The Journal of School Nursing2021, Vol. 37(4) 270–279© The Author(s) 2019Article reuse guidelines:sagepub.com/journals-permissionsDOI: 10.1177/1059840519864144journals.sagepub.com/home/jsn
This study assessed the prevalence of verbally being put down by others and intrapersonal and normative factors associated with being put down by others among middle and high school students. Students (N = 1,027) completed the Adolescent Health Risk Behavior Survey. Over 16% of participants reported being put down at school. Students who identified with the negative words confused, unattractive, dull, and careless and identified less with the positive words popular, smart, considerate, cool, and self-confident reported being put down by others. High school students were less likely to be put down. As students scored higher on the Negative Self-Description Scale, their odds of being put down increased. As students scored higher on the Positive Self-Description Scale, their odds of being put down decreased. Students who perceived their friends drinking alcohol regularly were less likely to be put down. Strategies to enhance self-perceptions to raise self-awareness and form healthy/positive identities are needed.
victimization, bullying, self-perceptions, emotional health, school nurse
Peer victimization has been robustly associated with developmental and health problems (Hawker & Boulton, 2000; Iyer-Eimerbrink, Scielzo, & Jensen-Campbell, 2015; Knack, Arnocky, Lawton, Wallace, & Sussman, 2013; Olweus, 2013; Swearer, Espelage, Vaillancourt, & Hymel, 2010). Adolescents who experience victimization commonly report internalizing (e.g., depression, anxiety, loneliness, low self-regard/esteem) and externalizing (e.g., rule breaking behavior, aggression, substance use, and other health risk behaviors) behaviors compared to nonvictimized peers (Moore et al., 2017; Wolke & Lereya, 2015). Victimized youth are more likely to have difficulties with social relationships including higher peer rejection, less social support, and lower quality friendships (Evans, Smokowski, & Cotter, 2014). School-aged youth who are victimized tend to experience academic difficulties including lower academic achievement (Arseneault, 2018; Hammig & Jozkowski, 2013; Priest, Paradies, Stewart, & Luke, 2011). Additionally, victimization during adolescence has been associated with somatic physical symptoms including stomachaches, headaches, dizziness, back pain, and sleeping difficulties (Moore et al., 2017). Adolescents who are victimized are at increased risk of reporting suicidal ideation and behaviors (Moore et al., 2017). Long-term outcomes of experiencing victimization include the development of mental health issues over time (Olweus, 2013; Wolke & Lereya, 2015).
These problems are concerning given the number of youth involved in victimization: Approximately 10–30% of youth are classified as victims (i.e., targets of intentional peer aggression), 4–12% are classified as bullies (i.e., aggressors against peers), and 4–6.5% are classified as bully/victims (i.e., aggressors against their peers and targets of peer aggression (Atik & Güneri, 2013; Knack et al., 2014; Vaillancourt & Hymel, 2006). Victimization can occur in several forms including physical (e.g., hitting, ruining possessions), relational (e.g., ostracism, spreading rumors), verbal (e.g., name-calling), and cyberbullying (e.g., through electronic devices) and can occur either overtly or covertly (Olweus, 2013). In the current study, we examined whether frequency of experiencing verbal aggression (i.e., being put down by their peers) influenced middle and high school students’ self-perceptions about peer-valued characteristics (e.g., popularity, attractiveness, immaturity). Given that there is currently mixed evidence about whether gender differences in verbal and relational aggression exist (García-Moya, Suominen, & Moreno, 2014; Orpinas, McNicholas, & Nahapetyan, 2015), we explored gender differences in our analyses in addition to examining the entire sample as a whole.
A large body of research has examined how individuallevel (e.g., grade level/age, gender) and group-level (e.g., peer-valued characteristics, Knack, Tsar, Vaillancourt, Hymel, & McDougall, 2012; Vaillancourt & Hymel, 2006) factors influence youth’s risk of being involved in bullying and experiencing the problems associated with victimization (Olweus, 2013). However, less is known about how adolescents’ own self-perceptions about peer-valued characteristics are associated with victimization. We sought to fill this knowledge gap by examining how adolescents’ self-report of being put down by others correlates with their selfperceptions about peer-valued characteristics and perceptions about the proportion of their friends involved in maladaptive behaviors (i.e., sexual activity, smoking cigarettes, alcohol consumption, illicit drug use).
During adolescence, peer relationships become increasingly important as youth develop self-identities and interpersonal skills (Knack et al., 2004; Reitz, Zimmermann, Hutteman, Specht, & Neyer, 2014). For example, high-quality friends play an important role in helping adolescents develop and refine their self-concept (Davis, 2013). Youth learn effective conflict resolution tactics, language and cognitive skills through their peer interactions (Knack et al., 2004) and increase their social cognition (Vetter, Leipold, Kliegel, Phillips, & Altgassen, 2013). A best friend’s personality can also help protect adolescents from peer aggression and maladjustment problems. For example, Knack, Jacquot, Jensen-Campbell, and Malcolm (2013) found a best friend’s agreeableness (e.g., considerate to almost everyone) moderated the relationship between boys’ agreeableness, victimization, and externalizing problems and between girls’ agreeableness and internalizing problems and prosocial skills. In other words, having a best friend who scores high on agreeableness had a protective effect on adolescents who were low on agreeableness.
