Which student groups are experiencing the achievement gap? Discuss factors that may contribute to educational inequality. 2. How can

McGilley, Beth M., and Tamara L. Pryor. ‘‘Assessment and

Treatment of Bulimia Nervosa.’’ American Family

Physician 57 (June 1998): 1339.

Miller, Karl E. ‘‘Cognitive Behavior Treatment of Bulimia

Nervosa.’’ American Family Physician 63 (February 1,

2001): 536.

‘‘Position of the American Dietetic Association: Nutrition

Intervention in the Treatment of Anorexia Nervosa,

Bulimia Nervosa, and Eating Disorders Not Otherwise

Specified.’’ Journal of the American Dietetic Association

101 (July 2001): 810–28.

Romano, Steven J., Katherine A. Halmi, Neena P. San-

kar, and others. ‘‘A Placebo-Controlled Study of

Fluoxetine in Continued Treatment of Bulimia

Nervosa After Successful Acute Fluoxetine Treat-

ment.’’ American Journal of Psychiatry 159 (January

2002): 96–102.

Steiger, Howard, Lise Gauvin, Mimi Israel, and others.

‘‘Association of Serotonin and Cortisol Indices with

Childhood Abuse in Bulimia Nervosa.’’ Archives of

General Psychiatry 58 (September 2001): 837.

Vink, T., A. Hinney, A. A. van Elburg, and others. ‘‘Asso-

ciation Between an Agouti-Related Protein Gene Poly-

morphism and Anorexia Nervosa.’’ Molecular

Psychiatry 6 (May 2001): 325–28.

Walling, Anne D. ‘‘Anti-Nausea Drug Promising in Treat-

ment of Bulimia Nervosa.’’ American Family Physician

62 (September 1, 2000): 1156.

ORGANIZATIONS

Academy for Eating Disorders, Montefiore Medical School,

Adolescent Medicine. 111 East 210th Street, Bronx, NY

10467. Telephone: (718) 920-6782.

American Academy of Child and Adolescent Psychiatry.

3615 Wisconsin Avenue N.W., Washington, DC 20016-

3007. Telephone: (202) 966-7300. Fax: (202) 966-2891.

<http://www.aacap.org>.

American Anorexia/Bulimia Association. 165 W. 46th

Street, Suite 1108, New York, NY 10036. Telephone:

(212) 575-6200.

American Dietetic Association. Telephone: (800) 877-1600.

<http://www.eatright.org>.

Anorexia Nervosa and Related Eating Disorders, Inc.

(ANRED). P.O. Box 5102, Eugene, OR 97405. Tele-

phone: (541) 344-1144. <http://www.anred.com>.

Center for the Study of Anorexia and Bulimia. 1 W. 91st St.,

New York, NY 10024. Telephone: (212) 595-3449.

OTHER

‘‘Bulima Nervosa.’’ U.S. Department of Health and Human

Services. <http://www.womenshealth.gov/faq/Easy-

read/bulnervosa-etr.htm>.

Rebecca Frey, PhD Emily Jane Willingham, PhD

Bullying Definition

Bullying is a persistent pattern of threatening, harassing, or aggressive behavior directed toward another person or persons who are perceived as smaller, weaker, or less powerful. Although often thought of as a childhood phenomenon, bullying can occur wherever people interact, most notably observ- able in the workplace and in the home. Bullying is also called harassment.

Description

‘‘Kids will be kids,’’ the saying goes, so warning signs of bullying are often overlooked as a natural part of childhood. However, although playground bullies have been around since time immemorial, such behav- ior should neither be considered acceptable nor excus- able. Bullying is a form of abuse and violence, and the tragic Columbine High School massacre in 1999 underscores the potential dangers of unchecked bullying.

There are many forms of bullying. Bullies may intimidate or harass their victims physically through hitting, pushing, or other physical violence; verbally through such actions as threats or name calling; or psychologically through spreading rumors, making sexual comments or gestures, or excluding the victim from desired activities. Such behavior does not need to occur in person: Cyberbullying is a persistent pattern of threatening, harassing, or aggressive behavior car- ried out online.

There are many reasons to stop bullying. Bullying interferes with school performance, and children who are afraid of being bullied are more likely to miss school or drop out. Bullied children frequently expe- rience developmental harm and fail to reach their full physiological, social, and academic potentials. Chil- dren who are bullied grow increasingly insecure and anxious, and have persistently decreased self-esteem and greater depression than their peers, often even as adults. Children have even been known to commit suicide as a result of being bullied.

