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Nurturing Hostile Environments: The Problem of School Violence

Fredland, Nina M. PhD, RN, CS, FNP

doi: 10.1097/01.FCH.0000304016.75136.04
Article

Although school violence directly affects the overall health and well-being of children and adolescents, clear priorities have not been identified for dealing with the problem. Horrific events such as the 1999 Columbine High School shooting in Littleton, Colo, and recent shootings at Virginia Tech have focused the nation on high-profile, media-worthy school violence to the detriment of addressing everyday forms of violence in schools. Policies that have been developed to reduce school violence have mixed reviews. To raise the consciousness of healthcare professionals, educators, legislators, and the general public, the most salient issues are discussed.

From the School of Nursing, The University of Texas at Austin.

Corresponding author: Nina M. Fredland, PhD, RN, CS, FNP, School of Nursing, University of Texas, 1700 Red River, Austin, TX 78701 (e-mail: nfredland@mail.nur.utexas.edu).

EVENTS such as the 1999 Columbine High School shooting in Littleton, Colo, and 2007 shootings at Virginia Tech have focused the nation on high-profile, media-worthy school violence often to the exclusion of addressing more common but less spectacular forms of low-grade violence in schools. Since Columbine, several school shootings make these occurrences seem more frequent; yet, school-related homicides remain rare events, accounting for 1% of child/youth homicides in the United States.1 National surveys report that more than one third of high school students (35.9%) admitted being in a fight at least once in the past year,2 and 29.9% of 6th to 10th graders reported moderate to frequent involvement in some form of bullying behavior.3 That is not to say that everyday violence and dramatic incidents are unconnected: student perpetrators of homicide were more than twice as likely to have been a victim of bullying by fellow students (odds ratio = 2.57, 95% confidence interval = 1.12, 5.92).4 However, in terms of prevalence, long-term impact, and demographic and geographic distribution, schools and their communities would be better served by reducing everyday violence and eliminating school environments that nurture hostility.

Because of the complexities of the problem of school violence, clear priorities have not been identified by the parties responsible for the safety of school-aged youth who otherwise agree on a variety of topics. For instance, it is widely accepted that school violence affects the overall health and well-being of children/adolescents, interferes with educational goals, and stalls normal healthy development. However, policies that have been developed to reduce school violence and curtail deviant peer behaviors have mixed reviews at best. This article presents the most salient issues in hopes of raising the consciousness of educators and healthcare professionals who are intimately involved with school-aged youth, and more broadly to increase the understanding of legislators and the general public. Thus, the purpose here is 3-fold: (1) to focus attention on the everyday problem of school violence, (2) to identify school policies in place such as zero tolerance and their effect on reducing exposure to violence; and (3) to suggest strategies to reduce school violence using an ecologic approach.

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DEFINING SCHOOL VIOLENCE

The fact that school violence is not easily defined contributes to the difficulty in preventing its occurrence. The Center for the Prevention of School Violence in the North Carolina Department of Juvenile Justice and Delinquency Prevention defines school violence as “any behavior that violates a school's educational mission or climate of respect or jeopardizes the intent of the school to be free of aggression against persons or property, drugs, weapons, disruptions and disorder.”5 The National Criminal Justice Reference Service operationalizes the definition as “any intentional verbal or physical act producing pain in the recipient of that act while the recipient is under the supervision of the school.”6 Accordingly, school violence is not limited to physical aggression but has many forms. Crimes at school can be objective or subjective playing on the “fear factor.” Bringing food to school laced with harmful additives, frightening fellow students with a toy gun, initiating malicious cyber attacks, or “rolling” (or asking aggressively) a fellow student in the stairwell for lunch money can all be categorized as school violence. National data from the Justice Department and the Department of Education report that 1.9 million 12- to 15-year-olds were victimized at school.7 Wilcox and colleagues,8 who assessed fear of victimization, perception of risk for victimization, and actual victimization for school crimes, found that youth felt most vulnerable related to everyday forms of violence such as kicking, pushing, shoving, theft, verbal insults, and unwanted sexual remarks; however, rarer incidents involving serious violent acts and threats with weapons received the most media attention and concern from parents.

