Bullying and Suicide Ideation: Testing the Buffering Hypothesis of Social Support in a Sub-Saharan African Sample

Psychometric properties of the multidimensional scale of perceived social support among university of Ibadan medical students

INTRODUCTION

The Multidimensional Scale of Perceived Social Support (MSPSS) is widely used to measure perceived social support. Despite its extensive application, the scale's psychometric properties have not been tested among Nigerian medical students, who face high levels of psychological distress. This study aims to evaluate the reliability, validity and factor structure of the MSPSS among medical students at the University of Ibadan, Nigeria.

METHOD

A cross-sectional observational study was conducted with 355 preclinical and clinical medical students from the University of Ibadan. Data were collected through an online questionnaire utilising the MSPSS, which includes three subscales: family, friends, and significant other. Internal consistency was assessed using Cronbach's alpha, and construct validity was evaluated through factor analysis. Confirmatory factor analysis (CFA) was conducted to assess model fit.

RESULTS

The MSPSS demonstrated excellent internal consistency (Cronbach's alpha = 0.927), with subscale reliability for family (α = 0.892), friends (α = 0.927), and significant other (α = 0.927). Factor analysis confirmed a three-factor structure consistent with the original MSPSS, explaining 80.3% of the variance. CFA showed strong model fit indices (CFI = 0.976, TLI = 0.966, RMSEA = 0.071).

CONCLUSION

The MSPSS is a reliable and valid tool for assessing perceived social support among Nigerian medical students. The findings highlight the scale's applicability for identifying students at risk and guiding necessary interventions in medical education.

CLINICAL TRIAL NUMBER

Not Applicable.

Adverse childhood experiences and suicidality in low-income and middle-income countries: a systematic review and meta-analysis

INTRODUCTION

Suicide is an important public health problem with a complex aetiology; this includes adverse childhood experiences (ACEs). Common to suicide and ACEs research is a lack of evidence from low-income and middle-income countries (LMICs). This review aims to evaluate associations between ACEs and suicidality in LMICs.

METHODS

In this systematic review and meta-analysis, a search for articles investigating associations between any ACEs and suicidal outcomes in LMICs was conducted using Medline, Embase, PsycINFO, CINAHL and Web of Science on 2 December 2022; updated on 14 January 2025. Cross-sectional or cohort study research articles investigating ACEs prior to age 18 and using population-based, probabilistic or total population, sampling were eligible for inclusion. Suicidal outcomes across the spectrum were eligible for inclusion. Identified records underwent two-step screening by two independent reviewers; data extraction and risk of bias assessment using Joanna Briggs Institute Critical Appraisal tools were also completed in duplicate. Random-effects models were used to calculate pooled ORs. Articles that could not be meta-analysed were narratively synthesised. Reporting of this review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement.

RESULTS

Ultimately, 118 articles were included; all were of low or moderate risk of bias and none reported on suicide mortality. Six ACEs were significantly associated with increased odds of suicidal outcomes: (1) bullying-victimisation, (2) emotional, verbal or psychological abuse victim, (3) parental separation, divorce or death, (4) physical abuse or violence victim, (5) physical attack victim and (6) sexual abuse victim. Significant ORs ranged from 1.19 to 2.61. Positive associations were found across subgroup and sensitivity analyses. Narrative review found statistically significant positive and non-significant associations between ACEs and suicidal outcomes.

CONCLUSIONS

ACEs are associated with suicidal outcomes in LMICs, highlighting the need for early intervention strategies and multisector public health approaches to reducing ACEs and their potential impacts.

Peer Relationships and Social Media Use in Adolescents with Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) is a common and debilitating disorder in adolescents, yet there is little research on the disorder in young people. The current study aimed to investigate peer relationship factors in 26 adolescents (aged 12 to 17 years) with BDD, compared to 27 adolescents with anxiety disorders and 25 adolescents without mental disorders. Participants completed self-report measures on peer appearance and general victimisation, peer support, appearance co-rumination and social media use. Adolescents with BDD and anxiety disorders perceived significantly less peer support than adolescents in the non-clinical control group. Although the frequency of perceived appearance and general victimisation did not differ significantly between groups, adolescents with BDD reported significantly more distress due to appearance victimisation than the non-clinical control group. Adolescents with BDD and anxiety disorders reported spending more time on social media than the non-clinical control group, and the BDD group engaged in significantly more online appearance comparisons than both the anxiety and control group. The relationships between BDD, victimisation, social media use, and other peer factors require further empirical investigation.

Suicidal ideation and suicide attempts among students aged 12 to 24 after the lifting of COVID-19 restrictions in China: prevalence and associated factors

Objective

To investigate the prevalence and associated factors of suicidal ideation and suicide attempts among adolescent and young adults in China from December 14, 2022 to February 28, 2023, when COVID-19 restrictions were lifted.

