Bullying perspectives among rural youth: a mixed methods approach

full article:

Introduction

There is a need for public health measures to curtail violence among youth; generating information about such violence is vital to understanding the phenomenon, and to creating anti-violence programs¹. This article focuses on the findings related to bullying from a mixed method study that addressed the meaning and perceptions of violence among rural youth in Alberta, Canada^2-4. In general, research on violence in rural settings is limited and, hence, the study described here provided a unique opportunity for rural youth to share their perceptions about a topic that has the potential to impact their daily lives. The findings emphasize a need for an action plan based upon a clear understanding of the youths' perceptions and experiences of bullying.

The definition of rural and small town for this study consists of residents in communities with a population of less than 10 000, living outside the main commuting zones of larger urban centres⁵. Youth includes those individuals from 11 to 19 years of age, in grades 6-12 in the public school system. Violence was defined as: 'an act with the intention, or perceived intention, of causing physical pain or injury to another person'^{6, p15}; whereas, bullying was viewed as physical or psychological harassment⁷.

What is bullying?

The following general overview is provided to illustrate what is currently known about this topic. Research on the subject has used various definitions of bullying but a common theme is that it takes the form of harassment and/or violence. The lack of common instruments to measure and examine bullying, and the lack of consensus regarding the definition of rural makes comparison between studies difficult.

Bullying involves a power differential between the bully, and his/her victim/s. As bullies' power increases and victims' power decreases, repeated bullying serves to consolidate this power differential⁸. Bullying has also been described as a direct abuse of power that leads to feelings of isolation, insecurity and terror in victims⁹. Bullying includes a range of activities such as name calling, cruel rumors and social isolation. Exact figures on the frequency of bullying are difficult to locate but in Alberta, where the study occurred, one in 10 children have been bullied⁹.

Bullying takes many forms, but the findings about the types of bullying that occur are fairly similar across countries¹⁰. A WHO study revealed that Canadian students in grades 6, 8, and 10 reported levels of bullying that, with respect to the 36 countries surveyed, fell in the top quartile for bullying others, and in the top one-third for being victimized. This study also found, when frequent bullying and victimization (at least twice in the last 5 days) was examined, Canadian rates fell into the mid-range for bullying (17th out of 36 countries), and the top quartile for victimization (9th out of 39 countries)⁸.

In the majority of bullying incidents, other children are involved with behaviors such as joining in the bullying, observing passively, or actively intervening to stop the bullying¹¹. Recent research on bullying has challenged the assumption that bullies and victims fit into categorical, dichotomous bully or victim dyadic patterns. Bullying is more commonly being thought of as dynamic, rather than static, with levels of involvement falling somewhere on a continuum¹². This departure allows for many different roles to be held by an individual, including: bully, aggressive bully, a victim, a bully-victim, and/or a bystander. An understanding of the various roles that students play in bullying (ie bystander, enabler), acknowledges the diversity of experiences along this continuum, ultimately showing how bullying is a group phenomenon¹².

Bullying is typically done by one other child or by a very small group of peers. It is much less common for children to be bullied by large groups¹¹. It also is much more common at school¹¹ and has been found to increase during the transition from primary to middle school, helping adolescents manage peer and dominance relationships as they move into new social groups¹³.

The suggestion that students are more likely to become victims of bullying if they are overweight or have a different ethnic origin has had limited empirical support. However, a recent study has shown that overweight and obese school-aged children are more likely the victims and perpetrators of bullying behaviors than their normal-weight peers¹⁴.

In general, boys and girls report being victimized at relatively similar rates, suggesting that gender may not be a risk factor for victimization. Children with internalizing problems such as depression and anxiety are at risk for becoming victims, as are children in friendships lacking affection and emotional support⁸. In this same article, girls reported being bullied by both boys and girls, whereas boys typically are only bullied by other boys. However other studies have found either no gender difference or marginal differences based upon gender¹¹.