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MAGNITUDE OF THE PROBLEM

Unfortunately, violence has manifested itself in school settings across the nation and globe. Parents of school-aged children, frightened by media reports, ask whether our schools are safe; while educators and researchers ask whether schools are conducive to learning. Is the school climate one of calmness and respect that fosters a comfortable exchange of ideas and promotes the acquisition of knowledge or is the school climate merely “nurturing hostile environments”? Often youth are fearful at school and sometimes avoid school out of fear.2 The environment may be chaotic and unsafe; yet, efforts to maintain safety and control by rigid classroom management may stifle appropriate student interactions. Neither scenario promotes educational goals. The law requires that children attend school; however, holding youth hostage in hostile environments is counterproductive to learning. Such environments can be oppressive, potentially dangerous, and unhealthy. Although some resilient children develop in positive ways under difficult circumstances, others, exposed daily to environmental hostility, may learn to adapt to the system at the expense of their personal motivation and excitement for learning.

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Prevalence of victimization

The prevalence rates of violent aggressive acts are at unacceptable levels among youth who report being victimized or involved in violent acts either directly or indirectly in increasingly high percentages. National surveys affirm that minor acts of aggression are commonplace and not isolated, infrequent events such as school shootings.3 Seventy-five percent of urban elementary school children have witnessed a robbery, stabbing, shooting, or killing,9 and 48.9% of seventh graders in four Mid-Atlantic middle schools (N = 309) reported personal violent experiences.10 The Youth Risk Behavior Surveillance Survey, a population-based national study, found that 43.4% of the males and 28.1% of the females had been in a physical fight in the preceding year, and 13.6% reported that the fight occurred on school grounds.2 Nearly one third of youth (29.8%) reported property stolen or damaged one or more times while at school. Six percent of students stated they did not go to school because they felt unsafe in the preceding 30 days. This was highest in ninth grade (7.7%) and among minority students (8.7% Black, 10.2% Hispanic). A survey of predominantly minority students (N = 6,400, 75% Black) in grades 6 to 8 found that 50% of the males and more than 36% of females had been in a fight or threatened to beat someone up in the past 3 months.11

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Prevalence of weapons

Homicide is the second leading cause of death in youth aged 10 to 24, and firearms account for more than 80% of those deaths.12 According to the most recent Youth Risk Behavior Surveillance Survey findings, 6.5% of students brought a weapon (gun, knife, or club) to school in the last 30 days, and 7.9% reported being threatened or injured with a weapon while at school (6.1% girls, 9.7% boys).2 The percentage of youth who were threatened with a weapon or injured by a weapon on school premises in the previous 12 months remained virtually unchanged between 1993 and 2005 (7.3% and 7.9%, respectively).13 Also, the percentage of youth who felt unsafe, and who as a result did not go to school on 1 or more days in the past month, increased from 4.4 to 6 during 1993–2005. Gun policies continue to be highly political, generating controversial constitutional debate without addressing the problem of weapon access, even in light of the aforementioned statistical evidence.

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Geographic differences

According to one study of pediatric fatalities in New York City (N = 263), most deaths from firearms occurred in the streets.14 A higher density of weapons in a particular geographic area can increase the likelihood that weapons could be carried on to school grounds. Thus, altercations that begin on school grounds may escalate and culminate in violent acts beyond school premises, but this does not mean that the violence is unrelated to the school setting.

Urban areas are more likely to report higher rates of violent crime than rural areas. Similarly, schools in urban neighborhoods are also more likely to have higher rates of violence than their suburban and rural counterparts, but media reports have shown that no school district is exempt. Almost every school, if surveyed, would report that incidents of victimization and perpetration occur on a regular basis.3,15

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Developmental factors

Most youth violence emerges during the second decade of life.16 Healthy People 2010 highlights adolescent injuries, disabilities, and deaths caused by violence and calls for prevention strategies directed toward the young adolescent,17 since the pathway to violent careers seems to begin with relatively minor forms of aggression in and around school. A longitudinal study of first-, fourth–, and seventh-grade boys (N = 1,014) identified several pathways and found that youth who engaged in overt acts of aggression such as bullying, fighting, and gang behavior graduated to acts of violence including rape and assault, while youth who engaged in covert behavior were more likely to subsequently engage in vandalism, arson, fraud, burglary, and theft.18 Associated risk factors included academic failure, low school connectedness, truancy, and dropping out.

When the US Supreme Court declared the death penalty for youth younger than 18 unconstitutional, the premise was that developmental level and limited cognitive decision-making ability could be mitigating factors.19 Furthermore, imaging studies confirm that brain maturation is a process that continues through adolescence and early adulthood, which means that brain structures that regulate impulsivity and futuristic thinking are still developing beyond 18 years of age.20,21 These facts advocate for special policies and a separate justice system for adolescents that bases punishment on case-by-case analyses of perpetrators' maturity and decision-making ability.

