A cross-national study of violence-related behaviors in adolescents.

BACKGROUND: Violent behavior among adolescents is a significant problem worldwide, and a cross-national comparison of adolescent violent behaviors can provide information about the development and pattern of physical violence in young adolescents. OBJECTIVES: To determine and compare frequencies of adolescent violence-related behaviors in 5 countries and to examine associations between violence-related behaviors and potential explanatory characteristics. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional, school-based nationally representative survey at ages 11.5, 13.5, and 15.5 years in 5 countries (Ireland, Israel, Portugal, Sweden, and the United States). MAIN OUTCOME MEASURES: Frequency of physical fighting, bullying, weapon carrying, and fighting injuries in relation to other risk behaviors and characteristics in home and school settings. RESULTS: Fighting frequency among US youth was similar to that of all 5 countries (nonfighters: US, 60.2%; mean frequency of 5 countries, 60.2%), as were the frequencies of weapon carrying (noncarriers: US, 89.6%; mean frequency of 5 countries, 89.6%) and fighting injury (noninjured: US, 84.5%; mean frequency of 5 countries, 84.6%). Bullying frequency varied widely cross-nationally (nonbullies: from 57.0% for Israel to 85.2% for Sweden). Fighting was most highly associated with smoking, drinking, feeling irritable or bad tempered, and having been bullied. CONCLUSIONS: Adolescents in 5 countries behaved similarly in their expression of violence-related behaviors. Occasional fighting and bullying were common, whereas frequent fighting, frequent bullying, any weapon carrying, or any fighting injury were infrequent behaviors. These findings were consistent across countries, with little cross-national variation except for bullying rates. Traditional risk-taking behaviors (smoking and drinking) and being bullied were highly associated with the expression of violence-related behavior.

Multiple risk behavior and injury: an international analysis of young people.

BACKGROUND: Multiple risk behavior plays an important role in the social etiology of youth injury, yet the consistency of this observation has not been examined multinationally. OBJECTIVE: To examine reports from young people in 12 countries, by country, age group, sex, and injury type, to quantify the strength and consistency of this association. SETTING: World Health Organization collaborative cross-national survey of health behavior in school-aged children. PARTICIPANTS: A multinational representative sample of 49 461 students aged 11, 13, and 15 years. MAIN EXPOSURE MEASURES: Additive score consisting of counts of self-reported health risk behaviors: smoking, drinking, nonuse of seat belts, bullying, excess time with friends, alienation at school and from parents, truancy, and an unusually poor diet. MAIN OUTCOME MEASURE: Self-report of a medically treated injury. RESULTS: Strong gradients in risk for injury were observed according to the numbers of risk behaviors reported. Overall, youth reporting the largest number (> or =5 health risk behaviors) experienced injury rates that were 2.46 times higher (95% confidence interval, 2.27-2.67) than those reporting no risk behaviors (adjusted odds ratios for 0 to > or =5 reported behaviors: 1.00, 1.22, 1.48, 1.73, 1.98, and 2.46, respectively; P<.001 for trend). Similar gradients in risk for injury were observed among youth in all 12 countries and within all demographic subgroups. Risk gradients were especially pronounced for nonsports, fighting-related, and severe injuries. CONCLUSIONS: Gradients in risk for youth injury increased in association with numbers of risk behaviors reported in every country examined. This cross-cultural finding indicates that the issue of multiple risk behavior, as assessed via an additive score, merits attention as an etiological construct. This concept may be useful in future injury control research and prevention efforts conducted among populations of young people.

The role of family, peers and school perceptions in predicting involvement in youth violence.

This study explored the relative importance of family, peers and school in predicting youth violence. The analysis was done on a nationally representative sample included 8,394 students from grade 6th-10th in Israel. Measures of youth violence included bullying, physical fights and weapon carrying. The findings suggested that all three social systems had significant relations with youth violence, respectively. Variables found to predict violence were: Family-lack of parental support regarding school; Peers-Lack of social integration or too many evenings out with friends; School-feeling of school alienation, low academic achievement and perceptions of frequent acts of violence in school. School perceptions had the strongest predicting power. Findings emphasized the importance of focusing on improving the daily school experience in reducing youth violence.

