Violent behavior is a significant public health problem worldwide, and data suggest that adolescents in different countries may have similar frequencies of violence-related behaviors including fighting, according to an article in the June issue of the Archives of Pediatrics & Adolescent Medicine. The researchers noted that violence-related deaths among US youths seem to be increasing.

In the current study, Eleanor Smith-Khuri, MD, and colleagues compared the frequency of violent behaviors among adolescents in five countries based on information from the World Health Organization's cross-national study of Health Behaviour in School-aged Children (HBSC), which surveyed health risk behaviors and lifestyles in young adolescents in developed countries. The survey data were obtained from adolescents aged 11.5, 13.5, and 15.5 years living in Ireland, Israel, Portugal, Sweden, and the United States during the 1997-1998 academic year. The survey was administered to 10,610 boys and 11,530 girls.

The researchers found that though the majority of adolescents did not fight or carry weapons, the reported frequency of fighting (average, approximately 40 percent), weapon carrying (average, approximately 10 percent) and fighting injuries (average, approximately 15 percent) were similar among youths from all five countries. However, bullying frequency varied widely between countries, ranging from 14.8 percent in Sweden to 42.9 percent in Israel for adolescents who bullied once or more per school term.

The researchers wrote, "These violence-related behaviors often occurred together in adolescents cross-nationally. A large proportion of adolescents who fought also bullied and vice versa; the percentages of those both bullying and fighting were 29.5 percent in Israel, 22.1 percent in the United States, 17.8 percent in Portugal, and 15.9 percent in Ireland. This percentage dropped to 9.8 percent in Sweden, but this value was still relatively high considering that only 14.8 percent of Swedish youths engaged in any bullying at all."

The researchers concluded that "Engaging in at least an occasional fight was so frequent, particularly in boys but also in girls, and was so consistent across countries that it might not be considered abnormal or alarming. In contrast, frequent fighting and frequent bullying were relatively rare behaviors, as were fighting injuries or weapon carrying at any frequency. We found that adolescents who fight are more likely to be boys in a lower grade (6th grade vs. 10th) who currently smoke, have been drunk, and dislike school. We also observed that adolescents who engage in fighting are more likely to manifest the characteristics of frequently feeling irritable or bad tempered and having been bullied. "

In an accompanying editorial, James A. Mercy, Ph.D., and Linda L. Dahlberg, Ph.D., of the Centers for Disease Control and Prevention, Atlanta, wrote that if youth violence is the same everywhere in the world, "then perhaps standard approaches to prevention can be applied that address violence as a universal function of the developmental process. If not, then prevention programs may have to be tailored to the specific etiological and cultural context in which such violence occurs."

"Within a global context, however, these countries [the countries studied by Smith-Khuri et al] represent a limited range of economic, social, and cultural experience. A more definitive understanding of similarities and differences in the epidemiology of adolescent violence must be informed by both cross-sectional and longitudinal comparisons among countries with a broader range of economic, social, and cultural characteristics," the editorialists added.