Bullying and suicide. A review

The positive association of physical activity on sadness and suicide behaviors for youth who have been bullied

BACKGROUND

Youth mental health is a public health crisis. Bullying has been associated with adverse mental health outcomes including depression and suicidal ideation. We aimed to update information regarding the associations between bullying and sadness and three suicide-related outcomes, along with the potential moderating effect of physical activity (PA).

METHODS

Using the 2017-2021 Youth Risk Behavior Surveillance System (YRBSS) with students in grades 9-12 we used descriptive statistics, chi-square tests, and multivariable logistic regressions to examine the association between students who have been bullied and who reported feeling sad or hopeless, as well as considered, planned, and/or attempted suicide, within the past year. We adjusted for PA, sex, race, and grade.

RESULTS

Almost 24 % (10,828) of the sample reported being bullied. Of those, 59.9 % were female, and 60.2 % were non-Hispanic White. They reported feeling sad or hopeless, and/or considered, planned, or attempted suicide in 62.1 %, 38.5 %, 32.0 %, and 19.8 % respectively. In multivariable analyses, youth who were bullied were more often reported [aOR (95 % CI)] feeling sad or hopeless [aOR 3.75 (3.57, 3.94)], considered [aOR 3.79 (3.59, 4.00)], planned [aOR 3.78 (3.57, 4.00)], or attempted suicide [aOR 3.90 (3.62, 4.21)] compared to those not bullied. Engaging in PA reduced the odds of each outcome by 5 %-8 % for each day of activity.

CONCLUSIONS

Bullied adolescents had increased risks of experiencing adverse outcomes. Engaging in PA appears to be incrementally protective. Further research is needed to determine specific intervention characteristics that may effectively protect youth from the negative consequences of being bullied.

Association between polyvictimization and multiple suicide attempts among sexual minority youth: Findings from the 2015-2021 National Youth Risk Behavior Survey

BACKGROUND

Few studies have examined the association between polyvictimization and multiple suicide attempts among sexual minority youth (SMY) using nationally representative samples.

OBJECTIVES

The objectives of this study were to examine the prevalence of polyvictimization among SMY and the cross-sectional association between polyvictimization and multiple suicide attempts among SMY.

PARTICIPANTS AND SETTINGS

Data for this study came from the 2015-2021 Youth Risk Behavior Survey. The sample consisted of 10,092 youth (aged 14-18 years) who self-identified as lesbian, gay, questioning.

METHODS

Multinomial logistic regression was conducted to examine the association between polyvictimization and multiple suicide attempts among SMY.

RESULTS

Of the 10,092 SMY, 13.9 % attempted suicide multiple times during the past year, and 15.6 % experienced three or more forms of victimization. Controlling for other factors, the risk of multiple suicide attempts was 10.72 times higher for SMY who experienced three or more forms of victimization (RRR = 10.72, 95 % CI = 7.52-15.27) and 3.90 times higher for those who experienced two forms of victimization (RRR = 3.90, 95 % CI = 2.70-5.62), when compared to their non-victimized SMY counterparts.

CONCLUSIONS

Interventions that seek to reduce violence and victimization targeted at SMY may be effective in preventing multiple suicide attempts among SMY.

Did childhood adversity increase the vulnerability of university students to the negative mental health impact of the COVID-19 pandemic?

OBJECTIVE

To examine a potential synergistic effect of history of childhood adversity and COVID-19 pandemic exposure on the association with mental health concerns in undergraduate students. Participants: We used U-Flourish Survey data from 2019 (pre-pandemic) and 2020 (during-pandemic) first-year cohorts (n = 3,149) identified at entry to a major Canadian University.

METHODS

Interactions between childhood adversity (physical and sexual abuse, and peer bullying) and COVID-19 pandemic exposure regarding mental health concern (depressive and anxiety symptoms, suicidality, and non-suicidal self-harm) were examined on an additive scale.

RESULTS

We found a positive additive interaction between physical abuse and pandemic exposure in relation to suicidality (combined effect was greater than additive effect (risk difference 0.54 vs. 0.36)). Conversely, less than additive interactions between peer bullying and pandemic regarding depression and anxiety were observed.

CONCLUSIONS

Childhood adversities have diverse reactions to adult stressor depending on the nature of the childhood adversity and the mental health outcomes.

Risk Factors and Correlates of School Bullying and Cyberbullying among Turkish Adolescents: Evidence from a School-Based Cross-Sectional Study

Background

Traditional school bullying and cyberbullying are common experiences that adversely affect the present and future mental health of adolescents. Cyberbullying has also increased during the last decade due to the growing use of the internet, mobile technological tools, and social network systems. This study aimed to investigate the risk factors of traditional school bullying and cyberbullying.

Methods

The sample comprised 5491 adolescents (53.7% male and 46.3% female) from Grades 7 to 12 in 15 public schools. Participants were administered a self-report survey, including sociodemographics, school bullying, cyberbullying, and related variables. A logistic regression analysis was performed to examine the factors related to school bullying and cyberbullying involvement.

Results

Boys were more prone to be perpetrators or victim-perpetrators of both school and cyberbullying. The results revealed that carrying a cutting tool, short sleep duration, using the computer and mobile phone longer, and poor academic performance were risk factors for being a perpetrator (p < 0.05). In addition, school bullying involvement was related to thin or overweight body perception (p < 0.001). Regression analysis indicated that being a victim or perpetrator of school bullying showed more significant risks for being a victim or perpetrator of cyberbullying (p < 0.001).

Conclusions

We found common risk factors for both types of bullying and an overlap between school bullying and cyberbullying. These findings should be considered for developing new intervention programs and policies for preventing bullying in Turkey.

Associations Between Peer Victimization and Aggression and Three Types of Domestic Violence in Adolescents with Attention-Deficit/Hyperactivity Disorder

BACKGROUND/OBJECTIVES

Peer victimization and aggression can be detrimental to the physical and mental health of adolescents. Adolescents with attention-deficit/hyperactivity disorder (ADHD) are one of the risk groups involved in peer victimization and aggression. The association between multiple types of domestic violence and engagement in peer victimization and aggression warrants more examination in adolescents with ADHD. This study examined the associations of parent-to-child aggression (PCA), witness to domestic violence (WDV), and child-to-parent violence (CPV) with the experiences of peer victimization and aggression among adolescents with a clinical diagnosis of ADHD in Taiwan.

MATERIALS AND METHODS

In total, 247 adolescents with ADHD (206 boys and 41 girls, mean age [SD] = 13.2 [2.0] years) agreed to participate in this study. Adolescents' peer victimization and aggression, PCA, WDV, and CPV in the previous year were collected.

RESULTS

This study found that 28.3% and 12.6% of adolescents with ADHD reported experiences of peer victimization and aggression, respectively. The rates of having PCA, WDV, and CPV ranged from 38.1% to 56.3%. The results of multivariable logistic regression analysis found that child-to-parent financial demand (p = 0.016) and child-to-parent control or domination (p = 0.018) significantly correlated with the experiences of peer victimization. PCA (p = 0.010) and child-to-parent control or domination (p = 0.042) significantly correlated with the experiences of peer aggression.

CONCLUSIONS

The results of this study show that both CPV and PCA significantly correlate with the experiences of peer victimization and aggression in adolescents with ADHD. CPV and PCA should be included in adolescent prevention programs.

Testing Comparability of Gender Bullying Victimization Assessments Through a Latent Class Approach

Bullying is a social and health problem that requires appropriate interventions based on valid and fair evaluations of bullying experiences. The validity of interpretations of bullying victimization scores can be compromised by measurement artifacts or biases that may arise during the assessment process. Boys' and girls' bullying experiences could lead to differences in their response processes when they answer the bullying scale items and compromise validity if such differences come from measurement artifacts. The study is intended to illustrate how to obtain validity evidence of response processes for the Students' Experience of Being Bullied Scale from the Programme for International Student Assessment (PISA) 2018 Student Questionnaire and test measurement invariance across gender by latent class analysis (LCA). The sample was taken from the PISA 2018 study and consisted of 11,599 Spanish high school students (50.3% female, 49.7% male). Response patterns were examined through LCA. Four profiles were found: (a) Not Bullied, (b) Bullied (All Types), (c) Relational Bullying, and (d) Potential Friendly Teasing. Measurement invariance across gender was analyzed by a multigroup LCA. LCA results do not guarantee equivalence of measurements. Class prevalence per group and a multinomial logistic regression were calculated to further examine gender differences across latent classes. Boys were more likely to belong to the Bullied (All Types) class and the Potential Friendly Teasing class, whereas girls were more likely to belong to the Relational Bullying class. These findings illustrate the possibilities LCA can offer to provide validity evidence of response processes and suggest that different bullying experiences of girls and boys could compromise the fairness and validity of comparative interpretations of test scores, which is an important issue to address to develop bias-free classroom interventions.