There are individual characteristics identified as contributing to bullying behaviors, such as anger, normative beliefs and social skills¹². Peer influences are also important factors in bullying incidents. For example, children who bully are more likely to have friends who have positive attitudes toward violence¹¹. There is also an association between familial characteristics and bullying behavior, including a lack of warmth and involvement on the part of parents¹², overly submissive parenting¹², a lack of parental supervision^12,15, and harsh, corporal discipline¹¹. In addition, young children exposed to parental violence^9,16 and child maltreatment¹¹ are more likely to bully in later childhood. Finally, neighborhood safety concerns have also been positively associated with bullying¹⁵.

Research conducted on the role of siblings in bullying found that children often bullied their siblings (40%), of this group, 30% were frequently abused by their siblings. When examining the victimization experiences more closely, 22% were often hit or pushed, 8% were often beat up, and 8% were scared they would be badly hurt. Fifty-seven percent of school bullies and 77% of school bully-victims also bullied their siblings¹².

There are numerous short- and long-term problems associated with being bullied. Short-term problems can include: depression, anxiety, loneliness, and difficulties with schoolwork; while long-term problems may include low self-esteem and depression¹¹, including suicidal ideation among victims¹⁷. Individuals who have been bullied have been found to have higher levels of depression and poorer self-esteem at age 23 years, despite the fact that they were no more harassed than comparison adults¹⁰.

There is an increased risk of numerous interpersonal problems associated with bullying. Some of the most prominent problems include: criminal activities, drug and alcohol abuse, and adult relationship problems^8,10-11. Antisocial and delinquent behaviors (ie vandalism, truancy, and frequent drug use) often continue into young adulthood with an increased likelihood of drinking, smoking, and poor school performance¹¹. When bullying occurs in adolescence, the sexual dimension in romantic relationships may also provide an outlet to exert power and control. These relationships will establish a foundation for subsequent intimate relationships, having patterns of aggressive behavior and victimization already developed. Craig and Pepler⁸ hypothesize that a proportion of young people who engaged in bullying during childhood may continue to use power and aggression in other significant relationships throughout their lifespan.

Rural bullying

There is limited research that focuses specifically on bullying within the rural context. Oliver and Hoover¹⁸ conducted a survey examining bullying among students in grades 7 to 12 in rural Ohio, Minnesota and South Dakota, USA. The survey was developed by the authors and used in previous research on the topic. Examination of six specific line items (eg 'victims of bullying bring it on themselves', 'bullies have higher status') noted that the students perceived that victims were partially to blame for being bullied and that being bullied served to make one 'tougher'.

Seven rural Illinois elementary schools were included in another American study which sought to determine the perceptions regarding bullying among students, parents and teachers¹⁹. The study provided baseline information for determining the context within schools which were to participate in a school violence intervention program. In total, 739 students in grades 4 to 6, 367 parents and 37 teachers participated by completing surveys. The students reported higher prevalence of bullying compared to the parents and teachers. In addition, bullying was associated with aggression and a positive attitude toward violence¹⁹.

Another American rural-based study found small differences in the frequency of bullying others, showing fewer suburban youth reporting participation in bullying¹⁰. There was also a 3-5% increase among rural youth who reported first-time bullying, than youth from town, suburban, and urban areas¹⁰. One other study, conducted in rural Appalachia, tried to determine the prevalence of bullying among students in grades 3 to 8²⁰. Of the 192 students who comprised the convenience sample, 158 reported experiencing some type of bullying in the 3 months prior to the survey. The authors concluded that bullying may be more prevalent in rural areas than was previously thought.

The literature discussed here indicates a gap in research on bullying within the rural context in general, and in the Canadian rural context specifically. This study was conducted in an attempt to rectify this and to provide an opportunity for rural youth to express their perceptions about violence, including bullying in their everyday worlds.

Method

A mixed method exploratory, descriptive study was conducted consisting of two phases: a qualitative phase followed by the development of a questionnaire that was administered in the subsequent quantitative phase. The overall goal of the study was to generate information about violence among youth in rural settings, in particular their perceptions and experiences of it. The second author's academic institution granted ethical approval for the study. This discussion focuses on the study findings related to bullying.

