title: Frequency of Aggressive Behaviors in a Nationally Representative Sample of Iranian Children and Adolescents: The CASPIAN-IV Study.
abstract: BACKGROUND
  This study aims to explore the frequency of aggressive behaviors among a nationally representative sample of Iranian children and adolescents.
  
  
  METHODS
  This nationwide study was performed on a multi-stage sample of 6-18 years students, living in 30 provinces in Iran. Students were asked to confidentially report the frequency of aggressive behaviors including physical fighting, bullying and being bullied in the previous 12 months, using the questionnaire of the World Health Organization Global School Health Survey.
  
  
  RESULTS
  In this cross-sectional study, 13,486 students completed the study (90.6% participation rate); they consisted of 49.2% girls and 75.6% urban residents. The mean age of participants was 12.47 years (95% confidence interval: 12.29, 12.65). In total, physical fight was more prevalent among boys than girls (48% vs. 31%, P < 0.001). Higher rates of involvement in two other behaviors namely being bullied and bulling to other classmates had a higher frequency among boys compared to girls (29% vs. 25%, P < 0.001 for being bullied) and (20% vs. 14%, P < 0.001 for bulling to others). Physical fighting was more prevalent among rural residents (40% vs. 39%, respectively, P = 0.61), while being bullied was more common among urban students (27% vs. 26%, respectively, P = 0.69).
  
  
  CONCLUSIONS
  Although in this study the frequency of aggressive behaviors was lower than many other populations, still these findings emphasize on the importance of designing preventive interventions that target the students, especially in early adolescence, and to increase their awareness toward aggressive behaviors. Implications for future research and aggression prevention programming are recommended.
authors: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Morteza
authors: M
authors: Sadinejad
authors: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Maryam
authors: M
authors: Bahreynian
authors: Department of Pediatrics, Ahvaz University of Medical Sciences, Ahvaz, Iran.
authors: Mohammad-Esmaeil
authors: ME
authors: Motlagh
authors: Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran ; Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mostafa
authors: M
authors: Qorbani
authors: Department of Social Health, Ministry of Education and Training, Tehran, Iran.
authors: Mohsen
authors: M
authors: Movahhed
authors: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Gelayol
authors: G
authors: Ardalan
authors: Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors: Ramin
authors: R
authors: Heshmat
authors: Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Roya
authors: R
authors: Kelishadi
keywords: Bullying; Iran; children and adolescents; physical fight; prevalence; violence