Certain nonbehavioral characteristics tend to be more highly valued among a peer group than other characteristics. For example, Vaillancourt and Hymel (2006) provided evidence that even adolescents who engage in behaviors often considered risk factors, such as aggressiveness, can be well received by peers if the adolescent is also viewed favorably in regard to peer-valued characteristics such as dressing well (an indicator of wealth), being attractive, and having athletic and/or academic abilities. Similar buffering effects of peervalued characteristics were found for adolescents who selfreported they were victimized by their peers (Knack et al., 2012) and for anxious-withdrawn adolescents (Markovic & Bowker, 2015). Although demonstrating the importance of understanding the peer group’s influence through peervalued characteristics, these studies did not consider whether target adolescents internalized how peers perceived them. Khatri, Kupersmidt, and Patterson (2000) provided some evidence that being bullied increased youth’s self-report of being unpopular; however, it is still unclear whether experiencing peer aggression is associated with youth making broader inferences about their perceptions of themselves. In this study, we examined the associations between victimization and adolescents’ positive or negative selfperceptions and how factors such as alcohol and drug use may influence these perceptions.
The perceived delinquency of friends and the larger peer group influences adolescents’ own behaviors (Cotter & Smokowski, 2016). For example, Prinstein, Boergers, and Spirito (2001) found that adolescents’ substance use (e.g., cigarette, marijuana, and alcohol use) was positively correlated with their friends’ use and that social acceptance influenced this association. Similarly, Osgood et al. (2013) demonstrated that friends’ alcohol use strongly predicted adolescents’ own consumption. Depending on what behaviors are valued and reinforced by peer groups, popularity and high status may be granted to individuals who engage in delinquent or maladaptive behaviors such as drug and alcohol use and risky sexual activity (Allen, Porter, McFarland, Marsh, & McElhaney, 2005). Indeed, when the peer group values were supportive of behaviors such as increased drug and alcohol use, popular youth were more likely to increase use compared to when peer group values were not supportive of such behaviors. Thus, we examined how perceptions of peers’ sexual activity, cigarette use, illicit drug use, and regular alcohol consumption were associated with adolescents’ reports of being put down by others.
The purpose of this study was to describe the characteristics of middle and high school students who reported being victimized by verbally being put down by others. First, we examined (a) the positive and negative characteristics that these students used to describe themselves (i.e., positive and negative self-descriptions), (b) their lifetime drug use, and (c) their perceptions of their friends’ sexual activity, cigarette smoking, use of illicit drugs, and use of alcohol. We described these characteristics for the total sample, and we compared bivariate scores by whether the individuals were victims of being put down, and by gender and school level (middle vs. high school). Second, using logistic regression, we examined whether the use of positive and negative selfdescriptions, lifetime drug use, and perceptions of friends’ behaviors predicted being verbally put down by others.
We performed an analysis of a cross-sectional survey, the Adolescent Health Risk Behavior Survey (Smith, McKyer, & Larsen, 2010), which was designed using the constructs of the biopsychosocial model (Irwin & Millstein, 1992). Items for statistical analyses were purposively selected based on a literature review of known and theorized factors associated with victimization at school.
This study was approved by the institutional review board at Texas A&M University.
A total of 1,992 middle and high school students (Grades 7–12) in one Indiana county were recruited, and 1,430 completed the Adolescent Health Risk Behavior Survey, a paperpencil survey (71.8% response rate), assessing the prevalence of substance use and intrapersonal and normative perceptions (Smith et al., 2010). Of these students, 1,027 (485 males and 542 females) were included in the present study after excluding those with missing data on the dependent variable, sociodemographics, and other study variables of interest. One third of the sample was in middle school (33.5%) and two thirds were in high school (66.5%). No information was collected on race; however, the U.S. Census Bureau for this Indiana County estimates race and Hispanic origin of the 146,986 residents as 83.5% White, 3.6% Black, 7.0% Asian, 0.3% American Indian or Alaska Native, 0.1% Native Hawaiian and Other Pacific Islander, 2.5% two or more races, and 3.5% Hispanic (U.S. Census Bureau, 2017).
Dependent variable. Being “put down” by others was the dependent variable for this study. Participants indicated whether the following statement was true or false: “More often than not I feel put down by others at school.” This dichotomous item was used in logistic regression analyses as the dependent variable; not being put down by others served as the referent group.
