Bullying and suicide risk among sexual minority youth in the United States

Trends in Suicidality and Bullying among New York City Adolescents across Race and Sexual Identity: 2009-2019

Despite evidence showing rising suicidality among lesbian, gay, and bisexual (LGB) and Black adolescents, separately, there is scant research on suicide risk trajectories among youth groups across both racial and sexual identities. Thus, we examined trajectories of self-reported suicidal ideation and attempt and their associations with bullying among New York City-based adolescents. We analyzed 2009-2019 NYC Youth Risk Behavior Survey data. We ran weighted descriptive and logistic regression analyses to test for trends in dichotomous suicidal ideation, suicide attempt, bullying at school, and e-bullying variables among students across both race/ethnicity and sexual identity. We assessed associations between suicidality trends and bullying with logistic regressions. Models controlled for age and sex. Suicidal ideation and attempt were 2 and 5 times more likely among LGB than heterosexual participants, respectively. Bullying at school and e-bullying were 2 times more likely among LGB than heterosexual participants. Black LGB participants were the only LGB group for which both suicidal ideation (AOR = 1.04, SE = .003, p < .001) and attempt (AOR = 1.04, SE = .004, p < .001) increased over time. Both increased at accelerating rates. Conversely, White LGB participants were the only LGB group for which both suicidal ideation (AOR = 0.98, SE = .006, p < .001) and attempt (AOR = 0.92, SE = .008, p < .001) decreased over time. These changes occurred in parallel with significant bullying increases for Black and Latina/o/x LGB adolescents and significant bullying decreases for White LGB adolescents. Bullying was positively associated with suicidal ideation and attempt for all adolescents. Findings suggest resources aimed at curbing rising adolescent suicide should be focused on Black LGB youth.

Minority stressors and suicidal ideation in sexual minority individuals across adulthood

BACKGROUND

Suicidal ideation occurs at relatively high rates among adults identifying as sexual minorities compared to those identifying as heterosexual, and minority stress is one explanation for this disparity. Minority stress is known to associate with increased suicidal ideation, but research on how minority stress associates with suicidal ideation in sexual minority adults across the adult lifespan is lacking.

METHODS

Data were collected online from 284 sexual minority adults ranging in age from 18 to 85. Participants were recruited from Prolific and completed self-report measures assessing past-month suicidal ideation and multiple sexual minority stressors.

RESULTS

The minority stressors of acceptance concerns, concealment motivation, and difficulty processing one's identity were positively correlated with likelihood of past-month suicidal deation. Age moderated the relationship between two minority stressors and suicidal ideation: identity uncertainty and internalized homonegativity. These relationships were only significant among older adults, compared to middle-age and younger adults.

CONCLUSION

Specific internalized minority stressors about one's sexual identity were significantly associated with past-month suicidal ideation for older adults. More research is needed on how minority stress impacts recent suicidal ideation for sexual minority adults across the lifespan.

Risk and protective factors for suicidality among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people, from countries with a high global acceptance index (GAI), within the context of the socio-ecological model: A scoping review

INTRODUCTION

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people experience higher prevalence rates of suicidality than their heterosexual and/or cisgender peers. However, there is limited research that can inform suicide prevention efforts. Our aim was to synthesize quantitative, qualitative, and mixed methods research on risk and protective factors among LGBTQ+ young people, from countries with a high Global Acceptance Index.

METHODS

A scoping review guided by Arksey and O'Malley's five-stage framework, using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews protocol. Five databases and grey literature were searched for relevant studies. Identified factors were clustered by thematic type, according to the socio-ecological model to identify empirical trends and knowledge gaps. The mixed methods appraisal tool was used for quality assessment of studies.

RESULTS

Sixty-six studies met our inclusion criteria. Overall, 59 unique risk factors and 37 unique protective factors were identified. Key risk factors include past suicidality, adverse childhood experiences, internalized queerphobia, minority stress, interpersonal violence, bullying, familial conflict, and anti-LGBTQ+ policies/legislation. Key protective factors include self-affirming strategies, adult/peer support, at-school safety, access to inclusive healthcare, family connectedness, positive coming out experiences, gender-affirming services and LGBTQ+ inclusive policies and legislation.

CONCLUSIONS

Overall, our findings affirm that multiple risk and protective factors, at all levels of the socio-ecological model, interact in complex, unique and diverse ways upon suicidality among LGBTQ+ young people. Implications for suicide prevention are discussed. Further empirical studies are required, particularly at the communities, policies, and societal levels of the socio-ecological model, and these studies should include a focus on protective factors and significant within-group differences.

