8–12 Experience as a bully, victim, or both has been associated with adverse physical and mental health consequences in the United States and elsewhere.10, 11,13–15 Being a victim of bullying has not only been associated with concurrent and future mental and emotional well-being,16 but also with educationally relevant outcomes, including lower achievement, feeling unsafe at school, and lower connectedness with school.17

CAUSAL PATHWAYS AFFECTING EDUCATIONAL OUTCOMES

  1. Top of page
  2. Abstract
  3. OVERVIEW AND DISPARITIES
  4. CAUSAL PATHWAYS AFFECTING EDUCATIONAL OUTCOMES
  5. WHAT CAN SCHOOLS DO TO REDUCE AGGRESSION AND VIOLENCE?
  6. PROVEN OR PROMISING APPROACHES
  7. SUMMARY
  8. REFERENCES

Associations between exposure to and exhibition of aggression and violence, in school and outside school, and unfavorable educational outcomes are well documented.10, 17–19 Three relevant causal pathways are cognition, connectedness with school, and absenteeism. It should also be noted that aggressive behavior can exert adverse effects on those who observe it by influencing them to act in similarly harmful ways.20, 21 This, in turn, can encourage initiation or maintenance of aggressive or violent behavior, thus perpetuating a vicious cycle.

Cognition

Exposure to aggressive experiences, in school and outside school, can profoundly affect mental health,10, 11, 14, 22 including adjustment at school.10 In a recent study of more than 42,000 11- to 17-year-olds, school violence was associated with internalizing behaviors (eg, depression, anxiety, sadness, withdrawal) and externalizing behaviors (eg, problems with conduct, getting along with others, bullying).23 Schwartz and Gorman24 suggest that exposure to community violence influences academic failure via two causal pathways: (1) symptoms of depression (ie, intrusive thoughts, low energy and motivation, and poor concentration) and (2) disruptive behavior (ie, aggression, impulsiveness, hyperactivity, and off-task behavior). In a cross-sectional study of community violence among 237 third to fifth graders from low-income families in Los Angeles, a link between violence exposure and academic difficulty was postulated to be caused, in part, by depressive symptoms and by low self-regulation abilities, exemplified by disruptive behavior. It is reasonable to conclude that both depressive symptoms and disruptive behaviors can interfere with cognitive processes that facilitate academic (and social) success.

Connectedness

Even as early as kindergarten, participation appears to be a prerequisite to achievement.25 The social and psychological climate and physical environment at school play a pivotal role in ensuring that youth like and are engaged in school. Several studies have documented an (expected) association between exposure to aggression and violence in school and connectedness.17,26, 27 In their study of more than 3500 third to fifth graders, Glew and colleagues found that victims of violence and bullying were much more likely to report feeling they did not belong at school.17 A smaller-scale, repeated measures study of kindergarteners (n = 200) reported an obvious finding: children who were less victimized liked school more.27 Although the link between school aggression and violence and school connectedness is clear, the direction of causality is less so. Indeed, a central premise underlying prevention programs is that increasing the extent of connectedness will result in reducing aggression and violence in schools.28 It seems likely that there are reciprocal relationships between the psychological climate and safety of schools and students' feelings of connectedness.

Absenteeism

It is not surprising that students who perceive school as dangerous (physically or emotionally) might choose to avoid school. As noted above, 5.5% of a nationally representative sample of high school students reported being absent at least one day in the past month because of feeling unsafe at school or traveling to or from school. The experience was reported more frequently by Hispanic and Black students than by Whites (9.6% and 6.6%, respectively vs 4.0%). Younger children who were less victimized were more likely to attend school.27

WHAT CAN SCHOOLS DO TO REDUCE AGGRESSION AND VIOLENCE?

  1. Top of page
  2. Abstract
  3. OVERVIEW AND DISPARITIES
  4. CAUSAL PATHWAYS AFFECTING EDUCATIONAL OUTCOMES
  5. WHAT CAN SCHOOLS DO TO REDUCE AGGRESSION AND VIOLENCE?
  6. PROVEN OR PROMISING APPROACHES
  7. SUMMARY
  8. REFERENCES

Given the pervasiveness of physically and verbally aggressive behaviors within US society (eg, within families, among peers, as portrayed in visual and audio media), school policies and programs cannot be expected to solve the problem. School health policies and programs can and must, however, directly address aggressive behaviors that occur within the school grounds. By doing so, they can favorably affect pro-social behaviors in and out of school. For youth, schools are one of the key social contexts in which aggressive behaviors occur. By the same token, schools can also be one of the key social contexts in which youth can learn and practice respect, tolerance of differences, and skills for minimizing and avoiding aggressive interpersonal interactions.

