Parental Characteristics Associated With Bullying Perpetration in US Children Aged 10 to 17 Years

Abstract

Objectives. We identified factors associated with child bullying in the United States.

Methods. We used the 2007 National Survey of Children’s Health to examine associations among child, parent, and community factors and bullying perpetration among children aged 10 to 17 years, using bivariate and stepwise multivariable analyses.

Results. African American and Latino children and children living in poverty and who had emotional, developmental, or behavioral (EDB) problems had higher odds of bullying, as did children of parents who felt angry with their child or who felt their child bothered them a lot or was hard to care for; suboptimal maternal mental health was associated with higher bullying odds. Children who always or usually completed homework and had parents who talked with them and met all or most of their friends had lower bullying odds.

Conclusions. Assessing children’s EDB problems, maternal mental health, and parental perceptions may identify children at risk for bullying. Parent–child communication, meeting children’s friends, and encouraging children academically were associated with lower bullying odds; these protective factors may be useful in designing preventive interventions.

Bullying is defined as intentional, repeated aggression perpetrated by a more powerful person or group on a less powerful victim.¹ Almost 30% of US middle and high school students are involved in bullying, including 13% as perpetrators of bullying (bullies), 11% as victims of bullying (victims), and 6% as both perpetrators and victims of bullying (bully victims).¹ Internationally, involvement in bullying ranges from 9% to 54%, with 3% to 20% as bullies, 5% to 20% as victims, and 1% to 20% as bully victims,² and measures of bullying vary across different studies. Bullies are more likely to experience depression, delinquency, and criminality as adults.^3–6 Victims have higher levels of chronic anxiety, depression, and psychosomatic complaints; lower self-esteem and poor psychosocial adjustment as adults; and greater likelihood of perpetrating school shootings.^3–6

Much of the research on bullying has been conducted internationally,^7–16 with a customary focus on sociodemographic and child characteristics associated with bullying.^{1,2,7–12,14–24} US studies have primarily relied on school-based self-reports from children, and few have used nationally representative data sets.^1,2,17–20 A recent meta-analysis of school-based bullying prevention interventions concluded that parent training and education are essential components of effective interventions to reduce bullying,²⁵ which suggests that parental characteristics and behaviors may influence child bullying. However, little information is available on parental characteristics associated with child bullying in the United States and whether these characteristics influence bullying independent of child or community characteristics. Research on children in the United Kingdom has shown that higher parental involvement with the child and increased maternal warmth are associated with decreased bullying.^8,9 Studies in local US communities have suggested an association of low parental monitoring and high family conflict with bullying.^18,21 One US study using nationally representative data found that parent–child communication was associated with bullying, but it did not adjust for other child, parental, or community characteristics.¹⁷ Previous studies of US children have not concurrently examined the associations of multiple factors, including child, family, and community characteristics, with bullying. In this study, we identified factors associated with child bullying perpetration using a national US data set and focusing on parental characteristics.

METHODS

The 2007 National Survey of Children’s Health (NSCH) was a population-based, random-digit-dial telephone survey conducted from April 2007 to July 2008 by the National Center for Health Statistics, sponsored by the Maternal and Child Health Bureau, using the state and local area integrated telephone survey mechanism.²⁶ The respondent in each household was the parent or guardian of 1 randomly selected child aged 0 to 17 years who was knowledgeable about the child’s health and health care. The survey was designed to provide national and state-specific estimates of children’s physical, emotional, and behavioral health and family and neighborhood characteristics. Estimates based on the sampling weights generalize to the noninstitutionalized population of US children.

Trained interviewers conducted 91 642 interviews. Interviews were completed for 66% of identified households, and the weighted overall response rate was 46.7%. The questionnaire was translated into Spanish and reviewed for accuracy and cultural appropriateness by an independent translator and Spanish-speaking phone interviewers. Similar procedures were used for Mandarin, Cantonese, Vietnamese, and Korean translations. Households were initially contacted by English-speaking interviewers, and respondents with limited English proficiency were called back by specially trained interviewers fluent in the appropriate language. More details on the survey design are available elsewhere.²⁶

We restricted the study sample to children aged 10 to 17 years (n = 44 848) to examine bullying among adolescents. Variables chosen for this study were factors in the literature associated with bully perpetration, youth violence, or delinquent behavior. The conceptual framework we used was that of the Centers for Disease Control and Prevention’s National Center for Injury Prevention, Division of Violence Prevention. This framework includes multiple levels of factors that increase the likelihood of violence, including individual, household, parental, and community characteristics that influence child and adolescent violence participation.^27,28

Measures

Outcome variable.