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Adolescent health outcomes

Although most adolescents claim good health, the leading causes of death for adolescents have changed from natural causes to preventable causes, and rates have increased substantially in the last few decades.12,22 Specifically, homicide is listed as the second leading cause of death among youth 15- to 19-year-olds and the fourth leading cause of death among 1- to 14-year-olds. In addition, suicide is the third leading cause of death among 10- to 24-year-olds.

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SCHOOL ANTIVIOLENCE POLICIES

Threat assessment

The government responded to fatal school shootings by developing 2 threat assessment models.23 The Federal Bureau of Investigation model aims to help school personnel evaluate threat credibility and the likelihood that an individual has the intent, motivation, and ability to complete the act. The second model, the US Secret Service and Department of Education Threat model, analyzed the personal characteristics of the perpetrators or would-be perpetrators. These individuals were not always aggressive but almost always had a history of 1 or more of the following: poor emotional coping, depression, suicide ideation, a recently bruised ego, bullying victimization, or a botched personal relationship. Both models focus on individual characteristics but do not consider important macrosystem values and beliefs that ultimately affect what occurs at the microsystem or individual level. School personnel using these limited models tend to label certain students as “dangerous.”

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Reporting laws

Laws have been enacted to promote prompt and accurate reporting of school-related crimes.24 The first law, The Safe and Drug-Free Schools and Communities Act of 1994, mandated that schools compile statistics determining the frequency and severity of violent acts, along with directives to make all schools drug and violence free.25

Zero Tolerance Policies (ZTPs) originated with the federal Gun Free Schools Act of 1994,26 whose original purpose was to intervene in “situations of26 (p35) truly dangerous” student “criminal behavior”.27,28 (p35) Since then, many states extended the law to include all weapons or potential weapons brought to school. These policies were broadened further to include bringing drugs to school and bullying behaviors. The zero tolerance concept encourages administrators to interpret policies literally without regard for the specific offense. One consequence is that toy guns and other outlawed items, substances, or activities that may in fact pose little or no real threat are violations of ZTPs. Thus, violations are lumped together and severe rationalized under the literal policy interpretation, which inadvertently trivializes serious infractions. For example, an adolescent who is caught with menstrual cramp medication violates the policy and is subject to harsh punishment or even expulsion. In cases of zero tolerance for bullying, a situation of name calling is categorized the same as severe forms of or sexualized violence. In view of literal interpretations, ZTPs have evolved into policies that vary greatly from the original intent of the law, which was to remove truly dangerous students from the school community.

Many examples of undue consequences have been reported. For example, a girl was suspended for bringing a knife to school to cut brownies.28 Another 10-year-old was expelled because her mother put a small knife in her lunchbox to cut an apple. In such cases, the crime did not match the severity of the punishment. It is not unreasonable to conclude that zero tolerance laws have exceeded their intended purpose. Instead of reducing school violence by concentrating on youth with malicious intent bringing real weapons to school, ZTPs have hidden the problem or “passed the buck” to another institution. Clearly, these negative policies are not productive and do not contribute to adolescent development at a critical point in their formative years. Furthermore, there are virtually no studies that evaluate the effectiveness of these widespread policies on weapon carrying in relation to school violence reduction and adolescent health.29

School administrators in the aftermath of events such as Columbine have urged school districts to adopt rigid policies to ensure school safety. In addition to actions subject to ZTPs, insubordination and other disruptive behavior often become immediate grounds for suspension or expulsion. Troubled youth, who find themselves alienated and disconnected from school, are likely to end up in a downward spiral. This punitive approach has not been in the best interest of adolescents, although it may be self-serving for particular schools, in that a problem individual goes away. However, adolescents, families, neighborhoods, and eventually society pay a high price. Often such policies have become an easy fix to eliminate problematic youth from the system. All cases should be taken seriously; however, more emphasis must be placed on appropriate consequences and interventions that ferret out troubled youth for the purpose of appropriately intervening before violence occurs.