The qualitative phase has been described in depth elsewhere^2-3. In brief, research assistants (RAs) were hired and trained; subsequently they conducted semi-structured interviews with the rural youth. An interview guide was developed by the authors that included a demographic form and questions that focused on definitions of violence and their experiences with it. Participants were accessed through the local schools in two participating resource-reliant communities in two health regions in Alberta, Canada. After receiving parent and youth consents, the RAs conducted the interviews. Constant comparison was used to analyze the transcripts for common themes; all authors were involved with this process with assistance from an RA who also compiled the demographics.

The quantitative phase included the development of a survey instrument which has been described in-depth elsewhere⁴. In summary, the questionnaire included seven questions designed to gather demographic data, and 70 questions that made use of a four-point Likert scale to collect views on topics, such as what youth violence is and how and when it occurs. Descriptive statistical tests were calculated for each independent and dependent variables. The t-test was employed for a comparison of means (two-tailed significance <.05).

Specific questions related to bullying were embedded in the questionnaire. Representing a study population that differed from the qualitative phase, participants from two Alberta rural schools located in two different health regions, were randomly selected and participated in the second phase of the mixed method study. This allowed for usage of the instrument in other rural locales to determine its suitability, while generating data about violence from other geographic areas.

Limitations

Although a limitation may be the inability to compare the findings with a matched group of urban youth, it is important to generate and highlight findings specific to rural communities in order to begin to produce information about violence within this specific context. Other limitations include the self-selection of study participants in the qualitative phase, and the limited number of participating rural schools. However, the number of students included in the qualitative phase is sufficient for this study design. In addition, generalizability is not a goal of qualitative research. The sample size for the quantitative phase reached an acceptable response rate and there was no plan to generalize our findings to other rural areas. Despite these limitations, the process of conducting a mixed-method study on rural youth violence demonstrated the usefulness of addressing this poorly understood topic in rural areas. Other limitations include that definitions of bullying as presented by the youth in the open-ended questions were not always clarified and a specific definition of bullying was not included in the Rural Youth Violence Questionnaire. However, the youths' perceptions, based upon their responses to specific questions and probes, matched our working definitions which emphasized bullying as a form of violence.

Results

Qualitative Phase One

Demographics: Of the total sample of 52 youths, there were 20 males and 32 females with grade 10 as the average grade being attended by either gender. Fifty participants (96%) were Caucasian and 31/52 (60%) lived with both biological parents. The majority had siblings living in the home with them; 31 youth or 59% lived with either one or two siblings. Only 2 (4%) had lived in their respective community for less than a year; 18 (35%) had lived in their respective communities for 16-20 years. The majority of the youths lived in town (n = 38, 73%) with far fewer living on a farm (n = 8, 15%), ranch (n = 3, 6%) or acreage (n = 3, 6%).

Understanding bullying: The open-ended interviews generated a number of responses from the participants about bullying in relation to the question, 'Is violence psychological in nature?' Although bullying was perceived as a type of physical violence by the participants, it was viewed more often as psychological violence. One participant referred to bullying as 'misplaced rage' because the perpetrator had experienced such difficulties in his/her own life. One female participant commented:

Sometimes with an individual they do it [bullying] just to make themselves feel better about themselves, like they're having a bad day and they just need to feel good, or somebody's made fun of them so they go around and they pick on somebody who just doesn't deserve it, or they actually stuff them in lockers, beat them up and all.

Interviews were conducted with two girls who admitted to being bullies. For one of these girls, other students would offer to do her homework which made her feel powerful among her fellow students. Participating in violence helped the other girl to look 'tough' and 'cool', images she wanted to portray. For example, she noted that after a fight which she initiated and won, 'I would walk down the hallway and people would move out of the way, because they didn't know what I was going to do'. Other participants commented that respect was given to those who were acknowledged as 'fighters'.

Another female participant said:

I used to get picked on a lot because I was the chubbier one at lunch, and the kids used to make fun of me because I was noted as the teacher's pet, the one with the good grades, and when I started losing weight, everybody calling me and wanting me and everything, I started throwing my fists.