We assessed bullying perpetration with the question “How often was this true for [child] during the past month: [He/she] bullies or is cruel or mean to others.” Respondents chose from the following options: never, rarely, sometimes, usually, or always. The child was classified as a bully if the respondent chose sometimes, usually, or always. This question has been used to evaluate bullying in previous studies using this response classification.^20,29,30

Child characteristics.

We selected independent variables (in part) on the basis of previous studies on bullying.^{1,2,7–12,14–24} Age in years was analyzed as a continuous and categorical variable, and child’s place of birth was analyzed as a dichotomous variable. We categorized the child’s race/ethnicity on the basis of US Census Bureau categories: Latino (or Hispanic/Spanish), non-Latino African American (or Black), non-Latino American Indian/Alaska Native, non-Latino Asian/Pacific Islander, non-Latino White, and non-Latino multiracial. The presence in the child of an emotional, developmental, or behavioral (EDB) problem needing treatment or counseling has been shown to be associated with bullying,^12,16 and we examined it in this study as a dichotomous variable. School involvement and performance have also been associated with bullying,¹⁷ so we also examined whether the child participated in clubs, organizations, or sports teams; completed required homework; and had ever repeated a grade.

Family characteristics.

We categorized the highest educational attainment of a parent or guardian living in the household as not a high school graduate, high school graduate or equivalent, or at least some college. Dichotomous variables were created for primary language spoken at home (English vs non-English primary language) and parental composition (2-parent married or cohabitating household vs other). The annual combined family income was classified as the percentage of the Federal Poverty Level (FPL) as determined by the US Department of Health and Human Services in 2007, using the following categories: 100% FPL or less, more than 100% to 200% FPL, more than 200% to 300% FPL, more than 300% to 400% FPL, and more than 400% FPL.²⁶

We examined several parental characteristics associated with child bullying and externalizing problems.^{8,9,17,18,20,21} Parental involvement with the child was examined using 2 dichotomous variables: whether the parent always or usually attends the child’s events and whether the parent has met all or most of the child’s friends. We assessed parental supervision with the dichotomous variable of whether the child had been alone without an adult in the past week. Parent–child communication was assessed by determining whether the parent and child share ideas or talk very well or somewhat well. We examined suboptimal maternal mental health by determining whether the mother’s mental health status was reported by the respondent as poor, fair, or good (vs very good or excellent). Additional independent variables included whether the child was always or usually harder to care for than other children, the child always or usually did things that bothered the parent a lot, parent always or usually felt angry with the child, parent coped with the demands of parenthood very or somewhat well, parent had someone to provide emotional help with parenthood, and the relationship between parents is completely happy or very happy.

Community characteristics.

Community characteristics associated with bullying in the literature^17,21 included school and neighborhood qualities. School and neighborhood safety were categorized dichotomously (unsafe vs safe). We also examined neighborhood vandalism and supportiveness (people help each other, watch out for each other’s children, and can be counted on in the neighborhood) as dichotomous variables.

Statistical Methods

We calculated national estimates using sample weights. We used SAS 9.2³¹ and SUDAAN 10³² in all analyses to account for the complex sample design. We removed unknown values from denominators when calculating estimates, except for family income, which was multiply imputed. We performed bivariate analyses of associations between the independent variables and bullying using the t test for continuous variables and the χ² test for categorical variables. Correlations between independent variables were low, with most less than 0.4; therefore, multicollinearity was not a major concern.

We used stepwise multivariate regression to produce a final parsimonious model of variables associated with bullying, without overfitting the data.³¹ We included all variables associated with bullying in the bivariate analyses as initial candidate variables in the procedure.³¹ The initial α-to-enter was set at .15, 2-tailed P values were reported, and P < .05 was considered to be statistically significant for inclusion or withdrawal from the model. We did not assess variables for their influence on other variables in the model during the stepwise procedure. We removed less than 8% of the sample from the multivariate analysis because of unknown values. Multiple logistic regression was used to obtain adjusted odds ratios and 95% confidence intervals for factors associated with bullying perpetration.

