U.S. adolescents more likely to engage in violent behavior than youth in other countries

The results of an international survey show that young adolescents in the United States are no more likely to engage in violent behavior than are youth in 4 other countries. The survey was coordinated by the World Health Organization and the U.S. participation was funded by the National Institute of Child Health and Human Development of the National Institutes of Health.

The study authors noted, however, that their findings fail to explain international statistics showing that U.S. youth are more likely to die of violent causes than are youth in other developed countries.

"Even though our youth are no more likely to fight than are youth in the other developed countries in the study, they're still more likely to die of violent causes" said Duane Alexander, M.D., director of the NICHD. "We now need to find the reasons for these deaths and find ways to prevent them."

The findings appear in the June issue of The Archives of Pediatrics and Adolescent Medicine. The current study is an analysis of information obtained from the World Health Organization's survey, Health Behavior in School-Aged Children. The study's first author is Eleanor Smith-Khuri, of NICHD's Division of Epidemiology, Statistics and Prevention Research.

The study authors wrote that, according to World Health Organization (WHO) statistics, U.S. adolescents are more likely to die of violent causes than are youth from other developed countries. (These statistics are available at http://www3.who.int/whosis/mort/table1.cfm?path=whosis.)

"An important question raised by our findings is why violence-related mortality in the United States is substantially higher than countries in which the rates of nonfatal violent behaviors (fighting, weapon carrying, and injuries from fighting) in young adolescents are extremely similar," the authors wrote.

One explanation they offered is that U.S. adolescents are likely to have access to more lethal weapons than are youth in the other countries. Another explanation is that American youth have different attitudes toward life and death than do youth in other countries. The authors cited a World Health Organization study, which reported that American youth are more likely to believe it's appropriate to kill to protect their property than were youth in Estonia, Finland, Romania, and Russia. Similarly, the cited study noted reports that adolescents in the United States are more likely to approve of war than were youth in any of those countries.

The researchers began the study to determine whether some degree of youth violence is a normal, expected, aspect of human development or whether it is influenced by cultural factors. To conduct their analysis, the researchers tabulated survey responses from adolescents in the United States and in Ireland, Israel, Portugal, and Sweden. Survey questions dealing with violent behavior asked how often adolescents fought, how many days a month they carried a weapon, how many times per year they were injured from fighting, and how many times per school term that they had bullied another student. The researchers in the respective countries surveyed three groups of adolescents whose average ages were 11 and a half, 13 and a half, and 15 and a half.

For the American adolescents, 60.2 percent had not been involved in a fight during the previous year. Likewise, an average of 60.2 percent of youth in the five countries combined had not been involved in a fight during the same time period. Similarly, 89 percent of U.S. youths had not carried a weapon in the previous year, identical to the average percentage of youth in the five countries combined who had not carried a weapon in the previous year. In the U.S., 84.5 percent of U.S. youth said they had not been injured in a fight during the previous year, while the average for all five countries combined was 84.6 percent.

Of the youth involved in fighting, most fought only occasionally. The rates for occasional fighting were similar for all the countries studied.

"…Occasional fighting, a common behavior among the study youth, is part of the normal but not necessarily desirable developmental process of adolescents," the study authors wrote. "In contrast, weapon carrying and injuries from fighting are not."

In contrast to the statistics on fighting, the statistics on bullying varied greatly among the countries in the survey. Israeli students were the most likely to have been bullied in the last school term (42.9 percent) and Swedish students were the least likely (14.8 percent). In the U.S., about 41 percent of student said they had been bullied in the last school term.

These statistical differences may reflect education campaigns to prevent bullying, explained another author of the paper, Peter Schiedt, M.D., M.P.H., a medical officer in NICHD's Division of Epidemiology, Statistics and Prevention Research. The Scandinavian countries recognized the problem of bullying in school age children before most other countries did and were the first to begin national educational efforts against bullying, he added. Dr. Scheidt said that these differences suggest that bullying may be amenable to national programs to reduce this violence-related behavior.

Regarding high profile school killings in the United States, the authors noted that one study reported that the most common motive for school shootings was revenge for having been bullied or ridiculed by other students.

"We hope that the wide range of cross-national bullying rates indicates that country-specific factors, such as the sociopolitical environment, play a significant role in bullying prevalence and that intervention-prevention programs can reduce both adolescent bullying and its associated violence rates," the study authors wrote.

The study also confirmed earlier findings that youth who smoke, drink alcohol, and have been victims of bullying are also more likely to be involved in violent behaviors.

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