Relationship between suicide ideation and attempts, bully victimization, dating violence, and depressive symptoms among Black and Hispanic youth

BACKGROUND

Suicide rates among Black and Hispanic youth have been increasing over the past decade in the United States. The objective of this study was to identify risk factors for suicide ideation and attempt among Black and Hispanic youth in the United States using intersectionality theory and minority stress theory as a framework.

METHODS

Data from the CDC Youth Risk Behavior Surveillance System (YRBSS; 2015-2019) were analyzed and delimited to include only Black and Hispanic youth.

RESULTS

About 37% of the subsample identified as Black and 63% of the subsample identified as Hispanic; mean age was 16 years (SE = 0.02). Weighted multivariate logistic regressions were used to explore associations between suicide ideation and attempt, depressive symptoms, bullying, dating violence, and being threatened with a weapon. Black and Hispanic youth who had depressive symptoms, experienced bullying, dating violence, or threatened with a weapon all had increased odds of having suicide ideation and suicide attempt. Hispanic youth had the higher odds of suicide ideation and attempt than Black youth. Girls in the study also had elevated odds of suicide ideation.

CONCLUSION

This study adds to the literature on risk factors of suicide in Black and Hispanic youth and bringing to awareness the gender disparities in suicide ideation and attempt among youth.

An eighteen-year longitudinal examination of school victimization and weapon use in California secondary schools

BACKGROUND

School safety has been a major public health issue in the United States and internationally for more than three decades. Many policies and programs have been developed and implemented to prevent school violence, improve the school climate, and increase safety. There are only a few peer-reviewed studies of changes in school violence over time. The study examined changes over time in school victimization, weapon involvement and school climate, comparing change trajectories by gender and race and different change trajectories among schools.

METHODS

A longitudinal study of the biennial California Healthy Kids Survey in secondary schools from 2001 to 2019. The representative sample included 6,219,166 students in grades 7, 9, and 11 (48.8% male) from 3253 schools (66% high schools).

RESULTS

All victimization and weapon involvement items had significant and substantial linear reductions. The largest reduction involved being in a physical fight (from 25.4% to 11.0%). There were reductions in weapon involvement (d = 0.46) and victimization (d = 0.38). Biased-based victimization only declined slightly (d = -0.05). School belongingness and safety increased (d = 0.27), adult support increased a small amount (d = 0.05), and student participation declined (d = -0.10). Changes were smallest among White students. Ninety-five percent of the schools showed the same pattern of reductions.

CONCLUSIONS

The findings are in contrast to the public's concerns that school violence is a growing problem. Reductions in school violence may result from social investment in school safety. A distinction should be made between school shootings and other forms of school violence.

Sexual orientation and psychotic-like experiences among Chinese college students: the role of gender

Objective

The mental health of sexual minorities has received increasing attention, but there are few studies on the risk of psychotic-like experiences (PLEs) among sexual minorities. The purpose of this study is to explore the relationship between different sexual orientations and PLEs among college students and the moderating effect of gender.

Methods

A total of 4,460 college students from seven provinces participated in this cross-sectional survey. The χ2 test and logistic regression were used to investigate the relationship between sexual orientation and PLEs.

Results

Of the participants, 4.9% identified as bisexual, 1.1% as lesbian/gay, and 5.6% were questioning/unsure; 60.1% of the sample experienced at least one PLE item, 59.2% reported delusional experiences (DEs), and 20.6% had hallucinatory experiences (HEs). Compared with heterosexual college students, bisexual and questioning students showed a higher risk of PLEs, DEs, and HEs, and lesbian/gay students showed a higher risk of HEs. Stratified analysis indicated that sexual orientation was significantly associated with PLEs only for female college students.

Conclusion

Sexual orientation is a predictive factor of PLEs. In particular, different sexual minority subgroups show the different effects on PLEs between male and female college students. Mental health interventions for PLEs could employ distinct strategies based on different sexual orientations and gender disparity.

The relationship between school bullying victimization and mental health among high school sexual minority students in China: A cross-sectional study

BACKGROUND

School bullying has become a matter of global concern for the general public. Sexual minority youth (SMY) may experience minority stress and victimization which are known to adversely affect mental health and happiness. However, a few scholars explored and linked sexual orientation with campus bullying, depression, and anxiety symptoms under the specific cultural background of China.