RESULTS

Among children aged 10 to 17 years, the prevalence of bullying was 14.9%. Approximately 73% of the respondents were mothers and 21% were fathers. Almost 4 of 5 children always or usually did all required homework, and fewer than 10% had an EDB problem needing treatment. Most parents shared ideas or talked very or somewhat well with their child (96%) and had met all or most of their child’s friends (81%). Fewer than 30% of mothers had suboptimal mental health. Among all parents, 7% felt their child was always or usually much harder to care for than other children, 6% felt their child always or usually did things that bother them a lot, and 3% always or usually felt angry with their child.

Child, Parent, and Community Factors and Bullying

Child’s race/ethnicity was associated with being a bully, whereas age, gender, and birthplace were not (Table 1). All other child characteristics were significantly associated with bullying. Of note, compared with nonbullies, bullies were less likely to always or usually complete all their homework. Among bullies, approximately 1 in 4 had an EDB problem, compared with 1 in 15 nonbullies.

TABLE 1—

Bivariate Analysis of Factors Associated With Bullying Perpetration Among US Children Aged 10–17 Years: 2007 National Survey of Children’s Health, April 2007–July 2008

Characteristic	Bully (n = 5 031), % (SE)	Not Bully (n = 39 817), % (SE)	Pa
Child
Male	51.9 (1.80)	50.3 (0.65)	.38
Race/ethnicity			< .001
Non-Latino White	47.4 (1.77)	60.3 (0.68)
Latino or Hispanic	24.0 (1.94)	18.1 (0.65)
Non-Latino African American	22.4 (1.36)	13.9 (0.44)
Non-Latino Asian/Pacific Islander	1.2 (0.25)	3.5 (0.33)
Non-Latino American Indian/Alaska Native	1.2 (0.24)	0.7 (0.26)
Non-Latino multiracial	3.9 (0.46)	3.4 (0.20)
Child born in United States	92.9 (1.17)	93.2 (0.39)	.8
Always or usually does all required homework	65.8 (1.73)	85.9 (0.49)	< .001
Has a personal doctor or nurse	88.5 (1.23)	91.6 (0.40)	.02
Participates in a sport team	50.4 (1.80)	61.1 (0.66)	< .001
Participates in clubs or organizations	48.7 (1.79)	61.6 (0.67)	< .001
Has emotional, developmental, or behavioral problems needing treatment or counseling	24.3 (1.36)	6.6 (0.31)	< .001
Has repeated any grade	19.6 (1.31)	11.0 (0.46)	< .001
Household
Highest educational attainment in household			< .001
Not a high school graduate	14.3 (1.35)	7.6 (0.40)
High school graduate	29.9 (1.66)	23.5 (0.56)
≥ some college	55.8 (1.81)	68.9 (0.65)
Primary language spoken at home not English	11.5 (1.49)	10.9 (0.54)	.69
Annual family income, % Federal Poverty Levelb			< .001
≤ 100	25.7 (1.45)	14.5 (0.50)
> 100–200	25.6 (1.79)	19.8 (0.57)
> 200–300	18.6 (1.59)	18.6 (0.52)
> 300–400	12.5 (1.47)	14.3 (0.47)
> 400	17.6 (1.25)	32.7 (0.58)
2-parent household	67.4 (1.63)	77.6 (0.54)	< .001
Parent–child interaction
Parent copes with demands of parenthood very or somewhat well	93.1 (1.00)	98.3 (0.18)	< .001
Parent and child share ideas, talk very well or somewhat well	88.9 (1.18)	97.7 (0.25)	< .001
Parent has someone to provide emotional help with parenthood	79.4 (1.62)	87.8 (0.48)	< .001
Parent always or usually attends child’s events	74.7 (1.60)	85.4 (0.50)	< .001
Parents’ relationship is completely happy or very happy	69.1 (2.01)	81.9 (0.59)	< .001
Parent
Parent has met all or most of child’s friends	66.7 (1.71)	83.4 (0.53)	< .001
Mother’s mental or emotional health < very good or excellent	48.7 (1.92)	26.7 (0.62)	< .001
Child always or usually does things that bother parent a lot	20.7 (1.45)	3.6 (0.28)	< .001
Parent always or usually feels child is much harder to care for than most other children	18.5 (1.39)	5.4 (0.37)	< .001
Parent always or usually feels angry with child	12.9 (1.21)	1.6 (0.14)	< .001
Child alone without an adult in past week	19.1 (2.32)	20.3 (0.98)	.64
Community
If a child got hurt outside, someone would help	88.8 (1.10)	92.5 (0.36)	< .001
People in the neighborhood watch out for each other’s children	85.0 (1.50)	90.9 (0.39)	< .001
There is someone in the neighborhood that can be counted on	83.7 (1.41)	90.4 (0.41)	< .001
People in neighborhood help each other	81.0 (1.57)	89.6 (0.44)	< .001
Unsafe neighborhood	20.9 (1.46)	11.9 (0.46)	< .001
Unsafe school	18.9 (1.27)	11.0 (0.49)	< .001
Vandalism in neighborhood	15.8 (1.32)	10.6 (0.45)	< .001

