目標：霸凌可能源於個人特徵(如犯罪)與社會(如暴力文化)之間影響。本研究旨以跨國視角探討探討個人肢體衝突、國家兇殺率與青少年霸凌行為之關聯。方法：納入2017/18學齡兒童健康行為調查(HBSC)，並整併2018世界衛生組織(WHO)兇殺率資料。排除缺少霸凌或飲酒調查且未記錄在WHO兇殺率國家(n = 6)，及未完整回覆變項資料之青少年(n = 21, 695)後，分析樣本來自40個國家或地區約180,000名青少年(n = 179,097)。霸凌行為與肢體衝突以二分法分類(0 = 無；1 = 至少一次以上)，採用多層次羅吉斯回歸進行分析。結果：各國霸凌盛行率差異顯著(6.62% - 51.70%)。空模型顯示，青少年霸凌行為存在國家差異(ICC = 0.11)。隨機截距模型發現，霸凌行為常見於有肢體衝突之青少年(AOR = 2.96， 95% CI = 2.88-3.04)，且居住在兇殺率較高的國家也會增加霸凌行為風險(AOR = 1.22， 95% CI = 1.12-1.34)。結論：個人肢體衝突與國家兇殺率皆會影響青少年霸凌行為，針對個人和社會背景之預防措施對防止霸凌行為和創造更安全、具包容性環境非常重要。

Objectives: Adolescent bullying may result from a combination of traits, such as delinquency, and sociocultural influences, such as a culture of violence. This study examined whether physical fighting and national homicide rates were associated with adolescent bullying using a multinational sample. Methods: Data were sourced from the 2017/2018 Health Behaviour in School-Aged Children study and linked to the 2018 World Health Organization national homicide rates. After we excluded incomplete survey responses (n = 21,695) and six countries for which data on adolescent bullying behavior or alcohol use were unavailable, we obtained a final sample involving 179,097 adolescents from 40 countries/regions. Data on bullying behaviors and physical fighting were dichotomized (0 = never, 1 = at least once) for ease of interpretation. Multilevel logistic regressions were also conducted. Results: Bullying prevalence varied significantly across countries (6.62%–51.70%). The null model revealed country-level differences in adolescent bullying behaviors (intraclass correlation coefficient = 0.11). The random intercept model indicated that adolescents who reported physical fighting had a higher likelihood of engaging in bullying behaviors (adjusted odds ratio [AOR] = 2.96, 95% confidence interval [CI] = 2.88–3.04). Living in countries with higher homicide rates was associated with an increased likelihood of engaging in bullying behaviors (AOR = 1.22, 95% CI = 1.12–1.34). Conclusions: Physical fighting and national homicide rates are risk factors for adolescent bullying. These findings highlight the requirement for intervention programs targeting both individual behaviors and broader social contexts to prevent bullying and promote safer environments.

學校霸凌；暴力環境；肢體衝突；兇殺率；多層次

bullying, violent environment, physical fighting, homicide rate, multilevel