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Journal of Adolescent Health 45 (2009) 368–375

Original article

School Bullying Among Adolescents in the United States:

Physical, Verbal, Relational, and Cyber

Jing Wang, Ph.D.*, Ronald J. Iannotti, Ph.D., and Tonja R. Nansel, Ph.D. National Institutes of Health, Bethesda, Maryland

Manuscript received January 15, 2009; manuscript accepted March 31, 2009

See Editorial p. 323

Abstract Purpose: Four forms of school bullying behaviors among US adolescents and their association with

*Address correspo

Health, 6100 Executiv

E-mail address: w

1054-139X/09/$ – see

doi:10.1016/j.jadoheal

sociodemographic characteristics, parental support, and friends were examined.

Methods: Data were obtained from the Health Behavior in School-Aged Children (HBSC) 2005 Survey, a nationally representative sample of grades 6–10 (N ¼ 7,182). The revised Olweus Bully/ Victim Questionnaire was used to measure physical, verbal, and relational forms of bullying. Two

items were added using the same format to measure cyber bullying. For each form, four categories

were created: bully, victim, bully-victim, and not involved. Multinomial logistic regressions were

applied, with sociodemographic variables, parental support, and number of friends as predictors.

Results: Prevalence rates of having bullied others or having been bullied at school for at least once in the last 2 months were 20.8% physically, 53.6% verbally, 51.4% socially, or 13.6% electronically. Boys

were more involved in physical or verbal bullying, whereas girls were more involved in relational

bullying. Boys were more likely to be cyber bullies, whereas girls were more likely to be cyber victims.

African-American adolescents were involved in more bullying (physical, verbal, or cyber) but less

victimization (verbal or relational). Higher parental support was associated with less involvement across

all forms and classifications of bullying. Having more friends was associated with more bullying and less

victimization for physical, verbal, and relational forms but was not associated with cyber bullying.

Conclusions: Parental support may protect adolescents from all four forms of bullying. Friends asso- ciate differentially with traditional and cyber bullying. Results indicate that cyber bullying is a distinct

nature from that of traditional bullying. � 2009 Society for Adolescent Medicine. All rights reserved.

Keywords: School bullying; Cyber bullying; Relational bullying; Parental support; Peers; Sociodemographic characteristics

School bullying has been identified as a problematic

behavior among adolescents, affecting school achievement,

prosocial skills, and psychological well-being for both

victims and perpetrators [1–3]. Bullying is usually defined

as a specific form of aggression, which is intentional,

repeated, and involves a disparity of power between the

victim and perpetrators [4]. Previous studies have found

that boys have a higher prevalence of bullying perpetration

than girls and bullying behavior tends to peak in middle

school and then decrease [5]. In one of the few analyses of

a nationally representative sample of adolescents in the

United States, Nansel et al [6] reported that the prevalence

ndence to: Jing Wang, Ph.D., National Institutes of

e Boulevard, Bethesda, MD 20892.

[email protected]

front matter � 2009 Society for Adolescent Medicine. All th.2009.03.021

of frequent involvement in school bullying in the past 2

months was 29.9%, which included 13.0% as bullies,

10.6% as victims, and 6.3% as both. In the US sample,

compared with Caucasian adolescents, Hispanic adolescents

were involved in more frequent bullying perpetration, while

African-American adolescents were less likely to be bullied.

Adolescent bullying may take many forms, such as phys-

ical [4], verbal [4], and relational or social [7]. Physical

bullying (e.g., hitting, pushing, and kicking) and verbal

bullying (e.g., name-calling and teasing in a hurtful way)

are usually considered to be a direct form, while relational

bullying refers to an indirect form of bullying, such as social

exclusion and spreading rumors. Studies on direct and indi-

rect bullying have consistently shown that boys are more

involved in direct bullying, whereas girls are more involved

in indirect bullying [8,9].

rights reserved.