Positive and negative self-descriptions. Self-descriptions were measured by asking the students to rate themselves on a 5-point Likert-type scale from 0 (not at all like me) to 4 (exactly like me). Positive self-descriptions included the words independent, considerate, smart, cool (sophisticated), self-confident, and popular. Negative self-descriptions included the words immature, confused, unattractive, dull (boring), careless, and self-centered. These descriptors were used to determine how students rated their own perception of themselves. Then, two composite scores were created. The Positive Self-Description Scale summed responses for all the positive descriptions (scores ranged from 0 to 24 with higher scores indicating a better self-perception; Cronbach’s α = .68). The Negative Self-Description Scale summed responses for all the negative descriptions (scores ranged from 0 to 24 with higher scores indicating a worse selfperception; Cronbach’s α = .58).
Perceived risky behaviors by friends. Participants were asked to estimate the proportion of their friends who engaged in four risky behaviors. Participants responded to four questions: (1) “What percentage of your friends are sexually active?” (2) “What percentage of your friends smoke cigarettes?” (3) “What percentage of your friends use illicit drugs?” and (4) “What percentage of your friends drink alcohol regularly?” Each item was ranked using a 6-point Likert-type scale (0 = 0%; 1 = 10–20%; 2 = 30–40%; 3 = 50–60%; 4 = 70–80%; 5 = 90–100%). This ordinal measure was treated continuously in analyses with higher scores indicating participants perceived a larger proportion of their friends engaged in these activities.
Lifetime drug use. To measure lifetime drug use among participants, θ scores were calculated from participant responses pertaining to 17 different substances (Smith et al., 2015; Warne, McKyer, & Smith, 2012). This standardized measure was generated using a two-parameter logistic (2PL) item response theory model (Embretson, Reise, & NetLibrary, 2000). Higher θ scores simultaneously indicate students’ reports of using multiple substances as well as those who had a lower prevalence of use among the other participants in the sample (Embretson et al., 2000). Details regarding the calculation for these specific θ scores are provided elsewhere (Embretson et al., 2000; Warne et al., 2012).
Demographic characteristics. Gender (male, female) and school level (middle, high) were collected to describe the sample.
The Adolescent Health Risk Behavior Survey was conducted by the Indiana Prevention Resource Center (2016). Schools were randomly selected from the Indiana county, and classrooms were randomly selected from participating schools. Participants were recruited by using a purposive quota cluster sampling technique while stratifying by grade level. Prior to survey completion, parents were informed about the survey, and only those who wanted their child to participate returned a signed form. Only students who attended school the day the survey was administered were eligible to participate. Both school and student participation were voluntary. More specific details about study methodology and data collection are reported elsewhere (Diep, McKyer, Smith, Pruitt, & Outley, 2013; Merianos, Rosen, Montgomery, Barry, & Smith, 2017; Smith et al., 2010; Smith et al., 2015; Warne et al., 2012).
All analyses were performed using SPSS (Version 24). Frequencies and descriptive statistics were calculated for all variables of interest. Sample characteristics were compared by whether the student reported being put down by others at school, gender, and grade level. X2 tests were used to compare distribution differences for categorical variables. Independent sample t tests were used to compare mean differences for continuous variables. Then, a series of three binary logistic regression analyses were performed to identify factors associated with being put down by others at school. The first model used all cases in the sample. The second model used only high school students. The third model used only middle school students. Fitting multiple models using different samples enabled us to examine the common and unique factors associated with being bullied at school by age-group.
Of the sample of 1,027 students, 16% described themselves as being put down at school more often than not, and this proportion did not vary by gender (15% of males and 17% of females). A larger proportion of students in middle school (20%) than in high school (14%) reported being put down by others at school (X2 = 5.26, p = .022). The leading three positive self-descriptions reported were considerate, smart, and independent. The leading three negative selfdescriptions reported were confused, unattractive, and careless. Students estimated a large proportion of their friends were sexually active and drank alcohol regularly (Table 1).
Put down. On average, students who reported being put down by others scored lower on the Positive Self-Description Scale (t = 7.91, p < .001; Table 1). More specifically, students who reported more often than not being put down by others identified less with the individual positive selfdescriptions of being popular, smart, considerate, cool, and self-confident. On average, students who reported being put down by others scored higher on the Negative Self-Description Scale (t = −6.60, p < .001); these students identified more with the individual negative self-descriptions of being confused, unattractive, dull (boring), and careless. No significant differences were observed in substance use or risky behaviors of friends.
Gender. On average, no differences by gender were observed in the Positive or Negative Self-Description Scales (Table 1). At the item level, compared to males, females had significantly higher scores in the positive self-descriptions of being considerate (p < .001) and independent (p = .010) and in the negative self-description of being confused (p < .001). Compared to females, males scored significantly higher in the positive self-descriptions of being popular (p = .002) and self-confident (p < .001) and in the negative selfdescriptions as immature (p < .001), dull (boring; p = .028), and careless (p < .001). On average, males reported a higher drug use score (t = 2.78, p = .006), and a higher proportion of their friends being sexually active (t = 1.99, p = .047), using illicit drugs (t = 2.86, p = .004), and drinking alcohol regularly (t = 2.42, p = .016) relative to females.