OBJECTIVE

This study was to examine the effect of traditional and cyber bullying victimization on depression and anxiety among Chinese sexual minority adolescents.

METHODS

This is a cross-sectional survey with a total of 3841 subjects among senior high school students in Hunan Province, China. Related information was collected through a series of self-reported questionnaires. The association between variables was examined via a set of logistic regressions.

RESULTS

Homosexuality (OR: 6.398; 95 % CI: 3.321 to 12.325), bisexuality (OR: 3.146; 95 % CI: 1.499 to 6.603) and uncertainty of sexual orientation (OR: 2.341; 95 % CI: 1.516 to 3.615) were significantly associated with a combination of traditional and cyber bullying victimization. Compared to the heterosexual group, the sexual minority students, especially the bisexual students has a higher risk of depressive mood (OR: 2.349; 95 % CI: 1.664 to 3.316) and anxiety mood (OR: 3.049; 95 % CI: 2.150 to 4.324). Further multivariate binary hierarchical regression showed that the effects of sexual orientation and mental health were statistically significant only among those who are not involved in bullying victimization, OR values are from 1.929 (95 % CI: 1.061 to 3.507) to 3.209 (95 % CI: 2.090 to 4.927).

CONCLUSIONS

Homosexuals are most likely to be victims of a combination of traditional and cyber bullying victims. Bisexuals are most at risk for emotional problems. Sexual minorities in particular, showed differences in mental health risks between bullied and non-bullied groups. More attention needs to be paid to bullying and mental health among sexual minority students in China.

Perception of Bullying in Early Childhood Education in Spain: Pre-School Teachers vs. Psychologists

In this work, quantitative research is carried out on the perceptions of early childhood education teachers and child psychologists about the incidence of bullying behaviors in early childhood education (3 to 6 years old) and their knowledge and experience in this regard. For this purpose, two questionnaires were used, each of them oriented to one of the two groups of professionals analyzed, whose answers were subjected to statistical analysis. As for results, it has been obtained that early childhood education teachers express having received deficient training in school bullying and have little experience in its detection and treatment. Furthermore, the teachers’ conception of bullying occurring in their own schools is not realistic and differs from the knowledge they have of the existence of bullying behavior in other schools. Likewise, the existence of action plans against bullying in the school conditions the teachers’ assessments. The assessments held by psychologists differ significantly from those of teachers, mainly in the identification of the origin of bullying (which teachers attribute to the use of digital technologies and psychologists to the social and family environment of the aggressor). Finally, some implications and recommendations in terms of the training of educational professionals on bullying and the need for greater collaboration between teachers and psychologists are reported.

Perceived rather than objective weight status is associated with suicidal behaviors among Chinese adolescents: a school-based study

BACKGROUND

We aimed to explore the relationship between body mass index (BMI) and body weight perception (BWP) with suicidal behaviors among mainland Chinese adolescents.

METHODS

A nationally representative sample (N = 10 110) of Chinese adolescents was assessed in this study. Suicidal behaviors (ideation, plan and attempt) were evaluated by four self-reported questions. Generalized linear mixed model was used to estimate the adjusted odds ratios (ORs) for the association between BWP/BMI with suicidal behaviors.

RESULTS

The prevalence of suicidal ideation, suicidal plan and suicidal attempt was 12, 5 and 2.1%, respectively. After adjusting potential covariates, perceiving oneself as obese was significantly associated with increased risks of suicidal ideation (OR: 2.4, 95% confidence intervals, CI: 1.6-4.0, P = 0.001), suicidal plan (OR: 3.1, 95% CI: 1.5-6.3, P = 0.002) and suicidal attempt (OR: 3.7, 95% CI: 1.5-9.1, P = 0.001) compared with perceiving as normal weight among male adolescents; the effect attenuated to null among female adolescents. Perceiving oneself as underweight and overweight both exhibited significant adverse effect on suicidal behaviors (only suicidal ideation and suicidal plan) compared with perceiving oneself as normal weight among male adolescents, but not among female adolescents. The actual measured BMI was not significantly associated with suicidal behaviors among neither gender.

CONCLUSIONS

Self-perception of their body image rather than actual measured weight may have a gender-specific adverse effect on suicidal behaviors among Chinese adolescents.