People who are bullies as children often become bullies as adults. Bullying behavior in the home is called child abuse or spousal abuse. Bullying also occurs in prisons and in churches.

Recently, attention has been turned to the topic of bullying in the workplace (sometimes called harass- ment), where bosses and organizational peers bully those whom they perceive as their inferiors or weaker

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than they. Those bullied at work often become per-

ceived as ineffective, thus abrogating their career suc-

cess and influencing their earning potential. Victims of

workplace bullying often change jobs in search of a

less hostile environment because organizations are

frequently not sensitive to the issue of workplace bul-

lying or equipped to adequately or justly deal with it.

Demographics

Bullying in children

Bullying among children is a persistent and sub-

stantial problem. According to a study published in

2001 by the Kaiser Family Foundation and Nickel-

odeon Television, 55% of 8–11-year-olds and 68% of

12–15-year-olds said that bullying is a ‘‘big problem’’

for people their age. Seventy-four percent of the 8–11-

year-olds and 86% of the 12–15-year-olds also

reported that children were bullied or teased at their

school. Children at greatest risk of being bullied are

those who are perceived as social isolates or outcasts

by their peers, have a history of changing schools, have

poor social skills and a desire to fit in ‘‘at any cost,’’ are

defenseless, or are viewed by their peers as being

different.

A study of more than 16,000 children in the sixth through tenth grades conducted for the National Insti- tute of Child Health and Human Development found that bullying is a common problem in the United States and requires serious attention. Nearly 60% of the children responding to the survey reported that they had been victims of rumors. More than 50% of the children reported that they had been the victims of sexual harassment.

The National Center for Education Statistics (NCES) of the U.S. Department of Education found that white, non-Hispanic children were more likely to report being the victims of bullying than black or other non-Hispanic children. Younger children were more likely to report being bullied than older children, and children attending schools with gangs were more likely to report being bullied than children in schools with- out a major gang presence. No differences were found in these patterns between public and private schools. Fewer children reported bullying in schools that were supervised by police officers, security officers, or staff

A young boy faces bullying from older and bigger kids. (Gideon Mendel/Alamy)

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hallway monitors. Victims of bullying were more likely to be criminally victimized at school than were other children. Victims of bullying were more afraid of being attacked both at school and elsewhere and more likely to avoid certain areas of school (for example, the cafeteria, hallways or stairs, or restrooms) or activities where bullying was more likely to take place. Signifi- cantly, victims of bullies were more likely to report that they carried weapons to school for protection.

Children who are identified as bullies by the time they are eight years of age are six times more likely than other children to have a criminal conviction by the time they are 24 years old. Bullying behavior may also be accompanied by other inappropriate behavior, including criminal, delinquent, or gang behavior.

Bullying in the workplace

Although research has been conducted on bully- ing in Europe for some time, the topic has only recently become of interest in the United States. There are no ‘‘official’’ figures currently available for incidents of bullying in the workplace. However, the nonprofit Workplace Bullying Institute conducted an informal survey of 1,000 self-selected volunteer respondents. Although it cannot be assumed that the volunteers answering the survey are representative of individuals in the workplace in general, the results do give food for thought concerning the prevalence of workplace bullying.

In the survey, 80% of the women and 20% of the men reported having been bullied at work. Sixty-one percent of the victims of workplace bullying said that the behavior was ongoing. The survey also found that 70% of victims of workplace bullying lose their jobs: 37% of the victims were fired or involuntarily termi- nated and 16% of the victims transferred to another position within the same organization. On the other hand, the survey found that only 4% of bullies stopped their aggressive or harassing actions after punishment and that only 9% of workplace bullies were trans- ferred, fired, or involuntarily terminated. Contrary to the cartoon portrait of male bullies, the survey showed that 50% of workplace bullying was done by women victimizing other women. Men bullying women accounted for only 30% of bullying, while men bullying men accounted for 12% of workplace bullying and women bullying men accounted for 8%. The figure with women bullying other women is par- ticularly interesting because such same-sex harass- ment (with the exception of sexual harassment) is usually outside the scope of antidiscrimination laws and is typically not tracked.

Causes and symptoms

As of this writing, there is no evidence to support the theory that there is a genetic component to bully- ing behavior. Particularly in children, it is most often theorized that bullying is a result of the bully copying the actions of role models who bully others. This frequently happens when bullies come from a home in which one parent bullies another or one or both parents bully the children. When such behavior is modeled for children with personality traits such as lack of impulse control or aggression, they are partic- ularly prone to bullying behavior, which is often con- tinued into adulthood.