J. Wang et al. / Journal of Adolescent Health 45 (2009) 368–375 369

As computers and cell phones are rapidly becoming

popular among adolescents, cyber bullying, or electronic bullying, is emerging as a new form of bullying. Cyber bulling

can be defined as a form of aggression that occurs through

personal computers (e.g., e-mail and instant messaging) or

cell phones (e.g., text messaging). Kowalski and Limber

[10] reported that among their sample of 3,767 middle school

students in the southwestern and northwestern United States,

22% reported involvement in cyber bullying, including 4% as

bullies, 11% as victims, and 7% as both. There is also

evidence showing that similar to traditional victimization,

experiences with cyber victimization are associated with

psychosocial problems such as emotional distress [11]. In

a study of Canadian adolescents in 7 th

grade, boys were

more likely to be cyber bullies than girls, and there was no

gender difference in prevalence of victimization [12]. As

investigation of cyber bulling is at an early stage, little is

know about other demographic differences, such as age,

racial, or SES differences in the prevalence of cyber bullying

and victimization in the United States or in other countries.

Among a number of risk and protective factors, previous

research indicates that parents and friends are two important

sources of social influences associated with adolescent

bullying and victimization. For example, previous studies

showed that positive parental practices, such as parental

warmth or support, could protect adolescents from involve-

ment in both bullying perpetration [13] and victimization

(i.e., being bullied) [14]. Compared with parents, friends

seem to play a more mixed role: having more friends was found

to be negatively related to victimization, suggesting a ‘‘friend-

ship protection hypothesis’’ [11,15]; yet adolescents identified

as bullies were found to be less socially isolated [16].

There is no doubt that parenting and friendships play

important roles for understanding adolescent bullying.

However, no studies have examined their roles across

different forms of bullying, particularly cyber bullying. In

addition, limited studies have been conducted nationally to

provide a valid estimation of prevalence of physical, verbal,

relational, and cyber bullying by adolescents’ gender, age,

and race/ethnicity in the United States.

The current study examined four forms of in-school

bullying, with two main purposes: (1) to explore gender,

age, racial, and SES differences in prevalence of each form

of bullying among adolescents in grades 6 through 10; and

(2) to examine the roles of parental support and number of

friends on each form. This study is among the first to examine

the new form of bullying, cyber bullying, using a nationally

representative sample of adolescents in the United States.

Method

Sample and procedure

Self-report data on bullying were collected from 7,508

adolescents in the 2005/2006 Health Behavior in School-

aged Children (HBSC) study in the United States. HBSC is

a World Health Organization collaborative cross-national

study examining health behaviors among children and their

social determinants [17]. To obtain a nationally representa-

tive sample with controllable estimation errors, the US

sampling design was a three-stage stratified design with an

oversample of African-American and Hispanic students.

The three stages were school districts, schools, and school

classes. Stratification was conducted by nine strata of census

regions and three strata of grades within each census region.

The software used for the current study, the survey proce-

dures of SAS version 9.1 [18], fully took into account this

sampling design in the analyses.

Data were collected through anonymous self-report ques-

tionnaires distributed in the classroom in grades 6–10. Youth

assent and parental consent were obtained as required by the

participating school districts. The study protocol was re-

viewed and approved by the Institutional Review Board of

the Eunice Kennedy Shriver National Institute of Child

Health and Human Development. Information was obtained

from 327 schools, of which 97 schools were identified as

ineligible schools. Data was collected from students in the re-

maining 230 schools; 85% (9,016) of the eligible students

participated in the HBSC study. The questionnaire contain-

ing the bullying items was given to approximately half of

the students in grade 6 (randomly selected); therefore, a total

of 7,508 students completed the HBSC questionnaire with

the bullying items.

Measures

Sociodemographic variables. Gender was measured as male or female. Grade was measured with five levels, i.e., grades

6–10. As evidence shows that bullying behavior peaks in

middle school, grade was collapsed into three categories:

grade 6, grades 7 & 8, and grades 9 and 10. Race/ethnicity

was collapsed into four categories: Caucasian, African-

American, Hispanic, and other, as there was insufficient

sample size for separate groups within other minorities.

The family affluence scale (FAS), developed for HBSC,

was used as the proxy for SES. The FAS consists of four

items on family material wealth (i.e., having own bedroom,

number of times on a traveling vacation in a year, number

of home computers, and number of cars owned). This scale

has shown desirable reliability and validity in previous

studies [19]. The four items were combined to produce

a linear composite score and standardized.

