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Peer Victimization and Suicidal Thoughts and Behaviors in Depressed Adolescents

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Abstract

Suicide is a leading cause of death among youth worldwide, and depressed adolescents are at a significantly elevated risk to report suicidal ideation, planning, and attempts. Peer victimization is a robust predictor of adolescent suicidal thoughts and behaviors (STBs), but little research has focused on why bullying leads to suicidal thoughts and behaviors. To address this empirical gap, we recruited 340 (246 female) depressed adolescents ages 13–19 (M = 15.59, SD = 1.41) within 48 h of admission for acute psychiatric treatment. At the initial assessment, participants were administered clinical interviews characterizing psychopathology, nonsuicidal self-injury, and STBs (ideation, plans, and attempts). Further, they completed questionnaires assessing 3 forms of victimization (overt, relational, and reputational), recent risky behavior engagement, and psychiatric symptom severity. Controlling for internalizing symptoms and age, overt and reputational bullying were associated with more frequent past month suicide attempts, but not suicide ideation. Past month risky behavior engagement, but not NSSI, mediated the relation between victimization and attempts. However, sex differences revealed that this effect only held for males whereas bullying was directly associated with suicide attempts among females. In contrast, overt and relational bullying were non-linearly associated with suicide plans, and these relations were not mediated by risky behaviors or NSSI. Results highlight the complex network of factors that lead victimized adolescents to engage in STBs and may inform targeted suicide prevention and intervention programs.

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Notes

  1. Values for methods employed sum to greater than 100% because adolescents could report more than one suicide method for their most recent attempt.

  2. We did not find strong evidence to include interaction terms in any of our mediation models. Results from these analyses are presented in Online Resource 1, Table S2 and S3.

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Correspondence to Jeremy G. Stewart.

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This study was funded by the National Institutes of Mental Health (K23MH097786), the Klingenstein Third Generation Foundation Adolescent Depression Fellowship, the Tommy Fuss Fund, the Rolfe Fund, and the Simches Fund, awarded to Randy P. Auerbach. Further funding was provided by McLean Hospital (Pope-Hintz Endowed Fellowship) and Harvard Medical School (Kaplen Fellowship on Depression, Livingston Fellowship), awarded to Jeremy G. Stewart.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Stewart, J.G., Valeri, L., Esposito, E.C. et al. Peer Victimization and Suicidal Thoughts and Behaviors in Depressed Adolescents. J Abnorm Child Psychol 46, 581–596 (2018). https://doi.org/10.1007/s10802-017-0304-7

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