Substance use and youth violence. A study among 6th to 10th grade Israeli school children.

This study examined the co-morbidity of substance use and violence among a representative sample of 8,394 6th-10th grade Israeli students. A representative national self report sample of 8,394 students in 6th through 10th grade. Measures included smoking, alcohol consumption, and illicit drug use, predicting involvement in bullying, injury during a fight and weapon-carrying in the past 30 days. We found across all grades, genders and ethnicities, daily smoking, use of hard drugs, history of drunkenness and binge drinking were the best predictors of violent behavior. Involvement in such behaviors put girls in higher risk for violent behaviors compared with boys. We concluded that use of substances immensely increased the odds of involvement in violent behavior, and this association was extremely strong for Arab girls. The study suggested that although girls were less frequently involved in substance use, the girls who did were at much higher risk for involvement in youth violence.

Cross-national study of fighting and weapon carrying as determinants of adolescent injury.

OBJECTIVES: We sought to (1) compare estimates of the prevalence of fighting and weapon carrying among adolescent boys and girls in North American and European countries and (2) assess in adolescents from a subgroup of these countries comparative rates of weapon carrying and characteristics of fighting and injury outcomes, with a determination of the association between these indicators of violence and the occurrence of medically treated injury. DESIGN AND SETTING: Cross-sectional self-report surveys using 120 questions were obtained from nationally representative samples of 161082 students in 35 countries. In addition, optional factors were assessed within individual countries: characteristics of fighting (9 countries); characteristics of weapon carrying (7 countries); and medically treated injury (8 countries). PARTICIPANTS: Participants included all consenting students in sampled classrooms (average age: 11-15 years). MEASURES: The primary measures assessed included involvement in physical fights and the types of people involved; frequency and types of weapon carrying; and frequency and types of medically treated injury. RESULTS: Involvement in fighting varied across countries, ranging from 37% to 69% of the boys and 13% to 32% of the girls. Adolescents most often reported fighting with friends or relatives. Among adolescents reporting fights, fighting with total strangers varied from 16% to 53% of the boys and 5% to 16% of the girls. Involvement in weapon carrying ranged from 10% to 21% of the boys and 2% to 5% of the girls. Among youth reporting weapon carrying, those carrying handguns or other firearms ranged from 7% to 22% of the boys and 3% to 11% of the girls. In nearly all reporting countries, both physical fighting and weapon carrying were significantly associated with elevated risks for medically treated, multiple, and hospitalized injury events. CONCLUSIONS: Fighting and weapon carrying are 2 common indicators of physical violence that are experienced by young people. Associations of fighting and weapon carrying with injury-related health outcomes are remarkably similar across countries. Violence is an important issue affecting the health of adolescents internationally.

The health of youth: a cross-national survey: a report of the 1993–94 survey results of Health Behaviour in School-aged Children: a WHO cross-national study

This report presents the preliminary findings from the World Health Organization’s fourth Health Behaviour in School-aged Children (HBSC) study. It provides a wealth of information about the health and lifestyles of over 100 000 children living in 24 countries who participated in the survey conducted during the 1993/1994 school year. Research teams, who were instructed to follow a rigorous study protocol, undertook the survey in each of the participating countries. Any survey carried out by more than one research team will have problems ensuring consistency in data collection. In this survey, as outlined in Chapter 1, such problems are further compounded by the questionnaire being administered in a variety of educational systems, languages and culture. Given such reservations about the likely comparability of data from different countries, cross-country comparisons of the prevalence of individual health behaviours based on the HBSC survey should be treated with caution. On the other hand, the data presented in this report do reveal considerable variations and common patterns in the prevalence of individual health behaviours among young people from different countries. It has been argued elsewhere that such large differences are unlikely to be fully accounted for by the above methodological problems, and may therefore reflect reality. Strong similarities in the interrelationships between variables in different countries are good evidence that there is validity in comparing the data from these different countries.