Bully/victim. The items assessing physical, verbal, and rela- tional bullying were based on the revised Olweus Bully/

Victim Questionnaire [20]. For each item, two parallel ques-

tions asked how often participants had either bullied others

(bullying) or been bullied (victimization) in the past 2 months

at school. Previous studies have reported a good reliability

and validity [20]. Two new items were added using the

same format to measure cyber bully/victim experience.

J. Wang et al. / Journal of Adolescent Health 45 (2009) 368–375370

After given a standard definition of bullying, participants

were asked how often they had bullied others or had been

bullied at school in the past couple of months in a variety

of different ways. Physical bullying was measured by one

item (hitting, kicking, pushing, shoving around, or locking

indoors). Verbal bullying was measured by three items

(calling mean names, making fun of or teasing in a hurtful

way, calling mean names about race, and calling mean names

about religion). Relational bullying was measured by two

items (socially excluding others, and spreading rumors).

Cyber bullying was measured by two items (bullying using

a computer or e-mail messages or pictures, and bullying

using a cell phone).

Response options were none, only once or twice, 2 or 3

times a month, about once a week, and several times

a week. A previous study recommended the cutoff point of

‘‘2 or 3 times a month’’ to code a student as involved or

noninvolved [20]. However, as it is not uncommon in the

literature of cyber bullying to count a single incident as an

experience of cyber bullying [11,21], we chose the cutoff

point of ‘‘only once or twice’’ for all items to make meaning-

ful comparisons across the four forms. Participants were first

coded as involved or not involved in each form for bullying

or victimization. They were then categorized into one of four

groups: involved in bullying others only (bullies), involved in

being bullied only (victims), involved in both bullying others

and being bullied (bully-victims), or not involved at all

(noninvolved).

Parental support. Parental support was measured by four items from the Parental Bonding Instrument, which were

included in the HBSC survey to measure parental support/

warmth [22]. The students were asked if their parent or

guardian 1) helps them as much as they needed; 2) is loving;

3) understands their problems and worries; and 4) makes

them feel better when they were upset. Response options

were almost never, sometimes, and almost always. The

mean of the four items was calculated. Because the distribu-

tion was highly skewed, the variable was dichotomized

around the mean into two categories: higher parental support

and lower parental support.

Number of friends. Two items asked about how many male or female friends the student had. Response options ranged

from 0 to 3 or more. Because a majority of the students re-

ported 3 or more for both items, the sum was calculated

and dichotomized into two categories (three or more friends,

and fewer than three friends) for easier interpretation.

Statistical analysis

All analyses were conducted using SAS version 9.1, with

adjustments for survey stratification, clustering, and weight-

ing. For each form of bullying, analyses consisted of two

steps: descriptive statistics and multinomial logistic regres-

sions. Descriptive statistics were used to determine the

prevalence of involvement in bullying and being bullied,

and the prevalence for each of the four bullying classifica-

tions. Multinomial logistic regression models were used to

compare bullies, victims, and bully-victims with those who

were never involved, in relation to parental support, friend

group status, and sociodemographic variables. To determine

whether parental support and number of friends were associ-

ated with each form of bullying differentially by gender, we

included two interaction terms in each of the multinomial

logistic regression models, i.e., interaction of gender with

parental support, and interaction of gender with number of

friends.

Results

Sample characteristics

Among the 7,508 adolescents who completed the survey

with the bully/victim items, 326 were excluded because of

missing information on variables included in the current

study (4.3%: 1.0% missing on demographic variables,

2.1% missing on parental or peer variables, and additional

1.2% missing on bully-victim items), resulting in an analytic

sample of 7,182 (95.7%). The sample consisted of 47.8%

males, 42.6% Caucasian Americans, 18.2% African-Ameri-

cans, and 26.4% Hispanic Americans. The mean age of the

sample was 14.3 years with a standard deviation of 1.42.

