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This study examined associations between two forms of peer victimization, physical and relational, and externalizing behaviors including drug use, aggression, and delinquent behaviors among a sample of 276 predominantly African American eighth graders attending middle school in an urban public school system. Regression analyses indicated that physical victimization was significantly related to cigarette and alcohol use but not to advanced alcohol and marijuana use; relational victimization contributed uniquely to all categories of drug use after controlling for physical victimization. Physical victimization was also significantly related to physical and relational aggression and delinquent behaviors, and relational victimization made a unique contribution in the concurrent prediction of these behaviors. Physical victimization was more strongly related to both categories of alcohol use, aggression, and to delinquent behaviors among boys than among girls. In contrast, relational victimization was more strongly related to physical aggression and marijuana use among girls than among boys, but more strongly related to relational aggression among boys than among girls. These findings provide information about the generalizability of prior research and have important implications for intervention efforts.This research was supported by Cooperative Agreement U81/CCU309966 from the Centers for Disease Control and Prevention (CDC). The research and interpretations reported herein are the sole responsibility of the authors and are not necessarily endorsed by the CDC or represent the views, opinions, or policies of the CDC or its staff.

Although peers are a major influence during adolescence, the relative importance of specific mechanisms of peer influence on the development of problem behavior is not well understood. This study investigated five domains of peer influence and their relationships to adolescents’ problem and prosocial behaviors. Self-report and teacher ratings were obtained for 1787 (53 % female) urban middle school students. Peer pressure for fighting and friends’ delinquent behavior were uniquely associated with aggression, drug use and delinquent behavior. Friends’ prosocial behavior was uniquely associated with prosocial behavior. Friends’ support for fighting and friends’ support for nonviolence were not as clearly related to behavior. Findings were generally consistent across gender. This study highlights the importance of studying multiple aspects of peer influences on adolescents’ behavior.

This study investigated reciprocal relations between adolescents' physical aggression and their perceptions of peers' deviant behaviors and attitudes. Analyses were conducted on four waves of data from 2,290 adolescents (ages 10–16) from three urban middle schools. Autoregression models revealed reciprocal relations between peer factors (i.e., friends' problem behavior, peer pressure for fighting, friends' support for fighting) and adolescents' reporting of their aggressive behavior. Bidirectional relations were also found between peer pressure for fighting and adolescents' frequency of physical aggression based on teacher ratings. Findings were consistent across sex, grade, and time. Findings suggest that multiple dimensions of peers' behaviors uniquely play a role in the development of adolescents' aggression and have important implications for interventions to reduce problem behaviors.

Objectives. To examine social-ecological correlates of firearm-related violence involvement among adults. Methods. Cross-sectional surveys were collected in the United States between August 2023 and September 2023 through an AmeriSpeak Panel (n = 1681), weighted to be nationally representative. Measures included self-reported involvement in firearm-related violence victimization and perpetration and hypothesized social-ecological risk factors. Results. About 5.9% reported ever perpetrating firearm-related violence; 6.9% reported experiencing firearm-related victimization. In a fully adjusted model, factors associated with perpetration were greater traumatic stress symptoms, beliefs about gun use to enforce respect, positive attitudes about firearms, and firearm-related victimization. Factors associated with victimization were adverse childhood experiences, family and friends’ histories of violence and suicide, traumatic stress symptoms, witnessing community violence, firearm-related perpetration, male sex, and lower income. Conclusions. A range of factors across social-ecological domains were associated with firearm-related violence, emphasizing the need for a contextualized approach to understand firearm-related injuries and deaths. Posttraumatic stress and exposure to violence may be particularly important to understanding the cycle of firearm violence. Intervention strategies should be expanded to include individuals vicariously exposed to violence, not just those directly victimized. ( Am J Public Health. 2025;115(11):1903–1912. https://doi.org/10.2105/AJPH.2025.308213 )

Although there is strong evidence supporting the association between childhood adversity and symptomatology during adolescence, the extent to which adolescents present with distinct patterns of co-occurring post-traumatic stress (PTS) and externalizing symptoms remains unclear. Additionally, prior research suggests that experiencing nonviolent, negative life events may be more salient risk factors for developing some forms of psychopathology than exposure to violence. The current study used latent profile analysis to identify subgroups of early adolescents with distinct patterns of PTS, physical aggression, delinquency, and substance use, and examined subgroup differences in exposure to three forms of violent and nonviolent childhood adversity. Participants were a predominantly low-income, African American sample of 2,722 urban middle school students (M age = 12.9, 51% female). We identified four symptom profiles: low symptoms (83%), some externalizing (8%), high PTS (6%), and co-occurring PTS and externalizing symptoms (3%). A higher frequency of witnessing violence was associated with increased odds of membership in subgroups with externalizing symptoms, whereas a higher frequency of nonviolent, negative life events was associated with increased odds of membership in subgroups with PTS symptoms. Interventions aimed to address childhood adversity may be most effective when modules addressing both PTS and externalizing symptoms are incorporated.