Bullying in children

According to the U.S. Department of Health and Human Services, children with dominant personal- ities and who are more impulsive and active are more prone to becoming bullies than children without these traits. Bullies also often have a history of emo- tional or behavioral problems. Victims of bullying, on the other hand, tend to be more anxious, insecure, and socially isolated than their peers, and often lack age-appropriate social skills. The probability of vic- timization can be compounded when the victim has low self-esteem due to physical characteristics (for example, the victim believes her/himself to be unat- tractive or is outside the normal range for height or weight) or problems (for example, health problems or physical or mental disability).

Warning signs and factors that may indicate risk for being or becoming a bully include:

� lack of impulse control (frequent loss of temper, extreme impulsiveness, easily frustrated, extreme mood swings)

� family factors (abuse or violence within the family, substance or alcohol abuse within the family, overly permissive parenting, lack of clear limits, inadequate parental supervision, harsh/corporal punishment, child abuse, inconsistent parenting)

� behavioral symptoms (gang affiliation, name calling or abusive language, carrying a weapon, hurting ani- mals, alcohol or drug abuse, making serious threats, vandalizing or damaging property, frequent physical fighting)

Symptoms that a child may be being bullied include:

� social withdrawal or isolation (few or no friends; feeling isolated, sad, and alone; feeling picked on or persecuted; feeling rejected or not liked; having poor social skills)

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� somatic complaints (frequent complaints about ill- ness; displaying victim body language, including hanging head, hunching shoulders, and avoiding eye contact)

� avoidant behavior (not wanting to go to school; skips classes or skips school)

� affective reactions (crying easily; having mood swings; talking about hopelessness, running away, or suicide)

� physical clues (bringing home damaged possessions or reports that belongings were ‘‘lost’’)

� behavior changes (changes in eating or sleeping patterns)

� aggressive behavior (threatening violence to self or others, taking or attempting to take weapon to school)

Each child will react to bullying in a different manner, and some children will react with only a few of these symptoms. This, however, does not mean that bullying is not severe or that intervention is not needed.

Bullying in the workplace

Bullying in the workplace is usually motivated by political rather than personal reasons. Workers com- pete over scarce resources such as promotions, raises, and the corner office or other honors. In an attempt to climb the ladder of success, some individuals do what they can to not only present themselves in a good light to their superiors, but to make one or more coworkers seem unworthy or inept. Bullying bosses demonstrate poor leadership styles and poor motivational skills, frequently attempting to further either their own or the company’s agenda through harassment, belittling, or other negative behaviors.

Common tactics used by bullies in the workplace include:

� discounting/belittling victim in public (making state- ments such as ‘‘that’s silly’’ in response to victim’s ideas, disregarding evidence of satisfactory or super- lative work done by victim, taking credit for victim’s work)

� false accusations (rumors about victim, lies about victim’s performance)

� harassment (verbal putdowns based on gender, race, disability)

� isolating behaviors (encouraging others to turn against victim, socially or physically isolating the victim from others)

� nonverbal aggression (staring, glaring, silent treatment)

� sabotages victim’s work

� unequal treatment (retaliating against victim who files a complaint, making up arbitrary rules for vic- tim to follow, assigning undesirable work as a pun- ishment, making unreasonable/unreachable goals or deadlines for victim, performing a constructive dis- charge of duties)

Diagnosis

Bullying in itself is not a mental disorder, although

aggressive or harassing behavior may be symptomatic

of a number of disorders, particularly antisocial per- sonality disorder and schizoid behavior. There are, however, a number of criteria to help determine if

someone is a bully. First, to qualify as bullying, the

bully’s behavior must be intended to cause physical or

psychological harm to the other person. Second, bully-

ing behavior is not an isolated incident but results in a

consistent pattern of such behavior over time. Third,

bullying occurs where there is an imbalance of power

whereby the bully has more physical or psychological

power than the victim. Harassing behavior is not con-

sidered to be bullying if it occurs between individuals of

equal strength and status or if it is a one-time event.