ZTPs, expulsion, and suspension are classic examples of the disconnect between current policies and what evidence suggests might truly make a difference in adolescents' lives. Continuing to emphasize punitive policies indicates that school systems, professionals, and communities have “given up on a sector of our youth.”28 (p357)

One of the best sources of data about adolescents is the National Longitudinal Study of Adolescent Health. Results from this study show that school and parental connectedness are important contextual factors.30,31 Youth who feel connected to their school engage in fewer violent behaviors over time,30 and youth who felt connected to both parents and school were less likely to be involved in a violent act with a weapon.31 Furthermore, tolerant disciplinary policies were associated with increased school connectedness.32 Additional protective factors identified in the literature include intolerant individual attitudes toward violence, parental monitoring, supportive relations with caring adults outside the family, prosocial skills, and academic success.33,34 It is illogical to disregard this evidence that suggests positive rather than punitive strategies.

The No Child Left Behind Act (NCLB), while intended to improve school outcomes, measures violence in terms of suspensions rather than actual violent acts committed in school.35 NCLB has decreased school suspensions to the chagrin of some teachers, who feel they cannot discipline students because the school may be labeled “dangerous,” resulting in loss of federal funds and student transfers by parents using vouchers. Although the intent of the law is positive, many schools are unable to meet the standards, particularly those with limited resources in high-crime, impoverished neighborhoods. Thus, under NCLB, youth who commit crimes at school may escape suspension or expulsion, learning that they can behave badly because the system's overall model is punitive and not nurturing.35

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STRATEGIES THAT NURTURE POSITIVE SCHOOL ENVIRONMENTS

Researchers who study the school violence problem do not agree on underlying causes. Many consider individual characteristics or flaws such as a lack of empathy to be the basic cause and advocate a criminal justice approach. The public health view promotes strategies that regulate guns, alcohol, and illegal drugs since these factors are often associated with injury and homicide. However, if one believes that root cause is embedded in the social structure, then the aforementioned approaches will have limited effect on curbing violent acts. Approaches at the societal level must focus on addressing economic inequality, racism, and other forms of disparity. Hence, the problem of school-related violence must be recognized as a multifaceted problem requiring a variety of strategies directed at individual, family, school, and societal levels.

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Ecologic perspective

The bioecological model, developed by Bronfenbrenner, is appropriate for examining school violence and determining what solutions might be feasible and most efficacious.36 Bronfenbrenner's approach considers the concepts of nature and nurture.37 Nature implies innate genetic contributions related to individual characteristics, while nurture emphasizes contextual factors, centering the adolescent amid levels of environmental systems. The microsystem is the first level in which the child/adolescent directly interacts with important societal processes, such as those with family, peers, sports teams, homework, teachers, and church. The second level, the mesosystem, refers to linkages between 2 or more settings that the child/adolescent is directly involved with on a regular basis. The most pertinent linkage for this discussion is between school and the peer group. However, other linkages such as church–peer group or home–peer group have bearing on adolescent development. For example, the home environment can affect school performance and may also make an adolescent more or less susceptible to deviant peer associations.

As previously stated, a disconnect occurs when school policies are punitive, narrowly focused, or do not consider the multifactorial nature of school violence within this ecologic perspective. Such policies are not likely to prevent overt or covert minor acts of aggression, found to be antecedent to major violent episodes.18,38 Such policies are not in the best interest of the adolescents in relation to both short-term and long-term health outcomes. A positive approach creates a school environment that values youth, role models prosocial behavior, and advocates a prevention–intervention continuum to decrease school violence by adopting alternatives to expulsion/suspension policies.28 The removal of misbehaving youth from the school academic and social environment, so necessary for their eventual success in adulthood is negative and punitive, and conveys to adolescents that society has given up on them.

To date the implementation of promising comprehensive evidence-based programs to reduce violence in school communities has been limited. Most curricula are directed only toward students, and not all of the players are involved. The Centers for Disease Control and Prevention, recognizing the importance of an ecologic approach, directed the compilation of a sourcebook for best practices in youth violence prevention.39 Four strategies considered key in preventing youth violence are identified and highlighted in the following areas: parent-/family-based programs, home-visitation programs, school-based social–cognitive approaches, and mentoring programs. Readers are directed to this work for exemplar programs in each category.

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Best practices: Parent-/family-based strategies

These approaches emphasize early intervention, recognizing environmental influences on family systems while focusing on developing positive parenting skills, and effective communication.39 Many best practices are based on the theory that early intervention is the most cost-effective way of maximizing positive long-term outcomes, since negative patterns are not firmly established in either parents or very young children. The involvement of family is critical to the success of any program to reduce youth violence. Research has found that, consistent with an ecologic model, both parent and school connectedness are necessary to mitigate the effects of violence exposure and prevent future violence.30 In addition, families that are at risk can benefit from community resources through home visitation programs that are most effective if initiated early with respect to the developing family.39 In sum, parents/family, along with school personnel, have the ability to influence peer relations positively.