Technology-supported cooperative learning as a universal mental health intervention in middle and high school

BACKGROUND

Adolescent mental health issues are a major public health concern, highlighted by the US Surgeon General as a crisis. Traditional school-based interventions show inconsistent success, creating a demand for effective solutions.

AIMS

This study evaluates the impact of technology-supported cooperative learning (CL) on adolescent mental health, focusing on positive peer relations and peer victimization.

MATERIALS AND METHODS

Participants included 813 adolescents (50.2% female; 70.7% White) from 12 middle and high schools in the Pacific Northwest. The study used hierarchical linear modelling (HLM) to assess the effectiveness of CL facilitated via PeerLearning.net.

RESULTS

Implementing CL led to significant improvements in peer relations and reductions in victimization and mental health problems, with moderate-to-large effect sizes observed across different demographics. Positive peer relations significantly predicted lower victimization and improved mental health.

DISCUSSION

The findings highlight the potential of technology-supported CL in addressing adolescent mental health by enhancing protective factors and reducing risks. Such interventions offer a scalable and sustainable approach for schools to address mental health challenges.

CONCLUSION

Technology-supported cooperative learning offers a promising strategy for improving adolescent mental health, demonstrating significant benefits in peer relations and reducing victimization. This approach provides schools with an accessible and effective tool to tackle the mental health crisis among students.

Bullying and self-harming behavior in universities - A cross-sectional study of a sample of 327 university students

INTRODUCTION

Bullying is a widespread public health issue, found in different contexts (e.g. schools, universities, workplaces, families), and it has negative consequences on both the perpetrator and the victim. There is a lack of studies addressing bullying among university students in Arab countries and more specifically in Lebanon. The objective of our study was to determine the prevalence of bullying among a sample of university students in Lebanon, its forms, and associated factors.

METHODS

The study consists of a cross-sectional online survey addressed to university students in Lebanon that evaluates sociodemographic data, presence and type of bullying, history of bullying during childhood, adverse childhood experiences, daily life functioning, and mental health status (reported psychiatric disorders, substance use, self-harming behaviors, and suicidal attempts). Chi-Square and Fisher's exact tests were used to compare the results between victims of bullying and the rest of the sample.

RESULTS

Three hundred and twenty-seven university students participated in this study. The prevalence of bullying was 14.1%. The main forms of reported bullying were verbal (58.7%) and social bullying (65.2%). The main associated factors were being a witness of bullying at university (84.8% vs. 56.2% - P<.001) and history of cyberbullying (13% vs. 4.6% - P=.024). Among students who reported current bullying, 28.3% had a psychiatric diagnosis, 19.6% reported substance use, 15.2% had self-harming behaviors, and 8.7% had suicide attempts. Victims of bullying in the university reported a significant negative impact on their daily lives (lack of interest in daily activities, academic decline) (83.7%) and mental health concerns (psychiatric disorders, substance use, suicide attempts) (88.4%).

CONCLUSION

Even though bullying is an event less experienced in university than in school, it is nevertheless still present with potential negative impact on the victims. Bullying in a university setting is a public health issue that could benefit from more studies as well as prevention and intervention programs.

Suicidality Among Syrian Refugee Children in Jordan

History of adverse events in childhood is one of the strongest predictors of developing negative mental health outcomes with suicidality being the most devastating consequence. Syrian refugee children are at very high risk of developing mental illness, however, the prevalence and significance of suicidal thoughts among this population remains undocumented. A total of 339 Syrian refugee children and adolescents aged 10 to 17 years and their parents living in Jordan were surveyed to assess resilience, depression and suicidality. Demographics and parental depression were correlated with child suicidality. Multivariate logistic regression analyses were used to determine the predictors of suicidality within this population. A total of 94 (27.7%) children reported suicidal statements. In the multivariate analyses we found that younger children were more likely to state suicidal ideation than older children. Of the children who stated suicidal ideation, 49 were in primary school, 19 in pre-secondary and 26 in upper-secondary school. In the multivariate analyses, mild (OR 2.633 (95% CI 1.283, 5.709)) and high (OR 6.987 (95% CI 3.532, 14.614)) depression levels among the surveyed children were predictive of suicidality. Experiencing bullying was also predictive of suicidality (OR 2.181 (95% CI 1.179, 4.035)) when compared to those who did not report any bullying. We report high rates of suicidal ideation among Syrian refugee children, especially in children with exposure to pre-existing depression or bullying. Prevention through raising awareness, education and early detection of depression are needed to address suicidality in this and other vulnerable populations of children.

Suicide and Suicide Risk in Adolescents

Suicide is the second leading cause of death for 10- to 24-year-olds in the United States and is a global public health issue, with a recent declaration of a National State of Emergency in Children's Mental Health by the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children's Hospital Association. This clinical report is an update to the previous American Academy of Pediatrics clinical report, "Suicide and Suicide Attempts in Adolescents." Because pediatricians and pediatric health care providers are at the front line of care for adolescents amid a child and adolescent mental health crisis, and because of the chronic and severe shortage of mental health specialists, it is important that pediatric health care providers become facile with recognizing risk factors associated with suicidality and at-risk populations, screening and further assessment of suicidality as indicated, and evidence-based interventions for patients with suicidal ideation and associated behaviors. Suicide risk can be mitigated by appropriate screening, bolstering of protective factors, indicated treatment, community resources, and referrals to mental health providers when available.

Factors associated with suicide attempts in the antecedent illness trajectory of bipolar disorder and schizophrenia

BACKGROUND

Factors associated with suicide attempts during the antecedent illness trajectory of bipolar disorder (BD) and schizophrenia (SZ) are poorly understood.

METHODS

Utilizing the Rochester Epidemiology Project, individuals born after 1985 in Olmsted County, MN, presented with first episode mania (FEM) or psychosis (FEP), subsequently diagnosed with BD or SZ were identified. Patient demographics, suicidal ideation with plan, self-harm, suicide attempts, psychiatric hospitalizations, substance use, and childhood adversities were quantified using the electronic health record. Analyses pooled BD and SZ groups with a transdiagnostic approach given the two diseases were not yet differentiated. Factors associated with suicide attempts were examined using bivariate methods and multivariable logistic regression modeling.

RESULTS

A total of 205 individuals with FEM or FEP (BD = 74, SZ = 131) were included. Suicide attempts were identified in 39 (19%) patients. Those with suicide attempts during antecedent illness trajectory were more likely to be female, victims of domestic violence or bullying behavior, and have higher rates of psychiatric hospitalizations, suicidal ideation with plan and/or self-harm, as well as alcohol, drug, and nicotine use before FEM/FEP onset. Based on multivariable logistic regression, three factors remained independently associated with suicidal attempts: psychiatric hospitalization (OR = 5.84, 95% CI 2.09-16.33, p < 0.001), self-harm (OR = 3.46, 95% CI 1.29-9.30, p = 0.014), and nicotine use (OR = 3.02, 95% CI 1.17-7.76, p = 0.022).

CONCLUSION

Suicidal attempts were prevalent during the antecedents of BD and SZ and were associated with several risk factors before FEM/FEP. Their clinical recognition could contribute to improve early prediction and prevention of suicide during the antecedent illness trajectory of BD and SZ.

Long-Term Relationships Between Negative Life Events and Suicidal Ideation Specifying Agnew's General Theory of Crime and Delinquency: A 7-Year Longitudinal Mediation Analysis

The purpose of this study was to examine the longitudinal mediationa(l pathways on the link between various straining experiences and suicidal ideation and to test whether its relationship was mediated by the role of negative emotions, constraints, and motivations. Data for this study were collected as part of the Korean Welfare Panel Study, which was a longitudinal study conducted among 7,027 Korean households, surveyed annually from 2006 to 2012. The results indicated that bullying victimization had important effects on negative emotions, although bullying victimization was not significant for later suicidal ideation. Peer delinquency was significantly correlated with negative emotions and positively predicted later suicidal ideation. Also, the significant impact of bullying victimization was transmitted to suicidal ideation through negative emotions. It implies that individuals' negative life events predicted strain or stressors generating negative emotions that, in turn, led to a high risk of suicidal ideation as a possible coping skill.

