Bullying and victimization among children.

Bullying among children is a significant public health problem world-wide. Bullying is most commonly defined as repeated, intentional aggression, perpetrated by a more powerful individual or group against a less powerful victim. Trends in victimization and moderate to frequent bullying may be decreasing slightly in the United States, but over 20% of children continue to be involved in bullying. Direct bullying consists of physical and verbal aggression, whereas indirect bullying involves relational aggression. Cyber bullying is an emerging problem which may be more difficult to identify and intervene with than traditional bullying. Bullies, victims, and bully-victims are at risk for negative short and long-term consequences such as depression, anxiety, low self-esteem, and delinquency. Various individual, parental, and peer factors increase the risk for involvement in bullying. Anti-bullying interventions are predominantly school-based and demonstrate variable results. Healthcare providers can intervene in bullying by identifying potential bullies or victims, screening them for co-morbidities, providing counseling and resources, and advocating for bullying prevention.