Bullying behavior in children can include any of the following behaviors:

� dominance (enjoying feeling powerful and in control, seeking to dominate or manipulate others, being a poor winner or loser)

� lack of empathy (deriving satisfaction from the fears, pain, or discomfort of others; enjoying conflict between others; displaying intolerance and prejudice toward others)

� negative emotions or violence (displaying uncon- trolled anger or a pattern of impulsive and chronic hitting, intimidating, or aggressive behavior)

� lack of responsibility (blaming others for his/her problems)

� other behaviors (using drugs or alcohol, or being a gang member; hiding bullying behavior from adults; having a history of discipline problems)

Victims of bullying—whether children or adults—

may need to be assessed and treated for an anxiety disorder if they need help responding to or recovering

from bullying.

Treatments and prevention

If bullying behavior is symptomatic of an under- lying mental disorder such as antisocial personality disorder, treatment and prevention should be guided by and address the underlying disorder. For situations

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in which bullying behavior is not part of a pattern associated with an underlying mental disorder, treat- ment and establishing organizational or familial proc- esses for dealing with it are required.

Bullying in children

To help keep a child from becoming a bully, it is important to be a role model for nonviolent behavior. Parents should also clearly communicate to the child that bullying behavior is not acceptable, and clear limits should be established for acceptable behavior and consequences for ignoring the limits should be defined. Teaching good social skills—including effica- cious conflict resolution skills and anger management skills—can also help potential bullies learn alternative, socially acceptable behaviors. If the child persists in bullying behavior or if the parent(s) suspect that their child is a bully, help can be sought from mental health professionals and school counselors. Taking the child to a child psychologist and participating in family therapy as appropriate can help teach a bully better interpersonal skills. Contacting the school counselor or a child psychologist is also an appropriate step in helping the victims of bullies.

If parents suspect that their child may be being bullied, they should make sure that he or she under- standsthatthe problem isnot hisor herfaultand that he or she does not have to face the situation alone. Parents can discuss ways to deal with bullies, including walking away, being assertive, and getting help. Parents should also encourage the child to report bullying behavior to a teacher, counselor, or other trusted adult. However, parents should not try to resolve the situation them- selves but should contact the school to report the behav- ior and for recommendations for further assistance.

Bullying in the workplace

Bullying in the workplace can be minimized if the organization develops and enforces anti-harassment policies and procedures. These should include a stated definition on what constitutes harassment, creating and implementing a disciplinary system to punish the bully rather than the victim, and instituting a formal grievance system to report workplace bullying. Other measures that can be taken include inclusiveness and harassment training, awareness training to educate employees on how to spot bullying behavior, and offering courses in conflict resolution, anger manage- ment, or assertiveness training.

Bullies are not the only ones needing help. The intention of a bully is to harm the other person; vic- tims, therefore, may experience a number of negative

consequences from being the victim of a bully. If the behavior associated with being a victim persists after the bullying situation has been resolved or if the sit- uation continues without just resolution, victims should be assessed for depression and/or an anxiety disorder if their symptoms warrant, and receive the appropriate treatment.

Resources

BOOKS

Einarsen, Ståle, Helge Hoel, Dieter Zapf, and Cary L. Cooper, eds. Bullying and Emotional Abuse in the Workplace: International Perspectives in Research and Practice. New York: Taylor and Francis, 2003.

Espelage, Dorothy L., and Susan M. Swearer, eds. Bullying in American Schools: A Social-Ecological Perspective on Prevention and Intervention. Mahwah, NJ: Lawrence

Erlbaum Associates, 2003.

Geffner, Robert A, Marti Tamm Loring, and Corinna Young, eds. Bullying Behavior: Current Issues,

Research, and Interventions. Binghamton, New York: Haworth Maltreatment and Trauma Press, 2002.

Needham, Andrea. Workplace Bullying: The Costly Business Secret. New York: Penguin Global, 2004.

O’Moore, Mona, and Stephen Minton. Dealing with Bully- ing in Schools: A Training Manual for Teachers, Parents and Other Professionals. London: Paul Chapman Pub-

lishing, 2004.

K E Y T E R M S

Antisocial personality disorder—A personality dis- order characterized by aggressive, impulsive, or even violent actions that violate the established rules or conventions of a society.

Anxiety disorder—A group of mood disorders characterized by apprehension and associated bodily symptoms of tension (such as tense muscles, fast breathing, rapid heart beat). When anxious, the individual anticipates threat, danger, or misfortune. Anxiety disorders include panic disorder (with or without agoraphobia), agoraphobia without panic disorder, specific phobias, social phobia, obses- sive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), acute stress disorder, gener- alized anxiety disorder, anxiety disorder due to a general medical condition, and substance-induced anxiety disorder.