Invited Commentary: Modern Epidemiology Confronts COVID-19-Reflections From Psychiatric Epidemiology

Dimitris et al. (Am J Epidemiol. 2022;191(6):980-986) outline how the coronavirus disease 2019 (COVID-19) pandemic has, with mixed results, put epidemiology under the spotlight. While epidemiologic theory and methods have been critical in many successes, the ongoing global death toll from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the sometimes chaotic public messaging underscore that epidemiology as a field has room for improvement. Here, we use examples from psychiatric epidemiologic studies conducted during the COVID-19 era to reflect on errors driven by overlooking specific major methodological advances of modern epidemiology. We focus on: 1) use of nonrepresentative sampling in online surveys, which limits the potential knowledge to be gained from descriptive studies and amplifies collider stratification bias in causal studies; and 2) failure to acknowledge multiple versions of exposures (e.g., lockdown, school closure) and differences in prevalence of effect measure modifiers across contexts, which causes violations of the consistency assumption and lack of effect transportability. We finish by highlighting: 1) the heterogeneity of psychiatric epidemiologic results during the pandemic across place and sociodemographic groups and over time; 2) the importance of following the foundational advancements of modern epidemiology even in emergency settings; and 3) the need to limit the role of political agendas in cherry-picking and reporting epidemiologic evidence.

The impact of peer victimization on Chinese left-behind adolescent suicidal ideation: The mediating role of psychological suzhi and the moderating role of family cohesion

BACKGROUND

The detrimental impact of peer victimization on suicidal thoughts has been tested in numerous previous studies, but the underlying mechanisms tying the two together remain unclear, particularly for left-behind adolescents in China, who are defined as the adolescent staying behind in rural areas for a duration exceeding six months while having one or both parents relocate to urban areas for employment purposes.

OBJECTIVE

This study intends to investigate the relationship between peer victimization and suicidal ideation in Chinese left-behind adolescents and the mediating effect of psychological suzhi (a comprehensive positive quality that related to developmental, adaptive, and creative behaviors) and the moderating role of family cohesion.

PARTICIPANTS AND SETTINGS

A total of 417 Chinese left-behind adolescents (M_age at Time 1 = 14.84 ± 1.08 years; 57.55 % male) were recruited for the study. Participants came from rural counties of central China in Hunan province which has suffered a large labor migration.

METHODS

We conducted a two-wave longitudinal study with six-month intervals. Participants completed the measures of the Chinese peer victimization scale for children and adolescents, the adolescent's psychological suzhi questionnaire, the self-rating idea of suicide scale, and the cohesion dimension of the family adaptability cohesion scale.

RESULTS

Path modeling results indicated that psychological suzhi partially mediated the link between peer victimization and suicidal ideation. Family cohesion moderated the association between peer victimization and suicidal ideation. The link between peer victimization and suicidal ideation was weaker for left-behind adolescents with higher family cohesion.

CONCLUSION

Peer victimization was found to diminish psychological suzhi, which in turn increases the risk of suicidal ideation. However, family cohesion buffered the negative effect of peer victimization on suicidal ideation, suggesting that left-behind adolescents with greater family cohesion may be better equipped to prevent suicidal ideation, which has implications for future family and school education and provides some ideas and a foundation for future research.

Association of In-School and Electronic Bullying with Suicidality and Feelings of Hopelessness among Adolescents in the United States

BACKGROUND

Suicide-related behaviors increasingly contribute to behavioral health crises in the United States (U.S.) and worldwide. The problem was worsened during the COVID-19 pandemic, especially for youth and young adults. Existing research suggests suicide-related behaviors are a consequence of bullying, while hopelessness is a more distal consequence. This study examines the association of in-school and electronic bullying with suicide-related behavior and feelings of despair among adolescents, adjusted for sociodemographic characteristics, abuse experience, risk-taking behaviors, and physical appearance/lifestyles.

METHOD

Using Chi-square, logistic regression, and multinomial logistic regression, we analyzed the US 2019 Youth Risk Behavior Surveillance System (YRBSS) national component. The YRBSS includes federal, state, territorial, and freely associated state, tribal government, and local school-based surveys of representative sample middle and high school students in the US. The 2019 YRBSS participants comprised 13,605 students aged 12 to 18 years and roughly equal proportions of males and females (50.63% and 49.37%, respectively).

RESULTS

We observed a significant association (p < 0.05) between being bullied and depressive symptoms, and the association was more vital for youth bullied at school and electronically. Being bullied either at school or electronically was associated with suicidality, with a stronger association for youth who experienced being bullied in both settings.

CONCLUSION

Our findings shed light on assessing early signs of depression to prevent the formation of suicidality among bullied youth.

Predictors of self-harm and suicide in LGBT youth: The role of gender, socio-economic status, bullying and school experience

BACKGROUND

Lesbian, gay and bisexual (LGB) young people's increased risk of self-harm, suicidal attempts and suicide compared with heterosexual youth is well established. The current study sought to examine whether these findings also apply to the trans (T) population and which factors act as additional risk or protective factors.

METHODS

In a national cross-sectional survey, 3713 LGBT adolescents, aged 11-19 years, reported on their own history of self-harm, suicidal ideation and suicide attempts, as well as their experiences of school and homophobic, biphobic and transphobic bullying. Logistic regressions tested the association between risk and protective factors on self-harm, suicidal ideation and suicide attempts.

RESULTS

A high proportion of the sample reported self-harm (65.3%), suicidal ideation (73.8%) and suicide attempts (25.7%). Demographic risk factors included identifying as female, non-binary or trans and being from a low-income background. Bullying and online bullying were associated with an increased risk for each outcome, and positive school experience was associated with a reduced risk for each outcome.

CONCLUSIONS

Consistent with minority stress theory, the study found high rates of mental health problems within LGBT youth. Interventions focused on improving young people's experiences in schools appear useful targets to help improve mental health outcomes.

Systematic literature review of digital resources to educate on gender equality

Violence and discrimination against women are serious problems that affect today's society regardless of culture or social environment. Educational and government programs addressing these gender issues are difficult to scale up, insufficient or, in some cases, nonexistent. Digital resources can contribute to address discrimination against women and different technological initiatives are being carried out around the world. Videogames and digital resources have proven their effectiveness as tools to educate, prevent and raise awareness about social problems. This article presents a systematic literature review of digital resources such as videogames, apps and simulations that address gender issues including violence and stereotypes. Throughout the review, we analyze multiple characteristics of the resources found (development tools, platforms, location, target audience) to classify the studies found. The main goal of this review is to present the status of gender-focused digital resources, their evaluation studies, including the metrics used and samples, as well as the acceptance and impact of their application. Most of the studies reviewed aimed to raise awareness about gender-based violence using serious games targeted at teenagers. For the resources evaluated, pre-post questionnaires were commonly used. However, many of the projects reviewed did not have evaluation studies or the resources were not openly available, thus limiting their massive application and their potential impact on society. We consider that our results provide a starting point to better understand the role of digital resources in raising awareness about gender issues, highlighting their current limitations, and providing recommendations for future research in gender-based digital resources.

A 6-year retrospective review of psychiatric emergency service utilization by school-age children

To explore utilization patterns and associated clinical factors of school-age children who present to a psychiatric emergency department. This was a 6-year retrospective chart review study of children 5-12 years of age who presented to a psychiatric emergency service from July 2012 to June 2018 (n = 1654 patients). Demographic variables, clinical diagnoses, lifetime adverse events (physical abuse, sexual abuse, and bullying), and history of self-harm were documented for each visit. We performed a chi square analysis to identify association between demographic and clinical features with key outcomes. Increased service utilization as defined by inpatient psychiatric admission, recurrent visits, or increased length of stay were found in patients who were adopted, presented with suicidal ideation or self-harm behaviors, had a history of abuse, and had a diagnosis of depression or autism. Trends over the course of the study indicated a significantly increased percentage of patients presenting with suicidal ideation, bullying, and self-harm behaviors. The data add to the limited literature regarding school-age children with a psychiatric emergency. Increased emergency service utilization for certain subgroups of children and trends over the course of the study underscore the need for enhanced treatment options for individuals with certain demographic or clinical features, and increased outpatient, intermediate, and inpatient treatment options, as well as preventative care.

The longitudinal course of childhood bullying victimization and associations with self-injurious thoughts and behaviors in children and young people: A systematic review of the literature

INTRODUCTION

Bullying victimization has consistently been highlighted as a risk factor for self-injurious thoughts and behaviors (SITBs) in young people. This systematic review of prospective, community-based studies explored associations between bullying victimization (traditional/face-to-face and cyber) across the full spectrum of self-harm and suicidality, in children and young people aged up to (and including) 25 years. Importantly, associations by sex/gender were explored.