Methods

Students in middle and high schools and colleges and universities in the province of Sichuan, China were asked to complete on-line cross-sectional surveys. Information was collected about sociodemographics, experiences related to the COVID-19 pandemic, suicidal ideation and suicide attempts. Participants also filled out the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 and the Social Support Rate Scale surveys. Factors associated with suicidal ideation or suicide attempts were explored using logistic regression.

Results

Of the 82,873 respondents (aged 12 to 24 years), 21,292 (25.7%) reported having thought of suicide at least once in their lifetime, 10,382 (12.5%) reported having thought about suicide within the previous 12 months, and 1,123 (1.4%) reported having attempted it within the previous 12 months. Risk of lifetime suicidal ideation was higher among middle school students than among older students. Risk of suicidal ideation and risk of suicide attempts correlated directly with severity of symptoms of depression and anxiety, and inversely with level of social support. Greater risk of suicidal ideation and suicidal attempts was associated with: being female, living in an urban environment, attending a boarding school, currently being in love, having parents who divorced or remarried, having parents who exhibit non-authoritative parenting behavior, having higher family income, having been COVID-19 infected, having been quarantined for a long time, and being dissatisfied with one's education.

Conclusions

Suicidal ideation and suicide attempts remain prevalent among young people in China. The potential associated factors identified in our study may be useful for targeting appropriate psychosocial interventions and developing mental health policies.

Face-to-face bullying in and outside of schools and cyberbullying are associated with suicidality in Kenyan high school students: a public health issue

BACKGROUND

Childhood bullying has been classified as a major public health concern by WHO, with negative effects on the health education and social outcomes of both bullies and victims. There is no current Kenyan data on the prevalence of face-to-face bullying and cyberbullying co-occurring in the same cohort of youth and how they are associated with different aspects of suicidality and socio-demographic characteristics. This study aims to fill these gaps in the Kenyan situation so as to inform current policy and practice.

METHODOLOGY

This cross-sectional study involved 2,652 students from ten secondary schools in Kenya, selected from three regions representing different levels of public funded schools and socioeconomic spaces. The outcome variable was derived from the questionnaire which asked students questions related to self-harm, suicide thoughts, plans, and attempts. Predictor variables were based on response on experience of bullying in school, out of school, at home, and cyberbullying. Other variables such as gender, age, family background, and class were also collected from the self-reported questions. Data were analyzed using SPSS version 25, with descriptive summary statistics and chi-square tests used to examine variables, and logistic regression analysis used to determine the associations between suicidality and experience of bullying.

RESULTS

The mean age was 16.13 years. More than half of the participants were male, with the largest proportion living in rural areas. Face-to-face bullying was more prevalent than cyberbullying, with 82% of participants experiencing bullying and 68% experiencing it almost daily in the past six months. Both face-to-face bullying and cyberbullying were associated with suicidal thoughts, plans, and attempts. Predictors of suicidal attempts included being bullied outside of school and being a victim of group bullying, while being bullied every day and being bullied by adult men were predictors of suicidal attempts in cyberbullying.

CONCLUSION

There is a high prevalence of face-to-face bullying both in and outside schools. There is also a high prevalence of cyberbullying. Both face-to-face and cyberbullying are associated with suicidality in Kenyan high school students.

Emotion regulation strategies on psychological distress and psychological well-being of caregivers of mentally challenged children: moderating role of social support

This study investigates the moderating role of social support in the relationship between emotion regulation, psychological distress, and psychological well-being of caregivers of mentally challenged children. A total of 315 caregivers aged 18-62 (Mage = 36.99, SD = 9.90; 38.7% male, 61.3% female) completed the Emotion Regulation Questionnaire, Multidimensional Scale of Perceived Social Support, Depression Anxiety Stress Scale, and Psychological Well-being Scale. The results indicated that social support significantly moderated the relationship between cognitive reappraisal, expressive suppression, and psychological well-being. However, the moderating effect of social support in the relationship between cognitive reappraisal, expressive suppression, and psychological distress was insignificant. The findings suggest that caregivers of mentally challenged children with high social support will report higher psychological well-being when they adopt cognitive reappraisal and expressive suppression strategies.

Social Support, Psychological Strain, and Suicidality: Evidence from Chinese Universities

This study aimed to apply psychological strain theory to explore the relationship between psychological strain and suicidality among Chinese young adults with a moderating effect of perceived social support. A questionnaire was administered with the Multidimensional Scale of Perceived Social Support (MSPSS), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Psychological Strain Scale (PSS) among 13,250 college students across China. The main determinants of suicidal behavior were examined with multiple linear regression. Two steps of multiple regression were employed to define the moderating effect of social support. A positive relationship between psychological strain and suicidality was reported in the study, and social support was confirmed as a moderating factor between psychological strain and suicidal behavior.

