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J Sch Nurs. 2018 Jan 1:1059840517707242. doi: 10.1177/1059840517707242. [Epub ahead of print]

Rates of Exposure to Victimizing Events and Use of Substances Among California's Middle and High School Students.

Larson S1, Brindis CD2,3,4,5, Chapman SA2,6,7, Spetz J2,6,7,8.

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1 Department of Community Health, San José State University The Valley Foundation School of Nursing, San Jose, CA, USA.
2 Philip R. Lee Institute of Health Policy Studies (PRL-IHPS), University of California San Francisco (UCSF), San Francisco, CA, USA.
3 Department of Pediatrics, UCSF School of Medicine, San Francisco, CA, USA.
4 Department of Obstetrics, Gynecology, and Reproductive Health Services, UCSF School of Medicine, San Francisco, CA, USA.
5 Adolescent and Young Adult Health National Resource Center, UCSF, San Francisco, CA, USA.
6 Department of Social and Behavioral Sciences, UCSF School of Nursing, San Francisco, CA, USA.
7 Healthforce Center at UCSF, San Francisco, CA, USA.
8 Department of Family and Community Medicine, UCSF School of Medicine, San Francisco, CA, USA.


Nearly half of 5- to 17-year-olds have experienced trauma in the form of at-school victimization. Exposure to trauma increases students' risk for mental health disorders and school failure. This study reviews at-school victimization in middle and high school students and associated health outcomes that may negatively impact academic outcomes. Analyzing the California Healthy Kids Survey 2010, we examine rates of victimization on school grounds, substance use, and symptoms of depression and eating disorders among a sample of 6th to 12th graders ( N = 639,925). Between 20% and 50% of students had experienced at least one type of victimizing event on school grounds, with the highest incidence in middle schools. A significantly higher share of victimized students reported using substances, symptoms of depression and eating disorders when compared to nonvictimized students. School district investment in school nurses, social workers, and school-based health centers could increase preventive interventions to improve school climate, student well-being, and academic success.


child and adolescent; mental health; school-based health services; substance use; victimization


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