Distinct policies and programs are needed for early and late-onset aggressive behaviors. Different solutions are more likely to succeed for each.7 Disruptive classroom behavior is a well-recognized and significant impediment to teaching and learning, and numerous policies and practices have been developed to address the issue. Some focus on establishing disciplinary codes and sanctions, and instituting safety and security measures. Those most likely to be effective, however, are more comprehensive in scope. Universal school violence prevention programs have been implemented at all grade levels, from kindergarten through high school. These programs are directed to all students in the target grade(s), not just to specific high-risk students. As with most health-related issues, prevention is preferable to after-the-fact remedial action.

The most current school health guidelines for the prevention of unintentional injuries and violence were published in 2001 by the Centers for Disease Control and Prevention.29 Recommendations cover 8 aspects of school-based programs and policies related to preventing unintentional injuries, violence, and suicide. Some relevant dimensions of the recommendations are outlined below. Much of the material is excerpted directly from the document.

Establish a Social Environment That Promotes Safety and Prevents Violence

Creating a culture within the school that supports pro-social values and norms30 should be a priority. To the extent that the school's social climate is characterized by respect, empathy, cooperation, and tolerance of differences and different opinions, students will be more likely to feel connected and to succeed academically and socially. The climate should create expectations for high academic standards, establish acceptable norms and rules of conduct that do not tolerate harassment, bullying, undesirable gang activity or other aggressive behavior, and create and enforce fair policies for dealing with aggression if and when it occurs. The climate should also stress the importance of and exemplify empathy and caring in interpersonal interactions between and among students and school staff.

Provide a Physical Environment, Inside and Outside School Buildings, That Promotes Safety and Prevents Violence

There is increasing understanding about the ways in which the physical environment of school may affect the chances for aggression and violence.31–33 One important aspect of the physical environment is the level of adult supervision. Another is the policies and practices that reduce the presence of weapons in school. Certain times, before and after school and during transitions within the school day, may pose particular risk for aggression. Special attention needs to be given to the physical environment during these times.34 Travel routes to and from school are also important, as evidenced by the extent to which students miss school because they are afraid of traveling to and from school. Although school officials cannot deal with this directly, they can work with local law enforcement officials to help ensure the physical safety of travel within the community, especially during key times before and after school.

Implement Curricula and Instruction That Help Students Learn and Apply Knowledge and Skills to Adopt and Maintain Healthful Choices

Strong evidence supports the effectiveness of some violence prevention programs. It is essential that educational leaders adopt curricula from worthwhile programs (ie, those of demonstrated effectiveness). These programs are identifiable through existing resources.3 One of the most important aspects of the violence and aggression component of a comprehensive school health program is to foster developmentally appropriate skills that will help youth learn, value, and practice pro-social behavior. These skills, which largely address issues of self-awareness and self-regulation, include, but are not limited to, communication and assertiveness, conflict resolution, impulse control and anger management, resisting social pressures, decision making, and problem solving. The acquisition and maintenance of these skills require time and practice. Without an adequate time commitment, youth cannot be expected to learn and use these skills in or out of school.

Provide Safe Physical Education and Extracurricular Physical Activity Programs

Physical education and physical activity provide a context in which youth may learn pro-social behavior. The cooperation and teamwork learned in these contexts can be applied in others. The approach is illustrated in a recent paper describing efforts to integrate school-based activities that simultaneously increase physical activity and reduce bullying.35

Provide Health, Counseling, Psychological, and Social Services to Meet the Physical, Mental, Emotional, and Social Needs of Students

Given the complex etiology of aggression and violence in American society, it seems clear that, despite all efforts, some aggression and violence will continue to occur. Primary prevention—preventing the problem before it occurs—should be an emphasis. Nevertheless, dealing with aggressive events and their physical, emotional, and academic sequelae, after the fact, will remain a necessity. On-site services provided in schools or through linkages with existing community resources are needed.

Establish Mechanisms for Short- and Long-Term Crisis Response

Policies and plans must be in place to deal with crises if, and when, they occur. A written plan should address both short- and long-term responses and services. Crisis plans need not be limited to violence, but should also address other precipitating factors (eg, environmental disasters, weather).