METHODS

MEDLINE, Embase, PsycINFO, CINAHL and Scopus were searched for articles meeting the inclusion criteria. Articles were screened by title, abstract and full text. Quality appraisal was performed using the Newcastle-Ottawa Scale for cohort studies. Data were synthesized narratively. The protocol is registered on PROSPERO (CRD42021261916) and followed PRISMA 2020 guidelines.

RESULTS

A total of 35 papers were included, across 17 countries. Results were presented by bullying type: traditional/face-to-face (n = 25), cyber (n = 7) and/or an aggregate of both types (n = 7). Outcomes included suicidal ideation (n = 17), self-harm (n = 10), suicide attempt (n = 4), NSSI (n = 4), other (n = 7). Studies measured outcomes in under 18s (n = 24), 18-25-year-olds (n = 8) and both under 18s and 18-25-year-olds (n = 3). Studies exploring the role of sex/gender (20%) found some interesting nuances.

CONCLUSIONS

Some weak to strong associations between bullying and SITBs were found yet conclusions are tentative due to study heterogeneity (e.g., methods used, conceptualizations and operationalisations of exposures/outcomes). Future research should address methodological issues raised in this review, and further explore gender differences in bullying, including by bullying sub-types (e.g., overt or relational) and victim status (e.g., victim or bully-victim).

The COVID-19 pandemic, well-being, and transitions to post-secondary education

This study examines the immediate and intermediate effects of the COVID-19 pandemic on the well-being of two high school graduation cohorts (2020 and 2021) and how changes in well-being affect students' educational plans and outcomes. Our unique panel data on 3697 students from 214 schools in 8 German federal states contain prospective survey information on three dimensions of well-being: mental health problems, self-rated health, and life satisfaction. Data is collected several months before (fall 2019), shortly before and soon after (spring 2020) as well as several months after (fall/winter 2020/21) the beginning of the COVID-19 pandemic. Applying difference-in-differences designs, random effect growth curve models, and linear regression models, we find that school closures had a positive immediate effect on students' well-being. Over the course of the pandemic, however, well-being strongly declined, mainly among the 2021 graduation cohort. We show that a strong decline in mental health is associated with changes in educational and career plans and transition outcomes. As adverse life experiences in adolescence are likely to accumulate over the life course, this study is the first to exhibit potential long-lasting negative effects of the COVID-19 pandemic on education and careers of young individuals.

Psychotic experiences, sexual minority status, and suicidal behavior among young adult college students in the United States

Psychotic experiences significantly predict suicidal behaviors; however, it is unknown whether these associations are conditional on sexual minority status. We analyzed cross-sectional data from the Healthy Minds Study (N = 109,975), which was collected between September 2020 and June 2021 from young adult (aged 18-34) students from across 140 colleges across the United States. Having psychotic experiences and sexual minority status were associated with significantly greater odds of reporting suicidal ideation, suicide plan, and suicide attempt, adjusting for sociodemographic characteristics. We found significant interactions between psychotic experiences and sexual minority status, such that the relations between psychotic experiences and suicidal behaviors were stronger among heterosexual students than among sexual minority students. However, the interactions disappeared for suicidal ideation and plans after adjusting for socio-behavioral risk factors. Future research can explore whether psychotic experiences predict suicide attempts among sexual minority status behavior socio-behavioral risk factors.

Analysis of Attempted Suicide in a Pediatric Setting: Extracted Notes for Clinical Practice and Complexity of Help

Background and Objectives: Suicidality among adolescents is a global mental health issue. However, the post-suicidal care of minors is insufficient and lacks complexity, as repeated attempts occur. Further, little is known about the social (i.e., family setting) and psychological (for example, exposure to bullying, suicidality, or addiction within a close environment) backgrounds of minors who engage in suicidal behavior in Lithuania. Thus, the aim of our study was to evaluate and compare psychosocial factors that may influence minors’ decisions to attempt suicide for the first time and then repeatedly and to extract notes for future clinical practice. Materials and Methods: Data from 187 cases of suicide attempts by minors treated at the Children’s Hospital of Vilnius University Santara Clinics from January 2011 to January 2018 was obtained and analyzed. Results: The data showed that 48.7% of minors hospitalized because of a suicide attempt had a history of previous suicide attempts. Minors who attempted suicide repeatedly were more often engaged in non-suicidal self-injurious behavior (p = 0.033). Further, a small number had experienced suicide within their close surroundings (p = 0.045). The comparative analysis did not reveal any significant differences in psychosocial backgrounds between first-time attempters and those who attempted suicide for at least a second time. Conclusions: Social and psychological support after a suicide attempt in a pediatric setting is lacking efficiency, as minors who repeatedly attempt suicide suffer from similar psychosocial burdens. Complex and targeted follow-up care is needed.

Self-Harm, Suicidal Ideation and Attempts among School-Attending Adolescents in Bamako, Mali

Suicide and self-harm are major public health concerns for adolescents globally, but there is a dearth of related research in West Africa. This study aims to examine the prevalence and associated factors for self-harm, suicidal ideation and suicide attempts among adolescents in the West African country of Mali. A questionnaire survey was conducted among adolescents attending school or university in August 2019 in Bamako, the capital of Mali. Logistical constraints necessitated convenience sampling. Outcome measures were self-harm and suicide ideation and attempts. Predictor variables included sociodemographic characteristics, bullying and mental health problems. There were 606 respondents who completed questionnaires; their mean age was 16.1 (SD = 2.4); 318 (52.5%) were identified as male; and 44.4% reported self-harm at some point in their life, with 21% reporting suicide ideation and 9.7% actual suicide attempts. For all three outcomes, older age, knowing somebody personally who had experienced self-harm or taken their own life, moderate to severe depression or anxiety, and being a victim of bullying were highly significant risk factors for self-harm, suicidal ideation and suicide attempts in these adolescents, while high self-esteem decreased the risk. The study suggests that self-harm and suicidal behaviour are relatively common in Malian adolescents who are still in education. However, much more research is needed to better understand this phenomenon.

Youth Bullying and Suicide: Risk and Protective Factor Profiles for Bullies, Victims, Bully-Victims and the Uninvolved

Bullying is closely associated with suicide. This study validates mixed evidence on whether young bullies, victims, bully-victims, and those uninvolved in bullying differ in suicidality, risk, protective factor profiles, and predictors of suicide. A total of 2004 Hong Kong adolescents and young adults completed the Hong Kong Online Survey on Youth Mental Health and Internet Usage in 2018. Bullies, victims, and bully victims, as opposed to the uninvolved, were found to possess higher tendencies of suicidal thoughts and behaviors. They had more distinct rather than overlapping risk and protective factor profiles yet shared psychological distress and diagnosis of a psychiatric disorder as common predictors of suicide. The results indicate that suicide screening assessments and training to detect common suicide predictors can benefit youngsters regardless of their bullying involvement. From the discussion, group-specific interventions include restorative justice approaches to promote reintegration and help-seeking among bullies, peer, and professional support programs geared towards lowering victim isolation and equipping gatekeepers such as teachers with skills to connect with both bullies and victims.

Suicide prevention: A qualitative study with Thai secondary school students

Background

Suicide is the second leading cause of death among adolescents around the globe. Therefore, understanding its causes and prevention is needed.

Objective

This study aimed to explore Thai secondary school students' perceptions related to causes and preventions of suicide and the learning needs of suicide prevention.

Methods

A descriptive qualitative approach was employed in this study. Purposive sampling was used to select 32 adolescents for focus group discussions and ten adolescents for in-depth interviews. Data were collected from September 2019 to March 2020 and analyzed using content analysis.

Results

Causes of suicide included seven sub-categories: parents' expectations of children's academic achievement, bullying, family problems, teenage love, lack of stress management skill, imitation behavior on social media, and substance use behavior. Suicide prevention consisted of five sub-categories: peer support, parental support, school support, health professionals and significant support, and knowing the value and believing in self. In addition, students' learning needs had two sub-categories: developing online learning platforms regarding suicide prevention and mental health promotion and prevention projects.

Conclusion

The findings of this study could guide nurses and other health professionals to develop a suicide prevention program for secondary school students. The study results could also be used as essential evidence for driving health care policy in promoting and preventing suicide in adolescents with the involvement of key stakeholders.

Does Anxiety Symptomatology Affect Bullying Behavior in Children and Adolescents with ADHD?