The Profile of Bullying Perpetrators and Victims and Associated Factors among High School Learners in Tshwane District, South Africa

Although bullying in South African schools remains a current public health and education discussion, the view has been limited to acts of criminality, and not much has been done to identify risk factors for being bullying perpetrators and victims in a school environment. This study used a cross sectional quantitative survey to determine the profile of bullying perpetrators and victims among high school learners in a township in Pretoria. The Illinois Bully Scale was used to screen for bullying perpetration and victimization, whilst the Patient Health Questionnaire-9 and the Beck Anxiety Inventory were used to screen for depression and anxiety symptoms, respectively, among the sample of learners. STATA version 14 was used for data analysis. The sample of 460 consisted of 69% females with a mean age of 15 years. The 73.91% of learners who fitted the categories of bullying consisted of 21.96% victims, 9.57% perpetrators, and 42.39% perpetrator-victims. The Pearson Chi² test of association found a significant association between being a bullying victim and reported lack of people who loved and cared for the learner. Being a bullying perpetrator was associated with anxiety symptoms of the learner and home alcohol use, while being a perpetrator -victim was associated with lack of family love and care, the school attended, as well as depression and anxiety symptoms. Using multivariate logistic regression, being a perpetrator-victim was associated with depression symptoms, anxiety symptoms, and home use of alcohol whilst being a perpetrator was associated with lack of anxiety symptoms. The study concluded that anxiety, depression, and the home environment are strongly associated with bullying, and most learners fitted the category of being both perpetrators and victims.

Associations between sexual identity, living with disability, bully victimisation, and HIV status and intimate partner violence among residents in Nigeria

BACKGROUND

The aim of the study was to determine the associations between sexual identity, disability and HIV status and bullying victimisation, and a history of physical, emotional and sexual violence in Nigeria.

METHODS

This was a secondary analysis of a primary dataset generated through an online survey conducted between February 7 and 19, 2021. The 3197 participants for the primary study were recruited through snowballing. The dependent variables were physical, emotional and sexual violence. The independent variables were sexual identity (heterosexual and sexual minority), HIV status (negative, positive and unknown), bullying victimisation (yes/no) and living with disability (yes/no). A multivariate logistic regression model was developed for each form of IPV. Each model was adjusted for age, sex assigned at birth, marital status and education level.

RESULTS

Respondents living with HIV had higher odds for physical (AOR: 2.01; 95% CI: 1.46-2.76; p < 0.001), sexual (AOR: 2.17; 95%CI: 1.55-3.05; p < 0.001), and emotional (AOR: 1.59; 95%CI: 1.24-2.06; p < 0.001) violence. Also, those with history of bullying victimisation had higher odds for physical (AOR: 3.79; 95%CI: 2.86 - 5.68; p < 0.001), sexual (AOR: 3.05; 95%CI: 2.27 - 4.10; p < 0.001) and emotional (AOR: 2.66; 95%CI: 2.10 - 3.37; p < 0.001) violence. In addition, females had higher odds of physical (AOR: 1.52; 95%CI: 1.13-2.043; p < 0.001) and sexual (AOR: 1.83; 95%CI: 1.34 - 2.50; p < 0.001) violence; and respondents cohabiting (AOR: 1.95; 95%CI: 1.12 - 3.28; p = 0.012) had higher odds for emotional violence. Respondents who were married have significantly lower odds of experiencing physical (AOR: 0.66; 95%CI: 0.45 - 9.60; p = 0.029), sexual (AOR: 0.40; 95%CI: 0.26 - 0.62; p < 0.001) and emotional (AOR: 0.68; 95%CI: 0.50 - 0.93; p = 0.015) violence when compared to singles. Younger respondents also had lower odds of experiencing sexual violence (AOR: 0.97; 95%CI: 0.95-0.99; p = 0.016).

CONCLUSION

HIV positive status and bullying victimisation seem to increase the risk for all forms of IPV while the experience of IPV did not differ by sexual identity and disability status. The associations between age, sex, marital status and IPV may suggest moderating roles of the factors taking cognisance of the cultural context of these relationships. Future relational analysis is necessary to further understand the pathways for the associations found between the variables in this study.

