Research has shown that victimization during adolescence is associated with numerous adverse health outcomes (Bauman, Toomey & Walker, 2013; Bowes, Johnson, Wolke & Lewis, 2016; Cole et al., 2014; Messias, Kindrick & Castro, 2014; and Sibold, Edwards, Close & Hudziak, 2015). The primary purpose of this research is to use data from the Youth Risk Behavior Survey (YRBS) to examine the relationships between two types of school-related victimization, 1) bullying and 2) threats or injuries with a weapon, and depressive symptoms and suicidality, including suicidal ideation and suicide attempts among US high school students.
Methods:
This research is a secondary analysis of YRBS data, which are collected biennially from a nationally representative 3-stage cluster sample design of US high school students. The binary (Yes/No) dependent variables for this study are depressive symptoms, suicidal ideation, and suicide attempts. The independent variables of primary interest are school-related bullying and threats or injuries with a weapon. Covariates are gender, race/ethnicity, survey year, and grade level. Four waves of YRBS data (2009, 2011, 2013, and 2015) were pooled for analyses. Data were analyzed using multivariate logistic regression with SPSS 24 Complex Samples™, which correctly incorporates the multi-stage sampling design and sampling weights and enables nationally-representative estimates with associated standard errors and confidence intervals. Analyses were performed for three samples, 1) all students, 2) male students, and 3) females students.
Results:
Among all students, there were significant relationships between school bullying victimization and depressive symptoms (OR=2.79, 95% CI=2.63-2.97), suicidal ideation (3.03, 95% CI=2.85-3.23), and suicide attempts (OR=2.86, 95% CI=2.57-3.18). Results also showed that there were significant relationships between school-related threats or injuries with a weapon and depressive symptoms (OR=2.57, 95% CI=2.34-2.83), suicidal ideation (2.80, 95% CI=2.51-3.12), and suicide attempts (OR=4.76, 95% CI=4.14-5.48). The association between weapon related victimization and suicide attempts was more positive (OR=4.76) than the association between bullying victimization and suicide attempts (OR=2.80). Separate analyses by gender showed that the relationship between weapon-related victimization and suicidal ideation was significantly greater among male students (OR=3.10, 95% CI=2.71-3.55) than among female students (OR=2.46, 95% CI=2.11-2.87). Results also showed that the relationship between weapon-related victimization and suicide attempts was significantly greater among male students (OR=6.45, 95% CI=5.29-7.85) than among female students (OR=3.56, 95% CI=3.01-4.21).
There were also significant effects of race/ethnicity and depressive symptoms and suicidality. Notably Hispanic students were significantly more likely than non-Hispanic White students to report depressive symptoms, suicidal ideation, and suicide attempts. All minority student groups were significantly more likely to attempt suicide than non-Hispanic White students.
Conclusion:
School-related bullying victimization and threats or injuries with a weapon have very large effects on depressive symptoms and suicidality among US high school students. Future efforts are imperative using evidence-based interventions to prevent all forms of bullying and weapon-related victimization and reduce the health-harming effects of school-related victimization.