Background

Anxiety disorders are common comorbidities in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) who are also at a high risk of bullying behavior. However, little is known about the roles of anxiety symptomatology in the relationship between ADHD and bullying behavior.

Objective

This cross-sectional, clinic-based study aims to investigate the associations between anxiety symptomatology and bullying involvement in youth with ADHD.

Method

One hundred and eighty children and adolescents with ADHD aged 10–18 years participated in the study. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) was self-rated, and the participants were interviewed with the Revised Olweus Bully/Victim Questionnaire to categorize bullying involvement. Data were analyzed through percentage, nonparametric statistics, chi-squared statistics, and logistic regression analysis.

Results

Sixty-nine percent of youth with ADHD reported involvement in bullying, of which 33.3%, 8.9%, and 27.2% were classified as victims, bullies, and bully-victims, respectively. The means and 95% confidence intervals of the total SCARED scores showed a significant difference among bullying behavior groups. The highest SCARED scores could be noticed in the victim and bully-victim groups, with the lowest scores observed in the bully group. Youth with ADHD who had comorbid anxiety were 3.51 times more likely to be bullied than those who did not have anxiety.

Conclusions

A differential effect of anxiety symptomatology on bullying behavior in youth with ADHD was evident. These results highlight the utility of including anxiety in the conceptualization of bullying problems in youth with ADHD to plan successful anti-bullying interventions.

Bullying involvement and suicidal ideation in elementary school children across Europe

BACKGROUND

Bullying involvement is associated with suicidal ideation among adolescents, yet there are no studies examining this issue among younger children.

METHODS

The School Children Mental Health in Europe study was conducted in seven countries in 2010 using similar methods to collect cross-sectional data from children, parents, and teachers. Suicidal ideation and thoughts of death were assessed using the Dominic Interactive among children. Parent and teacher reports were used to determine bullying involvement. The sample comprised n = 5,183 children ages 6 to 11 identified as bullies (n = 740, 14.3%), victims (n = 945, 18.2%), bully-victims (n = 984, 18.2%) and not involved in bullying (n = 2,514, 48.5%). Multivariate logistic regressions were used to assess the association of bullying involvement with suicidal ideation and thoughts of death.

RESULTS

Suicidal ideation was reported by 13.3% of those not involved in bullying, 17.1% of victims, 19.6% of bullies and 24.4% of bully-victims. Similarly, thoughts of death were reported by 19.0% of victims, 24.3% of bullies, and 25.0% of bully-victims. Children identified as being involved were more likely than those not involved to report suicidal ideation in bivariate analyses. When controlling for psychopathology and for maternal distress among other factors, the association remained significant for bullies (AOR=1.30, 95%CI=1.01-1.66), bully-victims (AOR=1.54, 95%CI=1.22-1.94), but not for victims (AOR=1.02, 95%CI=0.80-1.30).

LIMITATIONS

The study is cross-sectional. The assessment of bullying may have underestimated victimization.

CONCLUSIONS

The association of bullying involvement and child suicidal ideation is present among elementary school children across Europe, using multiple informants to avoid shared variance biases, and adjusting for key factors.

Prevalence and associated factors of school bullying among Chinese college students in Changsha, China

BACKGROUND

School bullying has attracted worldwide attention for its adverse outcomes; however, there is still a lack of research among college students. The aim of this study was to investigate the prevalence of school bullying victimization and the associated factors among Chinese college students.

METHODS

8098 Chinese college students from two universities in Hunan province were recruited in this cross-sectional study, and data on participants' demographic information, bullying history, suicidal behaviors, anxiety (Self-Rating Anxiety Scale) and depression (Self-reporting Depression Scale) were collected. Binary logistic regression was used to analyze the independent correlates of school bullying.

RESULTS

The prevalence of school bullying was 8.03% in our study. Gender (OR,0.792;95%CI[0.660,0.950]; p = 0.012); depression (OR,1.979; 95%CI[1.359,2.883]; p < 0.001); anxiety (OR,1.996; 95%CI[1.388, 2.869]; p < 0.001); suicidal ideation (OR,1.353;95%CI[1.087,1.684]; p = 0.007); suicide attempts (OR,1.772;95%CI[1.306,2.403]; p < 0.001); family income between 30,000 and 70,000/year (yuan) (OR,0.763;95% CI[0.627,0.929]; p = 0.007) and family income more than 70,000/year (yuan) (OR,0.578;95%CI[0.461,0.725]; p < 0.001) were independent correlates of school bullying. The bullying score was positively correlated with physical or mental disorder history, family history of mental disorder, suicidal ideation, suicide plans, suicide attempts, anxiety, depression, smoking and drinking alcohol (all p < 0.05), and negatively correlated with right-handedness, good relationship with parents and family income (all p < 0.05).

LIMITATIONS

No causal relationship could be drawn due to the cross-sectional design.

CONCLUSION

School bullying is quite common among college students. In order to improve students' mental health and prevent suicide, we should pay attention to the negative effects of bullying victimization such as depression, anxiety, suicidal behaviors and so on, apart from putting in place anti-bullying interventions.

Association of Online Risk Factors With Subsequent Youth Suicide-Related Behaviors in the US

IMPORTANCE

The association between online activities and youth suicide is an important issue for parents, clinicians, and policy makers. However, most information exploring potential associations is drawn from survey data and mainly focuses on risk related to overall screen time.

OBJECTIVE

To evaluate the association between a variety of online risk factors and youth suicide-related behavior using real-world online activity data.

DESIGN, SETTING, AND PARTICIPANTS

A matched case-control study was conducted from July 27, 2019, to May 26, 2020, with the sample drawn from more than 2600 US schools participating in an online safety monitoring program via the Bark online safety tool. For 227 youths having a severe suicide/self-harm alert requiring notification of school administrators, cases were matched 1:5 to 1135 controls on location, the amount of follow-up time, and general volume of online activity.

EXPOSURES

Eight potential online risk factors (cyberbullying, violence, drug-related, hate speech, profanity, sexual content, depression, and low-severity self-harm) through assessment of text, image, and video data.

MAIN OUTCOMES AND MEASURES

Severe suicide/self-harm alert requiring notification of school administrators; severe suicide alerts are statements by youths indicating imminent or recent suicide attempts and/or self-harm.

RESULTS

The 1362 participants had a mean (SD) age of 13.3 (2.41) years; 699 (51.3%) were male. All 8 online risk factors studied exhibited differences between case and control populations and were significantly associated with subsequent severe suicide/self-harm alerts when examining total direct and indirect pathways. These associations ranged from an adjusted odds ratio (aOR) of 1.17 (95% CI, 1.09-1.26) for drug-related content to an aOR of 1.82 (95% CI, 1.63-2.03) for depression-related content. When considering the total number of different types of online risk factors among the 8 measured, there was an exponentially larger risk of severe suicide/self-harm alerts; youths with 5 or more of the 8 risk factors present in their online activity had a more than 70-fold increased odds of subsequently having a severe suicide/self-harm alert (aOR, 78.64; 95% CI, 34.39-179.84).

CONCLUSIONS AND RELEVANCE

The findings of this study suggest that many discrete types of risk factors are identifiable from online data and associated with subsequent youth suicide-related behavior. Although each risk factor carries a specific association with suicide-related behavior, the greatest risk is evident for youths demonstrating multiple types of online risk factors.

A Co-Twin Control Study of the Association Between Bullying Victimization and Self-Harm and Suicide Attempt in Adolescence

PURPOSE

The aim of the study was to investigate the magnitude of an independent association between bullying victimization and self-harm and suicide attempt in adolescence after adjusting for unmeasured and measured confounding factors.

METHODS

Using the Child and Adolescent Twin Study in Sweden, we examined twins born between 1994 and 1999 (n = 13,852). Twins self-reported bullying victimization at age 15 years and self-harm and suicide attempt at age 18 years. We created a factor score of 13 bullying items, on which self-harm and suicide attempt items were regressed in three models: (1) among unrelated individuals; (2) among co-twins, in which a twin exposed to more bullying was compared with his/her co-twin who was exposed to less; and (3) among co-twins while adjusting for indicators of childhood psychopathology.

RESULTS

Among unrelated individuals, a one standard deviation increase in bullying victimization was associated with increased odds for self-harm (odds ratio [OR], 1.29 [95% confidence interval, 1.23-1.36]) and suicide attempt (OR, 1.68 [1.53-1.85]). Among co-twins, the odds attenuated for self-harm (OR, 1.19 [1.09-1.30]) and suicide attempt (OR, 1.39 [1.17-1.66]). Finally, when accounting for childhood psychopathology, there was a 14% (1.04-1.25) and 25% (1.03-1.52) relative increase in odds of self-harm and suicide attempt, respectively.