Prevalence of bullying and victimization

The prevalence of bullying and victimization are reported

in three ways: for each item (Table 1), for each form (physical,

verbal, relational, cyber; Table 2), and for each bullying clas-

sification (bullies, victims, bully-victims, and noninvolved;

Table 3).

At the item level, the two most common types of bullying

behaviors were calling someone mean names and social

isolation (Table 1). The two most common types of victimi-

zation were being called mean names and having rumors

spread about them. It is interesting to note that the percent-

ages of involvement in bullying and victimization are similar

for most items, except for spreading rumors, in which much

more victimization than bullying perpetration was reported.

Prevalence rates of bullying and victimization (Table 2)

are given for the total sample, and across each category of

parental support, number of friends, and the three demo-

graphic variables. In this sample, 13.3% reported that they

had bullied others at least once in the last 2 months physi-

cally, 37.4% verbally, 27.2% socially, and 8.3% electroni-

cally. The prevalence rates of victimization in the last 2

months were 12.8% for physical, 36.5% for verbal, 41.0%

for relational, and 9.8% for cyber forms.

When examining the combined measures of bullying and

victimization, we found that the prevalence of involvement in

bullying others, being bullied, or both, was 20.8% for phys-

ical, 53.6% for verbal, 51.4% for relational, and 13.6% for

cyber (Table 3). Among those who were involved in physical

Table 1

Percentage of involvement by bullying assessment item

Total (N ¼ 7,182) Male (N ¼ 3,395) Female (N ¼ 3,787)

Forms Items Bully Victim Bully Victim Bully Victim

Physical

Hit, kicked, pushed, shoved around, or locked indoors 13.3 12.8 18.1 17.2 8.8 8.7

Verbal

Called mean names, was made fun of, or teased in a hurtful way 35.2 31.5 37.6 32.0 33.0 31.1

Bullied with mean names and comments about race or color 9.1 13.1 12.0 15.2 6.5 11.3

Bullied with mean names and comments about religion 5.8 8.5 8.4 9.7 3.3 7.5

Relational

Social isolation: excluded from a group of friends or was ignored 24.0 25.6 24.3 23.6 23.8 27.4

Spreading rumor: told lies or spread false rumors 11.2 31.9 12.0 27.1 10.5 36.3

Cyber

Bullied using computer or e-mail messages or pictures 6.1 8.1 7.6 7.9 4.7 8.3

Bullied using cell phone 6.0 5.7 7.0 5.6 5.0 5.8

J. Wang et al. / Journal of Adolescent Health 45 (2009) 368–375 371

bullying, 38.9% were bullies only (i.e., 601 of 1,594), 36.0%

were victims only, and 26.3% were bully-victims. For verbal

bullying, 30.3% were bullies only, 31.7% were victims only,

and 38.1% were bully-victims. For relational bullying, 19.1%

were bullies only, 48.1% were victims only, and 32.8% were

bully-victims. For cyber bullying, 27.4% were bullies only,

40.0% were victims only, and 32.6% were bully-victims.

Multinomial logistic regressions

Multinomial logistic regressions were performed for each

of the four forms of bullying: physical, verbal, relational, and

cyber. In each of the four multinomial logistic regressions,

the bullying classification was the outcome variable, with

Table 2

Percentage of involvement in each form of bullying by gender, grade, race/ethnici

Physical Ve

Category N (%) Bully Victim Bu

Total 7,182 (100) 13.3 12.8 37.

Gender

Male 3,395 (47.8) 18.1 17.2 40.

Female 3,787 (52.2) 8.8 8.7 34.

Grade

Grade 6 1,041 (10.3) 14.9 21.5 35.

Grade 7 1,654 (20.9) 13.9 16.6 41.

Grade 8 1,660 (21.5) 16.1 14.8 41.

Grade 9 1,368 (24.9) 11.8 9.8 34.

Grade 10 1,459 (22.5) 11.0 6.5 34.

Race/ethnicity

Caucasian 3,304 (42.6) 10.8 12.1 35.

African- American 1,392 (18.2) 16.6 11.7 45.

Hispanic 1,699 (26.4) 15.4 13.6 36.

Other 787 (12.8) 12.3 14.6 32.