Integrate School, Family, and Community Efforts to Prevent Violence

Although schools can play an important role, family and community involvement is also essential. Their involvement will greatly enhance the effectiveness of school-based efforts. One of the most impressive long-term programs demonstrating benefits to youth relied on working with parents, as well as teachers and students. Clearly, increased parental involvement in schools and in the lives of youth will have tremendous benefits for all concerned. Fostering such involvement can be a challenge given the work and associated demands on parents, especially those struggling economically.

Provide Staff Development for School Personnel

As with any program, successful benefits will not accrue unless teachers, administrators, and other school personnel are knowledgeable, skilled, and motivated. Adults within the school setting have an important effect on youth through the behaviors they model. One dimension of a school's commitment to addressing the issue of aggression and violence is the extent to which time for relevant training and staff development is provided.

PROVEN OR PROMISING APPROACHES

  1. Top of page
  2. Abstract
  3. OVERVIEW AND DISPARITIES
  4. CAUSAL PATHWAYS AFFECTING EDUCATIONAL OUTCOMES
  5. WHAT CAN SCHOOLS DO TO REDUCE AGGRESSION AND VIOLENCE?
  6. PROVEN OR PROMISING APPROACHES
  7. SUMMARY
  8. REFERENCES

School-based programs of demonstrated effectiveness in addressing in-school violence and aggressive behaviors already exist.36–40 The strongest evidence for the value of such programs comes from two recent independently conducted reviews of current evaluative research. One was conducted by the US Task Force on Community Preventive Services, the other by Wilson and Lipsey.40 These independent reviews, while differing in methods, reach similar conclusions, namely that school-based violence prevention programs can work to reduce violent and aggressive behaviors by students.

The systematic review of published scientific evidence by the US Task Force on Community Preventive Services highlights compelling evidence that universal school-based programs (ie, those directed to all youth in a school or specific grade, as opposed to high-risk youth) reduce violent and aggressive behaviors. Favorable effects extended to students with low socioeconomic status or living in high-crime areas.36,37 The programs addressed a wide range of hypothesized mediating outcomes: knowledge, emotional self-awareness and control, empathy, social skills related to conflict resolution, problem solving, impulse control, and team work.36,37 Some emphasized modeling by teachers, parental support and involvement, and the entire school environment. Program value was assessed at each of four grade levels: pre-kindergarten and kindergarten, elementary, middle, and high school. All programs included a classroom component. Characterization of the different programs is complicated by variations in type and amount of information included in evaluation reports. Some general observations follow. Elementary and middle school programs tended to focus on disruptive and antisocial behavior, usually implemented by teachers, and took a cognitive/affective approach. Middle school and high school programs tended to focus on general and specific forms of violence (eg, dating, bullying), usually implemented by both teachers and others (peers, other adults), and emphasized behavioral and social skills. Programs differed substantially in frequency and duration. It is noteworthy that all program strategies (ie, cognitive/affective and behavioral/social skills) and foci (ie, disruptive behavior, antisocial behavior, bullying, dating) were found to reduce violent behavior at all grade levels.37

Wilson and Lipsey's40 meta-analysis of 249 school-based programs includes both universal and targeted programs, comprehensive multi-component programs, and programs for special schools or classrooms. Program modalities included behavioral strategies (eg, rewards, contingencies), cognitive strategies (eg, changing thinking and attributions, cognitive skills, problem solving), social skills (eg, communication and conflict management), counseling/therapy, peer mediation, and parent training. Program evaluations varied considerably with respect to outcome measures: aggression, school performance, social skills, personal adjustment, social relations, internalizing behaviors, problem behavior, anger/hostility/rebelliousness, school participation, and knowledge. Compelling results were found for both universal and targeted programs. Programs were most effective for students with low socioeconomic status. Effective targeted programs tended to use behavioral strategies and be characterized by higher levels of program implementation. The authors conclude that, overall, both universal and targeted programs have statistically and practically significant effects. Based on their finding that different universal and targeted program had such similar effects, they suggest that the best choice for a specific school may be that program that has the greatest chances for a high level of implementation. They note the existence of resources cataloguing programs with demonstrated effectiveness exist, including the National Registry for Evidence Based Programs and Practices (www.nrepp.samhsa.gov), Blueprints for Violence Prevention (www.colorado.edu/cspv/blueprints), and Collaborative for Academic, Social and Emotional Learning (http://www.casel.org).