CONCLUSIONS

The results suggest that bullying victimization was uniquely associated with self-harm and suicide attempt over and above the confounding because of unmeasured and measured factors (i.e., familial vulnerability and pre-existing psychopathy). However, magnitudes were small, suggesting that additional interventions and screenings are needed to address suicidality apart from bullying interventions.

Examining the profiles of school violence and their association with individual and relational covariates among South Korean children

OBJECTIVE

This study was conducted to identify the profiles of children who experience perpetration and victimization in school violence and to test whether individual- and relational factors may differentiate the identified profiles.

METHOD

This study targeted 4328 children in the 6 th -grade (47.8% female) extracted from the Seoul Education Longitudinal Study (SELS). Items used to measure school violence includes verbal violence, social exclusion, physical violence, spreading malicious rumors, extortion, coercion/threat. Those experiences were captured on the basis of frequency. Individual factors cover self-esteem and self-control, and relationship factors contain parent-child relationship and teacher-student relationship. Gender was introduced as a control variable. Latent Profile Analysis (LPA) was utilized to classify profiles, and a modified three-step procedure was used to verify individual and relational factors in created profiles of school violence.

RESULT

A three-profile solution was obtained: Exchanging rare verbal violence (90.20%), interpersonal victimization (7.50%), and inflicting violence (2.30%). First, higher levels of self-esteem made children less likely to belong to the interpersonal victimization group than exchanging rare verbal violence group. Second, greater selfcontrol made children less likely to belong to the inflicting violence group than the exchanging rare verbal violence group. Higher levels of self-control also increased the likelihood of children being placed in interpersonal victimization group rather than inflicting violence group. Third, cohesive and close parent-child relationship made children have a lower likelihood to be affiliated with the interpersonal victimization group than exchanging rare verbal violence group. Lastly, a cohesive and close teacher-student relationship made children less likely to belong to the inflicting violence group or interpersonal victimization group than exchanging rare verbal violence group.

CONCLUSION

The findings can guide how school-based violence prevention can be designed, including enhancing individual competencies (i.e., self-esteem and selfcontrol), by establishing regular training programs in school settings. In addition, findings that relationships with parents and teachers affect children's experiences of school violence suggest focusing not only on affected children but also on taking an approach that encompasses the organically connected relationships surrounding children. This could be achieved by developing and distributing relevant materials or various training programs for the purpose of building their cohesive and supportive relationship with children. Practical implications are discussed according to the findings.

Long-Term Profiles of Bullying Victims and Aggressors: A Retrospective Study

Bullying is a widespread and worrying phenomenon, related to many different personal, behavioral, and social variables which can modulate it and its outcomes, also in the long term. These relationships are usually studied in children and adolescents, but less often in adults who have suffered or perpetrated bullying in the past. The present work explored the long-term characteristics of bullying victims and aggressors using a retrospective design. A sample of 138 adults of different ages completed an on-line protocol that included measures of bullying and victimization, substance use, sensitivity to reward and punishment, social skills, antisocial behavior, emotional regulation strategies, depression, anxiety, stress, self-esteem, and risk of suicide. The sample was divided into three groups (victims, aggressors, and controls) based on their responses to bullying-related questions. A set of Multiple Analyses of Variance with group as a fixed factor was carried out for each dependent variable. Victims and aggressors did not significantly differ in their self-reported substance consumption. Victims showed higher global depression, anxiety and stress in the past than aggressors (M = 34.66, SD = 11.74; aggressors: M = 19.70, SD = 16.53), higher emotional lack of control (M = 23.97, SD = 10.62; controls: M = 17.11, SD = 7.95) and rejection (M = 21.72, SD = 7.24; controls: M = 16.33, SD = 5.67), lower self-esteem (M = 27.72, SD = 6.70; controls: M = 31.60, SD = 6.60), and a larger frequency of suicidal thoughts (in the past) than controls. Aggressors showed higher sensitivity to reward (M = 12.03, SD = 3.66; controls: M = 8.42, SD = 3.92), larger communicational and relational skills (M = 22.10, SD = 7.20; controls: M = 17.96, SD = 7.16), and lower emotional sensitivity (M = 14.80, SD = 4.10; controls: M = 16.76, SD = 2.21). Accordingly, the logistic regression analysis identified sensitivity to reward and low psychological adjustment as the main predictors of the aggressor and victim profiles, respectively. The present results are discussed considering the extant literature on bullying and may help to improve prevention programs for this relevant social scourge.

Predictors of bullying perpetration among adolescents attending secondary schools in Sokoto Metropolis, Nigeria, 2019

INTRODUCTION

bullying affects up to 85% of in-school adolescents in Nigeria. It presents a potentially serious threat to healthy adolescent development. Bullying has not been extensively studied in Nigeria and more so in northern Nigeria. Therefore, we investigated the types and predictors of bullying perpetration among adolescents in secondary schools.

METHODS

we conducted a cross-sectional study between January and March 2019. Using a multistage sampling technique, we recruited 390 adolescents. We estimated the prevalence and types of bullying perpetration, and we examined the predictors of bullying among the participants using chi-square and binary logistic regression at a 5% level of significance.

RESULTS

the mean age of adolescents was 15.2 ± 1.9 years. Majority of the participants 234 (60.0%) were in late adolescence (15-19 years), and 205 (52.6%) were males. The most prevalent type of bullying perpetrated was verbal [69.7%; 95% CI = 64.9-74.3%]. Overall, 307 [78.7%; 95% CI = 74.3-82.6%] had perpetrated at least one type of bullying. Male gender (adjusted Odds Ratio (aOR): 2.70; 95%CI = 1.43 - 5.10), attending a boarding school (aOR: 7.93, 95% CI = 2.91 - 21.58) and frequent parental conflicts (aOR: 5.23, 95% CI = 2.15 - 12.71) were independent predictors of bullying perpetration.

CONCLUSION

there is a high prevalence of bullying perpetration among adolescents in Sokoto metropolis, especially among males, those in boarding schools and those who experience frequent parental conflicts. We recommend that school principals should pay close attention to this behaviour and parents should be sensitized on the consequences of their domestic actions on their children.

Pathways from bullying victimization to suicidal thoughts among urban African American adolescents: Implications for nurse practitioners

PURPOSE

Children and adolescents who are victimized by their peers are at an elevated risk of suicidal thoughts and behaviors. Bullying and suicide are major public health concerns; however, studies have not fully addressed the link between peer victimization and suicidal behavior among urban African American youth. The current study proposed and explored the pathways from peer victimization to suicidal thoughts via internalizing behaviors (i.e., low self-esteem, depression, and hopelessness).

DESIGN AND METHODS

The sample consisted of 638 African American adolescents (aged 12-22) from low-income communities in Chicago's Southside. A path model using the structural equation model was employed, controlling for biological sex, age, and government assistance.

RESULTS

The study found that victims of bullying are likely to develop low self-esteem and depression, and depression can contribute to feelings of hopelessness, thereby increasing suicidal risks.

CONCLUSIONS

Understanding the pathways from bullying victimization to suicidal thoughts is beneficial for nurse practitioners who assess and provide services and treatment to adolescents.

PRACTICE IMPLICATIONS

Because of limited resources in urban schools, anti-bullying programs need to be cost-effective.

Abuse and suicide risk among college students in the United States: Findings from the 2019 Healthy Minds Study

BACKGROUND

Suicide has increased among American youth, and remains a concern on college campuses where students have reported increasing levels of psychological distress, alcohol use, social isolation, and loneliness. Abuse is known to be a risk factor for suicide, but more research is needed to understand whether current specific types of abuse and their co-occurrence are related to current suicidal thoughts and behaviors among young adults in college.

METHODS

We analyzed data from the 2019 wave of the Healthy Minds Study, a cross-sectional, web-based survey administered to undergraduate and graduate students. Using multivariable logistic regression, we examined the associations between abuse and suicidal thoughts and behaviors, adjusting for sociodemographic and mental health covariates.

RESULTS

In the past 12 months, 12.56% of the sample reported suicidal ideation, 5.70% reported making a suicide plan, and 1.28% reported making a suicide attempt. Over a third of the sample reported at least one type of abuse over the past 12 months. Emotional, physical, and sexual abuse were all associated with greater odds of all suicide outcomes, adjusting for sociodemographic characteristics and mental health. Endorsing multiple types of abuses was associated with greater odds of suicide outcomes in a dose-response fashion.