Representative sample—A subset of the overall population of interest that is chosen so that it accu- rately displays the same essential characteristics of the larger population in the same proportion.

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Rigby, Ken. New Perspectives on Bullying. London: Jessica Kingsley Publishers, 2002.

VandenBos, Gary R.,ed. APA Dictionary of Psychology. Washington, D.C.: American Psychological Associa-

tion, 2007.

PERIODICALS

Ahmed, Eliza, and Valerie Braithwaite. ‘‘Forgiveness, Reconciliation, and Shame: Three Key Variables in Reducing School Bullying.’’ Journal of Social Issues 62.2 (2006): 347–70.

Bowling, Nathan A., and Terry A. Beehr. ‘‘Workplace Harassment from the Victim’s Perspective: A Theoret- ical Model and Meta-Analysis.’’ Journal of Applied

Psychology 91.5 (2006): 998–1012.

Chan, John H. F. ‘‘Systemic Patterns in Bullying and Victimization.’’ School Psychology International 27.3 (2006): 352–369.

Cossa, Mario. ‘‘How Rude!: Using Sociodrama in the Investigation of Bullying and Harassing Behavior and in Teaching Civility in Educational Communities.’’ Journal of Group Psychotherapy, Psychodrama and

Sociometry 58.4 (2006): 182–94.

Heydenberk, Roberta A., Warren R. Heydenberk, and Vera Tzenova. ‘‘Conflict Resolution and Bully Prevention:

Skills for School Success.’’ Conflict Resolution Quar- terly 24.1 (2006): 55–69.

Kim, Young Shin, Bennett L. Leventhal, Yun-Joo Koh, Alan Hubbard, and W. Thomas Boyce. ‘‘School Bully-

ing and Youth Violence: Causes or Consequences of Psychopathologic Behavior?’’ Archives of General Psychiatry 63.9 (2006): 1035–41.

Ledley, Deborah Roth, and others. ‘‘The Relationship

Between Childhood Teasing and Later Interpersonal Functioning.’’ Journal of Psychopathology and Behav- ioral Assessment 28.1 (2006): 33–40.

Lee, Raymond T., and Céleste M. Brotheridge. ‘‘When Prey Turns Predatory: Workplace Bullying as a Predictor of Counteraggression/Bullying, Coping, and Well-Being.’’ European Journal of Work and Organizational Psychol-

ogy 15.3 (2006): 352–77.

Lewis, Sian E. ‘‘Recognition of Workplace Bullying: A Qualitative Study of Women Targets in the Public

Sector.’’ Journal of Community and Applied Social Psychology 16.2 (2006): 119–35.

Lutgen-Sandvik, Pamela. ‘‘Take This Job and . . . : Quitting and Other Forms of Resistance to Workplace Bullying.’’

Communication Monographs 73.4 (2006): 406–33.

Moayed, Farman A., Nancy Daraiseh, Richard Shell, and Sam Salem. ‘‘Workplace Bullying: A Systematic Review of Risk Factors and Outcomes.’’ Theoretical Issues in

Ergonomics Science 7.3 (2006): 311–27.

Nickel, Marius K., and others. ‘‘Influence of Family Ther- apy on Bullying Behaviour, Cortisol Secretion, Anger,

and Quality of Life in Bullying Male Adolescents: A Randomized, Prospective, Controlled Study.’’ Cana- dian Journal of Psychiatry 51.6 (2006): 355–62.

Parkins, Irina Sumajin, and Harold D. Fishbein. ‘‘The

Influence of Personality on Workplace Bullying and

Discrimination.’’ Journal of Applied Social Psychology 36.10 (2006): 2554–77.

Patchin, Justin W., and Sameer Hinduja. ‘‘Bullies Move

Beyond the Schoolyard: A Preliminary Look at Cyber- bullying.’’ Youth Violence and Juvenile Justice 4.2 (2006): 148–69.

Peskin, Melissa Fleschler, Susan R. Tortolero, and Christine

M. Markham. ‘‘Bullying and Victimization Among Black and Hispanic Adolescents.’’ Adolescence 41.163 (2006): 467–84.

Phillips, Debby A. ‘‘Punking and Bullying: Strategies in Middle School, High School, and Beyond.’’ Journal of Interpersonal Violence 22.2 (2007): 158–78.

Twemlow, Stuart W., Peter Fonagy, Frank C. Sacco, and John R. Brethour Jr. ‘‘Teachers Who Bully Students: A Hidden Trauma.’’ International Journal of Social Psy-

chiatry 52.3 (2006): 187–98.