School level. On average, no differences between middle and high school were observed in the Negative Self-Description Scale (Table 1). In only 1 item, self-confident, students in middle school scored significantly higher than those in high school (p < .001). On average, high school students scored significantly higher on the Negative Self-Description Scale (t = −2.64, p = .008). Compared to middle school students, high school students scored significantly higher in negative self-descriptions of being confused, careless, and selfcentered. On average, high school students reported a higher drug use score (t = −12.20, p < .001), a higher proportion of friends being sexually active (t = −12.54, p < .001), smoking cigarettes (t = −11.55, p < .001), using illicit drugs (t = −7.53, p < .001), and drinking alcohol regularly (t = −17.28, p < .001) relative to middle school students.
Table 2 presents findings from the binary logistic regression analyses; the main outcome was whether students reported victimization in the form of being put down by others. Relative to middle school students, high school students were significantly less likely to report being put down by others at school (odds ratio (OR) = 0.61, 95% confidence interval (CI) [0.41, 0.91], p = .015). As students scored higher on the Positive Self-Description Scale, their odds of being put down by others at school significantly decreased (OR = 0.84, 95% CI [0.80, 0.89], p < .001). As students scored higher on the Negative Self-Description Scale, their odds of being put down by others at school significantly increased (OR = 1.13, 95% CI [1.07, 1.19], p < .001). Students who reported larger proportions of their friends drank alcohol regularly were less likely to report being put down by others at school (OR = 0.81, 95% CI [0.65, 1.00], p = .049).
Given the strong effect of grade level, we ran the analyses separately for middle and high school. Similar to the total sample, in both grade levels having higher scores on the Positive Self-Description Scale decreased the odds of reporting being put down by others, and having a higher score on the Negative Self-Description Scale increased the odds. In middle school, having friends who used illicit drugs decreased the odds, whereas in high school having friends who drank alcohol regularly decreased the odds.
We examined how being put down by peers in middle and high school was associated with (1) positive (e.g., considerate, independent) and negative descriptors (e.g., confused, unattractive) and (2) friends’ perceived involvement in risky behaviors (e.g., illicit drug use, regular alcohol consumption). First, we found that high school students were verbally victimized at lower rates than middle school students. Second, we found that students who reported more often than not being put down by others were less likely to self-report being popular, smart, considerate, cool, and self-confident, and more likely to report being confused, unattractive, dull (boring), and careless. Third, we found several gender differences in how females and males endorsed selfdescriptions. Female students were more likely to selfreport being considerate, independent, and confused, whereas male students were more likely to self-report being popular, self-confident, immature, dull (boring), and careless. In addition, male students perceived more of their friends to be sexually active, use illicit drugs, and regularly consume alcohol compared to female students’ perceptions of their friends. Finally, we found that students who viewed themselves more positively (i.e., higher scores on the positive self-description scale) were at lower risk of reporting they were put down by others at school. In addition, students who viewed themselves more negatively (i.e., higher scores on the negative self-description scale) were at higher risk of reporting they were put down by others at school.
Our findings support previous studies that reviewed the role of peer-valued characteristics. For example, Vaillancourt and Hymel (2006) found that adolescents who were rated by peers as being attractive, athletic, tough, funny, and stylish were also rated as having higher popularity, power, and being liked. In addition, they found that adolescents who were aggressive were still able to attain high social status if they were rated high on other characteristics valued by the peer group. Knack et al. (2012) found similar patterns on the lower end of social status; adolescents who were rejected but deemed high on peer-valued characteristics were less likely to be victimized. Findings in the current study indicate that adolescents are aware of these peer-valued characteristics and may internalize their own standing on these characteristics. Our findings of self-reporting being put down by others and rating high on negative self-descriptors (i.e., confused, unattractive, and careless) and rating low on positive self-descriptors (i.e., considerate, smart, and independent) are consistent with Knack et al.’s finding that peer rejection and peer victimization were both negatively correlated with peer nominations of attractiveness, wealth, academic ability, and athletic ability.
Although some evidence suggests that personality traits are risk factors for being bullied (Lubans, Morgan, & McCormack, 2011), other researchers argue that personality characteristics do not adequately explain the negative physical and mental health outcomes experienced by those who are peer victimized (Knack et al., 2012). For example, Park, Jensen-Campbell, and Miller (2017) argued that people who are bullied develop a generalized sensitivity to social pain and react negatively to a variety of negative social situations. Moreover, the qualities of peers and friends can be protective factors against negative outcomes associated with being victimized (Knack, Jacquot et al., 2013). Our findings add to this literature by indicating that adolescents might be internalizing behavioral characteristics that are valued by peers. Because we cannot assert causality due to the correlational nature of our study, it is important for future researchers to examine whether these self-descriptions are an antecedent or outcome of negative peer relationships.