Teacher attitudes toward lesbian, gay, and bisexual students: Evidence for intergroup contact theory and secondary transfer effects

This article presents two studies that tested the predictive validity of intergroup contact theory and secondary transfer effects related to pre-service teacher attitudes toward sexual minority youth in classrooms. Multiple regression of feeling thermometer scores in Study 1 (N = 989) suggested that more favorable attitudes are present among younger, female, bisexual or homosexual, less religious, politically left-wing pre-service teachers with lesbian, gay, and bisexual contacts. Associations with family membership and hometown size were nonsignificant. Analyses of variance in Study 2 (N = 406) showed statistically significant secondary transfer effects. For instance, teacher candidates with no lesbian women contacts showed less sexual prejudice toward lesbian students if they were in social contact with gay men and bisexual people. Implications for teacher education, teacher professionalism, and the need to create safe spaces in school for LGBTQIA+ students are discussed.

Sexual minority status, school-based violence, and current tobacco use among youth

INTRODUCTION

Sexual minority individuals experience elevated risk for smoking and violence due to a combination of general and unique identity-based risk factors. This study examined associations among sexual minority status, school-based violence, and tobacco use, among youth.

METHODS

Data for this secondary data analysis consisted of Chicago-specific data from the 2019 Youth Risk Behavior Surveillance System (n=1562). Current use (≥1 day during the previous 30 days) of any tobacco product (cigarettes, e-cigarettes, smokeless tobacco, and cigars) and school-based violence (avoided school because they felt unsafe, were threatened/injured with a weapon, were in a physical fight, and were bullied) were estimated by sexual orientation (heterosexual vs gay, lesbian, bisexual, and unsure). A chi-squared test was used to investigate associations among the variables. Path analysis was employed to examine possible mediation effects of school-based violence.

RESULTS

Thirty percent of sexual minority youth and 11.5% of heterosexual youth reported current tobacco use (χ²=55.91; p<0.001). Nearly one-third (31.8%) of youth reported school-based violence, with a higher rate (41.2%) reported by sexual minority youth compared to heterosexual youth (28.1%; χ²=19.48; p<0.001). Path analysis confirmed these associations, controlling for sex, age, and race/ethnicity. The model showed that sexual minority status increased odds of current tobacco use by a factor of 1.8 (95% CI: 1.3-2.6) via its relationship with school-based violence, explaining 33.8% of the total association between sexual minority status and tobacco use.

CONCLUSIONS

Tobacco use was higher among sexual minority youth. School-based violence partially mediated the association between sexual minority status and tobacco use. Findings highlight the need for tobacco prevention and treatment efforts for sexual minority youth and school-based interventions to reduce exposure to violence.

National Trends and Disparities in Bullying and Suicidal Behavior Across Demographic Subgroups of US Adolescents

OBJECTIVE

Suicidal behavior and bullying victimization are important indicators of adolescent psychological distress, and are patterned by sex, race/ethnicity and sexual identity. This study aimed to estimate trends and disparities in these factors along with key demographics.

METHOD

Youth Risk Behavior Survey data (2015-2019, N = 44,066) were collected biennially through national cross-sectional surveys of US school-attending adolescents. Survey-weighted logistic regressions examined disparities in past-year bullying and suicidal behavior, overall and by demographics.

RESULTS

Bullying in 2019 was highest for female (vs male) students (odds ratio [OR] = 1.82, 95% CI = 1.62, 2.06), American Indian/Alaskan Native (vs White) students (OR = 1.48, 95% 0.91, 2.41, p > .05), and gay/lesbian (vs heterosexual) students (OR = 2.81, 95% CI = 2.07, 3.81). Suicidal behavior disparities affected similar groups. There was minimal evidence for shifts in disparities since 2015, with the exception of bullying for gay/lesbian adolescents. The prevalence of bullying victimization among gay and lesbian adolescents went from 31.6% to 44.5% between 2015 and 2019, surpassing the bisexual and "Not Sure" groups to be the sexual identity group with the highest rate of bullying victimization.

CONCLUSION

Interventions that operate on multiple structural levels and empower marginalized youth are needed.

Prevalence of bullying victimization and its association with self-perceived health, psychopathology, and suicidality: A nationwide population-based survey in Taiwan

BACKGROUND

The current study aimed to assess the prevalence of bullying victimization (BV) and its association with psychopathology and suicidality in a nationwide general population.

