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Bullying, cyberbullying linked to suicidal ideation in children, adolescents

Peer victimization in the forms of in-person bullying and cyberbullying is a risk factor for suicidal ideation and attempts in children and adolescents, according to a study published in JAMA Pediatrics.

A data analysis based on 34 studies on the relationship between peer victimization and suicidal ideation and/or attempts led researchers to recommend that schools use evidence-based practices to reduce bullying and related violence.

Mitch van Geel, PhD, and colleagues from the Institute of Child Education and Child Studies in Leiden and the Hotelschool, the Hauge, the Netherlands, designed the study to examine the relationship between peer victimization and suicidal outcomes via a meta-analysis of studies completed from 1910 to 2013.

“This meta-analysis demonstrated that peer victimization is related to suicidal ideation for older as well as younger children, boys as well as girls, and victims as well as bully-victims,” wrote van Geel. “Our study did not confirm the notion that the relationship between peer victimization and suicidal ideation was moderated by age or sex.”

Van Geel and colleagues searched for terms related to bullying, teasing, victim and harassment where they appeared along withthe term suicide. Resources including Ovid Medline, PsycINFO and Web of Science returned 491 applicable studies of which 34 had surveyed the relationship between peer victimization and suicidal ideation, resulting in a combined pool of 284,375 study participants.

Nine studies examined the relationship between peer victimization and suicide attempts, with a total of 70,102 participants.

Findings showed that peer victimization was related to suicidal ideation (odds ratio [OR]=2.23

[95% CI, 2.10-2.37]). The study participants in this category ranged from 9 to 21 years old. Bullying was self-reported in a majority of these cases, with only four cases using other forms of report to identify bullying events. There was no statistically significant difference in suicidal ideation among samples composed of all girls vs. samples of all boys (Q₁=0.41; P=.52), or between samples younger than 13 years old vs. samples of boys older than 13 years (Q₁=0.01; P=.92).

The data showed a significant relationship between peer victimization and suicide attempts (OR=2.55 [95% CI, 1.95 -3.34]). Participants in this category also ranged from 9 to 21 years old, and the related studies used only self-reporting to gather bullying and suicide attempt data. Because there were fewer studies in this category (n=9), researchers were unable to analyze differences among age, sex or cyberbullying in comparison with in-person, or “traditional,” bullying.

Cyberbullying was more strongly related to suicidal ideation than was traditional bullying (OR=3.12[95% CI, 2.40-4.05]), with significant differences in effect sizes (Q₁=7.71; P=.02).

“Whereas previous studies demonstrated that cyber-victimization is as strongly related to suicidal ideation as is traditional victimization, the present meta-analysis suggests that cyberbullying is even more strongly related to suicidal ideation,” researchers wrote. “This result, however, needs to be interpreted carefully, because we could include only 3 studies to estimate an effect size for cyberbullying."

The research team also noted that the broadness of the topics of bullying and suicidal ideation necessitate further research.

“Although bullying may be both verbal and physical, the effects of verbal and physical victimization may differ. Because most studies focused on combinations of different types of bullying, we could not analyze the effects of the different types,” they wrote.

Disclosure: The researchers report no relevant financial disclosures.