We conducted this cross-sectional study to determine the prevalence of intentional injuries (violence-associated behaviors and self-injury) and their association with socio-demographic characteristics among 1201, 15-18 years old adolescents in Tehran, Iran. For collecting the data, ‘Violence and Intentional Injuries’ questions of the Youth Risk Behavior Surveillance System were used. The Ethics Committee of Tehran University of Medical Sciences approved the protocol of the study. The sampling method was multi-stage random cluster sampling. Data were analyzed using SPSS software (Ver 16.0) and STATA (Ver 10). The univariate analysis and multivariate logistic regression analysis were applied.

The mean age of participants (609 females) was 16.74 (1.09). The prevalence of violence-associated behaviors and self-injury in both genders is presented in Table I. Overall, 63.9% of studied adolescents had at least one intentional injury behavior which was significantly higher in males than females (P < 0.0001, OR = 2.52, 95% CI = 1.97-3.22). Gender preference for males by parents [AOR: 1.77]; very high or very low parental supervision [AOR: 2.96 and 2.51]; making decisions in the family only by the father [AOR: 3.79]; adequate family income [AOR: 0.32]; lifetime water pipe smoking [AOR: 3.32]; and alcohol consumption [AOR: 21.24] were factors significantly associated with intentional injuries in females. In addition, poor wealth index [AOR: 3.42], having been punished by parents [AOR: 0.27] and lifetime water pipe smoking [AOR: 2.98] were factors significantly associated with intentional injuries in males.

In public high school students of Tehran, the rate of intentional injuries has been reported to be 58.5% [1] . It seems that the cause of the higher prevalence of such behaviors in this study is due to differences in the studied population. The current study was home-based and all adolescents had the chance to participate in the study. Although the prevalence of violence-related behaviors in this study was lower than that of other parts of the world [2], the prevalence of some behaviors such as participation in physical fighting and being injured was higher than that of 12-19 year old students in Malaysia [3]. Consistent with other studies, the current results show that socio-demographic factors are effective factors in committing violence-related behaviors [3-5].

The obtained findings indicate high prevalence of intentional injuries among adolescents, particularly males. Since numerous studies report effectiveness of rage control programs in preventing violence, planning for such programs and workshops can have a significant role in decreasing violent behaviors among adolescents.

Acknowledgements: Eesa Mohammadi (Tarbiat Modares University) for helpful and useful comments.

Funding: Tehran University of Medical Sciences (TUMS); Grant No 89-01-28-10494.

Competing interests: None stated.

1. Garmaroudi GHR, Makarem J, Alavi S. Health related risk behaviors among high school students In Tehran, Iran. Payesh. 2010;9:13-9.

2. Grunbaum JA, Lowry R, Kann L, Pateman B. Prevalence of health risk behaviors among Asian American/Pacific Islander high school students. J Adolesc Health. 2000;27:322-30.

3. Lee L, Chen PCY, Lee K, Kaur J. Violence-related behaviours among Malaysian adolescents: a cross sectional survey among secondary school students in Negeri Sembilan. Ann Acad Med Singapore. 2007;36:169.

4. Bergen GS, Statistics NCfH. Injury in the United States: 2007 chartbook: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2008.