LIMITATIONS

Data were cross-sectional and the response rate for this survey was 16%.

CONCLUSIONS

Universities can implement a multi-pronged approach that covers screening for types of abuse, initiating awareness campaigns around abuse and suicide, and training faculty and staff to make appropriate referrals. Student services must also be equipped to address students who perpetrate abuse.

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

Substantial evidence indicates that adolescents and young adults have a disproportionately high incidence of most forms of violence, including suicide. Suicidality often includes suicidal ideation. The present study examined the relationship between bullying and suicidal ideation, and further tested whether social support moderates the association between the dimensions of bullying (verbal bullying, physical bullying, and bullying victimization) and suicidal ideation among adolescent secondary school students. A cross-sectional design was adopted for the study. Participants were 394 students (249 boys, 145 girls) drawn from two secondary schools in Nsukka semi-urban area, in southeast Nigeria. Participants completed the Illinois Bully Scale, the Columbia-Suicide Severity Rating Scale, and the Multidimensional Scale of Perceived Social Support (MSPSS). Hayes' regression-based PROCESS macro was used to analyze the data. Verbal bullying, physical bullying, and victimization were independently positively associated with suicidal ideation. Social support was not independently significantly associated with suicidal ideation, but it moderated the relationship between victimization and suicidal ideation. The positive relationship between victimization and suicidal ideation was strongest for adolescents who had low social support, compared to those who had moderate or high social support. This finding is consistent with the buffering hypothesis of social support, suggesting that supportive relationships for victims can mitigate suicidal ideation.

Differences in Adolescent Experiences of Polyvictimization and Suicide Risk by Sexual Minority Status

Sexual minority adolescents (SMA) report more suicide risk behaviors than heterosexual adolescents. Polyvictimization (co-occurrence of multiple types of victimization) may be an important, underresearched correlate of this disparity. With the 2017 national Youth Risk Behavior Survey (N = 13,179), national estimates of polyvictimization and suicide risk were assessed among high school students by sexual minority status (SM vs. heterosexual), and multivariate relationships between sexual minority status, polyvictimization, and suicide risk were tested. Additionally, risk profiles of those who experienced polyvictimization (2 + types of victimization; n = 1,932) were compared across sexual minority status. Results confirm that SMA are more likely to experience polyvictimization than heterosexual adolescents (31.8% v. 12.9%, respectively); however, also indicate that polyvictimization does not fully explain elevated suicide risk among SMA.

Diagnostic and Therapeutic Challenges of Catatonia in an Adolescent With High Functioning Autism Spectrum Disorder: A Case Report

Catatonia is a psychomotor syndrome with specific clusters of speech, behavioral and motor features. Although potentially life-threatening, especially in its malignant form accompanied with autonomic dysregulation and medical complications, it is a treatable condition, when promptly identified. For a long time catatonia was considered a marker of schizophrenia, thus limiting the possibility of diagnosis and treatment. Due to growing awareness and studies on the subject, it is now known that catatonia can occur in the context of a number of diseases, including psychotic, affective and neurodevelopmental disorders. In recent years, there's been a renewed interest in the recognition and definition of catatonia in neurodevelopmental disorders, such as Autism Spectrum Disorder (ASD), where the differential diagnosis poses great challenges, given the considerable overlapping of signs and symptoms between the conditions. We present the case of a 15 year old boy with High Functioning ASD with a sudden onset of severe catatonic symptoms and the co-existence of psychotic symptoms, whose complex clinical course raises many questions on the differentiation and relation of said disorders.

Child-Mother Agreement on Experiences of School Bullying Involvement in Children With ADHD

Objective: To examine the levels of agreement between the reports of 452 children and their mothers on children's experiences of bullying involvement at school and investigate the factors influencing the levels of agreement in children with ADHD. Method: The levels of agreement between children's and mothers' reports were examined. The influence of age, sex, ADHD symptoms, and psychiatric comorbidities on the levels of agreement was also examined. Results: The results indicated low agreement on the experiences of bullying involvement in child-mother ADHD dyads. Age and hyperactivity-impulsivity, oppositional, depressive, and anxiety symptoms significantly influenced the levels of agreement on the victimization of physical bullying. Age significantly influenced the levels of agreement on the perpetration of physical bullying. Conclusion: Multiple sources of information are required when clinicians assess the experiences of bullying involvement at school in children with ADHD. The factors influencing the levels of agreement should be considered.

Bullying, health complaints, and self-rated health among school-aged children and adolescents

Objective

The aim of the current study was to examine whether health complaints and self-reported health were associated with bullying victimization in a large cohort of Icelandic children and adolescents.

Methods

In this study, we used data from a school-based cross-sectional survey, specifically, the Icelandic contribution to the international research network Health Behavior in School-aged Children (HBSC). The study population included all students throughout Iceland in grades 6, 8, and 10 (mean age 13 years, standard deviation 1.61). The participation rate was 84% (N = 11,018). Participating students completed an anonymous standardized questionnaire in their classrooms.

Results

Bullying victimization was associated with feeling depressed (odds ratio 2.61), having difficulty falling asleep, dizziness, and low self-reported health. No differences were found between sex and age groups.

Conclusions

Children and adolescents who are bullied appear to more often experience depression, difficulties falling asleep, dizziness, and poor health; however, health complaints were also relatively high among non-bullied children and adolescents. Bullying prevention measures must be implemented in children’s and adolescents’ social environments. In addition to assessing bullying interventions, further research should focus on methods of enhancing resilience in this population.

Health and behavioural outcomes of bullying victimisation among Indonesian adolescent students: findings from the 2015 Global School-based Student Health Survey

Bullying victimisation among adolescents is globally recognised as an important predictor for several adverse health and behavioural outcomes. Due to a paucity of studies in Indonesia, this study aimed to identify the adverse health and behavioural outcomes due to bullying victimisation among school-going adolescents and investigate the possible moderation by age and sex. This was an analysis of the second Global School-based Student Health Survey data of Indonesia conducted in 2015. The eligible samples were 9,601 adolescent students. The main independent variable was bullying victimisation status, while the dependent variables consisted of mental health problems, substance use, and other risk behaviours. Binary logistic regression controlling for some confounders was applied to identify the associations among sex-merged and sex-separated samples. Furthermore, adjusted margin probabilities of having adverse outcomes were calculated by bullying victimisation frequency and age. This study found that nearly 2 out of 10 adolescent students were bullied in the last 30 days. Bullying victimisation was associated with the odds of all adverse health and behavioural outcomes that include loneliness, anxiety, suicidal ideation, smoking cigarettes, alcohol use, truancy, physical fight, and sedentary behaviour. The associations were slightly larger among female than male students for some of the outcomes. The odds of these adverse outcomes increased with the rising frequency of bullying and by age. The findings suggest that bullying victimisation was associated with a number of adverse health and behavioural outcomes among Indonesian adolescent students. Implementation of anti-bullying interventions among students right from a young age is essential to prevent unexpected adverse outcomes and its detrimental consequences.

Bullying victimization, bullying witnessing, bullying perpetration and suicide risk among adolescents: A serial mediation analysis

INTRODUCTION

Prior work suggests that involvement in bullying was associated with a higher suicide risk among adolescents. However, the mechanisms of this association remain unclear. The present study aimed to understand the relationship between direct and indirect involvement in bullying (bullying victimization, bullying perpetration and bullying witnessing) and suicide risk by examining the serial mediation of negative coping styles and depressive symptoms.

METHODS

12,354 Chinese adolescents (mean age = 15.00, 54% male) were recruited from December 2018 to January 2019 in 18 secondary schools. Participants completed questionnaires that measured their direct and indirect involvement in bullying, negative coping styles, depressive symptoms, and suicide risk.

RESULTS

The relationship between involvement in bullying and suicide risk was mediated by negative coping styles, depressive symptoms, and also serially mediated by negative coping styles and depressive symptoms. Similar findings were obtained for both direct and indirect involvement in bullying.

LIMITATIONS

The present study is limited by a cross-sectional design. Future studies could examine longitudinal changes in the outcome measures CONCLUSIONS: Given the urgent need to reduce the high suicide rate among adolescents in China, our findings suggest that having a less negative coping style is an important protective factor. These results provide direction for the development of prevention strategies and targeted interventions within this population. Additionally, it is essential to develop prevention strategies and interventions not only for those who have been a victim or perpetrator of bullying, but also for those who have witnessed bullying.