Note. Children’s mean ages were 13.5 years (SD = 0.08) for bullies and 13.5 years (SD = 0.03) for not bullies.

^aP values were determined by the χ² test, with P > .05 considered statistically significant.

^bAs determined by the US Department of Health and Human Services in 2007.

Educational attainment in the household, family income, and family structure were associated with being a bully, whereas the primary language spoken at home was not (Table 1). Compared with nonbullies, a higher proportion of bullies lived in households that were low income, without 2 parents, and without parents who were high school graduates. Parents of nonbullies were more likely than parents of bullies to cope very or somewhat well with the demands of parenthood, share ideas with or talk very or somewhat well with their children, have someone to provide emotional help with parenthood, attend their child’s events, have a happy relationship with the other parent, and meet all or most of their child’s friends. Mothers of bullies were more likely to have suboptimal mental health than mothers of nonbullies. Parents of bullies were more likely than parents of nonbullies to always or usually feel their child did things that bothered them a lot, feel their child was hard to care for, and feel angry with their child. Parental supervision was the only parent characteristic not significantly associated with bullying.

All community characteristics were significantly associated with bullying (Table 1). Nonbullies were more likely to live in neighborhoods in which people were helpful, watched out for each other’s children, and could be counted on. Bullies were more likely to live in unsafe neighborhoods and attend unsafe schools.

Multivariate Analysis

Children aged 10 to 12 years were more likely to be bullies than were children aged 16 to 17 years. African American and Latino children had higher odds than White children of being bullies, whereas Asian/Pacific Islander children had lower odds (Table 2). Children with EDB problems had higher odds of bullying, whereas children who always or usually did required homework had lower odds of bullying. Children living in poverty had almost twice the odds of being bullies, whereas those living in households in which English was not the primary language had lower adjusted odds of bullying.

TABLE 2—

Multivariate Logistic Regression Analyses of Factors Associated With Bullying Perpetration Among US Children Aged 10–17 Years: 2007 National Survey of Children’s Health, April 2007–July 2008.

Independent Variable	Bullying Perpetration, AOR (95% CI)
Child
Age, y
10–12	1.36 (1.07, 1.72)
13–15	1.27 (1.00, 1.61)
16–17 (Ref)	1.00
Race/ethnicity
Non-Latino African American	1.42 (1.01, 2.00)
Latino or Hispanic	1.33 (1.06, 1.66)
Non-Latino American Indian/Alaska Native	1.18 (0.78, 1.79)
Non-Latino multiracial	1.16 (0.83, 1.62)
Non-Latino Asian/Pacific Islander	0.59 (0.35, 0.99)
Non-Latino White (Ref)	1.00
Child has emotional, developmental, or behavioral problem needing treatment or counseling	2.20 (1.77, 2.73)
Child always or usually does all required homework	0.55 (0.44, 0.68)
Household
Annual family income, % of Federal Poverty Levela
≤ 100	1.83 (1.37, 2.44)
> 100–200	1.70 (1.29, 2.24)
> 200–300	1.55 (1.15, 2.10)
> 300–400	1.41 (1.04, 1.90)
> 400 (Ref)	1.00
Primary language spoken in home not English	0.55 (0.34, 0.89)
Parent
Parent always or usually feels angry with child	2.99 (2.06, 4.35)
Child always or usually does things that bother parent a lot	2.11 (1.48, 3.00)
Mother’s mental or emotional health less than excellent or very good	1.57 (1.30, 1.90)
Parent always or usually feels child is much harder to care for than most other children	1.42 (1.02, 1.98)
Parent has met all or most of child’s friends	0.60 (0.48, 0.75)
Parent and child can share ideas or talk very or somewhat well	0.59 (0.37, 0.93)

Note. AOR = adjusted odds ratio; CI = confidence Interval.

^aAs determined by the US Department of Health and Human Services in 2007.