A male bully said:

You do get respect, you do get a reputation of being a tougher, or being a fighter, especially when you're new and you've just moved here, and your only defense is to get noticed by fighting, that's the first thing people do.

Another perspective was offered by a male participant when he commented:

Bullying other people just makes you sink even lower, like to me if a person's bullying another person, I'd say it's just not cool. But to other people, they'd say oh these bullies, he's cool.

Another viewpoint was that bullying others back allowed the individual to hide true feelings about feeling unwanted. A male youth admitted to feeling victimized and subsequently became a bully. However, at the time of the interview, this individual noted that he was no longer a bully.

Bullying was sometimes the result of peer pressure to conform to group values that focused on violence. In this way, group acceptance was ensured, as was noted in the following quote:

If there's a group of kids standing in the hallway and you're picking on someone, and if your friends don't say anything and they just stand there, then you'll quit because you just feel stupid. But if your friends are like ha ha laughing with me and they kind of go around, and you get worse and worse, and the problem gets bigger.

One other female youth supported these ideas when she said:

In a way the ones who stand by and watch are accepting it, but the ones that are participating are doing it, but the ones who are standing but are still accepting it because being silent about it is as good as accepting it, you're not standing up for anyone.

The interviews revealed that there was a hierarchy of students at their schools. This was referred to in different ways, such as the 'food chain' or the 'pecking order'. Names were given to describe the youth within these systems. For examples, 'skaters', referred to those who skateboarded and used illegal drugs while others were referred to as 'cowboys' and 'preppies'. The ordering that occurs within the groups cannot be altered and, hence, behaviors, activities and friends are pre-determined by your place within the hierarchy. For example, one female youth said:

You can't wear weird things in school ever...unless you're really at the top of the social ladder you can wear whatever you want and everybody else wants to be like you then.

In this instance, bullying helped to maintain the natural order of the groups within the school.

Bullying was perceived by the participants to be targeted toward individuals because of a specific trait they exhibited.

Hence, looking different, being perceived as homosexual, being a newcomer, or acting outside the norms of the group were all reasons cited for being a target of bullying. Bullying was also said to occur if a girl was promiscuous. In both of the participating rural communities, girls who demonstrated sexual behaviors beyond group norms were candidly criticized by the other participants.

Being bullied: Being bullied was humiliating; those participants who had been bullied noted its negative affect on their physical health and self-esteem. One male youth said: 'It's not good to be bullied, it brings you down, it's real negative'. One other male participant who was still being bullied at the time of the interviews stated: 'It [bullying] makes me feel like a pile of garbage, that people can just throw around!' Other participants noted that it was hard to concentrate on their school work when they were being bullied. In one of the communities, a female student had committed suicide due to the bullying she experienced from her classmates.

Those who were bullied were more often seen as victims, as indicated by one female youth who said:

Being poor or not, someone who is not as fortunate looking as others, but it is just something you can't control, yet you get bugged a lot. There's a lot of kids who can't afford as nice of clothes as the other kids, and they'll get bugged about it, or people who look different, they'll get bugged about it.

The youth who were interviewed talked about being the 'new kid' and that they were excluded from extracurricular activities. Individuals who were of a particular ethnic background (Aboriginal or Black) were also identified by the participants as being targets for being bullied. One participant freely provided advice about how to blend in to the school environment so that bullying could be avoided; his experiences were based on being bullied for wearing glasses but being defended by an older brother and his friends. One participant commented that sometimes individuals identify themselves as easy targets to be bullied. Finally, the participants noted that bullying was a learned behavior from one's parents who often were bullies themselves when they were young.

Quantitative Phase Two

Survey demographics: The combined student population in grades 6 to 12 at both participating schools was 259 students; a total of 180 students completed the surveys. There were two incomplete surveys resulting in a 69% response rate (n = 178). The youth involved in the survey were 12 to 20 years of age with a mean age of 16 years; the majority (62%, n = 110) were in grade 10. Sixty percent (n = 107) of the respondents were female and 40% (n = 71) were male. Seventy-three percent (n = 130) of males and females lived with both parents. Respondents were asked to identify from a minimum of zero to a maximum of four siblings. The highest percentage of youth (n = 68, 38%) had one sibling. Only 10% (n = 18) of the sample reported that they were part of a minority group. Sixty-four percent (n = 114) had lived in their rural communities for 11 to 20 years inclusive.