We found that friends’ perceived involvement in risky behaviors (i.e., illicit drug use, regular alcohol consumption) predicted youth’s self-report of being put down by others. Specifically, higher perceived illicit drug use among friends in middle school and regular alcohol consumption in high school predicted lower self-report of being put down by others. While potentially counterintuitive, youth who surround themselves with peers, who drink alcohol and use drugs may not be victimized because they are part of the “in crowd” or are themselves the perpetrators of victimization. It has been reported that youth who perceived their friends to victimize others also reported higher likelihood to engage in bullying behavior (Haynie et al., 2001). However, this study did not measure bullying perpetration, and it is also possible that some of the youth who reported being victimized were also bully perpetrators. While we are not suggesting that substance use is protective of victimization, our findings indicate that more research is needed to understand the role of the peer group characteristics, group identity, and delinquent/rebellious behavior as related to verbal victimization and substance use. Contrary to our findings, youth who are victimized also are at risk of engaging in risky behaviors including alcohol consumption (King, Vidourek, & Merianos, 2014) and smoking behavior (Haynie et al., 2001). According previous studies, bully-victims are at higher risk than either bullies or victims for risky behaviors and poor outcomes such as poor mental well-being (Haynie et al., 2001; Mark, Värnik, & Sisask, 2019). While larger proportions of males and high school students perceived more of their friends to be sexually active in the current study (see Table 1), perceived sexual activity among friends was not significantly associated with verbal victimization (see Tables 1 and 2). Additional studies are needed to examine associations between sexual behavior and verbal victimization relative to self-perceptions among middle and high school students. Unfortunately, other than substance use, we did not ask students to report their own engagement in risky behaviors or the victimization of others. Both bully perpetration and students’ own engagement in risky behaviors should be examined in future research.
Despite the contribution of our study, there were several limitations worth noting. First, we relied on self-report of being put down by others and friends’ perceived delinquent behaviors. Although the self-report nature of this study has limitations, we were interested in how students’ perceptions of their own social experiences (namely, being verbally bullied) and their friends’ behaviors (e.g., cigarette smoking, drug use) were associated with students’ self-perceptions. Future researchers should examine whether others’ reports of bullying have similar associations or whether there is something unique about one’s own perceptions. Relatedly, another limitation of this study is that we used a single-item measure of being victimized that was treated dichotomously (“More often than not I feel put down by others at school”) rather than assessing a range of victimization behaviors (e.g., verbal, physical, cyber). Moreover, this assessment lacked information about the severity and frequency that students’ perceived others putting them down and did not include a definition of what being “put down” meant (Vaillancourt & Hymel, 2006). Third, we did not examine bully perpetration or bystander behaviors; in the future, researchers should examine whether the associations identified in this study change after accounting for bully perpetration.
In addition, this study was correlational in nature and therefore was not designed to address questions of causality. It is also worth noting that the data were collected in a single county in Indiana, thus findings may not be generalizable to larger middle and high school populations in the state or country. Further, other important sociodemographics such as race, ethnicity, or household income were not measured, which may have been associated with victimization. Youth are affected by many people outside of their peer group; parents, teachers, youth group leaders, coaches, relatives, and others are also likely to influence youth’s selfperceptions as well as provide context and attributes for youth’s perceptions of their peers’ maladaptive behaviors (e.g., alcohol consumption, illicit drug use). Future research should consider the multiple social influences on youth’s self-perceptions.
In this study, we found an association between adolescents’ self-perception and self-reports of being put down by their peers. School nurses are in an ideal position to advocate for anti-bullying programs. School nurses can play a vital role in identifying students who are experiencing low self-esteem and issues verbal victimization by their peers. They are well positioned to provide early intervention, engage parents/guardians in discussions to identify solutions, and refer adolescents to appropriate services and professionals.
There are a variety of interventions targeting victimization. The current study findings support the need to address behavioral components and social skills to help youth form healthy positive self-identities. For example, Cox et al. (2016) conducted a systematic review of Australian programs that targeted (1) victimization, (2) alcohol and drug use violence, and (3) other violent behavior. They found that multimodal interventions that address both risk and protective factors are most impactful for reducing victimization and violence. Our current research suggests the importance of addressing behavioral characteristics that are specifically valued by the peer group (e.g., how to be self-confident or independent, strategies to reduce being careless or confused). While such interventions can be facilitated by school nurses in class settings or one-on-one formats, interventions should also more comprehensively include parents/guardians (and others in the family unit) to address concerns and encourage support. Introducing more comprehensive behavioral ecological interventions (Dresler-Hawke & Whitehead, 2009) may also require school-wide training to recognize victimization and risk behaviors as well as define effective communication channels between school staff, administration, and parents.
School nurses can play a key role in early intervention as early as the elementary school years. Prior research indicates that victimization that begins in the elementary years has the potential to lead to negative health outcomes during adolescence and adulthood (Stapinski et al., 2014; Takizawa, Maughan, & Arseneault, 2014; Wolke & Lereya, 2015). Elementary schools can potentially benefit from school nursing social strengthening and anti-bullying programs (Ferguson, Miguel, Kilburn, & Sanchez, 2007). Elementary school is an ideal time to implement this type of program as a preventive measure to help students as they begin to experience the developmental changes typical of middle school-aged children (Knack et al., 2004) and before victimization peaks.
