Merck Manual

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Violent Behavior in Children and Adolescents


Stephen Brian Sulkes

, MD, Golisano Children’s Hospital at Strong, University of Rochester School of Medicine and Dentistry

Reviewed/Revised May 2023

Many children and adolescents occasionally have physical confrontations with others, but most children and adolescents do not continue violent behavior or engage in violent crime. However, children who exhibit violent behavior before puberty may be at higher risk of committing crimes.

Many risk factors for youth violence are linked to experiencing prolonged or repeated stress. This stress can negatively change the brain development. Known risk factors for violent behavior include the following:

  • Exposure to violence or history of violent victimization

  • Developmental or behavioral issues

  • Alcohol and drug misuse by caregivers of the child or adolescent

  • Harsh, lax, or inconsistent disciplinary practices or neglect by parents or caregivers

  • Association with delinquent peers or gang involvement

  • Living in a community with diminished economic opportunities, high levels of family disruption, or social disorganization

  • Access to firearms

Violent video games may desensitize children to violence. Although experts do not think they actually cause children to become violent, children exposed to them are more used to violence being part of life.

Gang involvement

Gang members are typically ages 13 to 24. Gangs usually adopt a name and identifying symbols, such as a particular style of clothing, the use of certain hand signs, tattoos, or graffiti. Some gangs require prospective members to perform random acts of violence before membership is granted.

Increasing youth gang violence has been blamed at least in part on gang involvement in drug distribution and drug use, particularly methamphetamines and heroin.


Bullying Bullying Bullying is a form of violence in which repeated verbal, emotional, physical, and/or psychological attacks are done to dominate or humiliate another person. (See also Overview of Social Issues... read more is intentional infliction of psychologic or physical damage on less powerful children. Up to one third of children may be involved in bullying as bullies, victims, or both.

Social stresses, such as low family income and low parent education levels, are risk factors for bullying.

Bullying can take several forms, including

  • Repeated teasing

  • Threats or intimidation

  • Harassment

  • Violent assaults

  • Cyberbullying (use of e-mail, texting, social media, and other digital communication tools to threaten and/or spread hurtful information)

"Sexting," which is the act of sharing sexually charged messages or photographs (usually via cell phone), can be a form of cyberbullying if the messages or photographs are purposefully shared with other people to embarrass or harm the child who originated or appeared in the message or photograph.

Bullies act to inflate their sense of self-worth. They often report that bullying creates feelings of power and control.

Victims often tell no one about being bullied because they are ashamed, because they feel that nothing will be done, or because they fear the bully will retaliate. Children who are bullied may reach a breaking point, at which time they strike back with potentially dangerous or catastrophic results.

Both bullies and their victims are at risk of poor outcomes. Victims are at risk of physical injury, poor self-esteem, anxiety, depression, and school absence. Many victims of bullying become bullies themselves. Bullies are more likely to be imprisoned in later life. Bullies are less likely to remain in school, be employed, or have stable relationships as adults.

Prevention of Violent Behavior in Children and Adolescents

Violence prevention should begin in early childhood. Strategies include the following:

  • Not using violence to discipline young children

  • Limiting access to weapons and exposure to violence through media and video games

  • Creating and maintaining a safe school environment

  • Encouraging victims to report problems to their parents and school authorities

  • Teaching older children and adolescents strategies for avoiding high-risk situations (including places or settings where others have weapons or are using alcohol or drugs) and for reacting to or defusing tense situations

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