ORGANIZATIONS

American Academy of Child and Adolescent Psychiatry. 3615 Wisconsin Avenue N.W., Washington, DC 20016-3007. Telephone: (202) 966-7300. <http://www.aacap.org>.

Mental Health America. 2000 N. Beauregard Street, 6th

Floor, Alexandria, VA 22311. Telephone: (800) 969- 6642. TTY: (800) 433-5959. <http://www.nmha.org>.

National Institute of Child Health and Human Develop-

ment. P.O. Box 3006, Rockville, MD 20847. Tele- phone: (800) 370-2943. TTY: Telephone: (888) 320- 6942. <http://www.nichd.nih.gov>.

National Institute of Mental Health (NIMH), Public Infor- mation and Communications Branch. 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD

20892-9663. Telephone: (866) 615-6464. TTY: (866) 415-8051. <http://www.nimh.nih.gov>.

National Mental Health Information Center. P.O. Box

42557, Washington, DC 20015. Telephone: (800) 789-

2647. TDD: (866) 889-2647. <http://mentalhealth.

samhsa.gov>.

National Youth Violence Prevention Resource Center. P.O. Box 10809, Rockville, MD 20849-0809. Telephone: (866) 723-3968. TTY: (888) 503-3952. <http://www. safeyouth.org>.

U.S. Human Resources and Service Administration, Stop Bullying Now!<http://www.stopbullyingnow.hrsa.gov>.

Workplace Bullying Institute. Telephone: (360) 656-6630.

<http://www .bullyinginstitute.org>.

Ruth A. Wienclaw, PhD

Bupropion Definition

Bupropion is an antidepressant drug used to ele- vate mood and promote recovery of a normal range of emotions in patients with depressive disorders. In

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sponsored tour of classrooms in 1895. This time he was armed with the first comparative test—a school/ student survey—ever used in American education or psychology. During sixteen months of study, Rice administered his survey to nearly 33,000 fourth- to eighth-grade children, and he carefully tabulated modifying conditions such as age, nationality, envi- ronment, and type of school system. The survey fo- cused, in part, on the pedagogy of spelling. Rice found no link between the time spent on spelling drills and students’ performance on spelling tests. His study was far ahead of its time, not only method- ologically but also pedagogically, as he pointed to ‘‘the futility of the spelling grind.’’

Rice served as editor of the Forum from 1897 through 1907. He retired in Philadelphia in 1915, the same year that he published his last book, The Peo- ple’s Government. He had married Deborah Levin- son in 1900; they had two children. He died in Philadelphia, June 1934.

See also: Assessment, Classroom; Education Re- form; Herbart, Johann.

B I B L I O G R A P H Y

Houston, Camille M. E. 1965. ‘‘Joseph Mayer Rice: Pioneer in Educational Research.’’ M.S. thesis, University of Wisconsin, Madison.

Rice, Joseph M. 1893. The Public-School System of the United States. New York: Century.

Rice, Joseph M. 1898. The Rational Spelling Book. New York: American Book.

Rice, Joseph M. 1913. Scientific Management in Ed- ucation. New York: Hinds, Noble and Eldredge.

Rice, Joseph M. 1915. The People’s Government. Philadelphia: Winston.

Janet L. Miller

RISK BEHAVIORS

DRUG USE AMONG TEENS Christopher L. Ringwalt

HIV/AIDS AND ITS IMPACT ON ADOLESCENTS Denise Dion Hallfors Carolyn Tucker Halpern Bonita Iritani

SEXUAL ACTIVITY AMONG TEENS AND TEEN PREGNANCY TRENDS Sheila Peters

SEXUALLY TRANSMITTED DISEASES Angela Huang

SMOKING AND ITS EFFECT ON CHILDREN’S HEALTH Christopher S. Greeley

SUICIDE Peter L. Sheras

TEEN PREGNANCY Douglas B. Kirby

DRUG USE AMONG TEENS

Substance abuse is an international problem of epi- demic proportions that has particularly devastating effects on youth because the early initiation of alco- hol, tobacco, or other drug (ATOD) use within this population is linked to abuse and related problem behaviors among adults. The cost of alcohol abuse to society is estimated to be $250 billion per year in health care, public safety, and social welfare expendi- tures. Key trends in substance use by twelfth graders are displayed in Table 1.

Causes

A number of models and theories address the causes of adole

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