Our study indicates the importance of early intervention with a comprehensive approach that targets health risk behaviors and multiple spheres of influence to prevent and reduce verbal victimization. School nurses play a distinctive role in developing, introducing, and implementing school health programming to prevent verbal victimization and bullying behavior. School nurses can interact with students to help youth increase positive self-perceptions and reduce negative self-perceptions to foster self-esteem and healthful interactions with classmates. Further, school nurses are instrumental in recognizing other health risk behaviors such as alcohol and drug use, which are associated with victimization and can be addressed through school-wide, multimodal interventions.
Matthew Lee Smith is also affiliated to department of Environmental and Occupational Health, Texas A&M School of Public Health, College Station, TX, USA and department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA.
Ashley Bowman conceptualized the study and wrote the article. Jennifer M. Knack, Adam E. Barry, and Ashley L. Merianos wrote and critically reviewed the article. Kelly L. Wilson and E. Lisako J. McKyer critically reviewed the article. Matthew Lee Smith conceptualized the study, performed all statistical analyses, and wrote the article.
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Ashley L. Merianos, PhD, CHES https://orcid.org/0000-0002-5640-7227
Matthew Lee Smith, PhD, MPH, CHES https://orcid.org/0000-0002-8232-9285
Allen, J. P., Porter, M. R., McFarland, F.C., Marsh,P., & McElhaney, K. B. (2005). The two faces of adolescents’ success with peers: Adolescent popularity, social adaptation, and deviant behavior. Child Development, 76, 747–760. doi:10.1111/j.1467-8624.2005.00875.x
Arseneault, L. (2018). Annual research review: The persistent and pervasive impact of being bullied in childhood and adolescence: Implications for policy and practice. Journal of Child Psychology and Psychiatry, 59, 405–421. doi:10.1111/jcpp.12841
Atik, G., & Güneri, O. Y. (2013). Bullying and victimization: Predictive role of individual, parental, and academic factors. School Psychology International, 34, 658–673. doi:10.1177/0143034313479699
Cotter, K. L., & Smokowski, P. R. (2016). Perceived peer delinquency and externalizing behavior among rural youth: The role of descriptive norms and internalizing symptoms. Journal of Youth and Adolescence, 45, 520–531. doi:10.1007/s10964-015-0382-1
Cox, E., Leung, R., Baksheev, G., Day, A., Toumbourou, J. W., Miller, P., ... Walker, A. (2016). Violence prevention and intervention programmes for adolescents in Australia: A systematic review. Australian Psychologist, 51, 206–222. doi:10.1111/ap. 12168
Davis, K. (2013). Young people’s digital lives: The impact of interpersonal relationships and digital media use on adolescents’ sense of identity. Computers in Human Behavior, 29, 2281–2293. doi:10.1016/j.chb.2013.05.022
Diep, C. S., McKyer, E. L. J., Smith, M. L., Pruitt, B. E., & Outley, C. W. (2013). Normative beliefs about sexual activity among adolescents: An examination of peer group proximity. Journal of Health Behavior and Public Health, 3, 5–11.
Dresler-Hawke, E., & Whitehead, D. (2009). The behavioral ecological model as a framework for school-based anti-bullying health promotion interventions. Journal of School Nursing, 25, 195–204.
Embretson, S. E., Reise, S. P., & NetLibrary, I. (2000). Item response theory for psychologists. Mahwah, NJ: Erlbaum
Evans, C. B. R., Smokowski, P. R., & Cotter, K. L. (2014). Cumulative bullying victimization: An investigation of the dose–response relationship between victimization and the associated mental health outcomes, social supports, and school experiences of rural adolescents. Children and Youth Services Review, 44, 256–264. doi:10.1016/j.childyouth.2014.06.021
Ferguson, C. J., Miguel, C. S., Kilburn, J. C., Jr, & Sanchez, P. (2007). The effectiveness of school-based anti-bullying programs: A meta-analytic review. Criminal Justice Review, 32, 401–414.
García-Moya, I., Suominen, S., & Moreno, C. (2014). Bullying victimization prevalence and its effects on psychosomatic complaints: Can sense of coherence make a difference? Journal of School Health, 84, 646–653. doi:10.1111/josh.12190
Hammig, B., & Jozkowski, K. (2013). Academic achievement, violent victimization, and bullying among U.S. high school students. Journal of Interpersonal Violence, 28, 1424–1436. doi:10.1177/0886260512468247
Hawker, D. S. J., & Boulton, M. J. (2000). Twenty years’ research on peer victimization and psychosocial maladjustment: A metaanalytic review of cross-sectional studies. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 41, 441–455. doi:10.1111/1469-7610.00629
Haynie, D. L., Nansel, T., Eitel, P., Crump, A. D., Saylor, K., Yu, K., & Simons-Morton, B. (2001). Bullies, victims, and bully/victims: Distinct groups of at-risk youth. The Journal of Early Adolescence, 21, 29–49. doi:10.1177/0272431601021001002
Indiana Prevention Resource Center. (2016). Survey data. Retrieved from http://www.drugs.indiana.edu/
Irwin, C. E., & Millstein, S. G. (1992). Risk-taking behaviors and biopsychosocial development during adolescence. In Susman, E. J., Feagans, L. V., & Ray, W. J. (Eds.), Emotion, cognition, health, and development in children and adolescents (pp. 75–102). Hillsdale, MI: Lawrence Erlbaum Associates.