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Best practices: School-based strategies

Recommendations advocate a broad approach targeting the entire school community. Best practices in this domain focus on social–cognitive strategy, promoting problem-solving and skills-building techniques that foster the development of prosocial relationships.39 Students, teachers, counselors, principals, administrators, parents, legislators, and politicians all play a role in formulating the school environment. School administrators, faculty, and staff have the most direct influence on school environment, as well as the authority to influence peer relations. The principal sets the pace for a respectful school environment, and other adults within the school are responsible for nurturing that vision. A proactive approach led by caring adults in the school community can change attitudes and the school environment. This means that when disrespectful, disruptive, and violent behaviors are observed, some action is warranted that is caring and corrective but not overly harsh. What should not be tolerated is inaction and bystander indifference, whether the bystander is an adult in charge, a fellow student, or a group of students.

One has only to spend brief periods in hallways, cafeterias, bathrooms, or playgrounds of crowded public schools to observe chaos and lack of adequate supervision. Many times schools with limited resources have been forced to reduce staff. For example, an urban school, designated as “dangerous,” eliminated the middle-school counselor position for fiscal reasons. At the same time, they hired an outside security company to maintain order. This strategy was ineffective and served only to escalate problems, especially since a professional skilled in identifying problems and guiding youth toward positive alternatives and helpful resources was no longer easily accessible.

The School Health Index represents a positive step in helping schools comprehensively assess their strengths and weaknesses.40 This index is an alternative to the punitive policies as it focuses on prevention and wellness. Unfortunately, nationally based research found that most schools tend to select a few topics to address and do not meet recommendations in all areas. For example, 79.6% of elementary schools sampled reported having a crisis response plan. However, only 7.1% of these schools taught students about unintentional injuries; only 3.4% addressed violence/suicide; and despite the fact that injuries and violence are the leading cause of death in the school-aged population, only 1% addressed all 3 topics. Using this index to systematically assess schools and implement policies/programs accordingly is warranted.

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Mentoring programs

Another violence prevention strategy is the use of mentoring programs. This is particularly beneficial for at-risk youth who may lack supportive role models. This opportunity for community involvement potentially extends resources to parents and schools with limited capacity. The Centers for Disease Control and Prevention sourcebook reviews best practices for community-based mentoring programs.39

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Restorative justice programs

Based on the principle that strong communities are more likely to prevent violence and respond to incidents of violence in developmentally appropriate ways, restorative justice programs have had promising results in several geographic areas in the United States.41 Rather than focusing on punitive discipline and fear, methods are designed to change the normative culture and strengthen school connections while fostering community building and a sense of caring. Emphasis is placed on obligations and helping misbehaving youth understand how their actions affected community members. Instead of disenfranchising the youth, the consequences suggest rehabilitating and reintegrating them into the system.

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CONCLUDING REMARKS

School systems cannot realistically ignore surveillance and security related to preventing horrific events, even if the rate of occurrence is low because the consequences can be so devastating. Lessons learned from Columbine and other events that evaluate the profiles of those who commit murder in school reveals that most often the perpetrator is an adolescent, not an adult.42 The adolescent may be confused, misguided, lonely, lacking in supervision, and, in many instances, bullied, humiliated, or teased at school.

Home life for many adolescents is unhealthy. The national divorce rate underscores the existence of conflict in many homes. Adolescents in these unhappy situations frequently lack a sounding board to discuss their own concerns, and as a result often exhibit internalizing and externalizing symptoms such as depression and aggression. Often family issues are at the root of violent behaviors demonstrated at school. Although school systems are not likely to stem home conflict, society cannot ignore this possible cause of problems at school. Helping youth process troubling concerns that brim over into school life and prioritizing respectful daily school routines are more likely to reduce violence than negative approaches.

Harsh school polices, such as ZTPs, expulsion, suspension, and policies that focus only on school shootings, are not serving the majority of adolescents. These youth are struggling to cope with everyday insults, bullying behaviors, and acts of violence. Some school violence prevention strategies have been promoted that emphasize a positive prosocial model. Programs using an ecologic approach that considers the school environment and educate all stakeholders are more likely to benefit most students and prevent unhealthy outcomes. Such programs also have more potential to identify troubled youth and prevent serious violence.