Parents who always or usually felt angry with their child, felt that the child did things that bothered them a lot, felt that their child was much harder to care for than most other children, and had suboptimal maternal mental health had higher odds of bullying. Parents who had met all or most of their child’s friends and communicated very or somewhat well with their child had significantly lower adjusted odds of bullying.

DISCUSSION

This study included the largest US sample, to our knowledge, to be analyzed for sociodemographic, child, family, and community-level risk and protective factors for bullying perpetration. The prevalence of bullying perpetration was 15%, which is comparable with that found in other studies.¹ The findings suggest that parents’ perceptions of anger with their child, that their child bothers them a lot, and that their child is harder to care for than other children and suboptimal maternal mental health are associated with higher odds of child bullying perpetration, whereas high parental involvement and communication with children are associated with lower odds of bullying perpetration.

Children of parents who were frequently angry with their child and felt that their child bothered them a lot had more than double the odds of bullying perpetration. These parents’ responses may reflect an overall pattern of negative interactions with their child, in which the child may model aggressive responses learned from the parents, which may translate into bullying. Alternatively, parents’ anger and feelings that their child bothers them a lot may reflect frustration with their child’s bullying perpetration or other problematic behaviors, which can stem from peer or other nonparental influences. This relationship between parents’ negative feelings toward their child and bullying may also be cyclical, whereby parental factors can contribute to the child’s behaviors and ability to develop personal relationships, thereby resulting in bullying; these child behaviors could then exacerbate negative parental feelings and interactions with the child. The cross-sectional nature of this study precludes attribution of causality or directionality of these relationships. Parental anger with the child may also be a symptom of an unmeasured variable, such as family conflict, which has been associated with increased bullying.¹⁸

Children with EDB problems had more than double the odds of bullying. Previous studies have shown that bullies are more likely to have EDB problems and depression.^5,7,14,16,33 Maternal depression is associated with child delinquency, antisocial behavior, aggression, and externalizing behavior.^34–36 Suboptimal maternal mental health, however, has not previously been shown to be associated with increased child bullying perpetration. In our study, suboptimal maternal mental health was significantly associated with higher odds of child bullying perpetration, even after controlling for the child’s emotional or behavioral problems. It is unclear from this cross-sectional study whether maternal depression causes bullying or whether maternal mental health is affected by the child’s bullying perpetration. The relationship between maternal mental health and child bullying perpetration may be transactional, with the child’s behaviors contributing to suboptimal maternal mental health and the mother responding to the child with negative behaviors. Maternal depression is associated with negative parenting behaviors, including irritability toward the child and disengagement from the child.^36,37 The relationship between suboptimal maternal mental health and bullying perpetration may be mediated by the quality of mother–child interaction or decreased maternal attachment to the child, which are associated with bullying.^8,20

This study is, to our knowledge, the first in the United States to document that children with parents who meet their child’s friends had significantly lower odds of bullying. The study findings also revealed that children who complete their homework and whose parents share ideas and talk with them are less likely to be bullies. These associations could reflect parent–child communication and involvement with the child. This finding is consistent with research from the United Kingdom showing that children with higher levels of parental involvement have a lower likelihood of being bullies.⁹ Parents who are more involved with their children may be more likely to monitor the completion of their children’s homework and to help as needed. The findings may also reflect that bullying behavior itself affects whether parents meet their child’s friends and communicate well with their child.

Children living in households in which English was not the primary language had lower odds of bullying. Studies have shown that these children are more likely to be victims of bullying³³ and less likely to have behavioral problems and depression or anxiety.³⁸ This status may reflect lower levels of acculturation, which has been associated with lower rates of adolescent behavior problems, such as alcohol use, drug use, and risky sexual behavior (“healthy immigrant effect”).³⁹ Acculturation appears to play a role in bullying, but it may affect victimization and perpetration differently.

