Peer victimization increases suicidal ideation, attempts among children and adolescents

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1. Peer victimization in children and adolescents was associated with higher rates of both, suicidal ideation and suicide attempts. 

2. Cyberbullying was more strongly related to suicidal ideation in comparison with traditional bullying. 

Evidence Rating Level: 1 (Excellent) 

Study Rundown: About 20% of adolescents in the US contemplate suicide, and between 5-8% of adolescents attempt suicide per year in the US. Depending upon the country of residence anywhere between 5-20% of children are victims of bullying. This data has spurred an interest in exploring the relationships between peer victimization and suicide. This robust meta-analysis showed that peer victimization is indeed associated with higher risk of childhood and adolescent suicidality.

The strengths of the study include an in-depth literature search in multiple languages, large number of total participants captured by the included studies, and detailed statistical analyses to ensure that these results were not due to publication bias. Limitations include variability in the study designs, participant response rates, classification and reporting of outcomes, and the broad range of the terms like “bullying” used in the study. Due to this variability authors had to create control groups or combine groups based on individual study design in order to be able to compute a single Odds Ratio (OR). Further, only 3 studies were included to estimate the effect size for Cyberbullying.  The work emphasizes the need to identify and help victims of bullying, intervene appropriately, and set up programs for bullying prevention.

Click to read the study, published today in JAMA Pediatrics

Relevant Reading: Bullied children and psychosomatic problems: a meta-analysis

In-Depth [meta-analysis]: Relevant publications for the analysis were obtained by using search terms bully*, teas*, mobbing, ragging, victim*, and harassment in combination with the term suic* indexed on Ovid MEDLINE, PsycINFO, and Web of Science between 1910 and 2013. Study data was coded by two independent authors and differences resolved via consensus. Search included articles, book chapters, dissertations, unpublished articles, and posters in 7 languages. In order to be included, the studies had to measure suicide, the perpetrator of the bullying had to be a peer, and the population being studied had to be less than 21 years of age.

34 studies met inclusion criteria for studying the relationship between peer victimization and suicidal ideation (284,375 participants, OR 2:23, 2.10 – 2.37) and 9 studies met inclusion criteria for relationship between peer victimization and suicide attempts (70,102 participants, OR 2.55. 1.95 – 3.34). Sex, age, ethnicity, substance use, family violence, previous attempted suicides, attempted suicides of family members, and psychopathology were analyzed as potential confounders based on literature reviews on suicide. The effect size was not affected by the number of confounders controlled for.

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