Although there is empirical evidence supporting associations between exposure to violence and engaging in physically aggressive behavior during adolescence, there is limited longitudinal research to determine the extent to which exposure to violence is a cause or a consequence of physical aggression, and most studies have not addressed the influence of other negative life events experienced by adolescents. This study examined bidirectional relations between physical aggression, two forms of exposure to violence—witnessing violence and victimization, and other negative life events. Participants were a sample of 2568 adolescents attending three urban public middle schools who completed measures of each construct every 3 months during middle school. Their mean age was 12.76 (SD = 0.98); 52% were female. The majority were African American (89%); 17% were Hispanic or Latino/a. Cross-lagged regression analyses across four waves of data collected within the same grade revealed bidirectional relations between witnessing violence and physical aggression, and between witnessing violence and negative life events. Although physical aggression predicted subsequent changes in victimization, victimization predicted changes in physical aggression only when witnessing violence was not taken into account. Findings were consistent across sex and grades. Overall, these findings highlight the need for interventions that break the connection between exposure to violence and aggression during adolescence.

We evaluated the impact of the Olweus Bullying Prevention Program (OBPP) in an 8-year study in urban middle schools that served primarily African American students living in low-income areas. Participants included 2755 students and 242 teachers. We evaluated the OBPP with a multiple-baseline experimental design where the order and intervention start time was randomly assigned for each school. We assessed the frequency of bullying behaviors and experiences including physical, relational, and verbal aggression and victimization using teacher ratings of student behavior and student-reported data, as well as cyber aggression and victimization and school climate measures using student-reported data. For teacher ratings of student behavior, we found significant main effects across all subtypes of aggression and victimization, with some variability in the timing of effects. The pattern of findings showed delayed intervention effects for boys and a weaker impact of the OBPP on 6th graders. We found main effects for student-reported cyber aggression and victimization, relational aggression, and a composite of physical, verbal, and relational victimization. Decreases in victimization emerged in the 1st or 2nd year of intervention, and reductions in aggression emerged during the 3rd year. Across all findings, once intervention effects emerged, they remained significant in subsequent intervention years. The OBPP resulted in significant decreases in student- and teacher-reported aggression and victimization. However, this intervention had limited impact on general areas of school climate including teacher support, positive peer interactions, and school safety. Overall, the findings offer important prevention and research implications.

This study evaluated the Olweus Bully Prevention Program (OBPP) in urban middle schools serving a mostly African American student population. Participants were 1791 students from three communities with high rates of crime and poverty. We evaluated the impact of the OBPP using a multiple-baseline experimental design in which we randomized the order and timing of intervention activities across three schools. We assessed the frequency of violence and victimization using self-report and teachers’ ratings of students collected every 3 months over 5 years. Initiation of the OBPP was associated with reductions in teachers’ ratings of students’ frequency of aggression, with effects emerging in different years of implementation for different forms of aggression. Whereas reductions in teachers’ ratings of students’ verbal and relational aggression and victimization were evident during the second implementation year, reductions in physical aggression did not appear until the third year. Effects were consistent across gender and schools, with variability across grades for relational and verbal aggression and victimization. In contrast, there were no intervention effects on students’ reports of their behavior. Positive outcomes for teachers’, but not students’ ratings, suggest the intervention’s effects may have been limited to the school context. Variation in when effects emerged across outcomes suggests that changes in physical aggression may require more sustained intervention efforts. The intervention was also associated with increases in teachers’ concerns about school safety problems, which may indicate that teachers were more attuned to recognizing problem behaviors following exposure to the OBPP.

A clearer understanding of the promotive factors that reduce adolescents’ involvement in aggression and the protective factors that mitigate the influence of risk factors that emerge during adolescence is needed to inform prevention efforts. This study examined the promotive and protective influences of family factors on physical aggression using data collected from aggressive and socially-influential adolescents ( N  = 537; 35 % female) at the beginning of sixth grade and at three subsequent waves across the following 3 years. Family characteristics (i.e., better family functioning, higher perceived parental support for nonviolence, and lower parental support for fighting) at the start of the sixth grade exerted promotive effects that reduced levels of aggression at subsequent waves. Some support was also found for protective influences. A foundation of good family functioning at the start of sixth grade buffered adolescents from the risks from delinquent peers, from the spring of sixth grade to the spring of seventh grade. Low parental support for fighting reduced risks associated with witnessing community violence, from the fall to the spring of sixth grade, but at low levels of risk only. These findings suggest that interventions targeting high-risk adolescents might benefit by enhancing both promotive and protective family factors.

Violence disproportionately impacts Black American youth, representing a major health disparity. Addressing the possible root causes of structural inequities to reduce violence may increase the impact of prevention strategies. However, efforts to evaluate the impact of such interventions pose numerous methodological challenges, particularly around selecting an effective evaluation design to detect change at the community level, with adequate power and sampling, and appropriate constructs and measurement strategies. We propose a multiple baseline experimental design to evaluate the impact of a community-level youth violence and suicidality prevention strategy. A multiple baseline experimental design with multiple community units balances the need for scientific rigor with practical and values-based considerations. It includes randomization and plausible counterfactuals without requiring large samples or placing some communities in the position of not receiving the intervention. Considerations related to the conceptualization of the logic model, mechanisms of change, and health disparity outcomes informed the development of the measurement strategy. The strengths and weaknesses of a multiple baseline experimental design are discussed in comparison to versions of randomized clinical trials. Future health disparity intervention evaluation research will benefit from (1) building a shared sense of urgent public need to promote health; (2) respecting the validity of values- and partnership-based decision-making; and (3) promoting community-based and systems-level partnerships in scientific grant funding. The described study has been registered prospectively at clinicaltrials.gov, Protocol Record 21–454.