While it may be cute when a 3-year-old imitates his parent's bad behavior, when adolescents do so, it's no longer a laughing matter.

Teens who fight may be modeling what they see adult relatives do or have parents with pro-fighting attitudes, according to a study presented at the Pediatric Academic Societies (PAS) annual meeting in Boston.

"Parents and other adults in the family have a substantial influence on adolescents' engagement in fighting," said Rashmi Shetgiri, MD, FAAP, lead author of the study. "Interventions to prevent fighting, therefore, should involve parents and teens."

Dr. Shetgiri, assistant professor of pediatrics at University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, and her colleagues conducted 12 focus groups with 65 middle and high school students to discuss why youths fight and how violence can be prevented. Groups were divided by race/ethnicity and whether students were fighters or nonfighters based on self-report.

Youths said they fight to defend themselves or others, to gain or maintain respect, to respond to verbal insults or because they are angry due to other stressors. Girls also cited gossip or jealousy as reasons for fighting.

The discussions showed that parental attitudes toward fighting and parental role modeling of aggressive behavior influence youth fighting. Family attitudes also may prevent youths from fighting. Many Latino students, for example, noted that their parents condoned fighting only when physically attacked and said not wanting to hurt or embarrass their parents could prevent them from fighting.

Peers also can have a positive or negative influence on fighting by de-escalating situations or encouraging violence.

The conversations also revealed that nonfighters use various strategies to avoid confrontations such as walking away, ignoring insults or joking to diffuse tension. Fighters, however, said they are unable to ignore insults and are aware of few other conflict-resolution methods.

Potential interventions suggested by youths include anger and stress management programs led by young adults who have overcome violence, and doctors counseling youths about the consequences of fighting.

"Our study suggested that there may be differences between boys and girls, and racial/ethnic groups in risk and protective factors for fighting," Dr. Shetgiri concluded. "This has important implications for violence prevention programs and individuals working with violent teens."