Influence of Experiencing Bullying Victimization on Suicidal Ideation and Behaviors in Korean Adolescents

This study was conducted to identify the association between experiencing bullying victimization and suicidal ideation and behaviors, so as to identify the influencing factors on suicidal ideation, suicide plans, and suicide attempts among Korean adolescents. This study analyzed data from the Korean Psychosocial Anxiety Survey. The survey used nationally representative samples of Korean adolescents aged 14 to 18 years old. The experience of bullying victimization negatively influenced suicidal ideation and suicide plans, but not suicide attempts. This influence was reduced, but still remained after controlling depression, anxiety, relationships with family, relationships with teachers and friends, and social support. Influencing factors differed with suicidal ideation, plans, and attempts. Anxiety was the only factor associated with all stages of suicidality. When developing future interventions, health providers need to consider the differences in the factors associated with each stage of suicidality in adolescents.

Bullying, Victimization, and Resiliency: An Introduction to the Special Issue

This special issue focuses on bullying and victimization in young adults and factors that contribute to resiliency. The articles take into consideration cultural factors, gender, and trauma history. Several of the research studies illustrate the complexity of the factors involved in bullying and the traumatic effects of the victimization, and authors highlight targeted ways for intervention and prevention. This special issue also highlights some of the international work being conducted in these areas. The intention of this special issue is to stimulate discussion among researchers, policy makers and practitioners who are trying to reduce bullying and child maltreatment while empowering those who have been victimized. Additional research utilizing complex designs with community and school samples is still needed to address the factors involved in these situations.

Association between adverse childhood experiences, bullying, self-esteem, resilience, social support, caries and oral hygiene in children and adolescents in sub-urban Nigeria

BACKGROUND

Adverse childhood experiences (ACE) and bullying have negative effects on oral health. Promotive assets (resilience, self-esteem) and resources (perceived social support) can ameliorate their negative impact. The aim of this study was to determine the association between oral diseases (caries, caries complications and poor oral hygiene), ACE and bully victimization and the effect of access to promotive assets and resources on oral diseases.

METHODS

This was a secondary analysis of data collected through a cross-sectional school survey of children 6-16-years-old in Ile-Ife, Nigeria from October to December 2019. The outcome variables were caries, measured with the dmft/DMFT index; caries complications measured with the pufa/PUFA index; and poor oral hygiene measured with the oral hygiene index-simplified. The explanatory variables were ACE, bully victimization, resilience, self-esteem, and social support. Confounders were age, sex, and socioeconomic status. Association between the explanatory and outcome variables was determined with logistic regression.

RESULTS

Of the 1001 pupils with complete data, 81 (8.1%) had poor oral hygiene, 59 (5.9%) had caries and 6 (10.2%) of those with caries had complications. Also, 679 (67.8%) pupils had one or more ACE and 619 (62.1%) pupils had been bullied one or more times. The median (interquartile range [IQR]) for ACE was 1(3), for bully victimization was 1(5), and for self-esteem and social support scores were 22(5) and 64(34) respectively. The mean (standard deviation) score for resilience was 31(9). The two factors that were significantly associated with the presence of caries were self-esteem (AOR: 0.91; 95% CI: 0.85-0.98; p = 0.02) and social support (AOR: 0.98; 95% CI: 0.97-1,00; p = 0.02). No psychosocial factor was significantly associated with caries complications. Self-esteem was associated with poor oral hygiene (AOR: 1.09; 95% CI: 1.09-1.17; p = 0.03).

CONCLUSION

There was a complex relationship between ACE, bully victimization, access to promotive assets and resources by children and adolescents, and oral health. ACE and bully victimization were not associated with oral health problems. Though self-esteem was associated with caries and poor oral hygiene, the relationships were inverse. Promotive assets and resources were not associated with caries complications though resources were associated with lower prevalence of caries.

Internal consistency and correlation of the adverse childhood experiences, bully victimization, self-esteem, resilience, and social support scales in Nigerian children

OBJECTIVES

We evaluated the internal consistencies and the correlation between measures of adverse childhood experiences (ACE), bully victimization, self-esteem, resilience, and social support in children/adolescents in Nigeria.

RESULTS

The Cronbach's alphas were 0.67 for the ACE Questionnaire; 0.79 for the victimization subscale of the Illinois Bully Scale; 0.60 for Rosenberg's self-esteem scale; 0.81 for Connor-Davidson resilience scale; and 0.93 for multidimensional perceived social support scale. Social support was negatively correlated with ACE (r = - 0.21) and bully victimization (r = - 0.16) and was associated with higher self-esteem (r = - 0.29) and higher resilience (r = 0.15). Likewise, higher resilience was associated with fewer ACE (r = - 0.07), higher self-esteem (r = - 0.21), and higher bully victimization (r = 0.13). Higher self-esteem was associated with fewer ACE (r = 0.25) and lower bully victimization (r = 0.16), whereas bully victimization was positively correlated with ACE (r = 0.20). The correlations were all statistically significant.