Bullying and Suicide Risk Among Pediatric Emergency Department Patients

Abstract

Objectives To describe the association between recent bullying victimization and risk of suicide among pediatric emergency department (ED) patients. Methods Patients presenting to one of three different urban pediatric EDs with either medical/surgical or psychiatric chief complaints completed structured interviews as part of a study to develop a suicide risk screening instrument, the Ask Suicide-Screening Questions (ASQ). Seventeen candidate items and the criterion reference Suicidal Ideation Questionnaire (SIQ) were administered to patients ages 10 to 21 years. Bullying victimization was assessed by a single candidate item (“In the past few weeks, have you been bullied or picked on so much that you felt like you couldn't stand it anymore?”). Results A total of 524 patients completed the interview (34.4% psychiatric chief complaints; 56.9% female; 50.4% white, non-Hispanic; mean age 15.2±2.6 years). Sixty patients (11.5%) reported recent bullying victimization, and of these, 33 (55.0%) screened positive for suicide risk on the ASQ or the previously validated SIQ. After controlling for demographic and clinical variables, including a history of depression and drug use, the odds of screening positive for suicide risk were significantly greater in patients who reported recent bullying victimization (adjusted odds ratio=3.19, 95% CI=1.66-6.11). After stratification by chief complaint, this association persisted for medical/surgical patients but not for psychiatric patients. Conclusions Recent bullying victimization was associated with increased odds of screening positive for elevated suicide risk among pediatric emergency department patients presenting with medical/surgical complaints. Understanding this important correlate of suicide risk in pediatric emergency department patients may help inform ED-based suicide prevention interventions.

Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management

“…Consistent with recent media coverage, a history of being bullied also confers a dynamic risk factor for the child/adolescent age group. The victims of bullying as well as the bullies themselves are both at increased risk for suicide . Some studies have found that children who are both victims and bullies are at higher risk for suicide attempts than being victims or bullies alone .…”

Hospitalization for Suicide Ideation or Attempt: 2008–2015

“…Trends Several reasons have been suggested for the growing increase in depression, SI and SA, and suicide among children and adolescents. Bullying 34,35 (particularly the rise of social media and cyberbullying 36,37 ), the decreasing age of puberty in girls, 38,39 and trends in the use of antidepressants 40 have been proposed as possible factors. The effect of the economic crisis of 2008 has also been examined, although its effect on adolescent suicide-related behavior remains less understood than adult behavior.…”

Vitimização Por Bullying Em Estudantes Brasileiros: Resultados Da Pesquisa Nacional De Saúde Do Escolar (Pense)

“…In general, the negative consequences for the victims include a sense of insecurity, loneliness, decreased self-esteem, insomnia, depression, school absenteeism, low academic performance, and suicidal ideation, among other consequences. [8][9][10] Victims are generally described as being socially isolated, which restricts the amount of support and help they receive from peers, while at the same time, they do not have the social skills necessary to ask for help from their peers or adults. [11][12] Hence, victimization may occur for long periods without being noticed and more severely impact the education and health of students in the medium or long terms.…”