METHODS

The target population were all the people living in Taiwan, the study samples were obtained by the following processes. A computer-assisted telephone interview was performed to identify potential respondents using telephone numbers selected with the stratified proportional randomization method. Self-reported data were evaluated. Moreover, data obtained using the validated Brief Symptom Rating Scale (BSRS-5) and Concise Mental Health Checklist (CMHC) were used to evaluate psychopathological symptoms and overall suicidal risks, respectively. Results were further analyzed using the chi-square tests and logistic regression model.

RESULTS

In total, 1930 respondents from a national general population survey were included in the analysis. The weighted prevalence of lifetime BV in the general population was 13.5%. Based on the chi-square analysis, individuals exposed to BV were at high risk for psychopathology (a BSRS-5 score of ≥6 (x² = 45.5, P ≤ .001) and high BSRS-5 scores for all five items). Bullying exposure was significantly associated with lifetime suicide ideation and suicide attempt (x² = 85.7, P ≤ .001; x² = 17.0, P ≤ .001, respectively). The help-seeking behavior of respondents exposed to bullying did not differ significantly (x² = 4.6, P = .327).

CONCLUSION

Bullying exposure is associated with recent psychopathology and lifetime suicidality. Multifactorial interactive processes contribute to long-term harmful health implications in adulthood. Nevertheless, further research on the relevant mechanisms associated with bullying and potential interventions that can decrease morbidity must be conducted.

Comprehensive Sexuality Education Improves Primary Students' Explicit and Implicit Attitudes Toward Homosexuality

Comprehensive sexuality education (CSE) is a curriculum-based process that is inclusive to gender and sexual orientation. We used the attitude toward homosexuality scale and the single category implicit association test (SC-IAT) to measure differences between explicit and implicit attitudes toward homosexuality between migrant children with 6 years CSE learning experience (experimental group, N = 70) and those without (control group, N = 80). We found that the experimental group had more positive explicit and implicit attitudes toward homosexuality than the control group. In conclusion, CSE is a useful process for improving the explicit and implicit attitudes of migrant children toward homosexuality.

Effects of Bullying Forms on Adolescent Mental Health and Protective Factors: A Global Cross-Regional Research Based on 65 Countries

Adolescent bullying is a public health issue of great global concern. Given the serious negative effect of bullying on adolescent mental health, it is critical to seek protective factors to protect adolescent mental health. From a global cross-regional perspective, the study aims to explore the relationship between forms of bullying and adolescent mental health and the role of parental support as a protective factor. Data were drawn from adolescents aged 12–17 years in 65 countries from the Global School-based Student Health Survey between 2003 and 2015. After controlling the state-fixed effects, individual adolescent behavior, and family factors, the ordinary least squares model was used to analyze the influence of bullying frequency and forms of bullying on adolescent mental health. The results found that the prevalence of bullying in the sample of 167,286 adolescents was 32.03%, with the highest prevalence of bullying in the sample countries in Africa. Verbal bullying had the highest prevalence and the most significant negative effect on adolescent mental health. The study also discussed the differences in bullying among adolescents by gender, age, and region. “Parental supervision”, “parental connectedness” and “parental bonding” played a positive and protective role in the mental health of adolescents who experienced bullying.

Stigma and cervical cancer prevention: A scoping review of the U.S. literature

Cervical cancer is preventable through HPV vaccination and screening however, uptake falls below national targets. A scoping review was conducted to describe stigmas related to HPV infection and vaccination and cervical cancer and screening in the US. Results were organized into the domains proposed by Stangl and colleagues' Health Stigma and Discrimination Framework. Common drivers of stigma were fear of social judgement and rejection, self-blame, and shame. Positive facilitators included social norms that provided motivation to receive HPV vaccination and screening. Gender and social norms were notable negative facilitators of stigma. HPV infection and cervical cancer resulted in stigma marking through the belief that both result from incautious behavior-either multiple sexual partners or failing to get screening. Stereotyping and prejudice were stigma practices attributed to HPV infection and cervical cancer through these same behaviors. Stigma experiences related to HPV infection, cervical cancer, and abnormal screening results included altered self-image based on perceived/anticipated stigma, as well as discrimination. This review advances understanding of the multiple dimensions of stigma associated with these outcomes in the US population. Three areas warrant additional consideration. Future studies should 1) assess how stigma dimensions affect uptake of cervical cancer preventions efforts; 2) focus on US women most affected by cervical cancer incidence and mortality to identify potential differences in these dimensions and tailor interventions accordingly; 3) include women from geographic areas of the US with high rates of cervical cancer to adapt interventions that address potential regional variations in resources and need.