Understanding bullying

The Rural Youth Violence Questionnaire addressed violence in general and included specific items that focused on bullying. Therefore, the discussion presented here focuses on the findings related to the following specific items from the questionnaire:

• 'Bullying gives youth power over others'.
  
• 'Youth who are different are often targets of bullying'.
  
• 'Females tend to be bullied due to sexual behaviors'.
  
• 'Please indicate how often each of the following is a factor in youth being targeted for violence: skin color, the way youth speak, the way youth dress, hair style, the groups youth associate with'.

Examining frequencies related to the above statements generated the following findings. Fifty-two percent (n = 93) of the participants agreed that bullying gives youth power over others. The majority of the participants (88.2%, n = 156) agreed that youth who are different are targets of bullying. In addition, 69.3% (n = 122) agreed that female students were bullied due to sexual behaviors. The participants were also asked to respond to possible specific factors that identify students as targets of violence, not just bullying, by choosing often, sometimes, rarely or never. 'Never' was chosen as a response by 45 participants (25.4%) identifying skin color, 20 participants (11.2%) identifying the way youth speak as a target, and 13 (7.3%) identifying the way youth dress, as reasons for youth becoming targets of violence. However, 84 (47.5%) chose 'often' when identifying the groups youth associate with, and 42 (23.7%) chose hair style as reasons for youth being targets of violence.

Youth who had zero siblings or only one sibling were more likely to believe that youth who are 'different' are often the targets of bullying than were youth who had two or more siblings (t = 2.124, p < .036). When examining the factors related to youth being targeted for violence, only one significant difference among groups was found. Youth with one or more siblings were more likely to agree that the way youth speak is often a factor in being targeted for violence, than were youth with no siblings (t = -2.054, p <0.05).

The responses to the open-ended questions in the survey provided an opportunity for the students to express their views on violence in general; a number of the comments related to bullying specifically. One youth wrote, 'Now kids are bullied and picked on for so long that one day they just lose it and end up hurting themselves or another resulting in death'. Another said:

I think the biggest concern is the taunting and teasing. Actual physical violence happens a lot less than verbal violence. If you fight [physically] you might get beaten up but it is over after that. Walking down the hallway being called names is a lot harder to put up with.

Some of the respondents expressed concern that they themselves might even become a bully; one respondent said that he/she may 'become part of it and be seriously injured or lose track of my goals in life'.

Victims of bullying were described as '...too shy or scared to seek help' and that it is up to others to '...provide help for them...' recognizing that '...they will not tell us' about the bullying. 'This is why students who view bullying must tell'.

Personal safety emerged as a major theme with particular emphasis related to the fear of friends or the participants dying due to violence. These young people, particularly the females, are concerned that experiencing violence, such as bullying, could push a person to consider suicide. Other students who responded said that there is the need for 'student bullying committees, youth mediation, meeting with parents, and a celebration of difference among people as opposed to targeting them for violence.'

Discussion

Conducting a mixed-method descriptive, exploratory study on rural youth violence provided an opportunity to begin to examine violence in rural communities in selected areas of a Western Canadian province. Participation in the study allowed rural youth to express their ideas, perceptions and experiences about violence, including bullying. What they shared is valuable for parents, counselors and teachers in rural areas as they struggle with effective means to address bullying and its aftermath. Future research on bullying that examines both urban and rural contexts and the nature and influence of the various systems (ie family, peer group, school) that affect students' bullying behavior¹² would be useful pursuits. The survey instrument developed in this study needs to be tested in other rural contexts to assess its reliability and validity.

Integrating the data from the qualitative and quantitative phases helps us understand more fully the notion of bullying in the rural context. The findings from both phases of the study support the notion that bullying is about power⁸ and that schools are prime areas where bullying occurs¹¹. The qualitative comments illustrate how power was gained by individuals who were bullies. In the survey, the frequency responses to the statements about factors that impact bullying revealed that just over half of the respondents (52%, n = 93) agreed that bullying gives youth power, implying perceived inequality among youth.