The literature contains conflicting evidence regarding the associations of parental education attainment, family household composition, and community factors with bullying.^7,10,16,17 These variables were not associated with bullying perpetration in our stepwise analysis, which also examined parental and community characteristics. This lack of association may be because some characteristics were measured differently, such as family composition (other studies compared single-parent households with 2-parent households). Some studies showed that higher socioeconomic status is associated with bullying in bivariate analyses.^7,10 Our study finding that children living in poverty have higher odds of being bullies, after adjusting for parental characteristics, is also supported by the literature.^17,23 Contrary to previous studies,^{9,11,12,15–17,19,22,23} male gender was not associated with bullying in our study, which may be because our study sample did not contain boys aged 10 years and younger, and bullying among boys decreases with increasing age.¹⁶ Consistent with previous work, however, older children^11,19,24 were less likely to be bullies. The findings regarding increased bullying perpetration among African Americans and Latinos is also consistent with the literature.^2,8,12,16,19 In contrast to our initial theory, community-level characteristics were not retained in the final model obtained from the stepwise regression, perhaps because we accounted for family characteristics as well rather than limiting the focus to the child level.

Despite the strengths of the NSCH, which include the large sample size and breadth of question topics, certain study limitations should be considered. A limitation of the study is the cross-sectional survey design, which prevents inferences about causation and the direction of influence of the relational factors and bullying perpetration. Determining whether some of the child and family variables, such as child’s EDB problems, suboptimal maternal mental health, and parental perceptions of the child, predate the bullying or arise after the bullying is not possible. Further examination of these relationships should be conducted using a longitudinal study design.

NSCH data are based on parental report of child behaviors rather than child self-report or observed behavior. Methods of data collection about bullying differ across various studies and include assessment of bullying from child self-report,^2,17–21 parental report,¹⁸ teacher report,²² direct observation,²² and peer nomination.¹¹ Parental report may be subject to bias by underestimating rates of child bullying; parental perceptions of communication and involvement with their child may also differ from child perceptions. The NSCH parent-reported bullying question has, however, been used to evaluate bullying in previous studies using the same response classification of bullying (sometimes, usually, or always).^20,29,30 The finding in this study that parent–child communication is associated with bullying perpetration supports similar findings in a cross-sectional study based on child and adolescent self-reports, which showed that poor parent–child communication is associated with increased bullying perpetration,¹⁷ which suggests that the associations between parental characteristics and child bullying perpetration may persist across multiple reporters. These relationships should be further examined using self-report by children and adolescents, ideally in combination with peer and teacher reporting.

Another potential source of bias is social desirability, which may result in parental underreporting of child bullying perpetration and negative parental behaviors and overreporting of positive parental and child behaviors. Parental underreporting of bullying or negative behaviors may result in underestimation of the strength of associations between these factors and bullying, whereas overreporting of positive behaviors may result in overestimation of the strength of association between these factors and bullying. Other factors associated with bullying, such as peer influences,^19,21 self-esteem,^7,14 smoking,¹ alcohol use,^1,2 substance use,²⁴ parental use of physical discipline and harsh punishment,^18,21 child maltreatment,^8,22 and domestic violence exposure,⁸ were not available in NSCH. Of NSCH respondents, 21% were fathers. We did not examine the possible association of paternal mental health with bullying because paternal depression and involvement have not, to our knowledge, been shown to be associated with child bullying. Further research on this relationship may prove useful. The survey also did not include questions about parental experiences with bullying and child exposure to bullying in the home. The measures used were primarily single-item variables rather than scales, and some may be proxies for the underlying constructs. Mental health, for example, was measured with a single question rather than with a depression scale. The survey also did not include questions about victimization and whether perpetrators of bullying were also bullying victims.

In this study, several parental characteristics were associated with child bullying perpetration, even after controlling for sociodemographic and child characteristics. Negative parental perceptions of the child (the child bothers them, frequently makes them angry, is hard to care for) and suboptimal maternal mental health were associated with higher odds of child bullying perpetration, whereas positive parental involvement (parents communicate well with their child and meet the child’s friends) was associated with lower odds of bullying. Although we could not determine whether these associations were causal, results from the nationally representative data used in this study lend support to findings from previous international and community-based US studies on the potentially important role of parental factors in bullying perpetration.^8,9,17–21 Most current antibullying efforts, however, focus on school-based interventions with children.^40,41 These interventions primarily target children or school personnel, with minimal involvement of parents of bullies.⁴² Evaluations of school-based programs that engage parents have suggested that parental involvement may be an essential component of effective interventions but that it is often difficult to implement.²⁵ Programs that focus on the individual child, such as mentoring programs, and international studies of interventions that change the school environment have shown variable levels of success.^40,41 Continued efforts are needed to evaluate whether screening for childhood EDB problems, negative parental perceptions of children, and maternal mental health can be used to identify children at risk for being bullies. Parenting skills and parental interactions with the child could also be useful to consider when addressing bullying perpetration among children.