Future research should consider answering the following questions:

  • What are the perceptions of today's youth related to personal space boundaries, and are today's youth more physical by nature?
  • What is the relationship between pent-up anger and aggression stemming from frustrations at home transferring to school corridors, cafeterias, and classrooms?
  • What are the reasons adults in school systems hesitate to intervene when minor acts of aggression and bullying behaviors are observed or reported?
  • What methods are effective to sufficiently prepare and empower adult supervisors of youth in common school areas to intervene effectively?
  • What is the contribution of illegal substance use to the problem of school violence?
  • What is the association between test scores, performance, and expulsion rates?
  • How is the increasingly popular trend in home schooling related to hostile school environments? Are some home schooled youth afraid to go to school because they have been victimized or fear they will be victimized?

Stakeholders responsible for working to reduce school violence must use the attention brought about by events such as Columbine and Virginia Tech to focus on everyday violence and commonplace acts of aggression. Even minor acts of deviance/disobedience should be viewed as potential stepping stones to a Columbine-like event, and initiate opportunities to teach social skills, anger control, and problem solving. Unless priorities change within schools systems, unfair ZTPs, and damaging expulsion/suspension policies will interfere with adolescent development and education. Adult role models that choose not to intervene and do not model respectful ways to deal with everyday problems nurture hostile environments.