Although only one finding was statistically significant (ie the way youth speak can lead to being bullied), the frequency responses support that youth who are different (88.2%, n = 157) are perceived to be targets of bullying. Almost half of the sample (47.5%, n = 85) identified that youth who were targets of violence, not just bullying, belonged to particular social groups. Other factors, such as skin color or the way youth speak, were not identified as a reason for being a target of violence. Furthermore, in the qualitative phase, one of the female bullies noted that she had been bullied when she was overweight and became a bully after losing weight.

The findings negate the myth that rural areas are ideal places to raise children, in part because everyone 'knows everyone' and gets along with each other. The reality is that rural areas can be stratified by group with specific membership that excludes individuals²¹. Furthermore, networks within rural communities sometimes prevent members from attending to issues. A case in point is the extensive review of fatal school shootings in both Canada and the United States that concluded that social networks in rural communities actually hampered attending to the issues of bullying²². Although our study did not address shootings, the literature on this topic supports the notion that there are pecking orders among youth, and communities as a whole. Unequivocally, our study findings support the need to listen closely to the narratives that youth share, stories that provide a glimpse into the sometimes 'dark side' of their world.

In addition, the findings from our study reinforce the need for schools to continue to implement a curriculum that helps youth accept diversity among their peers. However, implementing this curriculum in isolation from community involvement and commitment will decrease its effectiveness. Therefore, we recommend working with youth, parents and community residents to develop and implement programs that celebrate diversity in rural communities.

In the qualitative phase, behavior demonstrating sexual activity among female youth that was beyond defined group norms was noted by the respondents as significant for being bullied. More specifically, the youth talked about female students who acted outside the peer norms of expected sexual behavior and these actions resulting in increased bullying. In the survey, the frequency responses showed that a greater proportion of youth (69.3%) believed female students who engaged in sexual behaviors outside the social norms were bullied more often. Awareness of this perception is important for school counselors when they interact with youth and assess bullying incidents. Simultaneously, it would be prudent to examine anti-bullying policies in school systems to determine their effectiveness in dealing with bullying.

The Qualitative Phase One interviews and Quantitative Phase Two open-ended comments clearly illustrate the experiences and impacts of bullying. Students who were bullied talked about the damage this caused to their self-esteem. They also talked about the need to do 'something' even though they do not approach the professionals within their communities. Incorporating community development strategies would be an effective way to address bullying in rural communities. Despite the caution from Newman et al²², there are many positive aspects of rural communities that can be built upon to deal with the serious issue of bullying. The history of rural communities that brings members together, the extensiveness of social relationships and commitment to helping one another out during times of need are all aspects that can be used to address bullying. The challenge is for people to listen, understand and set goals for action plans.

Conclusion

In conclusion, rural communities will benefit as a whole if bullying, an important societal concern, is addressed. Building on the social structure of rural communities is a first step, but listening to rural youth is the key if true change is to be implemented. Replicating studies on rural youth violence using the survey instrument described here will assess the reliability and validity of the instrument, while simultaneously generating further data on this important topic.

Acknowledgements

The authors acknowledge the funding provided by the Alberta Heritage Foundation for Medical Research. Heartfelt thanks are extended to the research assistants who conducted the interviews: Tanya Hossli, Lindsay Hampton and Paul Armstrong; to the transcriber Tina MacQuarrie, who prepared the transcripts; to the CIHR Health Professional Student Research Award Recipient Deana Nachachewsky, who assisted with literature reviews and web searches; graduate research assistant Lesley Masuk, who assisted with data analysis; Peter Gabor who provided statistical consultation; and Lana Gabor who was the input data coordinator. The cooperation and assistance of the school staff and other community agencies in the four participating communities is much appreciated and noted as being instrumental in successfully conducting this study. Last, but not least, the participation of the youth who were interviewed for the study was greatly appreciated because without their willingness to share their ideas, the study would not have been completed. A Senior Faculty Release Time Support Award to the first author from the Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan provided the time needed to prepare this article.