Parental support 3,736 (53.0) 16.3 13.8 42.

Lower

Higher 3,446 (47.0) 9.9 11.6 32.

No. of peers

<3 2,781 (38.2) 11.2 14.0 35.

�3 4,404 (61.8) 14.6 12.0 36.

Note: Family affluence scale (FAS) score was not included in this table because

noninvolved as the reference category, and with parental

support, number of friends, and the demographic variables

as predictors. The two interaction terms were not significant

in any of the four regressions, indicating no gender differ-

ences in the influences of parental support and number of

friends on adolescent bullying. Analyses were rerun by

excluding the two interaction terms. The odds ratios and their

corresponding 95% confidence intervals from the multivar-

iate analyses are reported in Table 4.

Gender. Compared with girls, boys were likely to be more involved in physical (bullies, victims, or bully-victims) and

verbal forms (bully-victims), but less involved in relational

form (victims or bully-victims). For cyber bullying, boys

ty, parental support, and number of friends (N ¼ 7,182)

rbal Relational Cyber

lly Victim Bully Victim Bully Victim

4 36.5 27.2 41.0 8.3 9.8

3 38.0 26.8 36.0 9.7 9.2

7 35.2 27.5 45.6 7.1 10.3

1 45.2 28.2 50.0 9.4 9.9

4 42.5 29.4 45.0 9.1 12.9

2 37.2 31.4 43.0 9.8 11.1

9 32.4 25.0 37.2 8.0 8.6

0 31.0 23.0 35.7 6.0 7.0

9 36.6 28.0 42.5 6.7 9.0

9 35.7 29.8 36.5 10.9 9.8

5 37.1 25.7 40.2 9.6 9.8

2 36.3 23.7 44.4 7.3 12.7

2 40.0 30.9 46.1 9.6 11.4

0 33.1 23.0 35.3 6.8 8.1

9 41.5 25.7 46.2 7.6 10.0

4 33.5 28.1 37.8 8.7 9.6

FAS was created as a standardized continuous variable in the current study.

Table 3

Percentage of bullies, victims, bully-victims, and individuals noninvolved in each form of bullying

Total (N ¼ 7,182) Male (N ¼ 3,395) Female (N ¼ 3,787)

Category N % N % N %

Physical

Involved 1,594 20.8 987 28.0 607 14.3

Bullies 601 8.1 366 10.9 235 5.6

Bully-victims 419 5.1 277 7.2 142 3.2

Victims 574 7.6 344 9.9 230 5.5

Noninvolved 5,588 79.1 2,408 71.9 3,180 85.7

Verbal

Involved 3,917 53.6 1,904 55.7 2,013 51.8

Bullies 1,186 17.1 589 17.7 597 16.5

Bully-Victims 1,491 20.3 759 22.6 732 18.2

Victims 1,240 16.2 556 15.4 684 17.1

Noninvolved 3,265 46.3 1,491 44.3 1,774 48.2

Relational

Involved 3,807 51.4 1,634 47.5 2,173 55.1

Bullies 727 10.4 388 11.4 339 9.5

Bully-Victims 1,249 16.7 515 15.4 734 18

Victims 1,831 24.3 731 20.7 1,100 27.6

Non-Involved 3,375 48.5 1,761 52.5 1,614 44.9

Cyber

Involved 978 13.6 466 14 512 13.3

Bullies 268 3.8 155 4.8 113 2.9

Bully-Victims 319 4.5 160 4.9 159 4.2

Victims 391 5.3 151 4.3 240 6.2

Noninvolved 6,204 86.4 2,929 86 3,275 86.8

J. Wang et al. / Journal of Adolescent Health 45 (2009) 368–375372

were more likely to be bullies, whereas girls were more likely

to be victims.

Grade. For these analyses, adolescents in 6th grade were set as the reference group to test grade differences. There was no

difference between 6 th

graders and 7 th

/8 th

graders on bullying

perpetrations (bullies or bully-victims) in any of the four

forms. However, 7 th

/8 th

graders were less likely to be victims

for physical, verbal, and relational forms. Compared with 6 th

graders, 9 th

/10 th

graders were less involved in bullying for

physical (bullies, victims, or bully-victims), verbal (victims

or bully-victims), relational (victims or bully-victims), or cy-

ber form (bullies).

