Bullying: An Unexamined Cause of Assault-related Emergency Department Visits for Urban Adolescents

This study aims to understand the prevalence of bullying in as well as the attributes and characteristics of injuries resulting from bullying treated in the emergency department (ED). Data come from 188 adolescents (ages 10–15) who were treated for a peer-related assault-injury in two United States urban EDs. Descriptive statistics were used to understand differences between bullied and non-bullied adolescents. A receiver operating curve (ROC) analysis was used to evaluate a possible risk index. Forty percent of adolescents identified that the incident was a result of bullying. Bullied youth reported significantly more previous bullying victimization and post-traumatic stress symptoms, but less aggression and rule breaking. A group fight, the fight involving a discordant gender, perceiving oneself as a victim, feeling that the person(s) meant to hurt them, and reporting that the fight was not resolved were significantly associated with an injury as the result of bullying. Situational characteristics such as the fight occurring in school and not arriving to the ED in an ambulance also were associated with an increased likelihood of a bullying situation. Having greater than three of these risk factors correctly identified 88% of youth who attributed the situation to bullying. Taking into account the characteristics of the assault and asking about the adolescent’s attributions of the incident can help identify patients and facilitate tailoring of appropriate intervention by social workers and other ED providers. ClinicalTrials.gov ID: NCT01770873.