Victims of bullying in childhood and suicide attempts in adulthood

Purpose

To examine whether self-reported exposure to bullying during childhood is associated with suicide attempts over the life course, and if so, what mechanisms could account for this relationship.

Subjects and methods

A random probability sample comprising 7461 respondents was interviewed for the 2007 survey of psychiatric morbidity of adults in Great Britain. Survey respondents were asked about suicidal attempts and whether they were bullied in childhood.

Results

Recall of being bullied in childhood decreased with age from 25% of 16–24-year-olds to 4% among those 75 or over with few differences in the proportions between men and women. Bullying co-occurred with several victimisation experiences including sexual abuse and severe beatings and with running away from home. Even after controlling for lifetime factors known to increase the risk of suicidal behaviour, adults who reported bullying in childhood were still more than twice as likely as other adults to attempt suicide later in life.

Discussion

Being the victim of bullying involves the experience of suffering a defeat and humiliation that in turn could lead to entrapment, hopelessness, depression and suicidal behaviour.

Conclusions

Bullying is already known to be associated with substantial distress and other negative consequences and this further evidence of a strong correlation with the risk of suicide in later life should increase further the motivation of society, services and citizens to act decisively to reduce bullying in childhood.

Predictors of bullying reported by perpetrators in a sample of senior school students in Benin City, Nigeria

Background

Bullying behaviour amongst adolescents is becoming a significant public health challenge. Whilst the traditional and electronic bullying as reported by victims has been widely reported, surveys amongst perpetrators, particularly in Africa, are still lacking.

Aim

This study is aimed at determining the prevalence of bullying by perpetrators and analysing the relationship between bullying perpetration and psycho-socio-demographic characteristics amongst senior school students in Benin City, Nigeria.

Setting

Senior secondary school in Benin City, Nigeria.

Methods

A cross-sectional survey of 465 final-year secondary school students aged 16–19 years, who were selected by multistage random sampling, was conducted. The students were made to fill a self-designed questionnaire, in addition to an adapted version of the Wagnild and Young’s resilience scale.

Results

The lifetime prevalence of bullying was 16.3%. Binary logistic regression revealed bullying to be significantly associated with students who are male (adjusted odds ratio [AOD] = 2.13, confidence interval [CI] = 1.16–3.93), have poor relations with their teachers (AOR = 2.98, CI = 1.68–5.29), have used alcohol (AOR = 3.51, CI = 1.74–7.09) and are involved in cult and gangsterism (AOR = 9.14, CI = 2.55–32.75).

Conclusion

The rate of bullying perpetration by youth in Benin City, Nigeria, is significant and is comparable to global occurrence. The predictors of bullying in this study suggest that perpetrators are individuals who may benefit from rehabilitative measures.

Role of School Bullying Involvement in Depression, Anxiety, Suicidality, and Low Self-Esteem Among Adolescents With High-Functioning Autism Spectrum Disorder

This study aimed to compare the severities of psychopathologies and the level of self-esteem among 219 adolescents with high-functioning autism spectrum disorder (ASD) who were classified into pure perpetrators, pure victims, perpetrator-victims, and neutrals in Taiwan. The experiences of school bullying involvement in the previous 1 year were measured using the Chinese version of the School Bullying Experience Questionnaire. The severities of depression, anxiety, and suicidality were measured using the Center for Epidemiological Studies Depression Scale, the Multidimensional Anxiety Scale for Children, and the 5-item questionnaire from the epidemiological version of the Kiddie Schedule for Affective Disorders and Schizophrenia, respectively. The level of self-esteem was measured using the Rosenberg Self-Esteem Scale. The results indicated that compared with the self-reported neutrals, the self-reported perpetrator-victims and pure victims had more severe depression and anxiety. No difference in depression, suicidality, anxiety, and self-esteem was found among the four groups of various parent-reported bullying involvement experiences. Mental health problems in adolescents with ASD who experienced bullying victimization should be routinely surveyed.

Self-Harm, Suicidal Ideation, and Suicide Attempts in Chinese Adolescents Involved in Different Sub-types of Bullying: A Cross-Sectional Study

Background: Bullying tends to peak during adolescence, and it is an important risk factor of self-harm and suicide. However, research on the specific effect of different sub-types of bullying is limited. Objective: The purpose of this study is to examine the associations between four common forms of bullying (verbal, physical, relational, and cyber) and self-harm, suicidal ideation (SI), and suicide attempts (SA). Method: This was a cross-sectional study of a sample including 4,241 Chinese students (55.8% boys) aged 11 to 18 years. Bullying involvement, self-harm, SI, and SA were measured via The Juvenile Campus Violence Questionnaire (JCVQ). The association was examined through multinomial logistic regression analysis, adjusted for demographic characteristics and psychological distress. Results: Bullying victimization and perpetration were reported by 18.0 and 10.7% of participants. The prevalence of self-harm, SI, and SA were 11.8, 11.8, and 7.1%, respectively. Relational bullying victimization and perpetration were significantly associated with SI only, SI plus self-harm, and SA. Physical bullying victimization and perpetration were risk factors of self-harm only and SA. Verbal victimization was significantly associated with SI only. Cyber perpetration was a risk factor of SA. Conclusions: The findings highlight the different effects of sub-types of bullying on self-harm and suicidal risk. Anti-bullying intervention and suicide prevention efforts should be prior to adolescents who are involved in physical and relational bullying.

Stressful Life Events and Negative Emotions on Delinquency Among Korean Youth: An Empirical Test of General Strain Theory Assessing Longitudinal Mediation Analysis

The current study examines the extent to which the argument of Agnew's general strain theory extends to a sample of South Korean youth to be able to explain the hypothesized direct and indirect/mediated effects of negative emotions derived from various negative life experiences of strain on delinquent behaviors. These experiences can include bullying victimization, parental abuse, poor friend quality, and poor physical functioning. Data for this study were compiled from the Korean Welfare Panel Study (KOWEPS), which is a longitudinal study among 7,027 Korean households surveyed from 2006 through 2012. This study utilizes the longitudinal mediation models for temporal precedence. Results reveal that adolescents with poor-quality friends during the previous year are more likely to engage in later delinquency, and adolescents who experience bullying victimization, child abuse, and poor friendship quality during the previous year are more likely to later feel negative emotions. Furthermore, early feelings of negative emotions are significantly related to later delinquent behaviors and partially mediate the link between poor friend quality and later delinquent behaviors. Finally, bullying victimization, child abuse, and poor friend quality generated negative emotions, which led to a greater likelihood of delinquent behavior later.

Influence of Personality Traits and Its Interaction with the Phenomenon of Bullying: Multi-Centre Descriptive Study

Bullying affects thousands of teenagers worldwide and has devastating consequences. Various studies suggest that the personality of teenagers is a risk profile for bullying. The aim of this study was to analyse the relationship between the personality of teenagers aged 14 to 16 years from three education centres located in the province of Seville (Spain) and bullying in any of its victim or aggressor roles. A multi-centre cross-sectional observational descriptive study was conducted in three education centres in the province of Seville (Spain). The sample consisted of 93 students. In order to measure the two main variables, the Bull-S test was used for bullying, and the EPQ-J questionnaire was used for personality traits. A descriptive and correlation analysis was performed between variables. The results showed that 14% (n = 13) of the sample were detected as victims and another 14% (n = 13) were detected as aggressors. Statistically significant differences were found between neuroticism (p = 0.044; Phi = 0.615), sincerity (p = 0.016; V de Cramer = 0.474), and anti-social behaviour (p = 0.007; Phi = 0.620) with the variables victim/aggressor. Bullies are typically males who score high on neuroticism and anti-social behaviour, with a tendency towards social dissimulation.

Cyberbullying Victimization and Perpetration in Adolescents with High-Functioning Autism Spectrum Disorder: Correlations with Depression, Anxiety, and Suicidality

The present study examined the associations between cyberbullying involvement and sociodemographic characteristics, autistic social impairment and attention-deficit/hyperactivity disorder and oppositional defiant disorder (ODD) symptoms in 219 adolescents with high-functioning autism spectrum disorder (ASD). Moreover, the associations between cyberbullying involvement and depression, anxiety, and suicidality were also examined. Adolescents self-reported higher rates of being a victim or perpetrator of cyberbullying than were reported by their parents. Increased age and had more severe ODD symptoms were significantly associated with being victims or perpetrators of cyberbullying. Being a victim but not a perpetrator of cyberbullying was significantly associated with depression, anxiety, and suicidality. Cyberbullying victimization and perpetration should be routinely surveyed in adolescents with high-functioning ASD.