Race/Ethnicity and FAS. Compared with Caucasian adoles- cents, African-American adolescents were more involved in

bullying perpetration (physical, verbal, and cyber), but less

involved in victimization (verbal and relational). Hispanic

adolescents were more likely to be physical bullies or cyber

bully-victims than Caucasian adolescents. Adolescents in

the ‘‘other’’ race/ethnicity category were less likely to be

relational bullies or verbal bully-victims, but more likely to

be the targets of cyber bullying than Caucasian adolescents.

Adolescents from more affluent families were less likely to

be physical victims but more likely to be cyber victims.

Parental support. With the group reporting lower parental support as referent, all estimates of ORs for parental support

were below 1.0, ranging from 0.50–0.90, indicating that

higher parental support was negatively associated with

involvement in bullying across all four forms. With physical

victims and cyber bully-victims as the exceptions, all other

CIs were significant.

Number of friends. Number of friends was related to involvement in all three traditional forms, i.e., physical,

verbal, and relational, but was not related to cyber bullying.

For physical, verbal, and relational bullying, adolescents

with more friends were more likely to be bullies, but less

likely to be victims, and with the exception of physical

bullying, they were also less likely to be bully-victims.

Discussion

Findings indicate high prevalence rates of having bullied

others or having been bullied at school for at least once in

the last 2 months: 20.8% physically, 53.6% verbally, 51.4%

socially, or 13.6% electronically. After categorizing respon-

dents into four categories (bullies, victims, bully-victims,

and noninvolved), we found that adolescents with higher

parental support reported less involvement in all four forms

of bullying while having more friends was associated with

more bullying (bullies) and less victimization (victims or

bully-victims) in physical, verbal, and relational forms, but

this was not the case for cyber bullying. Socio-demographic

differences in bullying varied across the four different forms.

Consistent with previous studies [14], our results on

parental support suggest that positive parental behaviors

Table 4

Relationship of sociodemographic characteristics, parental support, and number of friends with four forms of bullying using multinomial logistic regressions (N¼ 7,182)

Physical Verbal Relational Cyber

Categories a

OR b

95% C. I. OR 95% C. I. OR 95% C. I. OR 95% C. I.

Gender (Boy)

Bully only 2.41 (1.91, 3.05) 1.19 [1.00, 1.43) 1.03 (0.82, 1.28) 1.73 (1.21, 2.45)

Bully-victim 2.86 (2.27, 3.60) 1.40 (1.19, 1.66) 0.73 (0.63, 0.86) 1.21 (0.93, 1.58)

Victim only 2.22 (1.76, 2.81) 1.00 (0.83, 1.20) 0.64 (0.56, 0.73) 0.71 (0.54, 0.93)

Grade (Grades 7, 8)

Bully only 0.86 (0.61, 1.21) 1.24 (0.81, 1.89) 0.98 (0.64, 1.51) 0.78 (0.53, 1.15)

Bully-victim 0.94 (0.56, 1.58) 1.02 (0.74, 1.41) 0.86 (0.67, 1.09) 1.25 (0.79, 1.96)

Victim only 0.55 (0.41, 0.74) 0.67 (0.52, 0.87) 0.66 (0.53, 0.81) 1.14 (0.77, 1.67)

Grade (Grades 9, 10)

Bully only 0.67 (0.47, 0.96) 0.92 (0.62, 1.36) 0.79 (0.52, 1.20) 0.66 (0.45, 0.97)

Bully-victim 0.46 (0.29, 0.74) 0.59 (0.43, 0.83) 0.48 (0.38, 0.60) 0.75 (0.48, 1.17)

Victim only 0.22 (0.16, 0.32) 0.43 (0.33, 0.57) 0.49 (0.40, 0.61) 0.69 (0.45, 1.08)

Race (African-American)

Bully only 1.60 (1.05, 2.45) 1.52 (1.13, 2.03) 1.16 (0.90, 1.50) 1.74 (1.12, 2.70)