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REFERENCES

1. Centers for Disease Control and Prevention. School associated violent deaths. MMWR Morbidity and Mortality Weekly Report. 2006;55(SS-5). Available at:
2. Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States 2005. MMWR Morbidity and Mortality Weekly Report. 2006;55(SS-5). Available at:
3. Nansel TR, Overpeck M, Pilla RS, Ruan WJ, Simons-Morton B, Scheidt P. Bullying behaviors among US youth prevalence and association with pscyhosocial adjustment. Journal of the American Medical Association. 2001;285(16):2094–2100.
4. Anderson M, Kaufman J, Simon TR, et al. School-associated violent deaths in the United States. Journal of the American Medical Association. 2001;286(21):2695–2702.
5. Center for the Prevention of School Violence North Carolina Department of Juvenile Justice and Delinquency Prevention. Just what is “school violence”? [Newsbrief]. May 2002. Available at:
6. Hunter L, MacNeil G, Elias, M. School violence: prevalence, policies, and prevention. In: Roberts AR, ed. Juvenile Justice Sourcebook: Past, Present, and Future. New York: Oxford University Press; 2004:101–125. NCJ-206597. Available at:
7. DeVoe JF, Kaffenberger S. Student Reports of Bullying: Results From the 2001 School Crime Supplement to the National Crime Victimization Survey. (NCES 2005–310) U.S. Department of Education, National Center for Education Statistics. Washington, DC: U.S. Government Printing Office; 2005.
8. Wilcox P, Augustine MC, Bryan JP, Roberts SD. The “reality” of middle-school crime: objective vs. subjective experiences among a sample of Kentucky youth. Journal of School Violence. 2005;4(2):3–28.
9. Bell CC, Jenkins EJ. Community violence and children on Chicago's southside. Psychiatry. 1993;56:46–54.
10. Fredland Nina M. Physical, Behavioral, and Mental Health Outcomes of Young Adolescents Exposed to Community Violence, Home Violence and Peer Violence [PhD dissertation]. Baltimore, Md: The Johns Hopkins University. Accessed November 8, 2007. From ProQuest Digital Dissertations database (Publication No. AAT 3213706).
11. Clubb PA, Browne DC, Humphrey AD, Schoenbach V, Meyer B, Jackson M. Violent behaviors in early adolescent minority youth: results from a middle school youth risk behavior survey. Maternal and Child Health Journal. 2004;5(4):225–235.
12. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Youth Violence WISQARS Leading Causes of Death Reports: Online Database. Available at:
13. Centers for Disease Control and Prevention. YRBSS National Youth Risk Behavior Survey: 1991–2005. Available at:
14. Gill JR, Lenz KA, Amolat MA. Gunshot fatalities in children and adolescents in New York City. Journal of Forensic Sciences. 2003;48(4):832–835.
15. Centers for Disease Control and Prevention. Youth risk behavior surveillance. MMWR Morbidity and Mortality Weekly Report. 2002;51:SS-04.
16. Patterson GR, Forgatch MS, Yoerger KL, Stoolmiller M. Variables that initiate and maintain an early-onset trajectory for juvenile offending. Development and Psychopathology. 1998;10:531–547.
17. US Department of Health and Human Services. Healthy People 2010. Washington, DC: Government Printing Office; 2000 Available at:
18. Loeber R, Keenan K, Zhang Q. Boys' experimentation and persistence in developmental pathways toward serious delinquency. Journal of Child and Family Studies. 1997;6(3):321–357.
19. MacArthur Foundation Research Network on Adolescent Development and Juvenile Justice. Less guilty by reason of adolescence. Available at:
20. DeBellis MD. Developmental traumatology: the psychobiological development of maltreated children and its implications for research, treatment and policy. Developmental and Psychopathology. 2001;13:539–564.
21. Teicher MH. Scars that won't heal: the neurobiology of child abuse. Scientific American. 2002;286:68–75.
22. Irwin CE, Burg SJ, Cart CU. America's adolescents: where have we been, where are we going? Journal of Adolescent Health. 2002;31(65):91–121.
23. Augustyniak KM. Integration of Federal Bureau of Investigation and United States Secret Service/Department of Education threat assessment models into a conceptual framework for prevention of school violence. Journal of School Violence. 2005;4(2):29–46.
24. National Center for Victims of Crime. Reporting School Violence. Washington, DC: US Department of Justice; 2002:NCJ189191. Available at:
25. Public Law 103–382. (1994). Safe and Drug-Free Schools and Communities Act. SEC. 4001, 20 USC 7101.
26. Public Law 103–227. (1994). Gun-Free Schools Act. SEC. 1031, 20 USC 2701.
27. Casella R. Zero tolerance policy in schools: rationale, consequences, and alternatives. Teachers College Record. 2003;105(5):872–892.
28. Dunbar C, Villarruel FA. What a difference the community makes: zero tolerance policy interpretation and implementation. Family and Excellence in Education. 2004;37:351–359.
29. Hahn RA, Bilukha O, Crosby A, et al. Firearm laws and the reduction of violence a systematic review. American Journal of Preventive Medicine. 2005;28(2 suppl 1):40–71.
30. Brookmeyer KA, Fanti KA, Henrich CC. Schools, parents, and youth violence: a multilevel, ecological analysis. Journal of Clinical Child and Adolescent Psychology. 2006;35(4):504–514.
31. Henrich CC, Brookmeyer KA, Shahar G. Weapon violence in adolescence: parent and school connectedness as protective factors. Journal of Adolescent Health. 2005;37(4):306–312.
32. McNeely CA, Nonnemake JM, Blum RW. Promoting school connectedness: evidence from the National Longitudinal Study of Adolescent Health. Journal of School Health. 2002;72(4):138–146.
33. Department of Health and Human Services. Youth violence: a report of the Surgeon General [online]. 2001. Available at:
34. Resnick MD, Ireland M, Borosky I. Youth violence perpetration: what protects? What predicts? Findings from the National Longitudinal Study of Adolescent Health. Journal of Adolescent Health. 2004;35:424e1–424e10.
35. Loh L. Suspensions discouraged, educators say. Baltimore Sun. October 24, 2004. Available at:
36. Bronfenbrenner U. The bioecological theory of human development. International Encyclopedia of Social and Behaviors Sciences. 2001;10:6963–6970.
37. Bronfenbrenner U. Nature-nurture reconceptualization in developmental perspective: a bioecological model. Psychological Review. 1994;101(4):568–586.
38. Harter S, Low SM, Whitesell NR. What have we learned from Columbine: the impact of the self-system on suicidal and violent ideation among adolescents? Journal of School Violence. 2003;2(3):3–26.
39. Thornton TN, Craft CA, Dahlberg LL, Lynch BS, Baer K. Best Practices of Youth Violence Prevention: A Sourcebook for Community Action. Revised ed. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2002.
40. Brener ND, Pejavara A, Barrios LC, et al. Applying the School Health Index to a nationally representative sample of schools. Journal of School Health. 2006;76(2):57–66.
41. Karp D, Breslin B. Restorative justice in school communities. Youth and Society. 2001;33(2):249–272.
42. Tremlow SW, Fonagy P, Sacco FC, Vernberg E. Assessing adolescents who threaten homicide in schools. The American Journal of Psychoanalysis. 2002;62(3):213–233.
Keywords:

adolescent; crime victims; health; schools; violence

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