SUMMARY

  1. Top of page
  2. Abstract
  3. OVERVIEW AND DISPARITIES
  4. CAUSAL PATHWAYS AFFECTING EDUCATIONAL OUTCOMES
  5. WHAT CAN SCHOOLS DO TO REDUCE AGGRESSION AND VIOLENCE?
  6. PROVEN OR PROMISING APPROACHES
  7. SUMMARY
  8. REFERENCES

Violence and aggressive behavior, once considered a criminal justice problem, is now recognized as an appropriate and important focus of the education and public health systems. The nation's schools cannot singlehandedly solve the problem, or even address all of its dimensions, but there is a need, particularly among urban minority youth, to address the noxious effects of violence and aggressive behavior on academic achievement and educational attainment. Compelling research has shown that school-based programs can significantly reduce the nature and extent of these behaviors. Implementing these programs in schools serving urban minority youth must be a high priority to help close the achievement gap.

REFERENCES

  1. Top of page
  2. Abstract
  3. OVERVIEW AND DISPARITIES
  4. CAUSAL PATHWAYS AFFECTING EDUCATIONAL OUTCOMES
  5. WHAT CAN SCHOOLS DO TO REDUCE AGGRESSION AND VIOLENCE?
  6. PROVEN OR PROMISING APPROACHES
  7. SUMMARY
  8. REFERENCES
  • 1
    Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, eds. World Report on Violence and Health. Geneva: World Health Organization; 2002.
  • 2
    National Center for Injury Prevention and Control. Ten Leading Causes of Death, United States. Available at: http://webappa.cdc.gov/sasweb/ncipc/leadcaus10.html. Accessed February 25, 2010.
  • 3
    Centers for Disease Control and Prevention. Violence Prevention: Youth Violence. Available at: http://www.cdc.gov/ncipc/dvp/YVP. Accessed April 17, 2009.
  • 4
    Centers for Disease Control and Prevention. School associated student homicides-United States, 1992–2006. Morb Mortal Wkly Rep. 2008;57:3336.
  • 5
    National Center for Educational Statistics. Indicators of school crime and safety: 2007. Executive summary. Available at: http://nces.ed.gov/programs/crimeindicators/crimeindicators2007. Accessed August 27, 2008.
  • 6
    Eaton DK, Kahn L, Kinchen S, et al. Youth Risk Behavior Surveillance—United States, 2007. Morb Mortal Wkly Rep. 2008; 57:1131.
  • 7
    Brown BV, Bzostek S. Violence in the lives of children. Available at: http://www.childtrendsdatabank.org/PDF/Violence.pdf. Accessed May 11, 2006.
  • 8
    Brown SL, Birch DA, Kancherla V. Bullying perspectives: experiences, attitudes, and recommendations of 9- to 13-year-olds attending health education centers in the United States. J Sch Health. 2005;75:384392.
  • 9
    Dake JA, Price JH, Telljohann SK. The nature and extent of bullying at school. J Sch Health. 2003;73:173180.
  • 10
    Glew GM, Fan MY, Katon W., Rivara FP. Bullying and school safety. J Pediatr. 2008;152:123128.
  • 11
    Juvonen J, Graham S, Schuster MA. Bullying among young adolescents: the strong, the weak, and the troubled. Pediatrics. 2003;112:12311237.
  • 12
    Stockdale MS, Hangaduambo S, Duys D, Larson K, Sarvela PD. Rural elementary students', parents', and teachers' perceptions of bullying. Am J Health Behav. 2002;26:266277.
  • 13
    Arseneault L, Walsh E, Trzesniewski K, Newcombe R, Caspi A, Moffitt TE. Bullying victimization uniquely contributes to adjustment problems in young children: a nationally representative cohort study. Pediatrics. 2006;118:130138.
  • 14
    Fekkes M, Pijpers FI, Fredriks AM, Vogels T, Verloove-Vanhorick SP. Do bullied children get ill, or do ill children get bullied? A prospective cohort study on the relationship between bullying and health-related symptoms. Pediatrics. 2006;117:15681574.
  • 15
    Perren S, Alsaker FD. Social behavior and peer relationships of victims, bully-victims, and bullies in kindergarten. J Child Psychol Psychiatry. 2006;47:4557.
  • 16
    Kumpulainen K. Psychiatric conditions associated with bullying. Int J Adolesc Med Health. 2008;20:121132.
  • 17
    Glew GM, Fan MY, Katon W, Rivara FP, Kernic MA. Bullying, psychological adjustment, and academic performance in elementary school. Arch Pediatr Adolesc Med. 2005;159: 10261031.
  • 18
