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Involvement in Bullying and Suicide-Related Behavior at 11 Years: A Prospective Birth Cohort Study

https://doi.org/10.1016/j.jaac.2012.01.001Get rights and content

Objective

To study the prospective link between involvement in bullying (bully, victim, bully/victim), and subsequent suicide ideation and suicidal/self-injurious behavior, in preadolescent children in the United Kingdom.

Method

A total of 6,043 children in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort were assessed to ascertain involvement in bullying between 4 and 10 years and suicide related behavior at 11.7 years.

Results

Peer victimization (victim, bully/victim) was significantly associated with suicide ideation and suicidal/self-injurious behavior after adjusting for confounders. Bully/victims were at heightened risk for suicide ideation (odds ratio [OR]; 95% confidence interval [CI]): child report at 8 years (OR = 2.84; CI = 1.81–4.45); child report at 10 years (OR = 3.20; CI = 2.07–4.95); mother report (OR = 2.71; CI = 1.81–4.05); teacher report (OR = 2.79; CI = 1.62–4.81), as were chronic victims: child report (OR = 3.26; CI = 2.24–4.75); mother report (OR = 2.49; CI = 1.64–3.79); teacher report (OR = 5.99; CI = 2.79–12.88). Similarly, bully/victims were at heightened risk for suicidal/self-injurious behavior: child report at 8 years (OR = 2.67; CI = 1.66–4.29); child report at 10 years (OR = 3.34; CI = 2.17–5.15); mother report (OR = 2.09; CI = CI = 1.36–3.20); teacher report (OR = 2.44, CI = 1.39–4.30); as were chronic victims: child report (OR = 4.10; CI = 2.76–6.08); mother report (OR = 1.91; 1.22–2.99); teacher report (OR = 3.26; CI = 1.38–7.68). Pure bullies had increased risk of suicide ideation according to child report at age 8 years (OR = 3.60; CI = 1.46–8.84), suicidal/self-injurious behavior according to child report at age 8 years (OR = 3.02; CI = 1.14–8.02), and teacher report (OR = 1.84; CI = 1.09–3.10).

Conclusions

Children involved in bullying, in any role, and especially bully/victims and chronic victims, are at increased risk for suicide ideation and suicidal/self-injurious behavior in preadolescence.

Section snippets

Sample

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a birth cohort study, set in the United Kingdom, examining the determinants of development, health, and disease during childhood and beyond. The study has been described in detail elsewhere.30 In summary, 14,541 women were enrolled, provided that they were resident in Avon while pregnant and had an expected delivery date between April 1, 1991 and December 31, 1992. As shown in Figure 1, a total of 13,971 children who were alive at

Frequency and Gender Differences of Suicide Ideation and Suicidal/Self-Injurious Behavior and Peer Victimization

Of the children, 4.8% reported engaging in suicidal ideation, and 4.6%, in suicidal or self-injurious behavior. Although there were no gender differences regarding suicide ideation, more boys (6.4%) than girls (2.9%) reported suicidal or self-injurious behavior. More males than females were classified as bully/victims according to child (at both 8 and 10 years), mother, and teacher report. Males were more often victimized than females according to mother and teacher report, and were more often

Discussion

We found that children identified as victims or bully/victims, across different informants, were more likely to engage in suicide ideation and behavior (suicidal/self-injurious behavior), even after controlling for potential confounders. Both overt and relational victimization were associated with future suicide ideation and suicidal self-injurious behavior, supporting that indirect, more subtle, forms of victimization also lead to considerable psychological harm, which may include suicidal

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    • Cited by (0)

    Supplemental material cited in this article is available online.

    The UK Medical Research Council (Grant Ref: 74882), the Wellcome Trust (GrantRef: 076467) and the University of Bristol provide core support for Avon Longitudinal Study of Parents and Children. A PhD scholarship from the University of Warwick provided partial support for the writing of this manuscript (C.W.).

    This article is the work of the authors, and Dieter Wolke and Catherine Winsper serve as guarantors for the content of the article.

    Disclosure: Ms. Winsper, Ms. Lereya, and Drs. Zanarini and Wolke report no biomedical financial interests or potential conflicts of interest.

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    Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.