title: Perspectives on bullying among children who present to the emergency department with behavioral misconduct: a qualitative study.
abstract: The problem of bullying is an increasing public health threat encountered by emergency physicians especially in inner city emergency departments (EDs). Bullying may result in emotional disturbances and psychological trauma in children. Many children sent to the ED because of behavioral misconduct require immediate stabilization and treatment. The emergency physician performs an initial assessment and stabilization. Emergency departments are increasingly on the frontline of the bullying problem.
  
  
  OBJECTIVE
  Our objective was to explore children's perspective of bullying and their views of potential solutions.
  
  
  METHODS
  A qualitative study was conducted in a cohort of 50 children (age, 8-17 years), who were referred to the ED from school because of their behavioral misconduct. An interview survey tool about bullying was administered. It focused on what bullying meant to them and what advice they have for a child who is bullied. They were also asked what advice they would have for adults who try to help. We used grounded theory to analyze the data. Similar concepts were grouped, and the categories with similar properties and dimensions were defined. Common themes were then identified.
  
  
  RESULTS
  We interviewed 50 children, of whom 27 were boys and 23 were girls. Their mean (SD) age was 12.5 (2.12) years (range, 8-17 years). Bullying was identified by children as including physical, verbal, and emotional actions. Several themes emerged. First, a power imbalance between a bully and victim may render an individual vulnerable to bullying. Being different and weak also increases the risk of being bullied. Second, bullying is wrong, and the bully should be punished. Third, children should learn how to handle bullying situations and develop resilience against bullying. Finally, adults need to be more proactive to prevent or stop bullying.
  
  
  CONCLUSIONS
  Our results provide insights into the perceptions of children regarding bullying. We have garnered a better understanding of what these children feel adults should do to prevent bullying.
authors.affiliation: From the *Department of Pediatrics and Emergency Medicine, Lincoln Medical and Mental Health Center, Bronx, New York; †Department of Pediatrics and Emergency Medicine, St George's Medical School, Grenada, West Indies; ‡Division of Clinical Epidemiology and Evaluative Sciences Research, Center for Integrative Medicine, Weill Cornell Medical College, Manhattan; and §Hospital for Special Surgery, Education and Academic Affairs, New York, NY.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Waseem
authors.forename: Carla
authors.initials: C
authors.lastname: Boutin-Foster
authors.forename: Laura
authors.initials: L
authors.lastname: Robbins
authors.forename: Rita
authors.initials: R
authors.lastname: Gonzalez
authors.forename: Steven
authors.initials: S
authors.lastname: Vargas
authors.forename: Janey C
authors.initials: JC
authors.lastname: Peterson
mesh_terms: D000293:Adolescent; D001290:Attitude; D058445:Bullying; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000523:psychology*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D036301:Qualitative Research; D011795:Surveys and Questionnaires