    Juvonen J, Nishina A, Graham S. Peer harassment, psychological adjustment, and school functioning in early adolescence. J Educ Psychol. 2000;92:349359.
  • 19
    Nishina A, Juvonen J, Wirkow MR. Stick and stones may break my bones, but names will make me feel sick: the psychological, somatic, and scholastic consequences of peer harassment. J Clin Child Adolesc Psychol. 2005;34:3748.
  • 20
    Bingenheimer JB, Brennan RT, Earls FJ. Firearm exposure and serious violent behavior. Science. 2005;308:13231326.
  • 21
    Patternson G, Dishion T, Yoeger K. Adolescent growth in new forms of problems behaviors; macro and micro peer dynamics. Prevention Science. 2000;1:313.
  • 22
    Kochenderfer BJ, Ladd GW. Peer victimization: cause or consequence of school maladjustment? Child Dev. 1996;67: 13051317.
  • 23
    Youngblade LM, Theokas C, Schulenberg J, Curry L, Huang IC, Novak M. Risk and promotive factors in families, schools, and communities: a contextual model of positive youth development in adolescence. Pediatrics. 2007;119:S47S53.
  • 24
    Schwartz D, Gorman AH. Community violence exposure and children's academic functioning. J Educ Psychol. 2003;95: 163173.
  • 25
    Ladd GW, Birch SH, Buhs ES. Children's social and scholastic lives in kindergarten: related spheres of influence? Child Dev. 1999;70:13731400.
  • 26
    Eisenberg ME, Neumark-Sztainer D, Perry CL. Peer harassment, school connectedness, and academic achievement. J School Health. 2003;73:311316.
  • 27
    Ladd GW, Kochenderfer BJ, Coleman CC. Classroom peer acceptance friendship, and victimization: distinct relational systems that contribute to children's school adjustment? Child Dev. 1997;68:11811197.
  • 28
    Brookmeyer KA, Fanti KA, Henrich CC. Schools, parents, and youth: a multilevel, ecological analysis. J Clin Child Adolesc Psychol. 2006;35:504514.
  • 29
    Centers for Disease Control and Prevention. School health guidelines to prevention unintentional injuries and violence. Morb Mortal Wkly Rep. 2001;50:174.
  • 30
    Jagers RJ, Syndor K, Mouttapa M, Flay BR. Protective factors associated with preadolescent violence: preliminary work on a cultural model. Am J Commun Psychol. 2007;40:138245.
  • 31
    Centers for Disease Control and Prevention. Using environmental design to prevent youth violence. Available at: http://www.cdc.gov/ncipc/dvp/CPTED.htm. Accessed August 28, 2008.
  • 32
    Culley MR, Conkling M, Emshoff J, Blakely C, Gorman D. Environmental and contextual influences on school violence and its prevention. J Prim Prev. 2006;27:217227.
  • 33
    Mair JS, Mair M. Violence prevention and control through environmental design. Annu Rev Publ Health. 2003;24: 209225.
  • 34
    Anderson M, Kaufman J, Simon TR, et al. School-associated deaths in the United States, 1994–1999. JAMA. 2001;286: 26952702.
  • 35
    Bowes D, Marquis M, Holoway P, Isaac W. Process evaluation of a school-based intervention to increase physical activity and reduce bullying. Health Promot Pract. 2009;10:394401.
  • 36
    Hahn R, Crosby A, Moscicki E, Stone G, Dahlberg L. Effectiveness of universal school-based programs to prevent violent and aggressive behavior—a systematic review. Am J Prev Med. 2007;33:S114S129.
  • 37
    Hahn R, Faqua-Whitley D, Werthington H, et al. The effectiveness of universal school-based programs for the prevention of violence and aggressive behavior—a report on recommendation of the task force on community preventive services. Morb Mortal Wkly Rep. 2007;56:11.
  • 38
    Mytton J, DiGuiseppi C, Gough D, Taylor R, Logan S. School-based secondary prevention programmes for preventing violence. Cochrane Database Syst Rev. 2006; 3: CD004606. Available at: http://www.cochrane.org/reviews/en/ab004606.html. Accessed July 24, 2008.
  • 39
    National Institutes of Health. NIH State-of-Science Conference Statement on preventing violence and related health-risking social behaviors in adolescents. NIH Consens State Sci Statements. 2004;21:134.
  • 40
    Wilson SJ, Lipsey MW. School-based interventions for aggressive disruptive behavior—update of a meta-analysis. Am J Prev Med. 2007;33:S130S143.