Iyer-Eimerbrink, P. A., Scielzo, S. A., & Jensen-Campbell, L. A. (2015). The impact of social and relational victimization on depression, anxiety, and loneliness: A meta-analytic review. Journal of Bullying & Social Aggression, 1.
Khatri, P., Kupersmidt, J. B., & Patterson, C. (2000). Aggression and peer victimization as predictors of self-reported behavioral and emotional adjustment. Aggressive Behavior, 26, 345–358. doi:10.1002/1098-2337(2000)26:53.0
King, K. A., Vidourek, R. A., & Merianos, A. L. (2014). School violent victimization and recent alcohol use and episodic heavy drinking among youth. The Journal of School Nursing, 30, 187–195. doi:10.1177/1059840514521239
Knack, J. M., Arnocky, S., Lawton, C., Wallace, M., & Sussman, J. (2013). School bullying and health problems: A developmental examination of predictive and protective factors and coping strategies. In K. Dekker & M. Dijkstra (Eds.), School bullying: Predictive factors, coping strategies, and effects on mental health (pp. 147–167). New York, NY: Nova Science.
Knack, J. M., Jacquot, C., Jensen-Campbell, L. A., & Malcolm, K. T. (2013). Importance of having agreeable friends in adolescence (especially when you are not): Importance of having agreeable friends. Journal of Applied Social Psychology, 43, 2401–2413. doi:10.1111/jasp.12188
Knack, J. M., Tsar, V., Vaillancourt, T., Hymel, S., & McDougall, P. (2012). What protects rejected adolescents from also being bullied by their peers? The moderating role of peer-valued characteristics. Journal of Research on Adolescence, 22, 467–479. doi:10.1111/j.1532-7795.2012.00792.x
Knack, J. M., Vaillancourt, T., Krygsman, A., Arnocky, S., Vitoroulis, I., Hepditch, J., & Blain-Arcaro, C. (2014). Peer victimization: Understanding the developmental correlates of at-risk children and youth. In J. A. Burack & L. A. Schmidt (Eds.), Cultural and contextual perspectives on developmental risk and well-being (pp. 107–126). New York: Cambridge University Press.
Lubans, D. R., Morgan, P. J., & McCormack, A. (2011). Adolescents and school sport: The relationship between beliefs, social support and physical self-perception. Physical Education and Sport Pedagogy, 16, 237–250. doi:10.1080/17408989.2010. 532784
Mark, L., Värnik, A., & Sisask, M. (2019). Who suffers most from being involved in bullying—Bully, victim, or bully-victim? Journal of School Health, 89, 136–144. doi:10.1111/josh.12720
Markovic, A., & Bowker, J. C. (2015). Shy, but funny? Examining peer-valued characteristics as moderators of the associations between anxious-withdrawal and peer outcomes during early adolescence. Journal of Youth and Adolescence, 44, 833–846. doi:10.1007/s10964-014-0113-z
Merianos, A. L., Rosen, B. L., Montgomery, L., Barry, A. E., & Smith, M. L. (2017). Impact of perceived risk and friend influence on alcohol and marijuana use among students. The Journal of School Nursing, 33, 446–455. doi:10.1177/1059840517717591
Moore, S. E., Norman, R. E., Suetani, S., Thomas, H. J., Sly, P. D., & Scott, J. G. (2017). Consequences of bullying victimization in childhood and adolescence: A systematic review and meta-analysis. World Journal of Psychiatry, 7, 60–76. doi:10.5498/wjp. v7.i1.60
Olweus, D. (2013). School bullying: Development and some important challenges. Annual Review of Clinical Psychology, 9, 751–780. doi:10.1146/annurev-clinpsy-050212-185516
Orpinas, P., McNicholas, C., & Nahapetyan, L. (2015). Gender differences in trajectories of relational aggression perpetration and victimization from middle to high school: Gender differences trajectories relational aggression. Aggressive Behavior, 41, 401–412. doi:10.1002/ab.21563
Osgood, D. W., Ragan, D. T., Wallace, L., Gest, S. D., Feinberg, M. E., & Moody, J. (2013). Peers and the emergence of alcohol use: Influence and selection processes in adolescent friendship networks. Journal of Research on Adolescence, 23, 500–512. doi:10.1111/jora.12059
Park, A., Jensen-Campbell, L.A., & Miller, H. L. (2017). The effects of peer relational victimization on social cognition: Rejection attribution bias or a more generalized sensitivity to social pain? Journal of Social and Personal Relationships, 34, 984–1006. doi:10.1177/0265407516664418
Priest, N., Paradies, Y., Stewart, P., & Luke, J. (2011). Racism and health among urban aboriginal young people. BMC Public Health, 11, 568–568. doi:10.1186/1471-2458-11-568
Prinstein, M. J., Boergers, J., & Spirito, A. (2001). Adolescents’ and their friends’ health-risk behavior: Factors that alter or add to peer influence. Journal of Pediatric Psychology, 26, 287–298. doi:10.1093/jpepsy/26.5.287
Reitz, A. K., Zimmermann, J., Hutteman, R., Specht, J., & Neyer, F. J. (2014). How peers make a difference: The role of peer groups and peer relationships in personality development. European Journal of Personality, 28, 279–288. doi:10.1002/per.1965
Smith, M. L., McKyer, E. L. J., & Larsen, R. A. A. (2010). Factor structure and psychometrics of the adolescent health risk behavior survey instrument. American Journal of Health Behavior, 34, 328–339.