References

1. Kulig J, Nahachewsky D, Hall B, Grant Kalischuk R. Rural youth violence: it is a public health concern! The Canadian Journal of Public Health 2005; 96: 357-359.

2. Kulig J, Hall B, Grant Kalischuk R. Violence among rural youth: a focus on health interim report: phase I. Lethbridge, AB: University of Lethbridge, 2003.

3. Kulig J, Hall B, Grant Kalischuk R. Violence in rural communities: youth speak out! Rural and Remote Health 6: 500. (Online) 2006. Available: http://www.rrh.au.org (Accessed 30 June 2006).

4. Hall B, Kulig J, Grant Kalischuk R. Rural youth violence: a focus on health phase II. Lethbridge, AB: University of Lethbridge, 2006.

5. duPlesis V, Beshiri R, Bollman R, Clemenson H. Definitions of rural. Rural and small town analysis bulletin, Statistics Canada 21006-XIE. 2001; 3: 1-17.

6. Strauss M, Gelles R. How violent are American families? Estimates from the National Family Violence Resurvey and other studies. In: GT Hotaling, D Finkelhor, JTMA Kirkpatrick, MA Strauss (Eds). Family abuse and its consequences: new directions in research. Newbury, CA: Sage, 1988.

7. Arbor A. What do kids say about bullying? The Education Digest1993; 58: 16-23.

8. Craig W, Pepler D. Identifying and targeting risk for involvement in bullying and victimization. Canadian Journal of Psychiatry 2003; 48: 577-582.

9. Alberta Government. Alberta roundtable on family violence and bullying fact sheet. (Online) 2005. Available: http://www.familyviolenceroundtable.gov.ab.ca/pdf/fact_sheet.pdf (Accessed 5 January 2006).

10. Nansel T, Overpeck M, Pilla R, Ruan W, Simons-Morton B, Scheidt P. Bullying behaviors among US youth: prevalence and association with psychosocial adjustment. JAMA 2001; 16: 2094-2100.

11. Limber S. Addressing youth bullying behaviors. In, Proceedings of the American Medical Association Educational Forum on Adolescent Health: Youth Bullying. 2 May 2002; Chicago, IL: American Medical Association, 2002.

12. Espelage D, Swearer S. Research on school bullying and victimization: what have we learned and where do we go from here? School Psychology Review 2003; 32: 365-383.

13. Pellegrini A, Long D. A longitudinal study of bullying, dominance, and victimization during the transition from primary school through secondary school. British Journal of Developmental Psychology 2002; 20: 259-280.

14. Janssen I, Craig W, Boyce W, Pickett W. Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics 2004; 113: 1187-1194.

15. Espelage D, Bosworth K, Simon T. Examining the social context of bullying behaviors in early adolescence. Journal of Counseling & Development 2000; 78: 326-334.

16. Baldry A. Bullying in school and exposure to domestic violence. Child Abuse & Neglect 2003; 27: 713-733.

17. Lipman E. Don't let anyone bully you into thinking bullying is not important! Canadian Journal of Psychiatry 2003; 48: 575-577.

18. Oliver R, Hoover J. The perceived roles of bullying in small-town Midwestern schools. Journal of Counseling & Development 1994; 72: 416-421.

19. Stockdale M. Hangaduambo S, Duys D, Larson K, Sarvela P. Rural elementary students', patients' and teachers' perceptions of bullying. American Journal of Health Behavior 2002; 26: 266-278.

20. Dulmus C, Theriot M, Sowers K, Blackburn J. Student reports of peer bullying victimization in a rural school. Stress, Trauma & Crisis: An International Journal 2004; 7: 1-16.

21. Struthers C. Bokemeier J. Myths and realities of raising children and creating family life in a rural county. Journal of Family Issues 2000; 21: 17-46.

22. Newman K, Fox C, Harding D, Mehta J, Roth W. Rampage: the social roots of school shootings. New York: Basic Books, 2005.