Objective: Chronic teasing and bullying is a serious problem for 10% of children in the United States. Until teasing and bullying were linked to outbreaks of school violence, this problem received scant attention in the literature from researchers and clinicians alike. Moreover, despite the negative effects on children's psychological health, no valid instrument exists to identify children experiencing teasing/bullying. The purpose of the first phase of the Child-Adolescent Teasing Scale (CATS) project was to discover significant factors that constitute teasing/bullying experiences of middle school children as the basis for subsequent development and testing of an instrument to identify at-risk youth. In this paper, the CATS team will report results from Phase I of the project. Design: To elicit descriptions of children's experiences of teasing/bullying, the researchers used a multi-site focus group design. Population, Sample, Setting, Years: Focus group participants were 11-14 year old middle school students from three diverse regions of the United States: Massachusetts, New Mexico, and Mississippi. Participants in six focus groups of 8-10 children per group had the following characteristics: African- American (two groups), Caucasian/White (three groups) and Hispanic (one group). A seventh group was composed of children with visible chronic health conditions. The settings for the focus groups were three middle schools and one primary care health center. Data were collected over a 5-month period for all sites. Concepts: Teasing and bullying were the two concepts explored in this phase of the CATS study. Teasing refers to dynamic social interactions comprised of a set of verbal and/or non-verbal behaviors occurring among peers that is humorous and playful on one level but that may be annoying or distressing to the target child on another level. Bullying refers to repetitive persistent patterns of verbal and/or non-verbal behaviors directed by one or more children toward another child that are intended to inflict deliberate physical, verbal, or emotional abuse. Methods: After obtaining university human subject committee approval, researchers negotiated with the appropriate administrators at each site to gain entry to the schools and to a health center to conduct focus groups. Specific procedures were adapted as necessary for each site regarding specific plans for obtaining parental consent and student assent, providing small incentives for participants, and arranging the setting and schedule for running the groups. Researchers maintained consistency in important procedures by following established focus group guidelines. Group moderators used a semi-structured interview guide to elicit students' views about teasing and bullying. Group sessions were recorded and transcribed to produce verbatim accounts. Findings: Content analysis generated descriptions of behaviors that are sources of teasing and bullying. After initial coding of behavioral descriptions, the research team reached consensus about four major categories of sources of teasing/bullying: appearance, personal behavior, family/environment, and school relations. Comparisons across regions, racial/ethnic groups, and gender revealed commonalities of categories; however, cultural, geographic, and social-economic factors influenced some specific responses and interpretations. Conclusions: Middle school students in three regions of the United States with diverse ethnic/racial backgrounds provided descriptions of teasing and bullying experiences. These descriptions clustered into four main categories: appearance, personal behavior, family/environment, and school relations. Students' descriptions confirmed that teasing and bullying experiences were universal and distressing to varying degrees depending on context, frequency, and individually attributed meanings. Implications: Health care clinicians such as school nurses, pediatric nurse practitioners and pediatricians, and psychiatric-mental health nurses and other clinicians, and school staff including teachers, guidance counselors, and administrators may apply these findings to identify children at risk for psychological and physical harm from teasing and bullying. Recognition of common experiences may enable clinicians and educators to identify children who are at-risk and to attempt to ameliorate situations that give rise to harmful chronic teasing and bullying. The participants' descriptions of causes of teasing and bullying provided the basis for development of the Child-Adolescent Teasing Scale, an assessment instrument for identification of at-risk youth that will enable school staff, clinicians, and parents to seek and obtain intervention before serious psychosocial problems develop.
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