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Association Between Mental Health Disorders and Bullying In the United States Among Children Aged 6 to 17 Years

Monday, October 22, 2012: 2:15 PM
Versailles Ballroom (Hilton Riverside)
Frances G. Turcotte Benedict, MD, Public Health Program and Department of Pediatric Emergency Medicine, Brown University, Providence, RI

Purpose: Bullying is a widespread form of youth violence and a major public health problem that has an immense impact on children's mental health. However, few studies have investigated the mental health status of those who do the bullying. The objective of this study was to examine the association between mental health disorders and being identified as a bully among children between the ages of 6 and 17 years.

Methods: Data from the 2007 National Survey of Children's Health (NSCH) was examined. Survey respondents were the parent or guardian who knew the most about the health of the selected child. A total of 63, 997 children had data for both mental health and bullying status. Bivariate analysis and logistic regression was performed to assess the association between mental health status and being identified as a bully. A sub-analysis by type of mental health disorder and bullying status was also performed.

Results: In 2007, 15.2% of US children between the ages of 6 and 17 years were identified as bullies by their parent or guardian. Adjusting for potential confounders, children with mental health disorders are three times more likely to be identified as a bully compared to those with no mental health disorders. The diagnosis of oppositional defiance disorder (ODD) alone is associated with a six fold higher odds of being identified as a bully (Table 2).

Conclusion: The diagnosis of a mental health disorder is a major risk factor for being identified as a bully regardless of the type of mental health disorder. The diagnosis of ODD in particular places a child at even greater odds of being identified as a bully. This finding emphasizes the importance of providing psychological support to not only victims of bullying but bullies as well. Understanding the risk profile of childhood bullies is essential in gaining a better understanding of this public health problem and in creating useful and appropriate resources and interventions to decrease bullying.

Crude and Adjusted Odds for bullying among children between ages 6 and 17 years

Crude OR

(95% CI)

Adjusted OR *

(95% CI)

No Mental Health Disorder

Mental Health Disorder


3.00 (2.63-3.42)


2.96 (2.60-3.37)

No Depression



3.52 (2.87- 4.31)


3.31 (2.70- 4.07)

No Anxiety



2.96 (2.45- 3.59)


2.89 (2.41-3.46)




2.80 (2.41- 3.25)






7.28 (6.08- 8.73)


6.02 (5.03-7.21)

* Adjusted for gender, age, race, ethnicity, neighborhood safety, and parent-child communication