Bully-victim 1.24 (0.78, 1.97) 1.26 (0.99, 1.61) 0.83 (0.63, 1.09) 1.60 (0.90, 2.84)

Victim only 0.75 (0.53, 1.05) 0.77 (0.60, 0.99) 0.70 (0.56, 0.87) 0.79 (0.52, 1.21)

Race (Hispanic)

Bully only 1.39 (1.03, 1.89) 1.05 (0.79, 1.39) 0.86 (0.68, 1.09) 1.32 (0.90, 1.92)

Bully-victim 1.31 (0.94, 1.84) 0.94 (0.77, 1.15) 0.79 (0.62, 1.02) 1.56 (1.14, 2.12)

Victim only 0.90 (0.71, 1.15) 1.01 (0.81, 1.27) 0.85 (0.71, 1.02) 0.79 (0.55, 1.13)

Race (Other)

Bully only 1.22 (0.83, 1.82) 0.89 (0.66, 1.20) 0.65 (0.43, 0.98) 1.07 (0.62, 1.83)

Bully-victim 0.92 (0.53, 1.62) 0.78 (0.62, 0.97) 0.86 (0.65, 1.15) 1.13 (0.68, 1.88)

Victim only 1.28 (0.89, 1.84) 1.07 (0.81, 1.42) 1.04 (0.84, 1.30) 1.65 (1.10, 2.47)

FAS

Bully only 0.88 (0.76, 1.03) 1.07 (0.97, 1.19) 1.16 (1.02, 1.31) 1.16 (0.99, 1.36)

Bullying-victim 0.88 (0.76, 1.02) 0.96 (0.89, 1.05) 1.04 (0.95, 1.14) 0.98 (0.83, 1.15)

Victim only 0.85 (0.76, 0.96) 1.02 (0.95, 1.10) 1.06 (0.98, 1.13) 1.17 (1.02, 1.34)

Parental support (higher)

Bully only 0.57 (0.46, 0.70) 0.57 (0.48, 0.68) 0.62 (0.50, 0.76) 0.54 (0.37, 0.78)

Bully-victim 0.52 (0.38, 0.69) 0.58 (0.48, 0.70) 0.49 (0.41, 0.60) 0.78 (0.55, 1.10)

Victim only 0.91 (0.70, 1.19) 0.69 (0.57, 0.85) 0.61 (0.52, 0.70) 0.55 (0.43, 0.72)

No. of friends (more)

Bully only 1.64 (1.30, 2.07) 1.31 (1.07, 1.60) 1.49 (1.19, 1.86) 1.11 (0.79, 1.55)

Bully-victim 0.94 (0.76, 1.17) 0.79 (0.66, 0.95) 0.78 (0.67, 0.92) 1.09 (0.82, 1.47)

Victim only 0.78 (0.61, 0.99) 0.69 (0.57, 0.84) 0.72 (0.61, 0.85) 0.81 (0.60, 1.09)

FAS ¼ family affluence scale. Note: Boldfaced odds ratios and their 95% confidence intervals indicate that the confidence intervals exclude 1.0. a

Reference groups for gender, grade, race/ethnicity, parental support and number of friends are female, grade 6, white American, lower parental support, and

fewer friends, respectively. b

Alpha of .05 is used as the significance level.

J. Wang et al. / Journal of Adolescent Health 45 (2009) 368–375 373

protect adolescents from not only bullying others but also

being bullied. The protective effects were consistent for all

four forms of bullying, with similar magnitudes of strength.

The negative relations between having more friends and

victimization in physical, verbal, and relational forms

supports the ‘‘friendship protection hypothesis’’ suggesting

that friendship protects adolescents from being selected as

targets of bullies [15,23]. The positive relation between

having more friends and bullying in the three traditional

forms is consistent with previously reported lower social

isolation in bullies [16]. This may reflect a need among

adolescents to establish social status, especially during tran-

sition into a new group [5], and may explain the peaking of

prevalence rates of bullying in all four forms during 7 th

grade

or 8 th

grade, a period of transition to middle school (Table 2).

