Elsevier

Academic Pediatrics

Volume 15, Issue 1, January–February 2015, Pages 103-110
Academic Pediatrics

Issue for School-Aged Children
Why Adolescents Fight: A Qualitative Study of Youth Perspectives on Fighting and Its Prevention

https://doi.org/10.1016/j.acap.2014.06.020Get rights and content

Abstract

Objective

To identify risk factors for fighting, factors that protect against fighting, and strategies to prevent fighting, among adolescents who fight and those uninvolved in fighting.

Methods

Focus groups were conducted with middle and high school students, stratified by fighting (fighter/nonfighter) status, race/ethnicity, and gender. Groups were audiotaped, transcribed, and analyzed using margin coding and thematic content analysis. Themes were independently identified by 3 coders; disagreements were resolved by consensus.

Results

The 65 participants in the 12 focus groups were 13 to 17 years old. Reasons for fighting include self-defense, to gain/maintain respect, or anger; having goals for the future is protective. Nonfighters state that their parents condone fighting only when physically attacked and that they teach adolescents strategies to avoid fighting. Fighters describe mixed messages from parents, and pro-fighting attitudes and modeling of aggressive behavior among some family members. Nonfighters avoid fighting by ignoring insults or walking away. Fighters feel unable to use nonviolent conflict-resolution methods effectively. Peers may instigate or encourage fights. Suggested prevention strategies include anger-management and conflict-resolution programs, relationships with caring adults, and physicians counseling youth about the consequences of fighting.

Conclusions

Nonfighters use various strategies to avoid fighting, whereas fighters are aware of few alternatives to fighting. Conflicting parental messages about fighting may enhance the likelihood of fighting. Physicians can counsel youth about the negative consequences of fighting. Interventions that teach anger management and conflict resolution, promote adolescent self-efficacy for using nonviolent strategies, and address parental attitudes about fighting may be effective in preventing fighting.

Section snippets

Study Design

Focus groups were conducted with adolescents 13 to 17 years old, 6 groups with adolescents who have been in a fight (fighters) and 6 with adolescents who have not been in a fight (nonfighters). Students self-reported participation in a physical fight in the past 12 months. Groups were stratified by gender and race/ethnicity. Participants were recruited at 2 urban middle schools and 3 high schools using flyers and in-person visits to classrooms by study personnel, who stated that the purpose of

Results

There were 65 participants in 12 focus groups. The mean age was 15.7 years (Table 2), most identified English as the primary language spoken at home, and 37% of fighters and 82% of nonfighters lived in 2-parent homes. Among fighters (Table 3), 79% had hurt someone badly enough to need medical care in the prior year, 83% had been threatened by someone, over half had threatened someone, and almost one third had carried a weapon and threatened someone with a weapon.

Discussion

This is the first qualitative study, to our knowledge, to compare the perspectives of adolescent fighters and nonfighters about fighting and strategies to prevent fighting. Themes were examined in the social-ecological framework of risk and protective factors for fighting at the individual, relationship, community, and societal levels. Risk factors exist at all levels; however, protective factors were identified primarily at the individual and family relationship levels.

Parent–child

Acknowledgments

This study was funded by the Southwest Medical Foundation Program for the Development and Evaluation of Model Community Health Initiatives in Dallas (PDEMCHID), and supported in part by grant K23HD068401 to Dr Shetgiri from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Dr. Lee is supported in part by the University of Texas Southwestern Center for Patient-Centered Outcomes Research through a grant from the Agency for Healthcare Research and Quality

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