Smith, M. L., Warne, R. T., Barry, A. E., Rossheim, M. E., Boyd, M. K., & J McKyer, E. L. (2015). A biopsychosocial examination of ATOD use among middle and high school students. American Journal of Health Behavior, 39, 799–808. doi:10. 5993/AJHB.39.6.8
Stapinski, L. A., Bowes, L., Wolke, D., Pearson, R. M., Mahedy, L., Button, K. S., ... Araya, R. (2014). Peer victimization during adolescence and risk for anxiety disorders in adulthood: A prospective cohort study. Depression and Anxiety, 31, 574–582. doi:10.1002/da.22270
Swearer, S. M., Espelage, D. L., Vaillancourt, T., & Hymel, S. (2010). What can be done about school bullying? Linking research to educational practice. Educational Researcher, 39, 38–47. doi:10.3102/0013189X09357622
Takizawa, R., Maughan, B., & Arseneault, L. (2014). Adult health outcomes of childhood bullying victimization: Evidence from a five-decade longitudinal British birth cohort. American Journal of Psychiatry, 171, 777–784. doi:10.1176/appi.ajp.2014.13101401
U.S. Census Bureau. (2017). QuickFacts: Monroe county, Indiana. Retrieved from https://www.census.gov/quickfacts/fact/table/monroecountyindiana/PST045217
Vaillancourt, T., & Hymel, S. (2006). Aggression and social status: The moderating roles of sex and peer-valued characteristics. Aggressive Behavior, 32, 396–408. doi:10.1002/ab.20138
Vetter, N. C., Leipold, K., Kliegel, M., Phillips, L. H., & Altgassen, A. M. (2013). Ongoing development of social cognition in adolescence. Child Neuropsychology, 19, 615–629. doi:10.1080/09297049.2012.718324
Warne, R. T., McKyer, E. J. L., & Smith, M. L. (2012). An introduction to item response theory for health behavior researchers. American Journal of Health Behavior, 36, 31–43.
Wolke, D., & Lereya, S. T. (2015). Long-term effects of bullying. Archives of Disease in Childhood, 100, 879–885. doi:10.1136/archdischild-2014-306667
Ashley Bowman, MPH, MSW, is a graduate student at the College of Public Health, Georgia School of Social Work, University of Georgia, Athens, GA, USA.
Jennifer M. Knack, PhD, is an associate professor at the Department of Psychology, Clarkson University, Potsdam, NY, USA.
Adam E. Barry, PhD, is an associate professor at the Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.
Ashley L. Merianos, PhD, CHES, is an associate professor at the School of Human Services, University of Cincinnati, Cincinnati, OH, USA.
Kelly L. Wilson, PhD, MCHES, is an associate professor at the Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.
E. Lisako J. McKyer, PhD, MPH, is a professor, an associate dean for Climate and Diversity, and the Director of the Center for Community Health Development at the Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA.
Matthew Lee Smith, PhD, MPH, CHES, is a co-director and associate professor at the Center for Population Health and Aging, Texas A&M School of Public Health, College Station, TX, USA.
1 College of Public Health, School of Social Work, University of Georgia, Athens, GA, USA
2 Department of Psychology, Clarkson University, Potsdam, NY, USA
3 Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
4 School of Human Services, University of Cincinnati, Cincinnati, OH, USA
5 Department of Health Promotion and Community Health Sciences, Center for Community Health Development, Texas A&M School of Public Health, College Station, TX, USA
6 Center for Population Health and Aging, Texas A&M School of Public Health, College Station, TX, USA
7 Department of Environmental and Occupational Health, Texas A&M School of Public Health, College Station, TX, USA
8 Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
Corresponding Author:Matthew Lee Smith, PhD, MPH, CHES, Center for Population Health and Aging, Texas A&M School of Public Health, 212 Adriance Lab Rd., Suite 360, College Station, TX 77843, USA.Email: matthew.smith@tamhsc.edu