As previous studies found a high correlation between

traditional forms of bullying and cyber bullying, some

researchers have argued that cyber bullying is a ‘‘new bottle

but old wine’’ [24]. However, our results show a quite

different role played by friends on cyber bullying compared

with three traditional forms of bullying. Unlike physical,

verbal, or relational bullying, cyber bullying was not related

to number of friends. This reflects a distinct nature of cyber

bullying compared with traditional forms of bullying.

Our results show that boys and girls are aggressive in

different ways; boys engage more in physical or verbal

bullying, whereas girls use spreading rumors and social

exclusion as bullying tactics. The gender differences in direct

and indirect forms of bullying are consistent with previous

studies [8,9].

J. Wang et al. / Journal of Adolescent Health 45 (2009) 368–375374

Age differences were consistent across the three tradi-

tional forms of bullying. Compared with 6 th

graders, 7 th

/8 th

grades were less likely to be victims in all three traditional

forms. Adolescents in 9 th

/10 th

grades reported lower frequen-

cies of physical bullying and also less physical, verbal, and

relational victimization. Cyber bullying did not vary by

grade, with the only exception being that the proportion of

bullies was lower for 9 th

/10 th

graders than 6 th

graders.

The racial differences in the three traditional forms of

bullying were similar to previous studies [6]. We found

that African-American adolescents were more likely to be

bullies but less likely to be victims. Hispanic adolescents

were more involved in physical bullying. Our results show

that higher SES may protect adolescents from victimization

physically, but increased the risk of involvement in both

bullying and victimization electronically. This is likely due

to greater availability of computers and cell phones for

adolescents from wealthier families.

There were several limitations to this study. First, the

cross-sectional nature of the survey limits the ability to

make causal conclusions. Longitudinal studies are needed

to confirm the predictive effects of parental support and

number of friends on bullying. Second, all data were student

self-report. Testing information from multiple sources is rec-

ommended for future studies. Third, we used a cutoff point

for the variables of bullying and victimization and did not

examine the frequency of involvement in both behaviors.

However, the lower frequency of cyber bullying suggested

dichotomous classifications as the most useful categoriza-

tion. And this categorization allows us to further obtain

four distinct groups: bullies, victims, bully-victims, and

noninvolved. Last, we did not examine the association

between cyber bullying and the traditional forms of bullying.

Future studies are recommended on the relationship between

cyber bullying and traditional bullying.

Nonetheless, this study extends the previous literature in

at least four ways. First, we assessed cyber bullying among

US adolescents using the same format as in the revised

Olweus Bully/Victim Questionnaire, which has been used

internationally to measure the traditional forms of bullying

[20]. Even though the two items did not assess every mode

of cyber bullying behavior, we included the two major elec-

tronic devices: computers and cell phones. Using equivalent

time frame and response categories as the other bullying

forms allowed us to make comparisons between cyber

bullying and traditional forms of bullying. In a review on cy-

ber bullying [21], a wide variation in the prevalence was

observed in studies conducted in four different courtiers

including the United States. For example, from findings of

five studies conducted in the United States the prevalence

rates of cyber bullying ranged from 6% to 42%. One of the

reasons for the wide variation is the lack of a standard assess-

ment format. Second, we examined the prevalence rates and

correlates for four different forms of bullying behaviors:

physical, verbal, relational, and cyber. Our results suggest

the distinct natures of the four forms, especially between

the cyber form and the other three traditional forms, in terms

of their relations with other variables. Third, we examined the

co-occurrence of bullying and victimization within the same

person. It is important to identify bully-victims as a distinct

group; for example, only bully-victims showed gender differ-

ences in the verbal form of bullying. And last, we used

a large-scale nationally representative sample with sufficient

representation from multiple age and racial groups. In

conclusion, our results confirmed the important roles of

parental support and number of friends, and suggest that

demographic characteristic as well as different forms of

bullying should be considered when examining or planning

interventions on adolescent bullying.

Acknowledgments

This research was supported by the Intramural Research

Program of the Eunice Kennedy Shriver National Institute

of Child Health and Human Development and the Maternal

and Child Health Bureau of the Health Resources and

Services Administration.

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